R.I.P. Michael Jackson

This is going to be one of those days, where you look back and think “When I heard Michael Jackson died, I was doing…”

Well, I had just hurriedly rushed out of the C train at Penn, and was making my way to the LIRR track. I checked my Blackberry quickly, and happened to go to Twitterberry, when I saw the string of Michael Jackson-related tweets. My first instinct was to dismiss it as a hoax, though I could feel a lump slowly rising in my throat. This was Michael Jackson they were talking about, had they no shame? How could you suggest such a thing? Yet I decided to confirm it with the New York Times, hoping that it wasn’t true. When I saw that the first article was “Michael Jackson dead at 50″ I wanted to cry. I guess perhaps it’s an odd response to the death of someone who wasn’t exactly close to me. However, he defined my understanding of pop music from the first day I even knew anything about pop music.

Being raised in an Indian household meant there was Indian music most of the time. Michael Jackson represented my first glimpse of Western music. Yet my reaction was more of fear, since the first thing I heard by him was “Thriller” and happened to be watching the music video (keep in mind, I was maybe five or six). Fear, though, gave way quickly to admiration. He was the pinnacle of pop music, and no one has even come close to his skill and success (and no one ever will).

Perhaps I’m more sad because a few friends and I danced to “Thriller” for our senior dance at our Diwali program two years ago. It was a fantastic bonding experience for us, and a great learning experience (Michael’s moves are not easy, unsurprisingly). Michael Jackson is inextricably tied with that experience, and maybe that’s why his death elicited such an emotional response in me.

May he rest in peace, he was the best thing to ever grace the world of pop music. I hope the media is kind to his children, and to his memory.

The Odds of Dying From…

Have you ever thought about the odds from dying from reason x or y? I wouldn’t be surprised if you haven’t, but I’m sure it’s something that has crossed your mind at some point. A friend of mine sent me a link that gives the odds of dying from a whole host of possible causes. While it is kind of depressing to consider each and every scenario, this link also puts things into perspective, given a news media that seems to always be reporting deaths from this crash or that fall (perhaps it’s only the American media that’s guilty of that).

http://www.nsc.org/research/odds.aspx

The odds are given as one-year odds (for 2005) and lifetime odds (for people born in 2005). Most of the data represents a compilation of data from several injury categories. These categories are defined by the World Health Organization (WHO).

Most striking (and perhaps most unsurprisingly) are the lifetime odds of dying as either a pedestrian or as a car occupant: 1 in 627 and 1 in 261, respectively. So what this translates to is 1 out of every 627 people will die due to their being a pedestrian, and 1 out of 261 people will die as an occupant in a car over the course of their life. Given that there are some 300 million people in the U.S., that’s a lot of people. Yet this graph doesn’t really give odds of dying in a car-related accident due to other influences, like alcohol, drugs, medical condition, or distraction (Blackberry, cell phones, etc.). The odds represented here are compiled odds. Accounting for all of those factors would probably lessen the odds considerably. The lifetime odds of death due to air travel–a cause of great fear in a lot of people–sits at a comfortable 1 in 6,460. Whether this is because fewer people fly or air travel is more stringently regulated is up for debate, though I’d be willing to go with the latter.

The lifetime odds of death due to injuries or complications sustained as a result of medical interventions is 1 in 1,437. Again, the reason for death isn’t specified, whether due to medical malpractice or a physiological response to a treatment (like organ rejection, for example). The data represented is a compilation of deaths due to a whole host of causes that fall under the umbrella of medical interventions.

These should be taken with a grain of salt, given that for many of these causes of death, there are usually other factors involved. Nonetheless, most represent a decent estimate of one’s odds of dying from any given cause.

In the context of a media that seems to be fixated on deaths from murders, accidents, and suicides, we need to understand the real facts. I hate that I have to differentiate between real facts and mainstream-news-media-drivel. For those of you who haven’t seen “Bowling for Columbine,” I would highly recommend it for the sheer reason that it points out the disparity in news coverage between the U.S. and Canada, with the former being far more sensationalist. Based on the news given in the U.S., it would seem like people are dying from causes at far greater rates than would be predicted by the actual, calculated odds. It’s grossly misleading.

Obviously it’s good to know the risks of certain activities (or the odds, as are presented here, both are similar but are derived differently), yet it shouldn’t cause us to forego things because they carry an inherent risk (though assault and premeditated murders should really be avoided…among other things). It’s a question of weighing the risks and the benefits, and understanding what factors can reduce the risk of undertaking a certain activity.

So go live life…but be mindful of the facts.

R.I.P. H.M.

For those of you somehow associated with neuroscience, you probably have run into those two letters sometime during the course of your studies. Oddly enough, I didn’t know what H.M.’s name really was, until the day he died. H.M. didn’t know much beyond his own name and a few memories up until 1953. It was then that he underwent an operation to remove part of his brain that was deemed responsible for his seizures. As a result, he lost the ability to create new memories.

