The Root of All Evil?

Is Religion the root of all evil? Prof Richard Dawkins certainly thinks so. Reuters recently ran a report on how a few 'atheist' non fiction books were making the New York Times bestsellers list. No surprises for me there. If Da Vinci Code was any indication, a cocktail of religion and controversy certainly make a best selling recipe!
So who is Prof Dawkins? Well, basically he's this atheist Professor of Ethology (study of animal behaviour) at Oxford University. He's considered to be quite a big shot in his area of expertise which is centered around evolution.

If you wanna read more about him (he is quite an interesting and impressive character) just Wikify him here

So, anyways this Prof Dawkins has written a book called "The God Delusion". I guess the title says it all. Having read a few excerpts which I found quite fascinating, and boosted by my recent discovery that Da Vinci Code was available online, I tried to download some pdf version off Limewire or Ares, but have had no luck so far :( I might actually consider spending about 3000 bucks buying it off Amazon or something, considering the fact that its pretty likely to get banned in Sri Lanka in the near future! Dawkins take on religion is summarised in his introduction;

"Religion ... has certain ideas at the heart of it which we call sacred or holy or whatever. What it means is, 'Here is an idea or a notion that you're not allowed to say anything bad about; you're just not. Why not? - because you're not. If someone votes for a party that you don't agree with, you're free to argue about it as much as you like; everybody will have an argument but nobody feels aggrieved by it. ... But on the other hand, if somebody says 'I mustn't move a light switch on a Saturday', you say 'I respect that.'"

During my teens I went through this internal battle on the atheist/theist argument. There was a time I firmly believed in the presence of God, and then a period where I strongly believed it was highly unlikely that God really existed. As I went through this struggle, I decided to seek answers in the bible. At the time, most things in the bible just didn't make any sense. Most of Genesis was totally contradictory to Science. For example, while its been scientifically proven beyond any reasonable doubt that the earth is a few billion years old, the bible only accounts for a 'split second' of about 5,000 years. The creation of the earth and and its living creatures including man took a matter of 7 days, while science clearly establishes that man came along much, much later. The thing that drew me towards the presence of God was intelligent design. I felt it was not possible for something as advanced as the human being to have evolved on its own. It didn't seem to make sense that complex organs such as an eye could just evolve due to natural selection. The other thing that intrigued me, which didn't seem to fit in with the whole evolution thingy was 'Sex'. I don't mean sex as in sexual reproduction, but sex as in sexual intercourse. Did the act of sexual intercourse evolve? Did it happen in stages? Then why has it become more complex? Can't we just exchange genetic material by just kissing or something? When you think about it, sexual intercourse is a pretty complicated task at all levels. Just go through the Karma Sutra or some other sex manual to check out the diversity and complexity. And that's for us "intelligent" human beings. Take dogs for example. Horny male dogs going through puberty or whatever tend to hump anything humpable. I supposed they are genetically programmed to do this. Its hard enough training a dog to sit or give out its paw, and yet something that requires more skill and co-rdination seems to be so effortless! But why? Wouldn't it have been much easier to just deposit your genetic load without all the effort? Anyways these were some of the battles raging through my mind. Of course new devlopments in various branches of science including molecular biology and phylogenetics(just discovered that word;) certainly give evolution a pretty sound backing. I guess even to this day I am yet to completely resolve this internal battle. Somehow I doubt I ever will. Anyways reading through some of Dawkins writings took me back to those days and thoughts. The battle between atheism and theism will never end in my lifetime. Maybe someday the "truth" will be revealed and the battle will cease. I'm pretty sure that's not gonna happen in my lifetime though. Maybe I'm wrong, but for now, the battle rages on, with great interest one might add just looking at the current NY bestsellers list and of course the famous Da Vinci Code. I personally feel that religion should be open to reasoning nad questioning. While it is certainly acceptable that certain things cannot be scientifically proven, I don't believe in blind following either. Dawkins suggests that religion, which can lead to religious extremism is responsible for a great deal of conflict in the world. Anyways he does a much better job of getting his points across than me, so here are some of those excerpts from 'The God Delusion' and some very very interesting interviews with the man himself, courtesy of YouTube. SL users will as usual have to pause the clips and wait for them to download before watching them. Dawkins has also done a documentary called "The root of all Evil" which is available on both YouTube and Google video. It certainly makes some very interesting viewing and is worth the wait (to download of course). Please do post your comments on this one. I Would love to hear the opinions of fellow SL bloggers:)

