Posted in Philosophy

A Zimbabwean Passport is just as good as a prescription for antidepressants…

Being a citizen of the tiny nation of Zimbabwe is a hellish experience. The country itself has the aura of a detention camp. Freedom is as alien as an Arabic-speaking Martian. The whole country has become one big grumpy, grimy and slimy Rhodesian ‘Native reserve and urban ghetto’. At least under the racist Ian Smith there was LIFE. Everyone knew their place and had the choice to work hard to be the best of even the rot they were forced to be. There is no such choice in Zimbabwe. No one knows their place and as such have nowhere to start from. Hard work has been made a weakness. The harder the downtrodden Zimbabwean works the more they suffer for it. Working hard to earn a living now means nothing. One cannot even reap the fruit of their labours. The more money you make the longer you will wait to get it.

The elite have each acquired fiefdoms in which they rule, conquer and plunder. The Minister earns more money giving jobs than creating jobs. The prophets have sealed the gates of heaven itself with barricades of gold. The politicians have profered themselves with doctorates to pollute the noble corridors of the intellect with their pungent odour of ignorance, an odour which they wear as a perfume. The Police have organised themselves into uniformed thieves. The State police have embraced the psychotic delusion of being gods. The flag itself has become a crime. Speech has become blasphemy. Democracy itself has become treason.

A foreign stamp on the poor Zimbabwean’s passport has become the mystical antidote to death. The holder of a Zimbabwean passport has been made a schizophrenic dreamer. He dreams of leaving. Not just to greener pastures but to any other pasture he can flee to. Anywhere but Zimbabwe. That is where the cure lies. The house is on fire and stinks of charred dead hope.

Posted in Philosophy

WHY I AM ALWAYS ARMED…WITH A PEN

The analogy between the pen and the sword is timeless and irrevocable. My favourite ‘sword’ is the faithful BIC® clic medium black ball pen (pictured above). I always have at least two on my person. It has never ejaculated into my pocket and it never stutters. It is easy to prime; the side push button is resolute and never gives in to the pressure of my brutish writing. The tip is fine and elegant. The pen itself is very light and easy to manipulate. It is just like an AK47; trustworthy and obedient.

The sole purpose of a pen is to act as a medium of transmitting what is in the mind onto paper. It is thus, in my opinion, pointless to walk around with a congress of ideas in one’s head without equipping oneself with a means of deploying the most powerful weapon in all of eternity – an idea. Rudolf Hess and Emil Maurice, as Adolf Hitler’s secretaries in prison, put on paper one of the most dangerous ideas ever formulated – Hitler’s Mein Kampf. Wole Soyinka massaged his sanity and shook the entire Nigerian government by writing on tissue paper in prison on his route to winning the 1986 Nobel Prize in Literature. Albert Einstein penned the famous E=mc² on Swiss government paper as he laboured in the patent office. The Holy Qu’ran, the Holy Bible, impeachments, independence declarations, petitions, treaties and Constitutions have all been PENNED. The English Constitution is a notable exception, it is not written down on paper.

History is replete with tales of great ideas being birthed at the spur of the moment. Museums are well stocked with odd pieces of paper on which doodles of inspiration changed the world. Writers are particularly notorious for their private graffitti on napkins. I too am also hoping to have a piece of grime-smudged tissue paper with my handwriting on it locked up in a highly secure display cabinet in some obscure library or museum. I must admit, so far all my doodles and odd pieces of paper have been under safe storage at the municipality sewers.

As a medical doctor I can tell you this much; a pen can be a lethal physical weapon too, if used well. All that is required is an intimate knowledge of Human Anatomy and this explains why I have in my possession quite a safe number of textbooks on the subject which I religiously peruse whenever I feel physically threatened. It also explains why my older brother has a strong phobia against Human Anatomy textbooks. While growing up he would frequently taunt me and bully me (as all loving big brothers do) but one day I stopped him in mid-swing and gave him a calm but unforgettable lecture on the anatomy of the neck while pointing out the various parts of his neck with my trusted pen. There are so many sweet spots on the neck that are just waiting for the right pen in the right hands. The trachea, jugular veins, carotid arteries, lung apex and of course the space between the fourth and fifth ribs on the left chest just close to the nipple are just some of the few inviting rendezvous points for a definitive conclusion of any argument.

In the event that such an unlikely meeting is successful there is always the Police’s admission of guilt forms to be signed. Having a pen at all times is one sure way of making any negotiations with the Police go smoothly. They always have some line on some paper waiting for your signature even when you have not crossed their line (the blurry line of the law). In my country having an encounter with a policeman on a daily basis is as inevitable as stopping at a red traffic light. They are everywhere and oddly enough they almost never seem to have a pen handy to facilitate the purgatory process of getting them off your back. My guess is that they always conveniently forget their State-bought pens in their children’s satchels along with pocket money ‘dropped’ from some citizen’s pocket.

