Chillin'

We've been in Los Angeles 2 and a half days now & have not done any sightseeing at all. We are just enjoying being a family together in one place at one time again! Meals, movies, a bit of shopping & just trying to get over jet lag (read: waking up at 4 to 5 am) are enough for now.

Over the next few days, we will visit the University of Southern California, perhaps Venice Beach, Hollywood, and of course, with my guys, possibly visit a guitar factory.

Whatever we do, it won't matter....'cos we'll do it together.

:)

Vacation

We start heading out tomorrow for our yearly sojourn to the USA. A is already on his way from Singapore. W & I make our way out first thing in the morning, followed by Z at mid-day.

The logistical planning of this vacation has been challenging, to say the least.

I have started to feel quite unsettled, unsatisfied, in limbo with this lifestyle. With one son in college and the other heading to college next year, I am yearning for a Place To Call Our Own, somewhere for the boys to go to when they are on vacation, where A & I can retire to eventually.

The problem is: Where?

Diurnal Rhythms

It is my belief that teenagers are , innately, nocturnal creatures.

Reunions

Our house has become Hangout Central, with returning alumni on their summer break trying to spend as much time as possible with each other before everyone heads out to their various destinations.

I can't blame them, really, as many of these TCK's will soon not have a "home" to return to in Beijing as their parents get posted to other cities & countries. They will have an amazing network of friends around the world, stretching over many continents.

It's hard to say whether the pluses outweigh the minuses in being TCK's. One thing is for sure - goodbyes are damned hard to say.

Summer Summary

Our family of 4 lives in 3 different countries. The logistical complexity of this situation is summarized in our summer itinerary as follows:

7 travel dates

9 cities of origin, transit & destination

11 different flights on

7 different airlines

an alien at home

I am back in Singapore for a short spell. Although I have been making fairly regular trips back here from Beijing, the pace of change that happens here is so fast that I feel lost when I am here.

It's almost like I am slightly out of phase from the rest. The buildings are different, the streets have been diverted, the people whom I interact with are also different. I look for familiar restaurants & they are gone. There are so many new condos that have been built & old ones demolished.

I don't quite feel as at home as I thought I would.

I am not sure that I like this feeling.

Senior Year

The class of 2011 graduated last weekend, so the students of the class of 2012 are now officially seniors.

Which means W is now a senior in high school.

My baby, the senior.

O. M. G.

I can so clearly remember the first day of pre-school with him clinging so hard to me & crying when I dropped him off. It was hard for me to contain my own tears.

I know this coming year will just fly by. And it will be even harder to let go (for me) on the day when we have to drop him off in college.

Quilting Bee, Quilting Me

My new hobby, quilting. Here's what I've done so far.

My first creation, using a mixture of modern batiks & material cut from my late grandmother's sarongs (she was Penang Peranakan):

This cheerful flowery quilt now resides in my sister's home.

This was my next creation - a quilted comforter for Z to bring to college. It was made with predominantly blue colored material (Z's favorite color).

Then there are these two throws made up of leftover material from the previous quilts. I hate waste, so with winter coming, I figured our house needed a couple of extra throws for chilly winter Beijing nights.

Throws & comforters aren't the only things you can quilt...

Here's a reversible bread basket, again made up of scrap material.

Side A...

...and side B!

And how about some quilted coasters, again made up of scrap material from previous quilts.

I made a set of 10, found a big blue ribbon, bundled them up & voila...! A housewarming gift for the dear friend who first introduced my to the world of quilting. Alas, she will be moving back to the UK this summer, but the one-of-a-kind coasters will remind her of Asia ( and me!).

W, not wanting to be left out, asked me when I would be making him one, when he saw me making one for Z! So here is his, complete with guitar motifs and all.

The flannel backing makes it a very comfy blanket.

This was another farewell gift for a friend. Using the "Tumbling Blocks" design, it is also made up of material from my grandmother's sarongs.

You can even quilt for a good cause. Our school recently held a fund-raiser for the victims of the earthquake in Japan. I made a quilt throw to contribute to the Quilts for the Quake silent auction. I called it Summery Reds, also using the Tumbling Blocks design and here it is. It feels good to make a difference to a good cause.

