WELCOME HOME AT THE UMONHON NATION: SHABBAT SHALOM FROM THE INDIAN COUNTRY

I am proud to be a Consultant Endocrinologist to the UmonHon Nation in the USA.
Dutifully I appear at the appointed dates, as previously arranged with the Health Programme that I work with.
I arrived at the country of UmonHon Indians after a long and circuitous trip from Cochin in Kerala.
We have created an unusual set up. I work closely with a Nurse Educator, an out reach worker and a Peer Educator (modelled after the Peer Educators at MoPoTsyo.org in Cambodia). They select patients for me to see but all the screening and pre-counselling is done by them, and the room where we sit together and chat (seeing a patient will not be the correct way to describe our encounters) is large and roomy and the persons have large, comfortable chairs to sit on.

It is like visiting someone at their home. There is nothing to suggest that it is a Clinic since there are no Pharmacy or Laboratory or people walking around interrupting our chatter.
We have also plenty of time, so that no one is in a hurry. We have a CEO who is innovative and forward thinking that we have been provided with this luxury, us the providers of health care and the patients.
As I entered the premises, the office workers came out to greet me and warmly embraced me. It is true that I have been absent longer than my usual four weeks, and the welcome embraces were stronger. 
The peer educator informed me that she has brought the coffee and tea capsules for the Coffee machine as well as Perrier water, as they know I prefer sparkling water to still water. Our morning together was a very social one, with patients coming in at their hourly appointments. 
Just before lunch the person in charge of IT division dropped in and I repeated my request to him. I truly would like a MacBook Pro, as the computer I am using now belongs to the Nurse Educator and I have long overstayed the welcome of the loan! He said there is a MacBook Pro that can be assigned to me, and we drove to the Tribal Headquarters where he presented me with a 13 inch MacBook Pro, so that I can return the laptop on loan to the Nurse Educator.
The patient who came in the afternoon was one of the first people I had seen with Acanthosis Nigricans Grade 4 which denotes severe insulin resistance. While we were all engaged in social banter, I was amazed and  very grateful to be associated with a group of people such as the UmonHon Indians!
It was a Friday evening and I decided to drive to the next village where there is a Dollar General Store  to buy some candles. On my way back to this village, I was stopped by the BIA police car. I pulled over and the police officer came over and I recognized him as one of my patients.
I joked: If you want to see me, you have to make an appointment at the Clinic
He smiled and told me that the reason he pulled me over was the fact that I had crossed the white line on the right hand side of the road. He advised that I drive between the yellow line in the middle and the white line on the right..
Did you know that?
I have never known it nor have I taken note of that.

I came to the Blue House in the Reservation where I stay, lit the Shabbat Candles and said my thanks with a nice glass of Vouvray!
Shabbat Shalom.

AN APOLOGY OF LOVE TO IRAN

Iran entered my life early as my biological father was working there ,before he left for Brunei. I could have a wonderful conversation about Iran if we were to meet now!
Iran! Persia!the only thing I remember as a child was being told that there are 32 ways to describe a SMILE in the Persian language.
I was to fall in love with Iran once again! Hafez entered my life as did Shanameh and Makhmalbouf as did others.
I am grateful for this love that I felt; that fire was extinguished in KL two years ago but the embers burn on, at times burning a hole in my heart and at other times shining a light on the darkened moments that I lived through in Europe
I am grateful for Iran.
Forgive me for not returning your lvoe with all the fire it deserved.
You have disappeared  and I cant even look for you, in the depth of the veil of darkness imposed upon you by others, not only on you but also on your country, they have no moral authority and they have only violence and vengeance in their hearts.
you gave me Shamloo
 A thousand laughing suns are in your eyes. A thousand crying stars in mine.

Ahmad Shamloo

You gave me Soheil Nafisi

https://www.youtube.com/watch?v=6ZKKx6Y-6SY&index=9&list=RDMcoXvxcAr4E

(Soheil Nafisi singing a poem by Shamloo quoted below)

and I learned the wisdom of Hafez from you..

