Shalaya Tantra

Bollocks to panhandlers!

2007-04-19T14:58:00.000-07:00

I detest panhandlers.

"Help me buy a cup of coffee?"

"I'm so hungry."

"I just need enough for a bus ticket."

Lies. As a student, I could afford little. I never carried any cash around so that I would never be tempted to spend it. But when a man plaintively tells you he hasn't eaten for three days and piteously petitions you for money to buy food, a stone would be moved to pity.

I had an apple. I had been saving it for the long ride home, but his need seemed so great. I gladly gave it to the man, who thanked me as I boarded the bus. As I sat down, I glanced up and through the window, watched as he disgustedly threw my shiny-sweet apple in the garbage.

When I volunteered at the hospital, I would get free bus tickets to help me get there and back. Since I had to purchase a monthly bus pass to get to the university anyway, I would save these bus tickets for the holiday months when I didn't have to travel as often. When people asked me for money to buy bus tickets, I would hand them mine, only to hear them opportuning other strangers on the street for money to buy bus tickets that had already been secured.

I've since learned to donate my money directly to shelters and other agencies that help the homeless. For a number of reasons, it is difficult to measure the prevalence of mental illness and substance abuse among the homeless. Nevertheless, a 2001 study from the Canadian Psychiatric Association found that as many as 2/3 of homeless people using urban shelters have some sort of mental illness. Even if you look at more conservative studies citing a prevalence of 40%, the numbers remain impressive. That same year, the Canadian Medical Association Journal published a literature review by Stephen W. Hwang on homelessness and health in Canada. According to his research, mental illness and alcohol use disorders were widespread among the homeless.

So what does this tell me? This tells me that homeless people are less likely to be able to make well-informed decisions. As a surgeon, I cannot legally secure consent for a procedure from anyone who is mentally ill or under the influence of exogenous substances, as both of these compromise informed decision-making and, therefore, autonomy.

By simply and naïvely giving money to vagrants, there exists no guarantee that they will get the help they so desperately need. All it does is reinforce to the panhandler that this is a viable way to attain an income and therefore maintain the status quo. However, if I donate money to the agencies who provide food, clothing, shelter, and job training to the homeless, I can better ensure that those funds aren't spent on cigarettes or alcohol or crack.

Please think before you part with your spare change. Are you just trying to momentarily assuage your Christian middle/upper-class guilt by occasionally tossing a few coins the way of the homeless? If you truly wish to effect change in their lives, help them gain access to what they truly need.

For the butterflies!

2007-03-25T11:54:00.000-07:00

Yay, Taiwan!

***
Highway shut for butterfly travel

Taiwan is to close one lane of a major highway to protect more than a million butterflies, which cross the road on their seasonal migration.

The purple milkweed butterfly, which winters in the south of the island, passes over some 600m of motorway to reach its breeding ground in the north.

Many of the 11,500 butterflies that attempt the journey each hour do not reach safety, experts say.

Protective nets and ultra-violet lights will also be used to aid the insects.

Taiwanese officials conceded that the decision to close one lane of the road would cause some traffic congestion, but said it was a price worth paying.

"Human beings need to coexist with the other species, even if they are tiny butterflies," Lee Thay-ming, of the National Freeway Bureau, told the AFP news agency.

Under the bridge

Each year thousands of butterflies die when turbulence generated by fast-moving cars drags them into the traffic or under the wheels of oncoming vehicles.

Ecologists hope the triple-action effort of lane closure, protective nets and ultra-violet lighting will dramatically increase the milkweed's chances of reaching the breeding ground.

The protective nets are designed to force the butterflies to fly higher, reducing the chances of them getting caught in the traffic.

Ultra-violet lighting will be used below an elevated section of road to encourage the butterflies to head beneath.

The measures are estimated to have cost $30,000 (£15,200).

Resolutions

2006-12-30T18:04:00.000-08:00

1. I will work on my flexibility.
2. I will do 100 stomach crunches a day.
3. I will learn to be proficient at the guitar blues scale.
4. I will learn how to play "Clair de Lune" by Debussy.
5. I will finish my research project on MRI and Breast Cancer.
6. I will finish my latest oil painting.
7. I will sing every day.
8. I will dance every day.
9. I will kiss my husband passionately on the lips at least once a day.
10. I will make a fool of myself as occasion calls for (which is often).

