Doctors indeed

(From our own correspondent.)

I lived several hundred miles away from my mother and stayed in touch with her by occasional mails and phone calls. At that time I was a certified Advanced Cardiac Life Support instructor and certified as an EMT II.

During these years my mother would keep me informed in regards to her health. At one time she extolled the new health care she had signed into, HMO. In every subsequent communication she would bring me up to date on her getting regular health check ups and the occasional glimpses she would get of her wonderful doctor.

During a four year period following her getting on HMO she had bouts of incoherence. As my brother described, ‘She is getting fuzzy’ which was attributed to her turning 80. At times she became almost incoherent and on one occasion while I was speaking to her on the phone she sounded like she wasn’t all there.

By chance I visited my mother and together we went to a hospital to visit a friend of hers. As we were getting out of the car I noticed a general frailty about her and upon looking more carefully I noted she was slightly cyanotic. Instead of going up into the main hospital I steered her to the emergency room.

I identified myself as a paramedic to the ER staff and that the woman with me appeared to be having a heart problem. I asked that she be put on the 12 lead but the ER staff opted for a 3 lead to initially check things out.

As I stared at the trace on the scope a doctor appeared at my side. We both instantly locked on the P wave being weak or missing and consequently the QRS complex not firing correctly about three quarters of the time. Our mutual diagnosis took all of a few seconds. The doc immediately turned to a nurse to order the 12 lead. He then told me he wanted her to be checked into the hospital over night.

My mother protested as she always did, citing that her doctor had told her ‘Your veins are like garden hoses’. I switched from son to professional mode, informing her that regardless of what she had been told she had a serious condition and we were going to find out what was going on.

The 12 lead instantly confirmed the initial suspicions. The P wave was missing or mostly ineffective and she was getting about 1 out of 4 functional QRS complexes to do the job. As I looked at the read out her regular doctor and a cardiologist came into the room. I confronted the doctor, placing myself between him and my mother to be sure I got his attention.

I held up the print out. “Excuse me, Dr. …, my mother has apparently needed a demand pacemaker for the past four years and during this time she has been under your care and you have failed to diagnose the condition. The less than 10 minutes per year her insurance pays you has apparently taken precedence over the Hippocratic oath.”

The doctor turned on his heel and left the room. The cardiologist ignore the exchange, looked at the 12 lead print out, and asked both my mother and myself if he could schedule her for surgery the following day to implant a pacemaker. I enforced this to my mother informing her she will have the surgery. The cardiologist checked her into the ICU for the night.

24 hours after the surgery my mother was sitting up in bed. Almost her first words to me were ‘I feel like I had been asleep the past four years and just woke up.”

Well, she had. Her brain was receiving just barely enough oxygen to keep from being damaged. However, her condition was classic and any EMT I could have spotted it. The combination of overworked uncaring nurses with too many things to do and an even more uncaring doctor who ran patients through like they were on an assembly line left an obvious life threatening condition that was easily reversible go undiagnosed year after year.

Now, to be fair to the nurses who had seen my mother during that time, her cardiac condition is easy to overlook. Even if the P wave fails and the QRS doesn’t fully trigger, a pulse of sorts will still be felt. If the patient is borderline as my mother was, a quick BP check might only reveal low but acceptable blood pressure. It is entirely up to the doctor to do an assessment of the patient, taking a few moments of time to listen to complaints as well as doing a little detective work and possible preventive intervention. This is not as complex as it sounds. His patient is over 80 and occasionally feels dizzy and light headed. A quick ECG during each regularly scheduled visit is certainly in order, even if overlooking the complaint might be acceptable.

It is easy to blame the HMO, or any other medical insurer for the oversight and lapse, but the doctors are not blameless. They could forego a few thousand dollars a year, still afford the payments on the mansion and fourth car, and still afford the world cruise, though not as often. It is time the entire medical profession does what the lowly first responder, EMT, fire fighter, police officer, and a host of other jobs are required to constantly execute. Self assessment is definitely in order here. Who are they really working for?

Influenza - a politician's honeypot?

The Thai government has, in their kindness, decided to give cloth face masks to every school student in the country. This is supposed to be a preventative measure against the 2009 Influenza pandemic. Unfortunately it appears to be a chance for the politicians to earn a little, (or a lot) of extra gravy because the Thai government has not seen fit to provide the training or resources necessary to make best use of the masks and the masks are not fit for purpose in any case.