THE GOD DELUSION by Richard Dawkins

FROM CHAPTER 7: The "Good" Book and the changing moral Zeitgeist

There are two ways in which scripture might be a source of morals or rules for living. One is by direct instruction, for example through the Ten Commandments, which are the subject of such bitter contention in the culture wars of America's boondocks. The other is by example: God, or some other biblical character, might serve as - to use the contemporary jargon - a role model. Both scriptural routes, if followed through religiously (the adverb is used in its metaphoric sense but with an eye to its origin), encourage a system of morals which any civilized modern person, whether religious or not, would find - I can put it no more gently - obnoxious.

To be fair, much of the Bible is not systematically evil but just plain weird, as you would expect of a chaotically cobbled-together anthology of disjointed documents, composed, revised, translated, distorted and 'improved' by hundreds of anonymous authors, editors and copyists, unknown to us and mostly unknown to each other, spanning nine centuries. This may explain some of the sheer strangeness of the Bible. But unfortunately it is this same weird volume that religious zealots hold up to us as the inerrant source of our morals and rules for living. Those who wish to base their morality literally on the Bible have either not read it or not understood it, as Bishop John Shelby Spong, in The Sins of Scripture, rightly observed. Bishop Spong, by the way, is a nice example of a liberal bishop whose beliefs are so advanced as to be almost unrecognizable to the majority of those who call themselves Christians. A British counterpart is Richard Holloway, recently retired as Bishop of Edinburgh. Bishop Holloway even describes himself as a 'recovering Christian'. I had a public discussion with him in Edinburgh, which was one of the most stimulating and interesting encounters I have had.

THE OLD TESTAMENT

Begin in Genesis with the well-loved story of Noah, derived from the Babylonian myth of Uta-Napisthim and known from the older mythologies of several cultures. The legend of the animals going into the ark two by two is charming, but the moral of the story of Noah is appalling. God took a dim view of humans, so he (with the exception of one family) drowned the lot of them including children and also, for good measure, the rest of the (presumably blameless) animals as well.

Of course, irritated theologians will protest that we don't take the book of Genesis literally any more. But that is my whole point! We pick and choose which bits of scripture to believe, which bits to write off as symbols or allegories. Such picking and choosing is a matter of personal decision, just as much, or as little, as the atheist's decision to follow this moral precept or that was a personal decision, without an absolute foundation. If one of these is 'morality flying by the seat of its pants', so is the other. In any case, despite the good intentions of the sophisticated theologian, a frighteningly large number of people still do take their scriptures, including the story of Noah, literally. According to Gallup, they include approximately 50 per cent of the US electorate. Also, no doubt, many of those Asian holy men who blamed the 2004 tsunami not on a plate tectonic shift but on human sins, ranging from drinking and dancing in bars to breaking some footling sabbath rule. Steeped in the story of Noah, and ignorant of all except biblical learning, who can blame them? Their whole education has led them to view natural disasters as bound up with human affairs, paybacks for human misdemeanours rather than anything so impersonal as plate tectonics. By the way, what presumptuous egocentricity to believe that earth-shaking events, on the scale at which a god (or a tectonic plate) might operate, must always have a human connection. Why should a divine being, with creation and eternity on his mind, care a fig for petty human malefactions? We humans give ourselves such airs, even aggrandizing our poky little 'sins' to the level of cosmic significance!

When I interviewed for television the Reverend Michael Bray, a prominent American anti-abortion activist, I asked him why evangelical Christians were so obsessed with private sexual inclinations such as homosexuality, which didn't interfere with anybody else's life. His reply invoked something like self-defence. Innocent citizens are at risk of becoming collateral damage when God chooses to strike a town with a natural disaster because it houses sinners. In 2005, the fine city of New Orleans was catastrophically flooded in the aftermath of a hurricane, Katrina. The Reverend Pat Robertson, one of America's best-known televangelists and a former presidential candidate, was reported as blaming the hurricane on a lesbian comedian who happened to live in New Orleans.* You'd think an omnipotent God would adopt a slightly more targeted approach to zapping sinners: a judicious heart attack, perhaps, rather than the wholesale destruction of an entire city just because it happened to be the domicile of one lesbian comedian.

