NATURE VS NURTURE WHEN IT COMES TO HUMANITARIAN MEDICAL PRACTICE

Nature vs Nurture

Science vs Entrepreneurial

While watching a short video about some of the eye boggling science that is coming out of  Israel, I began thinking about Nature vs Nurture.

It is something we learn at school but soon after that we abandon that idea. I thought to myself, what is happening in Israel, a small country, surrounded by very militant, destructive forces, yet managing to invent, go forward, publish much more than all of its enemies including those flush with oil money, has to do with Nature.

No Arabs have won a Nobel Prize in recent memory but they like many of their beliefs like to go back to the glory of their centuries past. Yes their civilization was brilliant but was soon surpassed by those of the Europeans even when Ottoman Empire was at its peak.

Middle Easterners, with exception of Iranians don't seem to contribute much to the Science of the day, neither do Indians or Chinese, who are good at other things, but sluggish at other things. Individual Indians have become great entrepreneurs in the USA but you don't hear of them spearheading Science in any large way compared to the thousands who are in the industry.

So Individuals doing well, whether in Business or other entrepreneurial matters may have to do with their NURTURE.

As an anthropologist, I understand both Nature and Nurture may be constructed entities but in my mind, there seems to be a connection between Nature and evolving belief systems, and a lack of rigid belief in faith or dogma. Whereas those who do not succeed, seem to be stuck in millennia old dogma or belief systems which do not allow them to evolve. In Asia, I found both Islam and Hinduism to be very restrictive but Buddhism to be less so.

In Asia, those individuals who are extraordinarily good people do seem to have liberated themselves from fanaticism and keep an open mind. They have the best of the both oriental and occidental world.

Islam and Judaism and Christianity all encompass many races, but culturally there are great differences, even among the adherents of the same faith. Malays and Indonesians are the same race of people but their observation of the religion is very different and it is reflected in their differences in open mindedness and innovation, Indonesians being more so.

My Chinese Malaysian friends would remind me that the Chinese are driven by a sense of survival, which would cross both Nature and Nurture divide, but much more Nurture than Nature since Chinese do make excellent Entrepreneurs.

How nice if there was a way for us to know what plays a greater role in our own upbringing, then we could make appropriate choices of our careers.

I can give a great example from my profession, Medicine. It is most suited for people who are blessed with Nature, so that they can truly contribute to the welfare of others. Those whose life is dominated by Cultural Nurturing, might use Medicine as an entrepreneurial vehicle thus hijacking the original humanitarian aim of Medical Care. Indian and Pakistani doctors (Hindus or Moslems) are good examples of the latter.

Like in anything else broad generalizations would lead to the accusations of racism and elitism but I remember very clearly what Sr Altschuler, son of one of the founding fathers of Cuban Communist Party once said to me:

There are two types of People, one would like do things for others, and the other who would like to do things for themselves.

A good definition of Nature vs Nurture, I think after all that many years.

Then he added, if you belong to the second category, sitting on the balcony of his house in Vedado, La Habana, I urge you to go to the USA, you would love it. But by chance you belong to the first category, you will find Cuba to be a paradise.

As I prepare to return to Cuba after wandering all around the world, I have to agree with Sr Altschuler!

THE ORIGINAL VIDEO THAT MADE MY WANDER LIKE THIS IS HERE

Made in Israel-Medicine

https://www.youtube.com/watch?v=20Zfk8uQXak 

THE INCREASING INEQUALITY IN AMERICA..THE UNITED FRUIT COMPANY OF DEMOCRACY

The following news item in the BBC pages were not revelatory but certainly disturbing!
A superb democracy which promote democracies around the world, at times using very undemocratic methods, at times falls prey to the powerful forces of money..

It is of interest to those of us who are seriously interested in the principles of the United States, generosity, hospitality, friendliness..

But this article shows that it is all good and fine as long as you don't touch the oligarchs, the drug companies, the oil barrens, the media moguls or the agricultural conglomerates, and the food companies that make you fat so that their other oligarch friends can increase their profits too, in an indirect sort of way.

It is no coincidence that the oligarchs belong to the party which would be much more at home in Nazi Germany than a modern democratic state, they admire Putin for his policies, oppress the already oppressed, take away from people who already have little to give..

In my field of Medicine, I can see that most of the practicing doctors who are not serving the government or the people, are in one way or another tied up with some of these oligarchs, by becoming their peons. It is not uncommon to see these peons at all levels of medical practice from GP at a neighborhood to some of the professors at some second rate universities such as Tulane University in New Orleans.

