Passing away

Yesterday evening, my grandmother passed away...

The whole family had been expecting this event for some time. My grandmother had two strokes in quick succession in 1999, just before I entered medical school. The strokes themselves were not unexpected either. According to my mother she had diabetes mellitus and had poor compliance to her medication. During one of her follow-up visits she had a carotid bruit so obvious the doctor in the clinic told the medical students attending to listen to it.

Since those two strokes she's been in a vegetative state. That's over eight years. She's been living in a nursing home and just goes into hospital when there is something wrong. Every time my family wants the condition to be fatal so she can pass on and end the suffering, not just for her but for the rest of the family. This time their wish came true.

To be honest I didn't know my grandmother that well and I wasn't that close to her but I wish I were. She was very nice to me and to all her grandchildren when we visited her in her flat in Sheung Shui. In the end when my mother told me my grandmother had been admitted into hospital and this could be the time, I didn't want to go see her. Partially because I didn't want know what to say but really because of myself. As a depressive we are constantly warned to decrease the stresses in our lives, which include employment and relationship issues but also includes death. I didn't know how I would react to seeing my grandmother lying in a hospital with all the tubes and drips surrounding her. I didn't want a depressive episode coming again so soon after receiving other bad news about my test results. I feel guilty about that decision but I eventually I did go to see her in the evening and say my final farewell.

Right now I don't know how I feel. A lot of the time I feel apathetic - I don't have any feelings at all - and that worries me. I worry that I have had depression for so long my feelings are worn out and I can't feel anything. I have been noticing it lately when meeting patients in the wards, especially toward psychiatric patients who I should respond to. Most of the time I couldn't care less about people - class peers, patients, family, friends, even myself.

It's a constant feeling of emptiness...

A mixture of emotions

I am in the final rotation of my last year and it is constantly tiring for me. Everybody says the medicine rotation is the most difficult and stressful but for it is fatigue which is getting to me. I constantly have to take a nap in the hospital library even after I have followed my morning rounds. You don't even want to know how long I nap for...

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Along with depression I constantly feel angry, disappointed and despondent about the world around me. I know I shouldn't give the time of day to these emotions but part of the problem is due to my personality and my views on life. From an early age I had an idealistic view of the world. As human beings we have been blessed with opposable thumbs and a three digit IQ. I expect us to be able to solve the world problems easily and live in harmony. What is done instead is far from my idealistic view. Humans bicker over material wealth and ideologies, leading to the four horsemen of Apocalypse constantly tramping through the worlds. Humans destroy the planet in every known way and continue the devastation even with the knowledge that this destruction could lead to the annihilation of our planet.

I know I should know better to expect this. After all we are animals in the first place and we are just conforming to our genetic makeup - to survive and reproduce. Not everybody is intelligent or bothered enough to notice about the world problems and just want to survive. I should be more tolerant of other people's views considering I did grow up in a multi-ethnic society at school.

So why am I still pouring hot water over how crap Hong Kong television is or how immature my classmates are over psychiatric patients?

Bad day

When you wake up in the morning you don't expect the next cycle of your life to go wrong. You might dread the chores or tasks you have to perform but the view is you don't think today will be a bad day. This is what happened to me - today was suppose to be an easy day but it turned out for the worse.

Today was the initial day for my Medicine rotation and started off with an orientation meeting. I was slightly disturbed to find my name off the list and had to inform the administrative staff of the department to correct the error. The matter sorted itself out without a fuss but I felt disappointed by the incident. My situation of repeating the year was known more than six months ago and the error left me with the impression my predicament was not appreciated by the department. It is not difficult to stick a name into a group and all I'm doing is attaching myself to this group - it won't disturb the earth's axis or something disastrous like that.

