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Monday, April 26, 2010

Did You Know...

... that all the blinking you do in one day amounts to having your eyes shut for 30 minutes?
... and that in a lifetime the average person spends over 25 years SLEEPING?

Gets you thinking doesn't it?

Thursday, April 22, 2010

Southpark: Too Far This Time?

I stumbled a cross this bit of news on CNN (Read News Article) reporting that Southpark creators Matt Stone and Trey Parker might have gone too far on one of their notorious skits on religion and major religious figures, by allowing one of their episodes to feature Muslim Prophet Mohammad wearing a bear suit.

"This is a show, after all, that once painted God as a gap-toothed rhinoceros-monkey, portrays Satan as a simpering milquetoast and regularly features Jesus as a superhero -- the kind who's not afraid to ignore the peaceful teachings of the Sermon on the Mount to smite his opponents. The show has mocked Jews, Catholics, Mormons, Scientologists and atheists, among (many) others." - CNN

I have been a fan of Southpark for years and years so this really caught my attention because, while I found their fun poking at religion and its figures was witty, hilarious, and as bold as one can imagine, I've always wondered when and how it would get them in trouble (and I'm laughing as I write this!).
So here it is! "Revolution Muslim" a radical Islamist organization and movement based in New York City that advocates the re-establishment of a structured Islamic state, terrorism in both the US and in democratic countries around the world, the removal of the current rulers in heavily Muslim populated regions, the destruction of Israel, and an end to what they consider 'western imperialism' - Wikipedia -- Is it just me, or does it sound a bit odd that this group would be based in NYC??? Excuse my digression! -- has taken offense at the portrayal of their prophet and has released a 'warning', or so they called it, to Trey Parker and Matt Stone, reminding them of the murder of Theo Van Gogh, who was killed in 2004 by an Islamic extremist. Among his works was "Submission, a short film about abuse of women in Islam. The release included pictures of Van Gogh's dead body. According to the group, however, this was in no way a threat but a mere warning of what might happen as a consequence of the airing of the episode.

Super Best Friends

I can't help but laugh at the wonderful work of the makers of Southpark. Of note was one representation of almost all religious figures in a group gathering, with Prophet Mohammad covered by a black square with the word "CENSORED" contrasting in white.

I am not sure about the repercussions of this and what they can be, or if any other movements with more power have taken more serious offense than Revolution Muslim. And if they have, how different would the reactions be in NYC as compared to the Middle East? I am also wondering about freedom of speech and how it applies in this case! How can groups be allowed to run around threatening people who don't live by their values?

Video From CNN

Thank You Ayaan - You are the first Muslim I have ever heard speaking with such objectivity.

Sunday, April 18, 2010

Blind Item

I snapped this photo of the Lebanese Norwegian Cultural Week poster...
A funny twist!

Saturday, April 17, 2010

What's Lebanon's Stance on Slavery and Racism Again??

So here's another lie us self-righteous Lebanese tend to force feed ourselves. We don't condone slavery. We turn our backs to racism. Right?
Think again...
To your right is a nice classified ad for the exchange of a 1991 Dodge for a Sri Lankan domestic worker.

[Edit:This is to clarify that the classified is NOT in a Lebanese paper].

What more do we need? how much more disgrace, how much clearer does this picture need to be for the Lebanese to just shut the hell up and realize that we are probably the most self-absorbed, superficial, and prejudiced (oh yeah the list goes on...) people on the face of this planet?
I can only try and say how dumbfounded I was when I saw that classified. And in light of the no maids in pool article I can tell that it's only a matter of time before we find a few like these in our Lebanese media.

I really thought I'd have so much to say about this matter, so much to talk about and criticize, so many questions and so much eloquent rhetoric. Instead, I have only speechlessness, disbelief, and shame. I am ashamed of my country, ashamed of being Lebanese. This shame is growing by the day, exacerbated by the fake, smug, and holy stance that the Lebanese take on these and other matters.
Lebanese people are a friendly, welcoming, and humanitarian people. Or so would the media say. Of Course they do not tell you the whole story. I will stop here, too disgusted to continue writing.

