Pater noster...

This is a timely warning. A warning to the medical profession everywhere else in the world, particularly in Asia. Where I come from, families fight tooth and nail to give their children an opportunity to study medicine - specifically, MEDICINE. The respect and regard for the medical profession surpasses everything but religion and family ties. It is the ultimate goal for many people and while many doctors may not be well-paid, that wasn't their motivation anyway.

The shambles in the NHS, with MTAS and MMC just highlights how completely bankrupt society has become, using billions of pounds to prop up needless bureaucracy and management instead of delivering the actual health services that patients require. Pen-pushing has become a goal in itself to the detriment of jobs and training for the people who actually treat people - the doctors. You can blame the government - you could even blame the electorate - but the responsibility (as always) lies with doctors themselves. The British medical profession (and alas, doctors in most of the Western world) have allowed themselves to be trodden upon. The media is more influential at changing what people believe about health and science than doctors or scientists. We have abdicated our authority to the lowest of the low - politicians and the media. Most of all, we have locked ourselves in our ivory towers trying to keep our intellectual purity, trying our best not to be too 'paternalistic' and theorising that the public is the best judge of healthcare and politicians are the best judges of public needs. We have failed to see that without engaging the public - or at the very least, resisting the onslaught of bureaucratic burdens, we have made ourselves completely powerless. At this dire moment we have become pawns for the politicians while they systematically dismantle everything that made medicine a profession to which only the best could once aspire. We are divided and disunited.

Whether the current situation is saved or the whole thing collapses under itself, there is only one lesson that must be learned from this pitiful tale of woe. The medical profession everywhere else in the world must not allow itself to crumble. We are professionals, not peons. We devote our lives to helping the sick but that does not mean that we are desperate weaklings, 'nice guys' who can be kicked around at will. Most of all, the medical profession must retain its POWER - for power matters when confronted by power. Where I come from, the government would not dare meddle like this - for as long as doctors assert that THEY - and THEY ALONE make the best decisions in the best interests of patients, such trauma will not befall us again.

We have turned paternalism into a dirty word and lost our authority and now we are no longer healers but servants of the state. Doctors everywhere else - don't give an INCH!

The Late Fool

I still can't figure out if it's an April Fools' thing.
http://meded-portal.ucsd.edu/webportal/announc/taking_up_residence.html
How touchingly perfect. A bit like winning the lottery, I guess.

Strawberries and sunny days are here again.

Words, words, words.

Words can be beautiful things. Diverse examples (my personal tastes): "mahogany," "Chloe" "halcyon," "azure" and "lariat." Stunning words render me speechless.

Bubbles

http://www.bbc.co.uk/bbcfour/documentaries/timeshift/raj.shtml
I say, "let them eat cake." We're seeing a repeat of this wall of prejudice today. It's bad enough for 'native' Britons to emigrate to Australia to take up 'cushy' GP posts in the outback. I feel cheated by the slimy mongrel government that dares to call itself the saviours of the NHS. Let the whole rotten system collapse (like the Tube). They probably won't learn their lesson, but a nasty wake-up call to the masters of the universe is long overdue.
Unfortunately, I may depend on them for a job.

Which brings me to the medical bubble. The horrid, reflecting spherical prison that is the world of academic medicine. It's weightless and weird. A world unto itself. A protected place...and yet a trap for everything within it, longing to touch the outside yet afraid to do so, knowing that if those within step outside their boundaries their world and everything they know will burst around them and they will enter a far, far uglier world than anything the bubble held. You see, the medical bubble, for all its unfairness, idealism, caring, bigotry, poverty, wealth, rabid competition, generosity, self-serving stabbing-in-the-back, kindness, slimy sucking-up, pressure, overwork, failure and achievement - is simply a reflection - of the world outside. Leave it and you're no better off because it's just a closed-off continuum of the agony of everything you can experience - just with a different set of rules - in some ways, no better - and no worse...
So I'm scared. Terrified and horrified. Petrified and mortified. My bubble is not bursting - it's imploding.