"For what do we live, but to make sport for our neighbours, and laugh at them in our turn?"
-Mr. Bennet, Pride and Prejudice by Jane Austen

Freethought

2006-12-03T19:51:00.000-08:00

Freethinking, anyone?

An interview with Richard Dawkins

Mumble Happyfeet!

2006-11-27T15:35:00.000-08:00

I have found a new obsession: dancing penguins!

Restaurant Makeover

2006-11-09T20:12:00.000-08:00

Shift work has afforded me the luxury of loveseat lounging and watching cable television. My latest obsession is visiting the following restaurants featured on the show Restaurant Makeover.

The Town Grill

The Ossawippi Express

Sweet Divinity

2006-11-05T21:29:00.000-08:00

Pairing chocolate with sweet orange: absolute genius. Imagine my delight then, when Callebaut-deprived for seven months, I spied a slim white box, nestled unassumingly amongst its candy compatriots, bearing the Lindt insignia and the words Orange Intense. As if illuminated by an errant ray of gold-flecked light, the previously quiescent gilded letters spelling "Dark" and "Extra Fine" began to softly shimmer before my dazzled eyes.

Tearing back the silver foil wrapper, I broke off a corner, the fragrance of oranges and almonds filling my nostrils long before the silken chocolate had begun to melt on my tongue. Ambrosia, I thought deliriously. I have discovered ambrosia, my fingertips stained dark with melted chocolate.

Now if only Lindt made nectar...or do they?

Making lemonade...

2006-10-08T08:43:00.000-07:00

I never fail to be taken aback when people comment on my enthusiasm for my specialty. The archetypal surgeon is care-worn and gruff; terse and arrogant. Given that I am none of these things, it consistently elicits surprise when I happily state that I am, indeed, a surgery resident.

But I can understand how people can become jaded. The health care system here is not only inefficient but demoralizing to both staff and patients. With not enough beds, specialties strive to not admit patients. Until I came here, I had never heard of "turfing" the patient back to a service or that certain admissions could be viewed as "dumps".

For example, there was a patient with dementia who had a mass removed from his temple in clinic. He was then sent home with instructions that the bandages not be disturbed until his return appointment the following week. For pain control he was given codeine. Unfortunately, the codeine exacerbated his dementia and made him quite agitated. He proceeded to rip off his dressings, "necessitating" a number of trips to the emergency department in the early hours of the morning. His adult children could not be bothered to change the dressings themselves (a simple task), nor did they wish to engage the services of an in-home nurse, for this would incur additional cost to them. Why pay for a nurse when visits to the emergency department and a hospital stay paid by other tax payers (at a cost of over $1,000 a night) are "free"?

It became an argument between Medicine and Surgery as to who should admit this patient. We surgeons argued that there was no further surgical intervention required at this time and that had he not had dementia, this complication would not have arisen. Furthermore, admission to hospital was not necessary, given that the nursing staff were already stretched to capacity and the patient was more likely to receive greater supervision at home, contrary to his family's assertions. In addition, even if a surgical admission was warranted, nurses on the surgical ward are ill-equipped to manage demented patients. Medicine, however, argued that admission was necessary and that the patient's agitated behaviour was a complication of our post-surgical pain management. Therefore, regardless of the fact that dementia usually falls under Medicine's jurisdiction, in this case, the patient belonged on the surgical service.

In the end, we achieved detente. Medicine admitted him to one of their beds ("a total dump" to them, a completely appropriate decision to us), while we agreed to follow him every day to assess his wound healing.

Unfortunately, a situation like this is not uncommon here. We're supposed to act as a health care team in the best interests of our patients. I went into medicine to help people, not play politics. And if I had the misfortune of being a patient, I know I would feel hurt and angry to be made an unwilling participant in the medical specialties' game of patient hot potato.

When I become an attending, I intend to change things. In the meantime, I can only try to help my patients as best I can and not allow the system to alter my personal philosophy.

Good husband and father, my @ss.

2006-10-05T22:00:00.000-07:00

Why are parents and spouses of murderers, robbers and rapists often the only ones left bewildered by their loved-ones' acts? Surely, there must have been some indication prior to commitment of the crimes. A chance remark. An odd behaviour. One might argue that in denying that the person they love is capable of such deviancy, these people are refusing to acknowledge their own lack of insight and, therefore, their passive complicity. Defending their loved one then becomes a selfish exercise in ego preservation rather than an act of truth-seeking and justice.