This little incident was nothing compared to the news I received in the afternoon, that I failed my psychiatry test and would have to repeat the examination in March. I guess it wasn't expected - I had an inkling the examiner wouldn't pass me for my interview technique (I adopted the approach of having a chat with the patient instead of directed questioning). My mother always wants to find reasons for these kind of situations - I was too casual in my studying during this rotation, I watched too many videos on my laptop, etc. I tried to explain to her sometimes these things happen, that life doesn't always have an explanation.

Naturally I felt saddened by the news. I know many people are concerned when my mood goes down. When I get depressed, it is not long before I start thinking about suicide and all those nasty thoughts. This time I know what is happening and I can stop myself thanks to the cognitive behavioural techniques I have been taught by my psychiatrist. So this time around I'm OK. I don't need people reading this blog stopping halfway and frantically contacting me just because they haven't this portion. Unusually (or this maybe usual, since I don't know if any other people have this phenomenon) I get very severe chest pain, difficulty in breathing and an indescribable sensation in my arms; an aching, tired sensation like I have been electrocuted.

What bothered me more was my group peers and the impertinent pursuit of who had failed. As you might expect, we are notified anonymously as only our examination numbers and not our names are produced. Yet there are people who try to find out who has not passed. There are two many reasons why I don't like this. They are only wanting to confirm that THEY have not failed, since they can't be bothered to remember their own examination number and are always scared it is theirs. The second reason is for their own curiosity. They are not going to be empathetic/sympathetic to the person who has failed. How do I know this? Because I pointed I was one of the three people who failed and only one person out of several had the decency to be nice.

All this was happening while the class was having their group and class photos being taken. Something which would have taken fifteen to thirty minutes was stretched to an hour, just because people cannot shut up and listen or turn up on time. Why is it Hong Kong people cannot think about these things and only think for themselves?

Nothing much happening...

I've just finished my test for my current rotation on Wednesday, which has left me free for the past couple of days. I'm trying to relax before the next rotation starts. Nothing really is going on in life and I'm just blogging for the sake of blogging. Right now I'm trying to catch up with some of my shows. I have all of season 3 of "House M.D." and half of season 3 of "Doctor Who", although I'm regularly downloading "Have I Got News For You", "Top Gear" and "QI". Hopefully I can initiate myself to watch some of these shows plus a DVD or two.

There are some topics I want to write about in this blog but lately my way of thinking has been oriented to what I want to write here. I'm just too focussed on thinking about a topic to write about. I should just write what's on my mind. One thing I have just noticed is subtitles. In Hong Kong most, if not all, English programmes are subtitled in Traditional Chinese. Unfortunately the subtitlers are not very good or are not paid very well, since they don't get many of the subtitles right. Even though I cannot read Chinese I hear my parents complaining of the poor translation. Just now I was watching one of Nigella Lawson's many culinary shows on Discovery South East Asia Travel and Living. The subtitle for 'butcher' was poorly translated into 'slaughter man' - not something you want to be visiting on the grocery shopping.

It's even worse on another show I religiously watch - "Top Gear". Even though I cannot read the Chinese subtitles, many of the car manufacturers' names of their vehicles are not translated into Chinese but left in English. Yet the subtitler cannot even be bothered to look up the names of these cars. The Chevrolet Lacetti has even been written differently in the same show, for example 'Laseti', 'Reseti', etc. It is just so poor these subtitles do not go through quality control or through somebody who is well-versed in English and Chinese. You may not like the work you do but you should have some pride in the finished product since YOU did it.

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I cannot really blame Steve McClaren for the defeat in Russia. I think he did his best but unfortunately a bad penalty decision and a poor playing surface was just out of his control. At least he has the balls to keep Gareth Barry and recall Emile Heskey in recent times. Hopefully Israel can get a result against Russia so England can qualify.

Hopefully the other England in action this week will not suffer the same fate. I wouldn't mind if Jonny and co. lost, since they have exceeded all expectations by reaching the Rugby World Cup final. I just hope they have a good performance and there will be no repeat of the earlier match with South Africa.

