Alternative Philosophy of Life

Transcendence, transformation and moving to the next age

2013-07-26T19:18:00.000-07:00

Introduction

The country has been pounded by the lead politician with the word ’ TRANSFORMATION’ over the last year or so. The economic front worldwide is in turbulence and rather unpredictable. The American economy is wired with confusing messages and unintelligible numbers. Health care is escalating and inflation is like a ‘run-away train’ with no end in sight! In the midst of this when economic transformation is discussed as to how money is to be spent and what needs to be done to achieve the set targets, I worry what will become of the fundamentals of both life and the ethos of good governance. I am not sure if it was HG Wells who articulated his message in plain English as to a ‘the lecturer floundering with exquisite illumination relating to the irregular and fragmentary nature of creeds we produce’ that I am reminded of the lack of insight in young professionals I encounter today. They appear to be content with the doings of the day not caring about the fervent drive of policy makers to encounter insurmountable problems confronting the world. The haze is back as if to renew acquaintance having parted a year ago with less than expressed feeling of annoyance. The uncertainties are compounded by war and conflict. Some nations spend huge proportion of their GDP on defense and national security. At a more micro-level this is translated by household living in housing estates as fending for oneself (having to fork out some RM 100-500 a month) for the services rendered by security companies who appear to recruit, largely foreigners!

Transformation

Ivor Chipkin discussed critically about transformation in Southern Africa ( Transformation: Critical Perspectives on Southern Africa, pp. 31-51/10.1353.2011.0035) where four principles were referred to: to integrate diverse governments and administrations in a single service, changing the direction of public spending to focus on Black majority, change the demographic character of the public service to correctly reflect on South Africa’s population and deburacratize the public service in South Africa. This was after several decades of submission and unfair governance by White rulers of South Africa. It is often repeated that the troubles of humanity is not only due to misunderstanding but due to creed and colour, an incapacity to think, to want to remain different maintaining that some men have greater intellectual power than the ordinary, the ruled and the ordinary citizen. In such an environment any form and discussion are promptly closed with no recourse to elaboration and understanding. This absolute conclusion of effectual criticism and comment is assumed to be personal submission and consent.

Bureaucracy has been the bane of ineffectiveness if it is strictly applied overriding reason and pragmatism. This is often seen when impotence is exemplified because the problem cannot be handled by any single party as a result of delineation of duties by fragmented regional and national divisive governing bodies. Cross border assimilation for the betterment of governance must be in place for the transformation concept to be implemented effectively. I personally have my own beliefs of religion, moral values and life at large but that matters little as it is said that a majority of men on this earth are all some form of a philosopher. What my concerns are that mature adults are failing to come to terms with the rapid changes of society evolution and cultural mores giving in to personal pleasure and immediate gratification with minimal consideration of how their actions impact on national aspirations and worldly needs. There is clearly a need for a capacity to elaborate and discuss discursively questions that arise in life as to their form and thought. Empathy is said to eliminate objectivity and appear not inherently present in all actions of life. As an analogy one does not empathize as to what will happen to the naïve minority share holder in bursa trading when short selling is permitted. The ultimate aim is to enhance liquidity in the market!

Globalization

Two words have been haunting my life over the last two decades, globalization and ‘glocalization’. David Held and Graham Walls discuss globalization as a process which ‘embodies a transformation in the spatial organization of social relations and transactions , expressed in transcontinental or expressed in transcontinental or interregional flows and networks of activity, interaction and power’. There is a cross flow of all matters related to social and transactions across borders and continents. The extensive network of transportation and communication permits rapid transfer of these processes. This extends from commodities to personal matters and cultural-religious affairs. The impact is not only severe but rapid, the velocity of the processes only determined by the mode and media utilized. The finance system has evolved so quickly that one can transfer millions of dollars within minutes to most banks overseas. The flow of trade can be sped with air cargo transfer only limited by the speed of the aircraft and its ready availability. The magnitude to which globalization is growing is breath taking. The authors summarily state that globalization is here to stay and has intensified and facilitated all aspects of trade and life making world-wide interconnectedness a sign of being a developed nation

Hyperglobalists

Ohmae (1990) introduced the concept of a ‘single global economy transcending and integrating the world’s economic regions’ and many terms were introduced as ‘The Hyperglobalists’ and turbo-capitalism. All this appears to work towards denationalize economies. Do the citizens have a say and how does this impact on the lives of the people in a nations where recourse to philosophy and humanity is cherished as the making of a fine gentleman. Some thinkers of yesteryears often have lamented that the human mind should consider metaphysical education as a means of living well and collectively residing as fellow humans. With de-nationalization of strategic economic activities, we tend to lose sight of the ‘hidden factors’ that makes us human and humane. Globalization is a means to escape from social regulatory principles and contribute to a rather irate population who focus on global financial success and economic power and wealth. The recession that Malaysia suffered in the 1990s’ was frightening. Most did not what wrong they did- they did not expect the financial manipulators to control the nation’s ringgit so badly. The government of the day was perplexed and the citizens were furious. The solution to this financial crisis by World Bank was not acceptable to the then Prime Minister. Economic globalization is not about wealth accumulation but will inevitably affect the sovereignty of nations despite the acceptance of its philosophies by most political leaders.

The SHIFT World

Just as we are coming to terms with cultural revolution, globalization and the ‘wired or wireless world’ we are moving to what is called the ‘SHIFT WORLD’. This term needs to be dwelt with considering we have just started accepting the term that the ‘world is a global village and globalization is here to stay’. David Houle in ‘Entering the Shift Age’ rediscovers the shaping and re-shaping of the world. This would be a continuous process and citizens of the world need to be moving in tandem if we are not to be left behind. The shift world is where globalization is integral to national development and accepted by one and all, but there is a need to focus on the individual too. What is it that will impact on individuals? I have a an old version of a Nokia hand phone and when I was trying to text a message the other day attempting this with two fingers and getting the spelling correct , obviously taking a longer period than a young adult, a much younger tech-savvy colleague commented that I should but the new 4 G Samsung phone with a touch pad! I felt rather sheepish as the texting apparently interfered with the proceedings of the day. In the Shift Age over lives will inevitably be affected and this will range from how business is transacted and how technology will affect the environment. The world will become a more expensive place to live in as both land lines (internet connection) and hand phones have to be paid for in most households. The TV adds on packages for us to watch and the subscriptions keep rising as if they is no tomorrow.

Conclusion

There is a need for synthesis of all the effecting forces so as to meet the needs of citizens who have been living by the rule of conduct and several factors dictating modern livelihood. Economic transformation is essential but will need to be ‘glocalized’ so as to ensure the young and old can thrive in crisis and in peace times in the country. The environment must be congenial for the ingenious enquirer and those with less than normal capacity. Man has been endowed with exceptional ethical and moral gifts through religion and family unit dynamics- these need to be enhanced and engaged in any form of transformation. A collective synthesization of all factors and forces that has come out of globalization, transformation and the ‘shift age’ customized to the individual of the country would not eclipse out the basic human right to live and live well for generations.

Sivalingam Nalliah

27 July 2013

The General Elections and My Early Schooldays

2013-05-12T01:32:00.000-07:00

Introduction

I have neglected this column as I got entangled with one assignment after another. I always thought I could manage to get one article a month. The guilt of not having penned my thoughts was overwhelming –so much so that I sacrificed this afternoon on Saturday, 12^th May, to complete the task!

The General Elections (13th) in Malaysia are over after having waited almost a year for the final announcement. My Chinese friends invited my wife and me to a dinner that night, 5^th May, and to drop over at one of my friend’s house to watch the results. We had done the same during the previous elections. Anyway the night dragged rather slowly as we got irritated with the numerous ‘empty talk’ between the results which were too slow to come in? After all the anxiety, it looks like there is much more to tackle with the incumbent government not getting the two-thirds majority they were seeking.

As I trot along with my daily chores and tasks, I am reminded of my adolescent days and how the elections were. Much has changed and I am not sure if they are for the better.

Imperium

When I was at my daughter’s place some two years ago, boredom drove me to read an unlikely book entitled ‘IMPERIUM’. This was one of the three books written by Robert Harris, a fictional –historical novel about the life of a famous Roman lawyer and senator, Cicero. The reading was not easy in the beginning but I got hooked on finishing the book within three days, a remarkable feat by any measure, as most times these days, I tend to forget one character after another as I move through the pages leading to the frustration of having to flip back and forth trying to get the picture in order. This remarkable politician, orator and ‘manipulator’ of Roman politics reminds me of a similar state of affairs of current political climate of the free world. Harris tells of the young Tiro , the personal secretary of Cicero, who appears to reflect on the great man. The successful prosecution of corrupt politician (Verres) and the amassing of wealth while he took on the job of governor of Sicily are classic reminders of many politicians in power of today! The climax, at least to me, is the way Cicero is involved in back-room dealings that would eventually lead him to be elected as a consul.

Democracy and Political Aspirations

The Americans elect a President and then form the cabinet. In most Asian democracy the people vote in a party and then pick their chief executive through the elected party. The latter method has its own advantages but does not appear to reflect directly on people’s choice. The mandate to rule has followed much like in the ancient Greek and Roman days where the head of state is endowed with enormous power. The ruses and dealings described in the book by Robert Harris is not very different from what is happening today except that the conduits to reach the people on the ground is much more sophisticated with electronic media prevailing as an insurmountable force.

The asymmetry in knowledge of the political system and the implications of electing a representative remain a point of contention and is often exploited to garner support during times of elections. The one-man-one –vote rule has been questioned especially when the voter is illiterate and down-trodden, easily influenced by simple talk and rewards. When we discuss leadership, the charismatic leader should have little role today ,compared to one who is willing to lead by consensus. But during elections, charisma and oratory skills appeal to the audience and can alter opinions in selecting a leader.

Campaigns bring people together for a common purpose; to hear their point of view and why they should be selected. Some do it well as I noticed in one state where a power point presentation of the ‘state of the union’ was shared. ‘What have we achieved over the last five years?’ That was educative as good governance and effective management of the state led to surplus funds that could be used to improve the citizen’s life. The speaker likened the chief of the state to a responsible manager who was running a company for the people. The transparency of the accounts and justification for the various decisions made was a welcome shift from the usual “if I am elected I shall do……’ stance.

Reflections on the years gone by………

The ALLIANCE party led by the first Prime Minister Tunku Abdul Rahman was in power when I got the opportunity to go for an election rally at the Coronation Part in Malacca. I was probably 14 years of age but I knew about the election system and how the Labour Party and later the Socialist Front Party were putting up a fight against the ruling Alliance. They were supposed to represent the workers and the union likened to the working class revolutionaries of Western countries and the colonised countries like India, South Africa and Australia. Information officers used the becha (trishaw) and cars mounted with loud speakers announcing when and where the rallies were to be held. Prominent speakers I heard were the young Lee Kuan Yew (1963) campaigning for his People’s Action Party, PAP. This was after Malaysia had become a union with Singapore , Sabah and Sarawak joining the Federation of Malaya. The stage in the field (Coronation Park) was a lorry with its retaining side boards dismounted. The party logo was the backdrop and a gasoline run motor illuminated the numerous fluorescent lights on the stage.

The cunning Lee would provoke the audience and challenge anyone to debate with him. A member of the audience did come up the stage but was quietly removed by the policeman assigned to watch over as ‘the intended speaker did not have a permit’. Lee went on to tease about the slow growth of Malacca. The first Municipality flats built in town took more than several years. I remember Lee repeatedly referring to this particular construction, urging the listeners to come to Singapore and learn how to build flats rapidly!

Another speaker of the opposition much sought after was D.R. Seenivasagam. This imminent English educated lawyer from Ipoh was the leader of the People’s Progressive Party. He spoke English with an authoritative voice raising social issues that should be improved and perfected. Later, when I was in the varsity, I had the opportunity to listen to these pundits during the ‘GREAT DEBATE’ sessions.

The Municipality of Malacca would hold its own elections to choose the Mayor and Councillors and again the opposition would be very vocal about affairs of the day. Hasnul Hadi, an opposition leader drew huge crowds when he was vying for the Mayor’s post, but this did not translate to winning the election.

Revolution or Evolution

Last Friday , a group of nursing students were looking for a room in the Clinical Skills Unit which they could use for practising a play they were intending to put up for Nurses Day on 12^th May 2013. When I was trying to facilitate them in getting a room, I asked them what the theme was. They replied that it was ‘the revolution of nursing’. I was surprised that the nurses had revolted at some point in time!

I explored further if they knew more about the history of nursing but the reply, in unison, was Florence Nightingale who had started off life as lady of some good measure. I then spent some time asking them to further explore the subject and think of ‘evolution of the nursing profession’ rather than revolution. History of Medicine makes a lot of sense if we had some time to savour this aspect before contending with the commercialization of medicine.

My Many Firsts.

This small encounter made me reflect what I consider, now history. Again in my formative years they were many firsts. They impacted on our lives . They were the beginning of many more developments which we now take for granted.

The Cathay theatre was completed around 1963 opposite the old bus station before the bridge over the Malacca River which leads to the present Hang Tuah Road. The latter was known as Buovana Vista Road then (of good view). The first movie screened was Rockabye Baby starring Jerry Lewis (the comedian). We could only afford the 65 sen third class ticket. This comedy was good for a laugh and worth all 65 sen. As we cane out of the theatre at about 7 pm there was a lorry distributing free bottled drinks. This was the first time I was exposed to SEVEN-UP, a lemonade drink. Prior to that we only knew of F&N drinks which came in larger bottles and the local production by LONG CHAN.

If you walked down the opposite side of the CATHAY theatre towards Wolferston Road where the Capital theatre was sited, what is now Bunga Raya Road, there is a busy junction. It was here that the first traffic light was sited. Amazingly it drew a huge crown over the next few weeks (as it only worked at night in the beginning). People just stood there watching the lights change from green to red to amber!

My first bicycle was purchased from a pawn shop for 28 ringgit. Though it was a second hand bicycle, it was in immaculate condition. The pride in keeping it cannot be described in words. The first week was spent cleaning the mud guards at least daily and giving it a good wash weekly, polishing the steel rim of the wheels became ritualistic. The more comments you got from your school mates that your bicycle looks ‘fantastic’ the more you polished it till my father said that I could not purchase Brasso for the next three months! Although the most popular brand was Raleigh, my Robin Hood soon caught up with the adolescents. What appealed to us more was that it was made in England. I remember that you could not ride the bicycle without lights operated using a dynamo which was in contact with the moving wheel. This was a novel idea as the dynamo used to last forever. This earth was kept ‘green’ then as there was no need for batteries and there was no need to dispose off ‘exhausted battery’. After 1962 there was police statement that all bicycles were to bear an illuminated red reflector at the back. This was on top of the non-illuminated reflector that came with the bicycle. This meant we had to go to the bicycle shop to buy a bulb and case with some electric wire. It did not cost more than 40 seen then. Failure to comply resulted in a fine of 20 ringgit. Bicycle thefts were far and few. This was because all bicycles were locked when left in public places. Moreover, you could not sell your bicycle unless you produced a sales-purchase paper.

Game for anything

The other day, as I was returning from my evening walk, I caught the sight of two Punjabi children, sons of a neighbour known to me. I had not seen them for awhile but they quickly recognised me acknowledging my presence. One was 6 and the other 8 years. They were playing with a football. I engaged them by asking them to kick the ball to me. The younger one was so enthusiastic that he started chatting wanting to be the best soccer player in the world. Just then I wanted to test my own skills and if they were still there and if the joints will be kind to me. To my surprise I could lift the ball off, with my toes so as teach them how to catch it without letting it slip off. I showed them how to perform a ‘dead stop’ when the ball came rolling towards them and how to use both feet focussing on the position of the ball on the field as it approached rather than attempting to move the body so as to stop it with the dominant foot. They kids got so engaged that they did not hear the Indonesian maid beckoning them to return home as the sun was already setting.

That reminds me of my early life at school. Our school days were never complete unless we were also involved in the sports arena. Although I have played almost all field games I only managed to play for my house and not for my school. I remember very vividly when Mr Tan Tiek Kok was trying to select a junior rugby team I went for several practice sessions. My small build did not let me take on the role of full backs but I was particularly quick at being a scrum-half. After four sessions came the selection of 19 students. I was quite sure I would be selected but Mr Tan overlooked me. That pained me. A stocky guy, Reddy, who had been selected to be the full back, asked why I was not selected. Mr. Tan replied that I was rather thin and may get hurt-. I was shattered.

Athletics used to be held during the mid term and all school children had to participate. Although I had run the 100 m (110 yards) for the school invitation team , I did not make much progress in that area and thought I could develop more stamina and go for the 400 m ( they were referred as 440 yards). Some practice runs before the finals (of 8 students) improved my confidence. Almost all were about my standard. So I wanted some tips to get within the first three . The athletic teacher said I had to develop my own strategy if I was to win. I had no idea what it meant. Observing the A division students run, I noticed that the winner had increased his speed by the turn of the second round (of e two rounds of the school running track). That would be the last 100 meters or so. I adopted a similar strategy as our B division race was just after the A division. We set off well after the gun went and I sped off the main pack increasing my speed after the first round, only to realise I had started to speed much too early leaving me with another 200 meters to cover. I was exhausted by the time I had covered 300 meters and my eyes swelled with tears as I saw three of the pack behind me ,overtake me. I struggled to finish the race in fourth position and went home in despondence without a medal.

I needed strength for javelin, so I dropped that; pole vault left me in the pit without as much so as even lift myself off the pole, hit my knees when I tried the hurdles and did not make it far with long jump as I lacked height. But I had not tried high jump. I got myself into the last eight and began some practice jumps. The straddle was in fashion but the fall was broken on sand and not cushion. That was a bit painful. Initially , I did not have much hope but as they kept raising the bar I became better. It appeared to be all in my mind! I had to ‘hype myself’ and then, each time I approached the bar I got confused as to which foot I should take off with. This led to my failure eventually. Again I landed with a fourth place. I did no cry as this was a new event and I had achieved something.

When I was in Form 1 I enrolled in gymnastics and went to the sessions weekly. My Chong taught us kiddies the rudiments of jumping, rolling, standing upside-down on our heads and various other moves. There were no parallel bars and high swings though as the school could only get enough funds for floor exercises. The enthusiasm was not sustained as I dropped out after a year.

I liked soccer and field hockey. All classes had to form teams and to encourage maximum participation the school organised inter-class competitions when I was in Form 2. That brought us all onto the field almost every Saturday in the third term. My class won the inter-class competition. The sports classes were always after hours and that meant coming back to school at 4.00pm. The high point of these afternoon sessions was the idle chatter we got involved after the games till late evening. The conversation ranged from, if anyone had ‘The Lady Chatterley’s Lover’ by D.J. Lawrence to the why my volley ball playing faulted. We discussed how soft ball appears like rounders and why the game lost its appeal after Mr. Pond, the American Peace Corps teacher left the school to go back to the United States.

Growing up in Malacca and attending the Tranquerah English School (primary) and the Gajah Berang English School (secondary) was fun and educative. The interactions with the dedicated teachers impacted on our lives. The holistic approach inculcating basic education, teaching debating skills and introducing a degree of sportsmanship was appreciated by all. The opportunities to excel in any field were huge and many exploited it. The loyalty one had for our school was tremendous.

Conclusion

The world has changed with climate change and environmental pollution affecting health and life. The politicians draw the fate of their citizens through both good and bad policies. Elections come and go and hopefully good citizenry and responsible governance will reign. Our early education in 1960s and 1970s prepared us to meet challenges and prepare for the hard crash, if and when they come. We learnt to live without race issues and discrimination. My Chinese and Indian friends were not only my buddies but also my soul mates. We were exposed to good leadership and healthy habits. Face to face communication was the order of the day as television only came so much later and hand phones were not heard of. Only the rich homes had telephones in their homes. Many of the current leaders have had a different kind of education and that would certainly influence how they make decisions and draw policies. We hope they will draw on the wisdom of the many senior citizens to craft good laws and regulations to continue to sustain this country harmoniously.

Sivalingam

12 May 2013

Corporate Social Responsibility: Whose baby?

2013-02-28T02:56:00.004-08:00

Corporate Social Responsibility: Whose baby?

Introduction

Recently there was much cynicism when carbon copy ‘payback’ was given the reason for tax adjustments in personal income tax in a developed country. The contribution to preserving the green of the world contributing to overcoming the effects of climate change was minuscule, said the consumers. The philosophy behind the move is noble as citizens now are talking about the adverse effects on destruction to fauna and flora as nations clamour to become developed countries. Social responsibility is being infused by responsible governments to organizations and industry...

Corporate institutions have been reaping millions of dollars and corporate managers having been rewarded handsomely with huge bonuses and salaries that appear unreasonable to the common worker. Though these corporate organisations are turning in billions of dollars, all come with a price, whether it is related to production of a vehicle or the building of massive townships; the impact on the environment.

Corporate Social Responsibility: what it entails?

The new ‘buzz’ word is corporate social responsibility. The thrust of this new action is to improve the image and the reputation of organisations and business concerns. Most companies in the corporate world have visions and missions and core values. Core values relate to humanization of the functioning of the organisation. Human resource managers are now told to tone down in applying harsh rules in managing human capital. They have been told to re-visit standard operating policy and be practical in dealing with workers; to be flexible and tactful. This is essential for sustainability and retaining human capital.

The place or work needs to be safe, convenient and happy for efficient functioning. The Japanese are known to be practicing good working relations with employees and clients. Loyalty and productivity is promoted when employer –employee relationship is more horizontal than vertical. Valuing the customer comes with attending to his needs and reviewing his benefits and compensation. Good corporate culture nurtured over the years promotes the standing of the organization.

The Essential Components of CSR

A leading columnist in the New Straits Times (21^st Mar 2011) talks about four essential components for corporate social responsibility (CSR) activities. Victor SL Tan summarises the four essentials of corporate social responsibility as to how the workplace is rendered conducive and convenient to employers, which would effectively reflect on the how the employer makes the workplace safe. I find the subject important enough for large organizations to follow. In fact it is good citizenry that corporations and business concerns contribute a portion of their profits to sustaining biodiversity of the environment through such activities.

Clearly the organisation should ensure the standard and reliability of its products, whether it is a commodity as in the plastic industry or educating students to be professional as in the education industry. Both internal and external clients would judge the product for its quality and timeliness of delivery.

Impact industrialization has on environment

Developing countries and developed countries are battling with the impact industry has on the environment. Profits cannot be the only goal of an organization should focus on. Environmental studies have indicated what price has been paid as a result of industrialization and large scale destruction of the forests and hills. Organizations will have to play integral roles in making the environment safe for both present and future generations. The Kyoto Declaration and several other International Instruments have yet to impact positively on climate change. Perhaps the little steps taken at organization levels would be more effective. Pollution as a result of irresponsible manufacturing processes has contributed to changes seen in the ecosystem. Regulators should be not being the only agent policing corporations and industry. It is the responsibility of all to preserve the fragile ecosystem of Earth.

