Tuesday 12 February 2013

De considerationes in res externas

I am not going to go into the whole Romanian horse meat scandal. Knowing full well how the system works, having stumbled upon it numerous times in the past, I ascertain that neither the Romanian side nor its French counterpart or anybody else mixed into this business have executed their respective parts to the letter. In any case, even if in the end Romania presents irrefutable evidence that the mistake did not lie therein, the international image is once again distorted, adding to the numerous scandals from the past. When and if the evidence finally surfaces, nobody will care that it was not the Romanian abattoirs who were at fault.

What I found even more disturbing, however, was the Romanian Ambassador's appearance on CNN. Not only once have I expressed my sincerest disdain for people who are incapable of carrying out their job, who would not so much as earn a passing grade in what they do, if they were to be sincerely and objectively examined. An ambassador's first and foremost mission, besides representing the country, is to be able to communicate successfully with the authorities of the respective country, for the benefit of bilateral cooperation and for the benefit of the aliens legally living in said country.

The Romanian ambassador not only fails at representing Romania, from my point of view he actually did Romania a disservice by appearing on CNN, he fails at even the most basic of prerequisites of the job: speaking English! I am flabbergasted and wonder how difficult can it be to not be able to master a passing grade in proficient communication when you have been the ambassador since 2008?! And yes, I demand proficient communication because he is not just some random public servant, he is not just some member of the diplomatic mission, he is the ambassador. And to have a representative who can barely speak any English(but who has the irreverent audacity to name his English skill in his CV as "very good" ) and above that to send him on one of the most important and most watched news channels in the world to make a fool of himself is, well, just plain idiotic.

I shall say it again: A worse disservice has been done to the Romanian image by this baffling and meagre attempt at an explanation than by the scandal per se. It is not that I find it a necessity that the ambassador be Oxford schooled, most if not all of the people who are Oxford schooled(and who indeed are as such, not just pretend to be in their Curricula Vitae) do not wish to have anything to do with the country after the completion of the studies, but this cannot be the best that we can give. The man comes off as an inbred, uncultivated yob who was sent by "central command" to mumble a few unintelligible utterances. And when, as a British national, you are already taken aback by the fact that you may have eaten horse meat and had not known about it, the last thing you want to do is to see a man who claims to be an Ambassador to your Kingdom for 5 years but who barely speaks your language telling you that it was not Romania's fault. You get even angrier. And for good cause, too.

You do not represent me, sir. Nor do you represent any of the other people from the very select group of individuals who actually have the necessary qualifications to do their jobs. Enroll in an English class, you need it. Laugh for yourselves

Sunday 3 February 2013

De Feudalis Controversias

Normally, I do not particularly enjoy lowering the standards of writing this blog in order to tackle more mundane matters, but every so often a certain dispute catches my eye and if it touches on subjects of great interest for me or if it crosses over into discourse and rhetoric of arguments, I decide to tackle it.

A person has a neurosurgical problem. In Romania, you have a choice, you may go to any specialist you like or have heard of or think that is good enough to tackle your problem. So you go and pay 1/4, yes one quarter, of the minimum wage in order to see a most esteemed professor. This man is of poor reputation as a human being but is known to be above average as a professional. He has, naturally, as every slave master in history, a horde of apostles which praise him as the messiah of neurosurgery and then you have the former patients which again view him as a messiah, perfectly understandable attitude. You go see the professor. You wait for the better part of an hour. You are called in. No courtesy, no respect, not so much as a simple greeting. You tell him the problem. Your MRI is too old. Yes, but you're in pain. He looks at you with contempt and undisguised disgust. He tells you to do what you've done up to this point and then yells "Neeext!". You go pay 1/4 of the minimum wage at the front desk. The next steps, if you wish to solve your problem are to first pay another 1/4 or 1/3 of the minimum wage for a new MRI and then the exact same sum once again for a new consult. That, in order to get a diagnosis. If you've successfully completed these steps, you have a whole new adventure coming up, the surgery itself. And it will be much, much more expensive.