In November 2005, the citizens of Dover, Pennsylvania voted off their local school board the entire slate of fundamentalists who had brought the town notoriety, not to say ridicule, by attempting to enforce the teaching of 'intelligent design'. When Pat Robertson heard that the fundamentalists had been democratically defeated at the ballot, he offered a stern warning to Dover:

I'd like to say to the good citizens of Dover, if there is a disaster in your area, don't turn to God. You just rejected him from your city, and don't wonder why he hasn't helped you when problems begin, if they begin, and I'm not saying they will. But if they do, just remember you just voted God out of your city. And if that's the case, then don't ask for his help, because he might not be there.

Pat Robertson would be harmless comedy, were he less typical of those who today hold power and influence in the United States. In the destruction of Sodom and Gomorrah, the Noah equivalent, chosen to be spared with his family because he was uniquely righteous, was Abraham's nephew Lot. Two male angels were sent to Sodom to warn Lot to leave the city before the brimstone arrived. Lot hospitably welcomed the angels into his house, whereupon all the men of Sodom gathered around and demanded that Lot should hand the angels over so that they could (what else?) sodomize them: 'Where are the men which came in to thee this night? Bring them out unto us, that we may know them' (Genesis 19: 5).

Yes, 'know' has the Authorized Version's usual euphemistic meaning, which is very funny in the context. Lot's gallantry in refusing the demand suggests that God might have been onto something when he singled him out as the only good man in Sodom. But Lot's halo is tarnished by the terms of his refusal: 'I pray you, brethren, do not so wickedly. Behold now, I have two daughters which have not known man; let me, I pray you, bring them out unto you, and do ye to them as is good in your eyes: only unto these men do nothing; for therefore came they under the shadow of my roof' (Genesis 19: 7-8).

Whatever else this strange story might mean, it surely tells us something about the respect accorded to women in this intensely religious culture. As it happened, Lot's bargaining away of his daughters' virginity proved unnecessary, for the angels succeeded in repelling the marauders by miraculously striking them blind. They then warned Lot to decamp immediately with his family and his animals, because the city was about to be destroyed. The whole household escaped, with the exception of Lot's unfortunate wife, whom the Lord turned into a pillar of salt because she committed the offence - comparatively mild, one might have thought - of looking over her shoulder at the fireworks display.

Lot's two daughters make a brief reappearance in the story. After their mother was turned into a pillar of salt, they lived with their father in a cave up a mountain. Starved of male company, they decided to make their father drunk and copulate with him. Lot was beyond noticing when his elder daughter arrived in his bed or when she left, but he was not too drunk to impregnate her. The next night the two daughters agreed it was the younger one's turn. Again Lot was too drunk to notice, and he impregnated her too (Genesis 19: 31-6). If this dysfunctional family was the best Sodom had to offer by way of morals, some might begin to feel a certain sympathy with God and his judicial brimstone.

*It is unclear whether the story... is true. Whether true or not, it is widely believed, no doubt because it is entirely typical of utterances by evangelical clergy, including Robertson, on disasters such as Katrina. ... The website that says the Katrina story is untrue... also quotes Robertson as saying, of an earlier Gay Pride march in Orlando, Florida, 'I would warn Orlando that you're right in the way of some serious hurricanes, and I don't think I'd be waving those flags in God's face if I were you.'

---

FROM CHAPTER EIGHT: What's wrong with religion? Why be so hostile?

In July 2005, London was the victim of a concerted suicide bomb attack: three bombs in the subway and one in a bus. Not as bad as the 2001 attack on the World Trade Center, and certainly not as unexpected (indeed, London had been braced for just such an event ever since Blair volunteered us as unwilling side-kicks in Bush's invasion of Iraq), nevertheless the London explosions horrified Britain. The newspapers were filled with agonized appraisals of what drove four young men to blow themselves up and take a lot of innocent people with them. The murderers were British citizens, cricket-loving, well-mannered, just the sort of young men whose company one might have enjoyed.