Let us look at a little bit of information about the 2009 Influenza pandemic, frequently referred to as Swine Flu or H1N1.

The pandemic is believed to have originated in a giant pig feed lot at La Gloria village, Vera Cruz, Mexico. The lot is owned and operated by Granjas Carroll, a subsidiary of the giant US pork producing corporation Smithfield Foods Inc. (Smithfield moved much of their pork production to Mexico to evade considerably more stringent health and safety regulations in the USA.)

The La Gloria pig lot produces almost 1 million pigs per year. These pigs produce so much faecal effluent that it can not be properly treated on site. It has to be kept in giant lagoons that frequently overflow, polluting local water supplies. The amount of effluent is so great that the company has at times resorted to atomising the faeces and pumping them into the atmosphere, frequently spreading respiratory and other infections to local communities. Our new pandemic is believed to have started as a direct result of just such an episode following a spate of pig deaths at the lot.

The first known, index case of the pandemic was a four year old boy named Edgar Hernandez from La Gloria village. Edgar recovered, but since then almost 100% of the population of La Gloria have caught the disease.

The virus is particularly virulent, easy to catch, and is spread by inhalation or contact with mucous membranes. Most sufferers have fairly mild symptoms, a fever, sore throat, a cough and sniffles. However some, with previously compromised immune or health systems, will unfortunately die. The mortality rate for people who are confirmed sufferers from H1N1 varies from country to country. Some countries report mortality rates as high as almost 4% while the world average is a little under 0.5%. The higher mortality rates are presumed to be due to most mild attacks of the flu going unreported, this is true everywhere. Overall true mortality is likely to be somewhere between 0.1 and 0.2%. Thailand currently reports mortality of almost 2%.

The H1N1 influenza virus is a particle approximately 0.12 microns diameter, and it can survive for up to 24 hours outside a host body, either in the air or on a surface, as long as it is in a moist or humid environment. When it is expelled from the host, by a cough or a sneeze, the virus is generally carried in a drop of sputum that can range in diameter from 0.3 to 20 microns or more. The size of the sputum drop is important because it affects the manner in which the spread of the influenza can be controlled.

Influenza protection

To best ensure safety from influenza in a school, or other community, the following precautions should be taken:

• General measures.
  Proper hand washing is the most important factor in preventing transmission of disease. Hands can be washed with water and antimicrobial hand soap. If hands are not visibly dirty, an alcohol based hand cleaning solution or hand wipes can be utilized. Hands should be washed at least once per hour, before and after performing cleaning tasks and every time a person coughs or sneezes.
  Avoid touching eyes, nose, mouth or genitals. Wash hands if you do so.
  A constant supply of tissues is essential. If anybody coughs, sneezes or needs to clear their throat or nose it should be done into a tissue and the used tissue immediately discarded into a receptacle reserved for the purpose. Hands should be washed immediately afterwards.

• Face Masks.
  Face masks are of very little use as general protection against the influenza virus and may well increase the danger of passing it. All masks have a very limited effective usage period, ranging from about 30 minutes or so for the standard cloth mask up to a few hours for an N95 certified mask with activated carbon filter. (N95 are so called because they are certified to catch approximately 95% of particles of 0.3 microns.) For best safety, all masks should be N95 certified. Unfortunately most cloth masks, unless they are three layer finely woven silk with cotton filling, are little use unless the particles are 50-100 microns or so in size.
  Masks need to be used correctly if they are to have any efficacy. They should only be used if an infection is suspected and should be replaced before their period of efficacy is over.
  A damp mask, or one used past the safety period will become a reservoir of infection to be passed to anybody who touches it. Used masks need to be handled with care, using latex gloves, and disposed of under biohazard safety conditions, or sterilised for re-use with boiling water or a soak in antimicrobial solution containing alcohol or bleach

• Body temperature.
  All pupils or community members need to have their body temperature monitored on a regular basis. This is most easily and safely done in a large community by using standard infra red technology however any workable method should be used.
  If somebody shows an abnormal rise in body temperature, he/she should immediately be quarantined in a room set aside for the purpose and be taken to visit a doctor as soon as circumstances permit.
  When in quarantine, the pupil should wear an N95 certified face mask to catch sputum droplets. Any person entering the room or coming within 1 meter of the patient should also wear an N95 certified face mask, latex surgical gloves, eye protection and a disposable plastic coat.

