When Mike met Wilson

Most days start off with a plan, at least mine do and this day was no exception. Unfortunately there are days when that road map doesn’t quite work. So a few weeks ago, Philip and I, had decided to leverage on a trauma conference in KL and take the opportunity to go on a bike ride. We wanted to do a bit of riding to see what would fall off the bikes once we started putting a few miles on them.

This particular day, with my usual time optimism, began with me as the master of ceremonies for our undergraduate research week at the hospital. I figured I could quickly run over there, shake the right hands, go back home, pick up the gear and head north. As easy as eating apple pie. I have never claimed to have any meteorological experience of any particular worth, and this day was no exception. I looked up at the sky when leaving the hospital and though it wasn’t a brilliant blue, figured I could make it home before the notorious Singapore rain dropped buckets of water on me. Halfway home on the expressway I was proven fantastically wrong. Quick stop underneath the biggest tree in sight, a superman impression without the telephone booth; switch costumes and put on the rain suit (No, I do not wear red underwear on the outside), and in no time I’m back on the bike. Turn the key in the ignition and instead of that comforting growl I usually hear the bike goes tick, tick, tick. Crap, you know the sound of a dead battery when you hear it. Push it up the ramp and realize I own a really, really heavy 240 kg German obstacle, not helped by the water coming in from all angles. You see in Singapore rain gets you wet in a 360 degree approach; it just comes at you from all sides. Trying to pick up my iPhone and not get it wet wasn’t any easier either. Towing operator tells me 45 min. He was right on time, making it at 44 min while it rained for all of 43. Finally manage to get the German obstacle towed to the shop. Time is ticking away since it will take 4 full hours to get to KL but at this point I don’t have much of a choice. At BMW they are serving, beer, hotdogs and sauerkraut. Very nice after the open air shower but the service department turns out to be closed. So no new battery in sight and the 4 day bike trip seems a distant dream.

Then out of the blue Anthony Tan shows up, the guy I bought my bike from. I explain my predicament to him and it turns out he knows a guy who knows a guy who can get me a battery. Thank god for surgeons with shady connections. Two hours later Matt shows up having come through the rain with my new battery. Matt is slowly running out of uninked skin, and looks like he could have ‘borrowed’ my new battery somewhere. He turns out to be a Harley rider and a horribly nice guy, I pay him for his troubles and feeling suitably guilty for my presumptions ask if I can set up a donation account in his name. Next Wilson shows up, says hi, mentions that he works for MV Augusta and is considering buying a GS adventure. We have a quick chat and finally I am ready to go see Philip. 

I go home to find my wife, Mette, for good reason a bit skeptical about me leaving this late to go to KL. A few glares and some broad hints about drunk drivers are appeased with random facts about Malaysian’s predominant religion. This is probably not the best time to tell her other random facts about Malaysia’s nearly-worst-in-the-world road traffic accident statistics. As I head across the causeway I turn on all the lights the German engineers equipped the bike with, foglights, headlights the works and finally arrive in Petaling Jaya at 10.30 pm in glorious BMW style. A glad nights rest followed by wonderful Laksa for breakfast with Philip and his wife, Viola and off we head to the Cameron Highlands.

One of the biggest differences about riding a bike vs. driving a car is that on a bike you are part of the scenery while in a car you are merely looking at it. The scenery on the way was made exceptional by some short life expectancy 20 year olds on 125 cc bikes doing 130 km/hr with their feet placed on the tanks. Their engines being maxed out they draft behind us, other cars and trucks to slingshot pass them. Philip and I are slightly older (wink, wink) guys puttering along like responsible adults. The highlands are fantastic, elevation 1000m, 20 degrees C, tea plantations and a bit unexpectedly strawberry farms. 

We stayed overnight at the Old Smoke house Inn built in 1937 in a very English inn style. Lovely place, but felt a bit like a time warp. Next morning after having to wait for the morning rain to stop we head down the mountains to Kuantan by way of Ringlit, Kuala Lipis and few smaller towns. The scenery was stunning with the hills lined by tea plantations turning into hilly jungle as we came to lower altitudes. Riding in Malaysia is an organic experience, because nature has a way of introducing itself to you. We passed water buffaloes, cows, chicken and goats serenely crossing the road in front of us. I guess this is only an inkling of what is yet to come as we go through Myanmar, India and Pakistan. The riding was fantastic. I fell in love with the German engineers-the cornering, the torque, the brakes aaaha.  Viola was our photographer, and she started taking more pictures after we threatened to use duct tape to fasten her to the pillion seat when she almost fell asleep a few times. There is just no problem that cannot be solved with duct tape. If it hasn’t worked for you, you haven’t used enough. Have added a roll to the pack list for the Long Ride.

 The stay in Kuantan was well needed, as my skinny behind was going numb. The hotel was probably nice 10 years ago but the upkeep was falling a bit behind. Singapore was a 450 km ride away, and since it is monsoon season in east Malaysia we did expect some rain, but 5 (!) showers was a bit much even by my Swedish bad weather standards. Philip was freezing on his 1000 Vstrom while I was actually quite toasty on my GS.

So what about Wilson?

