Thursday, September 23, 2010

Mammograms? Much ado about not much, apparently...

A new study published in the New England Journal of Medicine once again has debunked the exaggerated benefits that mammograms produce. Not much, apparently. Have to screen 2500 women over 10 years just to avoid one death. This is not even considering the numbers of unnecessary screening, false positives and needless surgeries.

But I am not surprised.

When mammograms were first introduced, it was really difficult for anyone to refute the arguments that more screenings mean more lives saved. Of course in the process, more sales of mammography machines, more money to screening clinics and more money to breast surgeons. All happy, of course.... except the women who had to undergo needless breast surgeries. They were a small price to pay for the peace of minds of everyone else, apparently.

So now we know.

Tuesday, September 21, 2010

NTU down 101 places in latest best university rankings..... kept the eye on the wrong ball??

Changi Airport has apparently waltzed home with a whole barrage of best airport awards. This is kinda something Singaporeans have come to accept and to take for granted.

Singapore plays this game extremely well. I think it's something taught in the civil service school.... Best Awards 101 - "How to game the system". Almost every gahment and quasi-gahment organization picks up best awards galore, often by just astutely gaming the system. Doesn't matter what falls in the cracks, as long as the main checklist boxes score max points. Such training actually begins in school at a very young age, and schools, parents and students conspire ad work furiously through the year to pick up max points for all spheres of educational "excellence".

The universities play this game as well.

Once a while though, this gamesmanship backfires.

The Times Higher Education (THE) World University Rankings recently revised her ranking criteria to apparently deliver the "most rigorous, transparent and reliable rankings tables ever".

With a single stroke, our Nanyang Technological University fell 101 places to a pathetic 174th in the world. Our National University of Singapore maintained her position, just dropping 4 spots to 34th.

So someone in NTU now has a bit of egg on the face.... spending $$$ to restructure and game the system, only for the rules to change.

Is this a problem of not keeping your eye on the real ball...... going for the cosmetic rather than the substance.

Friday, September 10, 2010

Living to work.....or working to live?

I was one of those cheering MM Lee's comments about working,....and working on old age. Yay..! I don't want to retire....I love my work too much. I don't mind winding down as my brain neurones apoptose as I get older, but I do not really want to stop work altogether.

But I realize not everyone is as blessed as I am to be in a professional role that I enjoy.

You see, I live to work. As I am sure MM Lee does. If you live to work, it is not really work. You don't really want to stop working because only death will do that.

But many others (and I am sure they out-number people like me) who are not as blessed. These actually have to work in order to live. They do not have much of a choice. If they do not work, they potentially cease to live... Everyday I walk past the cleaners and menial workers who populate the corridors of the hospital, and I wonder if they share the same enthusiasm to not retire. To reach 55, or 60, or 65.... and to not see an end to this life of labour. A blessed existence? Hardly.

Surely we can have a society where we can be a bit kinder, and more gracious to those who have spent their lives struggling against a world that seems overwhelmingly stacked against them. Surely we should be able to say " Enough, uncle (or auntie),...enough, it's time for you to take a rest.".

But sadly, I don't think we have it in us.

Forgiveness and charity

Like all religious festivals, I am sure Muslims can also easily get distracted by the festival, and forget the religion. But I really hope not, because though not a muslim, I must confess to actually having a very high regard and yes, even love, for the Hari Raya spirit.

I love that the focus is on contriteness and forgiveness. Mohon maaf zahir dan batin. That gets to the core of all human relationships, doesn't it? None of the self absorbed wishes for wealth and prosperity. In fact muslims are required to perform the zakat (giving of alms) as part of their worship during this time.

It's a lovely time of year to cherish, even as our society moves along in her mad rush towards calculativeness, self-centredness and gracelessness.

Thursday, September 9, 2010

Islamic contributions to medicine

It is easy in today's world, especially when anything Islamic is receiving such bad press, to forget how important the Islamic civilization was in the development of modern medicine. While medieval Europe languished in darkness, it was the Islamic civilization that carried the torch for medical education, research and practice.

While we look to Hippocrates as a 'father of medicine', it was probably ibn Sina (Avicenna) who should best be regarded as the 'father of modern medicine'. But sadly, we remember Hippocrates and too readily forget ibn Sina.

Few also realize that the idea of hospitals ( although the word derives from the hospices of medieval Europe), was most likely copied in idea and design from the Islamic centres of excellence. There was licensing of physicians and the hospitals were sophisticated, well organized institutions that were way in advance of what Europe had. It was probably the returning Crusaders who brought some of these ideas back to Europe.

The practice of medicine was held to a much higher standard of ethics than was in Europe. The treatise by Adab al-Tabib (Conduct of a Physician) is well known, though not by those of us with a narrow European perspective of medicine.

He writes:
'If the patient and the one who serves him understand, then the physician describes the remedies to them and allows them to go on with the therapy If it is not understood, then he must, with his own hands, undertake the treatment that is necessary; he (i.e. the physician) does not explain anything to (the patient). In maintaining silence as to the diagnosis for one who would not understand, in case of error, it is better for the patient and for the physician. After he has completed the visit to his patient he must return to the above mentioned office to treat any of the patients and to understand the problems.'

'The physician must better his relationship to and endure the distress of the patients. He must pay attention to any statement heard from them. No matter what the circumstances, he must acquire information from anywhere or anything which may prove beneficial to the recovery of the patient. The physician must not discourage any complaints of the patient or display of his distress since these symptoms which occur may be important in the diagnosis of the illness. The physician must show mercy; this is not possible except by the fear of God. If the physician has these traits, then he speaks only the truth and does good for all the people.'

We can definitely learn more than a thing or two from the Islamic civilization.

Selamat Hari Raya Aidilfitri

Friday, September 3, 2010

Hippocrates - relevant today? Or, perhaps not......

Hippocrates who lived almost 2500 years ago is pretty much accepted as being some sort of a 'father of modern medicine'. At least the Western model of modern medicine. After all our Physician's Pledge is heavily modelled after the Hippocratic Oath. Among other things, Hippocrates, or at least the Hippocratic school has been credited with moving the practice of medicine away from superstition/dogma towards one more based on careful observation, and the positioning of the patient in a holistic context where he has an integrated relationship with his environment and the physician who is managing his disease. This line of thinking actually grew out of a medical philosophy that prevailed in the island of Kos where Hippocrates lived, and is collectively called the Koan philosophy.

Few people are aware that there was also a alternate line of thinking at that time which was developing on the peninsula of Knidos, just opposite to Kos. The Knidean philosophy emphasized the disease, and took great pains to dissect out, and diagnose the disease. The Knidean approach therefore focused on the specifics of the disease and specialized therapies.

The irony is that today, while we imagine we draw our heritage from the Hippocratic (and Koan) philosophies, the reality is that our prevailing medical practices are far more aligned with the Knidean school of thought in that we are far more concerned about diagnoses, categorizing and sub-categorizing disease, and aggressive highly specialized therapies.

The idea that the patient is a person who lives in an environment with family and friends, is often forgotten. So is the idea that there exists a relationship between the patient and his physician.

We desperately need to return to our roots.
Does YLL SOM have anything to worry about?