Sunday, October 23, 2011

Altruism doesn't seem to exist

I'm forever hearing Chinese people are the most kindest people in the world. This is mainly because I'm surrounded by Chinese people, who think that having a close family means that they are kind and nice. I tend to think this is bollocks. I have the belief that Mainland Chinese people are not that altruistic and I will explain why. Please note that all opinions are my own and if you don't like them, don't read on.

One recent story from Mainland China emphasis my point on Mainland Chinese people. It is the news that a two year old toddler was run over twice by vans and eighteen people walked by doing nothing before a rubbish collector did the decent thing by moving the child to the side of the road and seeking help. Here is where I become all Daily Mail and say the two van drivers plus the eighteen pedestrians should be stripped of all their human rights, face life imprisonments and have all material possessions taken from them.

Maybe I am overreacting to the situation. This could be an isolated incident and in fact all people in China, bar twenty people in Foshan, are good citizens. I really don't believe so. Whenever I meet Mainland Chinese people, most of them tend to be impolite, ignorant and selfish. They only do something to benefit themselves or their family. They are not kind to casual acquaintances or strangers. That is the hallmark of altruism for me. Anybody will help their friends or relatives. It takes true courage and decency to go out of your own way and help somebody you don't know or even don't like.

Maybe those eighteen idiots who walked past thought they might hurt the child more if the intervened, for example by moving the child they cause a neck injury leading to paralysis. Perhaps they thought if they helped out by performing CPR and caused my damage, they might be sued by the parents. Even with all these mitigating factors in their heads, there are other actions that can be performed. You can stop ongoing traffic from running over the child again. You can note down the license plate of the van who ran her over. You can call for the ambulance. You don't have to be intelligent or knowledgeable in CPR to do these things.

The selfish nature of people also affects another story concern Mainlanders. Recently the Hong Kong government have to limit the number of Mainland Chinese mothers giving birth in Hong Kong as they are stretching looking health resources. This has called an outcry from Mainland Chinese mothers who are married to men from Hong Kong, who say they have the right to give birth in Hong Kong.

This shows the ignorance of these people concerning the use of public facilities. Nobody has the absolute right to anything. Even the Hong Kong mothers have to be turned away when the obstetrics wards are full. The use of public facilities depend on their availability and resources. I have the right to use the sports facilities in Tai Po but maybe I can't use them when somebody has already booked them. There are hundreds of people awaiting a liver transplantation in Hong Kong but they can't get one because there are not enough donors in the territory. Not everybody in Hong Kong can be prescribed drugs to lower their cholesterol, even if their cholesterol is high, since it would bankrupt the Hospital Authority.

These women only want to give birth in Hong Kong so they can enable their children to have free education, health care and benefits. They don't care about equal rights, they just want a share of the pie they feel they are entitled to. Unfortunately the pie is not big enough to share.

Monday, October 10, 2011

TVB Pearl News hotties

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Monday, June 13, 2011

Naivety about food

This may be my last entry for a while. I really should be setting up trenches and digging into books for my upcoming exams in September and going to general outpatient clinics next month. So it will mean less time looking at Japanese race queens and US cheerleaders in the foreseeable future.

I also want to keep up my monthly rate of whining about not having a girlfriend.
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In recent weeks, there has been two major news stories about contaminated food. In Germany, nearly 2000 people were infected with E. coli from tainted vegetables. I'm not here to speculate which vegetables they were since nobody seems to know the source. Taiwan has been embroiled in a food fiasco recently, with harmful plasticisers being put in a variety of products, from food to skin products.

I marvel at the naivety of people who think this shouldn't happen in today's society. I like to say to those people to wake up, since this has been happening every since we started mass producing in the middle of the 20th century.

With an ever increasing population and the need to cut costs in production, multinational companies will find any way to cut corners, even if those mean less quality assurance. To boost the food production, society has been injecting all sorts of chemicals into animals and vegetable to maximise the yield. Unfortunately no food can escape a contamination scandal.