I have learned so much from God that I can no longer call myself a Christian, a Hindu, a Muslim, a Buddhist, a Jew. The Truth has shared so much of Itself with me that I can no longer call myself a man, a woman, an angel, or even a pure Soul. Love has befriended me so completely it has turned to ash and freed me of every concept and image my mind has ever known.

Hafez

and many of the voices of your ancient land where once my biological father lived..

On 24th of this month of October, someone celebrates a birthday and that candle is a testament of our love 

LOGIN 

ای کاش آب بودم

گر میشد آن باشی که خود میخواهی.

آدمی بودن

حسرتا!

مشکلیست در مرزِ ناممکن. نمیبینی؟

ای کاش آب بودم ــ به خود میگویم ــ

نهالی نازک به درختی گَشن رساندن را

(ــ تا به زخمِ تبر بر خاکاش افکنند

در آتش سوختن را؟)

یا نشای سستِ کاجی را سرسبزی جاودانه بخشیدن

(ــ از آن پیشتر که صلیبیش آلوده کنند

به لخته لخته ی خونی بیحاصل؟)

یا به سیراب کردنِ لبتشنه ای

رضایتِ خاطری احساس کردن

(ــ حتا اگرش به زانو نشانده اند

در میدانی جوشان از آفتاب و عربده

تا به شمشیری گردنش بزنند؟

حیرتت را بر نمیانگیزد

قابیلِ برادرِ خود شدن

یا جلادِ دیگراندیشان؟

یا درختی بالیده نابالیده را

حتا

هیمه ای انگاشتن بیجان؟)

میدانم میدانم میدانم

با اینهمه کاش ایکاش آب میبودم

گر توانستمی آن باشم که دلخواهِ من است.

آه

کاش هنوز

به بیخبری

قطره ای بودم پاک

از نَمباری

به کوهپایه ای

نه در این اقیانوسِ کشاکشِ بیداد

سرگشته موجِ بیمایه ای.

۳۰ شهریورِ ۱۳۶۸

Amorously - Soheil Nafisi

آن که می گوید دوستت می دارم
The one that says I love you ...
خنیاگر غمگینی ست
is a sad musician
خنیاگر غمگینی ست
is a sad musician
که آوازش را از دست داده است
That Can no longer sing 
ای کاش عشق را زبان سخن بود
I wish love could speak
هزار کاکلی شاد در چشمان توست
There is a thousand of houdan in your eyes
هزار قناری خاموش در گلوی من
There is a thousand of silent canary in my throat
عشق را ای کاش زبان سخن بود
I wish love could speak
آن که می گوید دوستت دارم
The one that says I love you ...
دلِ اندوهگین شبی ست
is an upset heart of night
دلِ اندوهگین شبی ست
is an upset heart of night
که مهتابش را می جوید
That is searching of his moon
ای کاش عشق را زبان سخن بود
I wish love could speak
هزار آفتاب خندان در خَرامِ توست
There is a thousand of smiling suns in your strut
هزار ستاره ی گریان در تمنای من
There is a thousand of crying stars in my request
عشق را ای کاش زبان سخن بود
I wish love could speak