Why did these cricket-loving young men do it? Unlike their Palestinian counterparts, or their kamikaze counterparts in Japan, or their Tamil Tiger counterparts in Sri Lanka, these human bombs had no expectation that their bereaved families would be lionized, looked after or supported on martyrs' pensions. On the contrary, their relatives in some cases had to go into hiding. One of the men wantonly widowed his pregnant wife and orphaned his toddler. The action of these four young men has been nothing short of a disaster not just for themselves and their victims, but for their families and for the whole Muslim community in Britain, which now faces a backlash. Only religious faith is a strong enough force to motivate such utter madness in otherwise sane and decent people. Once again, Sam Harris put the point with percipient bluntness, taking the example of the Al-Qaida leader Osama bin Laden (who had nothing to do with the London bombings, by the way). Why would anyone want to destroy the World Trade Center and everybody in it? To call bin Laden 'evil' is to evade our responsibility to give a proper answer to such an important question.

The answer to this question is obvious - if only because it has been patiently articulated ad nauseam by bin Laden himself. The answer is that men like bin Laden actually believe what they say they believe. They believe in the literal truth of the Koran. Why did nineteen well-educated middle-class men trade their lives in this world for the privilege of killing thousands of our neighbors? Because they believed that they would go straight to paradise for doing so. It is rare to find the behavior of humans so fully and satisfactorily explained. Why have we been so reluctant to accept this explanation?"

The respected journalist Muriel Gray, writing in the (Glasgow) Herald on 24 July 2005, made a similar point, in this case with reference to the London bombings.

Everyone is being blamed, from the obvious villainous duo of George W. Bush and Tony Blair, to the inaction of Muslim 'communities'. But it has never been clearer that there is only one place to lay the blame and it has ever been thus. The cause of all this misery, mayhem, violence, terror and ignorance is of course religion itself, and if it seems ludicrous to have to state such an obvious reality, the fact is that the government and the media are doing a pretty good job of pretending that it isn't so.

Our Western politicians avoid mentioning the R word (religion), and instead characterize their battle as a war against 'terror', as though terror were a kind of spirit or force, with a will and a mind of its own. Or they characterize terrorists as motivated by pure 'evil'. But they are not motivated by evil. However misguided we may think them, they are motivated, like the Christian murderers of abortion doctors, by what they perceive to be righteousness, faithfully pursuing what their religion tells them. They are not psychotic; they are religious idealists who, by their own lights, are rational. They perceive their acts to be good, not because of some warped personal idiosyncrasy, and not because they have been possessed by Satan, but because they have been brought up, from the cradle, to have total and unquestioning faith.

Richard Dawkin's interview with Newsnight

Richard Dawkin's interview with BBC

The Art of PP

Private practice or "PP" as it is most fondly referred to among doctors is a highly controversial issue in Sri Lanka, both among patients and doctors. From a doctors point of view the basic purpose of engaging in PP is to earn some extra money. Don't be misled. That is the sole and only reason doctors go into private practice. Is it wrong or unethical? I don't think so. Contrary to popular belief, Doctors in Sri Lanka are among the most poorly paid professionals in the world as well as when compared to our counterparts in the region. The current all inclusive salary (allowance) of a house officer is approximately Rs, 18,000. Once you finish your internship you earn a salary of approximately Rs 25, 000. A consultant would earn around Rs 40,000. Of course these are the salaries paid by the state. But that is my point. It would be quite difficult to survive on these salaries alone. And when there is an obvious demand for their services in the private sector, I see no problem in doctors carrying out private practice during off duty hours as long as it does not interfere with their regular jobs.

What exactly happens in private practice? During my final year rotations I had the privilege (at least I thought so at the time) of working with one of the most senior and well respected general practitioners in Sri Lanka. My colleague and I spent about two weeks basically hanging out in his clinic and 'observing' and occasionally helping out with his practice. The first thing he told us on our very first day went something like this. "Almost all patients that come to you have one diagnosis; SLI, and they are all treated with ADT" The medical field overflows with abbreviations. In a hospital setting any given sentence spoken between doctors would involve at least 2 to 3 abbreviations. GTT, FBS, FBC, HB, CXR, USS, UFR, LFT, ECG, ERCP, D & C......the list is endless. Still I was pretty sure I had never heard of SLI or ADT. Well according to him SLI stood for "self limiting illness" and ADT "any damn thing"! At the time I thought he was just kidding. Now I know what he said is the gospel truth. The workload of a typical GP consists of a few viral fevers, upper respiratory tract infections, diarrhoea, gastritis type abdominal pain and muskuloskeletal pain(basically odd aches and pains that have no specific cause). These would make up at least 90% of the patient workload. It is interesting to note that many of these are actually self limiting. Basically what that means is no matter what you do, the illness is going to settle on its own. It doesn't matter how you treat a viral fever. In fact you cannot. You just let your own body do the healing, and just help in whatever little way you can. How about an upper respiratory tract infection like a cold or a cough, or sore throat. Same thing. You don't have to do anything. Various studies have shown that antibiotics, and cough syrups given in simple upper respiratory tract infections don't have any real benefit. Why do doctors prescribe them? Its easy and convenient, and most of the time boosts your doctor patient relationship.