And although family members are not responsible for the actions of their loved ones, I feel that it is a slap in the face to the victims' families to state that a person who has perpetrated an act of violence is essentially a "good" person. Moreover, it is illogical. Goodness implies actively improving the lot oneself and others; in essence, acting in benevolence. How can one be considered benevolent when one's actions are clearly intended to inflict harm?

***

Funerals for Amish school victims

Funerals for four of the five Amish girls killed in a schoolroom massacre on Monday have taken place in the US state of Pennsylvania.

Hundreds of mourners gathered as the four, aged seven to 12, were laid to rest in the small town of Nickel Mines.

Each girl was buried in a plain pine coffin. A fifth victim will be laid to rest on Friday.

The girls were gunned down by a local man, Charles Roberts, who then killed himself. Five more girls were injured.

Doctors treating the survivors have reportedly taken one girl off a life-support machine and allowed her to be taken home to die.

Roads into the village were closed off to maintain privacy during Thursday's funerals.

The first girl to be buried was Naomi Rose Ebersole, seven, who was carried to Nickel Mines' hill top cemetery at the head of 32 horse-drawn coaches.

Similar processions were later held for Marian Fisher, 13, and the Miller sisters, Lena, seven, and Mary Liz, eight.

The funeral of Anna Mae Stoltzfus, 12, is scheduled to take place on Friday.

The Anabaptist denomination eschews technology and preaches isolation from the modern world to varying degrees.

Amish burial customs call for simple wooden caskets - and a girl is typically laid to rest in a white dress, cape and white prayer-covering on her head, the victims' funeral director said.

Forgiveness

Donations have been coming in from around the world to help with medical expenses - Amish do not carry health insurance.

One insurance company has pledged $500,000 (£265,000).

But the Amish have also reached out to the family of Roberts, the 32-year-old milk-tanker driver who killed himself at the end of the shooting spree.

Amish leaders have helped set up a fund for the family at a local bank.

A Roberts family spokesman said an Amish neighbour had also comforted the family hours after the shooting - and extended forgiveness to them.

"I hope they stay around here and they'll have a lot of friends and a lot of support," said Daniel Esh, an Amish artist whose grand-nephews were inside the school at the start of the attack.

In a final phone call, Roberts told his wife he had molested two young members of his own family 20 years ago.

In suicide notes he also made references to another incident 20 years ago, and said he had been haunted by dreams of repeating his actions.

Roberts had entered the one-room school in the village of Paradise, armed with guns, knives and 600 rounds of ammunition.

He ordered the women and boys to leave, tied up the girls, barricaded the doors and shot his captives in the head.

Roberts' wife Marie and other family members have said he was a good and loving husband and father, and that prior to Monday's attack there had been no hint of what he was planning.

The crime syndicate known as "Orthopedics"

2006-08-04T18:47:00.000-07:00

Orthopod. If you thought it referred to a species of dinosaur, you wouldn't be far from the truth. I suspect they have a height requirement because every orthopod I've met, male or female, is at least 5'7". One of the larger specimens I've encountered stood 6'7". I firmly believe that the interview process includes mandatory upper body strength testing. If you see a doctor with biceps the size of cantaloupes, chances are, you have just spied an orthopod.

I've never done an orthopedic rotation before. As a result, I was completely ignorant of the dazzling array of tools at the orthopedic surgeon's disposal. Persuaders and reamers, nails and screws in fuchsia, gold, and dragonfly green, cordless drills and rubber-ended steel mallets (also referred to as "universal persuaders").

We were fusing a lower spine and stabilizing it with instrumentation, which involved affixing metal rods approximately 6 mm in diameter on either side of the spine. These needed to be cut to size. Out came the giant, three and a half foot-long sterile wire cutters. My preceptor asked if I had ever tried to steal a bike, because the principle was similar. The answer became obvious as I tried to squeeze the handles together as hard as I could. The rod remained unyielding, nary an instrument mark on its shiny, titanium alloy surface. After having watched me struggle those few minutes, sighing, my preceptor took the wire cutters from me and with a quick SNAP SNAP the task was completed.

This experience has taught me that if you see a doctor riding your missing bicycle, follow him. You'll likely track him back to the orthopedic surgery unit at your local hospital.