The first food contamination scandal I can remember was when eggs in UK were contaminated with Salmonella bacteria in the late 1980s. This carried on into the mid nineties, with the BSE scare which made everyone go vegetarian for a little while.

China are not exempted from this kind of controversy. Everybody who lives in Hong Kong generally thinks the quality assurance is China is very poor. How can you account for the fact that most pirated goods come from China. The mainland has been embroiled with the melamine dairy product scandal and a ton more scandals since. Generally, I don't really buy anything from China, even if it is dirt cheap.

From feeding animals antibiotics and chemicals so they can grow bigger to pesticides on vegetables to heavy metal contamination in fish and seafood, everything we eat has something we don't want in it.

You just have to accept - do you want cheap food or do you want quality assurance. You can't have both.

Monday, June 06, 2011

As plain as fish and chips

In the past few years, I've been more immersed in cooking and baking, now that I have more free time in the evenings and weekends. I should be studying but after spending nearly nine years working my arse off for my mediocre medical degree, I think I deserve the opportunity to explore other avenues of pleasure. Some of my friends and work colleagues may have noticed my new found choice of hobby, by the pictures I post up of my culinary creations or even sampling some of my experiments themselves. The most indirect way they have noticed my recent fascination in food is the increasing size of my abdominal girth and my ever expanding cheeks. Clearly it is easier to gain weight than to lose weight.

I have tried all areas of culinary cuisine, apart from Chinese since I have my parents who can provide many dishes in this area. From chicken tagine to miso soup and mostly everything in between, I've tried a fair few recipes with some disasters and some successes. I do go back to my roots (kind of) by trying out typically British recipes, which include fish pie, cottage pie and roast chicken.

Now for all those non-English people out there, I know British food has a reputation of being bland and unoriginal. Even though I don't like nationalism and patriotism, I think I need to stand up for the humble chicken pie and toffee pudding. British cuisine may not be as exotic as Thai or Indian, or as delicate as the French or Italian. It doesn't try to be that way. British food is simple food or what I like to call "comfort food". It's not for ordering at a fancy restaurant. It's suppose to be easy to make at home and fills up your stomach.

Neither do I like people calling British food 'roast meat and potatoes'. To the naive person, what they usually order in most British pubs and restaurants may be roast beef and potatoes with gravy but there is a wide variation of British dishes if you just explore. Calling British food just roast meat and potatoes is like calling Chinese food just rice and noodles, Italian food just pasta and pizza and calling Indian food just curries. Each cuisine has its own variation and it is up to the eater to explore for him/herself the diversity.

So please, give the humble fish and chips a chance. Just don't try the pickled egg.

Friday, May 27, 2011

The green, green grass of home

I have been back at work for around a week, after having a staycation of nearly two weeks. I'm still at the stage of my career where I cannot store up my annual leave to take it all in one go. The longest time I can take is one week plus any extras I get if I'm on duty on public holidays.

Did I use my time creatively? Of course not. I spent most of my time festering at home, going on the Internet and sleeping. I was not productive, which meant I was not reading any books, studying any medical material or preparing for the two presentations I had to give when I returned to work. I give two reasons / excuses for staying at home.

1. My dad was away on a conference in Northern China, leaving my mum to take care for the two dogs we have. Naturally being a loving son, I had to stay at home to keep an eye on our two adorable mutts.

2. Since late April, the decorators have been disassembling our house to renovate certain portions. The smaller bedroom, the living room and the garage are getting a new look, meaning most of the furniture and items within those three rooms have been shoved into the two remaining bedrooms of the house. My bedroom looks like it belongs to an obsessive-compulsive patient, as most of the open space is occupied by small cupboards, dining chairs and storage units.

I will be thankful when the decorators leave. Not only is it tiresome having to wear slippers all around the house since most of the floor is carpeted with a thin layer of plaster dust, like a really sick version of an indoor Christmas, but I really don't like having all these items in my room. I do miss my open space, and so do my dogs since they have less floor to lie on.