Lets take an example which was actually a true incident told to me by a patient. This particular patient had an upper respiratory tract infection. Basically a cough and cold. Medical science knows that such an illness can take between 3-7 days for recovery whether you do anything about it or not. ie; it is a self limiting illness. The patient sees Dr A on day 3 of her illness. Dr A prescribes a cough syrup saying antibiotics are not necessary and she should be ok in a few days. On day 5 the patient still has her cough and cold, with just a slight improvement. Out of frustration at the lack of efficacy of Dr A's drugs she visits Dr B on day 5 of her illness. Dr B goes through her earlier prescription and notes she is already on a cough syrup and prescribes antibiotics, although there is no real need for it. The patient happily takes the "powerful drugs" and by day 7 her illness has disappeared and shes good as new. Patients conclusion; Dr B's excellent drugs cured her of her illness. The fact is whatever she did, statistically she would have been ok by day 7 anyways. Had the she seen the two doctors in reverse order then Dr A would have been the hero. Had she seen an ayurvedic physician or a homeopathy goon or even a quack, he/she would have been praised for her recovery. This happens day in and day out. Patients come to conclusions on SLI's assuming the drugs/balms/ointments/herbal supplements they have been prescribed have cured their illness. This particular patient was telling me, "Dr A didn't take any notice, he just prescribed a cough syrup. You don't need to see a Dr to get a cough syrup, I could have got one at any pharmacy. Dr B prescribed me some very good antibiotics. I was ok within 2 days." Who do you think the patient is gonna visit the next time she has an SLI? Dr B of course. Who do you think was the better doctor?

The ideal management of an average patient with a simple cough and cold with no co-morbidities is warm fluids and bed rest. A cough syrup may be taken at night to prevent nocturnal coughing but that is more than adequate. Unfortunately most patients don't know this, and doctors take advantage of it. Some of the most successful GP's are masters in the art of taking credit for curing SLI's. One particular GP used to prescribe drugs for the expected duration of the illness carefully explaining to the patient when his/her symptoms would subside and how long his drugs would take to "cure" the illness. Naturally when things happened right according to plan patients were impressed. The word spread around. This summarises the dilemma for the private practitioner. Remember, the goal of private practice is to make money. To make money you need patients. To get more patients you need to make your patients like you and spread the word around that you're a good doc. In certain instances what might be best for your patient might not be best for you. This brings about a conflict of interest. For example for a patient who requests antibiotics for a simple cough, refusing to prescribe them might lead to the patient rushing off to the next doctor. I have seen this happening on numerous occasions. I used to think Patient education was the key here. If you could explain that his or her SLI is going to settle on its own and antibiotics are not needed and may even be harmful, this would let you make the correct management decision while maintaining good relations with your patient right? WRONG! Studies have shown that most patients who do make a visit to their doctor with relatively minor illnesses expect a prescription and are disappointed not to have one. People obviously don't like to visit doctors. They aren't exactly the most fun people to hang around with, and why would you wanna wait hours and hours to see a typically rude and abrupt doc if u don't really have to. If you felt you illness was just gonna go away on its own you would most certainly not make that visit. People who eventually visit doctors feel that their illness needs some sort of medication and therefore feel the trip (and wait) to see the Dr is worthwhile.