Splintered

It's been 4 years. 4 years and I'm still the loser I was when I began. No progress there.
I have found a convenient dichotomy - the basis for my current 'framework for living.' It scares me. No, not 'multiple personalities' but just the way that a deliberately self-deluded person finds it necessarily to continue deluding himself in order to keep going. Here goes:
1) Happy me - the eternal optimist, appreciates things 'for what they are' (whatever that means).
2) Sad me - can't let go, clings to the past, constantly preparing for the worst, siege mentality, loner, trusts nobody
3) Kind me - would give selflessly in the name of charity, sees all people as worthy of being loved no matter what
4) Cruel me - sheer survival instincts applied even to daily living in blips of paranoia, vengeful and suspicious

The way in which it's possible to skip between the different extremes (usually in response to external stimuli) can be terrifying. You split yourself so much that you lose sight of what "the real you" actually is, so when people want to get to know "the real you" they see only a facetious lump whose attempts to modulate his accent are a symptom merely reflective of the deeper schisms within. Jekyll and Hyde, but not as grand. I don't even try to 'suppress' things; I merely attempt to behave as dispassionately as possible. I am becoming a drone, an automaton as far as emotions go. It's true to some extent - you can numb yourself to the outside world as a defense mechanism - and compared to many other people, I haven't even been as exposed to horrors that would make such a response more legitimate. In that case, it'll be interesting when the puddles of inconvenience become pools of adversity...

The future is bleak

The more I think about it, the more unhappy I become. The more desperate, dissatisfied, dejected, dolorous, doleful, downcast, downhearted, desolate, dispirited and depressed I become (kudos to Roget's Thesaurus). Only the future could be worse than the present (by no great leap of logic) and I dread what the next few years may bring.

Hoping desperately that I'm wrong, my little predictions of gloom are as follows:
1) The current 'bullish' economic outlook will collapse within the next two years. Just in time for me to finish medical school...
2) Global poverty and widening income disparities will continue unabated
3) No major environmental disasters will stem from 'global warming' and 'climate change' - yet politicians and the media will somehow find a way to blame these for hurricanes and earthquakes

I have no happy future. The world (on average, on the whole) has no happy future. It's going to be utterly impossible to find employment, whether meaningful or not. How does it feel at 21 to think that the past two decades have been an utter waste? It sucks. It sucks, bigtime. It totally, utterly sucks. There is no need for eloquence when you can't see the wood from the trees because the whole forest is crumbling around you in a hail of sawdust. There is no need - because you can't tell if you're wielding the chainsaw or whether that's simply the sound of your mind shredding the last elements of your sanity.

My first week in a laboratory has not done this to me. No, no - the lab has been good, so far. However, it has slammed home how utterly useless I am. I put in my 9-6 every day (it'll increase, I assure you, as the experiments progress) and yet I know I'll never feel satisfied with the outcome, constantly worrying about the past, present and future in a blur of anxiety. This is what happens when you're a pampered child loth to untie the deadknots of apron strings for fear of falling into the abyss over which you dangle, saved only by those same apron strings.

This is all one big delusion. The power to deceive oneself seems to be the only thing that can keep a person going, sometimes. It's an elaborate game of make-believe, where you cling to the past, veiling the present horror with the images of what you perceived you could have been just so you can live on to fulfill the tainted promise of a tomorrow that would be better off if it never came.

Dead and gone.

I have never understood fatalism, but it's starting to become clear that, give or take a bit, everything is truly pointless. No reason to stop striving, but you have to ask yourself why the world is such a depressing place.

Home Alone

I am an anti-social recluse. Never mind that - at this time of year when I descend into abject self-pity it is far more fitting to remember those who don't have the luxury to moan. This Christmas I earnestly wish and pray for:
Compassion and relief for the poor, tired, homeless and hungry. Healing for the sick; calm for the dying, comfort for the bereaved. Company for the lonely, abandoned, orphans, widows and the elderly. Safety for travellers, whether stranded or storm-tossed. Courage for those stationed abroad in the service of their country; peace for those torn apart by conflict. Self-reflection for those in power (yes, even them). Love for the brokenhearted. Joy for families. Most of all - hope - for everyone in this weary world - we are so desperately in need of that precious gift. Hope.
Amen.

