This song strangely has a very old feel to it with a fresh message. A mix of cheerful and somber.
And clapping, which spoils the mood.
And in the naked light I saw
Ten thousand people, maybe more
People talking without speaking
People hearing without listening
People writing songs that voices never share
And no one dared
Disturb the sound of silence
I wonder a lot and I don’t always find answers to my questions, but when I do, it’s fabulous 
Caveat: Ain’t encouragin’ no drinkin’ here. Photo by Vikingfjord US
This is a story of how a bunch of researchers discovered the wonders of Grapefruit. All medics know that grapefruit juice has certain compounds which affect how the body processes certain drugs. I took that for granted until one fine day, I asked myself, “How did they figure that out?”. Did doctors, while taking a history of a patient with some trouble with their drugs, ask if they had soy sauce, maple syrup on their waffles or grapefruit juice for breakfast? Did they then do the same thing with other patients with similar problems and see a pattern? I have rarely heard a physician go into that much detail about diet so I doubted that explanation. I looked up the literature (kidding, I just googled it) and uncovered an interesting story.
Sometime, either in the late 80s or early 90s, David Bailey and his team of Canadian researchers were doing experiments to see if consuming alcohol together with the blood pressure drug felodipine made any difference to the drug’s effectiveness. The participants were split into two groups, one was given alcohol plus the drug, and one, just the drug. To avoid the placebo effect, the experiment needed to be conducted in such a way that the subjects did not know whether they were having alcohol or not. Turns out one way to do this is to use a mixer. Specifically grapefruit juice, the sharp taste of which would mask the taste of alcohol. When they ran tests on the levels of drug in the subjects’ blood, they found out that the drug levels were way higher than expected, even in the grapefruit juice group. And that friends, is how we discovered the effects of grapefruit juice.
It turns out that pomelo and lime juice can also affect drug processing, while orange juice seems safe.
The Real Singapore posted a picture with a commentary about Mainland Chinese eating fetuses.
It looks real, with pictures and a dramatic story to go with it. Unfortunately, I couldn’t find a reliable source for the information. Worse, I see 83 comments (as of writing) and not one of them critical of the source, almost all of them accusing the Chinese of being idiots, inhumane, barbarians.
It is in fact, from an art exhibit by Zhu Yu. It was apparently republished by a Malaysian newspaper without caption. If you look carefully at the head, it looks like a dolls head.
Melektaus and Emery from About.com, discuss this further and rightfully note that this looks like a variation of the Blood Libel, where Anti-Semites accused the Jews of sacrificing children in their ritual. It was also used to justify European persecution of the Jewish minority.
It is one thing to be unhappy at government policy, it is another to demonise an entire country. The Real Singapore should know better than to publish patent falsehoods. It is feeding into the already rampant xenophobia. I also worry that the real Singapore isn’t thinking for itself.
Edit. After I finished writing, I notice a handful of comments, out of 150, actually pointing out the nature of the picture. Kudos!
One of my friends was on exchange and I noticed a logo on the said friend’s facebook profile.
Looks familiar?
It kind of resembled my own school’s medical society logo.
NUS MedSoc Logo
I recall, back in my first year, we had a short lecture on the history of medicine and the lecturer briefly spoke about the logo, with an amused look. Apparently there is a bit of confusion with regards to the symbol and strictly speaking, the Stockholm school uses it the way it should be, based on its roots.
The winged rod with two intertwined snakes is actually the Staff of Hermes (Mercury in Roman Mythology), known as the Caduceus. Some historians interpret it to symbolise “balanced exchange and reciprocity” which are values which drive commerce. Since Mercury is the “the messenger of the gods, guide of the dead and protector of merchants, shepherds, gamblers, liars, and thieves” this has come to symbolise all these aspects. It’s often erroneously used by Medical Societies, especially the commercial ones, and this can be traced to it’s adoption as the symbol of the US Medical Corps in 1902. Wikipedia covers this in more detail in a very readable fashion.
The actual symbol representing Medicine, based on Greek mythology, is the Rod of Asclepius, the god of healing and it comprises a single snake twined around a rod, as below.
The Actual Rod of Healing
After a lecture today though, I think the (misused) logo can potentially be re-interpreted in the light of Evidence Based Medicine (EBM).
Simply put, EBM is an approach where we use evidence to analyse treatments (and lab tests, physical exam techniques etc) to objectively figure out whether our treatments (or tests) actually work. This might seem like a mundane question to those outside of the field, because, if someone takes a pill and gets better, a treatment works right? The reality is a little bit more complicated than that. As a counter to that, I might ask, how do you know that the pill made someone better? They might have gotten better anyway in a few days. In addition to this, for long term illness, one sometimes has good days and bad ones. With this in mind, researchers (who are often Medical Doctors, but this can involve people from various healthcare fields) design studies to tease out the various factors so at the end of it, one can be confident that the treatment is effective.