The day after our return my first PhD student successfully defended his thesis - Well done Nakul. Then a quick lecture about metastatic breast cancer and some much needed catch up with family and kids. This is when Wilson calls. He had been calling in Malaysia but I thought it could probably wait until I was back and so hadn’t answered. He asked if I wanted to go to the Moto GP race in Sepang the next weekend. Mette was actually keen to join as well so I told him that we’d be happy to. When it finally occurred to her that this would mean 700 km in 1 day she backed out. Women ;)

So what can possibly fall off the bike you ask?

Sunday morning being a wee bit late as I cross the Singapore check point (my usual time optimism always leads me to believe I have more time than I actually do), and seeing Wilson in my rear view mirror, I gun it across the causeway, the bridge between Singapore and Malaysia which is no man’s land. At the Malaysian check point Wilson catches up, asks me if I have dropped anything since he saw a piece of paper flying off my bike? He had noticed something but couldn’t stop as cars were on his tail. Yep, something did fly off, my passport and employment card which I hadn’t put back into the tank bag, only laying them on top since it was such a short ride between the two checkpoints. Disaster!!! Wilson and I convinced the Malaysian immigration to let me through only to u-turn back on to the causeway. Halfway across Wilson pulls over – great, I think, he found it! Not! He has just run out of gas. Gas is so much cheaper in Malaysia that we all go across on fumes to fill up on the other side and he hadn’t entered in to his equation charging across the cause way rather fast; twice. Wilson joins me on my bike, back to Singapore, now convincing them to allow us to u-turn back to the other side of the cause way where my passport is. I think the officer realized the amount of paper work needed to bring back a Swede with no documents back into Singapore so he says yes, but Wilson and I cannot find any passports on the way (you think there would have been at least a few more fallen off). Morale at this point is very low, ok very, very, very, low. I leave Wilson by his bike to call those waiting for us in Malaysia while I do a last but futile check of the remaining stretch of the causeway, wondering what possible argument to use this time to cross the Malaysian check point with no papers.  As I am about to open my mouth the Malaysian officer says - Is this yours? Voila - passport AND employment pass in her hand. Of course I offer the usual; marriage, house, car. As usual I am also rejected. She declines mentioning she is married, I realize that polygamy is not allowed in Singapore and am a bit relieved myself. I am happy and amazed that people can be truly nice. Some unknown Malaysian had picked it up and returned it. Here is my official thank you, whoever you are, you are now famous. Now quick U-turn to pick up Wilson, pillion him back into Singapore to get gas. Singapore immigrations ask where his bike is, apparently the peak of the bridge determines the border and Wilson’s bike is in Malaysia, so the officer does not have to do anything. Yay! We get gas at Caltex, put the container in one of my paniers go back, fill up his bike and finally, finally, finally 1.5 hours late meet up with the rest of the group on the Malaysian side.

The rest of the ride was comparatively uneventful, the race a new experience for me. To be described on another day and yes, my panier lid also fell off one of my boxes going home.

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The Long Ride

As Asia modernizes rapidly, breast cancer is expected to increase in incidence with larger numbers of women being diagnosed with breast cancer each year. Some of the contributing factors are the changes in reproductive patterns with women having fewer children, reduced breast feeding and later age at child births as well as other lifestyle changes.

Evidence has also shown many breast cancers to be familial and hereditary. The multi-factorial causation makes this a difficult disease to tackle and emphasizes the importance of advanced research to improve current understanding of the disease. The explosion of breast cancer is further complicated with myriad challenges, including low awareness, limited resources and poor access to care in many Asian countries. 

While breast cancer is a worldwide issue, the solutions to early diagnosis and treatment are as varied as the peoples and their cultures.  An important part of the solution is to understand how different practices approach this global problem.

Two of NUHS’ finest breast surgeons will motorbike from Singapore to Sweden in March 2014, visiting cancer centers and hospitals in multiple countries en route. This official, four-month mission will take the team across 22 countries and about 40,000 kilometres. The team aims to raise awareness for breast cancer by conducting lectures, surgical demonstrations and participating in forums with collaborating institutions.

These collaborations will facilitate the establishment of a network of cancer centers across Asia and Eastern Europe where genetic studies and gene arrays with multiple ethnic groups can be conducted. The cancer genes in each region will be different and this new scientific knowledge will help enhance therapies of cancer treatments.

We also aim to study, along with anthropologists and social work specialists, the socio-cultural influences on breast cancer and related health seeking behavior. The varied beliefs regarding breast cancer across Asian societies have harmful impacts such as late presentation and lack of acceptance of treatment options; resulting in too many lives lost too early. In the face of such dire circumstances we feel compelled to spotlight the barriers and help bring about policy changes, establish awareness programs and improve access to care through our efforts.

Without funding, these research ideas will never become reality. High-quality research is essential to deepen our understanding of breast cancer, in order to improve treatment and to identify solutions with one ultimate goal – to save lives.

We hope the ride will be a modest testimony to the extraordinary courage we see on a daily basis in our patients as they go through the phases of breast cancer screening, treatment and survivorship.  While our difficulties in the planning and running of this mission end with our destination, their struggles continue, and we hope that providing a research fund to help understand their disease will be an enterprise that you will want to participate in.