THANK YOU FOR CHOOSING QATAR AIRWAYS.. IT IS BECAUSE OF FRIENDS LIKE AKSAM ABUTAHIR

long before the new Hamad International Airport at Doha, Qatar opened, I was on my first flight aboard Qatar Airways QR. I remember it very clearly. I was flying from Houston to Doha to Jakarta. I enjoyed that cozy lounge, visiting the various restaurants and cafe. Where are the Bangladeshis who guarded fiercely their fiefdom of the showers and bathrooms in that cozy lounge?
I sat down for a bite, my fellow passenger from IAH,a Parsi from Houston and a native of Bombay, would soon depart for her destination. I was attended by none other than Aksam AbuTahir from Sri Lanka. As QR entered my life, so did Aksam. Invariably, as if it had been planned, I would regularly run into Aksam at the new luxurious Al Mourjan Business Class Lounge at Doha, considered the best Business Class Lounge in the world. Always polite, always attentive, always thinking of your comfort, ready even before you had a chance to ask, Aksam was always there, I began to feel as if he was a member of my family.
I missed him two weeks ago when I transited through Doha on my way to Casablanca. I dropped him a note to say I would be transiting this day on my way from Colombo to Boston. I wanted to have a shower and when I came out , very refreshed, attended by Bangladeshis polite to a fault, Askam was waiting for me. We walked to the cafeteria and he personally took my orders for a snack and coffee. He also introduced me to two of his Sinhalese colleagues, both of whom I recognized from my previous visits, Chamila and Jayantha.
He then disappears and as I was finishing my offee, he comes in with Jayantha and Chamila, along with Anuka, from Nepal, who was carrying a nicely crafted dessert cake with the words:
Thanks for choosing Qatar Airways

Aksam, Chamila, Anuka and Jayantha from Al Mourjan Business Class Lounge of Qatar Aiways at Hamad International Airport in Doha, Qatar.

That was a nice touch, like a token of respect from a younger brother to me. I enjoyed it very much.
We walked out of the lounge together and he had arranged a transport for me to take to C12 from where the flight to Boston was to depart. A Tunisian drove me there, through this busy airport, with fashionable label shops on both sides, otherwise it would have been a long walk from Al Mourjan Business Class Lounge.
Quickly through the security and I was one of the first to board, where Mohammed from Beirut, Lebanon, the purser showed me to my seat, 4 A
Very seldom have I met professionals who are so well suited to their chosen career as Aksam. I wish him well at Qatar Airways and in all his future endeavours.

ඉස්තුති (istuti) බොහොම ස්තුතියි (bohoma stutiyi)

after a long journey I reached the tribal village of Omaha in a very isolated part of the USA.. 
I sent off a letter of thanks to the QR Customer Care Services. 
Very quickly I received a reply:

Dear Dr. Shaheb,

We are very pleased to receive your comments about the excellent service you received from our ground staff allocated at the Al Mourjan lounge in Hamad International Airport.

Our staff will be most delighted to hear about this when we convey to them your message.  Your satisfaction is certainly worth all our best efforts.

Thank you for taking the time to write to us and we look forward to welcoming you again on our flights in the near future.

Yours sincerely,

Michael Cheng

Customer Care Officer

Aksam had offered to organize a trip to his native island, Sri Lanka and this time he had reiterated that he is willing to help me with an itinerary

ආයුඛෝවන්
Any one wish to explore Sri Lanka with me?

YOM KIPUR IN COCHIN 5777 BREAKING THE FAST IN AN UNIQUE FASHION

 It was the most unusual Yom Kipur, not planned at all that way. The night before I had begun the observance in the company of a delightful Syrian Christian Orthodox family who had cooked up a storm. I had mentioned to my friend Mr M that I would like to break the fast in his company. He has been to Israel and considers many Jews among his friends in USA, South Africa and Israel; and prides on the fact that he might have jewish ancestry. He is, like most orthodox syrian christians, very pious and religious, with strict observance of the ritual calendar.

 To get some of the fundamental things to break your fast, such as a glass of wine, is not that easily accomplished in the state of Kerala with its strict Liquor laws. Some south african dry red wine appeared mysteriously on the table, as did two candles and a cheese cake to support it.

 I said the bracha and explained the significance of those prayers and also explained the difference between the religious jews about 15 per cent and the rest who could be classified as cultural or talmudic jews. An arbitrary division but which has great psychological impact in the west.

 American Jews would appreciate the irony of the food that came one plate after another.. it was the indian version of CHINESE food...

 My friends from Miami did point out that I had managed to break several of the food rules of Yom Kipur...Calamari and Shrimp are not food for this feast , but as the company was congenial and tolerant, every thing smoothly played out. 

 I felt that I had spent an extraordinary Yom Kipur, in Cochin, with extremely good food to begin my fast, and an ironic twist to the Indian food to break the fast. I did fast for the full prescribed hours, I did not eat or drink anything.