For the first time

2006-07-29T03:00:00.000-07:00

It took a long time to sink in. I can now honestly say that I saved a life the other day. It was a patient who had recently been moved to the Acute Monitoring Area (AMA), the place on the Internal Medicine floor where the sickest patients are placed for 24-hour observation. He had not been doing well. He had necrotizing pneumonia but now was complaining of a new chest pain. No changes could be found on x-ray and no cardiac cause could be found. It was in the early hours of morning when he began to breathe faster. His heart rate began to climb and his blood pressure rose. The nurses called me, worried that he was not looking well.

I quickly examined him. No breath sounds could be heard in the right side of his chest. I eyed his trachea...did it appear even slightly deviated? His pressures were climbing, not dropping. Good. But that respiratory rate was worrying me. The normal human person breathes up to 20 times per minute at rest. He was breathing 46.

Portable chest x-ray stat. EKG stat. CK and troponins stat.

The first chest x-ray was cut off and of poor quality, his frail little body was positioned awkwardly and his entire chest could not be completely seen. I asked the tech to repeat it. That's when I saw it.

A large pneumothorax with what appeared to be a deviation of the mediastinum to the left. Those can kill you. Quickly. I called my senior and asked her to confirm my diagnosis. Yes, it was a pneumothorax alright. Although tracheal deviation and hypotension are pathognomonic of tension pneumothorax, they are late findings. I told her I was going to perform a needle thoracostomy and that he needed a chest tube.

A rush of air greeted me after inserting the 14-gauge angiocath. I withdrew the needle, leaving the catheter in place and affixing it to his chest with a clear dressing.

He felt much better. His vitals began to normalise.

The needle thorocostomy was only a temporizing measure. He needed a chest tube. This was inserted with the aid of a general surgery colleague. On x-ray, the lung had re-inflated.

I had made the right decision.

Less self doubt, doctor. Less self doubt.

Mr. A

2006-07-23T05:22:00.000-07:00

Almost up until the last day of his life, he was a wanderer. He meandered through the hospital halls as he had once roamed the streets: hearing incessant secrets he tried to dissolve into silence.

His life was both a tragedy and a miracle. Those thin wasted legs, mottled and cool to the touch, had once carried him across European soccer fields. He told us his family had originated from Hungary, but a lifetime ago, he had left Hungary to play professional soccer for Poland. That family he spoke of no longer existed, or if it did, it could not be found.

If we could have contacted his sister, we would have told her that he was a medical marvel. He should not have been able to walk; the major arteries to his legs had long blocked off. Somehow, nomadic new vessels had formed, finding their way back to the main circulation.

His hand, however, had not been as fortunate. The fingers, when we found him, had blackened and withered. Moreover, the rotted flesh had become infected. He carried the smell of dying with him. The vascular surgeons would not amputate after discovering blocks to his arm’s blood supply. The newly debrided tissue would never have healed, dying back little by little over time until the entire arm was lost. Ideally, his own body would provide the solution. The useless fingers would simply fall away, shed like dead leaves from a tree before winter.

It was while doing a routine chest x-ray that we found the mass in his lung. Further investigations showed his body was riddled with cancer.

I would see him twice a day: once in the morning and once in the afternoon, all the while trying to ignore the sickening smell emanating from his room. He was pleasant and cooperative, allowing me to go about my business as his physician. I was never sure whether he fully appreciated that he was dying. Once I asked him if he knew why he was in hospital. At first, he replied that he didn’t know. I gently prompted him, reminding him of the scan we had done. He looked up and told me we had found cancer cells, as if we had told him we had found a bone he was unaware had been broken.

As I examined him, I would glance at his meal trays. The plates always looked as if they had been licked clean. My heart sank. Cancer is hungry.

One morning I discovered he had stopped eating, had stopped wandering the halls. Although he was breathing, he would not respond to his name, His organs had begun to fail. It would only be a matter of days.

What happens to the people no one claims? Are they catalogued by number, their remains in some warehouse until such time that a long-lost sister/brother/mother/father comes searching for them?

Unloved. Unmourned. But not forgotten. Goodbye, Mr. A.

I can't believe I missed towel day!

2006-05-31T20:25:00.001-07:00

Dang.

www.towelday.kojv.net/

I love a bald man!