Core values drawn by organisations cannot hang on walls within glassed frames. Enabling activities would be able to infuse a value system within the working environment. This value system would perpetuate corporations to play a greater responsibility to the community. Many leading organizations have been promoting corporate social responsibility activities but it is not enough... Community projects initiated and supported by organisations have far reaching benefits in both the short and long term. Bill Gates has dropped to second place in the world as the world’s richest man largely because of the establishment of the Bill Gates- Belinda Trust. Huge sums of money from his trust are available for research in several fields including medicine and science, all for the betterment of mankind.

Conclusion

It looks like it ‘payback time’ for organizations and industry. Corporate social responsibility contributes to good citizenry. Keeping the workplace safe promotes both mental and physical health of employees and employers. Climate change is real and future generations are being threatened. War and physical conflicts prevail with little respect for human life. Lawmakers and policy advocates cannot implement the call for sustaining the environment if organizations focus on profits alone. The responsibility needs to be extended beyond the premises of the factory.

Sivalingam Nalliah

28 Feb 2013

THE CONSCIOUS MIND

2013-01-14T02:40:00.001-08:00

INTRODUCTION

Theology in the 15^th Century or thereabouts had a huge impact on life in the Western World when Medicine took a back seat after enormous strides had made in understanding disease in combating infectious ailments and modernizing midwifery practice prior to that. The plague was seen as a curse on mankind and burning women as witches prevailed for a hundred years. However, in the non-Christian world, religion ordained ethical and moral practice and promoted scientific understanding. Eastern Medicine progressed with vigour in India, Persia and China. After the dark ages in Europe came a period of Renaissance when architecture, art and music became prominent. Colonization of the East, Africa and the Americas in the 17^th and 18^th hundred enabled the permeation of Western culture with knowledge and wisdom of the East and other nations of the Incas and Mayans.

December 21, 2012 passed by with a storm hitting our homes in Shah Alam. The sky was dark and lightening struck with such anger that it knocked off the automatic gate electrical system and the ICT modem in our home. Although the world was expected to end that day , according to the Mayan calendar, it did not, but the ferocity of the storm which struck that evening ,punctuated with a ‘whirlwind’ warned us the true effects of climate change and the instability of the weather. The flood mitigation system fell like a collapsed pack of cards as the highways plying our housing estate was flooded causing massive traffic jams.

THE CYCLE OF LIFE

As we trace mankind’s journey through the ages, it seems to come in cycles of order and plenty during the times of the Greeks and Romans in the West and growth of civilizations not very different from that of the Greeks in the Indus Valley and Sumeria in what is now Iraq. Then volcanoes erupted to wipe out civilizations, societal decay destroyed moral norms and disease eradicated thousands. We have heard about the ravaging effects of the plaque, small pox and cholera. A lack of identification of disease ad microbes placed the blame on spirits and evil forces. Following such devastations often came reigns with sensible approaches to life and rehabilitation and meaningful livelihood. The cycle is repeated and life is reorganized.

EVOLUTION IS PRESCRIBED

The world did not end on 21^st Dec 2012. We are now edging on in 2013. Geopolitical changes will carve out new patterns for living things and humans will need to take stock of lifestyle changes. Why confuse climate change with people and theology. This perplexing problem haunts me and as we grow with age we begin to philosophise, re-visiting the facts and myths and their origins. While man has made huge strides in understanding the universe, he also confuses us. When Copernicus delved in Astronomy and his discoveries he was scorned upon in the beginning and then we started accepting his views. Later physics took the forefront of new discoveries with Newton and the like explaining gravitation, matter and velocity before the Quantum theory came into the equation in the early 20^th century. Do we have all the answers? Do we accept Darwin’s ‘Origin of the Species’? The National Geography series simplifies many facts based on the evolution of living things.

Recently I watched a program where the commentator eloquently sets the scene with the whale, a mammal electing to lose its limbs, converting them into fins and remaining a huge animal with its carnivorous habits. The deep seas permit such an evolutionary change. The sea lion on the other hand, takes on a dual habitat depending on the deep seas for its food and learning to live on land! The penguin is a bird that elected to lose its ability to fly and walk upright staying on land in the Antarctic.

The Gods must be crazy to create diversity in both the plant and animal kingdom. But do we not see the adaptation to survive, procreate and preserve with the change in the environment. The ‘Dark Continent’ of Africa has some severe living condition even without poverty and war. The skin colour adapts the people to the hot dry weather of the sub-Saharan desert. As one moves up the Mediterranean Sea the skin colour changes to that of the North African, Greek and Roman-light skinned.

Move on further up north and the fair skinned blonde looks of the Scandinavians becomes apparent. Adaptations will continue to prevail with environmental changes and food availability. A simple example is how the dead body is disposed. If a death takes place while on a ship, a sea burial is in order. When wood is available, cremation appears to be in place. Many of these adaptations are justified by custom, religion and circumstances clearly indicating an alternative means of accepting life. The malleability of the human and animal is integral to its survival and we need to bear this in mind. Rigidity of practice, inflexibility of thoughts and dogmatic adherence to archaic way of life would pose a barrier to revolutionary and evolutionary thinking deterring adaptation and improved living.

FACTORING THE CONSCIOUS MIND

Hinduism remains a mystery to even those who practice the religion. After 35 years of both formal and informal worship, I understand that Hinduism is not a religion, by conventional definition, but a way of life. When empathy erodes because all and sundry are judged by others and measured using societal standards that can be questioned we begin to fall back on the thoughts that not all actions and thoughts can be explained by scientific understanding where a hypothesis needs to be generated and an experiment done so as answer the primary question. Many continue to ponder what happens after death and if there is a soul. When a the first heart transplant was done in South Africa , an old aunt of mine was perplexed; what would happen to his ‘soul’ assuming that the soul resides in the heart, a functional component that perpetuates our very being! Saints and theologians have delved in this subject in depth and have explanations and views. The subjective truth is not to be discussed here but as long as religiosity remains a part of society we need to live in harmony with the views of those who profess the soul and empathy. There must be some truth in this non-tangible feeling we have (not just the functioning of the autonomic nervous system of fright and flight). Why are some so very empathetic and then there is the ‘animal’ who maims and disfigures other humans? The horrendous fatal gang rape of a young medical student in India recently is a classic example.

WHEN DOES LIFE BEGIN?

The wonder question I now ponder over is what life is. When does it begin and what happens after death. Google the subject and up springs a volume of literature far too much to read. Does life in humans begin with the successful formation of the embryo? Does it begin with ensoulment even before birth? These questions have been answered rather convincingly by theologians and those concerned with the sanctity of life. Cells that are known to exist in its fundamental form are ‘alive’. The single cell organism continues to thrive exhibiting all the characteristics of living i.e it respires, reproduces by cleavage, excretes its by-products and gets its nutrition by engulfing what is available and suitable. If this is what being alive is, then the embryo stage is way up the evolution ladder. It then is comprehensible that current terms like ‘living and the soul’ have outlived their meaning and one needs to look at subatomic definitions for being alive. This way of redefining ‘living’ ultimately leads one to consider energy binding atoms and subatomic parts as being alive!

BEING CONSCIOUS

Philosophy, Psychology and ancient spiritual teachings frequently visit the state of awareness of either internal or external stimuli by referring to the mind, ego and superego. The branch of metacognition, which later got incorporated into ‘thinking processes discusses in great depths, layers of consciousness. The Hindu mantras relate consciousness to the universal sound’ AUM’. The deep thinkers go further to discuss seven levels of consciousness. If we were to apply the spiritualists’ teachings to science we begin to understand how much we do not understand. I discussed earlier that science and mathematics are based on proving a theory correct by equations and observations. Einstein brought us to the edge of uncertainty by introducing space and time through the theory of relativity. If two trains were moving at the same speed in the same direction each of the observers in opposite trains would have the illusion that they are motionless! Time and space are relative to the observer.

This stubborn illusion stays within our conscious mind and makes us think that there is a force beyond simple scientific explanation, yet to be discovered. But the basic principle we have to bear in mind is that without consciousness, time and space comes to nothing, nought! The quantum theory underscores this notion; particles exist even if we don’t persist’. What does this mean? The mystery begins when we enquire if there is life after death! I am pondering if the energy released from the body after death remains as consciousness (or is consciousness, energy that is to evolve and be incorporated into new cells!).

BIOCENTRISM

Robert Lanza, a scientist and theorist, introduced the concept that physics and chemistry cannot explain in entirety everything unless it was threaded through with biology. He uses the term ‘Biocentrism’ to explain life. Life creates the universe and not the other way round. It is quite gratifying in seeing some sense in this revolutionary way of thinking. Neuroscience of today underscores the primary theme of consciousness that creates reality. The schizophrenic patient and those with intense depression hallucinate, even normal people have illusions and inexplicable dreams haunt the ‘unconscious’ mind. Just as time and space depend on perception (they are not physical in the true sense), consciousness becomes a critical part of the universe.

A common event I see in the clinical wards is the ritualistic ward round when an intern scribbles away what he perceives as ‘reality’; not what actually occurs. The ‘animal observer’ creates reality and not the other way around. Most of what has been discussed during the ward round is not captured in the patient‘s bed head ticket, only what is perceived as reality by the illusionary views of the intern.

Lanza’s (with Bob Berman) theory of biocentrism appears aligned to the ancient teachings ( Vedas etc.) that consciousness not only generates but governs, and becomes a physical world. This brave new re-look at life is perhaps not new but puts in perspective what we have not been able to do, weave the basic principles of ancient teaching zooming down to consciousness in explaining the very tenet of life and its existence. Biology meaningfully builds on physics and chemistry. Biocentrism unravels the confusion we contend with when we pretend to understand the puzzles of science (Heisenberg’s uncertainty principle, the double-slit experiment, gravitational forces, and laws that shape the universe as we perceive it). Though there is radical opposition to what Lanza theorizes, he tries to convince the audience that the 200 or so parameters of physics governing the universe remain as such, orderly and ordained, so as allow the existence of life and consciousness.

CONCLUSION

I was quite surprised and disillusioned when I learnt that Pluto is not to be considered a planet in our universe, after I had firmly encrypted in my mind all the planets (Venus, Mars, and Jupiter etc.). It became even more unsettling that some of the planets are not solid! If you Google for more information, one would come across more inconsistent information which we have taken for granted for many years; what makes the core of the earth?

With age comes wisdom, so we say; but it also beckons questions about the beginning of the universe and what reality is. The human has evolved over the years and has become a complex organism. With this evolution comes intangible process of life and consciousness. If we break down the body we will eventually talk about subatomic particles involved in wizardry of reactions using and dissipating energy in some form (ATP, ADP etc.). A knowledge of physics and chemistry helps explain events and signalling pathways. But when illusion and hallucination are thrown into the equation of consciousness, we become perplexed of the complicated circuitry that needs further elaboration. What is time? Is it the inner sense that animates still frames? Appreciating spatial orientation needs energy and consciousness. A dear sister of mine was in ‘coma’ for two days. When she came out of her stupor she described a ‘beautiful garden with flowering plants and chirping birds-so serene, that she warned us not to wake her up should she go into yet another stupors state! That is the conscious mind, the beautiful mind. Time and space are but tools of the mind and we need biology to explain the intricacies of life and consciousness.
We will be continuously applying science and mathematics to explain the parameters that govern the universe. We are yet to be convinced if we can explain life, soul and consciousness.

Sivalingam Nalliah

13 January 2013

Initiating change for sustaining Mother Earth

2012-10-18T19:51:00.000-07:00

Introduction

The drive from Auckland to Wanggeri in Northland, 160 km north, was a scenic one reminding me of the calm and quiet green farmland of North Wales punctuated with hills of primary forest and windy roads lined by well cropped grass on the kerb. Watching the flowering dandelions on the edges with wild white lilies kept me away from dropping asleep after the 10 hour flight. The air was fresh as it whiffed through the slightly wound down quarter glass of the car, air conditioning was not needed; it was spring time. Although rain was forecast we were surprised by the sunlight and brightness of the sky with periodic shut out as the cloud laden with rain drop passed through. After two hours we were at our destination, again taken up by the cleanliness of the place and the general concern for civic mindedness.

The city council must have been efficient in upkeep of the surroundings as the grass along the roads were no longer than six inches. This was fern country and one could count numerous types of ferns ranging from bushes to trees mimicking palms. The pattern of the leaves gave way to the nomenclature, whether they we single lobed or multilobed leave, if the branches tapered as they drew towards the terminal edges and if they were flat or filmy in character.

People in the city were all aware of the ozone layer and kept reminding us to apply sun lotion to protect our skins. The winds were strong and chilly from time to time as the east coast was open to the Antarctic. Cycling is encouraged and pollution is to be kept to a minimum. Home prepared bread, celery and lettuce came from the back garden. Fried food and takeaways are frowned upon and children are encouraged to stop snacking. Milk is expensive although produced in the country as there is little subsidy from the government.

The Kyoto Protocol

I needed to update myself, but I am not sure if the US and Australia have signed the Kyoto Protocol as climate change is real and our Mother Earth will inevitably become barren devoid of humans and plants by the next century if conservation of energy is not put in place, war and destruction are not stopped, when oil as a source of energy runs out and food production does not increase. We have ourselves to blame as we take the environment for granted and many make little effort in moving away from depending on liquid petroleum and don’t educate ourselves and the young how we should correct the inequity in resource allocation and utilization worldwide.

The Transition Initiatives

‘The age of STUPID’ portrays the reality of pending disaster as Pete Postlethwaite’s documentary film (which was nominated for an academy award) rapidly dashes across the globe bringing up valid points that is destroying the planet. We were made to watch this movie borrowed from the city library. You could borrow almost everything from toys for children, magazines and periodicals large print books for the elderly and fiction novels. The archivist in Pete (the movie) brings us to the year 2055 and relents as to why we did not see the warning signs of destruction and why we did not change our current consumption of both energy and food practices. The minuscule steps taken reluctantly by governments in the right direction in attempting to save the planet are marred by greed and corrupt practices in the name of progress and development. Huge housing development and industrialization are clear testimony of deforestation (without reforestation) and environmental destruction. China is apparently draining resources and energy of the world at a rapid rate and much of this is related to relocation of Western industry hoping to make huge profits from low costs of production. When we hear about businessman stating he has made his money from being a developer, cynicism relates to the activities of such people, ‘are they developers or destroyers?’

Picking up a book entitled ‘The Transition Handbook’ by Rob Hopkins in Wanggeri (pronounced Fangarey) in Northland (New Zealand); I found it a hard book to read. There were so much revealing facts that lay the forum straight, the way to doomsday. But there is so much sense in it that I could not resist putting it down. Two terms comes out clearly i.e peak oil and climate change. Would you believe that almost everything we touch or feel converges on oil, let it be cosmetics, furniture, food or cooking. The historical origin of oil is worth repeating. Formed from zooplankton and algae, both of which are found on the ocean floors millions of years ago got deeper and deeper surviving the effects of global warming over millions of years. Buried so deep down chemical transformation caused them to become what we now know as oil. Natural gases, on the other hand, though formed through similar processes had their origin from the remains of vegetation. It was formed as a result of excess heat forming as a result of its proximity to the Earth’s core –crust. This brings in the concept of fossil fuel. Hopkins provides so much practical information that I feel should be part of everyday life, we need to share such information with our children who would be clearly be throttled by 2055, devoid of clean air, oxygen, vegetation, global warming and a lack of food supply!

The bare facts

A tank full of petrol (40 Litres) is said to be equivalent to four years human manual labour. Hopkins continues to give us simple facts like the energy to maintain a US citizen is equivalent to 50 people continuously cycling back and forth in the backyard, day and night! Jonathan Porritt has succinctly put his views on state governance as ‘What is remarkable is the failure of politicians to start planning in any way for this inevitable transition, or even to start preparing their electorates for this transition’. Our reliance on oil will spell disaster if we do not make a concerted effort to address its expected natural depletion by 2050.

The thought that climate change is for real is not realised in Malaysia where the rat race is on and children are taught to take up politics and business if they want to be progressive and to get their Porsche and get jet setting. The lifestyle change is apparent as eating out is fashionable and food stalls are open 24 hours a day. We hang out, so to say, and having a drink at all times is on. Throw in the new breed who don’t’ mind departing with RM 15 for a cup of coffee or RM 11++ for a mee Bandung in a Kopitiam outlet. We do not feel that there is food shortage worldwide and many thrive (or don’t thrive) for less than US$1/- a day!

The Green Book

The expressed feelings of wanting to do something for the community and the environment appear to be left to a few activists who seldom get into the limelight. Few know that talcum powder should be banned but the industry has too much to lose so we advise citizens to avoid using it even though linkage to cancer and lung disease has been known for over three decades. Self-reliance is not new to us as the second Prime Minister; Tun Abdul Razak introduced the ‘Green Book Plan’ in the early seventies when households were encouraged to grow their own green vegetables. This was indeed a wonderful plan, but it fell by the wayside not long after. Today we import vegetables from Thailand and China and worry about the use of pesticide. Tons of food we consume are imported which tells us a story, a story of a lack of resilience, the lack of wanting to be self-sufficient and the need for oil to grind the system.

Winston Churchill (quoted by Hopkins)) had this timely statement, when the internal combustion engine was introduced, ‘I have always thought that the substitution of the internal combustion engine for the horse marked a gloomy milestone in the progress of mankind’ (1954). Machine and computers have taken on several tasks and contribute to pollution endangering the environment. Transport is by far one of the largest consumers of oil and contributes to enormous amount of pollutants. It is an undeniable truth that development has paved the way to the threatening effects seen today to climate and environment. We have been party to this destruction by seeking more funds to build faster lanes and improved urban transport. Walking to school is a no go as the roads are not safe and parents are fearful of child kidnapping! We look for school buses to send our children, vehicles which have seen better days. It is perplexing how such old junks have been permitted to ply the roads emitting enough carbon monoxide to maim a few thousand persons a year.

Getting children and youths involved

How do we educate our children about ways and means to save this planet? Should we permit educationists to draw new curricular to ensure children of today are well versant in maintaining a sustainable environment. Focussing on conventional curricular which sets our children to obtain high marks would not create much awareness.

It has been said that Governments of the day do not lead but respond, in other words they are reactive and not proactive. Is this true? If this is true, it appears that the local community needs to take the lead in creating communities that care. Care about the ill effects of globalization of industry and economy, care about the carbon emission and care about why children in Africa and the war torn countries must suffer hunger and death while obesity is an issue in developed countries. Pete Postlethwaite’s ‘Age of the STUPID’ has an animated cartoon which diminishes the wealth and eases access to energy and luxury in Western countries and increases that for those in need in Africa and Asia so as to establish equity in all aspects of life.

It would be futile not initiating the positive approaches that are in vogue in UK, Australia and New Zealand. Having read Hopkins’s book ‘The Transition Handbook’ I thought it is worthwhile incorporating much of what is written in this column. In Chapter 8 he addresses Transport, Energy and Housing briefly. Private car ownership should be reviewed so as to give way to pedestrians and cyclists with a re-prioritization of trams and buses using biofuel and alternative sources of energy. Car clubs have been introduced so that no one owns a car. Rural communities are re-organizing themselves to be self-sufficient in both employment and production. This would curtail immigrant labour and would lead to increased productivity of human capital within the nation. Can we see that age limits for employment should not be the order of the day.Grandads would be employable in McDonalds if they are active and willing? Supermarkets need not depend on foreign cheap labour if the senior citizen can work or permitted to take on jobs.

We have always been complaining of increasing fuel prices and air travel. Hopkins’ positively impresses on that cheap air travel is not cheap. We need to review our perceptions of what a holiday should be, flying off to Bali and Aurora or to curtail fuel costs by visiting the local resort or go hiking up a hill in the vicinity? He aptly includes H.G Well’s comment, ‘When I see an adult on a bicycle, I have hope for the human race’. The UK apparently has been able to reduce energy consumption by 50% with an equal increase in renewables through carbon rationing based on Tradable Energy Quotas since 2010. Each citizen and business is assigned a carbon allowance with a yearly reduction in the quota. This has literally made citizens live within their assignment. Solar power and wind turbines have led to better fuel use in the domestic front since 2010. Tidal power and biomass fuel have both contributed to reduction of domestic fuel consumption.

Energy efficient houses are now in vogue. The PassivHaus concept is used where locally sourced biomaterials are used in construction. Solar heat and even occupants’ body heat are used as renewable energy. New buildings are designed to use such locally sourced materials including energy conserving concepts. Communal building would not be too far in the future where facilities would need to be shared rather than have dedicated sites. Can we imagine that you will need to use the communal cooking facilities using your carbon quota should you want to cook a meal in future? Condominiums have adopted concepts of shared entertainment outlets and swimming pools with acceptance. It would not be long before one placed restrictions on villas and extravagant living if carbon quotas come into vogue. John Ruskin’s states (Hopkins) ‘when we build, let us think that we build forever. Let it not be for the present use alone, let it be such work as our descendants will thank us for.’

Reminiscing the past

When I was in early secondary school we were taught the usefulness of the coconut trees in that every part of the palm could be utilized. Apart from the coconut used for extracting cooking oil, we could use the husk for fuel and for cushion. The coconut shell could be made into a container or used for fuel. The trunk could be used for fuel and the leaves were dried for making brooms. Nothing was wasted. A similar role for the oil palm plant was explained.

Menkuang leaves were used to pack our mee goring as plastic paper and Styrofoam were not available then. We used kerosene for our oil lights and the empty cans were used as ‘metal pails’ to carry water from the village well which never went dry.

However, two years later, when I was in Form 5, I was made to understand that it was not profitable to grow coconut in plantations because of the difficulty of plucking the coconuts. There were no workers willing to take on this job. They were also not as profitable as oil palm. That breathed the death knell for coconut in Malaysia. Plastics replaced coconut husk as cushioning materials in the furniture industry. The plastic broom replaced homemade brooms made from coconut leaves. Not long after we were paying some RM 3 for a coconut drink; largely imported!

Ironically the Lincoln hemp building company in the UK was awarded recently for innovation in building as they devised a hemp based building material. One environmentalist once wrote about the danger the water hyscene causes. This green water plant grows at a rapid rate covering most ponds and rivers like cancer. Little research I know of is focussing on this plant with succulent leaves and pink flowers cum parasite. If we could work on the use of the fibre drawn from water hyscene so as to make some biofuel, we could curtail the spread of this plant parasite!

Oddly these imperatives are being exemplified with facts and figures but prudent and responsible living would have not got us into this state of emergency where initiatives have to be in place to ensure continued survival of humans, animals and plants. Rationing is not new to me as I have gone through life when daily food on the table and a roof over the head were issues to contend with in my earlier age. We used to divide our daily food quota so that each of us gets that slice of bread or that number of cream crackers.

The day I entered medical school the May 13, 1969 racial riots broke out in Kuala Lumpur. We were all confined to the University Malaya campus. Most of us were freshies and had left home for the first time in our lives. But we had collected ourselves to adapting to the new environment and equally, to new friends. At the Fifth Residential College where I had taken residence, we were fed at the college dining hall for the first three days after the curfew and one evening were called together for an address by the Master of the College. We were told what the curfew meant, that we were not to leave the campus grounds, that classes would not begin till more news was available and how we were to take responsibility in maintaining the college premises and self as no workers were expected to come to clean the toilets except for those already in the premises. Food stock will run out if the curfew extended and we were to be prepared for food rationing of fried rice with ikan bilis. Medical students were to help out at the University Hospital as they were in need of helpers in the cleaning sector and kitchen. Blood was also needed and volunteers were requested to submit their names to the Master of the college.

