Finally has time to blog about things that I want to talk about for some time already.
> Mum wasn't very happy about my aunt's doctors (not only the one that screwed up the operation, but the rest as well).
Quotes: 'Why are they treating all their patients like a set of numbers - that can be deleted anytime?' 'Why are they just treating the symptoms, and don't attempt to solve the cause...'
According to medical anthropologist Susan Greenhalgh, the biomedical discourse consists of 4 different main components, namely objectification, quantification, pathologisation, and amelioration. Her categorisation of the biomedical discourse is very critical; probably you should be able to guess what she meant from the 4 terms she used.
I told mum not to be too upset about the doctors - because they can hardly be blamed. That is how they are trained- the biomedical discourse, which is viewed critically by some anthropologists and sociologists, is necessary for medicine to function as a science. Also, from their standpoint, a patient is merely one of the many cases that they have everyday - the patient surely doesn't mean as much to the doctor as she means to us. Anyway, I do not completely agree with the amelioration point: the ultimate aim of biomedicine is still to find out the cause of disease and eradicate it; amelioration is merely a transitional means to make the patient more comfortable. Also, it is unfair to blame medicine for doing that - we still know so little about our bodily processes, making treating the cause of disease sometimes simply impossible. That is why I can still find a job.
Medicine is a very complex profession - way more complex than the biomedical sciences as far as I currently understand. Medicine exists at the point where the social meets the technical - the social and the individual has a set of expectations towards the medical profession which, when placed against personal professional aspirations or even epistemological interests for general good, produces serious clashes that can hardly be resolved.
The mess is mind-bloggling. I have a certain interest towards the modern history of medicine which is filled with various forms of patient activism, the advancement of therapeutics, the creation of the asymptomatic patient, ethical issues behind the three-phase clinical trials and the double-blind, placebo-controlled phase II trials, the balance between the financial interests of pharmaceutical companies and patient accessibility to new treatment, etc etc...
Most of these things that I have been studying occurred in America, where the population is vividly conscious of their rights as individuals. Singapore didn't have to go through all these because we are in a different culture - but, as our population becomes more and more affluent, it would be expected that medicine and the biomedical sciences will have to struggle to remain at a position of authority.
Medicine is complicated because it involves people. Unlike many science and engineering disciplines, which do not directly relate to people, doctors directly deal with patients, and any decision that is made within the profession (e.g. should this drug or treatment procedure be licensed, etc.) directly affects the lives (literally - lives) of people. Thus, I have to agree that medicine is both a science and an art: not art in the sense that was widely perceived in a skillful surgeon but art in a sense that doctors need to make decisions and have an attitude that displays thorough understanding of all situations that their patients are being put through. When I say 'thorough understanding', I don't just mean the medical conditions that are observable and quantifiable - but also the social forces at work on the patient that created his illness experience. That's why medicine is an art.
If this is not handled properly, it is not only the doctor's credibility that is at stake, especially when it comes to decision making at the policy level - the whole profession's credibility can be at stake, because these issues are all life and death issues, and this carries with it huge social implications.
This is a huge burden that comes with the profession, because this is the nature of it. Mum understood it (hopefully) after I explained to her why doctors are mostly like that and why she couldn't help perceiving them as such - firstly, even if they are aware of these issues, it is still way easier to use a purely scientific approach to tackle every case presented to them. Secondly, it is also possible that they are not even aware of these issues, or they might just simply not be bothered. This is especially the case when they are practising in Hong Kong, which medical system is also highly strained and overstretched, there is no more important issue in the hospitals than to get rid of patients as fast as possible.
There are some readings that dealt with the relationships between doctors, basic scientists, physician scientists, the biomedical establishment, the pharmaceutical companies, the patients, and society in general, which I haven't got time to closely analyse and we don't have time to analyse them closely in class so, when I have the time I will write a part II to this :)
(DAD! LOOK AGAIN! When I decided to major in History of Science it is not irrelevant to my work! See how important these things are! :D Of course I won't allow this to compromise the quality of science coursework that I pursue so you can relax...)