Patient education does work sometimes. Some patients are grateful for not having to take any drugs, some are utterly disappointed and rush to the next doctor to get their antibiotics. Interestingly my parents happened to be from both extremes. My father is totally anti medication. He would consider taking a Panadol only if his life depended on it. He felt antibiotics were highly toxic drugs that would destroy your kidneys. He had read numerous articles about disastrous drug side effects, like the thalidomide disaster, and the monster of all side effects, Steven Johnson's syndrome. He failed to note however that the chances of experiencing some of of these side effects was like one in a million. You have a much higher chance of dying while crossing a typical road in Sri Lanka. However no amount of explanation would change his opinion. He would just stick to eating healthy foods and yoga for all his health care needs. So far its all good since hes been having only SLIs. Remember SLIs are treated with ADT. ADT includes antibiotics, cough syrups, homeopathy, aromapathy, reflexology, yoga, quack mixtures, whatever....
My mum is the extreme opposite. Soon as she develops a productive cough she requests a prescription for a good antibiotic. My attempted explanations go in vain as she strongly believes it is my inexperience that blinds me from the fact the she desperately needs an antibiotic! Thus, people have preconceived notions and attitudes. Just as certain superstitions and beliefs of people are impossible to get rid of so are their attitudes towards drugs and illness. Coming back to PP, I have noticed that doctors can't be bothered anymore. They just go with the flow. Anyone who wants antibiotics will get some. The same goes for vitamins. Specialists do the same. Its all about marketing your image and manipulating those SLIs. Two of my batch mates were working with a GP on a rotation basis. One of them was ranked among the top 25 in Sri Lanka in our year(from a total of about 750). I had personally worked with him and have loads of respect for him. He had excellent diagnostic and clinical skills with an in depth knowledge of diseases as well. If at all the only area he was lacking was his PR. He was pretty abrupt with patients and his tone can come across as rude sometimes. But that's just the way he is. Still I felt he would make a good Dr due to his medical skills. The other guy who was working with him was ranked in the bottom 200 or so. His clinical and diagnostic skills left much to be desired for and his management options were more than questionable. However in a GP setting these things hardly matter. After some time the relatively "smarter" one (lets call him Jim) was getting fewer shifts to cover, with more of these being given to the other guy lets call him Sam. Sam being a good friend politely inquired from the senior GP as to why Jim wasn't being called in. The GPs reply was something like this "Private practice is all about marketing. You don't need to know medicine to be a successful GP. But you do need to make patients happy. You need to make them feel like you care even if you don't. You need to pretend to take a great interest and take some extra time even though you actually need a minute or two. Jim is a good diagnostician, but he doesn't have that marketing element" Basically what he was saying is give the patient what he thinks he needs. Be it an antibiotic, vitamin, or simply a nice long chat and your practice will thrive.

I have a problem with this approach. Basically conning around to get your PP going seems unethical to say the least. However doing what you think is right and is best for the patient sometimes gets you negative points and is consequently detrimental to your practice. If trying to explain things to your patient only works sometimes, what then is the correct solution? Do you go with the flow and do your sales act? For me the answer is somewhere in between. A moderation of both extremes. Don't be a total con artist, and yet give some of the things the patient wants. For example I know one of the commonest complaints I get from patients regarding visits to their specialist is "They don't even look at you, they have already written the prescription before you have sat down" While this is an obvious exaggeration of the actual course of events the point is well taken. Most specialists spend a very short time with their patient. Most of the time that is more than the amount of time that is needed. When you visit an experienced specialist he has seen at least 500 cases just like you (unless you have a very rare illness). They know exactly what has to be done next. For example for a patient presenting with chest pain, the next most obvious step is an ECG. So if you're a middle aged man seeing your doc for chest pain, no matter what your chest pain was like, or anything else for that matter, you're gonna need an ECG 9 times out of 10. So as soon as you say the word chest pain any doc would know u need to check your BP, take an ECG, and order an FBS and serum cholesterol to assess your cardiovascular risk factors. This would be the next step in almost any middle aged patient with chest pain. Asking a few questions and writing these tests down on a piece of paper would take less than a minute. Thus such a consultation should take less than 2 mins. However such a consultation would not go too well with for your PP. You would be labeled as a rude doc who doesn't give a shit about his patients.

Unfortunately or fortunately specialists don't have the luxury of seeing that many SLIs and therefore cannot prescribe much ADT. Surgeons are a prime example. You cannot do ADT for a hernia or acute appendicitis. Your patient might end up dead. Hence most surgeons don't have to do the whole sales act. They just do their thing and if they are good enough they build their reputation on their surgical skills rather than their PR abilities. Nevertheless it is pretty disappointing the way most doctors go about their PP.