I would like to have listened to Kol Nidrei, the opening prayer for this night. But as I left to go back to Fort Cochin, I had an immense satisfaction of having done my mitzvah not only from a jewish point of view but a wholistic human view point as well.

I have learned a very good lesson on this Yom Kippur spending it with gentle, tolerant, sincere Syrian Orthodox Christians of Kerala.

FORT COCHIN 5777 EREV YOM KIPUR.. AN ENJOYABLE EVENING WITH A SYRIAN ST THOMAS CHRISTIAN FAMILY

YOM KIPUR 5777 IN COCHIN, KERALA 

I am impressed with the Christian Community in Cochin, their fierce devotion to their faith but done in good faith and vigour. Chicken and meat prices in Cochin goes down during Lent, my good friend Rockey Neroth told me later, because 80 per cent of the Christians observe Lent.
it was the Day of Atonement coming up and I find my self in Fort Cochin, where there is a beautiful synagogue but alas not enough Jews to make a minyan.
Last year at this time I was in Leticia, at the Colombian Amazon and it was a memorable visit. 5776

5775 was spent with good friends M and G in Miami, with a nice meal before going to the Temple Israel. 

Today at lunch time, George Mampilli, a descendant of Cochin Jews but a devout Catholic regaled me with tales of JOB, the prophet whose tomb I had the chance to say the Kaddish a couple of months back near Salalah in Oman. 
This devotion to the old testament and a fierce loyalty to Israel that distinguishes this community of christians has made themselves very endearing. 
The only Jew in town was going to spend the entire Yom Kippur praying, so I had to invent a way to celebrate Yom Kippur 5777.
RN is a good friend of mine, and if you see him in Israel you would mistake him for a local. He and his wife are devout syrian catholic christians, dating their conversion to the arrival of St Thomas in 57 of the Common Era. I had always wondered why this fierce loyalty among Syrian Catholic Christians to Israel and Jewish people? 
Imagine St Thomas arriving at the coast of Kerala, right near where Cochin stands now (before 1341 there was no COCHIN), the local people wonder who is this stranger who is preaching something so bizarre, the local king was Hindu who worship about 800 odd gods and for them the idea of a single god who was benevolent would have been alien. But there was a community in Muziris and the surroundings at that time who were already monotheistic and for them the preachings of St Thomas would have been attractive and understandable. At that time, Christianity did not exist as a separate religion but perhaps thought of as a liberalization of the orthodoxy of the religious practices in Israel of the time.
The community that could have been receptive would have been the Jewish Community of Malabar coast. They may have been the earliest converts to the new liberalized version of Jewish religion, in fact St Thomas was said to have to preach to the Jews. In my opinion there is a good possibility that the Syrian Orthodox Christians have jewish origins which may explain their millenium long loyalty and respect of the Jewish people.
I decided to accept RN's invitation to his house for a special dinner. 
The evening was as perfect as it could get. His family were in full presence, two sons and a daughter and their children, giving the house a joyous presence. The friendship between me and RN, which started many years ago when I left a 5 peso cuban note at the desk of his fledgling bookstore, the strength of which was evident during our conversations and consultations. I truly admire their values.
The dinner was delicious to say the least. I told them that I prefer seafood and dinner began with Kerala Fish specialty of Carimeen (pearl spot) a fish found in the backwaters of Kerala is a fresh water fish with soft meat which one picks with two fingers cooked in coconut curry. There was sardines from the Arabian sea; prawns in curry sauce with coconut bits, and it ended up with ice cream which truly had a creamy taste, of course devoid of the chemicals added to Ben and Jerry.
The dinner had started late allowing for the proper preparation of the fish and the two sons and their father and I sat down to enjoy a lovely meal. 
The whole atmosphere was pleasant and for me, as a Jew remembering Yom Kippur, it was the most appropriate thing to do in Cochin.
May the year 5777 be sweet for all of us
It was nice to be reminded by RN's wife that Job was especially blessed prophet and I thought, my life certainly has improved very much, in terms of professional and personal life since that visit to the tomb of Job a couple of months ago..

 this used to be the home of Mr Koder, the most prominent Jew of Fort Cochin, now converted into a hotel and restaurant

 In the absence of candles, two Bacardi bottles served the purpose and I could easily recite my borepri hagefen over that..Cane is also fruit of the earth..