2006-05-29T18:02:00.000-07:00

It all began with Patrick Stewart. He convinced me that only the most attractive and charismatic of men can pull off a bald head successfully. Others need to rely on the camouflage of hair to distract from their weaker features.

Nevertheless, I was skeptical when my husband first announced his intentions to shave his head. I loved his fine, wavy hair. Ever a man's man, my husband has had little use for mirrors. Never possessing the vanity of the metrosexual, who manicure their hands and pluck their eyebrows (my husband's eyebrows curve perfectly naturally over his green eyes, by the way), the only time my husband has ever set foot into a salon was when I decided I wanted to see what he looked like with blonde highlights.

Fate, however, had other plans for my husband's hair; these took the form of contact dermatitis compounded with tinea versicolor. No longer merely inconvenient, his locks had become a liability. The constant scalp irritation was inducing scarring. Not only would a shaved head be more comfortable, it would enable my husband to devote even less time to his appearance. In his eyes, this was a win-win situation, the verity of which I remained unconvinced. Resigned, I brought out the clippers myself.

That day, I experienced an epiphany. I didn't think my husband could be any hotter. I love rubbing his newly-shaven head; I could occupy the rest of my days doing so and die a happy, fulfilled woman.

Learning and Teaching

2006-05-27T10:02:00.001-07:00

There was a time when the profession of teaching was valued. Those who chose to pursue graduate work in education were assets to the staff and they were paid commensurate with their knowledge and experience.

Then, education became a right, not a privilege. Because education had to be easily accessible, it no longer held the cachet it once possessed. Soon, schools became the dumping grounds for parents unable or unwilling to take part in their children's lives. Teachers were no longer simply educators; they became counsellors, disciplinarians, and babysitters to ever-expanding classes filled with children who were there not for the love of learning, but for parental fears of breaking the law.

Because everyone was entitled to an education, it became unfeasible to pay all those teachers well with the limited funds available. So, with the need for teachers being so great, those who had attained graduate degrees found themselves disadvantaged. After all, one could pay a new graduate less, leaving more funds available for the salary of an additional staff member. The message was clear: those who expended extra time and energy into their chosen careers would be penalized. And what about those new graduates?

I've always hated the expression, "Those who can't do, teach." Why would you want someone with no knowledge or skill teaching you? Yet, faculties of education continue to participate in the promotion of this belief by setting the bar low for entrants in order to meet quotas set by governments. Many of my friends and classmates who could not achieve the grades to stay in engineering or science transferred to education. Others who had pursued degrees in English, art and psychology found themselves jobless and rudderless; hence, they turned to education. Where were those who truly wanted to teach?

I, myself, love teaching. There is almost nothing more satisfying than sharing your knowledge. In the ever-changing field of medicine, effective and efficient knowledge transference is paramount. Unfortunately, it is well known that not everyone in medicine possesses the inclination nor the skill to educate the next wave of future physicians. Many must teach in order to maintain their admitting privileges in a teaching hospital or to retain their research funding; inevitably, these lecturers reluctantly and, oftentimes, ineptly impart their theoretical or clinical wisdom, despite possessing an audience eager to learn. Those who can't teach, do, and nothing is more stultifying to the curious mind.

If governments truly value an educated populace, they should be willing to fund one, with the emphasis that learning is a privilege and not a right. Universities also need to change their mandates. They should separate those who wish to be teachers by default from those who truly have a love of education. I applaud those faculties of education who now require the successful completion of a pre-professional year prior to admission. Even more can be done. Volunteerism and teaching experience as evidenced by letters of reference should also be requirements for entrance and the minimum GPA should be increased. Certainly, those who can't do should not be permitted to teach.

By allowing a select number to become teachers, their societal value will come to the forefront. With increased value comes an elevation in compensation. Teachers will once again feel respected and that what they do is worthwhile. These are the people who I want to teach my children. Shouldn't everyone?

Do I really sound like that?

2006-05-20T18:18:00.000-07:00

To better understand the life my sister has chosen, I have created an audition CD in an effort to enter a singing competition. I have no illusions regarding my talent. One could describe my voice as being merely untrained, if one were being charitable; and if one were not, as akin to caterwauling. One year of voice lessons at age 16 does not a singer make, just as practicing little during the intervening years is not a blueprint for vocal virtuosity. Nevertheless, I girded my loins and attempted to create a passable audition CD.

