However, it has been ages since I've updated, and now, since it's early Sunday morning, I don't exactly have a lot of time to muse before jetting off to church.
In brief, though, this week has been bittersweet. I forget what that older movie is called, I think Four Weddings and a Funeral... well, it's been kind of close to that. The juxtaposition of death and new life all intermingling and clashing together sometimes gets a bit joltingly weird...
Sunday, March 04, 2012
Monday, February 06, 2012
FFT
2008 Copenhagen Consensus - the 30 solutions to global challenges that have the highest cost-benefit ratios, in descending order, from the viewpoints of economists:
1. Micronutrient supplements for children
2. The Doha development agenda (I personally am not so sure that this is particularly useful, but that's just my own political viewpoint)
3. Micronutrient fortification
4. Expanded immunization coverage for children
5. Biofortification
6. Deworming and other nutrition programs at school
7. Lowering the price of schooling
8. Increase and improve girls' schooling
9. Community-based nutrition promotion
10. Provide support for women's reproductive role
11. Heart attack acute management
12. Malaria prevention and treatment
13. Tuberculosis case finding and treatment
14. R&D in low-carbon energy technologies
15. Bio-sand filters for household water treatment
16. Rural water supply
17. Conditional cash transfers
18. Peace-keeping in post-conflict situations
19. HIV combination prevention
20. Total sanitation campaign
21. Improving surgical capacity at district hospital level
22. Microfinance
23. Improved stove intervention
24. Large, multipurpose dam in Africa
25. Inspection and maintenance of diesel vehicles
26. Low sulfur diesel for urban road vehicles
27. Diesel vehicle particulate control technology
28. Tobacco tax
29. R&D and mitigation
30. Mitigation only
1. Micronutrient supplements for children
2. The Doha development agenda (I personally am not so sure that this is particularly useful, but that's just my own political viewpoint)
3. Micronutrient fortification
4. Expanded immunization coverage for children
5. Biofortification
6. Deworming and other nutrition programs at school
7. Lowering the price of schooling
8. Increase and improve girls' schooling
9. Community-based nutrition promotion
10. Provide support for women's reproductive role
11. Heart attack acute management
12. Malaria prevention and treatment
13. Tuberculosis case finding and treatment
14. R&D in low-carbon energy technologies
15. Bio-sand filters for household water treatment
16. Rural water supply
17. Conditional cash transfers
18. Peace-keeping in post-conflict situations
19. HIV combination prevention
20. Total sanitation campaign
21. Improving surgical capacity at district hospital level
22. Microfinance
23. Improved stove intervention
24. Large, multipurpose dam in Africa
25. Inspection and maintenance of diesel vehicles
26. Low sulfur diesel for urban road vehicles
27. Diesel vehicle particulate control technology
28. Tobacco tax
29. R&D and mitigation
30. Mitigation only
Sunday, January 01, 2012
FFT
As the Ruin Falls
All this is flashy rhetoric about loving you.
I never had a selfless thought since I was born.
I am mercenary and self-seeking through and through:
I want God, you, all friends, merely to serve my turn.
Peace, re-assurance, pleasure, are the goals I seek,
I cannot crawl one inch outside my proper skin:
I talk of love - a scholar's parrot may talk Greek -
But, self-imprisoned, always end where I begin.
Only that now you have taught me (but how late) my lack.
I see the chasm. And everything you are was making
My heart into a bridge by which I might get back
From exile, and grow man. And now the bridge is breaking.
For this I bless you as the ruin falls. The pains
You give me are more precious than all other gains.
- C.S. Lewis
All this is flashy rhetoric about loving you.
I never had a selfless thought since I was born.
I am mercenary and self-seeking through and through:
I want God, you, all friends, merely to serve my turn.
Peace, re-assurance, pleasure, are the goals I seek,
I cannot crawl one inch outside my proper skin:
I talk of love - a scholar's parrot may talk Greek -
But, self-imprisoned, always end where I begin.
Only that now you have taught me (but how late) my lack.
I see the chasm. And everything you are was making
My heart into a bridge by which I might get back
From exile, and grow man. And now the bridge is breaking.
For this I bless you as the ruin falls. The pains
You give me are more precious than all other gains.
- C.S. Lewis
Saturday, December 24, 2011
Advent musing
If was I really, really smart, then I would have deliberately journeyed through a proper Advent exercise. Which I failed to do again, this year (thank goodness that God is so gracious and forgiving!).