Permaculture

The movie, ‘Age of the STUPID’ needs to be seen by all as it summaries the goings on that are destroying Mother Earth. Clips on abuse of energy and food by some developed countries, plight of the illiterate and the overpopulated areas, the need for access to healthcare, the ugly oil magnate and the reason for the invasion of some oil producing countries by ‘war lords’ are clearly exemplified using multiple clips of life and hardship from various parts of the world.

Permaculture is a term seen in Holkin’s book which is a ‘conscious design and maintenance of agriculturally productive systems which have diversity, stability and resilience of natural ecosystems. It is a harmonious integration of their food, energy, shelter and other material and non-material needs in a sustainable way! (Graham Bell)’. David Holmgren has categorized some basic permaculture principles. These include the power of good observation so as design well for energy intensive solutions. As energy passes through our natural systems ways and means should be incorporated and developed so as to trap such energy. One principle to trap human urine for adequate nitrogen production for fertilizer. Compost and woodpiles are means of re-utilizing energy. Whatever measure taken should be productive. In one initiative, vegetable farming in UK in urban sites beside maintaining the lawn and growing flowering plants, produced gave incredible rewards.

Self-regulation and feedback permits sustenance and maintenance that is energy efficient. Using a well-designed eco-system overall where weeding, use of pest control and fertilizer would be in wanton. Renewable resources and services like soil aeration with worms and retaining soil by growing trees are welcome approaches. Reducing or producing no waste is a measure one can adopt through system design. Utilizing cycling methods rather than linear ones is the way to go. Trapping rainwater in our country should be part of housing designs. Seeing our daily chores from a wider perspective permits the design of new patterns of work. This underscores the need for diversity and creativity so that we can respond to change in a systematic way that contributes to the sustaining the environment and eco-system. A local newspaper, The Wanggeri Leader, had a movement that was educating children in school on how to manage e-waste. Reading on, there is much to be concerned about what happens to the old computers we leave with the ‘old newspaper man’. The scrap metal collector dumps them on to central collection centre and then we don’t know what happens to all the plastics and metal that goes to making the computer. Restoring old computers for use in those in need is an option that is promoted by some NGOs. Concerted efforts need to be taken that computer based gadgets last for longer periods than what appears to leach out resources today when leaders in the industry come out with new additions and modifications ever so fast to catch the eyes of the ‘trendy’. I still remember the days when my uncle used to have a Grundig radio that ran on a battery the size of a loaf of bread when electricity was not available. As the battery ran out the melodious songs became slower and eventually stopped. Then he would remove the dying battery and ‘dry’ it out in the sun for a few hours hoping to get a few more days of use!

More Initiatives

John Croft founded the ‘Gaia Foundation of Western Australia ‘developing the “Dragon Dreaming’ method. The four stages of his method are:

· Dreaming and visioning

· Planning

· Doing

· Celebrating and evaluating

Apparently only 1% of the dreamed project took on after the initiation. But it did not matter. What was important was to begin the awareness campaign, to be clear that the impetus for success comes from the two or three people who initiated this project that would contribute effecting change and reduce energy needs. We see that corporations of today have initiated CSRs but to what extent they have succeeded vary. Each project initiated by Transition Initiatives of Hopkin and John Croft emphasize that the members should make their own decision with organizations like local councils and state government only facilitating rather than driving them. The ultimate aim in all transition projects and proposals is to make them truly community led . It may seek support from local authorities but the aim is to be independent of coercion and stipulation.

Mick Winter (Hopkin), in his book Peak Oil Prep states that state governments ‘stay out of local governments’. It is the fear of initiators that such projects would be suppressed by the authorities but apparently this is not true as people in power may favour such projects and learn from initiators of such projects to influence and inspire their proposals and policies for energy conservation and various other developmental projects like housing, population growth, food production, public transport and housing.

Conclusion

The trip to New Zealand has made me read more on Sustaining the Environmental and conservation of energy through little moves and changes in life style. Mahatma Gandhi made salt from the sea when the British began rational salt in India. When one is pushed to a corner creativity and innovation begins. Climate change and the depletion of oil are both occurring and if the citizens of the day do not take heed we will commit ‘suicide’. It is our duty to educate the young and the old that we should not take things for granted and that we have to be part of Transition Initiatives in order to leave a liveable planet for the future generation. Recycle, re-use and renew today.

References

1. Hopkin R The Transition Handbook Finch Publishing, Sydney 2008

2. Croft J ‘Gaia Foundation of Western Australia ‘Four stages that any project will go through’ pp. 241-243

3. Winter M, Peak oil Prep pp. 147

Becoming a developed nation

2012-10-07T01:15:00.000-07:00

Getting set to go

Assigned to go to a meeting in Cambridge I had to make preparations sorting out the trip details and finding out about the temperature and weather as that would dictate the type of clothes I was to pack. It has become a chore getting packed as I also have to anticipate the numerous checks I have go through at the airport. Well aware of the long queue when one comes through Heathrow Airport I waited patiently as I moved the first barier (whihc said 'approxiamtely half hour to immigration' . As I would be coming in at half seven am and would not be check into my hotel in Cambridge till after 2 pm, I thought I should take a slow ride using the National Express Bus. Online booking was easy but stipulated I should take an insurance, so there I was, down a further pound!

The National Express stated it was a direct run, so I thought I could get a good ride and hopefully I could doze off after the 14 hour flight into London. Autumn was setting in as the leaves of most of the trees lining the M1 Highway had browned. There were miles and miles of farmland but they had been closely shaved off the turf. Bales of hay were steeped up on the edges creating a blanket of brownness over the once green fields. Strong winds made the few trees I saw bow in one direction while the sky was overcast with thick clouds. The sun peeped in between occasionally, as the bus trotted along.

I did not know there would be four stops on the way but that was okay, at least I got to know where Luton Airport was and the little towns littered along the way, with their quaint steeples and uncanny brick walled houses devoid of colour or plaster.

I did not have an idea where I should drop off in Cambridge as there were two stops and I had selected to hop off at Trumpington Park & Ride station. When I arrived at the latter it looked like as if I was still out of town and I sheepishly told the driver if I could not get off here and if he knew where Hills Road was (where my hotel was located). He answered in the affirmative but permitted me to ride into town with the remaining passengers, the last stop. A taxi ride brought me gingerly to the steps of the hotel, so I did not have to struggle too much with my luggage.

Planning to move around Cambridge

Planning to move around in a new place, finding the cheapest means of transport, reasonably priced restaurants and how to operate the washing machine have become a bit cumbersome at my age. Going through the internet to locate sites of interest is often so easy for the young of today. It has always been a problem for me - reading maps that don’t stay in one page but requiring a great deal of scrolling tends to make me lose orientation. I look forward for some saviour to help me trace the shortest route on a printed hardcopy. The GPS is something I have to get a hold of. This statement comes about as the young man at the counter in the hotel told me I could have access to the internet though the free WIFI –I-Cloud, while I was in the hotel. Planning to sort the internet access at night I planned to work out the times of the bus rides after dropping my bags in the allocated room.

The last time I had been to Cambridge was some 15 years ago when a scientific meeting was held at Selwyn College. As all had been planned then, and we had to reside in the college premises, I did not venture on my own except go to the River Cam to view the weeping willows, a sight one should not miss in Cambridge.

The bus rides to my meeting site was both educative and informative as one could observe the behaviour of the local people and also that of foreigners, many being students checking into the colleges as the new academic year was beginning.

Learning and leaning

In between boring deliberations on how to detect holes in condoms and what should be acceptable for clinical trials so that manufacturers of non-hormonal contraceptives will not find the ISO too stringent, I managed to escape into the city for the usual walkabouts in this University City built in the 1200s.

The King’s College has not changed much; in fact all the colleges have the same outlay with a large quadrangle of well-trimmed lawn and four storey buildings as if stacked like matchboxes with closed windows arounf the quandrangle. There are signs all over the qunadrangle , ‘No entry to visitors’. I was told that only the Master of the College is permitted to walk on the grass! Further down the road was St John’s College with a distinct sign at the entrance ‘Entrance fee for visitors’!
An uncanny remark by a British born Indian youth protesting to his friend pushing a bicycle caught my ear, 'Ridiculous them chargeing entrance fees to enter into the qunadrangle of St. John's College'!

The Round Church further down the road was yet another heritage building. As I was tracing myself back along St. John’s Street a young man stopped me asking me for directions to St. John’s College! He would not have known that I had discovered the site not 15 minutes earlier as he thanked me, hurrying along, as I pointed out the direction with an air of confidence.

The ‘Corpus Clock’ at King’s Parade in Cambridge shows a giant grasshopper clawing its way minute by minute to keep time shown on a 24 carat gold face shield illustrating both technological advance and creativity in line with development in this otherwise city well known for its traditional approach to excellent tertiary education. Just on the left, opposite St Benet’s Church, owned by the Corpus Christi College is the Eagle Pub, established in the 1400’s as Eagle and Child which was in close proximity to the Cavendish Laboratory in the 1950s, where Watson and Crick, the Nobel Prize winners (discovery of the DNA double helix) used to have their meals and drinks. Apparently this pub was the largest inn then and was patronised by these Nobel laureates frequently. A blue plaque hangs over the entrance reminding visitors of the historic event of the discovery of the double stranded DNA, even if one does not know what DNA stands for .

The contrast in style in these landmarks is the demonstration of collective pride exhibited by the residents of Cambridge; the need to recognise the effort of others so as motivate readers to move on in life, modern or traditional. The short five day trip to Cambridge made me realise the sense of sensibility that was apparent everywhere. The developed nation status is not about being able to put up the tallest building and having the highest per capita income alone. It is about sustaining a social state of caring for its citizens and maintaining a safe place to live in.

Sustaining a safe environment

Being environment friendly the buses boast of being fuel efficient and low emission. Drivers are pleasant in assisting people into their vehicles and it is so heartenin to hear both locals and visitors thanking the driver each time they alight at the end of the journey. Professionalism is at its best in these dedicated workers who pride over efficiency and accountability. Timeliness is in built and if the UNI-4 bus is expected to arrive at the stop at 0740, it does come in time (+/- 2 minutes). Walking 20-30 minutes to their destination is not uncommon and I have not seen that many bicycles in Cambridge since I read that China had the largest number of bicycles in the world. I see the shift in the re-awakening of citizens in this city bicycling to work compared to automated travel e look for in our country!

It was in the sixties when I cycled to school that I always wanted to know where the nearest bicycle repair shop was before I went on my destination. The commonest problem then was a bicycle puncture. I remember vividly the Chinese bicycle shop owner who had a small wooden stool to sit and a metal cross bar made from metal pipes to hang the bicycle over its cross bar so that he can freely wheel the punctured tyre. He would exteriorise the outer tyre so as to deliver the inner rubber tube; completely get it out of the rim and re-inflate to detect where the puncture was by dipping the inflated inner tube systematically in an old half cut metal drum filled with murky water. Once the puncture site was recognised, this area was dried with an old rag, and then sandpapered before glue was applied with his finger. A pause followed as the glue dried and an e patch of rubber cut from old inner rubber tubes was placed over the site to fix the puncture.

It was pleasing to see a number of bicycle repair shops in Cambridge; the clock appears to have been wound back! It is not so back in Malaysia where the youths of today either want a car or a motorbike. One afternoon, as I was riding the bus to my meeting site, I overheard two youths , clearly from one of the EU countries (probably Spain) who had just been admitted to one of the colleges in Cambridge discussing in depth about which bicycle to buy and if a second hand one for 140 British Pounds was a good buy. The conversation went on to the cost of the course and how to get the best deal with sharing accommodation. As the European economic squeeze is being felt by everyone , Britain is not spared and the common man on the street is aware of getting the best deal, how to get a bank loan for the university course and what the job opportunities will be available in the long run. Two of the women delegates at the meeting I was in were lamenting about the how the children will cope after they graduate, will they have a job, how are they going to afford a mortgage to purchase the first house and are the banks safe to look after their deposits.

Caring for the maimed and ill

The politicians are the target of all newspapers. There is so much talk about how millions of pounds were lost because of a failed railway project and how the National Health System is slowly being given less money to run the healthcare system. Britain had one of the best health care systems in the world, a system born after A.J. Cronin’s book, the Citadel. Developed countries have thrived well over decades as healthcare; education and housing were all taken care by the government of the day. The Scandinavian countries have such an enviable and excellent social system that one does not mind paying taxes during their active working lives as they would be looked after in their retirement years.

Conclusion

Developing countries will need to strive to developed status by getting the priorities right- education is about responsibility to the environment and accountability to a safe and fair system for the people. Rapid technological advances have advantages in precision and efficiency but a cost- eco-friendly approaches are mandatory. If one is save the world, producing graduates ready for the market should be the aim, healthcare should be affordable and accessible to all and agriculture and food should be given reasonable place in any budget drawn by governors of nations.

Sivalingam

7th Oct 2012

6^th Oct 2012

Deschooling Society, Unschooling Schools and Institutional Neurosis

2012-08-31T04:14:00.001-07:00

Introduction

The morning is not complete without interaction with patients and doctors. I continue to share what I feel about medical education with younger specialists and doctors whenever the opportunity arises. My observations are rendered irrelevant as medical care has evolved to take new dimensions .The impact of technology is now seen in the forefront of diagnosis and care; little do we see reasoning and how clinical skills helps in arriving at a diagnosis. Although I want to hold onto the old adage of great clinicians like Osler and even the teachers I learnt from in medical school some 40 years ago, holistic care appears to be relegated to the back as the patient is compartmentalized into systems and organs. In medicine, variety is not the spice of life. If I am a patient I do not want to be ‘processed by different specialists and doctors ‘for me to get appropriate care. I don’t want the imaging department and the laboratory to dictate what my diagnosis is. But I can just lament as two generation have come in since I started practising medicine.

Ritualism and Social Oppression

The ritualistic ward round I see today is no longer relevant to me as I walk through the wards. I choose to go and see a patient who appears to require some counselling or clarification about her ailment. It is not uncommon for many patients to declare they do not know why a surgery is to be done though they have consented to it; a combination of fear, wanting to know more from a third person and inadequate understanding as a result of language are often the reasons.

I sense a commonness and personal alchemy when I read the commentary by James Drife, Emeritus Professor of Obstetrics and Gynecology at Leeds lamenting and reminiscing the 40 years he had been with the National Health Service in the UK , quoting Alan Bennett ‘s play (1968), ‘our generation was sick and tired of hearing our elders reminiscing’. But he goes on to say that much has changed in caring for the sick, for the better or worse is debatable. Certainly it has become costly to fall sick as medical insurance companies and managed care are now part of modern medical care.

Talking of ward rounds, what do we see today, the consultant does a wiz round, and if he is not available, patient care slowly shifts to the second rank of young specialists and medical officers who are at various stages of training? At times it is comical to view the scene when two to three specialists walking through the ward from bed 1- bed 48 rather predictably with another 3 trainee doctors and perhaps 5-6 interns. No indication of personalization or prioritization can occur with such a large troupe! Additions in the bed head ticket like ‘patient not in bed’ (because she has gone to the toilet) throws the responsibility of care on the patient! An authoritative prescriptive command as to what is to be done for the patient after being told about the case, a wry comment and the procession moves to the next bed, a clear sign of paternalism and ‘I am in charge’ attitude. A path of least resistance is taken as the junior most doctors quickly scribbles on the patient’s notes, whatever he/she gathers from the encounter, without comment or clarification. The entry could be ‘change antibiotic, get MRI done, and trace the urine results. He rushes to the next bed just in time, as the procession would have moved on not waiting for him to complete the task of entering the wise words uttered; ready to scribble again! I am reminded of Omar Khayyam’s ‘…the moving finger writes and having writ moves on…’

What has happened to professionalism and patient care today? It worries me a great deal. How do we teach empathy and social interaction? What has the medical curriculum done in developing the professional today. Something is missing here, old I may be, but there is gap, a missing link. Something has happened to society and what appears apparent. Is it the education system?

Institutional Neurosis

Many a time, I drop in later in the morning after the routine ward rounds are over as the resident and house officers are left to complete the tasks of the day, clerking new cases, performing discharge summaries, getting appointments from radiotherapy etc. Last Wednesday, two days after the Hari Raya break , the ward was literally empty. One medical officer was at the nurse’s counter with four house officers. I thought I could share my wisdom and hence came around attempting to evoke some enthusiasm in in each of them. The severe disappointment was a lack of appropriate response to almost all the questions I asked although they had all just recovered from a consultant’s ward round. Doctors today work hard but they could make it more productive and efficient if we got rid of redundancy of reviews, progressive approaches and continuity in care. Ritualism does not give rise to quality care. When a senior doctor is assertive and does not provide for deep discussion, we lose out in exploratory learning. We are task oriented and we get jobs done and fail to give complete care.

Working in an institution for a period of time promotes ‘ordering’, following routines and fulfilling the work plan prescribed to complete the task. What I am amazed is the lack of breath and depth in knowledge of doctors today. Education in schools has done something ‘terrible; that after completing 5 years of medical education, they lose out on enthusiasm and the goings on outside the field. I am generalizing here but few doctors in their junior years , whom I have asked know current affairs, the plight of the oppressed in other countries, what countries are in Africa, the ancient civilizations, who invented the television and what the Annual Budget released by the Prime Minister in Parliament means to the consumer. Good citizenry is required of these young professionals to pave the path to freedom of thought, to be innovative and have great imagination to work to develop a utopian world.

When I was a student in the Psychiatric ward, Dr Teoh J I talked to us about ‘institutional neurosis’, where long staying patients go into a state of apathy, are submissive and lose interest in the surroundings. Enforced loneliness and loss of cognition contribute to a particular attitude and appearance they take. An exploratory article on the subject is written by Russell Barton (1966). Sometimes, I wonder, does this only occur to psychiatric patients only!

Deschooling Society and Unschooling schools

I mentioned that these bright kids who entered medical school with such enthusiasm and vigour go through five years of doctrinated learning and evaluations, assessments, examinations and information that appears to nullify that initial ‘oomph’ at the end of the curriculum. Quite a few students give a sigh of relief when they get the final professional examination results, ‘No more reading and examinations anymore’.

Education was a sign of development and has been in vogue since the 17-18^th century. Today compulsory education is in force in most countries of the world. Responsible governments ensured that premises were available for children to be educated in which eventually grew into schools and institutes. Today schooling is big business and private education is very expensive but much sort after.

However, how do schools prepare for the future is the question. At least 12 years of formal education is in place excluding the few years spent in pre-school. The first and best teacher is mum, but with the promotion of pre-schools, the responsibility of learning has shifted to teachers and formal education. Are we in the right direction? That may be a point for discussion in a different forum.

In 1964 John Caldwell Holt was vocal when he wrote ‘How children fail’ and commented on the ‘pressure adults exert on children’ because of schooling. Later, in 1967 he wrote another treatise on ‘How children learn’.

Schools have faults which need to be addressed today. Ivan Illich has written and discussed ‘Deschooling society’ to get out of the ritualism and the oppressive effects schooling has on learning. He has discussed about the ineffectiveness of institutional education and that self directed education should be promoted; new educational funnels need to be created. Current computer mediated education is making resources available at any time and at any place. Whoever wants to learn can access knowledge. Although the school is now said to be the ‘new world religion’ and is the fastest growth market we should be concerned about social polarization in multicultural regions, social degradation as a uniform curriculum is prescribed in a ‘one fits all’ approach. Institutionalizing values have their setbacks as new cultures and behaviour develops. Education philosophers are concerned about being socially powerless and getting into a state of psychological impotence.

When I was in secondary school I was taught about the Norman invasion of England. My history teacher spent hours emphasizing the impact the feudal system had on society where the peasants were exploited by the landlord. That system pulverised the very individuality of the peasant. Should we now be concerned about the new dimension schools have in directing the young mind in meeting set curriculum? We all went though a similar system. The good side was that we socialized to a good extent, we had teachers as role models and education gave us the breath to appreciate life. But I still can’t understand the relevance of learning additional mathematics and giving me a test on geography when I wanted to become a doctor. I firmly believe that we do not need the matriculation or Form Six classes to go to university. I am sure many would agree with me that they would have done their professional education just as well without the Intermediate classes!

Unschooling schools permits natural learning and intentional learning. Home schooling was for the elite in Victorian times but has now come to stay. Most times the parent becomes the mentor in home schooling. The concept of Unschooling as in home schooling is different from deschooling society which is advocating anti-institutional school.

Ritualization and following the words of contemporary theologians would not permit imagination and innovation. The ‘helpless’ student needs to take a broader perspective of education and not be bent in achieving grades and attain mastery of definable skills and behaviour. Although personal growth is not a measurable entity, one can evaluate the final school product and determine how effective he is as a professional, citizen and contributor to society’s needs.

Of course several factors impact on the concepts and the way forward would be difficult to conceptualize till basic needs of society is met i.e food and shelter, protection from harm and a safe environment . Education is fundamental to progress of a nation but there is a need to determine if the process of education is producing the intended products.

Conclusion

I have tried to look at the product of one profession I am familiar with and desire that the education curriculum, whether it is primary, secondary or tertiary be re-looked. I am of the opinion that society needs to have a dynamic curriculum so as not lend to intellectual schizophrenia. We do not want to produce professional s and citizens who lack motivation and show severe signs of working within restricted horizons. It is clear that increasing passivity would lead to lack of productivity and cooperation. In fact it may lead to destruction of culture and progress. Institutional learning is not the only means of education. The desired outcomes need to dictate how education should be accessed and leant.

Sivalingam Nalliah

31 Aug 2012

The Root of Empathy

2012-08-18T03:20:00.002-07:00

Introduction

Working with medical students permits me to reflect on my own days where I looked for a friend and counsellor in my formative years in medical school. That is the time where the metamorphosis occurs from adolescence to adulthood. The kind and learned Moses Christie Karunairatnam, our Biochemistry lecturer, struck me as a scholar who wanted to share his wisdom and kindlness, truly living to the Tamil interpretation of his name ( Karunai- kindness!). I could approach Dr Tan who was our Physiology lecturer who was easy going and not confronting. The founder Dean held himself above all others and was revered as the icon of medical education. He had to be the Dean and nothing else, befitting all the attributes of a head teacher you would have read in Tom Brown Schooldays.

To be a professional taking care of the sick and maimed, one needs role models and have an innate feeling for the less fortunate. Empathy is one attribute that needs to be exhibited, something I recognised in many of my teachers, whether in medical school or in primary and secondary schooldays. Now, we do research in empathy, although I had falsely accepted that empathy comes with those who take up the profession of doctoring. It pains me to see how rapidly the scenario has changed and less time is spent to express this trait in our daily duties.