However its nice to note that patients are becoming more and more knowledgeable about their illnesses. In the West it has already happened. Most patients come to visit their docs with files of print outs from various online journal articles with the latest research findings about their illness. Some even use this as a tool to check how updated their doc is. While Sri Lanka has a long way to go to before coming there, I sincerely hope one day we can let our patients handle their own SLIs without having to spend their hard earned money on doctors consultations, unnecessary antibiotics, and vitamins etc etc. Who knows maybe even doctors may one day actually put their patients needs before their own. Well, it is nice to dream.....

Sri Lankan TV ads: A class of their own...

I do not watch TV for many reasons. The most obvious reason for the most part has simply been a lack of time. However the last couple of weeks has given me plenty of time to be doing things I wouldn't normally do :) I guess watching TV could have been one of them, except finding something interesting enough to watch on our local TV stations proved to be a daunting task. The other reason I do not watch TV is the ads. I cannot voluntarily bare the torture of having to sit through numerous 'retarded' ads, which are annoying to say the least. However thanks to whoever invented the remote control (God bless his soul!), I am spared the agony of having to sit through the spectacle. Unfortunately the only time I am somewhat forced to sit through the talents of the Sri Lankan advertising industry are during cricket matches. Changing channels between overs can be pretty risky, considering the fact that you are already are a ball behind due to the attempted asphyxiation of the 30 sec or so break between overs with multiple ads. Yesterdays SL vs WI match was no different. I was pretty grateful to the SL team for finishing off the match early, especially since I had other commitments that evening and was regretfully going to miss most of the 2nd session. Luckily though the windies put up a dismal performance and the rest is history. This time though i ended up watching a few ads. I had no idea Sri Lankan cement producers were capable of producing such versatile multipurpose cement. One particular cement brand was especially useful at stopping lorries wtih malfunctioning breaks, thus saving the life of an innocent girl just in the nick of time. I couldn't quite figure out what the ad was trying to say. Perhaps it was suggesting that since a bag of its cement could stop a speeding lorry in its tracks, it would similarly add a great deal of power and stability to whatever structure is built using it? Or maybe its something much more bigger than that. I was thinking the government should supply all our bus stands, major highways and junctions with bags of this particular cement brand. (incidentally I seriously cannot recall the name of the brand, so much so for the effectiveness of branding!). Anytime a reckless private bus driver comes along a passerby could just hurl a bag of cement thus saving 100s of lives annually.

Another cement brand was found to be very useful in bearing the weight of 7 elephants one on top of the other! Very impressive indeed! I'm sure that has to be some sort of record, and it might even open up some doors for export to international zoos and circuses. Basically anyone that needs to carry around a couple of elephants would find it most useful.

I am no advertising or marketing expert. In fact I am far less knowledgeable about these things than the typical pvt sector employee. Still most of these ads just don't make any sense. The only purpose they seem to serve is to increase brand awareness. As to whether they genuinely increase the sales of a product is surely debatable. I'm sure it must be pretty difficult to accurately asses the effectiveness of ads. But still, surely our marketing managers must have an ounce of common sense! Most of these ads seem to just provide some sort of cheap entertainment. Others tell very touching stories but as to whether they really sell the product is another issue. The above two ads are just an example. Many have been worse. There have been numerous such ads in the past, which fortunately seemed to have deserted my memory.
However the other side of the story has to be told. There certainly have been very impressive and effective ads. Unfortunately they are far and few in between.

Watching sports a health hazard?

CNN recently reported an interesting study on how men seemed to delay treatment during a football game. Here are some excerpts...

"When is a man's medical emergency not all that urgent? Apparently when sports are on the tube.
A drop in the number of men going to the emergency room during sports broadcasts on TV is followed by a surge afterward, reports an ER doctor who reviewed case numbers over three years at the University of Maryland Medical Center in Baltimore"

"It was a two-stage decision: If they were hurt, whether to go to the hospital or not. If they needed to go to the hospital, could they finish the game or not?"