An extra element of complexity is added when we consider the fact that certain treatments can be potentially harmful. Drugs sometimes have side effects or may have dramatic effects which can cause harm under various circumstances. An example is the use of “blood thinners” to prevention ischemic strokes due to blood clots choking the blood supply to the brain. Blood clotting (or coagulation) is a chemical reaction where proteins in the blood clump together with cells to form a clot. The clotting of blood is important to prevent bleeding but in diseases of the blood vessels, there is an increased tendency for blood to form a clot and block blood vessels. Blood thinners, or more accurately, anti-coagulants, impair this process. They don’t actually make the blood thinner. However, in a legitimate bleed, you still do want the blood to solidify and cause the bleeding to stop. A consequence of blood thinners is that the bleeding may not stop in the event of an injury.
With this in mind, it is imperative that Doctors use research and figure out how to balance the risk of an uncontrolled bleed versus the risk of a stroke in diseases of the blood vessels. Part of this strategy is to use the right drugs (some are weaker and hence less likely to cause bleeding) and to understand the patient and disease better (those with severe disease may still need stronger drugs). These days, there is a cost element that doctors need to be aware of, and we also know that the more complex a treatment, the less likely patients are to accept it and it may be more difficult to follow it. What this means is that our role has become more complex and we need to “balance and negotiate” a multitude of factors when we treat people.
If you dig around a little, there is this uncanny symbolism to the myths and paraphernalia associated with Hermes. A publisher used the staff as an emblem with a biblical quote reminding one to “be ye therefore wise as serpents, and harmless as doves.” Seems a lot like an exhortation to be a critical thinker but to balance it with empathy for patients. Hermes is also the “messenger of the Gods” and seen as a guide. Doctors are often looked up as people who “know the science” and there is a huge expectation upon us to be able to communicate this to patients, to help work with them to tailor their treatment. He is seen as swift and cunning and a navigator, and people expect us to be on their side when it comes to navigating the vast an complicated realm of healthcare.
I smugly laughed back in my first year when the lecturer potentially interpreted the Medical Society’s logo as representing the “commercialisation” of medicine. However, knowing this background it seems amusingly appropriate.
And the bit about Hermes as the god of Gamblers? Here’s a quote from the Oxford Handbook of Clinical Medicine (aka the Medical student’s pocket bible).
“Rather, medicine is for gamblers. Gamblers who use subtle clues to change their outlook from pessimism to optimism and vice versa”
I was randomly trying to look up information for a report when I discovered this trick. I cannot believe that Google is actually sifting through pages to give you a differential diagnoses. I think at this rate, Google will achieve self-consciousness by the time I graduate. They might also add in an empathy module. As such, maybe I should just quit school and focus on rehearsing my “would you like fries with that?”*
*Or “ni yao fries?”
“The menstrual cycle is an extremely well coordinated process involving four main players that act together like an orchestra. They are the hypothalamus, the anterior pituitary gland, the ovary and the endometrium” – Professor K. Arumugam, from A practical approach to problems in Gynecology for the undergraduate.
I happened to be reading that guidebook since I’m doing an Obstetrics and Gynecology attachment. The first time I talked to my friend about this quote, she bluntly remarked that it must have been written by a guy. And it’s true. Despite what the professor says, most of my girl friends would agree that a period is less like an orchestra and more like a Justin Bieber concert gone bad. The more time I spend in the Gynecology clinic, the more I am convinced of this fact. I am constantly surprised by the fact that women could have hidden such a large part of their lives from us men, though I feel that part of the reason is that we never really asked. I think the next time I’d be prepared to listen a bit and offer a hug and some anti-inflammatories.
In this context, it was absolutely hilarious when a friend shared this article with me about how a disgruntled boyfriend posted a complaint on the Facebook page of a Sanitary napkin company. I think Adweek has covered the story really well, including the original post on Facebook together with the company’s HILARIOUS video response. I strongly suggest you read the article.
To my guy friends, I think there’s a bit more we can do to make the world a better place. To my girl friends, Cheers mate!
Looks like just another real estate advertisement. Someone trying to tell you how amazing their apartment is. How it’s so nice that you should definitely think about renting it. Oh but of course, if you look at the last line in the picture, it’s “Non Indian Race, all other race prefer” in terrible English. I guess that means if you are Bangladeshi, Pakistani or Sri Lankan, you’re more than welcome.
That sounds a lot like Racial Discrimination to me. Seeing this in 21st Century Singapore makes me uncomfortable on one hand, on the other hand, I’m glad to know who to avoid.