I naturally felt sorry for the person who had to live through this, and, having seen a lot of patients with vertebral column complaints this month, I know how painful and irritating it is. It came as no surprise to me, however, knowing the professor in question, the concept of "professor" in Romania and the Romanian healthcare system in general.

What flabbergasted me was a fervent opposition and incredible reactions from literate, some even medically literate individuals who were actually trying to persuade us that the reaction was somehow understandable, and that it is perfectly all right for the professor to act like that, as long as the operations go well. I strongly oppose this idea. There should not be a difference in Mentality between Romania and the "healthcare of the west". Because until the mentality changes, until it is profoundly and completely altered, all the money, the technology and the specialists in the world won't save the rotten system from swiveling helplessly in its own muck.

One of the points raised was that in Romania you may go to the professor directly if you so see fit, as opposed to the western countries wherein the GP arranges these matters on your behalf. A western physician will now ask: why do I want to go directly to the professor? We don't want to discuss the latest findings in the genetics of glioblastoma multiforme, we want to establish a relationship and I, as a patient, want a surgery. In the west the professor is not necessarily the best surgeon, he is an esteemed scientist and is at the forefront of his field. It is obvious that in Romania you want to go to the professor in order to maximize your chances of recovery, because in Romania professors, especially in surgical fields, are irreverential twats with a strong appetite for money who have the most experience because, especially in neurosurgery, and I speak this knowing full well what the situation is, they do not let others do the surgeries, thereby profoundly hindering their chances of gaining experience. There is no clear separation between subspecialties in Romania, spinal, skull base, vascular, oncological, there are but meagre attempts. Usually, the professor does everything. Except opening and closing, those are beyond his dignity. This is the root of the problem and it also explains why "he has to do 6, maybe 10 surgeries a day"- a bit of an overestimation, but let's assume it's true. That happens because he lets nobody else operate and acquire experience. It is not a singular case, though, don't imagine he's the only one doing it and that is precisely why I am not using names.

Another point raised was that it was not expensive. 1/4 of the minimum wage for a consult in a country with a social system of health insurance. I don't want to hear that that is an acceptable price for other countries, for other systems. No. It's a lot for Romania. If the system is bad, change it, don't charge 1/4 of the minimum wage for a consult lest I be forced to call hypocrisy. The extremists among the professor's gang were practically yelling that this is the system nowadays and that if you do not like it, you can die. This is an actual quote "This happens everywhere in the world. If you have the money, you pay, if you don't, you die". First of all, this is not the case "all over the world" as I doubt the person in question had seen even 1/100 of the world in order to assess the healthcare system. Secondly, I think certain U.S. courts would be more than happy to offer a considerable amount of money as compensation for such a failed attempt at practicing medicine. I don't care that we are talking about Romania. You are a doctor first, surgeon second. It's common sense. If you curse at everybody you meet while walking in Hyde Park on a Sunday afternoon because you were so taught in your family and that is the system, don't use this as an argument to make me think it is acceptable. It is not. And it is you, who are swearing, who is the antisocial individual, and not the everybody else for not understanding your "system". If you have nothing but disdain for your patients, find another job. It's quite simple, really. If you're incapable of bedside manner, you Fail at half of the job. Romania is no exception.

And above all, detractors of the victim complained that the matter should have not been made public. Yes it should have. Public awareness is the first stop to ever having any hope of changing something. I must stress this once more, I don't care what kind of surgeon you are if you fail at half of that which is your job. The fact that you are a professor does not rattle me in any way, nobody is above the law and neither are you. I was most disappointed to see that this lesson is still not learned. Not to mention that when you have an idea and you wish to raise arguments to support it, you need to know what you're doing. Otherwise, you're simply stating one senseless bit after another. And people need to know. Even if it's Romania and it's a professor with experience in a complicated field, it is still not acceptable. Just like you wouldn't have him swearing at you in the street.