This week is simply, insane. I have a midterm on Monday, discussion leading on Tuesday, midterm + homework due on Wednesday, and a paper due on Thursday.
My sleep cycle is completely messed up. Now I would sleep from 4 or 5am to maybe 7:30 or 8am, then go for class and lab, and then throughout the day sleep whenever possible.
I am in hibernating mode. On Sunday I bought 6 cans of Chunky soup, 12 Krispy Kreme doughnuts, 3 packets of pineapple tarts, 6 packets of instant noodles, 3 packets of plain noodles, 3 packets of flavoured egg noodles, and 2 packets of spaghetti in addition to the sausages, ham and vegetables that I already have. This is only the 5th week - can't imagine what is going to happen later into the semester.
I will only be relieved when 14 May comes! Sigh it's really like counting down to ORD...
On a lighter note, this song is quite funny - although a bit fatalistic I must say:
Just thought of this: if you enjoy shopping in VivoCity, you will actually say 'I enjoy shopping in vivo' :P
> Ferret: No matter how old the post is as long as you post a comment I will be able to see it because it goes into the moderation page first :P Hmms, what about defining miracles as something happening in your favour when you least expect it? I don't quite understand the 'want' and 'need' dichotomy - doesn't the dichotomy undermine the meaning of a miracle? If you intrinsically have faith and believe in God - does it matter if it is a 'want' or a 'need', which is naturally a subjective category anyway?
This is the best thing I have heard so far regarding my citizenship issue!
British Nationality Act 1981 (c. 61)
13. — (1) Subject to subsection (2), a person who has ceased to be a British citizen as a result of a declaration of renunciation shall be entitled, on an application for his registration as a British citizen, to be registered as such a citizen if—
(a) he is of full capacity; and
(b) his renunciation of British citizenship was necessary to enable him to retain or acquire some other citizenship or nationality.
(2) A person shall not be entitled to registration under subsection (1) on more than one occasion.
(3) If a person of full capacity who has ceased to be a British citizen as a result of a declaration of renunciation (for whatever reason made) makes an application for his registration as such a citizen, the Secretary of State may, if he thinks fit, cause him to be registered as such a citizen.
Official link to the Home Office webpage regarding this issue:
As you can see, I am not that enthusiastic about getting the Singapore citizenship. This kind of thing, well, it's more like an administrative problem to me... Now, since I got to know about this, I just have to pray that the law won't change - to keep my escape route open.
If you get to choose, would you choose to hold an EU passport or a Singapore passport?
Now I have an added incentive to go to the UK to do PhD - that will help me open my network there. Part of the escape route plot.
Singapore is stupid in not allowing people hold dual citizenship. They say that Singaporeans are not ready and probably it may take another 20 - 30 years for that to realise... I don't know what is there to be ready about though. Before you make it realise, those who can go somewhere else would have - like some of my friends now, even though they are native Singaporeans.
If Singapore can't even keep native true-blue Singaporeans around, no bureaucratic measure is going to keep people like us - who acquired our Singaporean identity - around. Remember, if we can give up our native country's citizenship (not applicable to me - the HKID thing is a PR status and does not involve citizenship), we can give up Singapore's as readily.
Anyway, from what I know quite a bit of Hongkongers who grew up in Singapore don't identify themselves as Singaporeans. I am already a more 'Singaporean' one - and I do still bear this kind of thinking. To us who are immigrants citizenship status is not important - what is more important is security and convenience - that is why a lot of people in Hong Kong tried so hard to get Canadian or US or British citizenships and yet in the end they still decide to continue living in HK. It doesn't mean that we are loyal to those countries, it doesn't mean that we identify with those countries - we just need those passports so that we can run when we need to. Like the analogy I always use... I can go hide in some village in Czech Republic anytime and no one will be able to find me :P
People will denounce us for our lack of loyalty, and why would we need to run? This is something that those people won't understand. There is no need to explain; we just have to hide in some village in Czech Republic and we won't hear you anymore. And while you are still scolding us, we would already be enjoying life reading newspapers by the fireplace and farming cows so oh well, you do whatever you want :P
I am in my lab now, my experiments are still not working (I am now trying to find out why), and I am pretty fed up now, that's why I am writing this...