I do miss the open space, which is a reason why I live out in the suburbs. It's also a reason why I don't go out that often. I don't really like the crowds of Hong Kong. All that jostling and pushing in the streets leads me to yearn for large pastures and wide fields.

Now I'm not only counting the number of on-calls I have left (five including the one I'm on now), I'm waiting for the decorators to leave so I can finally have my room to myself instead of sharing it with my parent's ornamental furniture.

Thursday, May 05, 2011

The bottom half of the internet

Many events have taken place in the past week: the royal wedding of Prince William Windsor and Catherine Middleton, the killing of Osama Bin Laden, the introduction of the statutory minimum wage in Hong Kong and Arsenal finally beating Manchester United to blow open the Premier League title race. I wanted to write about these momentous happenings but I thought better of it, as there are far too many opinions floating around anyway.

Everybody has an opinion of everything in the world, whether you think you do or not. Some choose not to express them, which can be a good or a bad idea depending on the issue that is being commented on. The people who do express the opinions have now more ways than before to make their ideas heard. I'm not just talking about the internet, with the comments section that appears at the end of an article and blogs, but other types of media want people to interact with them, such as the news asking people for pictures taken on the day of the royal wedding or radio programs who have listener phone-ins regarding whether it was lawful to the moral leader of al Qaeda.

For the most past, having this medium to express oneself creates more good than bad. The common person has the ability to influence events on par with the giant news corporations. Just look at the revolutions in Egypt and Tunisia. The governments of these two Arab nations were not brought down by arms or companies but by the average Joe (or would that be Muhammed) in the street with Twitter accounts, Facebook messages and blog entries like mine, although they had much more influence than my blog.

Yet there is that minority who are no longer silent but start to type away in the comments section to prove to us they are either idiots, racists, fascists, xenophobes, etc. The internet and social media allow these people to have a voice, which is detrimental to the human race. Yet sometimes it is a good thing. If we didn't have these avenues for them to vent their spleen, we wouldn't know they thought Hitler was a hero, black and white people shouldn't mix or that the woman's place is at home. It does weed out these people into the open and gives us the opportunity to ignore them in the long run. If we didn't have these ways of people allowing to express themselves, they might try to express themselves in more physical rather than verbal ways. Think of the mass killing sprees that people go on - usually they had posted a video or a diary entry expressing their views.

You don't need to think of the bottom half of the internet as a place for lunatics or morons, just think of it as flytraps or a red flagging system to warn us of these idiots.

Monday, April 18, 2011

Dignity in dying

When you are studying medicine and particularly if you are an internal medicine specialist, you get drilled a lot about "quality of life". It's not about curing a disease or saving a patient's life. It's about the quality of life the patient will have after a doctor has intervened on him or her.

Being alive is not necessarily a good thing. As medicine and technology progresses, the life expectancy in the developed world is getting higher. The quality of life gradually decreases as you get older for most people, mainly due to age and the deterioration of the bodily functions but also due to the long term medical conditions people have. Society also suffers in the long term. There will be a higher percentage of elderly people living in society. The situation creates a burden on the public health services in recent years, as doctors have to treat their chronic and recurrent illnesses.

I know I have a tunnel vision view of the situation, since most of the elderly people I come in contact with have such medical conditions which require hospitalization. I know there are many elderly people who enjoy their retirement years, looking after their grandchildren or doing leisure activities which they never had time for when they are working. Yet there are a lot of elderly people who lying in beds in old-age homes, unable to feed themselves and requiring a nasogastric tube for nutritional supplements. They are unable to communicate to the outside world their bedsores are hurting or that they need to go to the toilet.

At this stage I would like to bring the people who advocate against euthanasia. Do they really think there is any dignity or quality of life in this kind of person - the bedbound, non-communicable, double incontinent, old-age home resident? I know doctors are there to save lives but we also have a duty to the people under our care to ensure they are comfortable and pain-free. Maybe death is a release for these kinds of people.