Empathy and Compassion

Language is a beauty in that one can express thoughts and what we want to communicate in words. We often ponder if there is a difference between compassion and empathy. Well, there is a difference. The word ‘compassion’ is derived from Latin to mean ‘to bear with or to suffer with’. Empathy is slightly different and is taken as a component of ‘compassion’ to mean ‘enter into or maintain a relationship to caring’.

In the Hindu faith Ahimsa is widely used to refer to ‘God quality within a person’. Ahimsa was advocated by the great Mahatma Gandhi in his non-violent movement for Independence of India. Compassion is central to Buddhism where the Buddha professed ‘absolute compassion of all creation (Karuna’). The Judeo-Christian sect also maintains compassion as a manifestation of God’s love and mercy.

Clearly empathy is the recognition of others suffering ; how one perceives the wants, needs, sufferings, feeling and emotions by putting oneself in the other’s shoes. There is a deep connection that goes beyond sympathy and intense resonance is experienced in understanding the emotional changes in the other person. K.R Eister, in his treatise, ‘The Psychiatrist and the Dying’ moves to advice the caregivers ‘to give themselves selflessly to the dying as a free gift of love’.

Ernest Hemingway quotes’ ‘when people talk, listen completely. Most people never listen’. This is a call for giving a ear to the needy and sick. Aristotle, the Greek philosopher once said, ‘to perceive is to suffer’. The novelist J.Scott Fitzgerald quotes, ‘when you feel like criticizing anyone, just remember that all the people in this world hadn’t had the advantage that you’d had ‘.

The Revered Gautama Buddha upheld the need to empathise by this famous quote,

‘Resolve to be tender with the young, compassionate with the aged, sympathetic with striving, and tolerant with the weak and wrong. Sometime in your life, you will have been all of this’.

Mahatma Gandhi, the most tolerant human I have read about, in his Godly statements commented, when Hindu and Muslim religions divided India into two countries during the struggle for Independence, “I call him religious he who understands the suffering of others”.

Medical Student’s Feedback

When my mentees or protégés go away from the medical school curriculum to do their electives, they need to do a rotation in a field that is different from the normal curriculum. I often persuade them not to get stuck with a large hospital getting impressed with more application of technology but go out into society so as to appreciate the needs of the community. Quite a few students have been advised to change their initial proposals to areas I thought would benefit them more as far as empathy is concerned. On the otherhand , I did not have to counsel a few, as I could see this innate trait inherent in some of them; that feeling they want to serve and share. I was particularly impressed by one shy female student who often expressed the lack of confidence she had with her spoken English Language. She wanted some experience in rural health close to her hometown in Sarawak. I guided her how she could maximise her experience by working with the allied health staff. But I also persuaded her to read some books written by doctors expressing humanism to improve her English Language. I requested her to give me a report on the works of the writers she had read. What I got was an amazing reflective report on the works of Albert Schweitzer, the Nobel Peace Prize winner who worked relentlessly looking after the sick in a small hospital in West Africa, Anton, the Russian novelist who had been a doctor expressing the emotive trauma he had suffered through his stories about mental institutions and poverty and the author of the Sherlock Holmes series (Arthur Conan Doyle) , himself a retired ophthalmologist.

Another student elected to work with children who had hearing impairment and she was compassionate in her report elucidating the details of educating these ‘challenged ‘ children and the dedication and commitment of the teachers who clearly were limited by both expertise and facilities. The same student went on to do an attachment in a distant village in Nepal where a small 30 bedded hospital with a visiting doctor (weekly) nursed and cared for leprosy patients and those with neurological damage due to spinal injury. Again the student was more than compassionate in her longing to serve the disadvantaged and how lack of funds and medical expertise did not stifle the existence of the hospital. She was passionate in her expressions of caring despite language being a barrier to communication.

Is empathy a trait or can it be taught?

Western culture has been taunted as nurturing the stereotypical belief that women are more emotional than men and this being related to masculinity and feminity. The fallacy is that women are able to express and communicate their emotions to others better compared to men. The masculine male is expected to supress and control his emotions leading to the often quoted statement, ‘boys don’t cry’. Did we not see the emotions expressed by Andy Murray when he lost the much needed Wimbledon Tennis championship to Roger Federer this year? When Murray won the Olympic Gold medal, beating Federer convincingly in front of the British crowd, did we not empathise with him, let aside Murray expressing his emotions openly. Boys do cry!

Although research into empathy shows that female doctors appear to be more empathetic than male doctors, this is not a universal phenomena. Empathy appears to be a trait although we do feel it can be taught as we grow and understand human relations.

The empathy culture

For successful communication the Japanese have ‘omoiyari’ as a core value which refers to harmonious relations. It is intuitive and is a kind of indirect communicative style inculcated in the culture. The closest translation of ‘omoiyari’ is empathy. It is an understanding of unexpressed feeling, desires and thoughts. It is meaningfully expressed as kind and caring and is incorporated into the educational curriculum apart from it being part and parcel of the Japanese culture.

A Japanese medical student of mine (the only one) has been in communication with me over the last 2 years as my mentee and I see in him all the attributes of empathy. He expresses this humanistic aspect in whatever communication he has with me, sharing his feelings along the way. Recently he lost his grandmother to illness but the poignant expression of empathy, the guilt of not being able to be with her the last few days, the satisfaction of having spent a couple of days a week before her passing is testimony of the ‘omoiyari’ feelings.

In the USA social and emotional learning has been revitalised through programs like ‘Root of Sympathy’. The Institute of Learning and Brain Sciences in Washington, Seattle has initiated the ‘Seeds of Empathy Program’ for the 5 year olds and ‘Root of Sympathy’ for the 9 year olds. The NoVo Foundation is a promoter of societal transformation to encourage social and emotional learning.

Empathy, though may be a trait, needs to be taught as the world has become compartmentalized by job descriptions and skills containment. The supervisor wants the products to come with zero defect and mechanization and computerization that goes with current job descriptions, neither permits nor desires one to evaluate the feelings of employees and staff. Key performance indices count for bonus and not empathy. Socialization skills are reduced to completion of work measured by indicators and timelines. The term ‘societal control’ is offensive as it affects empathy. Today industry and organizations continue to program the human to perform and produce leaving the soft skills to lie by the side leading to stress, conflict and destruction of human value and morality. The threatening elements of mother earth’s environment can be traced back to a lack of empathy. Human aggression at work and play and a lack of regard for authority and societal norms clearly points to a lack of moral instruction and empathy for others.

Can Empathy be learned?

The common situation observed when aggression sets in, is that one gets upset and loses himself ; at this stageb one can say that empathy is sacrificed. As empathy is central to humanity one needs to explore if empathy can be learned. Experiments on animals show that empathy is not only seen in humans alone but also in animals.

In one experiment ,monkeys who are rewarded with food if they completed an electric circuit were induced to press the bar twice to get double the reward (food). But in the process of getting more food another cohort of monkeys nearby were made to suffer pain should the experimental group of monkeys pressed twice to get double the food. On seeing their fellow monkeys suffering pain, the experimental monkeys refused to press the bar even once, preferring to starve! Similar experiments have also been done on mice. Several observations by naturalists point to this phenomenon among the animal kingdom. With such innate behaviour can we imaging how cruel people are when they kill and maim in the various conflicts involving humans throughout the world?

Animals can’t be very different from humans as they too reproduce and mind their young. They protect and feed and show their feelings too difficult for humans to understand.

Recently an article appeared in Science (2010; 328:633-636) declaring the frog to closely resemble the human as far as human genome are concerned- the frog is a ‘kissing cousin’. This then reminds me the fables I read that of the forg turning into a prince on being 'kissed '. Now I wonder if it was a fable! The amphibian’s genome ( Xenopus tropicalis) resembles that of humans. Apparently 80% of the human genes associated with diseases is found in this species. Hence, exhibit some empathy when you feel like destroying a frog in the garden the next you spot one, consider kissing it!

If psychological learning theories are true to understanding the human mind then Behaviourism, Cognitivist and Metacognitivism should impact on how we can learn humanism and empathy. Parents as role models have a huge impact on the growing child. They could influnece the young in empathy and compassion. The environment has an enormous impact on how emotional intelligence is nurtured. I would opine that empathy can be taught and behavioural conditioning would contribute to successful adoption of empathetic approaches.

John Hurt gave a real –to- life performance in the movie, ‘The Doctor’. This arrogant surgeon became an empathetic person after he fell victim to cancer and learned about humanism from a fellow young girl who eventually succumbed to blood cancer. I encouraged one medical student to see that movie and she wrote a moving commentary of the finer aspects of compassion and empathy.

Is Empathy in our Genes?

We talked about human traits that navigate us through emotions and empathy. Are there genes we have that controls empathy and stress. One hormone called ‘oxytocin’ which is so vital in parturition and breast feeding is now thought to be beyond it being a ‘love hormone’. It now looks like kindness, love, caring and feeling for others is genetically ‘wired’. Oxytocin has a great influence on social and emotional processing.

Serena Rodrigues Saturn and colleagues in California (Nature) reported that character traits like openness, caring and trusting is linked to genetic variations. The oxytocin receptor incorporates a docking mechanism in operating as a hormone and neurotransmitter. If the person has a ‘2G’ variant gene of the oxytocin receptor the person exhibited better social skills and higher self –esteem compared to those with a ‘AA or AG’ allele. The latter group, in their experiments were less capable of handling stress and difficult situations .

Conclusions

Compassion and empathy are human traits which signify the ability to feel for others. Although there appears to be evidence that this trait is genetically linked, rearing of the young through role modelling and exposing them to a humanistic environment would promote this social characteristic. Culture and religiosity have an impact on exhibiting empathetic behaviour. In a just world empathy goes beyond the environment of the person to ensure sustainability of the race, environment and all living things.

Sivalingam Nalliah

18 Aug 2012

Cell talk, mischief and cancer: What has the boson got to do?

2012-07-25T06:53:00.000-07:00

Introduction

When you are in the twilight years of your life there is so much to reflect and you also realize that so much more needs to be said and done. The oft repeated statement, ‘if I had been younger,’ keeps ringing in your ears with predictable regularity! But then you console yourself and say that there is this element of wisdom that allows you to ponder over yet to be discovered concepts and phenomena. It is at this stage of your life when you discuss the meaning of existence and confuse yourself with theology, mathematical physics and what is the origin of man.

Nearly four decades have gone by since entering the field of Medicine and I see how the practice has changed influenced by technological advances and fragmented by organ specific therapy and applied therapeutics based of ‘search and kill’ philosophy. Within these two weeks two of my doctor friends died of cancer and both did not discover its existence dying within a few months of diagnosis. I spent nearly 12 years treating cancer in women and went through the rudiments of diagnosis, breaking bad news, operating on many and using a combination of radiation and chemotherapy. A few lived for many years but I saw several who fell by the side, crippled and maimed by the disease. Depression and melancholy was not only experienced by the victims and family but they affected me equally.

Now I re-look at the advances in the understanding of cancer and wonder, have we understood the disease and its origin? I become more sceptical as I view current treatment with some degree of despair.

The scorn of cancer

The patient who had premalignant disease had a good lease of life. Those who had early disease had good prognosis but those with had advanced disease did not thrive for long and it pains me to see how futile attempts are made by earnest oncologist with little respect for dignity and quality of life. This reminds us of medical ethics and the right to make decisions on terminating life! Why does cancer develop in the first place? When a disease invades to a limited extent would we call that cancer? Endometriosis can be very aggressive in penetrating the adjacent organs but we call it benign disease. Conventional teaching in pathology has categorized cancers based on the organs that are inflicted with the disease. We also have seen that some forms of cancer do not spread so quickly as others. If we take cancer of the uterus, they tend to penetrate the inner layers much more slowly than the cancers of the lungs. Cancers of the ovaries and lungs in fact are at an advanced stage when they are detected. Why is this so? Medical teaching outlines how cancers would spread directly into the neighbouring areas before permeating to the lymph nodes and blood vessels when they become more widespread.

We have been experimenting with various forms of therapy like regional removal of the tumor leaving a wide margin to more radical surgery where the entire tumor is removed extending the surgery to removing the lymph nodes and other affected organs. If all fails or surgery is not possible then cancer drugs and radiation are employed. Having said that we continue to contemplate if the treatment given is the most appropriate because unlike exterminating infections with antibiotics, killing cancer cells has been less than optimal.

Cell talk, cell adhesion and cell signalling

Organs in the body are made of numerous cells bound together working in harmony, recognising their roles and that of others. However when the harmonious relationship breaks down due various reasons like reduced immunity and aging, the cells grow autonomously and begin to proliferate with little respect for adjacent normal cells.

Current views have moved to molecular biology and cancer biology to determine new ways of controlling and treating cancer. But have we succeeded? A scan of subjects relating to cells talking to each other, how they adhere and work in synergy and how they die eventually and are replaced is still being studied and enormous information is now available on of cell signalling. Apoptosis is regulated suicide. Key proteins cited are p120caterin which entails nuclear condensation, shrinkage of the cell with membrane blebbing and eventual fragmentation of DNA. CASPACES are mentioned as central regulators of apoptosis which play a role in cleaving cellular proteins.

Current concepts of breast cancer reviews cell biology and cell-cell adhesion much of it being related to ErB2; increased proliferation permits motility resisting apoptosis but no invasion takes place. But with loss of yet another protein, E-cadherin invasiveness of the tumor occurs. Spread of cancer to distant sites can be suppressed by amplifying the effects of ErB2 which is now the basis of using newer medication like trastuzumab. Although the explanation for a cancer of the breast remaining at its original site (in situ) or spreading to distant sites (metastasis) is much more complicated than what has been mentioned above, experimental biologist continue to develop newer drugs to combat cancer based on an understanding of the various proteins that contribute to cell adhesion, cell signalling and apoptosis.

Other signalling processes involved in the catabolic process are called macroautophaging or autophaging. Nutritional deprivation is inevitable in cancer. A similar but less severe state follows stress, differentiation of cells, neurodegerative disease and infection. Under these circumstances Lyoscyem in the cytoplasm degrade releasing aggregates of abnormal proteins and excess damaged organelles result. The kinase mTOR appears to be critical to autophagy induction.

Cell cycle control is essential for regulated cell growth and the process is essentially maintained in an orderly fashion because of G1/S checkpoints. The whole transition from the G1 phase of the cell cycle to permit entry into DNA synthesis (S-phase) requires different stimuli and checkpoint control (e.g. TGF-beta, replication senescence, growth factor withdrawal). Any or a combination of these factors going wrong will set off a series of misconduct and perhaps will lead to premature cell death or excess cell proliferation.

The cytoskeletal system remains another dynamic site for both regulation and adhesion between cells. The adheren junction structures both strengthen, spread, degrade and reform using various proteins establishing connections between its counterparts and adjacent cells. In what has been described as the stable model complex of cadherin, beta – cadherin is bound to actin skeleton. A whole bunch of adaptor proteins are involved including kinases and phosphatases. Key proteins cited are p120caterin. Breakdown of this process clearly upset the whole equilibrium between and within cells with disastrous consequences.

Can we stop this cancerous growth?

The destruction of cancer cells through gene modification and gene transfer has been the basis of viral oncolysis (i.e the destruction of cancer cells) using viruses that replicate themselves. Thymidine kinase coupled with herpes simplex virus has been seen to infect cancer cells killing them. This has been possible by affecting the spatial control of transcription.

How has all this contributed to cancer biology and cancer treatment? Essentially we are beginning to get a microcellular picture of the complex array of action of proteins within the cytoplasm, nucleus, and cellular membrane, between cells and how the harmonious relationship can be maintained or destroyed.

The basis of drug development to fight disease is derived form the understanding of the functioning of normal signalling pathways. Angiogenesis is common in cancer. New blood vessels are formed in the process of cancer cell proliferation. This is not unlike what normally happens when there is an infection of when a wound is inflicted. In cancer the inductor is hypoxia, a lack of oxygenation. The hypoxia inducible factor (HIF) is a transcriptor factor that is sensitive to changes in oxygenation delivery to the cell. Normally, when the HIF is hydroxylated and acetylated (with normal concentrations of oxygen) it is transported to the nucleus where it induces expression of targeted gene products. Several growth factors like VEGF, FGF, TGF, which are growth factors will induce a cascade of signalling pathways which are responsible for several further activities which are involved in growth of blood vessels like the proliferation of endothelial cells and changes in permeability of the endothelium and cell migration. Such dynamism is coupled with changes that are induced to occur in yet another set of proteins, the extracellular matrix proteases. Several regulators will induce the tissue matrix to remodel so as to prepare to receive the migrating endothelial cells from existing blood vessel so as to form new blood vessels.

This whole process is bizarre in cancer. Host susceptibility, some abnormal trigger in perpetuating the process of cell division to take on a different pathway from that of the norm and unbalanced host-tumor relationship may contribute to abnormal proliferation and cancer. The resultant lack of cell-cell adhesion principle and bizarre cell signalling mechanisms have been implicated in an abnormal growth becoming aggressively invasive and eventually destroying the organelles and ultimately the organism.

Current treatment and are we on the right path?

Current strategies of chemotherapy is based on cell biology; ionizing radiation appears to be rather non-selective in destroying cancer cells and to some extent normal cells leading their ability to arrest the growth of cancer cells albeit temporarily . The use of radioactive iodine in treating thyrotoxicosis and short lived radioactive substances to produce three dimensional coloured images of functioning tissues in the body in positive emission tomography have opened novel approaches to cancer treatment. The use of biomimicry principles has made it possible to fox abnormal cells to undergo early ‘suicide’ but its extensive use in treating disease may be limited in view of the complex signalling processes in the organelles of the cell making this approach rather non-directive.

My current views are that scientists are unravelling the secrets of the goings on in cell biology at a molecular level and knowledge derived from the numerous engagement of cell metabolic pathways are being used to direct therapy to control division of abnormal cells. However, the complexity of the pathways appears to override the fundamental steps as the simplicity of using the principles in killing bacteria with antibiotics do not seem to work in cancer biology. At this point in time we will continue to understand the numerous substrates involved in metabolic pathways and the discoveries will continue without end after the chapter on DNA was first revealed by Watson and Crick.

We got to go subatomic!

I am of the opinion that gene therapy and ionizing radiation will not be the ultimate answer in treating cancer. I can see that newer diagnostic tools will continue to be developed as we discover and understand the processes of organelle functioning but there will be huge gaps in putting the pieces together for many decades. Cancer treatment will continue to be targeted at ablative surgery, chemotherapy and radiation therapy for years to come. We will be dwarfed by the lack of understanding of cell biology and will need to take a new approach. Just as we see the role of the radiologist changing to become imaging specialist and intervention specialists, I see that the roles of physicians will become less distinct. The radiologist will eventually become therapist as they would be holding the key to tools that will target control of subatomic particles in the cell that would eventually be the point of attack in treating disease, whether it is cancer, inflammation, degenerative disease or mere senescence.

This brings me to the uproar in scientific circles of Particle Physics. Quantum physics changed our thinking and then we got confused if light is a wave! Do protons have weight? Particle physics (high energy physics) appears to be derived from the fundamental elements of earth, fire, water and air. They form the basic building blocks of matter. We learnt that the nucleus has protons and neutrons. Electrons have negative charges and there is a balance within the particle to keep the spin in place. Then sub particles were discovered in quarks, again there are u-quarks and d-quarks. More than 200 subatomic particles have been discovered forming the basis of what is called the ‘standard model’. All the particles interact with forces keeping them in harmonious motion. Subset of second and third generation particles came into our knowledge pool (CHARM and STRANGE) and counterparts of electrons like MUON and TAU were discovered. To add on the understanding of the strange ways particle physics work, it is now agreed that each quark and lepton family has an ANTIMATTER partner (a mirror image). When particle and antiparticle get too close in this ‘double act’ they lead to annihilation. They burst with release of enormous energy (High Energy Physics). This is the basis of Einstein’s e=mc^2.

It has been over five decades that mathematical physicists have been trying to understand the origin of the universe. Since the times of the discovery of gravity, knowledge of the molecule and subatomic particles has increased to a very large extent. The Standard Model of Particle Physics does not seem to explain all the forces including that of gravity. The superstring theory remained a hypothesis with its own limitations.

Several scientists have been throwing more light to explain the gaps we have in the knowledge of Particle Physics. Higgs in Edinburgh, Scotland theorized more than four decades ago about field points with no push or pull factor. In 1964 he put forth the idea about how massless particles acquire mass. It was then plausible to accept his views as if there was no Higgs field, quark particles would ‘flit past each other at the speed of light’. Hence some ‘invisible field ‘was present to keep all in place. It was Leon Lederman, a Nobel prize winner’ who referred to Higgs Boson as the ‘God Particle’. The acceptance of Higgs Boson and that all the elementary particles interact with each Higgs field hence slowing down their motion (inertia) was announced recently in CERN in Geneva. The Large Hadron Collider measuring 17 miles in length has been in in the news for the last several months illustrating the fundamentals of particle collision energy.

Why am now confusingly yarning about a multitude of areas with little coherence? I started to talk about cancer treatment I was involved in and the despair I have encountered when managing advanced disease. I went on to talk of the modalities of treatment available in surgery, chemotherapy and radiation. Then I introduced the discoveries of the goings on within the cell and cell biology. I touched on the need for cell-cell talk, cell adhesions and cell signalling. I then despondently talked about how rudimentary our tools are for treating cancer. I alluded to the role of subatomic particles when we developed newer imaging tools like PET. The standard model of particle physics could not explain everything and now we know about Higgs Field that has no pull or push factor like the other subatomic particles.

Personal Views

What I now opinionate is that cancer treatment would not be successful if we do not take it further down molecular biology to subatomic levels. Ablative surgery would not be the ultimate. Chemotherapy would be close to stagnating cell division but would not contain the cancer cells forever. Causing cell suicide and cell destruction as in radioiodine therapy would be closer to our goals. Radioisotopes will work if we could deliver it in such a way that the difference in rate of cell growth between normal and abnormal cells could be determined with accuracy so as to deliver the exact dose. We are fully aware of the role proteins play in both normal and abnormal cells. We are also cleat that all these subcelluar material are formed from atoms. Hence we need to down the subatomic pathway and use the principles of Particle Physics. An environement needs to be created ,in all probabilities the Higgs Field, around potential 'mischief cells , so as to keep cells in a state of suspension and evetually control cancer. This would require very early detection or deviation from normal cell growth. Micro nanotechnology would be the possible approach in introducing the appropriate subatomic particle to detect cells who have the potential to behave abnormally!

New approaches are essential as although cancer drugs have been novel in attacking programmed and abnormal cell growth, they are not good enough to cure disease in the long run. Results from years of use of a combination of surgical treatment, chemotherapy and radiation have not shown us the perfect way to manage cancer patients..

Conclusion

A close relation between scientist and physician is inevitable if we want to combat cancer. The way cells respond to stimuli will follow predictable pathways irrespective of conventional pathological classification. We need new taxonomy that would classify disease according to subatomic particles since all matter are related to the atom and its sub particles. Treatment of disease should be directed to the stereochemistry of proteins by developing fields of low energy which could keep cancerous cells in a state of suspension. In time to come all one needs to do is to swallow a treated sub particle which would find its way to the subatomic boson within the protein that’s gone wary so as to induce a state of suspension or impotency!