• Premises.
  All surfaces likely to be touched by community members need to be sterilised on a regular basis by spraying and wiping with an antimicrobial solution containing alcohol or bleach. These include counter tops, door knobs, stair banisters, tables, chairs, desks, elevator buttons and panels etc. Computer keyboards and other sensitive equipment should be fitted with plastic covers that can be sprayed and wiped.

• Air conditioning.
  Rooms with air conditioning should be fitted with N95 certified sheet filters and have the temperature set low. Virus particles will be caught by the filter, and if they pass through, will be taken out of the air by the dehumidifying process of the air conditioner and will be pumped safely outside and away with the drops of water and sputum removed during the cooling and dehumidifying process. A cool room temperature will also help in early identification of those with a rising fever.

The Thai government must be fully aware of all these measures as promoted by the WHO, the CDC and health authorities throughout the developed world. Why have they thrown them out of the window and reccommended almost the exact opposite behavior. Could it be that a member of said government has a fiscal interest in the face masks that are being distributed. Thailand's history of "transparency" would seem to indicate the probability that this is the case. We await the scandal likely to erupt in a few months time.

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Note: Several companies manufacture N95 certificated filter masks and rolls of filter material. 3M is possibly the most widely distributed, but Japanese and European companies are competing in the market. A good 3M disposable N95 certified mask sells for about US$1.00 and can be sourced directly from 3M or found on sale at many home improvement centres.

Christianity, the origin of Morality?

I was recently told by a friend that he had only become honest and moral because he had discovered Jesus. We had something of a discussion about this subject, so I felt it would make an interesting blog post.

If you wish to explore pre Christian teachers of morals, you can do little better than read Pythagoras a non-religious philosopher mystic who was deeply influenced by the teachings of Buddha. Following Pythagoras came Socrates who taught the meaning of what is just, and insisted that moral sentiment depended on knowledge, not any form of theology. One of his famous teachings: "We ought not to retaliate, or render evil for evil to anyone," is perhaps uncomfortably close to words said to have originated with Jesus, but they come from three hundred years earlier.

Plato was the forst sociologist and taught that moral law is utilitarian, logical law for the good of society. Aristotle, after Plato wrote the first treatise on Ethics. He too had no theocratic hangups.

By the 3rd century BC, the Stoics, taught natural ethics and self control as a basis for life. Their movement continued until just after 500 AD when Emperor Justinian closed their schools because their teachings of logical morality owed nothing to his Christian faith.

Leucippus and his student Democritus were the first European philosophers / scientists / evolutionists in about 400BC who taught that the object and origin of moral law was simply the concern for human welfare.

Epicurus, the last of the great Greek philosophers, again taught that moral acts were those which promoted a passionless tranquillity of life. They had nothing to do with religion.

Now have a look at Christian teachings. The oft quoted "Golden Rule of life", the "Royal Law" the most famous of Christ's teachings, "Thou shalt love thy neighbour as thyself" is a quotation from the Old Testament; Leviticus 19:18: "Thou shalt not avenge, nor bear any grudge against the children of thy people, but thou shalt love thy neighbour as thyself: I am the LORD." This is 500 years older than Christianity and some 100 plus years after the Lord Buddha was teaching about universal love, where he stated that every man "should love his fellows as a mother loves her children," and "hatred ceases by love: this is an old rule." A bit different from the Jewish position, where his neighbour was only regarded as being a fellow Jew. The Jews excluded other races from the necessity to be loved, much as many Christians do today.

If we stay at the time of the Buddha, about two hundred years before the Old Testament was written and have a look a bit further East at the teachings of Confucius "Recompense injury with kindness" and "What you do not like when done to yourself, do not do to others." Confucius's student Menicus went on to teach, "A benevolent man does not lay up anger' nor cherish resentment against his brother, but only regards him with affection and love." About the same time Lao-Tse was teaching, "Recompense injury with kindness." All these great moralists were living in the heart of Agnostic China, where religion did not have any import.

Christianity, did it introduce humanity to morality? I am afraid not.