So many things can affect the quality of your voice: the time of day, how tired you feel, the temperature of the air, your level of hydration. There is also the psychological pressure of recording; in attempting to do your best, you end up making mistakes you otherwise would not have made. At least, that's my excuse.

There is a finite number of times you can sing in a day before your voice gives out. Unfortunately, there is no guarantee that you'll have recorded a perfect take by the time that occurs. This is problematic not only if you have limited time in your schedule to record, but if you also lack the funds to secure a recording engineer for a second or even third session.

Fortunately, my husband is a veritable modern renaissance man, and recording engineer is but one of the many hats he wears. Poor thing. I'm sure his head was ringing by the time he had finished.

Certainly, when I play back my voice, it isn't as resonant nor as well-pitched. I hear myself go sharp and flat in places I don't recall being out of tune. My breaths are more obvious and my tempo is inconsistent. It is a truly humbling experience.

So to all the singers out there, I have so much respect for what you must go through in order to succeed at your chosen career. I certainly couldn't do it, which is why I'm staunchly sticking to my day job.

"He seemed so normal..."

2006-05-04T23:57:00.000-07:00

To the-girl-I-once-was and others like her:

There are people in this world you will come to wish you had never known. Manipulative, controlling, abusive. A narcissistic liar with borderline personality disorder, once my ex-boyfriend realised that I had somehow found the strength to not return to him a second time, he threatened to make my life miserable and proceeded to do so by stalking me for 4 years.

The only people who had believed what was happening to me were the security guards on campus and at my place of work, my sister, one high school friend, and the man who eventually became my husband. The bastard had his act perfected to the extent that even my own best friend had been deceived.

There are many people like him: seemingly ordinary people who turn violent once they realise that you have finally seen past the façade of normalcy to the ugliness underneath. They lied to you. You aren't stupid or worthless. You are lovable. Believe that you deserve more than what they could ever give you. They will try to express their "remorse" by attempting to shower you with gifts, professing that they will never harm you again. Do not be fooled. They have not changed.

They prey on the naïve, the inexperienced; particularly those who have little or no self-esteem. They will study your fears and insecurities, systematically exploiting them to their advantage. They will insinuate themselves into every aspect of your life in order to create the illusion of dependency. They feed upon this feeling of control, this sense of superiority. But watch how quickly their magnanimity and charm disappear the moment they feel their position as superior is threatened.

I promise you it will not be easy to leave, but there are people in this world who will believe you and help you. You have had the resilience to come this far. You are stronger than you know.

It has been said that what doesn't kill you, makes you stronger. This suggests that one is better for the experience and that one should even be grateful. I do not believe this. Like a bone that forever bears evidence of having once been broken, what doesn't kill you, leaves you damaged. Scarred tissue only ever achieves a fraction of its former tensile strength. And long after the healing is done, your body will send aching reminders of past insults and injuries, painful testaments to what you have survived.

These scars will forever be a part of you. Accepting this is the first step towards wholeness. It is now your responsibility to yourself and to those who truly love you to walk away and heal. Look to your future, for no one can change the past. Not even God.

Looking back, if I am grateful for anything, it would be for the choices I made to get myself out of that abusive relationship and for the support I received, sometimes found in the unlikeliest of places. It was through these that I have been able to realise my heart's desire. It can be the same for you.

Take care of yourself. I love you.

Shalaya

Art + Medicine = Sexy

2006-05-01T18:49:00.000-07:00

I've been painting again. One of our walls was simply crying out to be decorated, so I pulled out my canvases, cleaned my brushes, and began. And I've taken up singing again. I think it's time.

Wealth

2006-04-24T13:59:00.000-07:00

I was speaking with a close friend of mine the other day about what it meant to be wealthy. Our discussion specifically revolved around material wealth and what distinguished the truly rich from those who considered themselves so.

At one point in her life, my friend had access to millions of dollars. She had owned a number of Porsches and other high-end sports cars. She moved among some of the most exclusive social circles. When she travelled, she stayed in the best of hotels and sipped Cristal at the finest restaurants.

I, on the other hand, came from a white-collar middle-class family. Given that I've lived the life of a student for the past twelve years, wealth is as foreign a concept to me as playing the guzheng. I enjoy haggling and derive great satisfaction from getting a good deal.