There is a whole spectrum of what the doctor can do to "hasten" a patient's departure. It can range from not actively investigating for a condition if you know that the treatment would be futile. Doctors often find some abnormality in blood results or radiological examinations, which will require further tests just to make sure what they mean. Most of the time elderly patients don't want to know or find the investigations too invasive for their liking to proceed any further. One step up from that is knowing what is wrong with them but finding the treatment to gruesome or harsh to endure, rather opting for "palliative" treatment.

Now we head into murky waters with the next phase, when an elderly patient is an acute deteriorating condition. Doctors often say in those conditions, that cardiopulmonary resuscitation (also known as CPR) or intubation is futile due to the patient's advanced age, poor medical history, current condition and grave prognosis. Doctors at this point usually talk to the relatives with these facts in mind and nowadays both parties agreed not to actively resuscitate the patient, issuing a "Do Not Resuscitate" (otherwise commonly known as DNR) order. This is very commonplace, especially for cancer patients and elderly patients.

The extreme of the spectrum will be euthanasia. Most people would have some idea of the policy in the Netherlands or have come across the news of the Dignitas clinic in Switzerland. Naturally some people are appalled we can do this to our fellow human beings but we have no problem putting pets to sleep or killing people in the name of war.

I think in the 21st century, when people are living longer with more chronic disabling conditions, that firm guidelines needed to be laid down for euthanasia. Sooner or later people will opt for this rather than wait for the natural death that will never come. There are those from the religious right who say that life was given by God and only He can take it away. However not all people believe in a religion and the arguments against euthanasia now have to be universal and appropriate for this day and age.

I think most of the rules for euthanasia are pretty self evident. The person has to be coherent enough to give the order that we wants to die and there has to be good evidence he or she gave that order. Often this is difficult for people who are lying on the bed, unable to communicate to the outside world. The problem could be circumnavigated by signing a piece of paper with witnesses or even better a video of them giving explicit instructions that they want to die if they turn into a vegetative state.

The other big rule is that they are either dying with very little time to live or that their quality of life is so severely poor that continuing living is equivalent to Hell on Earth. All of this is very subjective but there are some aspects we can put a rule or number on, like how long the patient has to live or which diseases we can allow the person to have to meet the criteria.

I know some people are appalled that a doctor can write about this subject but we are not making the decisions, the patients (or the patient's relatives) are. We just give the facts and often our opinions and it is the patients or their relatives that decide. I often come across a few relatives who insist on CPR, even though we know it would be futile. And in those situations, we don't say no - we actually respect their wishes and do what they ask.

We have to acknowledge the preciousness of life itself but also that there is some dignity in dying.

Thursday, April 07, 2011

Road rage

I have been back at work for the past week after being on leave for about ten days. I didn't really do much. Most of the time was spent online and watching old episodes of "Mock the Week" and "QI". I must really spend some of my waking hours doing something positive.

I have been transferred to a new hospital which focuses on convalescence and rehabilitation. Many other colleagues says the working hours are supposed to be easier but I just find the work just as gruesome as ever. At least there are fewer calls to have - just the four per month.

After spending most of the time at home during my staycation, I'm now back to driving to work. I've been driving regularly for the past year and half, so I hope I have enough experience to comment on other road users. I'll leave my thoughts about BMW drivers to another day but I do have many complaints about other drivers.

The main complaint I have is other drivers not using their indicators, either to change lanes or when they are turning. I know it is a minor thing to focus on but I really do not like drivers who don't indicate when they changing lanes or when turning right / left. It is such a small task to be performed yet there are those out there who don't do it. Not only it is an inconvenience to other vehicles but it can also be a hazard.