It is definitely true that, for people working in a lab, their mood is determined by how their mice, cells, bacteria, antibodies and PCR behave.
Nothing seems to be working well recently. Even that nest of baby mice that I tried to keep till P15 died because their mum stopped feeding them after I took 3 baby mice out at P5.
Now I have to wait till I can get hold of a pregnant mouse and wait another 19 days. If I couldn't get those P5 tissue to stain, I will seriously cry.
I don't think it is the antibody's problem; most probably the problem lies with the tissue sample. My antigen seems to be either killed or masked after I kept them for a long time in sucrose to get rid of ice crystal artifacts - and it mysteriously doesn't work on paraffin. The level of expression is not distinctly high, making staining very difficult... I have done it before though, and I have proven its existence using Western blot, but I think pretty soon I have to get a Q-PCR running in order to confirm it at the RNA level. Just to make sure that I am not seeing things like mouse IgG (same size as my protein) - Q-PCR cannot cheat me.
Those bacteria that I transformed are acting funny also.
If anyone has ideas, please please please tell me! Anything would be good; I will know whether it is ingenious or idiotic after I tried it :P
Hahaha okay, I must say that some of the stuff in the chill until become ice post is exaggerated a bit. But the part about caffeine is true!
I seriously need some proper sleep... and good news is, we have some ICE coming tomorrow. Hopefully it will get sooo slippery that I can't go for class tmr!
WASHINGTON... GAITHERSBURG... COLUMBIA... BALTIMORE... ANNAPOLIS... WINCHESTER... FRONT ROYAL... LEESBURG... CULPEPER... MANASSAS... MANASSAS PARK... FAIRFAX... ALEXANDRIA... FALLS CHURCH... BAYARD... PETERSBURG 851 PM EST THU FEB 21 2008 ... WINTER STORM WARNING NOW IN EFFECT UNTIL 10 PM EST FRIDAY... THE WINTER STORM WARNING IS NOW IN EFFECT UNTIL 10 PM EST FRIDAY.
A STORM MOVING IN FROM THE SOUTHWEST WILL BRING PRECIPITATION INTO THE COLD AIR ALREADY IN PLACE OVER THE REGION. THE RESULT WILL BE LIGHT SNOW OVERNIGHT... FOLLOWED BY FREEZING RAIN FRIDAY INTO FRIDAY NIGHT.
LIGHT SNOW HAS BEGUN TO OVERSPREAD THE CENTRAL SHENANDOAH VALLEY AND NORTHERN VIRGINIA. ONE TO TWO INCHES OF SNOW IS EXPECTED OVERNIGHT. THE SNOW WILL CHANGE TO FREEZING RAIN EARLY FRIDAY MORNING.
THE FREEZING RAIN WILL BE ON AND OFF DURING THE DAY ON FRIDAY AND INTO FRIDAY NIGHT. SIGNIFICANT ICING... AROUND A QUARTER OF AN INCH... IS EXPECTED. THIS WILL LIKELY CAUSE SUBSTANTIAL TRAVEL PROBLEMS AND POWER OUTAGES. STAY TUNED TO THE LATEST FORECASTS THROUGH THIS EVENT.
This semester is crazy! 2 midterms next week, and still 12 more weeks to go...
At this rate I am going most probably I will end up (again) feeling sick all the time from all the coffee that I drink, and will have to resort to eating tylenol and antacid to counteract that.
To ensure that I have a continuous supply of caffeine-charged drinks, I have bought myself a tea maker. I have a lot of various tea leaves with me - from English tea to various forms of Chinese tea, some from Singapore and some from unknown sources - which I don't know how to consume before the tea maker. So now other than instant coffee my arsenal just got powered up.
