Writing blog entries

For some reason, I spend a lot of my time thinking of what I should write in my blog. This phenomenon is usually confined to idle moments such as driving to and from work, in the midst of a lecture or when I'm out jogging. It's not particularly productive but it just happens. I have no real logical explanation why I do it. Perhaps I just want to articulate my thoughts to the world better, so people who read this will have a better understanding of whom I am. I want my blog entry to flow naturally, from sentence to sentence like if I was speaking to you or if you were watch a great riveting drama. I want readers to feel once they finished reading one particular blog entry, that topic has been extensively covered and there is no need to revisit the issue in the future, barring any change or any dramatic events in my life or something new has popped up.

In reality, despite all the time I spend idly planning my blog, that is never the case. I tend to write as I think without reading back what I have typed or revising what I have written. I don't want to spend too much time writing this blog, since I DO want to live a life. Inevitably not everything is covered in that entry about that topic. I loathe to revise any entry, especially if the passage has already been published on the internet and where everybody from random strangers to my closest friends have already read what I have to say on the subject and have given insight of their own on that subject. Like some lame horror movie sequel killer, I will always return to the same subject in the future with what seems like a new approach but actually is the same drivel dressed up in a different way.

Perhaps I try to give myself too much pressure in trying to produce too many blog entries in a certain period or trying to write the perfect article about that subject. I should take my time in writing these entries before posting them. I know my command of the English language is nothing compared to the likes of columnist I admire and read (such as David Mitchell, Charlie Brooker and Mark Steel) but I want something that is representative of me and will get people to like what I have written, or at least think it is not written by some maniac. 

So I resolved to setting myself some basic rules on writing my blog:
1. Give myself a topic within a certain time period to write about and set myself a deadline to finish the topic off. This should give me time to think of new angles about that particular topic.
2. Don't immediately post the blog up, even when I think I finished typing it. Let it simmer for a few days before going back to it to see if any new ideas have popped up.
3. Actually read back through what I have written. I actually notice I do have a lot of grammatical errors scattered throughout my blog, so I should be a good writer and actually draft what I write.

Hopefully these new rules should lead to a more flowing blog which will be more understandable and more representative of my thoughts. However these rules haven't solved the problem of thinking of some witty and concise way to finish the blog.

and dieting

As some of you may well know, I have been exercise and dieting extensively for the past two months. Thankfully it has paid dividends with a drop of three kilos within this time limit. However I'm still obese (by Asian standards) and still got a long way to go - actually eight more kilos before I'm consider "OK".

Apart from running / walking in excessive heat after work everyday, I have resorted to dieting. This has been a dramatic turnaround for me. I do love to cook and I do love my desserts, so having to cut out both means I can identify with smokers and alcoholics trying to give up their vices. I tried cutting out breakfast but by about half way through my morning clinic sessions, I'm embarrassing myself in front of patients with steadying growling noise coming from my stomach area. So instead of being addicted to desserts now, I'm addicted to Kellogg's Special K (other breakfast cereals are available, as the BBC would say). Apart from Crunchy Nut Cornflakes, this is the only cereal I like. I can actually eat Special K for breakfast, lunch and dinner, if social circumstances allowed me to.

Unfortunately I still have to go out for lunch, since all the other doctors in my clinic do. So I still have to eat unhealthy stuff whenever I go out. Everybody knows if you cook for yourself or cook at home, you have some measure of control what crap goes into your body. If you go out to eat, you don't know how much preservatives / salt / sugar they put into your food.

One of the disadvantages of going out to eat is the portions. I hate to waste food and so cringe inwardly whenever anybody leaves a substantial portion of their meal on the plate. I have to cringe at myself now, since I leave all the rice / potatoes on the plate since I've started the Atkins diet. This carries on to dinner since I have asked my parents to cut out the rice for me at dinner.

So what other extremes have I gone to lose weight? Only drinking diet Coke / Pepsi and now using artificial sweeteners in all my tea / coffees. Yes, I'm very serious about losing weight but only if it makes me look better and gives me a better chance of attracting the opposite sex.

Now to give myself a break, I need to have that tiramisu my dad made...

Down in the doldrums.... again

I have been accused by an anonymous reader of being too negative in my blog. Unfortunately he/she didn't leave an email address for me to reply to say that is the whole point of my blog. This is suppose to be an avenue for my depression to dissipate itself to the wider world instead of ruminating in my mind, causing more havoc. If you don't like what you see, then don't read it - simple as that.