Every person he met from then on was new, every place he visited was unfamiliar, no matter how many times he came into contact with them. I can’t imagine living a life like that, but his life allowed us to understand more about how our minds worked.

Thank you H.M. Maybe you will finally find some familiarity in the hereafter. Rest in peace.

I Don’t Get It

Somehow, killing just doesn’t seem to equate into any sort of act of retribution. I don’t see how taking a life, or taking several lives, justifies any valid philosophy. Since when does storming a crowded place, taking out your rifle, machine gun, or pistol and firing bullet after bullet into people achieve any sort of good? What good does it do to target people and take hostages, and watch as they bleed and sweat fear for their lives and shame for being somehow, culpable for some vague and uncertain deed in the eyes of their captors.

Who are we to judge who is worthy of life and worthy of death?

This is the credo of terrorist organizations today, or so it seems, that in taking life and striking fear, something good is achieved. Most recently, several gunmen opened fire in coordinated attacks across several of Mumbai, India’s hotels, restaurants, and hospitals. It was clear that these gunmen were targeting foreign nationals. In most of the terrorist attacks in recent years, the sites tended to be those frequented by foreigners. Why?

I am not even going to try to interpret their actions, it’s not my place. I am not going to talk about God, and I’m not going to talk about religion. They have been unfairly dragged through the mud and I am not going to continue with it.

So where does one start to dissect a mind, a mind of a person so caught up in their own mission that the mind is indistinguishable from the mission? Have you ever tried to convince someone they are wrong about something they strongly believe in? It’s about as effective as talking to a wall, except the wall is sticking their fingers in their ears and trying to talk over you.

No one ever goes out wanting to do something “evil.” Everyone is convinced that they are the good guys. Can doing good be so relative? How can one begin to standardized “good deeds” and “evil deeds?” Won’t terrorists see that they have inflicted unbelievable pain on their fellow man, won’t that (in theory) make them realize that their view of supposed “goodness” is fundamentally flawed, when death and suffering are imperative to achieve any “good?”

Then again, maybe they won’t. Goodness and evil at this point in time are still (unbelievably) relative. One can only hope that this changes.

I pray for the people who were lost today in Mumbai, as well as for the people who have been lost and will continue to be lost if good and evil remain concepts that are open to interpretation. May their souls rest in peace.

EDIT: For up to date pictures/information about what’s going on in/around the Taj Hotel, please refer to my friend Arun’s blog: http://arunshanbhag.com/2008/11/26/mumbai-blasts-taj-is-burning/

Sometimes it Takes a Death Sentence to Give Life Meaning

I am going to be working on cancer-related research (gliomas for those of you who are extra curious) starting next semester, in the clinical realm. So I met today with the head of neuro-oncology in the hospital where I will be working. Since most of the work being done was at the clinical cancer center, I went there to meet with him. Turns out he’s pretty busy (go figure), so I ended up waiting in the waiting room for a while.

It was interesting to see how many pleasant faces there were given that, I think, most of the patients there were suffering from brain cancers. I especially enjoyed observing one patient, an elderly man, who was doing nothing but cracking jokes as he waited. He had, in fact, been waiting there for three hours and had traveled from Long Island to the city to meet with his doctor. At one point, he turned to one of the other patients who had been waiting there for a while herself, and asked with near deadpan-delivery, “Do you think that if they make us wait through the night, they’ll give us turkey?” This was an elderly man who couldn’t have been younger than eighty with both a personal nurse and a walker at his side, waiting in a cancer waiting room, asking gleefully about turkey. I loved his attitude, and it made my wait all the more pleasant.

I hope it doesn’t take a death sentence for me to realize that, sometimes, we shouldn’t sweat the small stuff and that we need to understand that there are better things to worry about (like for example, turkey). Sometimes you can find beauty in the madness, and maybe, that’s really all that life’s about.

There is Something Fundamentally Wrong Here…

I have no health insurance.  I have to worry about getting a cold, getting a flu, getting food poisoning, or some other unfortunate ill.  Heaven forbid I do, I have no way to go and see a doctor for any sort of treatment.  In the back of my head, I worry every time I step out off the curb into the crosswalk, worry that some crazed taxi driver will gun his engine and inadvertently take me out.  In that case, I hope I go quickly and painlessly, and not have to end up in a hospital and drive my family into bankruptcy.  That is my prayer, in the supposed land of freedom and opportunity.

I, along with many of my peers, went to college and are pursuing further grad work.  I, along with many of my peers, are in debt up to our eyeballs.  Cornell Arts and Sciences costs something in the order of $40K, though I was in Cornell’s College of Human Ecology, a measly $20K as a New York State resident.  Meanwhile, I just Googled the tuition cost to attend the University of Cambridge in England and here is what it said:

“In 2009, the University of Cambridge will charge tuition fees of £3,145 (plus a small inflationary rise to be determined by the DIUS) per year for all courses, as outlined in our Access Agreement, which has been approved by the Office for Fair Access (OFFA).” (http://www.cam.ac.uk/admissions/undergraduate/finance/tuition.html).  That’s $4654.  Per year.  At one of the world’s premier universities.  In order to succeed in the land of freedom and opportunity [the United States] you must be willing to fork over an arm and a leg, in addition to your firstborn.  This is the mantra that the country continues to chant.