 Karimeen in coconut curry 

S

 Sardines

 Shrimps in coconut bits

A radio Interview with DURIAN ASEAN in KL in 2014 Misconceptions about JEWS JUDAISM and ISRAEL

During the early part of 2014, I had stopped by the synagogue in Yangon to pay my respects to Moshe Samuels the custodian of the once magnificent synagogue of the Burmese Jews of Iraqi origin. There was a small group of Asian visitors and a very inquisitive young woman, Arlene Tan and I became friends. On my next trip to Malaysia, she wanted to interview me, on a delicate subject.
After the independence and formation of Malaysia, Israel which already had good relationships with Burma, Thailand and other countries in the region wanted to have diplomatic ties with Malaysia but the leaders of the new republic of Malays did not want to have diplomatic relationship with 
Israel and also forbade its citizens from travelling to Israel, and to this day do not allow Israeli citizens from visiting Malaysia. The logic of this decision is rather convoluted and has no historic or economic or social reasons but rather an emotional one of casting their vote with their moslem arab colleagues. 
An average Malaysian has absolutely no knowledge about Israel or Jews or Judaism, lest he has travelled to the west or lived in the west and the information is the one fed by the state which borders on Stalinist blood libel!
I know and like Malaysia and Malaysians and when I got this chance to explain ourselves to the listeners I was happy to do so.
I just saw that the talk has been uploaded to youtube, in audio form and those of you, especially from Malaysia, Indonesia and Brunei would benefit from listening to it. Strangely enough India is very pro-Israeli and in  Cochin and Kerala the places that I know reasonably well, average citizens do know a lot about Jews and Israel.
Currently the only Jews in Malaysia are the expatriates living there. there is a jewish cemetery in Penang. The best known Malaysian or Malayan Jew was David Marshall, the first Prime Minister of Singapore. Singapore maintains good relations with Israel and has a jewish community which consists of Iraqi merchants of another century and expatriate jews. Jews are welcome to attend services at the synagogue there.

so here is the link to the youtube audio of the Interview.
https://www.youtube.com/watch?v=HeihwzqodQM

There is historical interest in the Jewish Community of Indonesia
http://www.jodeninnederlandsindie.nl/en/

Indonesia does allow Israeli visitors for tourism but obtaining a visa is not easy. Malaysia requires prior approval from Ministry before Israelis can get a visa. I have never met an Israeli in Malaysia. Israelis can visit 147 countries in the world and 14 moslem countries refuse entry to visitors from Israel: Bangaldesh, Pakistan, Malaysia and Brunei are in Asia.

THE TEDIOUS ITINERARY OF A PHYSICIAN ANTHROPOLOGIST TO THE INDIANS

The tedious itinerary of a Physician Anthropologist

Most of you will have absolutely no interest in this itinerary, I am putting this down on paper because I am so confused, when trying to juggle between USA holidays, flights over to Europe, my brother’s request to go to SE Asia and in between doing some work. But then again, work and life has been the same, I do not know where life ends and work begins, and as some philosophers might say, I have never found work to be stressful and travel is a form of transporting between these non-stressful events.

Three months in this year left, which would see me travelling to India twice, both times to Fort Cochin, the only place I know in India; once to Malaysia (even though I have been there four times already this year) and my second visit of the year to Cambodia. There would be two visits, both of them two weeks long to the American Indians, twice to La Habana and one visit each to Brussels and Brittany.