However, on the cusp of yet another Christmas Day, there is a mix of feelings about it. I think (though it's a completely artificial separation) that there are separate feelings between the secular and the sacred this time around. Certainly, due to the circumstances, the secular has taken particular predominance over the past two weeks, and though there has been much merit - in anticipation, in joy and contentment there, it makes me wonder how that has (or has not) transferred over to the sacred side of things.
Do I look with wonder and anticipation of the birth of Christ? Am I joyful and content at His promised coming? Am I more concerned about the gatherings, and the family, and the food, than I am over our humble, bastardized, refugee Arab Christ-King? Even now, would I know Him? Would I recognize Him in His lowly estate and bow to worship Him? Would I even obey the angel to hasten to the manger? Would I even want to muddy my party shoes to step inside to look at the Babe?
I think some of these questions probe at deeper aspects of my faith and devotion. What, exactly, am I devoted to? Am I devoted to the holiday? To the idea of the holiday? (For we know, of course, that Jesus was more likely born in the springtime, and that December 25th is simply a Roman machination to stamp out pagan festivals) How does one measure the amount of ardour and devotion to the Christ-King if one is not particularly interested in Christmas? Should I even be interested or concerned about the supposed sacred aspects of Christmas at all?
I'm not sure. Indeed, I love the dark, crisp nights, the hot chocolate, the eating together, the carols, the lights - the whole shebang. However, it makes me question how much I love the reason for the season, rather than the season itself...
However, on the cusp of yet another Christmas Day, there is a mix of feelings about it. I think (though it's a completely artificial separation) that there are separate feelings between the secular and the sacred this time around. Certainly, due to the circumstances, the secular has taken particular predominance over the past two weeks, and though there has been much merit - in anticipation, in joy and contentment there, it makes me wonder how that has (or has not) transferred over to the sacred side of things.
Do I look with wonder and anticipation of the birth of Christ? Am I joyful and content at His promised coming? Am I more concerned about the gatherings, and the family, and the food, than I am over our humble, bastardized, refugee Arab Christ-King? Even now, would I know Him? Would I recognize Him in His lowly estate and bow to worship Him? Would I even obey the angel to hasten to the manger? Would I even want to muddy my party shoes to step inside to look at the Babe?
I think some of these questions probe at deeper aspects of my faith and devotion. What, exactly, am I devoted to? Am I devoted to the holiday? To the idea of the holiday? (For we know, of course, that Jesus was more likely born in the springtime, and that December 25th is simply a Roman machination to stamp out pagan festivals) How does one measure the amount of ardour and devotion to the Christ-King if one is not particularly interested in Christmas? Should I even be interested or concerned about the supposed sacred aspects of Christmas at all?
I'm not sure. Indeed, I love the dark, crisp nights, the hot chocolate, the eating together, the carols, the lights - the whole shebang. However, it makes me question how much I love the reason for the season, rather than the season itself...
Sunday, December 11, 2011
Needing a good editor...
What is one of the interesting mental tug-of-wars that I have with myself is the meta-meaning of narrative. (Yup, that's the kind of stuff I think about). What I mean is this: In the work that I do, evidence, science, data - these are the things by which decision trees, management guidelines and the like are created. Clinically, in many ways, it doesn't matter about the 'lived experience' as much as the 5-yr survival curve, the PPV, the percentages of side effects, the timeline of prognosis. All very numeric, qualitative and statistically significant.
Not to say it's not important: It is. It's critically important in making key decisions and deciding how to proceed with disease management.
However, the other end of the spectrum is how personally important the post-modern sense of narrative is to draw meaning. Our bodies may be made of amino acids and molecules, but our lives are constructed of stories. And stories hold great power in describing meaning.
At any rate, it basically comes down to: stories are how our lives are made. Stories are how we transmit who we are to others. That amazes me, really. It amazes me in considering how, in many ways, it is the stories that are the critical touchstones to help decision making.
I think I'm blathering a bit, but it is still quite something... this is definitely not well-written as a story, that's for sure...
Not to say it's not important: It is. It's critically important in making key decisions and deciding how to proceed with disease management.
However, the other end of the spectrum is how personally important the post-modern sense of narrative is to draw meaning. Our bodies may be made of amino acids and molecules, but our lives are constructed of stories. And stories hold great power in describing meaning.
At any rate, it basically comes down to: stories are how our lives are made. Stories are how we transmit who we are to others. That amazes me, really. It amazes me in considering how, in many ways, it is the stories that are the critical touchstones to help decision making.
I think I'm blathering a bit, but it is still quite something... this is definitely not well-written as a story, that's for sure...