Perhaps in time we can build an enlightened society where frankness, courage, honorableness, and consideration for others and a social or utilitarian theory of morals rules our lives without hangups from misplaced teachers, clergy, mullahs and busybodies behind net curtains. We need to love our fellow beings and allow acts and thoughts that injure no one in any way. These must be regarded as a man's or woman's own business, not meat for the narrow minded or bigoted bible thumping pulpit screamer.

From Prometheus Unbound:

None wrought his lips in truth-entangling lines
Which smiled the lie his tongue disdained to speak;
None, with firm sneer, trod out in his heart
The sparks of love and hope till there remained
Those bitter ashes, a soul self-consumed.

None talked that common, false, cold, hollow talk
Which makes the heart deny the yes it breathes,
Yet question that unmeant hypocrisy
With such a self-mistrust as has no name.
And women, too, frank, beautiful, and kind
As the free heaven which rains fresh light and dew
On the wide earth, past; gentle, radiant forms,
From custom's evil taint exempt and pure,
Speaking the wisdom once they could not think,
Looking emotions once they feared to feel,
And, changed to all which once they dared not be,
Yet, being now, made earth like heaven; nor pride
Nor jealousy, nor envy, nor ill shame,
The bitterest of those drops of treasured gall,
Spoiled the sweet taste of the nepenthe, love.

Percy Bysshe Shelley (1792 – 1822)

Mishes - Benedikta House

From: http://www.akha.org/content/missions/benediktahouse.html

Benedikta House

Mr. Woon and his boy friend Mr. Thavee

The investigation into the activities of Mr. Woon at Benedikta house happened at the request of the Akha.

Traditional Akha said that Mr. Woon was trying to convert people at Hooh Mah Akha village and had taken down some village signs.

We went to Mr. Woon's Benedikta mission and wanted to pay him a visit, but he wasn't there, so we just got a picture of the old wooden house.

Then we got an email that said Mr. Woon was getting 10 million baht to build a very large "fake orphanage", since most of his kids were not orphans. We were told that Mr. Woon was one strange guy.

At this time an Akha man called us and told us that Mr. Woon had a homosexual lover named Mr. Nok Thavee and that the two of them were raping and selling some of the young boys as young as 8 years. We were also told that he had molested scores of other boys in the shower.

Mr. Woon reportedly bought the new house below in Chaingmai Laguna Homes Complex for Mr. Nok Thavee. Mr. Woon's blue Ford is shown.

Shortly after this time three male victims of Mr. Woon filed claims in the court in Bangkok. An article about Mr. Woon appeared on the front page of the Daily News Thai Language paper in January,2004.

Mr. Woon turned himself in to the CSD police in Bangkok and paid 500,000 baht and was released. We later ;;heard a larger sum was also confiscated. But as to date we have no more information on the criminal procedings in Thailand. We were told by sources that there was a criminal case pending in Sweden against Mr. Woon. (of Malaysian nationality, Mr. Woon also holds a Swedish passport and was sponsored by a Swedish Mission http://www.kungsbacka.pingst.se/mission/index.htm

His link in Thailand is now missing from the site.

Swedish police contacted us but never contacted the children witnesses in six months time. The Swedish embassy never contacted the children either.

We find this very disturbing, that children who went to this much effort to go to Bangkok, find their way through the justice system, and file a case, are ignored by the Swedish government.

Pictures below show the old orphanage, with sign, then where some of the kids were relocated to around the corner. Ms. Eva of Ban Chavit Mai, which also has Akha children and a bakery downtown Chiangrai, helped move some of the kids. Of Swedish citizenship also, we wonder what Ms. Eva knew and when she knew it?

Huts of Akha from Hooh Mah Akha who were converted and moved to a lowlands marsh, the remains of one of the splendid mountain homes. Religious fanaticism imposed on indigenous people can make fools of many.

;;

The video below from Al Jazeera television is interesting.

The sooner the Thai powers that be understand that their policy of protecting religion includes the protection of the rights of minorities to practice their age old beliefs, whether they be Buddhist, Animist or other, the better. It is evil incarnate to permit the coerced conversion that is taking place in Thailand's hills in current times.

Royalty

The protection of the royal institution of Thailand, like many similar regimes, has two rationales. First, reverence for the royal personage or institution and insecurity. Thai's leaped on the protect the King bandwagon, understandably, when various foreign interests were busy dividing up the place for their own gains.