Travel is anthropology to me, the cultural diversity and the slow motion movement of people from various parts of the world onto my path. I especially enjoy flying Qatar Airways with its multitude of nationalities and the wonderful lounge at Doha; I feel like the Cuban Ambassador to Fort Cochin (May our Ambassador in New Delhi forgive me), Both KL and Siem Reap are welcome destinations. Brussels is to relax, just catching up on reading Medical and Anthropological literature, just today found a book, written by a Finnish Anthropologist:  KINSHIP, LOVE AND LIFE CYCLE IN CONTEMPORARY HAVANA, CUBA, which will make a good reading on the long flight from Colombo to Boston via Doha. Visiting Cambodia is a lesson in Medical Anthropology even though the Angor archeological site is a distraction (having visited it at least five times) and look forward to a simple way of living. KL has a special place in my heart, have made good friends there and always grateful that I was introduced to the Yogic Philosophy of Patanjali in KL. Habana is the moveable feast and this year I would like to welcome the New Year walking along the Malecon as the clock chimes midnight. American Indians, especially the tribes that I visit have become like a family to me. While they live in an isolated part of the USA, and getting there takes effort and time, once I am there, I am completely immersed in their culture and enjoy the warmth of family life. So this is a short summary of my world for the next three months.

I can spend hours planning my trips as it involves various favourite airlines and the incredible length I would go to fly them. A normal flight from Miami to Brussels which I did less than one week ago, would involve flying to Boston on American Airlines, then on Qatar Airways to Doha, back track with them to Casablanca and take an Iberia flight to Madrid, then on to Brussels. Only a Frequent Flier junkie would understand the logic behind it, if you are one I don’t have to explain it to you.

This was an unusually fecund year for Frequent Flying Benefits, as I held Gold status on Copa in Panama, United in USA and Etihad in Abu Dhabi and Executive Platinum status with American in USA and Diamond Status with Avianca in Bogota. Next year, I plan to reduce it to just three: EXECPLAT with American Airlines, Gold with Qatar and Gold with Copa Airlines. Patterns of flying might change as well: Brussels/Brittany/London would remain, as would Miami, Havana and the Indians. I have a feeling that I might travel more to my Australasian stomping grounds, beginning with a trip to Melbourne and Auckland and perhaps Cairns, and Suva in Fiji. In South America I would be happy to go to Buenos Aires in Argentina as well as Leticia in Colombian Amazon.

So here is an uninteresting or boring for most, itinerary of an enterprising Physician Anthropologist

I have just arrived from Habana, Cuba via Miami, flying Havana to Panama City to Miami to Boston to Doha to Casablanca to Madrid to Brussels.

8             October               Brussels to Istanbul to Male on Turkish, then on Spice Jet to Cochin

14          October               Cochin to Colombo

15          October               Colombo to Doha to Boston to Chicago to Omaha

16          October               To the American Indians

28          October               Omaha to Chicago to Boston to Doha to Colombo to Singapore, arriving on 30

30                                     Johor Bahru, Malaysia

31                                     Malacca, Malaysia

1             November         KL

4             November         Siem Reap, Cambodia

8                                       KL

9                                       Fort Cochin, Kerala

13          November          Salalah, Oman

15                                     Salalah to Muscat, Oman

16                                     Muscat to London to Brussels

19          November          Brussels to Casablanca

20          November          Casablanca to Doha

21          November          Doha to Boston to Miami

23                                     Miami to Panama to Havana

28          November          Havana to Panama to Miami

29          November          Miami to Chicago to Omaha to the Indians

15          December           Omaha to Charlotte to Miami

18          December           Miami to Boston to Doha to Casablanca to Lisbon arriving 20

21          December           Lisbon to Nantes, France, train to Auray in Brittany

26          December           Auray to Nantes, France to Casablanca, Morocco

27          December           Casablanca to Doha to Boston to Miami arriving 29

30          December           Miami to Havana, Cuba

Home Sweet Home..