Sivalingam Nalliah

25 July 2012

DEVILS, DRUGS, DOCTORS and HISTORY

2012-07-04T14:43:00.000-07:00

Introduction

Devils, Drugs and Doctors; what’s the association, you may wonder. This book was given to me by an Australian Academic with whom I stayed for a week back in 1991. The author of the book, Howard W. Haggard explains that it is a story of ‘Science of Healing from Medicine-Man to Doctor'. Printed in 1929 by William Heinemann (Medical Books Ltd), I am hoping it will fetch a princely sum from Christie’s! The reason for bringing up the contents of this book is to illustrate the rapid evolution of Medicine today and how it has changed from being an art depending on wisdom and experience to a huge degree of fragmentation of the approach to the sick with the development of medical technology, imaging and super-specialization. I pray common sense will prevail and the holistic care of the patient will become the order of the day.

History of Medicine is a wonderful field that portrays the works of great healers from the East and the West. Ironically, the title of the second chapter in Haggard’s book is 'Saiy Gamps and The Midman' and begins with ‘Medicine declines and fanaticism rises'. It refers to the death of civilizations. The Roman Empire declined and Greek Medicine deteriorated. The Christian religion was in ‘ascendancy, and under the influence of theology, spirituality reigned superior to the physical aspects of disease'. While the teachings of the religion of the day were relevant, there was a replacement of rational medicine by superstition. As medical knowledge ground to a halt with resurgence of religion, the great teachings of Hippocrates and Soranus were buried and not available to the public in the Middle Ages. Ignorance and barbarism dominated daily life. The author explicitly quotes about the ‘birth of caesarean operation done without anaesthesia by the executioner and barber and not by physicians as it was below their dignity to perform such procedures'.

The beginning of Midwives

Albert Magnus (1193-1280), a clergyman, wrote a book for midwives not for the good of the childbearing mother but to ensure the baby is born and lived long enough to be baptized! Safer maternity care was encouraged by a manual written by Eucharius Roslin in 1513 which highlighted the works of the Greeks including the inclusion of the superstition of medieval medicine and fumigation with dove’s dung. The title of Roslin’s book was ‘The Grade of Roses for Pregnant Women and for Midwives’. ‘The Byrthe of Mankynde’ was a version derived from Roslin’s book. Men could never be involved in Midwifery in the Middle Ages. A story is quoted in this chapter that a certain Dr Wertt of Hamburg , Germany, was very keen to see a birth of a child and had dressed in women’s clothes to see the event. He was caught and burnt to death!

When we talk about medical men of the 1500s one would come across Ambroise Pare’ from France who described podalic version for the child who was not in the normal position in the pregnant uterus. He opposed Caesarean deliveries and preferred internal podalic version , as he felt by inserting the hand into the uterus and pulling on the legs of the unborn child, the results would be better. During his time a School of Midwives was opened at Hote Dieu in Paris. This school lead to qualified midwives as safer persons for caring pregnant mothers. Pare’ also encouraged the physicians be called in when midwives could not handle difficult pregnancies, something that was thought to be a blow to the ‘dignity of physicians of those days'. Several scientific achievements of the 16^th century and radical changes in Medicine were taking place during that time and are worthy of note. Copernicus revealed that the planets were revolving around the sun and Galileo talked about the ‘law of falling bodies’. Vesalius was introducing the foundation of human anatomy and syphilis was named by Girolamo Fracastoto (he wrote a poem in which appears the term- ‘Syphilis sive Mobus Gallicus’) . History has much to say about this disease which was not scorned upon till late in the 18^th century. Moses is said to have attacked this problem by associating it with immorality though.

Biblical Times and Morality

In the times of Moses (Old Testamount) it is said that , not unlike the times of today where the vice trade thrives worldwide, foreign prostitutes called ‘strange women’ were not allowed into the larger cities but could set up booths and tents along highways where they ran a combination of providing their ‘services’ together with selling their wares. In Rome of the old days (Roman empire) it is said that prostitutes could be identified as women who were elegantly dressed with a huge number of ‘admirers’ around them . It is also recorded in Ancient Greek times that prostitution was a ‘social institution’ (reference: Medical Thread in the Moral Snarl. Devils, Drugs and Doctors’). While courting prostitutes was an act of adultery in Rome, the Greeks did not consider such an act as unacceptable. Gender bias is obvious in that sexual contact with a prostitute was a ‘male privilege’ whereas in Rome it became a practice of both sexes!

What is perplexing is that the principles of healing have not changed over the years from time immoral. The basic tenet of treatment recorded stems from three aspects i.e. faith healing, hygienic therapy and drug cure. Today we use the same principles. While faith healing varies, we have to bear in mind the importance of treating the psychological elements of disease which is amenable to a variety of therapeutic strategies varying from suggestion, hypnosis and plain explanation of the course of disease. Western Medicine reigned high but now we are becoming comfortable with ‘alternative and complementary medicine’. There was white magic and black magic then, such practices prevail to this day!

Therapeutics and Drugs

The modern use of drugs based on theory of disease is often referred to as the ‘Galenic system’. Galen, a physician of 159 AD appeared to be have based medication for illness on more robust principles compared to that of Hippocrates. Galen’s theory looked at the human body as the universe in that it had all four elements;, fire, water, air and earth. All four had to be in equilibrium to be healthy. Heat and cold were balanced. Should there be an imbalance as manifested by symptoms and signs, then various therapies had to be instituted. Cooling, moistening and drying were vital therapeutic measures. The use of medication assisted in the process. The use of herbs persisted as a form of treatment long after he was dead but till today we see the importance of his theories in treating disease. The term ‘cool as cucumber’ is drawn from Galen’s practice of medicine. Ego continues to hound physicians even up to now. Galen, unlike Hippocrates, was said to be very egoistical and his intellectual honesty was suspect because it is said that he did not record his failures, only his success. Today, we see the same malady. Scientists, physicians and journals often report the successes, not the failures!

Historical perspectives bring back to us several reminders that there are periods of success and phases when there is deterioration and decline. While scientific principles were known to be used other factors influenced their application. Today we see a combination of advanced technology in Medicine and invasive investigations intertwined with herbal medicine and faith healing. Is that why they say the ‘word is round’?

Hippocrates said, ‘some patients, though conscious that their condign is perilous, recover their health simply through contentment with the goodness of the physician (Precepts IV). He also states that a physician who is a lover of wisdom is the equal of GOD. A Japanese proverb, on the other hand aptly states that ‘better go without medicine than call in an unskilful physician'. But is it not true that ‘a doctor is a man who is licensed to make grave mistakes’? (Quote: Leonard Louis Levinson).

Conclusion

Reading about history permits comparative studies and to reflect. We have made huge strides in medical advancement but the principles laid down from the times of Hippocrates and his likes remain. Benjamin Franklin said that ‘he’s the best physician that knows the worthlessness of the most medicines'. So it cannot be wrong when one says that a miracle drug is any drug that will do what the label says (Eric Hodgins). Life span has increased and health is a bonus. So do we look forward to becoming old because we live longer now? Oddly a Chinese proverb states that ‘man fools himself; he prays for a long life, and he fears an old age!.

Sivalingam Nalliah

5^th July 2012

Reflecting Progress in Views and Thoughts

2012-05-31T10:38:00.001-07:00

Introduction

Having been caught in a web between meeting timelines in editing two books and contending with the daily grind of work has been challenging at my age but I am not regretting what I have got myself in. The ever resourceful youths of today and the continued expressed interests they show in wanting to be mentored carries me through crises and storms. There is so much to share and when our views are still looked on as words of wisdom there is ‘seed money’ to continue writing and problem solving.

The last three weeks have been punishing as I had to prepare for a lecture to be given to postgraduates one day before their final clinical examinations. I was not cynical in wondering if any would be interested in listening to lectures the day before an examination when I was warned that they would be attentive lest some pointers for the next day’s examinations may leak out! Plainly this was not the purpose, I thought as I dwelt with the pathophysiology of hypoxia, infections and maldevelopment of the brain causing cerebral palsy.

Immediately after the four day of postgraduate examinations I had the pleasure of sitting through the convocation of one cohort of final year medical students back at my University. They were all dressed prettily, young men and women and had much to say about their new workplace (as many had begun working as interns). That day was pleasing to mind and body, to see these young people having achieved their aims of becoming doctors.

Then I reflected; are they done, have they attained what they worked for, what else is in stock for them? That brought me to Edinburgh, a planned holiday to visit my daughter. My wife and I had decided not to venture far from the city as we had done some travelling in Scotland on a previous trip. I did not want to exhaust myself especially after the long flight from Malaysia.

Reflecting on Scottish Soil

Montague Street is walking distance from the University Town and I had walked up the Golden Mile leading to Edinburgh Castle a few times. The city was much quieter this time around and I thought that economic recession must be severely affecting the city. However, later I came to understand that the students were away on holidays and hence the ‘major’ population were out of town. I wanted to visit the Museum of Scotland again when my wife retorted that the ‘entire city was a Museum’! The weather was not particularly cheery though it was summer. The greens were pleasant to the eye and the lack of humidity made me comfortable but I still needed to have my cardigan on as it was chilly most times.

The Scottish have always felt that they are different from the English and have wanted to be a separate country. The Scottish Parliament was established for this purpose though they remain in the United Kingdom. Brave heart, the movie clearly illustrates the independent thinking of the Scotsman. As I read the historical perspectives of life as a Scotsman, I realise how deeply internalized this feeling is. The historical buildings in the centre of the city are stupendously regal and they portray the proud nation they are.

During a previous trip some three years ago, we drove to a village on the invitation of an old friend, a gynaecologist, who lived about an hour and half north, in a village close to Stirling. This loveable character who had retired several years earlier as a consultant had this beautiful cottage where he lives with his wife. They were more than happy to have us for lunch, a typical Scottish meal of roasted chicken and potatoes. Immediately after lunch he beckoned us to walk the hills, something we could not decline despite his wife’s protest (she kept my wife out of harm’s way). Such a joy it was to see this healthy old man chattering about his feats and how he leads an active life of daily walks, swimming in the ponds around the hills, and the regular sailing trips he makes with his family. He must be past 70 but there you are, the life of a retiree, and he is looking forwards to more healthy living.

Trip to the Museum

What makes the Scots proud? Alexander Fleming discovered Penicillin and antibiotics were born. The Nobel Prize he worn with all the other medals are displayed at the Scottish Museum. Jackie Stewart, the F1 Driver and champion for many years prides the nation for the best built motor engine used by Stewart. The continued harassment by the English has kept them wanting to prove their might in all fields. Ian Donald, the famous gynaecologist from Glasgow is the father of Ultrasound. Dolly, the first cloned mammal was a product of the experiments of the Scotsman, again proudly displayed at the Museum of Scotland.

Was this a Bookshop or was it a Library?

Going on laid back holidays with a kinder weather; though chilly, it was a comfortable, allows me to read a bit, taking me away from the routines of medicine. The Autobiography of Benjamin Franklin reflects on a multitalented human who had the energy to become a well-known statesman, author, inventor, printer and scientist; the outstanding high moral standards was well recognised as characteristic of the man. From modest beginnings he rose to become an accomplished American of his time through sheer effort and determination. If one needs motivation seek this book, get the hard copy or ‘KINDLE’ it! Although his autobiography was not published till after his death, one can measure the man’s methodical approach to llfe as he scribbles the outline of his autobiography in the first three pages of the book. This approach has been the very principle of ‘scaffolding’ adopted as a learning theory. He leaves nothing to imagination and includes topics like, ’learn French and German, Marry, Erect a Library, Affection for my brother (the one younger brother he had), Father’s remark and advice upon diligence! His social responsibilities goes beyond selfless devotion and building hospitals. He touches on his scientific mind very briefly through what he calls his success of electrical experiments. He mentions about the famous ‘lightning kite and various discoveries’.

Would it not be vital to reflect on what we have today, material wise and why the turmoil in the world is causing such havoc when people like Benjamin Franklin ignites productively those hidden talents one has to make the world a better place to live in. We continue to get into the blame mentality and soon get overpowered by mundane gossip and unproductive ventures.

We blame politics but that too is based on the rule of law. I could not spend more time but did spend about three hours at the Blackwell Book shop not far from Princess Street one afternoon, in Edinburgh. I was overwhelmed with the enormous number of books on various subjects that ignited more enthusiasm in me. A quick scan from primary school books through to Politics and Academia illustrates why it is worthy for us to be here off and on. The subject of philosophy appeals to me as it is perplexing yet relevant. I read a little about Aristotle and how he was passed over not being selected to take over the Academy after Plato passed away. It was revealing how he had to leave Greece and find his way to be in the courts of Macedonia. There is little that suggests he had a great influence on Alexander the Great when he took over the throne after his father Philip died (Alexander was just 16 years). My primary school history classes suggested that Alexander died of malaria at the age of 28. Yet this book reveals he died due to indulgence in alcohol and that he never went beyond what is now Pakistan and India because China was not revealed to him in his geography of the nations.

Several books on pedagogy and andragogy in the bookshop appealed to me and I feel must be made required reading for all teachers. The basic principles of teaching are based on specific learning theories and the wonderful array of information I found was overwhelming.

Anatomy Acts

Andrew Patrizo and Dawn Kemp have put together a treasure of thinking skills based on Anatomy. If one feels Anatomy is a dry subject do read this book (Anatomy Acts: How We Come to Know Ourselves). Clearly it is Scottish and it was lying in my daughter’s bookshelf and now I am the proud owner of the book!

The introduction reiterates the glory of the Scots and the authors have intertwined literature and poetry into history as they explore the anatomy of the human body. Those who have read the Great Books and have a weakness for English Literature would not put this book down as it cleverly use analogies of the vast fields of America and sea faring feats to explain the ‘Paradoxes of Interiority’. Over 500 years the authors throw the veil over’ your good sense in exploring the human body’ through Scottish eyes. It is a fact that Scotland has been one of the most important countries for medical teaching and training. Reference is made to the Edinburgh Town Council in 1540 granting the Incorporation of Barbers and Surgeons the right to perform dissection of executed criminals against the wishes of relatives. This was the only way to explore the inner secrets of the human body. The fresher the body the more it attracted observers. This Act ‘demonstrated that the criminal should be denied a decent burial but by permitting it be dissected by anatomists, it was seen as ‘the final act in a drama of retribution and punishment ‘.

Anatomical dissection drew an audience as if it was a theatrical act. It is mentioned that in Bologna (ITALY), notices are displayed about a forthcoming dissection as if a new play is in town. Vesalius, one of the earliest anatomists, would perform these acts in a church (San Francesco) with public demonstration. During one such session there were 500 students where he showed his skills and implored the wrong information (on anatomy) of his rivals.

The illustrations contained in the book portray a mixed feeling of disregard for the dead and the wantonness for exploring the human body.

A poem appears in Chapter 1 where dissection is seen as one of brutality in pursuit of knowledge:

‘Behold the Villain’s dire Disgrace

Not Death itself can end.

He finds no peaceful Burial-place

His breathless, Cosre , no friend.

His Heart exposed to prying Eyes

To pity has no claim:

But dreadful! From his Bones shall arise

His Monument of Shame.’

Subsequent chapters are endowed with culture and nature. In explaining the nervous system reference is made as to how our state of ‘nerves’ are inherently tied to our nature. The higher you are in society the more mature (graduated) are your nerves. If one has read or see the classics like ‘Sense and Sensibility’ or savoured the works of Milton and Shakespeare one can appreciate how daintily the Madame of the house moves and addresses the Lord in impeccable English manners. The spleen was erroneously tied up with the nerves. Reference is made to the ‘mind stirring the body towards diverse motions and renders it nervous’ in a well-received book published in 1733 by Dr George Cheyne (English Malady). The gist of the book is to explain why the English were melancholic and suicidal. The book has three parts but the title is intriguing; English Malady or a Treatise of Nervous Disease of all Kinds as Spleen, Vapours, Lowness of Spirits, Hypochodriacal and Hysterical Distempers.

Conclusion

Deep learning provides us the tools to be able to see perspectives of life from different angles. I have not attempted to portray the greatness of the Scotsman using the illustrations above but I am reflecting on our education principles that which discriminates the ordinary from the extra-ordinary. Scotland has a population of about three million but the 500 years of history illustrates a section of the world that has not been left behind. Their illustrious sons have given so much to Medicine and many other fields that we could look up for creativity and motivation.

I spent but four days in Edinburgh but I seem to reflect with envy as to that much we can give if we looked at life in a broader sense. What made the authors of Anatomy Acts write a book that appeases to non-medical and medical readers? How cleverly they have used their background exposure to history, culture, literature and language to craft a well thought though text that makes reading so interesting. The message is powerful; the power is not in the hand but in the mind and the pen!

Sivalingam Nalliah

Edinburgh 1 June 2012

Sarcasm, Irony, Satire and Wit

2012-04-24T13:44:00.003-07:00

Introduction

It has been more than four decades I have been reading about ‘sarcasm’ as part of communication in the English Language. So much has been written and most of the reviews throw 'sarcasm' in bad light lumping wit, irony, puns and nihilism under this word. Ironically current comedy shows that draw huge audiences especially in UK and US are more than puns, they are based on blatant rude 'sarcasm', correct me if I am wrong. Whether it is a late night American show or a comedy show in the Malaysian theatre, these entertainers thrive on ‘sarcasm’!

Sarcasm has been described to be a ‘primary weapon in the arsenal of anti-socials’! That is true if the expressions were designed to be so. There are other ways of looking at 'sarcasm' that could lend to social communication and social order. Some consider 'it' to be witty while yet others feel it is one ‘sure-fire way to get the ever present human detritus off your back’.

A definition I found on the ‘net’ for sarcasm was ‘a keen reproachable expression; a satirical remark uttered with some degree of scorn or contempt, a taunt, a gibe or a cutting jest’.

Do children understand the subtle message?

Penny Paxman from the University of Calgary (Gazette 13-01-2003, Vol 33 No 1) reveals that children do not grasp the concepts of abstract talk and sarcasm at an early age. When they are teased about their behaviour or dressing through witty, humorous or sarcastic comments the message is not got across. Her experiments clearly indicate that cognitive development has not advanced for subtle adult comments to be understood. In fact such comments should be avoided as it can be counterproductive.

Amanda Onion quotes Candice Mills’ findings that young children are extremely gullible up to the age of eight years. Beyond that age information processing changes markedly for them to be able to be cynical.

Processing Sarcasm in the Brain

Sarcasm is a very complex higher order skill that requires an ability to understand other people’s state of mind and emotions. People who are rather sensitive and unsophisticated do not take sarcasm well (that is when the problem starts). In such situations sarcasm is thought to rank low on the communication scale. The neuro-anatomical basis for sarcasm is traced to the pre-frontal lobe of the brain. Research by Sharma-Tsory & Tomer R indicates that people who have prefrontal lobe damage have impaired performance on sarcasm task. Within this group those with right ventromedial lesions had the worst deficit in understanding sarcasm.

The complexity of sarcasm

This is one skill that one cannot master. Many languages use two negatives to make a positive. what is understood when one says, ‘sure, sure’, in response to a comment which that they disagree to! Many a time expressive words with wit embedded go unnoticed because it is so ubiquitous. Oscar Wilde, the American write has his ways of expressing his views on this subject. Many are 'sarcastic' when we don’t agree with authority. One former prime minister once said that forest destruction is national development. He is quoted ,'We are a responsible country; we will conserve 30% of the forest. Those developed countries who make so much noise are very clever people. They can even turn deserts into greens and golf courses. Perhaps the only element that is lacking is that they don’t have the tropical insects we have. Perhaps, we can provide them with such insects!

I said the subject of sarcasm is rather complex and those who brand statements as ‘sarcastic’ maintain a low level of tolerance to humour. Even a phrase like ‘too bad’ which can be an expression of sympathy, has been misinterpreted as sarcasm. Exponents of sarcasm feel it is an art that few have, it is wit.

How often have we heard these comments?

“Hi, nice day, isn’t it?’ This is meant to break the ice, getting a conversation going.

Three types of replies can be anticipated:

1. ‘Yes, it is.” (even if it pouring outside!)

2. ‘No, it isn’t. (correction, as it pouring outside)

3. ‘Oh yes, it was a lovely day. I just began enjoying it before tolerance of inane comments was tested. But, Thanks for wasting my time anyway; I am going to look this way now!’

While not being rude, all comments are sarcastic. The third comment clearly is meant to hurt. But when expressed by a stand-up comedian, he will get the better of you making you laugh and parting with your money, in the process. So there is money to be made in sarcasm!

Here is a nice one which I extracted from the Internet (source unknown).

There is a long queue at the cashier counter and you have just reached your turn with 15 items to be cleared and your parking ticket is due any minute now.

An unassuming old lady is behind you with just a single item and she asks you if she could go before you.

Your reply,

'Oh yes, please be my guest. I have forgotten how little my time is worth in comparison to your obvious need of a Dove soap bar'. Snort and don’t let her pass!

Doctors' waiting time is often a test of tolerance and one cannot refrain from making comments like how long it takes before seeing a doctor. Again the following comments are drawn from the Internet.

After waiting for two hours you are called into the consultation room. He makes a snide comment hoping you weren’t waiting too long!

Your reply:

You want to be subtle so that the doctor does not hurt you during the examination.

‘Oh no, doctor, the wait was not too bad. But I think I may have left a stain on your waiting room chair. My hemorrhoids have been bleeding heavily again.

By the way would you mind checking them out while I am here!'

Irony, Wit, Satire etc

We talked of pun; a form of wit. Wit is not an attribute everyone has. It can rely on words alone or telling a joke deliberately to make people laugh. Sigmund Freud refers to jokes as dreams that satisfy the unconsciousness desires. They go deep into the mind in releasing one from inhibitions and permits further explorations which may be cynical or aggressive. The urge to laugh begins early in life, the baby begins to produce social smiles, and these become chuckles later on often leaving a happy smile. Man is the only animal endowed with this characteristic of smile and laughter.

Satires are different in poking fun at individuals and situations. Many of the late night show and stand up comedians thrive on this ability. But when this becomes a bit more brutal one refers to as sarcasm.

Quotes by some of the well know ‘comedians’:

‘My wife is such a bad cook that roaches hang themselves in the kitchen.

Her cooking is so bad that flies chip in to fix the screen door!

Most guys go home to get pot roast,

I go home and get roast pot!

You ever see meat loaf that glows in the dark?

In my house, I pray after dinner!

My wife’s former English Lecturer from Melbourne (Dr Douglas Mucke) has written a book on ‘Irony’. It is worth reading this difficult subject neatly tackled in this small book. Irony implies 'that the opposite of the meaning or message is communicated'. It is a rather subtle ‘hit’ as often it begins as a simple statement or compliment and then comes the ‘sting’ often concealed within!

W.C Fields has this to quote,

‘Long ago, a young girl drove me to drink,

I never wrote to thank her.'

Changing the words of a story or song to make it sound humorous is a parody. Ironically some of the words that appear since biblical times appear to be humorous in nature. Laughter is said to have been traced to the Old Testament.