This kind of de-democratization is extending its tentacles to all walks of life. I am a traveller and thus member of a few Frequent Traveller Programmes, and i see that their worth is being eroded for the ordinary traveller but being upgraded for those who are in the upper levels of spending . Those who have travelled in the USA based airlines either in the USA or abroad would have noticed this definite two class system of the Favoured and not so favoured sons of the Land of the Free?

At least at Airline Clubs, Hilton Hotels and Certain airline call centers, there are distinctions and it has nothing to do with how much you are paying for their services just that day, which would be much more than a frequent traveller who is feted and fed would be paying.

So, here is the article from BBC
Be warned, some of the information would be offensive to ethically minded honest citizens of this world!

White, Older, Suit, wedding ring, gold watch, Financial Times, Leather Sofa, look of disdain for poor, immigrants and foreigners, faithful church goer, donates to NRA, don't have to tell you which party he would be voting for ! (these comments are mine)

The US is dominated by a rich and powerful elite.

So concludes a recent study by Princeton University Prof Martin Gilens and Northwestern University Prof Benjamin I Page.

This is not news, you say.

Perhaps, but the two professors have conducted exhaustive research to try to present data-driven support for this conclusion. Here's how they explain it:

Multivariate analysis indicates that economic elites and organised groups representing business interests have substantial independent impacts on US government policy, while average citizens and mass-based interest groups have little or no independent influence.

In English: the wealthy few move policy, while the average American has little power.

The two professors came to this conclusion after reviewing answers to 1,779 survey questions asked between 1981 and 2002 on public policy issues. They broke the responses down by income level, and then determined how often certain income levels and organised interest groups saw their policy preferences enacted.

"A proposed policy change with low support among economically elite Americans (one-out-of-five in favour) is adopted only about 18% of the time," they write, "while a proposed change with high support (four-out-of-five in favour) is adopted about 45% of the time."

On the other hand:

When a majority of citizens disagrees with economic elites and/or with organised interests, they generally lose. Moreover, because of the strong status quo bias built into the US political system, even when fairly large majorities of Americans favour policy change, they generally do not get it.

They conclude:

Americans do enjoy many features central to democratic governance, such as regular elections, freedom of speech and association and a widespread (if still contested) franchise. But we believe that if policymaking is dominated by powerful business organisations and a small number of affluent Americans, then America's claims to being a democratic society are seriously threatened.

Eric Zuess, writing in Counterpunch, isn't surprised by the survey's results.

"American democracy is a sham, no matter how much it's pumped by the oligarchs who run the country (and who control the nation's "news" media)," he writes. "The US, in other words, is basically similar to Russia or most other dubious 'electoral' 'democratic' countries. We weren't formerly, but we clearly are now."

This is the "Duh Report", says Death and Taxes magazine's Robyn Pennacchia. Maybe, she writes, Americans should just accept their fate.

"Perhaps we ought to suck it up, admit we have a classist society and do like England where we have a House of Lords and a House of Commoners," she writes, "instead of pretending as though we all have some kind of equal opportunity here."

DO THEY SERVE MATZOH ON AMERICAN AIRLINES? LAMENT FOR A MISSED SEDER BY A JEW WHO WANDERED A BIT TOO MUCH

One of the earliest lines of Spanish Poetry that made me want to learn the tongue of Cervantes, was, read on my way from school in Sweden to home in Melbourne:
Puedo escribir los versos mas triste este noche.
I can write the saddest lines tonight.

I have the same feeling tonight. Whereas Pablo Neruda was expressing his adolescent longings for his lover, my sadness comes from the fact that I want to be with my mischpochah

Why is this night different from all other nights?
Precisely!

(New Indonesian friends from Bogor)

On my first European adventure, many moons ago, I was going to be in Rhodos during Pesach. I found out from research in printed matter of that time that there was a family Toledano of Turkish ancestry living in that island, I got in touch with them and requested to be present at the Seder. That was the time I realized that Sefardim can eat rice during the Pesach, whereas that pleasure is denied to the Ashkenazim.

(my sentiments are reflected in this photograph)

So many Sederim, in so many countries, memorable ones with my dear friend Irena and her husband at their Coconut Grove house, each year the table graced by Jewish souls from various continents. Regardless of where I was in this planet, I made a point of being there.

(a bakery in Teheran to remind my exiled Iranian Jewish friends of the delicacies of their country)

A South African one with good friend Cecil, an Israeli one with Shimon, Australian ones and listening to the melodious Malayalam songs in Cochin during one Pesach.
Never have I forgotten the significance of this ritual and always marked my calendar.