And my latest creation, using t-shirts belonging to Z which he got as freebies from all the gigs which he performed in before going to college. Being extraordinarily large in size by China's standards, he could never fit in any of these free shirts. So instead of allowing them to collect dust or eaten by moths in the closet, I decided to find a way of creating something useful which he could also keep as a memento of his musical "career" in high school! This is an extra large throw (for an extra large guy!) that will keep him warm in the cold winter nights of Indiana...

I find quilting to be therapeutic in times of stress. I love the satisfaction that comes from piecing the different patches together into a cohesive design. I like the way contrasting colors which seem like they would clash seem to be able to come together once you group them in certain ways using different materials to mesh them into a pleasing blend.

I guess it's kind of like life, isn't it? No matter how different we all are, if we work at it & come together, the Whole is usually more beautiful than each individual piece.

Debut

W. & his band release their first EP this weekend.

I am eager to see what kind of reception they get. I have yet to listen to the whole thing, just a couple of songs at a few of their gigs.

In my biased opinion, pretty good, for a bunch of teenagers.

Stay tuned for details....

The Radical Notion that Doctors are People, Too

This article was written by one of my favorite doctor bloggers.

She says what I've always felt about people's (as in non-doctor people) perceptions of what doctors are/should be.

Upgrades

A & Z keep telling me to upgrade my mobile phone to a Smart phone.

I don't need a smart phone, I tell them. I am happy with the one-handed action of my trusty old Motorola Slider. None of that hold-it-in-one-hand-while-you-slide-your-finger-of-the other-hand-on-the-touch-screen that one needs to do in order to answer a phone call. If I want to browse the internet or check my email, I have my iPod touch.

I've had my cell phone for the last 4 years - a record in my family, I think, as far as cell phone possession is concerned. I'm a simple girl, I am. I'll just use my phone for phone calls & text messaging for now, thank you very much.

Changes

It's that time again. Lots of change happening.

Z has just returned from the US having finished his first year of college. Wasn't it just yesterday that I saw him parade down the aisle during the high school graduation ceremony with his classmates?

W is preparing to apply to colleges this fall. Here we go again...

A's job brings him to Singapore, which leaves me single parenting for the moment. Because of W, I am remaining in Beijing till he graduates from high school next year. It would not be fair to uproot him from high school in his senior year. Besides, we don't think Singapore will welcome him with open arms (a whole different story which will be left to be told another day).

Me? Well. I just finished my 2nd year heading the parent organization in my son's school. It's been a fun & occasionally rocky ride. What a difference it has been from clinical practice as a physician. It has exposed me to so many people from so many cultures & backgrounds. It has enriched my life, and I have made friends whom I will call friends for the rest of my life. When we eventually leave Beijing next year, it will be with a heavy heart as we say goodbye & farewell to so many good friends. Some have already left. Some will be leaving at the end of this school year. But with technology, we will remain connected somehow.

Change is inevitable, I know. But it doesn't make it any easier.

Politics

I admit, shamefully, that I have never been much into the political scene in Singapore. I think it's partially because of the fact that growing up in the 70's & 80's, the PAP, under the leadership of the revered Lee Kuan Yew, was held in high esteem by most of the citizenry. And rightly so, as it was under its governance that Singapore was able to progress the way it did, from pretty much a Third World country, to the modern city with the super-efficient infrastructure of today.

Now, with the General Elections coming up, it has been wondrous to see the enthusiasm & interest shown by the citizens of Singapore. Living behind the firewall that China has built, it has been difficult to follow who is running for what, and in which constituency, Even with a VPN, it is difficult to view videos of speeches posted on Facebook and Youtube. What I can see are numerous postings of links to videos & articles about various candidates, but it gives me a disjointed picture of what is happening.

I will not be voting this election, only because when I tried to register myself as an overseas voter, the information required of me was quite impossible to get (detailed dates of when I arrived & left Singapore for the last three years???!!! Puh-lease.).

I do hope that it is a wake-up call to the PAP that they have to listen. Their arrogance in thinking that they will remain in power, no matter what they do has to stop. From personal experience, this arrogance permeates different departments in various Ministries; and their refusal to listen may come with a price.

We will see in about a week.

Impressions from China - Blockage

Here's the usual sequence of things whenever I try to watch a video on Youtube or Facebook these days, behind the Great Firewall of China:

Connect to VPN

Go on to website.