EAT TO MAKE YOUR DNA HAPPY: ANOTHER INNOVATION FROM DR GORDON BRUCE WALLACE OF WANTIRNA SOUTH IN MELBOURNE AUSTRALIA

COOK FOR YOUR DNA

My good friend Gordon with his wife recently visited La Habana, my current home. We had known each other since our days as Junior Doctors at Repat Hospital in Melbourne, which we recollect as the golden days of our training for the real life Medicine. Gordon has gone on to become to practice the art of medicine, taking into consideration, the aspirations and abilities of the people to whom he ministers, successfully I may say, watching the outcome of patients.

One thing we both shared from the beginning was our dislike for rules and regulations in the practice of medicine imposed by professors and peons of the industry, with their illogical algorithms and constructed numbers as gate keepers for treatment. Many years later, many of these algorithms, evidence based treatments belly flop and the professors move on to other computer generated models, we plod on, dealing with every day people, in my case, the poor of the United States, the marginalized Native People of that continent.

We had long discussions about health of the society in general, and I was able to share with him some new information from Israel about nutrition and microbiome and level headed dietary advice in the midst of the jungle of experts in all sorts of fields. Australia did take a lead in defining Glycemic Index by defining the increase in blood sugar of a thousand different edibles that one comes across on a daily basis, but they forgot one important aspect: The Patient. In our lifetime, the demography of Australia had changed and as the Israeli research shows, a slice of bread may result in blood sugar excursions which is not consistent from person to person and that without knowing the microbiome of the person, it is hard to give nutritional advice. During his years of practice to a stable population in a Melbourne suburb, Gordon had made many discoveries which in the future may be scientifically proven but certainly intuitive and in tune with the explanatory models of the patients.

He had always been like this. I remember many years ago his attempts to get the management of Qantas, the national airlines of Australia, at that time an International player in aviation, to give passages to doctors on their long haul flights to Europe, but turned down. I had been called many times by the flight attendants to look at people who do not well traveling and should not be traveling in cramped conditions in the economy class but could offer some comfort and alleviate the suffering. I couldn’t help but chuckle when I read that ANA the popular airline of Japan with a wide outreach to other continents has introduced a concept of ANA doctor on board and would allow qualified practitioners to register as ANA doctor on board while traveling, to be called upon in case of need.

Gordon is a man ahead of his time when it comes to health care delivery to his patients, because he is unbound from conventions of Australian medical systems and the egoistic, self-fulfilling, and often unnecessary arrogant attitudes of the doctors at the Consultant levels. I am a GP, he would announce proudly.

While talking about the laboratory abnormalities with no current evident explanations among the American Indians (such as high alkaline phosphatase which is an enzyme in the liver, bone and guts; lower to non-measurable levels of CPK, an enzyme in the muscle), Gordon talked about Melanoma in Australia, a very prevalent cancer among its population, coming in at number 4. But Australians of darker skin colour are spared of this high prevalence and Australians of Asian ancestry tend to have a lower incidence. Darker skin does protect us from the UV radiation, associated with the Melanoma formation. Discussing these matters, accompanied by the excellent Mojito at the roof top bar facing the ocean in La Habana, I told him of a study done in Cuba where genetic mapping was able to point out the racial admixture from the past, to such a degree that most people who looked white had some black or Amerindian ancestry and most people who looked black had a fair bit of European genetic presence.

Right now, we treat patients as if they are a number and that studies done on people who are different from them in looks, socioeconomic status and race, are doled out as if we expect to get good results from it. The failure of modern medicine in USA or Europe or Australia to control chronic diseases to any great degree or prevent diseases and its complications over the years show that one medicine does not fit all and that we need to individualize our treatment, taking into consideration the explanatory model of the patient, the socioeconomic status and the current and future expectations of the patient and in fact a patient oriented rather than a disease oriented medical care.

We could reel off diseases which affected people of pure European or mixed European ancestry much more than Africans or Asians, such as Type 1 Diabetes, many of the autoimmune disorders and the higher than normal prevalence of metabolic diseases and mortality from Diabetes and Cardiovascular diseases from immigrants from South Asian region or origin. Malaysians or Cambodians don’t too well in Australia the statistics say, of course it does matter whether you are a Chinese Cambodian or a Khmer Cambodian!