According to my friend, this is in stark contrast to the wealthy, to whom price is no object. What they want, they want now. They subscribe to the belief that "If you have to ask, you can't afford it." As an example, she used the instance of a man she had met, who fancied himself rich. A self-made millionaire, he had been driving down the highway in his vintage Cadillac when he decided to get something to eat. The only dining establishment for miles was a dingy, poorly lit diner. When he opened his menu, he was surprised to learn that a steak cost $28. The non-steak fare was similarly overpriced. He then got up and left.

In her mind, the fact that he would rather search for another restaurant than pay an extortionate price for a meal indicated that he, in fact, was not rich. The truly rich should have no concern regarding cost.

Or should they?

I have a photograph of my friend and I, which she had custom framed in a shop. It is lovely. The glass was cut to the photo's specific proportions and hand-bevelled.

But the picture itself is not of an unusual shape or size. A less costly alternative would have been to purchase a frame and place the photograph inside herself. However, the latter would have required visiting different shops in search of a frame that suited her purposes and aesthetic sensibilities.

This brings us to the present day. My friend has experienced a drastic reversal of fortune. Many of the friends she had when she was wealthy have since disappeared. In exchange, she has found less affable companions: bailiffs and bill collectors. She has taken out a loan against her home. Last winter, she could not afford to keep up the payments to heat her house. With no hot running water, she would bathe out of a basin using water heated on the stove. Finally, she swallowed her pride and accepted social assistance. I had been so worried about her state of affairs, I had sent what money I could spare to help.

Sometimes I would think of her, surrounded by the trappings of her former wealth: the boxes of diamond and emerald jewellery, the room devoted to her designer wardrobe, the collection of perfume and cut crystal purchased on a whim, the hand-tufted oriental rugs. It must have all seemed an absurd nightmare to she who had once dined with diplomats and nobility; she, who could now little afford fresh milk and bread.

She could not part with these things, these symbols of what she once was. She had once looked into selling it all, but discovered that she would only be paid a pittance for her treasures. Apparently, the rich prefer their things new.

This brings me to my own conclusions about what it means to be rich. Wealth is not a state of mind nor an attitude. It is an arbitrary numerical value assigned by society, and those deemed by society to be extremely wealthy are not generous by default. Indeed, frugality is conducive to accumulation of wealth.

It stands to reason that one can always lose what one possesses. At some point, money must be an object. Otherwise, one may well find oneself bathing out of a basin.

Gluteus Maximus

2006-04-09T14:36:00.000-07:00

Constraints on space and finances, not to mention on time to entertain, allowed us to remain oblivious to the benefits of upholstered furniture for almost seven years. However, our couch-free status became painfully apparent once we moved into our new place last week. Thus, four days ago, we resolved to embark on The Great Couch Quest.

The first difficulty we encountered was negotiating the streets of an unfamiliar city. It wasn't simply a matter of navigation. That was the least of our worries. Contrary to previously held belief, there are worse drivers than those in the city we left behind. Inconceivably, signalling here is an even more foreign concept. Similarly, the term "Driver's Education" does not seem to have penetrated the local social consciousness. Traffic lights and speed limits are subject to interpretation. For example, red does not necessarily mean stop. If a red light had a voice, it would say, "P-pardon me. I realise that the yellow light indicates that you should speed up, but if it isn't too much trouble, please stop- ah, I see. Oh. Well. (Watching the tail lights disappear in the distance.) As you were."

After a number of near-death experiences, we eventually made it to each destination. We wandered through the various furniture establishments, ranging from warehouses to fine showrooms, all the while being silently stalked by various species of furniture salespeople (from the common Pliss bifrummus to its more aggressive cousin, Yoomus bifrummus), who quickly assured us that they would remain at a respectful distance but would be ready to assist us at a moment's notice.

I am a woman of champagne tastes...on a beer budget. When presented with a sea of choices, I have the dubious talent of being able to instinctively select items with the highest price point, despite them being scattered amongst numerous similar-looking alternatives. Case in point: unmindful of the tags, after sitting on numerous sofas, I displayed an unmistakable propensity for those which we were later informed were, if not the priciest, certainly among the top three in the store. Apparently, my ass has extravagant tastes.

I don't know who are crazier; those who design furniture or those who design textiles. There is an inordinate abundance of ugliness out there, my friends; ugliness that knows no bounds. Witness this fine example, one of three members belonging to a set priced at over $20,000:

In the end, we decided to sacrifice appearance for comfort and utility, consoled in our belief that we could relegate the furniture to our future basement and purchase anew, once our house was built.