‘Abraham is told by GOD his 90 year old Sarah will bear him a son’

His response (as chronicled Genesis 17.17): Abraham fell on his face and laughed!

Sarah soon joins him in laughter at the prospect of pregnancy.
Abraham names his son, Isaac (in Hebrew, it means God’s laughter)’. It is said that the term ‘laugh’ appears 43 times in the New Revised Standard version of the Bible.

The earliest joke book appears to be in Greek, ‘The Philogeles’ or ‘Laughter Lover’. Two authors appear to be involved in its production, Hierodes and Philagrius.

Sarcasm and Culture

It is said that sarcasm is rampant in the US and also in India. It is used as a common means of communication. On the other hand sarcasm is not welcome in Latin America. The President of the US institute of Languages says that because of a lack of sarcasm in Latin America , there is more respect between people!.
The cultural and societal differences are far too numerous to quote when we deal with the vagaries of sarcasm, wit, irony and puns. The French apparently don’t delve in irony (Peter Merle). It is again quoted that ‘one culture regards as brutal sarcasm that may come as jocular pleasantry or interrogative jargon in another’. Newspapers in Indian language use loaded language with both cynicism and sarcasm leading to a huge increase of middle income class buying newspapers and periodical for such flair (Language in India, 2003; Vol ¾-4).

V. Ramesh (the Hindu, 2003; 17^th July) quotes that Cho S. Ramasamy (the actor and advocate) is scathing particularly when criticising critics. He was referred to as the ‘Sultan of Sarcasm’. His political satire “Mohd bin Tughlug” is a brilliant parody of Indian Democracy mocking the parliamentary system and the collective responsibility of the cabinet.

As we scan the subject further, so much is written on the subject that one needs to be literally well armed to know the differences in the interpretation. As one writes satires we talk in terms of smacking nihilism, but if it evokes laughter in the majority, sarcasm becomes wit. Much also depends on mismatch between intonation and message that makes one draw a conclusion as to what category of humour it is.

Steve Holden has this to say,

‘A native Yorkshire man, who migrated to the United States, I was told to moderate my aggression.
I was puzzled, as I was not naturally an aggressive person'.

It took me several days to realise sarcasm, meant humorously, and was interpreted as aggression!

I am convinced that those of us who have this endowed characteristic to recognise wit in a conversation welcome such but those who do not have this attribute categorise any talk that deviates from the core as sarcasm. What is perceived as sarcasm had irony and when the latter is introduced appropriately without the nasty and bitter bite, would be a welcome approach to healthy conversation.

What would you consider of these statements that I extracted from the Internet?

1. The journey of a thousand miles begins with a broken fan belt and a leak in the tyre!

2. If you tell the truth, you don’t have to remember anything.

3. A poem translated (Heinrich Heine, 1847)

‘Marrying a French’

Once you are my wedded wife,

Enviable you will be

Yours will be an idle life,

Full of bliss and glee.

And all your nagging I will face,

With patience’ gentle force.

But if my verse you don’t praise,

Then thou I shall divorce.

Here a couple of statements for you to categorise as humour or sarcasm. They involve doctors.

1. Your infection may be antibiotic resistant, but let’s see how it responds to intensive litigation. ( Alex Gregory)

2. In the operating theatre, the surgeon is demonstrating after one failure.

‘Next, an example of the very same procedure, when done correctly’ (Tom Cheney).

Conclusions

It is all about words and how it is interpreted. In the use of language, the appropriate interjection to break monotony and to be the live wire in communication, one needs wit. It would be futile to categorise a statement as sarcastic and lose out on making the majority happy. On the other hand ,It is no point saying that sarcasm is a crude form of satire when it hurts another human. But when it is made to make another happy, I would advice, say it with the right intonation. Whether it is sarcasm, irony or pun, the primary aim should be to strengthen our communities and unite society.

Sivalingam Nalliah

25 April 2012

Using Humour in Communication

2012-04-22T05:42:00.000-07:00

Introduction

Humour has been a part of communication in human interaction. It was often been frowned upon during the Renaissance as rather downright rude and misinterpreted as derogatory. However, radical pedagogy now incorporates humour as having a positive effect in teaching and reflects well as a good attribute of a teacher. The origin of the word is traced from Latin, as HUMOUR meaning fluid. This could be any bodily fluid including phlegm and black bile. The earlier reference to humour nor having a good impact on life was probably the meaning of such fluid as black bile was in reference to melancholy.

Robinson (1977) described humour as ‘any communication perceived by interacting parties as humorous and leads to laughing, smiling or a feeling of amusement’ appears to be simple enough. This definition contrasts to that in the Webster Dictionary, ‘mental faculty of discovering, expressing or appreciating something that is comical, amusing or absurdly incongruous’. Humour evokes happiness if incorporated in any communication appropriately without causing discomfort in the audience.

The two prisoners

Randy Garner (Humour, Analogy and Metaphor in Teaching) relates this story of two prisoners who have been confined to prison in a desert. One of them plans to escape and outlines his route and wants the other to join him in getting out of the prison. After intently listening to him, the partner opts not to join in the ‘escape plan’. The day comes and the first prisoner makes his way out. To his horror, he finds the escape route arduous because of the harsh terrain and near impossible access to any road or transport. Soon after he is caught and brought back to be confined to prison when he meets his partner. As he describes the short success he had and how he could not get very far, the second agreed and said that he had tried it before and met the same fate. When the prisoner asked his partner why he did not tell him so, he replied,’ No one publishes negative results!’

The benefits of humour is teaching

Humour is a social behaviour and can cut the monotony of learning mundane factual material presented in lectures and tutorials. As an adult learner I had the misfortune to sit through some lectures and tutorials by lectures who literally read the text to complete a class session. Nothing is boring then to listen to such boredom. Many a time I tried to chip in my humour during the class but this was not well received by my much younger ‘lecturer’. In ‘Transforming Thought: the role of humour in teaching (Bruneer, 2002) refers to two components of humour impacting on the audience; a psychological and physiological one and a creative component. The first (psychological and physiological) evokes laughter and in the process brings out several excellent beneficial effects of relieving anxiety and stress and improving bonding between the lecturer and the student/students.

A good laugh is sometimes addictive as endorphins are released. One gains attention and in fact retains information better with humour combined with analogies and anecdotes. The students tend to relax and better rapport is built. Berk (1998) in ‘Professors are from Mars and Students from Snickers, (Maddsion, WI, Mendota Press)’ clearly states that teaching can be fun with humour. Humour not only makes the class interesting and enjoyable but cognitive retention improves. Self motivation improves and students are better inspired to learn. Another vital point is the increase in self esteem that comes with a marked reduction of anxiety and improved rapport and unity in the class.

Techniques for using humour

Sometimes we tend to feel that the subject matter is so dry that it is not possible to introduce humour. This appears to be wrong. One can introduce humour under any circumstance. Learning English has been said to be one subject where one would find is difficult to use humour to learn. Sue S. Minchew and Peggy F. Hoppes (2008) disagrees and they looked at opportunities to use humour in teaching English. They quote some techniques and create activities for the students. One example is ‘elevated vocabulary’. It is not uncommon for students in Malaysia to confine themselves to a stereotyped approach in communication. This is largely due to limitation of the vocabulary they have and the technical nature of the subject (as in Medicine, Mathematics and Statistics). Nothing can be more discouraging then to ask them to delete such mundane terms used in the description of the subject they are assigned. Minchew advices to ask the student to build on the terms used which the teacher thinks is stereotype. It would be better if they re-write and express the same in different terms.

One example quoted by the authors (M&H):

‘Birds of a feather flock together’.

Re-write: Members of an avian species of identical plumage congregate!

Another example:

“Beauty is only skin deep’

Re-write: Pulchritude possess solely cutaneous profundity!

“Dead man tells no tales”

Re-write: Male cadavers are incapable of yielding any anecdotes!

I am often in the habit of using one liners to induce humour in the conversation, but many a time they seem not to be acceptable to some. In those circumstances , I feel I am misinterpreted because of either a lack of understanding the English Language or prevailing cultural differences between the listener and my comment. I am often reminded of the fact that what is acceptable to one culture may not be acceptable to another. This is, in fact a very important negative aspect of humour; some sensitive audience may event wrongly consider such statement as bordering on sarcasm!

Oscar Wilde aptly put this statement “Life is too important to be taken seriously”.

I firmly believe that humour and use of analogies, in the process of communication, is a social device that improves communication. The benefits are too many to be left untouched if one wants to be an effective teacher.

Lest I forget, I said there are two components of ‘Humour’ that impact on the audience i.e Psychological/Physiological and Creative Act. The former is associated with laughter and the later refers to comedy. The fact that the audience feels the speaker is comical means that he is creative and this brings out the humorous capacity in him. This second component, when used appropriately has very powerful effect in the communication and even the most stressed student joins in the communication with little barrier between the speaker and himself. Often there is huge difference in age and intellectual capacity between the teacher and the student and this discrepancy often deters free communication. With humour and comedy the psychological barrier is broken and better rapport develops roping in the shy and introverted student into the discussion. Consequently cognitive retention improves as stress is removed.

Is Humour Distracting?

This is often of concern but a good teacher should know when to introduce humour and when it is not appropriate. When humour overtakes the primary objective of the communication then its purpose is lost. There are many do’s and don’ts in introducing humour in the class lest it be misinterpreted as irrelevant , racist and sexist remarks. Delivery of humour must be done skilfully and appropriately.
Using analogies and reflecting past experiences are effective to send home clear points. When I emphasise the importance of clarification and clear instructions , often there are excellent examples available , especially in the clinicala and hospital setting. Errors often occur when the order is not clearly articulated. Using acronyms and short forms can have disastrous outcomes in the clinical wards.
I am reminded of my younger days as the only medical officer in Tangkak District Hospital in 1975. This was the first posting after completing my housemanship. Though a novice , I was made the Medical Officer in charge of the hospital (there were non other, anyway!). Apart from learning the rudiments of hospital administration, I took on the training of my nurse and hospital assistants.
Rohana (not her real name) was one of the 6 new staff nurses posted to my hospital after they had recently graduated from nursing school. This was a time when the use of English as the medium of instruction was replaced by the National Language (Malay). Although Rohana spoke reasonably good communication English she had to make an effort to understand my rather rapid speaking habit .

One day she was following my ward rounds in the male ward when I had to examine a gentleman who had partial paralysis of half his body (hemipelgia). I asked her for the 'tendon hammer'. Rohana quickly disappeared. I was puzzled . Anyway I found the 'tendon hammer/tapper' in one of the compartments of the 'round trolley'. As I was completing the examination, I saw Rohana dragging the ward 'attedant' by his hand into the ward. The distraught attendant has indeed displeased expecting some reprimand from me as the medical officer in-charge of the hospital. I couldn't avoid laughing at the scene. When I asked Rohana why she had dragged the poor blighter in she quickly retorted , 'Doctor, you asked for the 'attendant'. What do we see here, a lack of communication ( tendon vs attendant).

On another occasion, I had instructed Rohana, who was then in charge of the female ward , that I would be doing a 'dilatation and curettage for a patient who had an 'incomplete abortion'. In those days there was no operation theatre in that hospital and I had to perform the procedure using analgesics in one part of the main ward. The staff nurse was expected to prepare the 'only set' of instruments available . As the patient was very anaemic, I was concerned if she would be safe for the analgesics and tranquillisers I would normally administer before the procedure. Wanting to avoid using the drugs mentioned, I informed Rohana I would be performing the procedure under 'cervical block'. I had meant I would inject a local anaesthesia into the cervix (neck of the uterus)rather than administer the sedatives intravenously. As I was very busy that day as I had to see about 30 outpatient's , I also informed Rohana I should be back to the ward to perform the procedure by 11 am that morning. When I got back, what did I see- a very frightened patient lying on the couch with both her legs strung up on stirrups and lying literally 'up-side down' ! Rohana had placed two large wooden blocks under the bed at the foot end!. When I asked her why she had placed the patient like so, she promptly replied , "Doctor, you said you wanted to do the procedure under BLOCK!' (blocking the bed vs cervical block). Although running the 100 bedded hospital by myself was challenging , these anecdotes were humorous enough to get me going over the months!.

A widely divergent background often is a set back in tolerating humour as they may not appreciate what is being said and find it distracting. A common joke I often crack is during ward teaching is about the rubbish bin . In public hospitals (3^rd class) a plastic waste bin is placed under the bed of each patient. As students jostle around the class to listen, inevitably one student would ‘knock the bin off’. I would promptly utter ‘she/he kicked the bucket’. Those who had come through vernacular schools would not recognise this ‘idiom’ and would stare with a square face while those who had gone through English education would burst out in laughter!

‘Humour as a Double Edged Sword: Four Functions of Humour’ by (Meyer, 2000) explores the pitfalls and risks of humour differentiating acceptable vs unacceptable behaviours. We need to be wary about how humour should be introduced to derive the benefits . Some good principles to follow in introducing humour in the class are to ensure it is appropriate and given in the right ‘dose’ so as not to be distractive. It should not produce anxiety and should avoid gender and social bias. The target should not be the student unless he is a ‘player’. The aim is to build unity and improve comprehension. Students often value and appreciate teachers who humour them.

N.Sivalingam

22 April 2012

It is a Borderless World

2012-03-18T02:26:00.002-07:00

When compelled to do a module on Qualitative Research a new world opened up as the rigour of a scientific approach in testing hypothesis using a sample of the population was lacking. One starts to use the ' first person' approach and enquiry goes in a rather unregulated manner as one is discovers more and more as one reaches for answers to question that arise as one gets deeper into the problem. Extremely ‘heavy words’ like ‘epistemology, ontology and triangulation’ are common in qualitative research. I could not understand these terms initially till I started looking at their use in the context of research. The module taught me new perspectives . When we do social sciences and population studies one can’t hide under statistics and experiments alone. Qualitative research throws an entirely new angle to enquiry.

Recently I was scanning a medical education journal when I came across ‘Positivism’ and ‘Post-positivism’. Intrigued by yet a couple of new terms and expressions I read more on the subject and became more confused as I learned ‘Positivism’ as akin to ‘enlightenment’. It expresses the meaning of knowledge being not ambiguous but very accurate and certain. It is now clear that by using a scientific approach to explain ideas and theories one could observe patterns of characteristics and determine relationships to established laws that we use in both science and sociology. We know that scientific understanding through theories cannot explain all phenomenon. Newtonian physics is one example. While science attempts to verify concepts using established approaches ( we term it ‘methodology'); positivism also has adopts methodology that is recognized as in scientific experimental models. It is an inconvenient truth that ‘positivism’, like scientific methodology, lends itself to verification, hence concurring with empirical views that scientific discovery potrays.

A blurring of my understanding of the subject further compelled me to ask myself if a ‘positivist’ approach can be 'scientific' in the true sense! The excellent programs on 'National Geography' on TV made me wonder about the following scenario. Does the predator wanting to hunt pick it's victim at random when a herd of cattle pass by. The typical act is 'watch, and then pounce. The defence posed by the herd often breaks down as each animal runs off when danger is imminent and overwhelming, leaving the weakest behind. This common phenomenon, seen as the ‘law of the jungle’ does not afford good explanation as to why 'animals were not born vegetarian! How does this translate to a positivistic approach in research?

I began this discussion in the beginning by stating a ‘heavy‘word-epistemology', which refers to the theory of knowledge, its origin and nature. It is said that the epistemology of positivism is objectivism. Unlike what is done in scientific methodology, in this context one can still evaluate the subject of investigation but without any manipulation of the facts of the case as we would have adopted in scientific methodology. As I related the action of the predator in the wild above, where the weak falls victim, the entire subject as to why this chain of events happens and how the scene impacts on life can be deduced, a fact that positivism explains.

Qualitative analysis hence has a distinct methodology that provides answers to the problem or observation. The approach to data collection is ‘rich’ yet purposeful and it is possible to use various methods to get such rich data; that which cannot be obtained with experimental methods.

Oddly in the positivist approach, values and beliefs are not factored into the equation (so that one is not biased). What one is interested in is the generation of new knowledge that can be added on to what is already known. While I ponder over the work of the originator of ‘positivism’, Auguste Comte, I confuse myself in the philosophical approach to life and the dichotomous paths taken by sociologist and scientists. The Quantum Theory threw in a spanner in my rational thinking as it claims to deal with ‘the tinniest thing-subatomic particles ‘. Planck who introduced the Quantum Theory revolutionized physics and paved the way to the understanding of cosmology and answers to naïve questions like ‘ is the moon still there when one is not looking!

Do I see borderless learning where clear concepts of the Theory of Relativity ( explained by a simple formula e=mc2) was supposed to be a break though in physics but not very long after , gets entangled in controversy with the thinking of cosmologist and quantum physicists.

Friedrich Hegel introduced the dialectic triad of thesis, anti-thesis and synthesis. Basically the approach is logical as when an idea strikes (thesis), we discover more and talk about it, collect data and information and in the process evoke conflicting views and statement (anti-thesis) till we come to a stage of resolution (synthesis). What I am saying is the perplexing expression of facts, ideas and theories that are generated, appear not to make it easy to understand phenomena. We have been taught to fall back on rational ideas and use fundamental knowledge but as our experiences expand conventional education appears not enough to give meaning to theories and phenomena.

An Eastern Philosopher-Thinker correctly stated that ‘no statement about the world is ultimately valid’.
To sum up we need to continue to contend with theories and ideas and utilize various rational means of understanding to explain the happenings of the world. Without quickly resigning to ‘special creation and theology’ we should continue to create a certain degree of dissonance and conflict within our mind so that evolutionary and revolutionary thoughts continue to race though our mind. There is yet no perfect model in this world!

N.Sivalingam

17 Mar 2012

Free Expression in the world of Art

2012-02-02T22:51:00.000-08:00

Introduction

‘The power of the pen is greater than that of the sword’ a common expression to illustrate how writing can be used as a weapon for inspiring people, to communicate and engage with them and eventually win them over. Philosophers like Bertrand Russell wrote on ‘Power’ and biographers portray the lives of leaders and friends in books so that their lives will remain in words forever. We would not have heard about the humanitarian Albert Schweitzer if not for biographers and historians. ‘All men are brothers’ spells out the humanism in him and the sacrifices he and his wife made beyond colour and creed..

Art has always been a means to express oneself. Political leaders like Winston Churchill and Adolf Hitler were known to paint art pieces apart from being politicians. They were orators and also keen writers. When I was 'googling' for Ten Great Artists of the world, Western painters like Leonardo da Vinci and Michelangelo appeared. A common theme in all these painters is the impact Christianity had on their works.

Caravaggio (1571-1610) used the candle or light in his paintings often closely adhering to realism. Even details of ‘dirty feet’ were included. The inclusion of male figures (Calling of Mathew) is an illustration of religiosity that appealed to the people then. But each artist had his style. Caravaggio’s works were said to be ‘quirky’ with his subjects being ‘androgynous and erotic’.

Titian (1480s) often showed his strength in his paintings with strong colour. One great work of his ‘Venus of Urbino’ coveys ‘delight in erotic pleasure, often deriving his inspiration from mythological characters. There often appears an intertwining of myths, religion and illusion in many paintings of that period.

Ruben (1577-1640) dramatised the events using figures which were complex and caught between ‘heaven and earth’. ‘The Descent from the Cross’ clearly draws his imagination from religious teachings.

Sketching is a form of art and I have often tried to keep boredom away by sketching. At times there is no firm plan in such activities and it all depends on the moment, hence , any space on the pages (hard copies) of the minutes of meetings are not spared. Sketch on them, was my philosphy. Many call this ‘doodling’.

Is it Art of Doodling?

The following sketches have no themes, but are just free drawing on whatever came to my mind. People seated next to me were often the inspiration to practice drawing profiles. I wanted the face profiles to be facing left (as most times I found it easier to keep the faces the right!). There you have (left ), all the profiles facing left!

Kept the left hand hidden

Profiling to the Left

As you keep going on this hobby . At other times, many thoughts come to my mind and all the elements that I did not know about the great painters appear to become operational. There is a great deal of dynamism in the process. For instance, I always felt it was very difficult to place more than two figures together as I could not get the proportions correct. Should I try and get over that, hence the following was drawn (at home, drawn from some newspaper articles).

Well, then I thought that it is worth including some thoughts people express in the illustrations (Idea from Mera Pind), ‘can we have culture ,when things go away, we can create a little space for ideals and ideas!.

After that came a series of fervent attempts to do some profiling and including words of ‘wisdom’ lest they be lost forever appeared .

Recalling History

I was not sure if the three illustrations above are recognizable as our forefathers of Malaysia. A young colleague working in the computer division in my university could recognise them as our former Prime Ministers but she could not name them (the generation gap). Tengku Abdul Rahman, Tun Abdul Razak and Tun Hussein Onn did not evoke that much controversy (at least that I can remember) as I was growing up. But I can now see how geopolitical changes have rapidly enveloped us in more negativism than positives. All three PMs had to contend with communism as a threat and the community leaders were relevant in putting this country together to live harmoniously although there were firebrands in the Parliament then in people like Tan Chee Koon, the Seenevasagam brothers (from Ipoh), Lee Kuan Yew (when Singapore was part of Malaysia).

Well Known Artists and Pretenders

Picasso (1881-1973) was said to have produced some of the best works when he was younger but his style, when he started to promote CUBISM gave meaning to new perspectives in art. When he drew ‘Guernice” there was distortion and torture with decomposition and lack of form in humans and animals. I thought this was an exercise in non-conformism. It releases the artist from insisting on realism and character, perhaps it is an illustration of boredom or arrogance in art.

I was scanning a Sunday magazine two years ago in Edinburgh when a thought came to me that I should try to draw some of the illustrations in that magazine. But I had forgotten to bring along my paper and pencil. I expressed my frustration to my daughter who did not tell me she had slipped out to the nearby shops to get just those paraphernalia (at a cost of 7 sterling pounds!).

Not to disappoint her I sat down to try to draw the following but Picasso’s original were too painstaking to detail that I added my own to complete the task.

Vincent von Gorg (1881-1890) was a Dutch painter who led a depressed life not being able to sell his paintings as they did not fall in line with the themes of that era. His brother was his agent. His religious background and his own personality contributed to his lack of purpose in his life. He drifted from place to place drawing on his inspirations from the common folks and life in the village. Many of his drawings and paintings were dull and depressing until he experimented with brightness and colour though they had a naivety in them. As I was glancing through a book of his paintings I thought I could sketch to determine if an onlooker could recognise them without knowing they were drawn from von Gorg’s work.

I found it difficult to put his paintings (in colour) on paper using a pencil. The fields in front and the dull overcast and depressed winter do not come out well.

This illustration of ‘another depression’ of von Gorg was an attempt to try to get the proportions correct. I often had a problem drawing the hands and the feet and hence I have pushed myself at various attempts to get this aspect correct, most times, it fails, as is shown below.

Get at the difficult task

The teenager hugher up had both her hands out but it became too frustrating to get the fingers of her left hand, so I conveniently parked it behind her!