On top of it all is the widely accepted, and slowly recognized metabolic explanation that Diabetes and Cardiovascular and cerebrovascular and degenerative diseases are inflammatory in nature and that the microbiomes may have a causative role in them.

So we could easily put out a pamphlet and jovially dedicate to our fun times at Repat Hospital... The Repat doctors medicine for your DNA... We laughed out loud to the amazement of the usually ebullient Cubans present at the roof top bar as the sun was setting over the US embassy into the sea...  

If you wish we can give you a couple of articles to show you how relevant was our laughter laden conversations were in La Habana, the moveable feast of a city. (The first article was published after our conversation in La Habana took place)

Here is one about Asian Americans, first of all, they are a heterogeneous group. For example, migrants to Australia from South India are racially different from those from the North. In South East Asia, the Chinese are the healthiest (perhaps also the wealthiest, which may have something to do with it). People who have undergone trauma, such as the Khmer under Khmer Rouge have epigenetic changes that give rise to illnesses.

The Burden of Cancer in Asian Americans: A Report of National Mortality Trends by Asian Ethnicity

Caroline A. Thompson, Scarlett Lin Gomez, Katherine G. Hastings, Kristopher Kapphahn, Peter Yu, Salma Shariff-Marco, Ami S. Bhatt, Heather A. Wakelee, Manali I. Patel, Mark R. Cullen and Latha P. Palaniappan

DOI: 10.1158/1055-9965.EPI-16-0167 Published October 2016

Abstract

Background: Asian Americans (AA) are the fastest growing U.S. population, and when properly distinguished by their ethnic origins, exhibit substantial heterogeneity in socioeconomic status, health behaviors, and health outcomes. Cancer is the second leading cause of death in the United States, yet trends and current patterns in the mortality burden of cancer among AA ethnic groups have not been documented.

Methods: We report age-adjusted rates, standardized mortality ratios, and modeled trends in cancer-related mortality in the following AA ethnicities: Asian Indians, Chinese, Filipinos, Japanese, Koreans, and Vietnamese, from 2003 to 2011, with non-Hispanic whites (NHW) as the reference population.

Results: For most cancer sites, AAs had lower cancer mortality than NHWs; however, mortality patterns were heterogeneous across AA ethnicities. Stomach and liver cancer mortality was very high, particularly among Chinese, Koreans, and Vietnamese, for whom these two cancer types combined accounted for 15% to 25% of cancer deaths, but less than 5% of cancer deaths in NHWs. In AA women, lung cancer was a leading cause of death, but (unlike males and NHW females) rates did not decline over the study period.

Conclusions: Ethnicity-specific analyses are critical to understanding the national burden of cancer among the heterogeneous AA population.

Impact: Our findings highlight the need for disaggregated reporting of cancer statistics in AAs and warrant consideration of tailored screening programs for liver and gastric cancers. Cancer Epidemiol Biomarkers Prev; 25(10); 1371–82. ©2016 AACR.

One could sense that Gordon is a genuinely caring practitioner of our art of medicine. He has all the qualities which has been catalogued for the “hard working doctors” who may have forgotten the human elements while caring for the diseased. (Pun intended)

Published in Cardiology December 2015

FRIDAY, Dec. 11, 2015 (HealthDay News) -- Seven behaviors should be implemented to improve the art of medicine, which can help improve relationships with patients, according to an article published in Family Practice Management.

Thomas R. Egnew, Ed.D. from the University of Washington School of Medicine in Seattle, reviewed the literature and delineated seven behaviors that promote more consistent practice of the interpersonal aspects of medicine.

Egnew describes seven behaviors that include focusing on the patient, ideally taking a moment to prepare before entering the office, and establishing a connection with the patient, preferably before opening the electronic medical record in the first few minutes of the consultation. Other tips include assessing the patient's response to illness and suffering, use of communication to foster healing, use of the power of touch, use of humor and laughter, and showing empathy.

Anyone who knows Gordon will readily admit that he possesses those qualities in good measure!