Thursday, December 01, 2011
Sounding the foghorn through the gloom....
Still here, but still foggy, so haven't had much to think about or say. Will try to be interesting soon.
Saturday, November 12, 2011
Grace through suffering
I notice that quite a few of my posts are things that I've observed, and learned, from patients. I remember being told when I was a student that one of the beauties of practice is the ability to develop these long-term relationships with people.
Recently, a friend made me question just how funny/humourous I was anymore. I remember being funny once, and I'd like to think that I still am, but ever since then, I've been watching and waiting to see if any of my patients will do anything hilarious. Which they don't. It's too bad, as I now think my job inherently has the capability to swallow and hold a whole lot of suffering (as noted by the last essay that I had posted), and though there is much joy in walking alongside patients through their valleys, it's not exactly laughsville.
One patient re-taught me a lesson that I think is easy to forget. This patient has a spouse (who is also my patient) who is dying, slowly, ever so excruciatingly slowly, and so very young. They have a tiny child at home, and in the course of dying, which will likely take years, the disease will gradually take their mind and their body. In fact, it already has, and the increasing lack of control over their emotions, their rationality, their paranoia, and the volume and tone of their voice is taking a toll on the well spouse, trying to ask them to shush in front of the toddler, trying to get them to calm down to not scare the child. In the days where they are more lucid, they can actually have a conversation, but mostly, day after day, my patient arrives home from work to a barrage of baseless accusations, and screaming, and a great dread of coming home to their spouse. My patient hasn't really told many people at work; it'd be too hard for them to understand exactly what this dying process is like. They also have no other family; it is just the three of them. So, they spend their days, going to work, coming home, caring for the child, dealing with the spouse, and then collapsing, exhausted until it starts again. They dread the weekends. There is no one else to take the child for weekends, no siblings, parents, cousins, aunts who can share the burden of care. It is a situation that leaves me worrying for this patient, how they will make it through the next few years without being broken and burnt out.
And yet, they are still able to teach me lessons. They pointed out, how it has made them appreciate that, when interacting with others, that they don't really know the depths of suffering or sadness that the other may be dealing with, in the dark, in the private spaces, and has helped them demonstrate, shall we call it "grace"? to others and treat them gently. And that, I found stunning. That even in this hellish home, ravaged by this illness, my patient can still find grace for others. I don't think they would call it that, I don't think that they would even recognize the word, but, despite all their suffering, it is humbling for me to be reminded of their ability to remember that others may also be walking similar paths...
Recently, a friend made me question just how funny/humourous I was anymore. I remember being funny once, and I'd like to think that I still am, but ever since then, I've been watching and waiting to see if any of my patients will do anything hilarious. Which they don't. It's too bad, as I now think my job inherently has the capability to swallow and hold a whole lot of suffering (as noted by the last essay that I had posted), and though there is much joy in walking alongside patients through their valleys, it's not exactly laughsville.
One patient re-taught me a lesson that I think is easy to forget. This patient has a spouse (who is also my patient) who is dying, slowly, ever so excruciatingly slowly, and so very young. They have a tiny child at home, and in the course of dying, which will likely take years, the disease will gradually take their mind and their body. In fact, it already has, and the increasing lack of control over their emotions, their rationality, their paranoia, and the volume and tone of their voice is taking a toll on the well spouse, trying to ask them to shush in front of the toddler, trying to get them to calm down to not scare the child. In the days where they are more lucid, they can actually have a conversation, but mostly, day after day, my patient arrives home from work to a barrage of baseless accusations, and screaming, and a great dread of coming home to their spouse. My patient hasn't really told many people at work; it'd be too hard for them to understand exactly what this dying process is like. They also have no other family; it is just the three of them. So, they spend their days, going to work, coming home, caring for the child, dealing with the spouse, and then collapsing, exhausted until it starts again. They dread the weekends. There is no one else to take the child for weekends, no siblings, parents, cousins, aunts who can share the burden of care. It is a situation that leaves me worrying for this patient, how they will make it through the next few years without being broken and burnt out.
And yet, they are still able to teach me lessons. They pointed out, how it has made them appreciate that, when interacting with others, that they don't really know the depths of suffering or sadness that the other may be dealing with, in the dark, in the private spaces, and has helped them demonstrate, shall we call it "grace"? to others and treat them gently. And that, I found stunning. That even in this hellish home, ravaged by this illness, my patient can still find grace for others. I don't think they would call it that, I don't think that they would even recognize the word, but, despite all their suffering, it is humbling for me to be reminded of their ability to remember that others may also be walking similar paths...
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