Sic transit gloria mundi

"He renamed the month of January after himself and April after his mother; he banned ballet, gold teeth and recorded music; he ordered the construction of a lake in the midst of the desert and a ski resort on the snowless foothills of the Iranian border...interspersed with the crowd were stony-faced officials ensuring the public enjoyed the event. We heard of people being summoned to police station for not smiling broadly enough at such occasions." - BBC News, reporting the death of Saparmurat Niyazov.

Simple things.

It has taken me a long time to realise that turning back and changing direction can mean different things. Perseverance means that you don't stop hammering away; that does not mean you have to keep using the same mallet. A change of tactics (bearing the goal in mind) is a change for the better.
Good heavens, for such a simple truth I sure took my time.

Jenner and Pasteur would be turning in their graves...

I try to avoid overtly-'topical' issues; times change faster than catwalk fashions and there really is very little point trying to chase the wind.
Nevertheless, we all have our own little 'passions' and 'pet hates' and idiosyncrasies and it would be remiss of me not to cite my own. Vaccines. More specifically, the profound distaste I harbour towards the anti-vaccine lobby.
Is it not difficult enough for scientists to develop vaccines in the first place, for millions to perish for lack of treatment, for vaccine costs to price out those who really need them - is it not enough, I ask you - that now the vocal few seek to cast doubt over one of the scientific/public health advances that has done most to improve human health? Must the ravages of diseases like measles, polio or rubella once again stalk the West before these (I'm trying to control myself here) incomparable idiots stop their questioning of something that has most probably prevented their own deaths? They claim side effects, pharmaceutical/government conspiracies and more besides. Science panders to skeptics (i.e. the scientific community) and it is this approach to testing hypotheses that underlies the phenomenal work researchers undertake to bring vaccines to fruition. No, vaccines are not 100% perfect (no drugs are). I am driven mad with rage by the disgraceful actions of this idiotic few. This isn't an issue of more or less, it is one of life and death.

Patronising, paternalistic and authoritarian as I am, I would have compulsory vaccination written into law (with obvious exceptions - allergies etc). If you're too selfish that you won't protect yourself or your own child, at least spare a thought for the rest of the world - two words: herd immunity.

Cost-Benefit Analysis

I don't understand why pavements have to be made of marble or shiny tiles that get wet within the first five seconds of tropical rain and turn into deathtraps of slippery evil for pedestrians.

My mind was wandering as I listened to music (it tends to). The world would be a somewhat kinder place if we all submitted to that naive impulse to give the benefit of the doubt to our fellow human beings. For example - who knows if that irritating frog-like lady on the subway who kept treading on your toes is actually a war widow who spends her Saturday afternoons helping young children at church? No matter - it's incredibly difficult to find the goodness in everyone - tedious and pretentious, some might say - but worth a try nonetheless, as a goal in itself.

I sometimes wonder how much of our destiny is truly ours to shape - so many different faculties could have been developed in different ways if only a mentor, teacher or friend had influenced us in alternative ways. You can look back and wonder whether or why, but hindsight isn't much of a clue to the future.
Teachers are really, really powerful people - but then perhaps I'm just giving them the benefit of the doubt.

Iz Lives

So I sat there, falling into yet another one of my states of self-pity and depression (the non-clinical sort, if one exists). Hurrah - yet another crisis of self-doubt from a 20 year-old who (by his own admission, no less) doesn't deserve to have another bout of weltschmerz. The meaning of it all - pondering, wondering, gazing at the door as my mind turned into a whirlpool of nonsense. I'm naive enough to believe in 'goodness' and yet cynical enough to dismiss the notion, optimistic enough to cherish the prospect of encountering it while the pessimist within has lost all hope of it. Schadenfreude vs Empathy. Worse still would be gluckschmerz - good heavens, I think I'm beginning to see myself for what I truly am - an evil conniving hypocrite who baldly admits his flaws in a bid to dissociate himself emotionally from the cold interior that's melting like the polar ice caps. There we go with the self-pity again. Round and round in circles - a bit like Dante...borrowed that idea from my younger brother's English essay.
What of life? What of death? What of hope? Just get on with it, make your heaven here on earth, forget glory or damnation and just do your best - I don't know the correct descriptive term for this little mantra. I somehow find that innately depressing. There we go with the depression again.
Still I sit here, those thoughts spiralling out of control as I play Israel Kamakawiwo'ole's 'Somewhere over the Rainbow' medley - the haunting power of that voice reaches over and floats into my little reverie. I listen and am unable to cry. Those bundled up thoughts, scrunched up in the brain's backyard just stay there, stubbornly refusing to give way. The music soars and my eyes close as I rock backwards in my chair as I hear those words 'why now oh why can't I?' Little channels of envy swirl around. I'm actually so happy with the simple things - the soft toy blue elephant, the simple songs, the simple food, the simple words and yet - the world around churns these into a curd of dissatisfaction, guilt and misery. O Lord, subtract the selfishness, add the goodness, multiply the friends and divide and flaws. I might be a normal person, then.