De Ente et Essentia

An anecdotal reference to the life of Thoma d'Aquino tells that he, during his 2 years of imprisonment on the family grounds due to his insistence on joining the Dominican order, was permanently harassed end constrained by his family into relinquishing his desires. Things even got so out of hand that his brothers brought the most attractive prostitute to entice him into losing his path. The story follows that he drove her off using a blazing hot fire poker and that in that night, had a vision of two angels bestowing him with a holy mark of chastity.

This reminds me of Blaise Pascal, the renowned physician, mathematician and philosopher, who during his infamous "nuit de feu"(night of fire) had a series of uninterrupted sacrosanct visions which led him to retire to a monastery and live a very pious life from that particular moment on, albeit a very short pious life.

I have often heard hefty critique and disdain being brought against these men and indeed against most of the people who are affected by religious visions. Before we are to pass judgment onto them and decide which part we are to take, we need to take a closer look on the historical and social aspects that surrounded these people during the troubled times of the 1200s and of the 1600s. A child born around that time did not have many options with regard to faith, answers, ideas standing before him. Joining the clerical ranks was an honour and, especially for people with a high degree of authoritarianism and ambition, living a deeply pious, virtuous life was the equivalent of getting a promotion every day, in present day terminology. Indeed, the feeling of serving the one and only, almighty Creator of all that is, was and will be, the feeling of belonging to a structure that transcends mere human existence was perhaps the best one could be in that world, if one was not blessed with the opportunity of either being born in a noble family, or being born as an heir to the throne, enjoying the material benefits of royal life.

The brain is wired to function so that it constantly works in the background to sort and solve problems, to put our existence in as good an order as it can achieve, or at least that is what one of the psychological theories accepted today holds true, thus aiming at an explanation at the nature of dreams. Thus, Pascal's fever of over 42 degrees Celsius, which is accompanied most often by hallucinations, was interpreted semiotically by his brain as the fire that Moses felt when God presented him with the tablets on the mountaintop, the presence of the Lord manifested into the telluric realm. We may very well imagine the fear and uneasiness that he felt at the same time, relating to both his illness as well as to his fever, forcing his brain to grasp at any explanation available. As a very literate man, he was well accustomed to the representations of the angelic realm, thus his brain constructed all the images necessary to make him feel as a material presence inside the heavenly realm. The brain was actually fooling itself and became convinced by itself. And since the brain forever thought that God Himself had sent the visions and had allowed access into the ethereal sphere, the brain was, actually, God.

It is a most facile argument to dismiss all paranormal activity and all spiritual visions as mere figments of a hyperactive imagination which desperately wants to believe in something and that clings to the existence of higher beings in order to make it through the day and give life meaning. I do not much like generalizations, but this appears as an undeniable truth. The brain creates the images, there is no activity of the retina, the brain is not actively perceiving something that is happening in reality. Or is it?

1991, The Barrow Neurological Institute in Pheonix, Arizona. A younger Dr. Spetzler, world renowned neurosurgeon and in my opinion one of the best that ever existed, operates on a patient named Pam Reynolds. She had a very complicated large aneurysm requiring that her brain be deprived of all the blood, the heart would be stopped and the body coupled to a cardiopulmonary bypass machine. During this time, she was under intense medical monitoring and the electrical activity in her brain was closely monitored, The ears had a clicking mechanism installed inside to measure electrical activity in her brainstem(stimulating the vestibulocochlear, for my physician colleagues), eyes taped shut. As her heart stopped and all electrical activity in her brain ceased, as evidenced by eeg and electrophysiological monitoring, she had an out of body experience and could later recall in great detail discussions from within the OR and various instruments for instance the high speed drill, which she could not have seen before the induction of the anesthesia as these are brought in the OR sterile in their own bags and are unpacked only in the moment of use. Furthermore, she met dead relatives and had the infamous light at the end of the tunnel vision. I have read some mind-boggling "explanations" by various physicians who seemed to forget basic neuroscience when attempting to offer a "scientific" explanation for this occurrence. Let me be very clear: the brain had no blood. The neurons were not functioning. There was no electrical activity. There is no chance that her brain had so much as seen one dot, let alone create an image. Prof. Spetzler himself acknowledges that he has no explanation for that which had happened during his aneurysm surgery.