(a young girl dressed in Kayin traditional dress at Thaton, Myanmar)

One such morning in Baracoa, on the first day of Pesach, I was wondering where to get red wine and other things to celebrate the Pesach and I ended up with a lifelong friendship with Dr. Jesus Menendez, the cigar chomping revolutionary, who arranged all the necessary ingredients and I surrounded by a group of atheist Cubans, conducted a Seder in Baracoa, chanting the Sephardic melodies.

Another time, in Siem Reap. a good friend organized wine and chicken and rice while they sat around in a circle in wonder listening the stories of Pesach

I have spent this holiday with good friends and family all around the world, Portland with an exiled Iranian family, in La Havana where at the communal seder I met a certain Hallegua reminding him of the Hallegua families of Cochin, Corpus Christi with my dearest friends.. the list goes on and on.

(Bear Butte, sacred to the Indians. I was here yesterday)

Early this year, I noted the date for Pesach for this year and for the first time in my life it seems, I made the error of the dates. I put down Pesach 15 April. Last year I did a Seder for the first time in Bruselas and had to go to the Sephardi store to get the necessary things.

The last two months have been in places with hardly any Jewish presence. Kachin and Kayin, Khmer and Malay, Sundanese and Jawanese.. all the time keeping in mind that I have to be in Bruselas on the first night of the Pesach on the 15th of April, woe is me for not checking the date!

After a most delightful week with the Lakota I arrived at the house of my sister in Miami, who by the way is a devout Catholic but is very respectful of my leanings.
Earlier I had called the American Airlines, during this busiest time of travel in this part of this world, and organized to leave on the 14th April to arrive in time, before the sunset in Bruselas! My sister had already bought the necessary Matzoh for me to take to Bruselas...

Isnt Passover tomorrow night? my sister queried to my horror!
No, I insisted, Pesach starts on Tuesday.
You better check she said, then quoting that irrevocable authority, I heard it on CNN!
Panic!
rushed to check the dates, Google of course puts other articles and useless information before giving you the dates and sure enough my sister was right, this year Pesach starts at the night fall of April 14th!
My brother in Portland confirms..

then it suddenly dawns upon me, unlike any other night, tomorrow night, I would be flying from Miami towards Madrid!
Just this time I am not enchanted about it!

I just want to be with my mishpochah, the Jewish world where I know who I am ..

While the entire world would be celebrating tomorrow and day after tomorrow evenings, I will sing the very same songs the night after that, so that the continuity is not lost, of this millennial tradition of Seder..

My brother would be listening to the Moroccan Melodies while the other one would be at the home of an Iranian Jewish family, I will think of the prayers at homes of friends in Melbourne, Cape Town and Buenos Aires..

Now a practical question, Do the serve Matzoh on American Airlines?

OPTIMIST, PHILOSOPHER, HUMANITARIAN: THE DIABETES CRUSADER OF KUALA TRENGGANU, DR MENON

Most medical students would swear that it is the humanitarian interest that brought them to the study of Medicine. In my years of studying and teaching Medicine in Asia, Australia, Europe and the Americas, I have observed that these good intentions disappear by the time they become doctors, overcome by the distress of the society and their position in it, except a few diehards who cling on their dreams.
I once met a classmate of mine from Guyaquil, Ecuador who now enjoys capitalist accoutrements of his predatory medicine while complaining about everything including his patients, he asked me"
What happened to our dreams?
Excuse, I said to him, I still live my dreams.
So meeting a doctor, who has had a parallel life but still keeping and living that dream is an occasion for celebration in my heart.
I met one such doctor today in Kuala Trengganu in Malaysia. The location is significant in that during my travels around the world it is rare that I meet doctors of this caliber. A couple of years ago, the ageless man of Thursday Island (see my blog under that title) told me about the doctor attending to him, and during my short stay at KT, I couldn't meet him face to face because of his busy schedule.
Talking in an excited voice, Dr M, whose ancestors came to this country from the land of the western ghats, revealed his analytic thoughts about what lies underneath the physiology of Medicine, now hijacked by drug companies, much to the delight of their stockholders.