Blog Action Day

Today is Blog Action Day, when blogs all over the world unite to write about one single issue to raise awareness. This year it is the environment and it is appropriate given this year's Nobel Peace Prize was recently awarded to the Intergovernmental Panel on Climate Change and Al Gore. I am sure this piece of news, whether or not the recipients were worthy winners, how the issue will move forward and whether or not Al Gore's documentary "An Inconvenient Truth" is alarmist after an UK court decided not to show the film in schools, will be written elsewhere.

What I will write about is how Hong Kong views and acts upon environmental issue. Hong Kong society is really driven on results and finance. Therefore it is no wonder the environment is not on the top priority on people's list, when making money and sending your kids to the best schools is what is on your mind. I think many Hong Kong people view environmental issue with a sense of hopelessness and despair. They think there is nothing that can be done by them, which is totally the wrong view. Every time the Air Pollution Index is raised dramatically in Hong Kong, it is always blamed on the weather or an incoming typhoon. Nobody actually says it is due the air pollution. I always see cosmetic advertisements on the television blaming air pollution for the poor quality of women's skin and they should buy facial cleansers to get rid of the soot and grime. Why don't we tackle the primary problem first by decreasing air pollution instead treating the secondary effects? As everybody in the medical sector knows, prevention is better than a cure. In terms of other countries and states Hong Kong is still far, far behind in terms of environmental thinking and policies. When I was in Berlin six years ago, I was astounded to find all outdoor rubbish bins where separated into four compartments - paper, cans, bottles and others. My friend recently found the same phenomenon in Seoul. Although we are starting to have this in Hong Kong, I still think it would be better to replace the rubbish bins in Hong Kong with this type of compartmentalized rubbish bins.

If Hong Kong people's views on the environment are to be changed, it is important to think how a Hong Kong citizen thinks and use this approach. As Hong Kong is results-driven society, you have to think on economic terms for them.

Tourism
Visitors to Hong Kong do not want to climb the Peak just to find their view of the harbour is obscured by a black smog which won't dissipate for days on end. Neither will they want to come back if every time they step out into the open air they are induced into coughing. It stands to reason cleaning up the air and water is important for tourism and not just for the environment.

Finance
I remember reading a 'Time' magazine article many foreign investors are turning away from Hong Kong to Singapore with air pollution being a primary concern. They do not want to bring their families to a filth-ridden place to live, even if it is only for a few years. Cleaning up the air can help bring foreign investment into the region.

People who pollute our water and our land just don't realize they eventually have to pay up for the clean up in the end. They may not have to pick up the trash or clean up the water now - that's the government's job. Yet the government are funded by the taxpayers' money and if they have to continue to clean up this mess, eventually our taxes will rise to fund these operations.

Hong Kong has some of the highest land prices in the world. With so many people in such a small area, land is at a premium. Unfortunately some of this land has to be allocated to rubbish dumps - trash has to be buried somewhere. If we started to recycle more of our garbage, less land is needed for rubbish dumps and could be used for other purposes, such as wildlife conservation or even residential housing. Panellists on an episode of 'QI' laughed when they heard the largest rubbish dump on the Earth, Fresh Kills New York, was to be turned into a golf course and remarked the situation could turn out to be like that episode of 'The Simpsons' when you see all rubbish coming up in mounds. However my local driving range in Tai Po was converted from a rubbish dump to what it is now - a very nice place to practise my golf swing (although I still slice all my balls to the right). In Hong Kong we should maximise our space and I applaud the Chief Executive to encourage schools and private buildings to put our high-rise building rooftops to good use, such as building up green areas or placing solar-panels to decrease the electricity requirement of the building

Health
All my doctor friends know air pollution can exacerbate health problems, especially respiratory and cardiovascular diseases. Decreasing our pollution will help these people, decreasing the severity of their disease on their daily lives. This can lead to more productive people contributing to our economy instead of taking sick leave. It will lead to less consultations and hospital admission, decreasing the impact on our already crippled health service system. Water pollution should be tackled, since pollutants can act as nutrients for micro-organisms to grow. This will decrease the amount of water-borne infections and food poisoning.