Monday, April 5, 2010

Modern Medicine and Cruelty... The Positives?

Read Cruel Discussion and Modern Medicine.

I've talked and talked and rambled on about the disillusionment one stands to feel during one's progression in physician training over the years. My avid readers will remember the "Ladies and Gentlemen, Your Future Doctors!" 'saga'. If you don't, check out Part I and Part II. (Does time fly or what?).
Anyways in the second part I go on about how you lose this sense of idealism, this cleanliness, if you will, that people commonly associate with medicine. Now some one and a half years down the line, this incident comes and reshuffles my perception of the world of medicine and what it all stands for.
In the OPD (Out Patient Department) we care for patients on a visit-to-visit basis. It is usually the least expensive form of healthcare, and so inevitably we get to see the less fortunate patients who are paying petty fees for consults with doctors in a high-ranking hospital. The ramifications of this, which I will save for another -long- post, and the experience of such 'encounters' sometimes shakes you to your core. The socioeconomic aspect that we never really come to face on the ward floors with high class (I hate to say it) patients is a rude awakening to say the least. So one of my last patients in the OPD Pediatrics rotation was K. an 11 year-old boy whose chart (We view charts before meeting with patients) said that he had growth failure. As I read more and more pages, and came across more and more test results and differential diagnoses, I got to the note that was written when K. had last visited the OPD clinic. At the time (some 2 years ago) he was diagnosed with Laron-type dwarfism. In brief, Laron type dwarfism (also Laron Syndrome) results from a mutation of the Growth Hormone receptor, and a subsequent Growth Hormone insensitivity leading to failure of growth due to severe IGF1 deficiency (IGF1 mediates the action of Growth Hormone).

The Visit
K. walked into the room and I immediately saw his prominent foreheaed (typical of the syndrome). To me he looked like a 4-5 year-old toddler, physically, and somehow even though I knew about his condition, I was still dumbfounded when he greeted me with a noisy low-5 followed by a firm handshake worthy of a grown man. Or when I heard his 11 year-old voice and his 11 year-old vocabulary. Or as I saw his 11 year-old movements manifest in a 4 year-old body. His 11 year-old self confidence, assertiveness, and demand of autonomy also struck me as he insistently forbid his mother from answering my questions for him. I think I've stressed it enough, it was one hell of a surprise, despite the fact that I knew about it.
K. was without a doubt the most pleasant patient I've had during this rotation. He had a persistent contagious smile that revealed a set of run down, crooked and decay nibbled teeth. He made jokes, played with my stethoscope, and everything else he could find in the room. The whole interview and physical exam took place in a light atmosphere and in the best possible conditions. NOT to be soon forgotten.

Of The Sadness of Reality
One promising modality for the treatment of Laron Syndrome is recombinant IGF1 (marketed under the name Increlex in the U.S.), which can bypass the action of GH on its deficient receptor, thereby restoring growth satisfactorily if treatment is initiated in a timely fashion.
Sadly, Increlex is unavailable in Lebanon. And apparently it is a very expensive drug, which as you might have concluded makes it a problem for an OPD patient struggling to pay even the LBP 10,000 OPD fee.
As documented in K'.s chart, K.'s mother was told about this treatment when they had last visited OPD. She was also told that it was not available and that there was no way she could afford it even if it were. She was coming a couple of years after that visit in the hope (in her own words) that "Dr. N had something new for her and her son".
- Dr. N: There still are no significant efforts to market the drug in Lebanon.
- Mother: Oh.
- Dr. N: As I told you last time we are trying but your son's condition is so rare that it's hard to find proper treatment here. And the expenses would be just impossible.
Dr. N once again sent K. and his mother home empty-handed. I could not tell whether the expression on the mother's face was one of disappointment, helplessness and resignation, or of expectation.