Nevertheless, I harbour secret desires for re-upholstering, given how good the bones of these couches are. See for yourself:

Future Fine Furniture
Although my aesthetic sensibilities continue to smart, my butt is saying, "Thankyouthankyouthankyou..."*

*(Get your churlish mind out of the gutter.)

Out with the old...

2006-03-24T12:29:00.000-08:00

In the process of packing up all our worldly goods into cardboard boxes as we prepare to move 3,000 kilometres eastward, I came across a yellowing ruled notebook. It contained a few cursory notes from a senior-level university English course that I had almost forgotten I had taken. The following short-short story enclosed therein still elicits a chuckle. The author is unknown, but it appears to have been written in the 1940s or 1950s.

Oct. 4	Ad for female stenographer	$1.00
Oct. 4	Violets for new stenographer	$1.50
Oct. 6	Weekly salary for new stenographer	$45.00
Oct. 9	Roses for stenographer	$5.00
Oct. 10	Candy for wife	$0.90
Oct. 13	Lunch for stenographer	$7.00
Oct. 15	Week's salary for stenographer	$60.00
Oct. 16	Movie tickets for wife and self	$1.20
Oct. 18	Theatre tickets for steno and self	$16.00
Oct. 19	Ice cream sundae for wife	$0.30
Oct. 22	Mary's salary	$75.00
Oct. 23	Champagne & dinner for Mary and self	$32.00
Oct. 25	Doctor for stupid stenographer	$375.00
Oct. 26	Mink stole for wife	$1,700.00
Oct. 28	Ad for male stenographer	$1.50
	TOTAL EXPENSES FOR MONTH	$2,321.40

Wallis Simpson lied.

2006-03-22T10:19:00.000-08:00

"You can never be too rich or too thin."
I beg to differ with Her Grace, the late Duchess of Windsor. You can be too rich, à la Jocelyne Wildenstein, the New York socialite who has purportedly spent over $4,000,000 so far in her dubious pursuit of felinity in efforts to win back the affections of her philandering big game hunting billionaire-husband.

It didn't work. He was horrified. Her plastic surgeon should be horse-whipped for therapeutic nihilism.

And, of course, you can be too thin:

The Oath

2006-03-21T20:06:00.000-08:00

When I took the Hippocratic Oath, seemingly inexplicable tears welled up in my eyes as I recited the final few lines. Although I knew I was merely repeating words that others had pronounced long before me, it was as if everything: the countless hours of studying, the anxiety, the tears, the sleepless, harried nights in the hospital, all had led me to that one crystalline moment of clarity. This was why I became a doctor.

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

-Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University

Sweet cheeses!

2006-03-03T13:41:00.000-08:00

For Samson, it was Delilah; for Oedipus, overriding hubris; for Achilles, it was his gastrocnemius/soleus-calcaneal tendon. For Shalaya, it is cheese.

Cheeses I have loved:

Asiago
Babybel
Bocconchini
Boursin
Brie (double cream, of course)
Chevre (imported from France, please)
Cheddar (aged)
Cottage
Cream
Danish Blue
Emmental
Feta
Gouda
Haloumi
Havarti
Marscapone
Mozzarella
Parmigiano reggiano
Provolone
Ricotta
Romano
Sardo
Stilton

Cheeses I have met with and left on bad terms:

Camembert
Oka
Wensleydale

As you can see, the second list is substantially shorter. My goal: to try every known cheese in the world, starting with the prodigious cheese listing at Cheese.com.

What's your weakness?

Who knew?

2006-02-24T10:57:00.000-08:00

I found this questionnaire on-line. My answers are enclosed in parentheses:

1. What's your ideal internship? (Working for a cause you feel strongly about)
2. Of these, what's your best subject in school? (English)
3. When it comes to work, you like: (Helping people)
4. In class, you tend to be the one who: (Always shows up for class)
5. In your opinion, college is a time to: (Prepare for your career)
6. You could never study something that: (Had you sitting behind a desk all day)

You Should Get a MD (Doctor of Medicine)

You're both compassionate and brilliant - a rare combination.
You were born to be a doctor.

What Advanced Degree Should You Get?

What were you born to be?