 

 

This Malaysian doctor had been born with a kind heart and a sharp intellect and nurtured both as a student in the UK as well as a junior doctor in the rural areas of Malaysia. He chose to live in this medically underserved eastern seaboard, but never abandoned his fiery enthusiasm and curiosity of human physiology, in the academic isolation of the early days of being a doctor. A lifelong interest has been the human physiology, his curious mind kept alive by asking not HOW but WHY (anthropologists ask WHY, medical doctors ask HOW). He refused to accept the drug company gospel about how drugs worked and this Bumiputra, son of the soil (even though the soil may not be only Malaysia) has through observation, incorporated his experience into his medical practice, ignoring the collected but influenced wisdom of paid peons of the drug industry and their Administrative and Medical Association colleagues.

This over a lunch of local dish of Fried Rice  at a restaurant facing the calm ocean. We talked about our own interpretations of how human body works in Illness, Health and Disease and how we can alleviate the suffering of the patient.
His main concern was the welfare of his patients, no greed, no commercial interest, I never heard him say any single bad thing about his patients, but only his strong desire to make their lives better.
I have noticed that erudite, curious, intellectually oriented doctors are attracted to Neurology, Endocrinology and Renal Physiology (not nephrology, dialyzing for dollars) and Dr. M was no exception. We reminisced about our student days in London, with afternoon lectures at Queen Square with impeccably dressed Prof Sir Roger Bannister and Prof Zilkha, giving orations on history and physiology of neurological illnesses.

The conversation led us to discuss another mutual passion and dream-DIABETES, prevention, treatment and attenuation of suffering.
I had always wanted to be of service to the rural Malays of Malaysia, the neglected in more than one ways of this emerging nation of divided racial and religious loyalties. Malays are gentle souls, they are being burdened disproportionately with Pre-Diabetes and Diabetes. Dr.M has already a plan in mind, to devote his talents to the holistic service of this population, to prevent and treat and alleviate the suffering in the field of Diabetes. He paraphrased the ancient dictum, if you know Diabetes, you know Clinical Medicine. Having been involved in such work among American Indians, I was happy when he invited me to join the ranks to educate and treat Diabetes in his region and for patients under his care.
Two hours went by swiftly. His phone was ringing constantly and he was wanted back in the hospital. We parted with the promise that we shall see each other soon.
I felt a tremendous satisfaction of meeting a good human being in this country, Malaysia, a country that I am fond of.
I know I will be returning to KT soon enough.

IRAN IN MALACCA. JADE in Malaysia tinged with Nostalgia

Almost two years to this day. I had arrived at KLIA after a memorable journey, which made this arrival even more memorable.
Omaha-Denver-Los Angeles-Honolulu-Guam-Hong Kong with a long layover-Kuala Lumpur, indeed a circuitous route to reach the Far East. I had been working with the Winnebago Indians and on that chilly early morning, I met HP from Bogor who was to become a very close friend. My mind was already at KLIA, where just a few hours earlier an Iranian air flight would have deposited the teacher of my re-entry into the Iranian culture.
It was a memorable trip. Included was a visit to Malacca, Hotel Puri and my good friends IH/AG. They treated us to a nice nyonya meal, the breeze at the Malacca Club. IH is an aficionado of Chinese culture and history and was surprised to learn that Iran also produced Jade.

Few months later IH received a package from Iran, sent through an Iranian resident of KL. Fortunately IH's daughter lived nearby and she was able to take delivery of the lovely jades from Iran. Since then she had made a pendant and a ring jewelry featuring those jades. When IH/AG came to pick me up at the Hotel Puri, she gave me the little gift which had been sent along with jade and books on Iran to her. It was in a small lacquer box with Iranian motives on them, on opening a nice clear Jade shone out.
I felt grateful for the ingenuity of the oppressed people of Iran and their hearts as big as a bakery in the sky, but also felt immensely sad. After I lost contact with our friend in Iran, I also lost touch with the quotidian culture of Iran, the great literature and movies from that ancient country.
Thank you, NM
So it was only fitting that on my CX flight over to Asia, the movie I chose to watch was by Ashgar Farhadi, symbolically set in a suburb of Paris, about an Iranian man and  a French woman separating their lives.
And the title was, once again appropriately,
THE PAST   PASSE
Yes, Iran is in the past. It appeared when my father lived there, it lay submerged while I wandered around the world, it made an appearance in 2012 and now in Malacca, in 2014.
I looked at the laquerbox with its shiny green content I realized that once again Iran had disappeared into the oblivion..
CHASM, while it lasted..

a vegie meal in Malacca with IH/AG

While I was writing this I made a mental note that whilst being in Asia less than one week, I had already been in Kuala Lumpur and Malacca in Malaysia, Rangoon and Thaton in Burma, Siem Reap in Cambodia and my next destination was Kuala Trengganu!