Iz Lives

So I sat there, falling into yet another one of my states of self-pity and depression (the non-clinical sort, if one exists). Hurrah - yet another crisis of self-doubt from a 20 year-old who (by his own admission, no less) doesn't deserve to have another bout of weltschmerz. The meaning of it all - pondering, wondering, gazing at the door as my mind turned into a whirlpool of nonsense. I'm naive enough to believe in 'goodness' and yet cynical enough to dismiss the notion, optimistic enough to cherish the prospect of encountering it while the pessimist within has lost all hope of it. Schadenfreude vs Empathy. Worse still would be gluckschmerz - good heavens, I think I'm beginning to see myself for what I truly am - an evil conniving hypocrite who baldly admits his flaws in a bid to dissociate himself emotionally from the cold interior that's melting like the polar ice caps. There we go with the self-pity again. Round and round in circles - a bit like Dante...borrowed that idea from my younger brother's English essay.
What of life? What of death? What of hope? Just get on with it, make your heaven here on earth, forget glory or damnation and just do your best - I don't know the correct descriptive term for this little mantra. I somehow find that innately depressing. There we go with the depression again.
Still I sit here, those thoughts spiralling out of control as I play Israel Kamakawiwo'ole's 'Somewhere over the Rainbow' medley - the haunting power of that voice reaches over and floats into my little reverie. I listen and am unable to cry. Those bundled up thoughts, scrunched up in the brain's backyard just stay there, stubbornly refusing to give way. The music soars and my eyes close as I rock backwards in my chair as I hear those words 'why now oh why can't I?' Little channels of envy swirl around. I'm actually so happy with the simple things - the soft toy blue elephant, the simple songs, the simple food, the simple words and yet - the world around churns these into a curd of dissatisfaction, guilt and misery. O Lord, subtract the selfishness, add the goodness, multiply the friends and divide and flaws. I might be a normal person, then.

Prospects

The future is bleak. I remember muttering to the few who cared to listen (back in 1999) that the world would end in either 2000 or 2006. The millennium came and went and here we are today. A recent reminder from an old friend of the 2006 deadline made me wonder if it still matters. Who cares anymore? What on earth is the point? It might as well be over.

hexakosioihexekontahexaphobia

Please, please, please - people! See some sense!
Surely 6/6/1666 would have scared the living daylights out of these luddites.

Odd, that.

http://observer.guardian.co.uk/uk_news/story/0,,1784869,00.html

It was reported last week that hundreds of junior doctors in Scotland, who have spent up to £100,000 on their medical education and could have taken some of the hard-to-fill consultant posts, may be deported within months.

As for the final two paragraphs:
100,000 ? Nah. Double that.
That's why I'm going to sit the USMLE...

Rigor mortis

Life is just a long, drawn out process of having all your emotions, hopes, dreams and any goodness you might ever have possessed crushed and blended away with each passing day. It all comes unstuck in the end. More's the pity because I can faintly remember, once, long ago - clinging to hope. What a lie. What a sham. What a shame.

Drawing blanks

It has taken me twenty years to realise the value of doing nothing. I shall endeavour to spend some quality time this summer ... doing nothing. Absolutely nothing. Not easy, you know. Not easy at all.

Cute?

Some kind soul posted a comment on the posting 'Los Angeles to Mosul for 140' - it's been about 10 years since I was last called that and - boy does it feel good... Jason the little munchkin...a stodgy, podgy, inky-dinky plippety-ploppety happy blobby cutey-pie with not a care in the world. Like a jolly pork pie just before he gets eaten!