And then there are contracts. As a typical Zimbabwean I am always hunting for work and I choose not to tempt Fate by not having a pen ready to sign a contract of employment whenever and wherever it may pop up. In fact I have never signed a contract of any kind with a pen that has never felt the warmth of my bosom (the breast pocket is the best place to incubate your pen). It is because of this simple reason that I find women to be the best people to borrow a pen from in winter; you get the added advantage of avoiding frostbite on your fingers through the use of a pen from the warmest of bosoms.

Last but far from least are the drug prescriptions, referral notes and odd medical scripts. That needs no explanation. Obviously this is the main reason I always carry a pen and if my essay has given the reader a contrary impression then I guess I have done a darn good job.

Posted in Health, Literature, Medical, Philosophy, Theology

The Difference between a Surgeon and a Physician

I always stand guard against over-generalisations and over-simplifications but sometimes there is no choice but to succumb to the banalities of common literature. A surgeon is a medical doctor who specialises in doing operations (as the British say) or operating theatre procedures (as the Americans call it) while a Physician on the other hand specialises in prescribing drugs and everything else other than “cutting to effect a cure”. There are overlaps of coarse: Surgeons also prescribe medications and Physicians also do some surgical procedures. The subject of my essay however is not about the qualifications and job descriptions of the two but in the juxtaposition of personality traits that continues to pique the interest of any individual who finds themselves picking lilies, thorns and roses in the rich field that is the medical profession.

Scientific work has been done to better understand these differences. A few come to mind. Rene Warschkow et al did a comparative cross-sectional study on personality traits in Internists (the American term for Specialist Physicians) and Surgeons in Switzerland using the Frieburg Personality Inverntory and published some interesting findings. In general, Surgeons viewed themselves as having excessive achievement orientation and extraversion (talkative, energetic, enthusiastic and assertive) while their counterparts, the Physicians, admitted to having decreased aggressiveness. In the study Surgeons had the stereotype of being less inhibited, more excitable, aggressive and strained while Physicians on the other hand were almost balanced and had the stereotype of having highly developed social orientation. McCulloch et al also published interesting findings on tolerance of uncertainty, extroversion, neuroticism and attitudes to randomised controlled trials (how a doctor accepts the new science) among one thousand (1 000) Surgeons and Physicians who were mailed questionnaires and replied. Surgeons were found to be more extroverted (the talkative doctors) and less neurotic while also being more intolerant of uncertainty. However, no difference was found in the attitudes regarding clinical trials.

On the 27th of September 2013, at the International Conference on Residency Education, Dr Joseph M. Drosdeck of Wexner Medical Centre Ohio made a very fascinating presentation on his findings in a study he did on 68 Surgical participants and 124 non-Surgical participants on the Five Factor Model (also known as the Big Five Inventory Survey). I have to admit this single work of science – the Big Five Inventory Survey – has been the single most powerful driving force behing this nifty essay. Drosdeck compared five aspects of personality:

1. Extraversion (explained above)

2. Agreeableness (sympathetic, kind, mature, caring and affectionate – both hostility and indifference)

3. Conscientiousness (organised, thorough, diligent and planful). Good impluse control also falls under this category.

4. Emotional Stability (Neuroticism) – calm in the face of adversity. Low scores were associated with Anxiety, Depression and self – consciousness.

5. Openness to Experience (Intellectual, creative, artistic – Conventional andConservative) OR

Preference to familiarity

I found Drosdeck’s conclusions very fascinating. He concluded that there are indeed inherent personality differences between Surgical and non-Surgical specialties AND personality traits change during medical training. This is exactly what we ALL have known: Surgeons are born but can be made. Physicans are born but can be made. Now that I have the warm embracing cushion of fact allow me to embellish and indulge.

I know a real Surgeon. I have met him. He has a very deep voice and he loves his drink. Legend has it he once vomitted into an open abdomen while operating. He was called to an emegerncy (even though he was not on call) while lubricating and because he is a real Surgeon he responded. The patient survived, made a full recovery and the Surgeon is still a real Surgeon. I remember a particular day. I was seated somewhere in a plain dark corner while the Surgeon introduced us the meek medical students to Surgery. He said and this I remember clearly for it was during one of those few moments I actually paid attention during a lecture, “A Surgeon has eyes of an eagle, the heart of a lion, hands of a baby……”. He must have said more but I blanked out as usual. He is a politician, loves authority, thinks he’s the greatest Surgeon on earth, thinks being a Surgeon is the greatest call on earth and believes, “God’s greatest gift to mankind is a functioning anus.” He has childish tendencies. I remember one day in theatre we had a very interesting case and my other boss, the other real Surgeon, decided to grace the theatre with his presence. In came in the real Surgeon late, takes one look at the other real Surgeon and sulks his way through one of the best acts of thievery I have ever seen. I believe a Surgeon has to be a very good thief. He has to break into a home, take what he came for and leave everything as close as it was before he broke in. He has to go in, grab, fix and get the hell out of there before he gets caught. Before he gets caught by the Creator.