Wait for website to download (may or may not happen. If it happens, may take a few minutes to do so)

Select video

Wait for video site to download (ditto - see above)

Click "Play", then pause to allow download to happen

Open new tab & browse other website while waiting for video to download (if at all).

or Go do an errand (eg wash some dishes, put laundry in the washing machine, or dryer....you get my drift...)

Go back & check if video has finished downloading.

If partial - watch whatever you can first till the video stops, then press Pause again, to allow remaining video to download.

This way, a 10 minute video may take about an hour to finish watching, if I am lucky.

Or it may not load at all.

That is the state of internet blockage in China.

Frustration +++

The Big M

There's something to be said about living in a temperate climate during a certain phase in one's life. Especially when said phase involves hot flashes which occurs sporadically without any warning, making one feel like there is a furnace within one's chest whose heats spreads upwards & outwards & makes one feel like one is suddenly sitting in a sauna.

I am going to miss the winter.

Hormones are powerful things.

My internal thermostat as been reset to a temperature lower than previously. I used to be the one to turn up the temperature setting in the winter. Now, I am the one who turns it down, much to the dismay of my significant other & our two boys. I throw off the covers in bed in the midst of winter, whilst A continues to snuggle deeply within its warmth next to me.

My sleep pattern has altered, & sleep requirement diminished.

My taste in food has changed: I suddenly crave salmon sashimi where previously I would turn my nose up at it & push it aside. Similarly, I now love cold soba & choose this over hot ramen soup. Cherry tomatoes are suddenly delicious. Perhaps the Chinese theory of the balance between heatiness & cooling-ness has some meat to it.

Some of my friends are surprised when I tell them I am peri-menopausal. I am in my mid- to late 40's already, I tell them. Perhaps I should be flattered that they think I am younger than I really am.

As the bumper sticker says, "I'm still hot, but now it comes in flashes. "

Impressions from China - Spring Fling

The magnolia & apricot blossoms are gone.

Apple blossoms are on the tree.

26 degrees Celsius today. Two weeks ago, it was 5 degrees.

Man, that was a quick Spring.

Ideals

"Is it worth having a liberal arts college here?

THE deal is set for the Yale University and the National University of Singapore to set up a liberal arts college here ('Yale-NUS College gets faculty, alumni backing'; April 1).

But the question I want to pose is: Is it worth it?

The college will be offering a degree in liberal arts, which is not exactly a commercially viable qualification.

The fact is, to live and succeed in a competitive country like Singapore, there is more pressure on students such as myself to get a degree that will help us get a stable job, rather than something we would like to do.

The unfortunate truth is that students go to university for the degree, and not for the experience.

Also, the liberal arts 'scene' in Singapore is virtually non-existent. Students who want to actually apply what they learn in the programme will have to migrate to a country with more liberal arts opportunities, something conservative Singapore cannot provide.

Therefore, having a course that binds Western and Eastern cultures becomes moot.

Also, why not go straight to Yale, or any other university in a liberal arts savvy foreign country to study since they will have to migrate anyway? How useful will the students find this programme?"

I wonder if the author of this letter to the editor is being sarcastic or does it truly reflect the attitudes of the youth in Singapore today?

Inside Job

I have never taken a course in Economic.

And I would be the first to admit ignorance when it comes to the why's & wherefore's of today's global economic woes.

Watching this Academy Award-winning documentary has opened my eyes somewhat on what went wrong in the US. I am astonished at how this blatant abuse of power was allowed to go on and work its way insidiously into the American financial & banking system. I am also amazed at the millions & billions of dollars that ended up in the pockets of those who played their part in causing the 2008 economic downturn in the first place.

Shame on you.

U Turn

TODAYonline | Commentary

Bring back medical fee guidelines

Concerns about over-charging highlight the need for a guide to

private doctors' fees

by Conrad Raj

04:45 AM Mar 22, 2011

In the wake of the Susan Lim saga, it might be time to review the ban by the Competition Commission of Singapore (CCS) on medical fee guidelines.

Without going into the merits or demerits of the ongoing court case involving Dr Lim, many among the public have become concerned over the high charges being levied on medical services here in Singapore.

Singapore's reputation as a medical hub and its medical tourism business may also have been adversely hit by the court revelations and the testimony given by many in the medical field to overcharging by the profession.

In June last year, the CCS ruled that the guidelines were anti-competitive, on the grounds that price recommendations by trade and professional associations might harm consumers because they "distort independent pricing decisions" as there may be no incentive for cost-effectiveness or innovation.