In this most recent issue of charging the entire Foreign Correspondence Club of Thailand, FCCT, with a supposed insult to the Royal institution has several interesting facets. We can ignore the obvious for the moment. Thailand does not care that much what the world opinion of the country is. Generally speaking, their short sightedness is legendary. The relevant persons in foreign countries that operate businesses in Thailand know full well that good graces can be bought and how to buy them. The rest of the world, and the working class of Thailand itself can go leap off a cliff. Thailand is a full standing member of the international 'prostitute your country for profit' club.

One of the more interesting aspects of this FCCT brouhaha is that the police will investigate the offense. Now it is well know the police in general are an entirely rogue organization. They legally collect bribes, and almost always place the interests of their senior officers first and foremost, which of course means the politicians and elite who pull their strings. There never has been a serious effort to clean up the act of the Thai police and probably never will be.

In keeping with the police being manipulatable we have Jakrapob himself who will suffer (or not) various penalties for his actions dependent upon his connections with police and government officials. What penance he may ultimately pay could easily be less that the penalties the FCCT might receive. After all, justice is not only for sale, it will give preferential treatment to Thai nationals first. Unless, of course, we are talking about a serious foreign business interest who's damaged position could adversely affect various persons of an even higher position than say, Jakrapob can manipulate.

Then of course we have Laksana Kornsilpa, the whistle blower, and where exactly her loyalties lie. Therein lies the rub, and the crux of the matter. The laws pertaining to protecting the royal institute are extremely archaic, and at present, pretty ridiculous. His Majesty King Bhumibol has led a life that is far above critical reproach. Criticism of him will only serve, ultimately, to further highlight the incredible service he has done for the country during his long and justly esteemed reign. By all means, if it is felt it is required, lower the boom on the Royal ridiculers when your king acts like Than Shwe and the entire ruling authority is a farcical bananarama. Don't lessen King Bhumibol by enveloping his services to not only Thailand but the world in a small minded shallow mud slinging endeavor that is invariably enacted, at least in part, to simply further a persons social or political goals.

Do I accuse Ms Laksana of less than altruistic intents? By no means! I accuse her of Lese Majeste of course, but that isn't the relevant issue here. Lese Majeste?? My dearest Ms Laksana, His Majesty is, first and foremost, the epitome of Buddhism in this country. Beyond that, he has sternly ruled his own life and all the people he has affected by rigid codes taken directly from the Dharma. No where within those teachings will you find advocacy for recrimination or selective justice. What you, Ms Laksana, are charging, is that neutral individuals disseminated information that could be considered harmful to the Royal Institution. NOT His Majesty. Did they do this allegedly criminal act with intent, be it deliberate or incidental, to harm the Royal Institute? Perhaps, if you completely ignore the Buddhist teachings and only pursue the ancient, pre-civilized code of grabbing a larger club and pummeling anyone who you disagree with. Or, of course, there is the possibility that the Royal Institution presently represents ideals or goals that coincide with your own personal interests. Regardless which, it is seriously doubtful if any will find your actions and intents to fully adhere and support the eightfold path. Choose dear Madam, the intents and desires of the King, or the petty recriminations of the small and shallow people who support the Royal Institution as they see fit, when it is convenient and the institute not always a perfect reflection of the intents of the foremost Buddhist of Thailand.

Idiocy

Today I have just about had it. Thailand has a few draconian laws and some particularly stupid ones, far too out of date for the modern 21st century world. One particular law that glovelike fits this category is that of Lese Majeste. It is not legal to say or write anything or take any action that might be deemed disrespectful to the monarchy of Thailand.

Now, H.M. the King is a wonderful man. He has done a lot of good for his country over the 60+ years of his reign. I have respect for him, but to be unable to point out a carbunkle that needs attention is just plain wrong. Anybody and everybody benefits from well-meaning criticism. Why not H.M.?

The following is from the Nation (English language Thai) newspaper today:

FCCT board faces police probe over lese majeste - By Pravit Rojanaphruk - The Nation - Published on July 2, 2009

For the first time in its five-decade history, the whole board of the Foreign Correspondents' Club of Thailand (FCCT) has been accused of committing lese majeste, a crime with a maximum jail sentence of 15 years.