Another interesting article published by BBC some time ago about Heart Attacks and Strokes in Dutchman following football matches says;

"Most Dutch people have unhappy memories of the France - Holland match in the 1996 European Championships - but they are the lucky ones.
Researchers have found that the number of fatal heart attacks and strokes suffered by Dutchmen on the day that their side went out of the tournament on penalties was significantly higher than normal. "

"In total, about 14 additional deaths occurred - an increase of around 50%.
No corresponding increase in deaths occurred in women. "

"Scottish study
A previous study found that Edinburgh Royal Infirmary treated an incredible 151 patients for football-related problems during the 1998 World Cup in France.
Problems included:

• A fan rushed to hospital suffering an asthma attack which came on as he watched the Scots go down 3-0 to the Moroccans in the 1998 World Cup
• Another fan who needed treatment for self-inflicted deafness from his shouting at the television
• One fan - sporting a full Scotland strip - was found unconscious after having overdosed on temazepam. He required treatment for psychosis when he said the Scottish squad was talking to him through the television screen.
• Eight fans who suffered chest pains, two who suffered hyperventilation, one with palpitations and three with alcohol-related seizures"

Read the complete article here;
http://news.bbc.co.uk/2/hi/health/1081413.stm

The above figures are certainly pretty scary. What about Cricket and those nerve biting finishes to those cliffhanging one day matches? The press has certainly highlighted a few heart attacks occurring 'due' to these close finishes. And how about delaying treatment? Would someone experiencing potentially serious symptoms put off obtaining medical care during an interesting phase of an ODI? Like maybe when Sanna boy is on song? I'm sure its more than possible. Still I find it unlikely that someone with very severe chest pain is gonna be doing any cheering. But then everyone does not experience chest pain during a heart attack; the so called "Silent MI" - a doctors and patients nightmare. I guess that's the kind of patient who would be most likely to postpone medical treatment, ignoring the excessive sweating, nausea, palpitations and breathlessness that would normally warrant a fairly quick visit to the Doc. After all don't we all experience at least some of these during a tight one day match. I few years ago while working in state hospital, I remember my consultant checking up on the streptokinase (a clot buster) supply in the ward on a match night, expecting a few extra heart attack admissions. Strepto is a relatively expensive drug not freely available in state hospitals. It has to be pre-ordered as supplies are limited. So if one runs out of streptokinase on a casualty night one is most certainly screwed!

And what about the seemingly innocent symptoms that are potentially life threatening? A slight dropping of an eyelid? A crooked smile? I wonder if its time to issue a surgeon generals warning before an ODI :)

A birds eye view....well almost...

Google earth has to be one of the coolest pieces of software ever! While I'm sure almost everyone would appreciate the extremely detailed satelite pics, the likes of Osama, Prabhakaran and the likes must certainly be most pleased to say the least. Detailed images of "high security zones" such as the Bandaranaike internatioanl airport and nearby airforce base, Temple trees, etc etc would certainly make their lives easier! Anyways I dont think any of this takes away from the coolness of google earth! Seriously, if you havent installed it already you should do so asap! However, dont bother if youre not on broadband, it does consume a hell of a lot of your bandwith and is quite slow on our local ISPs. Well, I did some sightseeing today and took a couple of pics.....enjoy....




World Trade Center & Neighbours...





Royal College, Colombo :)



and the other school...





the National Zoo... well, the other one





The himalayas...




Niagara Falls...




Paris, and her most famous landmark...



Dubai...





Male international airport...



Statue of libery...





Osama's best pals place...


Osamas dart board...the shape says it all...


The Washington monument...


My home town....you can even see my roof!

Tom Cruise on Psychiatry...

And our very own Nimal Siripala on Psychiatry issues of the Paradise Isle...

Only 14 specialists for 376,000 victims

Sri Lanka is grappling with a shortage of mental health specialists with only 14 of them being available for the whole country, Health Minister Nimal Siripala de Silva said yesterday.
Addressing a seminar at the Health Education Bureau, Minister de Silva said the situation created a grave impact because some 376, 000 people were known to be suffering from mental illnesses.
The Minister said the problem had been aggravated as doctors did not choose mental health to pursue their higher studies, and therefore the Ministry had decided not to allow doctors to select courses on their own. Instead, the Ministry will determine what courses doctors should follow based on the country's health needs.
He also said 60 percent of doctors who went abroad for post-graduate mental health studies, had not returned to the country. "In future, neither the GMOA nor the Post Graduate Institute of Medicine (PGIM) will be given a chance to select doctors for higher studies in medicine. It will be done by the Health Ministry in keeping with the country's health needs," he said.