Was talking to yc just now. He was asking me why didn't I choose to go to Cambridge - he didn't apply because he thought it is very hard to get in (which is not true if you intend to do natural sciences; same as Hopkins at ~25 - 30% - and upon knowing that he went '**** I should have gone there to chill until become ice!' :P). Well I wanted to do something different, which is true - though now when I think back, if I have gone to England, these are the advantages:
1. Everyone knows where I am studying in. I won't get stares which probably suggest 'you must be some rich kid who cannot study that's why you go to the US right' and even more stares when I say my school is in Baltimore, which get relieved only when I add to that 'ohh it's one hour from Washington DC and it's on the East Coast'. And I wouldn't have to correct EVERYONE when they think that they are smarter than Johns Hopkins's father because they feel that 'John' shouldn't be spelt with an 'S' at the back.
2. I would be able to feel really powerful when it comes to the sciences because I would be devoting all my energy to it. I won't feel that I have lost out in something because I wouldn't have done ANYTHING in the humanities - hence I wouldn't have known.
3. I would probably have stepped onto every single conceivable European country by now. Probably except Bosnia and Kosovo. I might even have gone to Ukraine and Belarus.
4. I would be able to fulfill the 3 years residency requirement, get my UK ID card, identify myself as a real British, be eligible for fully-funded PhD studentships everywhere in the EU, and then be eligible to chill there for the rest of my life.
If we have known #4 way earlier I would probably have gone there with my parents' money. Though if that is the case I wouldn't be able to fulfill #3 - but I am eligible to work anywhere anytime so I might not live like a king but should still be pretty alright.
(See? That's why I have to go back to DHS and make sure that my juniors think properly before they take up scholarships.)
Going there to chill until become ice for master's is one of his options. Even if I ever decide to go there for graduate school I don't think I can chill to that kind of extent - but it is a fact that, in Cambridge, you cycle for 15 minutes in any direction you will find yourself in the middle of some field blooming with yellow flowers in spring but down here you cycle for 15 minutes in any direction you will reach a ghetto. Okay maybe not towards the north, but you get the idea.
There is this NIH - Oxcam thing sounds quite interesting (there is an Advanced Scholars track for non-US citizens who commenced studies in the UK), and since I am dropping the MD/PhD idea, I am considering the UK option again.
(Hahaha there is one great thing about the NIH - Oxcam thing. During the 2 years with NIH I will definitely choose to live in Rockville - 15 minutes Metro to Bethesda from there, is the centre of Chinese food in Maryland, and it is a very nice place :D)
Err hmms the triangle on the left is supposed to be an aeroplane that can fire missiles! (I got this picture from the Internet :P)
Now times have changed:
I have no use for it now. Though when I go back to Singapore for my one year attachment I am sooooo going to buy one and install it on my workstation computer :D
... listening to my Mama Mia! soundtrack and it ran to the last song: ABBA's (of course)'I Have A Dream'.
I love this song - and my experience with it has always been surreal.
It made an impression when I was on a train in Scotland. I was heading back to England after 2 days of hiking and beautiful scenery - and the train was passing through miles after miles of deserted moorland when I was playing the same soundtrack on my iPod.
So it made an impact, with the angels and 'something good in everything I see'. Yup, no matter what happens it is always a blessing somehow.
I found the song in the KrisWorld system on my flight back to Singapore from Frankfurt. So I just kept looping it when I didn't feel like watching any movie.
And today I was listening to it alone again - I was at my workstation in my lab (hardly anyone is around) working on my AIDS homework while waiting for my slides to finish incubating. Suddenly it felt like I was back on that train in Scotland again - journeying and journeying alone, towards goodness knows what.
Not a very healthy feeling - but who can journey together with me? People around me can help me but certainly not travel with me or even for me.
I used to fill up gaps in my life using work - to a very large extent I still do, except now I have this blog and a bit of beliefs and fantasies here and there. Though for how long do I have to continue doing so?
My mum told me that my aunt is getting better... Great news. Have not heard anything from sushi though; she is my main source of accurate information basically :P
Anyway, I finally migrated almost all my applications to Google! This solved my attachment problem, because even though sometimes I still cannot open my attachments (for some weird reason) I can still see the contents using Google Documents. And Gmail is just so much better when it comes to threads.