Laksana Kornsilpa, 57, a translator and a critic of ousted and convicted former premier Thaksin Shinawatra filed a lese majeste complaint against the 13-member board at Lumpini police station on Tuesday night.

Laksana was quoted on ASTV Manager website as claiming the board's decision to sell DVD copies of Jakrapob Penkair's controversial speech at the club back in 2007 constituted an act of lese majeste.

She alleged that the whole board "may be acting in an organised fashion and the goal may be to undermine the credibility of the high institution of Thailand".

ASTV Manager daily also quoted Laksana as saying some major local newspapers may also part of a movement to undermine the monarchy.

FCCT president Marwaan Macan-Markar said the board members have decided not to give separate interviews. It issued a statement saying: "The FCCT will cooperate with such an inquiry [by the police]."

The board, includes three British nationals including the BBC's Bangkok correspondent Jonathan Head, three American nationals, including two working for Bloomberg and the Wall Street Journal, an Australian national and a Thai news reader for Channel 3, Karuna Buakamsri.

Social critic and lese majeste case defendant Sulak Sivaraksa, reacting to the news, told The Nation yesterday that "the problem of [abusing] lese majeste law is now utterly messy".

"The fact that leading world intellectuals like Noam Chomsky and others have petitioned to [PM] Abhisit [Vejjajiva to reform the law] is a testimony to it. If we let it goes on like this it will get even messier. It's time for the government to do something."

A source within the FCCT, speaking on condition of anonymity, said he was "surprised" at the latest allegation, which came after two years of the speech being made, adding that "it places Thailand in a very poor light".

DVDs were set up largely for club members who missed interesting talks and sales are restricted solely for FCCT members. Few copies of the Jakrapob talk are understood to have been sold because a manuscript of his talk circulated in Bangkok shortly after he was charged, and the video can be downloaded free from some websites.

In the comments' section on ASTV Manager's website, most posters expressed support for Laksana and praised her for the move.

One said: "Put them in jail for 99 years."

Another asked the site to post a picture of Jonathan Head so the person could attack him if he or she ran into him.

(You can download a copy of Jajrapob's speech from the Reporters without Frontiers site here: http://www.rsf.org/Jakrapob-Penkair.html

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The sheer, mindblowing stupidity of charging the whole board of the Foreign Correspondents' Club of Thailand with lese majeste over a DVD, of a public-domain, year old speech, on sale to members only just beggars belief for this modern century.

Unfortunately the person asking for a picture of Jonathan Head so that he might be attacked is only too symptomatic of the acute xenophobia displayed by much of Thai society today.

I am only one of many here who are looking for a way to leave. I fear H.M. is elderly and unhealthy. He is unlikely to see many more seasons pass. There will probably be a less than peaceful transition to the next monarch, if any, and expatriates are highly likely to be fairly high up in the firing line. A significant (hopefully) minority of the populace have an acute dislike of non-asians and blame us for the worst part of their ills.

In the past week I have even met two Thai families, well connected people, who are trying to sell up to move away before the excrement is spread far and wide by powerful propellers. I wish I had such a chance.

Why?

July 4th is soon here. This is a little thought to celebrate the large numbers of American fundamental evangelical missionaries who run, like termites, over our hills spreading their news of flaming hell and damnation and the simple dip in the river to solve all ills.

Why?

Why are you trying to destroy my beliefs, my society, my culture?

What makes you so very sure your values, your God is better than mine?

Will He teach me what to sow, and when?
Will your God teach me what herbs to mix to ease my wife's pains in
childbirth?
Will He teach me how to look after my water supply, what to put on my land to strengthen my crops, how to respect my family, my elders, my children?

My Gods do all these things, and very much more.

What does your god have to offer me, except pain and dissent, empty promises of salvation or threats of everlasting suffering?

Why can't you just go home and leave me happy, in peace in my village?

Why?

The honeymoon is over

New blog - first post. This is just a little test to get things started. We are hopeful this joint effort will soon be worth exploring.

If you are personally known to the contributors and would like to join our number. Please contact us to be given permissions and log in etc. All posters will likely be posting under the same anonymous name, "The Honeymoon Is Over."

Well. It is set up and the first post is about to find its bed. Until tomorrow then.