I'm going to further disappoint that anonymous reader as this blog entry is going to be another depressing read. For the past few weeks a low mood has been creeping up on me. I shouldn't have this problem anymore. I take my anti-depressants regularly and attend my follow-ups as scheduled. I work in an respectable profession, helping sick people to their ailments. I get paid quite handsomely enough to live comfortably, since I don't have to pay rent, not in debt or don't have to support anybody since my parents are financially well off. I stay in contact with my friends but don't get to meet them as often as I like.

And that's where it starts - trying to look at the bad sides of things. Before long I'm back looking at all the standard stuff when I'm depressed: I'm 31, single, still a virgin (interpret yourself if that is a good or bad thing), still living with my parents and still have depression which requires anti-depressants (and quite a high dose as it is).

Yet there are things which have contribute to my low mood. There are little triggers which accumulate to eventually break the camel's back. Annoying drivers who do not indicate with their lights when they are going to change lanes or take a turn. Demanding patients who ask about four different problems in a consultation that is supposed to last seven minutes. Acquaintances on Facebook putting up hundreds of photos of their babies in the same position.

And what was the final straw? Learning that one of my good friends is pregnant. I should be happy for her and her husband, and I am, but I'm also sad for myself. That's what you get when you're a depressive. You don't care about everybody else and their problems, you get selfish and care for yourself. Forget about all the poverty, disasters and deaths in the world, you only care that you don't have a girlfriend in your life. Forget that other friends older, better looking and more intelligent than you are still single, you only care about yourself. And I hate myself for think about that way.

As the usual disclaimer, I don't expect people to pay attention. Actually it is better that you don't pay attention, since it feeds my depression more. I don't expect anybody to help either since it is my own internal problem. I just wish for better drivers in Hong Kong and for people to stop putting so many photos into the albums without even sorting them out. Then I can stop whining about that stuff.

My relationship with music

I have to state that I'm not a big fan of music. Unlike my friends, I have a modest collection which mainly deals with pop start from the 1990s to early 2000s. Since mid 2000s, I have become less interested in music, instead listening to podcasts and radio programmes.

This was evident a few days ago when I made the few excursions for shopping. I decided to patron the new HMV in Central. Whilst looking through the entire music section, there was only two albums I bought: The best of Whitney Houston and the best of The Who. I am one of these bad people who only buys "The Best of" albums from artists. Usually that means waiting for the artist to die or retire, or for the band to break up. The only other album in my radar is "The Best of S Club 7" (I know that I have bad taste in music).

Perhaps I am more of a singles man. I tend to love individual songs rather than a whole album. I have to like enough of the songs on an album to persuade me to buy the CD, hence only buying "The Best of" albums. Unfortunately Hong Kong doesn't have a very good download music market. Most of the download music here is Cantopop (or I can't read Cantonese well enough to understand their download sites). I can't access iTunes to download music here in Hong Kong.

Anyway I must get back to listening "The Who" and finding ways to download music legitimately in Hong Kong.

Exercise..

For those who know me, I've been trying to lose weight by dieting and exercise. I may dress up my motives by stating I want to be fitter and more healthy. Ultimately I want to attract women more and I know I won't get my foot in the front door if I keep looking like Kim Jong-Un's half brother. (Seriously how can North Korea's new dictator can look so pudgy and have the rest of his nation starve to death?)

I initially started my campaign against the bulge by doing some stretching exercises at home and it was a wake up call. You know you don't move your muscles much when stooping down to pick up something strains a back muscle. Actually my so called wake up call was when I was approached by a sales person of a gym chain trying to sell me a gym membership. During this demeaning procedure when one of their personal trainers was telling me everything I was doing wrong with my life, I had to do some sit ups. Every time I came up, my whole body was shaking due to the underdevelopment of my rectus abdominis muscles (yeah, I still remember some anatomy from my medical school days). Fortunately my willpower is a little bit more formed than my muscles and I didn't sign up to their gym, despite the glare the personal trainer gave me.

Anyway now that I spend most of my free time stretching, even when I'm surfing the Net, my muscles have started to become looser and if I were a cow I would deem edible now. But that's not the point. The next stage was actually getting me down from the fatty Kobe beef to a better lean steak. That meant some aerobic exercise. I started off cycling around the neighbourhood I live in and have gradually increased my workload over the past few weeks.

What I lack is motivation and a definite schedule. I think I have to go join a gym and start losing the pounds. I think I would be more motivated if I put a little money into this project. Thankfully there is a gym nearby to where I live, so I don't have to travel far after work. Hopefully I will have some willpower to join a gym in the first place.

Next time, I will be writing about dieting and crankiness...

Hypes and fads

Years ago I remember many of my university peers where reading the Harry Potter books at the height of their popularity. Even though I watched the movies, I never got into the book hype and got round to reading the series. I truly believe the reason why a lot of people read their books was because it was the fashion and they didn't want to left out when talking with their friends.