The Guidelines on Fees (GOF) for services and procedures in the private sector were put in place in 1987 by the Singapore Medical Association (SMA) - which represents the majority of medical practitioners here - after complaints of overcharging for medical services by doctors who were more interested in squeezing their patients than in curing them.

The GOF is a set of recommendations on private doctors' professional fees, which includes fees for consultations, surgery, preparation of medical reports and court appearances.

But the CCS felt that the GOF was now redundant as other benchmarks had become available - namely that of government hospitals, which provide hospital care and medical services for 80 per cent of the population. And the CCS noted that since these restructured hospitals do not refer to the GOF when making pricing decisions, patients could use their charges as a basis for price comparison when going to private hospitals.

The CCS had also pointed out that the Ministry of Health (MOH) requires patient medical bills to be itemised and financial counselling be provided and that hospital bill sizes are made public on MOH's website.

The commission urged the SMA to "work with MOH and hospitals to further improve the delivery of pricing information ... so as to allow patients to make more informed choices".

"In general, price recommendations by trade or professional associations are harmful to competition because they create focal points for prices to converge, restrict independent pricing decisions and signal to market players what their competitors are likely to charge," the CCS said. "This is a common position adopted by many competition agencies in the world, even for the medical sector."

But now, in response to a recent article in Today, the CCS has suggested that the SMA could provide information on actual pricing.

"In general, CCS recognises that information on actual pricing, and transparency in the reporting of prices actually charged in the market, are useful for consumers to make informed choices in their purchases of goods or services. CCS, therefore, supports the publication of historical price information to help consumers.

"However, this is very different from issuing price guidelines, which by their very definition, are intended to influence what prices should be set rather than merely providing historical price data," the CCS said in its letter.

Although the SMA had voluntarily scrapped its pricing guidelines in 2007, in October 2008, it wrote to the Ministry of Trade and Industry to request that the GOF be excluded from Section 34 of the Competition Act. After consulting with MOH, the ministry declined the request last year.

But it may be time now for the SMA to restore the public's faith in the medical services by bringing back guidelines, perhaps with the proviso that these are only guidelines and not mandatory charges binding all doctors.

These guidelines could provide a range, as suggested by the CCS, rather than a specific price that those in the medical services could charge. However, they should avoid the extremes which could give a distorted picture and could include overcharging by the unscrupulous.

The guidelines are a useful frame of reference: Patients should not be asked to buy a pig in the poke - a service they do not know the true value of. Dying patients may not be in the proper frame of mind to make the right judgement call.

And foreigners could use a guide to the range of charges they can expect in Singapore, enabling them to compare the expense with that of other medical hubs.

Perhaps private clinics should be requested to post their range of fees, either at their premises or on their websites, so that it would be possible for patients to shop around, like in the case of restaurants. Some doctors might feel it beneath their dignity to post their service and price menus - but then, being unscrupulous is even worse.

More importantly, such a move would not be anti-competition.

Well.

I guess it takes sensational headlines to make the CCS wake up to what the original price guidelines were supposed to do for patients. Call it "historical price data" or call it guidelines. It's semantics, really. What they have suggested was really what the guidelines were meant to do in the first place.

Light Bulb moment

Finally, a bright spark.

(Letter to the editor, Straits Times Forum, March 19)

Ban ineffective screening tests

I REFER to the reply from the Ministry of Health ("Why Medisave can't be used

for all screening tests"; Thursday) to Mr Arthur Lim's letter ("Allow use of

Medisave for more screening tests"; Monday). In the name of medical ethics,

the Ministry of Health should perhaps consider a ban on tests that are of

questionable effectiveness when used as screening tools.

Going by the phenomenal growth of some medical centres, and the increasing

complexity of some packages they offer, medical providers must be doing

a roaring business.

With some packages costing as much as $9,000, could it be that a large

proportion of tests in the packages are probably not recommended as screening

tools? And if they are, why are they even allowed to be there? Shouldn't

the public be protected from such practices?

(Addendum: I am not advocating banning these tests, some of which are useful

for patients recovering from cancer, to check for recurrences. I just hope that

this is a wake up call for both patients and doctors - patients to start asking

intelligent questions about the tests & procedures which they allow themselves

to be subjected to; and doctors to stop pushing some of these health screening

packages to laymen who may have the false impression that these tests magically

detect early cancer.

Wake up, people.)