I also made iGoogle my homepage, set up Google Calender and Google Reader, and placed Google Map, MSN Web Messenger and NCBI Search (includes OMIM!) on my iGoogle.
The Google Toolbar is already giving me a lot of convenience - it effectively enabled one-button access and search to Amazon, YouTube, Facebook, Google Map, Wikipedia, Dictionary.com, and Gmail in my browser. And I can search for any particular term in a webpage using one button.
Haha now if I want anything, all I need to do is to launch my browser or hit the 'home' button and everything would be there.
Sigh it is things like these that turn me off clinical practice.
Thought all were going to be fine already... my mum had booked tickets to go back to relieve my sister of her duty, and everything seems under control.
My aunt was wheeled again into the operating theatre yesterday evening. Intestinal perforation.
According to the story my sister gave me:
> She was supposed to be scheduled for laparoscopic hysterectomy. You would say - simple operation isn't it. We thought so too. > However, during the operation, the surgeon discovered adhesion of the intestines; initially I do not know what kind of adhesion that is (to the peritoneum, etc.) but now I know - at least part of it is the adhesion of the uterus to the descending colon. This made the laparoscopic procedure impossible, so the surgeon switched to total abdominal hysterectomy. > Post-op she experienced intense pain and bloatedness in her abdomen after ingesting some random pills (unknown origin) and liquid food. So they took her off food, introduced a drainage NG tube, and put her back on IV saline/glucose. > Black drainage from the NG tube. > CT scan showed air and/or fluid in abdominal cavity. > No one suspected anything. > Yesterday they tried giving her food again - this time I don't know what is the clinical manifestation. They discovered problems during one of the routine tests from various discharges and suspected perforation. > She underwent surgery again - this time the gastroenterologist found a small cut in her descending colon, possibly due to the previous surgery, and (local?) inflammation of the area. So he has to excise a small segment of her large intestine. > I don't yet know the outcome.
According to my sister, there doesn't seem to be signs of peritonitis. Thank God.
Hopefully by the time I get this written, she would be well on her way to recovery... I have been praying... _______________________________________________
Sigh these are human errors that can be avoided. In the first place, laparoscopic hysterectomy can't be done easily on her - even if possible. She had a previous non-invasive procedure aborted before, because they can't locate anything properly using MRI.
I don't like bashing doctors... Though one thing obvious is that, when the surgeon is too confident and when he has multiple procedures to do everyday, if we were to ask for top quality healthcare, that is seriously expecting a bit too much?
I have not had problems with the healthcare system personally, because I have never had serious problems myself and every time I went to see a doctor I was more curious about everything than expecting quality healthcare. And I used to work with doctors so I can understand their point of view.
Now I am placed in a position where I am the close relative of a patient who suffered because she didn't receive the care she deserved. What am I supposed to say?
Don't we have things like this in the news all the time too? Sigh I rather just do research. Although I won't save anyone directly but I also won't cause suffering unnecessarily. Yes I love the science, so? I need everything for my research anyway.
I am a biomedical scientist, my sister is a physiotherapist, I have an aunt who is a nurse, I have also a not-that-distant cousin who is a radiotherapist, and if I were to continue (unlikely), I can be a historian of medicine. No one (yet) in my family is a doctor. So:
Doctors and future doctors, please... Do your patient no harm, even if you mean well. Know your limits, don't take unnecessary risk (my aunt can live a perfectly fine life without the operation), don't use your patients as subjects to test/show your skills, when you participate in trials put your patient's interest at top priority, and treat every patient as your first patient humbly and with utmost care even if you are going to be late for your most important Valentine's Day date. I promise I won't doubt your professionalism if you can do that, I promise I won't make you break these rules because of my own professional interest, and if I am that most important Valentine's Day date I would feel more happy if your patients are more important than me - if you know me well enough you will know that I really mean it.
These days I have been asking my sister to explain stuff to me. It used to be the other way round!