As I tried to launch myself to more sketches, I also thought some words would add to the meaning of the sketch, hence started to pen some of my thoughts in the process.

‘The feet were not getting out of me’, I thought, and hence sat down to draw just that, without losing myself in the rest of the body and environment. Keeping the tress empty was most apt as it cut down my duration to complete the picture and by making the tree ‘shed its leaves’!

Von Gorg is said to evoke emotional and intellectual resonance, but the poor artist would not have committed suicide if due recognition was given early in his life and he had the drugs and treatment we have today. While the 1400s drew their inspiration from Christian theology many of the Asian artists played to the political events of the day, the success work of others who appealed to collectors and impression lists.

Conclusion

Art in the form of paintings, sculptures and handiwork will be part of the human culture. They evoke meaning to life and have been affected by moments of the day. It was not easy for Claude Monet to get his ‘Impressionist School’ in Givery as heintroduced realism in art. It looks so simple; give life to the flowers and the house and the village by way of painting. Art appears to be an experiment on paperand canvas , based on the working of the mind. Some may be symbolic while others have hidden expressions that need Freudian analysis. Just try reading my mind when I drew the following!

Sivalingam

2 Feb 2012

Resolutions for the NEW YEAR

2012-01-15T15:57:00.001-08:00

New Year Resolutions repeatedly appear before the close of the year and continue to be published year in year out in media. I tend to be envious of the opportunities granted to the few invited columnists who tend to share their thoughts with readers. Many now see these comments has parochial, redundant and with little effect on the lives of many. Two articles appear in the NST ( Jan 14, 2012) and are worthy of comment.

Haris Hussein eloquently traces his thoughts back to his youth and resents making resolutions as they get broken within ‘15 seconds of being made’. Emma Reynolds, yet another columnist extends the period of breaking their New Year resolutions ‘nine days after they are made’. She goes on to explain that many resolutions are often for the betterment of physical and emotional well being.

Just as we want to be better persons and live in peace resolutions are reflective in nature and makes one realize the need to review, repent and pave the way to better living. But is it appropriate to make resolutions based on one calendar year? Perhaps we need to look long term as behavioral changes do not occur overnight!

Even if one believes that resolutions are integral to life, it appears futile that in our earnest desire to set new goals to improve ourselves and the lives of others, we don’t sustain them, as commented by both the above columnists. It is then fundmanetal that we set should goals for life rather than for each calendar year. There needs to be a purpose in life and setting goals paves the path to a direction.

Some of us resort to mentors, gurus and teachers who would facilitate achieving the goals we set. Motivational speakers are aplenty and continue to attract huge audiences wanting to listen to their clouded comments and pragmatic solutions using analogies that appeal to logic. They captivate many. However, how much they impact on the lives varies a great deal. When the discourse invites a fee, often I fail to see the honest intention!

Exposure to the media permits us a window to the world. Newspapers tend to sensationalise the plight of a few and report events that often relate to catastrophes and bad intentions of humans. The message is clear that many humans are in need of food, money, education and medications. Transport and poor infrastructure and illiteracy are the cause of lack of access for healthcare and education. Lack of political committment and abuse of power by leaders for personal gain contributes to the plight of the world’s citizens. The few NGOs and well wishers continue to uphold that principle of sharing and wanting to give to those in plight.

Many want to give but can’t or don’t know how to. ‘Teach them how to fish, don’t give them fish’ a common saying that promotes the idea of facilitating the under privileged to learn new methods to fend for themselves is such a noble notion. Could we organise a voluntary group to salvage the old bicycles and furniture that many discard , to be repaired and refurbished, to be sent to those in need. Several projects of this nature have contributed to the improvement of many who find transport and access to schools near to be impossible.

Deepak Chopra, a well known inspirational and motivational speaker and author of numerous books on similar topics prides in his interpretation of life and organization of the world through his views, which I think has a strong basis on the philosophy of life derived from ancient India. He speaks with little uncertainty that the world economic crisis is due to cronyism, corruption and power mongering of the ‘bankster’, gangsters in the financial industry. A subject well articulated in the NST (Jan 14, 2012) entitled “The Soul of Consciousness’’ explores Deepak’s deep thoughts on a variety of topics relevant to the social and economic climate today. He says that it is not acceptable that 50% of the population live on less than $1/= US a day and 20%, on less than $2/= a day. There is a Jain saying that there is ‘there should be doubt in any certainties’.

Those who mean well are not comfortable with the leaders of the world who bleed their citizens under the pretext of governing. Henry D Thoreau, the moral philosopher, said that ‘the government is best that which governs least!’ Will this argument find responsive ears? He first promoted the term ‘civil disobedience’ which became the hallmark of the black movement of US under Martin Luther King who drew meaning from a freedom fighter, Gandhi. Mahatma (the Great SOUL) Gandhi fought for independence in India largely based on non-violence and civil disobedience. He writesthat his earliest period of his life was one of ‘storm and stress’ just like what many adolescents go through, as he was experimenting with life. When he was studying at the Inns in London he was a ‘volatary of violence’ and often repeats for the need to practice the ‘silence of a monastery’ when there is a clash between violence and forgiveness, seeking out the latter most times. Even when one does not agree with another Gandhi professed that one should focus the anger on the ‘arrogance rather than the person’.

The world has reached the ultimate and the balance is tipping to further erosion of values and destruction of the environment. Deepak Chopra calls for collective conversation to meet the economic disparities and gross social injustice, call off terrorism and stop the devastative acts that is destroying the eco-system.

He is averse to positive thinking, a term that often appears to melt down argument. The world class tennis player, Nadal, recently commented that being the ‘nice kid in the block’ is not the way to make change as he laments about the punishing tennis playing circuit that would lead to early self destruction because of ‘self injury’. We have to speak out; he says and cannot keep quiet when we can’t cope!

Deepak Chopra feels talking positive in the midst of all circumstances stifles creative thinking. His comments that positive thinking are worthy of repetition. Quoting J. Krishnamurthy, he says that the highest form of intelligence is the ability to observe without judging yourself. When you are a silent witness to your own thoughts, emotions and feelings, your own behaviour and your own speech, there is a subtle but definite transformation that leads to higher consciousness. Instead of having a positive mind, how about having a quiet mind?’

The last statement clearly points to the teachings of the Bhagavad-Gita and the guidance given by the many gurus, the need to move one stratum higher in self realization. The governing principles of achieving peace and wellness now appear to transcend to personal transformation and impacting this goodness to the environment. So are the annual resolutions necessary?

Sivalingam

15^th Jan 2012

What's in your mind

2011-12-31T18:40:00.000-08:00

A baby is born

The delightful news about the birth of our first grandson, Rahul purported my wife to add a few notes on the congratulatory card she had bought. When I protested that there were enough well written wishes in print and the fact that my wife had already crowded the side of the page with many words of her own, she insisted I should add my own words. Reluctantly I wanted to add another congratulatory note to my son, but I thought I should a bit original. So I wrote,

“When a baby is born,

So is a mother, and a father & .....”

I submitted my share and then I learnt that what I had written was not new!

It took us over two months before we could cuddle the new addition to the family. After getting acquainted with not only the newborn but also the new mother and father, the short spells when I was able to cuddle him evoked new feelings and experiences. Trying to exclude all medical knowledge of child development I wanted to remain a grandfather and continuously awaited the correct signals from the new ‘mother’ as the baby was being exclusively breastfed. Fearful of breaking the routines lest the infant becomes fretful, I waited my turn to retain him in my arms.

The time did come, not very long after, and there was that short communication when he maintained his focus on me feeling delicate and appearing thoroughly innocent. It was at that point that I pondered as to what was going on in his mind. The eyes were bright and there were no distractions except for the blinking of his eye lids. I could recognise at least five differing expressions on his face , other than that due to his his cry. His tongue shot out rapidly as he tried to get a taste of his clenched hand. It lasted perhaps five minutes before he got bored and started exploring around. What was clear was the maturity of the muscles of the face and the uniqueness of the mind. He would never be able to tell me what went through his mind during the five minutes and I will never know his thoughts.

The brain is an amazing organ that continues to be explored. It develops so fast and remains active for a greater part of our life. What is astounding is the difficulty we all have as to how it works to coordinate the rest of the body. We are clouded by the functionality of the brain and the exhibition of its attributes as behaviour, mind and feelings. Is the mind a separate entity? The controversy will always invite intense discussion. The working of the mind has been the subject of research contributing to the development of a new field called psychology, originating not some 200 years ago
.

The Locked-in Syndrome

The cuddling of our new infant and the attempted exploration of his thoughts brings me to a novel I read based on a Frenchman, chief editor of ‘Elle’ who unfortunately suffered a catastrophic stroke that affected his brain stem sending him into a coma for 20 days. Although he drew himself out of the comatose state, he was a total neurologic ‘vegetable’ requiring mechanical support and total nursing care. Jean-Dominque Bauby was totally paralysed except for his ability to see the world through the window of one eye and being able to respond by blinking.

The ‘locked in syndrome’ Bauby suffered illustrtaes the frustrations of a 45 year old man who had been a writer all his life, wanting to portray the inner strength he has in expressing his feelings to the outside world. He articulates these feelings through Claude Mendibil who ‘painstakingly translates Bauby’s inner feelings and thoughts into works based on the flicker of his eyelids. Clearly Claude retains an amazing understanding of his past life and his present predicament. Alive he is, but he fears the loneliness and suffers the frustrations of his invalidity. The book composed by Claude entitled ‘The Diving Bell and the Butterfly’ clearly reflects on Bauby’s isolation as if confined under an impenetrable metallic bell despite being aware there is a huge wide world out there. The brightness of the butterfly is one to be admired but as Bauby feels, while one knows about its beauty, its life is rather short.

Although Bauby did not suffer his entrapment for long (he died) the earnestness to share his feelings with care givers and others makes the book good reading. One can’t deny the compartmentalised way patients are treated nowadays and this is well portrayed in the book. He has sufficient time to reflect on the days he spent giving his aged 93 year father a shave and the unplanned trip he makes to the 'Lourdes' in Rome with Josephine , his wife who spends a greater part of the drive to the Holy Land reading about the life of Charles Sobraj in ‘The Trail of a Snake’. He relents his poor understanding of religion when he is reluctant to wait in the half mile queue outside the Basilica when he is curtly told off by Josephine ‘it would do a sinner like you good!’ He also recollects the wink he gives a waiting invalid devotee who responds by sticking his tongue out when he blushed ‘stupidly scarlet'.

The systematic way he dissects the nursing care he gets at the naval hospital in France is worthy of note and would be a motivating factor in teaching the novices in the medical field about empathy and holistic care. The daily daily he goes through, as if being processed like some dirty laundry, is poignantly portrayed rather melancholically. He has little embarrassment to contend with as his carers turn him on his special bed, clean everypart of his body, change his urianry catheter, transport him in wheel chair and at times ,leave him alone for hours on end permitting him to watch TV where the channel is not changed although he prefers to watch documentaries. He describes the ugly side of an ophthalmologist who comes to stitch up his ‘lazy eye’ not realizing the benefit of it in avoiding the eye drying up and developing corneal ulcers. The fear of having the good eye (the only window to the world) stitched up similarly shows the lack of communication between patient and doctor.

Exuberating humour Buaby observes a demented woman who bites nurses, seizes the genital of orderlies and screams 'fire' invoking unintended fear in the ward. She is often left screaming her lungs out. He dreads Sundays when his visitors fail to arrive, no physiotherapists, no speech therapists and no psychiatrists. He feels Sundays are like crossing a desert. Even the nurses on duty are pre-occupied with their own gloom and lethargy recovering from their visits to the pubs on Saturday night. He sees how time gallops away and yet no one is around to read him the books that are aplenty in the ward.

Decision making and the Working of the Mind

The decision to treat terminal illness and those who find no quality in life is fraught with much controversy and disdain. Theologians leave the answer to divinity and the pragmatists profess assisted euthanasia as a way out. Doctors are ever in a quandary when the mechanical respirator should be disconnected. Albert Einstein was suffering from severe abdominal pain towards the end of his career when he was diagnosed with impending rupture of an abdominal aneurysm. When surgery was being contemplated he declined retorting that he has had a good life and that he be left alone with some papers and pen so that he could put his mathematical thoughts till the end. Although admitted to a hospital in Princeton he passed away on the 18 April 1955 without further intervention having completed some 10 pages of mathematcial formulae
.

The saints and sages contemplate working on the soul to move to an ' upper level of conscious state', to Nirvana, devoid of the working of the ‘monkey mind’. Self realization is a state of mind that keeps one at peace with oneself. Again one questions what is the 'mind' and if there is an anatomical location for it. The pineal body was once thought to be the seat of the mind. Without going into any controversy I am reflecting on what my grandson was thinking as he focussed his eyes on me for that short five minutes, as the eyes were intense and deep thoughts were inevitable. Bauby was consciously expressing his feelings though trapped within his ‘mind’. He was not meditating but if he had been taught the elements of meditation he may have been able to detach him to a state of conscious that would have made his existence less painful. He may not have to bear the pain of seeing the less than empathetic treatment he alludes to. Indeed it is perplexing how the mind works!

Sivalingam N

31 Dec 2011

The Games We Play

2011-12-10T21:15:00.000-08:00

The Games We Play

When I was in New York some 10 years ago my colleague asked me if I was game to go to the Letterman’s Reality Show. My first question was how much it would cost and when he replied that he could get a cheap ticket for less than US$ 50/= , I reluctantly agreed. He had asked the Malaysian UN Representative’s office staff to assist us. The officer whom he had approached had laughed at him as we did no know that one would have to book at least six months ahead for the show! However, we were pleasantly suprised at alternative arrangements made to see the ‘Beauty and the Beast’ play which had been running for over a month.

Plays, Concerts and radio-TV shows are popular means of entertainment and they play to full audiences every night they open in the US, UK and Europe. I am reminded of U-En Ng’s comments in the NST (December, 11). He commented on the lack of enthusiasm and patronage in Malaysia when it comes to exhibitions and performing art in Malaysia as they don't run long enough for the sponsers to make enough profits. He comments on the excellent facilities we have in the Petronas Philharmonic Hall and the numerous cultural centres in this country. But performing art, the fine arts and exhibitions appeal to but a small segment of our society. Neighbouring Singapore has made it more attrcative or is that more Singaporeans are taken up by the these concerts and plays.
U-En Ng laments that Bridges’ Project ‘Richard 111’ with Kevin Stacey is not playing in Malaysia and one would have to travel to Singapore to catch it.

The Art Theatres in Malaysia are kept alive by small groups of interested actors. Tiara Jacqueline has come on bravely in making some successful shows. The Instant Cafe was a hot when it brought on the best of stand up display by a few actors like Indie Nadarajah. We do see several plays being staged though they don't run for weeks on end as in the West. I am told that several Chinese troupes are reviving the art and we do see the occasional Taiwanese plays. Ramli Ibrahim’s Indian cultural dance shows appeal to a selected group including expatriates.

Performing Art, Literature and Language will play pivotal roles in crafting a new populace that can’t be compared to education acquired through the formal syllabus preparing one to pass an examination. The ‘cultural desert’ we survive in needs to be watered down with elements of fine arts and the wisdom imparted through literature and the human expressions seen through play acting. Learning through parables has been in vogue from time immemorial. Greek mythology and Shakespearean tragedy send home clear signals relating to ethical and moral principles of life. The Aesop’s fables taught us, as children, the social norms and morals that should be incumbent within. Religious instructions and the verses of holy books all teach us to be good and be humane through stories and verses.

I was asked to deliver a lecture recently on ‘Pregnancy in the Advanced Age’. I was wondering what new can I say to the audience who would be largely professionals who themselves are not new to the common problems surrounding the woman who gets pregnant late in her life (after 35 years). The oldest woman who had conceived by assisted conception ( IVF) was 70 years ! I had but 25 minutes to convey my message. After doing so research and completing my power point presentation, it dawned on me that instead to adding the last slide with a ‘Thank you’, I should pen a short poem about the ‘aging egg’. I thought I shall share this poem (if you consider it to be so) so that I can include myself as having contributed to the work of ‘ART and Living’.

The Aging Oocyte

Trapped , I was for 43 years

In the ovaries of my Egg Bearer

I was not recruited to join the other oocytes

As I was to remain as primordial

I was told that that my colleagues, fellow oocytes

Were mature to go onto to the surface

Of the ovary , to join in the race,

To find a suitor, the ideal sperm

My Egg Bearer thought otherwise

As she postponed her reproductive function

For a career as a professional

Though she was already 30.

When she found the right guy

I was still destined to remain dormant.

Suppressed, oppressed and depressed

Surrounded by hormonal contraception

At 43 , I heard that My Egg Bearer was ready

To permit the ‘release’ from my confines

But then I was already old

ATP and vigour , I had but little

My ‘egg mother’ went to an IVF centre

I was bombarded with FSH, LH and Hormones

I remained unmoved for a while

Till the fourth attempt, I got out from imprisonment!

I pulled out of my slumber

Too weak to make

The passage all the way to the ovarian surface

Of the right ovary where I had resided so long.

I made it to the site

Where I was destined to be rescued

By a directed metal probe,

They called it 'Egg Retrieval'!

They dropped me into a petri dish,

Surrounded me with nutrient media,

Poked my skin with a micromanipulator

Trying to get my 42 year suitor in , a sperm.

We are now in union

As an ‘embryo’ they say,

Waiting for our turn to be transferred

Again we have to wait till the other attempts in embryo transfer fail!

We hope we don’t have aneuploidy ,

Or breaks in our life string, the chromosome.

We hope we will survive the transfer

The implantation into the uterus

We promise to behave , not produce some rejection

In our destined place , the uterine cavity,

As we are old in years; between us we are 85

Pray, don’t let this happen to others please !

Dato Dr Sivalingam Nalliah (10 Dec 2011)

Penned for the lecture on ‘Pregnancy in the advanced age’ at the O&G Congress, College of O&G Academy of Medicine

Sivalingam Nalliah

11 Dec 2011

Age related disorders in writing skills

2011-11-19T21:14:00.000-08:00

A rather odd title for sharing this short missive- a good friend of mine who is past 65 years retorted that his reading habits had been curtailed by the difficulty in focussing on the script appearing in the law journals he used to read. That is a shame but you can’t fight macular degeneration that affects your eye sight with advancing age, though he was blaming the ophthalmologist who, not very long ago, had performed a rather successful cataract surgery on both his eyes.

As a senior citizen one has to be prepared for the eventualities of aging and society needs to be mindful of this in assisting the old in improving the quality of life of those who had contributed enormously to society when they were in the prime of age.

My lawyer friend’s lament was not being able to summarize the facts of cases he was working on as well as some ten years ago; memory has been failing and patience has been affected largely due to the time taken to perform research to prepare his cases for the courts. This has also affected his ability to put his thoughts into words. Another good physician friend of mind said that the mind must be kept busy; although he is reaching 80 years he makes it a point to write, putting into words his thoughts, lest they be lost forever. This same person introduced me to the section on writing novels in the month of November. Although I started the first page (one had to submit a portion of the proposed novel everyday of the month eventually ensuring that at least 50 000 words are completed) I failed to go beyond the third day!

As I was glancing through two books that I read recently (‘Churchill’s Empire’ and ‘Writing’ by Catherine Hilton & Margaret Hider) it dawned on me the power of writing despite the SMS designed Generation Y with the use of the mobile phone. Winston Churchill, the war time Prime Minister of Britain was a voracious reader and eminent journalist. He wrote extensively on his travels in India and Africa from the late 1890s as he saw action in the North West Frontiers of India (what is now the Afghanistan-Pakistan Border), the Boar War in South Africa and the English occupation Egypt and Sudan. In his earlier years and when he served as Secretary (Minister) in the Colonial Office and later as Home Secretary he firmly believed in the superiority of the whites and in Imperialism. The desire to rule as colonial masters was a notion he upheld for several decades. The nasty relation with the Blacks of Africa and Indians of India are well portrayed as he upheld his loyalist attitude to the English crown. However, he triumphed over Nazi Germany and played a pivotal role in ending the Second World War. But history will relate the problems that were created after the war in the birth of a new nation in Israel, the plight of the Palestine’s, the nationalism of the Egyptians and President Nasser’s nationalization program in developing Egypt and controlling the Suez Canal.

Churchill was a prolific writer even in his old age, and the power of his pen can only be evaluated from reading his chronicles and books, clearly reflecting on his views of dominant role of Great Britain. It brings me back to the subject of encouraging writing as a means of communication, and in the process writing correct English (what our colonial masters left behind). Undeniably English is now a universal language and we continue to be baffled by the changing policies in the country about the use of the language in the formative years of school education. I firmly believe that children have the capacity to learn numerous languages when exposed early in life. It should not damper the learning of other subjects. Anyway we could continue to discuss this controversial statement for ever without reaching a consensus!

Catherine Hilton & Margaret Hyder contend that the ‘aim of writing is to communicate ideas, thoughts, feelings or put messages across’; it does not matter who the audience is. Writing skill is unlike speaking as some formality is involved, one needs to place ideas in place, such ideas must flow in a logical fashion and there is time for one to construct the entire passage by reading over that which is written.

The differing point of writing when compared to speaking is that no interaction takes place. When there is interaction response are immediate and both the speaker and the audience are engaged. (Hilton & Hyder). In writing the writer holds the audience (or loses) depending on how the message is drafted. I wanted to begin by saying that my old lawyer friend who is clever fellow with a broad foundation in the English language would have spent the better part of his senior years writing. However, with age comes not only wisdom but disabilities as I have alluded to above.

Unlike the writings that appear in print, where the reader /audience are silent, the multimedia including blogs permits the audience to respond and put their views together and respond to the writer. This interaction is different from that one engages with a live audience but the writer has the opportunity to feel the ‘pulse’ of the unseen audience though comments sent in by readers (in blogging).

Use of the computer has had a positive impact on writing ( the font size can be increased at your whim and fancy) and spell check gives us confidence in moving on at a faster rate especially we old ones who are still down to ‘two finger typing’. The dictionary and thesaurus are at hand and corrections are easily done. Many senior statesmen continue to write till their ripe old days. The former Indian President Radhakrishnan was an exponent in writing as he was recognised as a great philosopher. Mahathir Mohammad, the former Malaysian Prime Minister was not only an astute statesman but a prolific writer and continues to pen his thoughts.

Writing skills develop with continued use of language to express one’s thoughts and feelings. One should not be afraid of using his writing skills to express views and beliefs. The reader can judge and decide to accept or reject views expressed. The aging mind must be occupied and expressions through writing are one effective way, I believe.

Sivalingam Nalliah 20 Nov 2011

Am I getting the message across......?

2011-10-29T21:01:00.000-07:00

It is often perplexing when students don’t respond to a question when learning in a group. This often lends to reactions by the ‘initiator ’-the lecturer who asked the question expecting an answer as in a normal conversation between two persons. The complex relationship in a classroom setting is evidently quite different from a conversation in the corridor.
The situation in this complex relationship is rather unnatural as we have to factor in several interactions , the group that is watching the expected response, the confidence the student has in getting the answer correct, previous experiences with the same lecturer or with other lecturers which may have resulted in a traumatic outcome and the student’s own ability to communicate, to articulate his thoughts, his ability to organize his answer based on how he has understood and analyzed the question thrown at him.