Energy conservation
Everywhere in Hong Kong is cooled by air-conditioning. Yet there are places who turn their airconditioning so high it is like stepping into an Arctic wonderland. Don't these people know turning up their air-conditioners uses up more electricity, leading to higher utility bills? The Hong Kong government has already suggested air-conditioners should be set at a temperature of 25.5 degrees Celsius but there are many places, such as trains and the underground, which don't seem to heed this advice. Using energy efficient lighting maybe costly at first but in the long run, it uses less power, last much longer and is more cost-effective. So why don't people see that?

Hopefully what I have written has given you more food for thought. Hopefully you will remember to switch off all electrical appliances once you've used them (including lights) and try to recycle as much as possible. One more thing to add, since you are reading this on your computer - try to use darker backgrounds or decrease the brightness/contrast on your computer screen. White backgrounds or light colours tend to use up more energy.

Doggy teams

I have quite a high disdain for the paparazzi. They invade people's privacy in order to obtain grainy photos of them doing trivial stuff. These items of "news" are the lowest form of journalism to have existed. In the grand scheme of the world, the release of Paris Hilton from prison would rank far below the conflict in Iraq and global warming but even some credible news outlets such as MSNBC deem this item worthy enough to headline their news show.

Yesterday I saw firsthand how the paparazzi can be so intrusive. Lydia Shum, a well-known Hong Kong actress. There were swarms of photographs already at the hospital when the ambulance carrying her arrived at the Accident & Emergency Department. Seeing on the news how hectic her entrance was appalling. Most of the photographers were blocking the way to the Accident & Emergency Department. What if something happened and she started going into shock or dying? Where is her privacy with her doctor? Photographers would argue the A&E is a public setting where they are allowed in and they are just reporting the truth but I think the security should have known beforehand and kicked them out.

As a public, we have tendency to perpetuate this phenomenon. By reading this type of gossip, we are just telling the newspapers we like this kind of "news" and we want you to print more. The irony is that even writing this blog entry will also perpetuate this phenomenon. The few people reading this entry will want to go and try find items regard this piece of "news". Please don't - Lydia Shum should have her privacy and she be able to recover without us having to peer through her hospital window. Just do the decent thing and pray for her. I've tried to be as ethical as possible by not posting any links or photos to this entry about the matter.

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I love autumn - it starts to get cooler and life is not as hectic. The most marvellous fact is my favourite shows are back on air - "Top Gear", "QI" and now "Have I Got News For You".

Wanting to be a part of something

I wish whenever there is a wedding, a barbeque or a get-together at a bar, that I am invited. I wish people would tell me how they are doing and it's been a long time since we last met. I wish my old friends would contact me and reminisce about the good old days whilst reminding me of what they are doing, what kind of relationship they are in and, God forbid, if they have little munchkins running around making their life a misery.

But you don't always get what you wished for. I don't get invited to people's weddings, barbeques or drinking sessions. Not everyone wants to contact me. I always hear news about other people from someone else.

Yet there are reasons (and not excuses) for this. I wasn't particularly close to many people, so I shouldn't expect an invite to go out. I can count the number of friends I'm close to and bother keeping in contact with me on my hands (Evelyn, Poemen, Herbert, Simon, Connie, Theola, Arthur, Jasmine). Some people don't know how to contact me, having lost touch for so many years. When they do, my mobile phone is usually on vibrate so I don't often pick up or it takes me so long to reply its not worth bothering reading the answer.