Which is good, in a sense our knowledge complements each other. Though she might not really need to know what I know more than I need to know what she knows.
Developmental biology is amazing. In the meantime there are also too many things to learn... hmms I better go back to my reading :P _________________________________________________ Some interesting stuff to talk about:
Regarding the HK scandal: although it is interesting to follow, but hmms cut those people some slack? If the purpose of the person releasing the pictures is to expose the extreme hypocrisy of the entertainment industry and to do damage, he sure has achieved his aim. There is no need to keep releasing new photos everyday...
It is more interesting to see how the artists involved and how EEG actually go about doing damage control. Reconciling the information released with the images of the artists that have been created and maintained for years is almost impossible - and this incident shattered the dreams of lots of people.
Yiran's reaction is always the most classic:
'I like Twins lor... totally spoilt their image in my mind... sighhh... they are so cute...' (Yes they are indeed very cute. Definitely cuter than S.H.E..)
So, next time when they release another album - how is it possible for you to buy it without such negative images flooding your mind?
Anyway, Gillian Chung has made a public announcement, quote: '... I was naive and foolish... and I have already grown up now...'
Commentaries are already cautioning the exploitation of the phrase 'I was naive and foolish' by young people, incorporating into popular sub-culture and thus legitimising similar actions.
This is the worst scandal in the history of HK's entertainment industry. The following link features a very funny article written on the subject together with some censored pictures. Well, obviously I won't post the link to the real ones here... Though they can very easily be googled. If you are interested.
Friendly warning: the article is a little sexually explicit, and the pictures are basically scaled-down censored porn :P
1. Hmms it's not right to be promiscuous, but putting moral judgment aside, it is simply extremely stupid to record whatever you have done on video or film and store them in your computer. Seriously don't understand why would anyone do that... Just asking for trouble basically.
2. Errr I guess humans are the only animals that love to see other individuals of their own species having sex. I don't think mice or dogs have the same kind of behaviour. Maybe I should go and ask the psych or cog-sci people why :P
I know this is a bit late, but anyway, CNY lasts for 15 days isn't it.
Some updates:
Work is piling up, and I don't feel that I have enough time to finish them. I will have a paper due in less than a week, and I promised myself to complete some history research for my competition paper by the end of next week.
I am supposed to start exploring some epithelial cell culturing techniques so that I can use that technique (hopefully) to make my knock-down experiments more comprehensive. I have not started. And I am supposed to be starting to read up and form arguments for my PURA proposal. Haven't really started either.
Going for some prostate cancer conference tomorrow for half a day... and then most probably I'll have to be doing work after that. I hope I won't get distracted on Sunday, so that I can at least finish my paper and do some reading. Still have to teach tuition at night.
Sigh don't think will have the energy to go for skiing anymore :(
I think I got myself interested in too many things. That always happens to me... and I can't multi-task that well. Oh well. I'll see how it goes :P
Wishes for the new year? Miracles would be good: small and nice miracles. Haha this sounds remotely like Disney... Let the year of the rat be filled with miracles!
Don't credit me - save that 1/3 of the credit and give it to our parents too. It is them who give us what we have now, and it is their values that I am carrying whenever I nag you. Even without me around, you can still be what you are.
I won't pretend I understand what you are going through... I have not gone through something like this before. Probably the most similar case I had was just before I left for the US two years ago... when I have to go back to HK twice and solve those problems, once with mum and once with dad. I saw mum go through similar stress - the kind of helplessness when you know that if nothing is done something bad will happen but you cannot do anything. I simply exploded when I saw how irresponsible he was for himself and even then tried to ridicule us.
From what I read and from what I heard from mum you are handling the situation excellently. Though I ask you for one thing: for the good of our aunt motivate our two cousins to do things that they should do as sons. Pull them to one side and teach them if you have to and if possible. You can't be the only person showing that level of care in our generation. Aunt Bonnie knows - she is the patient, she is most sensitive to these things - and if she sees too huge a contrast it is not good for her emotionally either. Though you can't don't care - you still have to do your best. But to the best of your ability get our cousins to do the same...