Another fad that has gotten the whole world, and especially basketball fans in Asia, is the rise of Jeremy Lin, the point guard for the New York Knicks. Out of nowhere, he has been scoring points and dishing out dimes as if he was an All-Star player. More importantly he was getting the Knicks winning again and back into the playoffs. Thankfully the commotion has died down, especially since opponents have become aware of him and started to defend against him better. Nowadays his numbers are down and the New York Knicks are back to losing.

So why all the fuss about Jeremy Lin? There have been other player like him before, who come out of the blue to surprise everybody. So what makes him different. Is it because he is Oriental (I didn't use the word "Asian" as it means different things to different countries. In the UK, if you say Asian you mean anything pertaining to the Indian subcontinent whilst in USA you mainly mean anything looking Oriental)? This maybe the main reason since there have been few Asians making a big impact in the NBA. On the flipside, he's of Taiwanese of origin only - he was born and brought up in California. He's upbringing and style of play have not been influenced by his ethnicity

Is it because he's undrafted? This is unlikely to be major factor, since there has been many players how have been undrafted who have gotten to better things. One case is Ben Wallace, formerly of the Detroit Pistons who was Defensive Player of the Year many times and actually has won a NBA championship ring.

Is it because he's an unconventional player in his origins - a non-white player from a Ivy League school. This maybe a contributing factor since not many Ivy League graduates become great players. The last player from the Ivy League was Chris Dudley (who?) from the Portland Trail Blazers in 2002-3. There have been great Ivy League NBA players such as Bill Bradley and Geoff Petrie but that's about it.

Anyway the Knicks are back to losing again and Lin is still doing too many turnovers to become a great player. Let's just see how it goes.

Hypes and fads come and go, so don't always catch the wave and surf it to the end otherwise you might crash onto the rocks

Professional hatred (part 5)

Anything to do with finance

I mentioned I don't like accountants / bankers / stockbrokers in a previous entry of my blog. Yet with the economic crisis as it is around the world and what has happen since I last wrote that entry, I think I should elaborate more.

I, with about 99% of the world's population, don't know a single fact about high level finance. I just about cope with managing my bank accounts and credit cards. I know there is a complicated network out there to generate money but I'm just as ignorant about it as I am ignorant about quantum physics and art. Yet I can get by just managing my bank account, probably because my job pays well and I live cost free at home.

I don't really like anything with stocks or bonds. One of the reason's why I don't like anything to do with the stock market, apart from knowing next to nothing about it, is if your job's sole purpose is to make money, then you have to look at what you really contribute society. I judge people's occupation by how much it gives back to the community. If the world had to start again (for example after a nuclear war has wiped all technology on Earth or an alien invasion has decimated the planet), which jobs would be most useful. At the bottom of the pile are the jobs I hate (see any of my previous entries for details).

I'm sure that most of the bankers and stockbrokers are nice people in real life - I have one as a younger brother. Yet there are some, a minority, that just take things over the edge and screw up people's lives. Yet we value these people enough to given one million pound bonuses despite their bank being still in the red. That says more about our society than those people, on second thoughts

Let's just say this: I'm not against rich people. I'm more about distributing the wealth (yes, my socialist rantings are beginning to surface). It is just not me saying it. Even the wealthiest French people were saying they should be taxed more back in August last year. There are wealthy people who are willing to have their taxes raised to help society, in USA and around the world.

If we want these people's jobs to become poisoned chalices, shouldn't we do a little bit more like not be friends with them, throwing stuff at them when the walk in the street or just not pay for their services? The unfortunate problem is we do need banks. These people have become a necessity rather than an option

Round and round we go

Since I've been driving regularly for two and half years, I have become more incensed with other drivers. I have gotten past the stage where I think only BMW and Mercedes Benz drivers are bad; now I know most people behind a steering wheel in Hong Kong don't respect any kind of traffic or moral laws.

One thing I cannot get is how people don't know how to use roundabouts. It should be easy. Let's assume we are driving on the left hand side of the road (i.e. British, Japanese), the roundabout has two lanes and you know which exit to take. If you are taking the first exit (i.e. immediately turning left), you should stay on the inside lane (i.e. the left lane). If you are taking any other exit, you should go on the outside lane (i.e. the right lane). This assignment should avoid any collisions. The only problem is if you don't know which exit to take. If you are such a cretin (no offence), then take the inside lane (the left lane) and drive until you know which exit to take.

Oh, and remember to indicate which I will be writing about later when I stopped steaming through my ears after typing this entry.

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.

TVB Pearl News hotties

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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.

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.

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.

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.

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.

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.

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.

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...

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.

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.