I know a real Physician. I have met him. He talks well, dresses well, walks fast and praises everyone….at the appointed time. He is eloquent. When he talks you have no choice but to listen. He makes sure you know that he knows what he is talking about. He smells good too. The nurses talk about him as if he invented soap. I heard one say, “He smells of water”. Not ‘like water’. OF water. He too loves authority though he seems to shun it. He is soft. Soft-spoken and very very verbose. He loves euphemisms. AIDS is not in his vocabulary but it certainly is what he knows best. It is ‘retroviraemia’. He can recite all the latest guidelines but never calls Diabetes ‘high blood sugar’ unless talking to a patient. It is ‘glycaemia’. He can do a full examination in under ten minutes and come up with ten different diagnoses. He knows all the drugs: their names, uses, dosages and everything about them that you do not want to know. He thinks “Surgeons just like cutting and nothing else”. He thinks they are not intelligent. He is very gentle. Even his handwriting is gentle and delicate.

A doctor is either a Surgeon or a Physician. Paediatricians, Radiologists, Psychiatrists, Anaesthetists, Oncologists, Gynaecologists, Haematologists, General Practitioners and the works. Every doctor is either a Physician or a Surgeon………….or a Pathologist. Now those people are different and special. They have their own category. I know a Pathologist.

Posted in Health, Philosophy, Theology

On faith healing and our Medicine: KICKING THE HORNET’S NEST

 

It might appear as if the ever flourishing false prophets and popcorn faith healers have made a huge dent on the coffers of trained Physicians through their promise of instant cures which unfortunately occur less frequently than they claim to do. Quite to the contrary, the effect has been a huge boon in critical cases that failed to respond to pricey anointed oils, stickers, bangles and cucumbers who find themselves paying for expensive tests, drugs and procedures which could have been easily avoided if only they had come in sooner.

It is with despair and anger that doctors in Christian countries perpetually attend to patients who snub evidence-based medical advice in preference to consistently unreliable charms and chants conjured and propagated by those who claim to be God’s elite. It is indeed not uncommon to see a patient twice at both extremities of a spectrum of hellish experiences of deception that comprise the act of attending and believing in these myriad false churches. A typical case of a young lady coming in with abdominal pains secondary to a growing ectopic pregnancy who refuses surgery and instead opts for a US$300 one-on-one session with “my Papa” but later comes back with a ruptured tubal pregnancy that requires $600 life-saving blood transfusion on top of the surgery originally advised on rings true in the minds of most doctors practising in a Zimbabwean hospital.

The driving force of this madness is the belief in the myth that seeking professional advice or imbibing prescribed medication is a testimony of lack of faith. The notion is that one only needs prayers and impartation (through physical objects such as oils, stickers and such) for complete healing. The simple rebuttal to this draconian contention is that the Bible does not teach that. It is with utter disgust that we find these “anointed” objects actually being sold in these churches. Buying a blessing? Purchasing a miracle? Are these not the things that Jesus Christ physically and violently destroyed in the temple of Jerusalem. What is it he said about the function of churches (temples)? These false prophets and their flock might benefit from reading Mark 11:15-19. What are these churches really based on if not on the Holy Bible which they obviously have not read or choose to distort or ignore?

Here is my argument. I believe doctors are part of God’s miracles. The Son of God Himself chose a Physician (by the name of Luke) to be part of his elect Twelve. Getting professional medical treatment is not mutually exclusive with faith in God and in His healing. Doctors are simply instruments used in the grand scheme of preservation and perpetuation of life. It would most definitely be imprudent for one to pursue faith healing without at least knocking on a Physician’s door.

Posted in History, Literature, Philosophy

BOOK REVIEW: ENIGMA by Robert Harris

Between the covers of this book are pages of raw talent. With ENIGMA, Robert Harris has driven me into a rut where every other book I am going to have the misfortune of reading will only pale in comparison to the sheer quality of just this one book.

The plot is deceptively predictable – a genius, young but eccentric mathematician gets a crack at decoding the legendary Nazi naval code Enigma while falling for a sweet but wayward dame who may or may not be a spy. It is the typical plot for this particular genre; a genre built around the complex and by nature illicit art of mathematically decoding codes (cryptanalysis). The young Tom Jericho gets invited back to Bletchley Park (the British spy headquarters for code-breakers) from a sojourn he was forced to take in quiet Cambridge following a nervous meltdown at work. On his unceremonious arrival – as the prodigal weakling – he is shocked to find the the girl he lost his virginity and marbles to, Claire, had literally gone AWOL. He acquires the uncanny assistance of Claire’s roommate Hester in searching for the disappeared lass.