Another irritation I have is people jumping the queue. You know the scenario - you're lined up in traffic when some git drives in the exit road or adjacent lane to cut the queue. I really do hate those people. They intentionally do it because they know they can get away with it. My dad those it often and when I'm in the car when he does it, I chastise him until we get to our destination. Thankfully he does it less, or at least not when I'm riding with him.

To all drivers, there are other road users. Just because you own an expensive car like a BMW 5 series doesn't give you the excuse to drive like a prick.

Wednesday, March 16, 2011

Reflex charity

Christchurch - 21st February 2011
Haiti - 12th January 2010
L'Aquila - 6th April, 2009

What have these places and dates have in common? They were major earthquakes that have happened in the last few years. Yet most of them have disappeared from most people's minds, especially to one person who I was catch a lift who totally forgotten what had happened in Christchurch just under one month ago.

I'm using this point and the recent earthquake in Sendai to emphasize what I call reflex charity. Most of us don't think about the disasters in the world until it is staring us in the face and affecting our own lives. Only when it is in the news do we feel compelled to do something about it and not at any other point in our lives.

The case in point is the Sendai earthquake recently. Most of us acknowledge that it is a disaster and send our condolences and prayers to the people in the area. But what are most Hong Kong people concerned about from the Sendai earthquake? That Japanese milk formula powder will go up in price or even worse not become available, despite a whole range of other choices available. We also have the media scaring us into the belief that the radiation will be swept from Japan to Hong Kong from the exploding nuclear power plants. We have this belief from the media, despite the facts...

1. Sendai is more than 3000 km away from Hong Kong.
2. Radiation is not "contagious" although there is a rare possibility radioactive particles could be deposited on objects such as food and clothes.
3. Authorities would obviously check most imports for radiation.
4. The prevailing winds around Japan will tend to blow the radioactive particles towards the Pacific Ocean.

I hate this kind of reflex charity. People from these disaster stricken areas will have to live on through the hard times, long after the camera crews have gone home. Remember the 2004 Boxing Day tsunami? Touristy areas such as Phuket will recover quickly but impoverished areas such as Indonesia, which have had numerous earthquakes since, still have yet to recover.

Everywhere there has been a major humanitarian crises. Barring earthquakes, there are other natural disasters. Remember the 2008 Cyclone Nargis which swept Burma and killed more than 100 000+ people. Do you really think the military junta will be helping the impoverished there? What about human rights disasters such as the ethnic cleansing that was going on in Darfur, Sudan.

And don't get me started on other humanitarian and natural issues. People in the developing world are constantly dying from hunger, poverty and diseases. We constantly are demolishing are earth and wiping out species just so we can have a better lifestyle.

What I am trying to stay is we really shouldn't have this reflex charity. We really shouldn't need TV charity programmes such as Comic Relief and Children in Need to constantly remind us about giving to the needy. We should be doing this on a regular basis. I know a great deal of my friends are quite well off and can afford to give a little bit to charity. What everybody should be doing is just setting up a Direct Debit or whatever else you call it. Just donate a little bit of your money to a charity of your choice every year. It doesn't have to be a lot, just a little bit will be nice.

Because charity shouldn't have to be a knee jerk reaction, it should be a constant action all the time.

Thursday, March 10, 2011

A modern day Chaplin?

When I'm not on call, I catch up with a lot of British TV. My current fad is watching "Fast and Loose". From the creators of "Whose Line Is It Anyway?" and "Mock the Week", it's a bit like the former program. Fans of the American version of WLIIA will be happy to see Wayne Brady in "Fast and Loose".

One of the highlights of "Fast and Loose" is the interpretative dance segment performed by David Armand. In this section, Armand mimes a song using its lyrics as the inspiration and the other comedians have to guess what the song is, without listening to the song itself.

If you don't know who David Armand is, one of his most famous interpretative dances was at the Secret Policeman's Ball 2006 for Amnesty International. During that event, he mimed the lyrics to the song "Torn" by Natalie Imbruglia, who later joined him on the stage - first singing and then miming the words herself.