When we talk about communication we are so very familiar with the ‘new millennium’ kid, the so called wired kid or is it ‘wireless kid’! It is a familiar scene now that it is no longer possible for one to have a conversation for more than 10 minutes without an interruption as the other party fumbles for his hand phone and breaks off the communication to answer the call, which could not be that important. The person on the other line had made the call without a single thought as to what the receiving person would be doing at that point in time.

Ironically we see these at all levels of society, not only among kids and young adults. It was amusing when I saw a leading politician recently, coming out of his car as a huge group was waiting to greet him. He had his mobile phone ‘attached ‘to his left ear being held with one hand, while the other hand was systematically outstretched willing to shake the hands of large group of willing supporters. Would this be civil or is part of the ability to multitask!

I often lament that the next generation would be lacking that bit of empathy and would fail to have the human touch if the electronic media transacted through our society without any respite for human communication.

‘Communication in a changing world’; that is what I wanted to address. However I thought I should digress and discuss the elements of communication as well elaborated by Bethami Dobkin & Roger Pace, (2003). The model sited in their book reminded me of the Artkinson and Schiff’s ‘memory ‘model. Although communication can be verbal and non-verbal we are mindful of the visually challenged and those who have hearing impairment who lead meaningful lives utilizing their skills in communication, verbal or otherwise.

Whatever message is transmitted during the communication involves several channels and media, they go through a sieve like barrier, so that the listener has the option of not registering it (encoding) or decoding it. Clearly one would want to be engaged in the complex situation to be communicating, otherwise the message gets thrown away.

The ‘working memory’ , according to Atkinson and Schiff last but 20 seconds and if the message transmitted is not captured to be encoded after analysis, it just gets brushed off, like raindrops falling on the wind screen of your car. Should there be some enthusiasm in wanting to be engaged, then all the factors like meaningful language, interest and active learning, need to be in place before there is a reaction to complete the communication loop. The latter could be a verbal expression immediately after or non-verbal expression of understanding and acceptance.

The SMS that one uses with mobile phones has had a lasting impression of how communication has changed. All the processes as to how the mind reads is explicit in the SMS. If one types ‘I would prefer face to face learning’ it may take that much longer. An alternative would have been ‘I wld prefer F2F lerning’. Is this correctly written? That would be another arguing point but the message is understood and communication is complete, if that was the original objective of communication.

It is a changing world and new communication skills would have to be accepted as we move to another generation of people. Initiation and interpretation are all elements of the mind, the maturity of thought and the makings of our alignment to understand each other. The ability to vocalize is intrinsic to the human race and as to how to use it to communicate should be left to innovativeness, flexibility and practicality, I believe, though it is rather difficult to fathom in totality as we become unfamiliar with the language of the new millennium kids and the Y generation.

People contend that messages are indeed the thoughts and ideas expressed by others. It may have an emotive context especially when expressed in the first person. The charismatic leader exploits this aspect to the maximum to reach out to his listeners and supporters. Music icons and preachers are great communicators. Intonations and hand expressions, facial expressions and specific movements which are all non-verbal enhance verbal communication. Communication is multidimensional and the man on the street is always learning newer and newer media that is used. The means of communicating will not abate with the conventional e-mail, video conferencing, face- book and twitter as long as innovations and appeal go hand in hand. It is a dynamic world that we live in and we have to keep track of the rapid changes to be able to communicate. There is now a huge move to make education virtual and computer mediated learning will mould the future generation to begin learning and working using communicational channels which have less and less face to face communication.

The context of communication is an often misunderstood area because of the meaning behind the message. If we have an invitation to a wedding addressed to couple and a dressing code is required, it is only civil that the invitation is accepted or declined and the dress code is adhered to. In the context of the modern world it is clear that one expects just the two people at the wedding. However, in the Asian context, the message (invitation) may have a deeper meaning and may permit the entire family to come! The diversity of culture does play a big role in considering the context of communication.

It is a peculiar truth that communication is irreversible especially when vocalized. There is little way we could retract a statement once made and that makes it so important to be careful what is said. An apology after a harsh statement can be difficult to mend, we all know that. At times we use such a strategy to close a discussion or to drive home a point.

Conclusion
Communication is integral to interpersonal relationships and is a complex subject. Most arguments centre on poor communication and peace reigns when communication is at its best. Cultural diversity and the context of the environment will impact on communication whether it is verbal or non-verbal. As good humans we need to be civil in communication and be mindful of the sensitivity of the message as once it is communicated it is irreversible.

Further Reading:
Bethami A Dobkin & Roger C. Pace. Understanding the Process of Communication in Communication in a Changing World. 2003; Mc Graw Hill, Boston

Sivalingam Nalliah 30th Oct 2011

The Language We Use

2011-10-16T05:44:00.000-07:00

The Language We Use
Colonialism left us with the English Language and that was the lingua franca for many years in schools and university. As we were taught by locals who were not native English speakers we often held on to their philosophy of making the discussion brief. To curtail having to read long assays, I believe, this was a ploy by our teachers. More than 100 words for précis or 350 words for imaginative composition invited severe reprimand and a drop in grades! A second mute point was to ensure the language you used was simple without ‘flowery language’. It bored me writing the same style to get the point across so long as it was grammatically correct that I attempted an essay with enough adjectives to cover most of the terms found in Collin’s Pocket English Dictionary culminating in getting 45 % for the paper! That moved my confidence that much lower that I never attempted deviating from the safe zone thence on!
Using bombastic words has its value in showing your peers that you are that bit higher in the use of the language. Though you did not favour such words or what I surmised as meaningless communication I have found that it did sound different. I recall the English book ‘Tom Brown’s Schooldays’ where the opening statement ‘by the pen of Thackary and pencil of Doyle’ or some such statement in introducing the Brown’s ; I thought that was a novel way of starting the page. The mundane ‘it was a sunny day and we were preparing for the picnic we had planned’ sounded so routine that I thought reading the work of others does influence you to some extent.
The word ‘bombastic’ is an oft repeated word that invites equally unfamiliar meaning as being ‘pompous, pretentious, grandiloquent and overbearing’. However when one wants to make life easy for the unintended reader alternate terms for ‘bombastic’ like ‘ostentiously lofty in style and orotund’ takes the cake.
Surfing the ‘net’ for ‘Trilogy of Life’ I came across a feature article written by Leo Goldsmith (http:/notcoming.com/feature/triologyoflife, 17th July 2004). The author was portraying the wonderful works of Pier Paolo Pasolini who was a complex person of very high calibre and a great intellectual who met his untimely death in 1975 in Italy. Apart from writing numerous novels and poetry he was a great filmmaker and activist. The Trilogy of Life related to three famous works; Chaucer‘s Canterbury Tales, The Decameron and The Arabian Nights. I was familiar with the last, had heard about the Canterbury Tales when I was exposed to Medieval European History at the age of 13 but had not heard about The Decameron. The poetical works in the Canterbury Tales was indeed unfamiliar territory and I refrained from reading the book although there is hard copy lying in my home for the last 40 years.
Goldsmith has a smudge of bombastic language, at least to my mind but the articulation is so meticulous that it sends out the message so aptly about the works of Pasolini as a great film director. ‘Pasolini produces feature films where nudity, casual sex and naked flesh are integral to his works’. That sentence by Goldsmith is easy to comprehend. However the subsequent terms like ‘rustic, libidinous pursuit of casual sex’ was a tardy bit too much for me to clearly understand till I reached for my English dictionary. Google’s has made it easier by having the Thesaurus icon just above this page. What do I see in Thesaurus; rustic refers to ‘rural, country, pastoral and bucolic.’ Bucolic’ is unfamiliar to me so I go back to Thesaurus! I return with ‘rural’ but what happens to ‘libidinous’? No results are found! Perhaps my English teacher was right in correcting me that simple language would suffice for communicating the issue , all that is said is ‘ Pasolini often portrayed scenes using naked flesh and loose moral values’. Having said that, I marvel as to how columnists waken me up by infusing such euphemism. “The air of naiveté with which Pasolini infuses this trilogy is entirely calculated’ adds Goldsmith. Such meaningfully placed words spell a deeper understanding of Pasolini as having construed well ahead , the viewer and underscores the craftiness of the man.
Bombastic or simple language, the colonial masters of this nation have left a lasting legacy.
Sivalingam
16th Oct 2011

The Poetry Reader

2011-08-13T06:41:00.000-07:00

I am no poet and many attempts I have made often lacked the impact required of good peotry. My primary school days remind me of Nathianile Hawthorne and a book we had had to buy 'An Anthology of Poems'. If I did not get anything from the subject at least I learnt about the word ' anthology'.

My school teacher had all the characteristics of a dramatist as he lived the words of each poem we read. Some were related to those maimed at First World War, others were philosophical and yet some were just comedy. We did not read about great poets of the day but Hiawatha is vivid in my mind, it was about the a Red Indian in the USA, if I remember right!

It dorned on me then that I should put some words together and see if I can re-live the days when I was not yet nine, being read poems in school. The note below potrays a Poetry Reader and his young audience.

The Poetry Reader

Children have come from far and near,
With enthusiasm, curiosity and plain fanfare,
They come in droves with parents and carers,
As they hear that the poetry reader is here.

Assembled in planned rows, they sit on the floor,
In the huge hall, that could accommodate more
Prim and proper they look, the clothes they adorn,
T-shirts, pants, sports shoes and all.

They await the man they have heard about,
Impatient they get, the curtain is not raised.
An announcement comes, what they had longed for,
‘The poetry reader is ready, to read to you more.’

A stocky man he was, not to be raved over,
Kind he looked, balding head, nothing to cover.
He wore a long robe over his attire,
Gave the impression that the colours were on fire.

‘Come forward my children, come hither’,
His voice was soft but became firm and louder.
Moved forward they did as ordered,
Like the waves of the sea, before they retired!

‘I am the poetry reader, you all gather,
But I am more a story teller.
I read poems, prose and all you desire,
So children, be silent lest my voice, you don’t hear’.

‘Silence must prevail if you want to listen,
To the messages I send through bards and tales.
Many are the values I want to share,
Gather the meaning; you must lead life with care’.

‘Poems have changed so very much,
As experimentation with writings became a norm.
Differing ideas impact the mind,
More freedom to express, imagination of any kind’.

‘Herbert expressed ‘Easter Wings’ in the shape of a wing,
Poems took shape in the form of star, wheel and string.
Baffled will you be if you thought of poems in patterns,
As writers became bolder, penning their thoughts to denote contents’.

‘There is a message in all one writes,
The way it’s expressed, meaning is concealed ,
Read on and on, till you come to the end,
Clearly you may see what the writer has penned’.

‘Words are joyously said, intertwined with earth, soil and till,
Keep close to the style, and decipher what is said,
Look hard at the plight of the writer as he expresses,
Is he sharing a deep thought, idiom or life’s messes?’

‘Listen to a poem, Finnegan’s Wake from Joyce,
Written so long ago, but still gives voice,
The line is long, but intonations I include,
Pause I shall, at every full stop and comma’.

‘His consciousness, he expresses and puns, uses
The English is old, but meaning so rich,
Joyce is good at his choice of words,
But I won’t read his passage lest you insist’.

‘Poems are to be read for joy, they portray,
Love and feelings, misery and tales.
Rhythm and rhyme, vocabulary and words,
Are poems written in unorthodox ways?’

‘Does it matter the way they are said?
The poem and prose is read as it is made.
I read with respect for those who wrote,
I share the meanings, poems or prose!”

“Watch I shall, at your faces for grimaces,
Pausing at commas, scanning eager faces,
At full stops I shall longer, wait,
Looking at you, ensuring you are in the correct state’.

‘Ask me a question, my children and friends,
But not before I have stopped to pause,
Then I would know you want me more,
Remain I shall, a poetry reader.’

Sivalingam Nalliah

12th Aug 2011

Midlife crisis -is it for all ?

2011-07-04T05:29:00.000-07:00

The 'empty nest syndrome' is for real as I sit to pen these few words. It has been a busy weekend minding the house and completing my task in view of the coming 'high stake MBBS examinations' and preparing the the lectures I am scheduled to give to professional bodies till the end of the year.

Sustenance and mental drive are essential to complete the job; both of which I seem to lag behind as I touch 63 years of age. Vivid flight of ideas seem to percolate through my mind severely disturbing my focus. My mind runs back to the early years at the university and I am reminded about the infatuation with a university mate for a few months; work schedeule and the lack of finances helped me keep those thoughts remain 'virtual' till she moved on to more reponsive parties!

Viewing old Indian movies on TV brings me back to the days when I used to fall in 'love' with every other actress from the time I was eight years of age till early secondary school! The intense emotive cry of the lead lady and the sterotype dressing they adorned made the saree remain an unmatched garment impacting me so deeply that I built within my mind the ideal wife I would want!

Time has flown by and I am still trying to keep the mind intact by actively being involed in intellectual activities. Apart from the daily work at the medical college I am reminded of the joy of reading , a habit both my daughter and son seem to find joy in. Last year William Dalrymple's 'City of Djinns' was sent to me for my birthday.

Quoting the author's very words' if poetry, music and elephant fights were the preferred amusemnets of the court, the humbler folk of the age of Safdarjung had their patridges'. Basically the story depicts the life of the last Moghul ruler of India.

Poetry is indeed a means of communication through words which have within them rhyme and rythmn. Like an artist trying to display his thoughts and perceptions in colour, the poet uses vocabulary and sentences to express his views and feelings. To keep my mind from idling and to relax it in times of stress I too try to write in poetic words, but clearly I can see the limitations and frustrations.

What is the relevance of quoting a Scottish author writing a fiction based on Indian history and attempting to explain what poetry is in simplistic words? Well, such thoughts makes us ponder on differing means of communication, the spice of life is in making presentations complex so that the hidden meaning can be explored.

As I read the newpapers, books and scholastic articles in medical journals, authors appear to express their thoughts and views, skewed or otherwise. The point is made and thoughts expressed. The reader is left to surmise and contend with the conclusions and information. Won't that awaken the idle mind? It is with that primary purpose I started this blog.

I tried to complete a task given to me on ' the overactive bladder' a malady postmenopuasal women suffer from, last week. The job got more complex when I was also assigned to lecture on the same conditon to some professionals. Two weeks of power point preparations, writing an abstract at short notice to the organisers of the confernece and generating a full scientific article for another scolastic journal exhausted me so much that I allowed myself to drop the urgency in submitting last month's article for the blog.

Father's day last week was spent with my wife giving me a lunch treat with another couple in a nearby hotel. That same day phone calls from the children expressing their good tidings followed and a wonderful card from my daughter from Edinburgh , appropriately entitled "Lord of the Manor" - I left to water the plants in the garden after reading her message!.

The next day a gift followed and this time it was Michael Fitzgerald's 'Adolf Hitler: A Potrait'. My keen interest in biographies of leaders made this timely gift appropriate so as to complete my collections over the years. Although Hitler is the most hated human after the Second World War, few would deny the rise of an Austrian having failed to get into the Art Academy in Vienna to lead modern Germany, having left school at the age of 16 ( wanting to be an artist!) The book puts in perpective what leadership is about and what it means to be a team builder. Although Hitler never had any formal education beyond the said age , he was a ferocius reader and compensated his intllectual deficiency through listening and undersatnding the principles of socialism. What made him what he grew up to be, has to reflect on the hardship of his early life (see Mein Kempf). He is probably the earliest of national leaders who promoted the 'green environment philosophy and ensuring agriculture should be a sustainable project in Germanay (and that saved many from shortage of food).
Always a shy person in private and with several failures in his personal relationship with the four women mentioned in the book, he proved to be a great orator who used this asset to the best in moving the crowds. I am in no position to speak more in glorifying him, as the holocaust that was seen during his days cannot be forgotten and will always remind us that when power overwhelms an individual common sense fails to prevail.

The growing unrest in the Middle East appears not to be aborting as people cannot tolerate leaders who fail in maintaining democracy. When Egypt saw the fall of Hosni Mubarak, I am reminded of the role of 'guided democracy' prophezed by Indonesia's Sukarno. State control does little to keep peace and involving the people in the management of the goverment is paramount.

The midlife crisis is not about one's self and his abilty to cope with the daily tasks and stresses alone, but his concerns if the world is a safe place to live in. Responsible goverments will gauge the people's needs and that's what makes countries 'developed'. I should not be concerned about the welfare of my family and the healthcare of me and my community after years of paying income tax as that becomes the responsibilty of the establishment. If that is so, I will need to develop strategies to deal with my emotive and coping abilitites through senior ciizen's facilitites that are made available within the community.

Let's pray the govenment of the day would make education, healthcare and the wellbeing their people their responsibility the world over.

Sivalingam Nalliah

4th july 2010

Life is complicated or do we complicate it?

2011-04-07T07:01:00.001-07:00

A recent article in the New Straits Times (April 6, 2011) makes interesting reading. It was written in plain English and lived up to the title ‘How to live a simple and peaceful life’. It pains me to see how people in middle class and upper income bracket travel miles and spend enormous effort, time and money seeking the ‘truth’ and yearning to live in peace through soothsayers and instructional leaders. As the teachers part with their wisdom, the followers must find solace and the solution to what they were yearning for. Do all attain what they set out for?
The belief system and value added interactions have benefited numerous followers, many who have imbibed that learnt during the interactions with sages and coaches, while many more continue to seek the ‘SOURCE’.

It is undeniable that among us there are many who need a ‘guru’ or a teacher. Socrates was a great teacher who instilled in his followers to enquire and question the facts of the ‘matter’. Socratic thinking is now advocated as a powerful means of nourishing the inquiring mind. Gautama Buddha left the comforts of palace life to enter years of learning about life far from that of the material world. He achieved Nirwana, the ultimate of but few!

In order to closely follow these great teachers is an arduous task in the present day. Getting detached from family and work is near impossible. The tasks ahead and the duties of the husband, son and daughter are enormous. Perhaps one could allocate a few hours for self improvement and instructional classes. Under these circumstances, the article above rang a bell. Hey, here is a compromise!

Try to make life as simple as possible! Imagine that one cannot complete all the tasks within a specified time without getting stressed. The boss won’t know about that, he just wants them done! So the advice is prioritizing and performing those that are relevant. Have a discussion with people at work or family members, depending on the list of tasks; if all the assigned jobs have to be done? Could the list of tasks be short listed? One will be surprised how little is missed when one drops 2 out of the original 6 tasks!

The day should be begin ‘yesterday’. Otherwise planning is not possible. When the day’s work is done, pondering over what needs to be done the next day allows for space and valuable time for you to reflect and review. Reviewing the list of tasks would permit cutting down redundancy.

Currently public hospitals in Malaysia have a surplus of house-doctors. If one was to audit what they do, one would be able to appreciate the amount of redundant documentation with little benefit to the care of the patient. In other institutes where there is a lack of delegation of work, the ‘mandor’ concept prevails. I continue to see this in commercial banks where there is a delay as some processes require a supervisor to go through the request. If we do less by reviewing the processes, more quality time is created.

Tasks and the job we are at need to be ‘savoured’ and enjoyed. If one gets up in the morning, moaning that he has to go to work, the going will be tough and trying. A positive attitude and being proud of the job are assets for good living. After graduating from medical school, nothing is enjoyable than to show one’s prowess at healing the sick. That is the job of a doctor or a nurse. That is what medical graduates worked for. So by accepting this unique responsibility and performing the tasks required of you, less stress is experienced. One would find joy in the encounters and the ‘lark’ within you will leap in excitement and good health.

Learning and re-learning the processes of the day contributes to making life simple and enjoyable. Being happy at what one is doing is likened to the endorphins released in the body by the obsessive road runner-it can be invigorating and addictive! Love yourself by loving what you do.

The ‘SOURCE’ one looks for can be in the very place where you are, whether it be at work or at home. Re-look at what is already there, at yourself and what you do!
SLingam
7th April, 2011

The Human Mind- Evolution and Exploration

2011-04-01T20:03:00.000-07:00

Charles Darwin inspired scientists to accept his theory of evolution. He was convincing in explaining the current concepts that has contributed to the evolution of the human brain and mind. Adaptive to the environment, the human mind has certainly achieved a degree of complexity that it remains a ‘mystery’, a mystery that is in need of exploration and understanding.

Human psychology was popular in the European states as scientists and philosophers attempted to understand the workings of the mind through study of behaviour. As far back as 1879, a German, Wilhelm Wundt opened the first exploratory psychology school in Leipzig.

Learning about the mind from scientific principles can be difficult. Language, memory, the conscious and subconscious states are presumed to develop through forces unknown. Why do some acquire skills to speak in various languages so quickly while others don’t? How do children learn the mother tongue as their brain develops in a way different from adults learning a second language? Why does the memory of the child become more complex as they grow ? These are questions that need exploration of psychology of the mind.

The human is a social being and has enormous capabilities in thought processes and planning. The human mind can be both devious and forgiving, emotive and melancholic. We use different terms-the criminal mind, the kind person and psychotically depressed person!

We know, through Charles Darwin’s evolution theory that random inheritable changes have contributed to survival of humans who can adapt as the environment changes. Such an evolutionary process is necessary for existence and generation of the next set of humans. The term ‘natural selection’ becomes relevant and appropriate.

The theory of adaptation for survival is now well demonstrated in the pregnant uterus. Barker, an epidemiologist in the UK observed that survivors of the great wars (First World War)in Europe beget children who were destined to develop chronic diseases when they became adults. Barker’s theory is now accepted and now labelled ‘ fetal origin of adult diseases’. Mothers who were afflicted with conditions that affected nutrition and oxygen supply to the fetus were seen to deliver ‘growth restricted fetuses’. Such affected babies were light (smaller) for their age and gestation. Long term follow up revealed that they were more prone to diabetes mellitus and coronary heart disease.

What we see here is an adaptive process where the fetus has to make changes in its metabolic and bodily functions to survive in an unfavourable environment-the poorly nourished uterus. Such changes come with a permanent change in their organ function. How does this tie up with the development of the mind and behaviour. Although differences between such babies and those born to normal mothers do not show a great difference in cognitive functions in the short term, more needs to be done to see the effects on the mind in later life.

Memory is a rather complex subject to study but theorist have been explaining the way memory develops. We are clear that memory is not static. The dynamic status is seen in all of us as we grow older. Memory declines after 30 years and that is worrying. Alzeimer’s disease and organic brain disease are debilitating and affect adversely quality of life. Are we wary of why these develop? What is the capacity of our memory. How do we ‘hide’ our loss of memory when we grow older. Do we repeat ourselves –have we been told that they have heard about that which you thought you were conveying for the first time?

There are ways to sustain a good quality of life through mind training and adapting to memory loss as we age. The mind has a huge capacity and we continue to learn about the mysteries surrounding it. We need to exploit this capacity through various strategies whether it be meditation, completing cross-word puzzles or doing one SUDUKU a day!

For a free assessment of memory go to:
http:/www.bbc.co.uk/science/humanbody/mind/surveys/memory/
SLingam
2nd April 2011