What sets ENIGMA apart from the numerous other books in this genre is the depth of understanding of the science itself exquisitely blended with powerful prose and hints of poetry to create a beautiful work of art. It is lines like, ‘She wore her long, dark hair like a headache….'{describing Hester on page 301) that remind the reader that what they have in their hands is not just a novel but a literary work of art. As I was reading the book I could not help but silently compare it with what I thought was up to that point the best book in the genre, Dan Brown’s DIGITAL FORTRESS. After I read Dan Brown’s book I always felt like the book was well researched and interesting but there was one thing it was missing. I never knew what that thing was till I read Robert Harris’ book. What DIGITAL FORTRESS was missing was Robert Harris.

I highly recommend him.

Posted in Literature, Philosophy

Lines Written During a Period of Insanity

This witty poem written by William Cowper sometime in the later decades of the 18th Century AD is one of my favourites. It is a disturbing tragedy with heavy Biblical references which makes it a difficult read for anyone with a less-than-par didactic knowledge of the Christian go-to book.

Judas was one of Jesus Christ’s disciples who sold out his ‘Master’ to the Jewish High Priests for a paltry thirty pieces of silver. It takes no great imagination to conceive that Judas was and still is disliked by Christians hence the line “Damned below Judas: more abhorred than he was.” This line is the pivot of the entire poem. In actual fact the entire poem sounds like a suicide note. The fact that Judas killed himself gives credence to my assertion.

The other character that needs unmasking is Abiram who is described in the book of Numbers as the leader of a group of dissidents who rebelled against the authority of Moses and Aaron. The poet laments that he deserves “to receive a sentence/ Worse than Abiram’s“. Self-pity is heightened when the narrator claims that even Hell will refuse to receive him after his death for his sins are so great than hell will actually feel like a sanctuary for a sinner of that stature – a sinner worse than a traitor and a rebel against the ‘Master’ himself.

When all these nuances are factored in it becomes somewhat more apparent that there is a tinge of madness in it all. We are left wondering, “how on earth can someone think they are that evil?”. The form of madness alluded to in this poem is not the psychotic Schizophrenia-type but the deep depression type. Depression was considered a form of madness in that era and the poet himself suffered from serious bouts of depression. It is believed that William Cowper wrote this poem around 1773 when he was in the middle of one of his dark days.

Hatred and vengeance, my eternal portion,
Scarce can endure delay of execution,
Wait with impatient readiness to seize my
		Soul in a moment.

Damned below Judas:more abhorred than he was,
Who for a few pence sold his holy Master.
Twice-betrayed Jesus me, the last delinquent,
		Deems the profanest.

Man disavows, and Deity disowns me;
Hell might afford my miseries a shelter;
Therefore Hell keeps her ever-hungry mouths all
		Bolted against me.

Hard lot! encompassed with a thousand dangers,
Weary, faint, trembling with a thousand terrors,
I'm called, if vanquished, to receive a sentence
		Worse than Abiram's

Him the vindictive rod of angry Justice
Sent quick and howling to the centre headlong;
I, fed with judgement, in a fleshy tomb, am
		Buried above ground.
Posted in History, Literature, Neuroscience, Philosophy

BOOK REVIEW: NEMESIS by Isaac Asimov

This is by far the most intense scientific work of fiction I have ever read. The genius and prolific Professor of Biochemistry Isaac Asimov outdid himself in this book. It exudes a nostalgic aura of missing one’s future even before one has lived out his present.

The book is set in the third century of this millennium, in a world where technology is only limited by the depths of astrological exploration. Man has set up colonies in space. The ultimate drive of humanity is a way out of Earth or rather OFF it. Our planet has become a cesspit of disease, poverty and anarchy. Only the colonies offer some modicum of peace and order. Societies are once again divided along racial lines with the best of them setting up base in their own ‘world’. Among these many colonies strewn all over the galaxy is Rotor a community of mostly scientists ruled by an astute political visionary by the name of Commissioner Julius Pitt. He sets the ball rolling when his chief Physicist Dr Insigna discovers a planet that can possibly sustain life. He launches a campaign to convince the citizens of Rotor to pack up and go to the dwarf star Nemesis. They agree and they move. The book is essentially about the effects of that move.

The way this simple story is interwoven and well-thought out is outright astounding. It left me asking myself, “Did all this come from just one brain?”. To make things even more interesting if one were to read a good number of Isaac Asimov’s books an obvious trend of dabbling in the prophetic. This book proves just that. It was ahead of its time. In fact I can say, with a heavy helping of imagination, that Isaac Asimov deserves a place right next to George Orwell in the Literature Hall of Fame.