He does the same in "Fast and Loose" using such classics as "Eternal Flame" to modern day hits such as "Hit Me Baby One More Time". You have to watch it to fully appreciate the comedic value plus the entertainment on show.

I know I might court controversy by comparing him to a great comedian such as Charlie Chaplin in my blog entry title but the comparisons are worth noting. Charlie Chaplin was famous for using physical gestures and facial expressions to get his comedy across the the audience. David Armand uses the same techniques in his comedy routines. Armand may never get to the same level of fame or fortune as Chaplin but his technique with the great master are quite similar.

But you have to see it to really believe it...

Sunday, February 06, 2011

A mid-life crisis?

I think I reached a point in life when a significant amount has already gone past by me and I haven't achieved much. It was my 30th birthday recently. It was supposed to be a free evening for me but unexpectedly I was asked to be on-call when the original doctor reported in sick. So I was spending my birthday making sure people were kept alive, at least until the next day.

That day seemed to sum up my life. I'm now thirty years old, still a virgin and single (in the order of priority I think are important). Most people I know are in the process of becoming specialists by taking their exit exams, are married or in the process of walking down the aisle and some of them even have the cheek of bearing children. To top it all off, my younger brother has just proposed to his girlfriend, thus making me look like the older brother loser that I probably am.

It's often hard not to compare to your friends and colleagues, but it is difficult to ignore when they post that they've passed their exams in their Facebook status or display fifty photos of their daughter from exactly the same angle on Flickr, despite the fact that they already uploaded photos of her doing the exact same a day before. I often thought I should emigrate to somewhere to avoid comparing my own life to the life of my friends but I would suffer the same problem elsewhere and my own friends' life would haunt me over the medium of the Internet.

Look, I'm trying to correct these things. I know I'm not going to accelerate my career path anytime soon, so I just try to ignore what my other doctor friends/colleagues are doing. I just wallow in the truth that in six months time I won't have to be on-call ever again or have to work during weekends. That is some small comfort to me.

I try to ignore that people I know are having kids, even though it is nearly impossible to do so. Don't get me wrong, I'm happy for these couples. Yet honestly I really cannot picture them having sex. Not that it is totally gruesome but they are just some of the most conservative people I know. Sex for them would be a chore to get to a baby, not something wonderous and enjoyable.
Most of the time, I think they would do the task missionary style and have it done with in five minutes. I don't think the female part of the couple even orgasms.

I'm trying dating websites at the moment but the ones in Hong Kong are not very good. They offer very minimal service and if you want to get much better coverage, you have to pay exorbitant amounts. Only one website seem to be adequate, meaning I have had one correspondence. The others are just not worth it.

The options at work are not that great. I've only met a few ladies I would like to date. Yet it is often so hard to engage whether they are interested in you or not. I have one in mind. We often chat over the Internet but I don't know whether she likes me or not. I probably wimp out and won't ask her out on a date, primarily because I don't know where to take her or what to do on a date. That's how pathetic I am.

Thursday, January 27, 2011

A new life

For the past four weeks, I have been slowly adapting to a new life in my new hospital's Department of Medicine and Geriatrics. After staying six months in my previous hospital's Department of Paediatrics and Adolescent Medicine, it has been difficult changing ways. I used to be in a relatively small department in a small hospital. Now I'm in a large department in a very busy hospital.

Slowly but surely I have been getting use to being a internal medicine resident. I am thankful that there have been a number of changes which occurred before I came which makes my life a little bit easier. Firstly I only have to do a ward round once in the morning and that is it. Sometimes doing an afternoon ward round doesn't help and should only be done if there have been any new cases or changes. Secondly there are protected hours for the doctors on-call to sleep, otherwise they would never sleep.

At least the people are nice here, when they have a chance to speak to you. I'm grateful that my seniors are not very harsh on me when I make mistakes or ask for help/advice. I'm learning a lot and I hope most of it stays in the brain.