My Reactions and Thoughts
I was deeply saddened by this outcome and for a brief moment I felt helpless and ashamed that we had to send a patient home after telling him in no uncertain terms: "there is a drug for what you have, we're sorry but you just can't have it". So what are the issues here? I mean after stepping out of that personal, humane, human, emotional roller coaster ride of a first reaction, what are the circumstances that need to be discussed?
We hear a lot every day about how medicine has been commercialized to a degree where incidents such as these are possible. We also hear about how shameful it is that medicine is a financially driven institution. And what we hear most are the sad individual stories such as the one I've told you in my long and by now surely boring account. But what is the bottom line? If anyone knows me they know I'm a bottom line kind of person. So what is it in this case?
Well the bottom line, stripped of all emotion, all sentience, and all humanity, is a sad realization that money is and always will be a major, major factor in the drive for research of all kind. Putting all of this baggage aside, a patient is buying a product (in this case a drug that is the result of years and years of expensive research and trials), in order to use that product for personal reasons.
This is how impersonal and desolate the bottom line of modern medicine has become. And to me that's all that matters because there simply is no point trying to discuss how and why it comes down to this. So is it correct to assume that my disillusionment has surpassed all the good that medicine has brought and is bringing to this world? That in the end it can be boiled down to a simple transaction between a care provider, a pharmaceutical company, and an ill person?

The answer is a resounding NO. To me there is always a positive side to this. One positive side that will not be affected by the source of motivation of pharmaceutical companies, is that no matter what happens, medicine will always strive toward a common goal. And that common goal (besides, of course, the financial rewards) being what it is, which ranges from the curative eradication of disease to the palliative nature of the most trivial of pain medication, I can confidently say that medicine does more good than harm.
Sure, unfortunate patients will benefit less than others and K. here is a prime example. But if we consider the long term outcome of the situation, we are hard-pressed to see that had there not been this monetary incentive for research, Increlex would have probably never seen the light of day! But the bottom line is that it HAS. As a result of this, we HAVE a drug, it IS helping SOME people and maybe one day this drug WILL be available to everyone. I will go out on a limb here and say that an inevitable period during the life of this drug (and this applies to all drugs and forms of medical treatment or diagnostic tools one can think of) when it will be administered in a discriminate fashion among patients is only an obstacle, a hurdle that we will overcome in our drive toward global availability and affordability of the drug. This situation now is better, in my humble opinion, than not having any drug at all, and I would be surprised if anyone argues otherwise.

Sad. But true.

Friday, April 2, 2010

Brilliant Recap on Religion

Came across this skit by George Carlin on religion and its shortcomings.
I know some of what he says may be a bit disrespectful and his language might be a bit raunchy. But look past this and you'll find a good argument. And a funny one!

I somehow identified with Carlin on this one. I was never a believer. Since childhood, and since I could remember having any sense of logic and my own opinion on a few things in life, I just couldn't get myself to accept the dogmata of religion. There always seemed to be just too many discrepancies, to many dissonant axioms for me to just believe blindly. And let's face it, blind faith is the requisite in this department.
So what Carlin says in this skit summarizes (very briefly) my views on religion.
One thing though is that I've always been sincerely respectful of people's beliefs, as I've said in earlier posts; what drives me out of my mind though are people who use the 'faith argument' in discussions to try and convince people of the validity of the God Theory and all that it entails. These are the only instances where anyone will hear me badmouthing religion (and not spirituality).

Yesterday was holy Thursday and I tagged along with milady and a few friends for the traditional 7-Church visit. "This isn't tourism", smiled L., who was all too aware of my views on the matter, "you should have some thoughts, maybe say an informal prayer here and there!"
The thing is, there were many, many thoughts entering my mind at the time. At every church visit, every time I walked into a church since I was a kid, I would start thinking and thinking. Wondering, asking myself questions. Questions and thoughts about how people seemed taken and immersed in their belief, and the sense of their trance-like state. Every time, the experience is touching to say the least. And every now and then, I felt like one or two of my thoughts were of my family and loved ones, and these were the thoughts that I felt were somehow 'emitted' or 'sent off' without me necessarily wanting them to, in some raw and random hope that someone really is up there. But... you know the rest. These feelings and thoughts never consolidated into anything more powerful and for me, I don't know. I guess something more compelling will have to happen for religion to have a better chance with me. Don't ask what.

So please for those of you who will view this video, don't be outraged and blinded by a few bad words and scream blasphemy!