And maybe I cannot go to whatever event they invite me to. I hate going to sing at Hong Kong karaoke bars. I hate the way Hong Kong people barbeque. I don't like the fact that bars are all dark so that you can never see the person if he or she is sitting right next to you and that the music is so loud it is impossible to have a conversation. I hated the last (and so far only) wedding I went to, since I didn't have much in common with the fellow guests and felt really isolated. I hate to keep hurting myself by stabbing my arm with a fork to get rid of that dread feeling of depression that washes over me when I feel like that. So many of my friends live abroad that I would have turned down their invitations anyway.

I want to be a part of a community but want to be left alone at the same time...

Irritable beyond the extreme...

I am the point when I'm getting pissed off about my mum. When my mother retired from her job last month, I thought it would be beneficial for my depression to have somebody monitoring my condition, to push me when I needed to study or to get out of bed. A month on, it has been a total nightmare. It feels like I'm in the novel "1984" with Big Brother constantly watching over me and dictating my life.

My mother "thinks" (and I use the word "thinks" very loosely) that I should spend the entire waking hours studying. She "thinks" my depression will benefit from 24 hours of constant studying, seven days of just looking at textbooks and not allowed to watch videos, movies, Internet or anything I would classify as pleasurable. She even questions me when I want to cook or bake. Every conversation is started off with the question, "Why aren't you studying?"

I can't say she is acting like a parent because I don't think she has my good intentions at heart. All she wants is my future happiness without thinking about my present state. If I'm not happy now, what use is it preparing for the future? I've tried reasoning with her but it seems she is not listening. She just doesn't understand.

Overbearing and constantly looking over your shoulders

During paediatrics, one is taught parents are always right regarding the child's health. While I find that true in most cases, it is wrong to assume this would apply in all aspects of life. Parents are not always right and do not always make the right decisions.

Parents make many decisions based on their experience and what they overhear from friends or family members. Very few parents would actually go and read up a book regarding what is right for the child or read up the latest data or study regarding what is beneficial for their son or daughter. Very few parents will ask their child if they want to attend violin lessons, football clinics or tutorial classes. Parents just assume the kids will benefit from them, which necessarily may not be the case. Parents will act emotionally rather than rationally when making decisions about their children. I would never doubt their love for their child but I always use a phrase for parents which I have used with some of my friends - "They have good intentions but wrong methods."

Parents cannot always justify their decisions regarding their children. A lot of parents will blindly use anything so their children can have an advantage in the world. Hong Kong parents send their children to tutorial classes but it does not make them necessarily smarter or happier. They do not send them out to play in the playgrounds in fear of injury but don't want them to play video games inside, fearing it will 'rot their brains' (which it doesn't). All they want them to do is study so they can get to a good university and hopefully a well-paid job. Unfortunately parents are sacrificing the present for the future in this case.

In spite of all this, I know parenting is a difficult task. Unfortunately we let too many young people have children and they are themselves too immature to take care of kids. In the most extreme I wish governments should ensure young people are capable of bringing up children. Perhaps issuing licenses to allow having children should be considered? Just a thought.

Going up and down

Just a small entry today, since I'm not in the mood to write a long entry...

I have a great deal of pet peeves in my life - little things I shouldn't give a fuss about but I do. Perhaps it is my perfectionistic personality or my negative view through depression that I have so much criteria on life. Lately one pet peeve has been on my mind - using the lift.

In the modern world when everybody has gotten so damn lazy, many people are more willing to waste time to wait for a lift to go up or down one floor instead of taking the stairs. There are instances when I can accept using the lift for this purpose - carting around heavy items or immobility of the person in question. Nonetheless there are a great deal of hospital workers who rather waste people's time in the lift by going from the first to the second floor. I rather like the lift system in one hospital where one lift goes to the even-numbered floors whilst another lift goes to the odd-numbered floors. At least it forces people to use the stairs.

Another point about using the lift is Hong Kong people are not very willing to push inside and let other people in. They just want to stay near the door so it is easier to get out. If you are going to get out at the end, why doesn't one go to the back of the lift to allow for more people to enter the lift? Yet another example of Hong Kong people not thinking about others.