So getting back to my story.  I have no health insurance, and I’m signing loan after loan to pay my way through school.  Theoretically, I have only another…5 more years of school to go before I get a steady paycheck.  After that, maybe another thirty years before I pay off my loans.  Even if I didn’t take my double-masters detour from medical school, I would still be paying off loans well into my child’s teen years.

I have tried to find a job, but finding a job in itself is a hassle.  I finally got one, after 6 to 7 months of searching (not including the tutoring position I currently have).  Other friends, though, are still in the job-hunting game, with little to no success.  Most, if not all, are from top-tier universities around the country.  Even if they’re not, they are certainly smart and capable, yet they are all being denied.  Welcome to the United States, the land of freedom and opportunity.

Why have we failed our own people?

Part of the problem is we are still operating in an exclusively capitalistic mindset.  Privatize this and that so that the brunt of the cost falls on the individual and the group is spared.  Leave it to market forces, because the market will cure all.  We have no concern for the group, just the individual, whose health and future is put in the hands of the market.  This is the equivalent of leaving them in the hands of a temperamental child, easily swayed, and never entirely stable.  Inflation is only driving costs up.  While, in the case of healthcare, Medicaid and Medicare do exist and for education, there is state and federal financial aid, they are imperfect solutions.

Medicaid remains a often-abused and neglected system.  Millions, if not billions of dollars, are being spent because clinicians are billing the system fraudulently, exploiting loopholes in the system that have yet to be resolved.  If they aren’t inappropriately billing the system, they are less likely to treat patients on Medicaid, and those hospitals and clinics that do accept Medicaid are notorious for being sub-par in comparison to their private counterparts.  While Medicaid targets those who are often well-below the poverty line, and private insurance takes care of people in the upper brackets, there is still a whole set of people who are neither poor but are neither capable of shelling out money for private insurance that are left without health insurance.  There are no resources for these people.

“Give me your poor, your tired, your huddled masses…” unless they’re above this income bracket and below another.  In that case, you’re on your own.

Yet even if you can pay for private health insurance, you are probably out of luck if you were to end up with a major medical condition.  While routine checkups and most lab tests are covered by most health insurance plans, the more complex procedures are oftentimes not covered.  So regardless of your status, in terms of health insurance coverage, there are problems just waiting to happen from which no one can effectively bail you out.  Russian Roulette, if you will.

Welcome to the United State, the land of freedom and opportunity.

If someone wants to have enough money, not just to pay off health insurance, but to have a decent quality of life, they need an education.  Education, especially in recent years, has become prohibitively expensive.  People who would otherwise be capable of getting into an Ivy League are stopped short by the costs, and have to go somewhere else (which may not necessarily be a bad thing, refer to my earlier post).  Inflation is driving up university costs at astronomical rates, and greater pressures are being put on colleges to construct new buildings and upgrade what they already have, adding to the cost.  Why do we have to be restricted from attending some of the nation’s finest universities by something like cost?  We have become a society of debtors, in part due to this phenomenon.  Don’t even get me started on the fact that, despite the fact that we pay through our (insert orefice of choice here) for a halfway decent education, we lag behind most of the world, especially in science and mathematics.  That’s for another post.

The irony is that I want to be a doctor with a few grad degrees aside from my MD, and currently I neither have health insurance nor a sound way of even paying for one grad degree, let alone medical school.

Welcome to the United States, land of freedom and opportunity.

Dear President-elect Obama: Do you hear the the death moans of a nation once at the pinnacle of greatness, now reduced to a society of forgotten people, languishing in their own physical and financial sickness?  You spoke of healthcare for everyone, where even the poorest person can have the same healthcare as a United States Senator.  Coming from a distinguished background, you know the pain students go through to get a decent education, just to enjoy some of the benefits that you have.  I will bite my tongue and pay my loans off as best as I can, dutifully carry around my bottle of Purrell in an effort to stave off illnesses for the time being, and look both ways before I cross the street (in a very anti-New Yorker fashion) but at some point this needs to stop.  I need to stop worrying about how I’m going to pay for my education and I need to stop worrying about whether my next step could land me in a hospital.  More importantly, though, my younger brother shouldn’t have to worry about which college he can afford to go to, or how he’ll be able to get healthcare once he’s older.  My parents shelled out a lot just to see me enjoy opportunities that in some cases, they had to forgo.  Now that the second one is lining up for his turn, I don’t want to see them struggle anymore.

Can you bring meaning back to the phrase “Welcome to the United States, the land of freedom and opportunity,” and not leave it sounding sarcastic and empty?  Can you fix it?