You can do it. This is something I can do if I am there.
This is not the time to blame anyone as to why things turn out this way. We all know where the responsibility lies. It lies within our family - our uncles and aunts take care of them too well, to such an extent that they don't need to care about anything, and we are too far away to be of any influence. You feel helpless because you are not of the right generation to say or do anything, which is true. But our cousins also need a positive influence from their peers, which you can act as one. Seriously, I know nuts about them - I don't know what to say to them most of the time, you told me before that you don't either - sigh, maybe you should call them out for a meal or coffee or hang out for an afternoon after everything is over and talk to them a bit.
I just told mum - we just have to accept who everyone is. It is impossible for someone who is not trained to handle any situation even in normal circumstances (like choosing subjects?) to miraculously become someone like you when crisis hits. We cannot even demand that from them, because even if we do so they'll just stand there and cry. But if you want to do something, you can be a good influence - but don't let the uncles and aunts say things like 'see how well Hiu Yan handles things, not like you...' because that will only backlash.
Although you are the youngest in the family we didn't want you to be dependent - and you have proven that you aren't. Just remember, we are always there for you, just like you will always be there for us. And you are doing better than me in your studies now! Which is great! Haha congratulations on your scholarship! :)
Mum intends to go back to HK next Tuesday, she just told me. Let me know of any updates, so that I can prep myself and prep her a bit. Because we don't stay in HK, we should act as mediators, not trouble-makers... I know what to tell her NOT to do, but you have to tell her what TO do. Once she arrives your responsibility is over - except the physiotherapy part - and focus on the cousins then. I will tell mum that, whenever possible and if the two of you want to do something for our cousins (and for our aunt and uncle), she has to talk to everyone. And she has to be the one to initiate it.
Mum called me and told me about my aunt's operation - apparently there are some complications. She described all her symptoms to me and asked me for opinion - but there is nothing I can do to help her. I know nothing about this stuff; my sister knows better than me - even if you give me all her medical records and put her in front of me I still cannot do anything about it.
I am supposed to be good at the biomedical sciences, but it is also a fact that I don't know anything and I cannot do anything about anyone's illnesses. Note the distinction between biomedical sciences and medicine - medicine is the practical use of the biomedical sciences to solve people's problems, while the biomedical sciences are the scientific framework which medicine is based on. My job is to expand the framework, so that medicine has more tools to use. I don't use the tools, I make them.
I was telling my sister: she is going to become the more popular one among mum's friends because her skills are practical - she can actually heal people (yes she has healed quite a few because there are always people volunteering to be her lab mice - I am one of them :P). Haha no one is going to disturb me because no one will even understand what I am doing - and I would be really lucky if no relative or family friend actually criticises me for being useless because I won't seem to be very productive considering the education I am getting.
I am worried for my aunt. MSNed sushi and told her to send my regards, do whatever she can to help her and the family, and update me. Though, when this kind of things happen my reaction would be to trust doctors intelligently, don't do anything extra, don't try to act smart and most importantly, consult your doctor before seeking any alternate treatment. The doctors are doctors because they know what they are doing; the auntie next door who has gone through a similar operation won't know more than the doctor who actually opened her up, and whatever herbs that she used might work for her but might even kill you because everyone is different physiologically. If the doctor doesn't know what he is doing, find one that knows. If they make any mistake, sue their asses off. Anyway, for doctors to work optimally we have to trust them. Common sense?
Hmms, how do people actually react to illness? Illness doesn't only affect the patient - it affects everyone around him. It affects his loved ones, his friends, his colleagues, his doctors, his bosses, practically everyone: and different people react differently.
I just read a graphic novel called Epileptic by David B.. It is a disturbing book - it describes how the author and the author's family dealt with his brother's frequent epileptic seizures, apparently incurable. The book basically highlighted how the parents gave up hope on modern medicine and their religion, and started their tireless search for alternative treatment - macrobiotics, esoterism, mysticism, magnetism, alchemy, you name it - until a point of time when they ceased to believe in these things altogether. They didn't even start a new treatment with any hope.