Saturday 2 February 2013

De Onus Responsibilitatis

Anyone who has ever found themselves in the position of assuming their responsibility exhibits one out of the two possible attitudes: either the position of responsibility gives one a false sense of importance and relevance or one dreads said responsibility, hating every consequence and activity pertaining to it.

Alas for those who are adepts of the latter manner of behaviour, society is built around the principle that each and every individual is directly responsible of his or her own life and that he or she must follow the rules that society has instituted into effect to the letter lest he or she may face at most the rigours of the law and at least the opprobrium of his fellow citizens. This is taken even further due to the fact that almost every activity which defines our everyday life encloses in itself the natural assumption of assuming responsibility.

So far, there is no clear indication as to why I would even bother to speak of such a subject. Perhaps ill-inspiration or ill-advice have made me write just for the sake of writing, forfeiting the ideas upon which this blog was built, namely knowledge, virtue and critical thinking. Why even bother to write at all? There are two main reasons which lay the foundation pertaining to this essay, and I shall present these as questions: If taking on responsibilities appears to be one of the main functions we need to accomplish as humans living in a society ordered to our liking, why is most of the population on this planet wasting precious energy every day in order to run away from them? And further, by the law of Occam's Razor(Ockham for the connoiseur who knows who the 13th Century personality was), would it not be readily apparent that the system is fundamentally wrong and it places an unnecessary burden on a being destined most evidently for someone else?

First off, allow me to call hypocrisy on those "select" individuals whom, upon reading the previous paragraph automatically, out of low self-esteem and self-insufficiency, categorized it as a sophism, as an "argumentum ad populum". I did not hold my readers' collective intelligence in contempt, I did not assume that the principle of the razor is readily apparent due to the hefty population marching in a certain direction, that of responsibility waiver. On the contrary, I was merely asking the esteemed reader whether it would not be of a more common-sense logic to assume that in the innermost sanctum of the human spirit, responsibility is of no real value and thus society was born on poor judgment and the wrong kind of principles?

And assuming that were the truth, I still do not insinuate that all is lost. Quite the contrary. As Hegel put it, if we were to view for instance the history of philosophy as a series of systems of thought which one after the other suffered the same fate we would actually be witnessing the eternal futile quest of man for the truth and a very sad story of how nothing that man will ever think, especially details and questions pertaining to himself, will ever be good enough, nor will this train of thought ever come to a definitive stop at a station where the absolute answer is to be found. Rather, the systems flow into one another, being quite similar to the flowing metamorphosis of the ideas that Hegel envisioned, and form one giant collection, named by the great Carl Jung the collective subconscious.

But if we indeed need to assume responsibility, and if this is such an integrative part of human existence that society cannot exist without it, why do we not resort to the one tool which can help us shape the world of tomorrow with as much ardour as we can muster up? Why do we not teach it specifically in schools? It is never taught, except for extremely meagre, failed attempts at making pupils, especially in the limited domain of middle education, take responsibility for unimportant matters for extremely short periods of time. You might never use advanced mathematics in your entire life, but you need to use the faculties of decision-making and you need to assume your responsibility every day.

If I am to believe in Schopenhauer, then I am to think that people are led through life by various instances of the same power, the will. Whether the will to live, or, to move on more recently to Nietzsche, the will/lust for power, it is a very egoistical undertaking which has nothing to do with the ability to assume one's responsibility. In fact, were one to be egocentric, the rules of society, aside from their coercive means of enforcement, would mean nothing so long as one's expected ends are not as they should be. If we were to marshal along Schopenhauer's ideas, we would also come across the idea that art, in itself, puts a stop to any and all yearnings, or wills, and offers the person a moment of beatitude, devoid of needing and coveting. This is for instance, in this critic's opinion, the Oxford accent in Her Majesty's English. Or, sometimes, just an ambiguous, unidentifiable text, which forces the reader to think until the last neuron in the neocortex gives up and retires, drifting off into a refractary state.