Throughout his childhood the author locked himself up in strong armour. Throughout the book he didn't mention any friends - he didn't seem to have any, not until he went to Paris (i.e. left home) to attend college. His friends before his brother was down with epilepsy ostracised them soon after. He used a lot of imagery - war imagery, obtained from books about great warriors and which he expressed in the form of drawings, fiction, and comic strips - to fight his own war against his brother's illness. He didn't talk to people about it. When he started to open up this issue when he was in college, his friends too eventually found his stories to be 'too heavy' and began to distance themselves from him. Instead, he had this group of ghosts - including his grandfather's - in his garden which he confided in.
When the illness first struck the brother imagined himself as Hitler - a dictator with supreme power - which, in some sense, gave him the psychological shelter against reality. Intrinsically he wanted to fight - he wanted to be like Hitler, which could control everything when he was in power. As time went on, he succumbed - he became stuck in the past, started to evade problems, wanted people to take care of him, and started using his illness to get things he wanted. Eventually he turned violent, delirious, sometimes to the point of insanity - but he didn't - it is just that, it seemed that he never was going to become independent ever.
I have a lot to share on this topic - from what I have read, to what I have experienced working as a medic in the SAF, to what I have experienced in my family - and I can't say everything. I’ll save them first.
Illness affects the patient, and it affects a whole bunch of people around him. Illness changes people's ways of life, views of the world, standard of living, social circle, roles in society... It is not only a biomedical problem.
Yes to us different forms of illnesses are sets of problems lying there for us to solve. I have been spending my past year working on prostate cancer. But we shouldn't forget: prostate cancer is not a problem confined to the laboratory, or a problem confined to the walls of our outpatient cancer centre. When someone gets prostate cancer, it affects him and people around him in all aspects, in different ways, in various levels. The cancer is not merely weird cells expressing weird proteins at weird times dividing at weird speeds.
The patient is not merely a subject of study. He is part of the social - don't underestimate him. His illness can affect the doctor treating him too; if I am the scientist investigating whatever strange illness he has, his affects me too, even though I am not even at the frontline. A very vivid example is SARS. If I am one of the guys doing the investigations, my life would have been tilted 90 degrees to the horizontal for those few months. Especially when the patients keep dying and we still know nothing about the disease.
Doctors have to see patients as patients, each as unique individuals with his unique set of problems, before the patient and the doctor can build a good relationship with each other and thus both can have a wonderful medical experience. Scientists like me do not have this kind of problem, but we have to constantly remind ourselves that the problems that we are solving are not merely biomedical problems - they all have their social implications. We have to remind ourselves not to become heartless and turn a blind eye to patients' needs and feelings - when we have to fight for funding, when we have to announce our findings, that's when the problem emerges.
All these sound so remotely idealistic, and they have no economic value. NUS/NTU don’t even have anthropology and history of science and medicine. (Also - I am the first Singaporean (as far as I know) in Hopkins doing HSTM.) Not that we have much of a choice either - I can't lecture Singaporeans on the importance of such issues because there are more pressing concerns in Singapore. I’ll be chided as 'idealistic' and 'impractical'. Will talk about that some other time :P
There was a time when to amplify DNA, You had to grow tons and tons of tiny cells. (Oooh) Then along came a guy named Dr. Kary Mullis, Said you can amplify in vitro just as well.
Just mix your template with a buffer and some primers, Nucleotides and polymerases too. Denaturing, annealing, and extending, Well it’s amazing what heating and cooling and heating will do.
[Chorus] PCR when you need to detect mutation (detect mutation) PCR when you need to recombine (recombine) PCR when you need to find out who the daddy is (who’s your daddy?) PCR when you need to solve a crime (solve a crime) [x2]
[Advertisement] (PCR) To all the scientists out there doing PCR, Bio-Rad salutes you with the all-new 1000 series thermal cycling platform.
I have no use for it now. Though when I go back to Singapore for my one year attachment I am sooooo going to buy one and install it on my workstation computer :D