Saturday, October 4, 2014

ESBL - Extremely Sedative/Seductive/Sexy Boy's Love ?

OK. Fine, I am probably fed up with studying microbiology and their pharmacology counterpart. I wonder how can one make to remember all the odd names of microorganism and the worst part the therapeutic name of chemotherapy drug for infectious disease. Salute to ID physicians. Not to mention lots of laboratory characteristics, clinical pictures and therapeutic regime to remember. Phiew! Now I am doubting whether I can continue with Med.

ESBL - Extended Spectrum Beta-Lactamase producing organisms, usually referred to Gram Negative Enterobacteriaceae. The un-ending war between human and pathogens had started since the early beginning of human species in the written or unwritten history. Well, pathogens simply way older than us, photogenically speaking. Human and pathogen stories also made up of great part of history of medicine. We can say we are co-evolved with them. Somehow, there are quite novel suggestion that we, human are made of viruses? see video:


The first antibiotic being discovered is Penicillin, by Dr. Alexander Fleming on 28 September 1928. It had marked the start of the an era of modern medicine where people try to come out with various biologic missiles and bombs to fight against human pathogen in this un-ending war. It seems like, we are winning the war initially, but halt! Don't mess up with ancestors or our human seniors, they are master in adaptation. It has not even been a century from where human first discovered these seemingly effective "weapon" until now where resistant strains of microbes, the titans are flaring out to bash human critically.

Eradication of microbial disease is a will-o'-the-wisp; pursuing it leads into a morass of hazy biological concepts and half truths.——Rene Dubos
If the world fails to mount a more serious effort to fight infectious diseases, antimicrobial resistance will increasingly threaten to send the world back to a pre-antibiotic age. ——Gro Harlem Brundtland,
Lesser and lesser effective antimicrobial been discovered, while more and more resistance strains of pathogens are emerging, we are almost left with no option eventually. Perhaps aggressive fight is not the solution? This let us to ponder how human can live peacefully with pathogens.

Well, back to the post title, ESBL - Extremely Sedative/Seductive/Sexy Boy's Love. It is a good example of how human behaviors are closely related to human health and infectious disease. Well, I am not trying to stigmatized people of any sexual orientation, but using gay/man homosexuality as an example would yield great impact because most people have the stigma towards this group of people.

When we think of gay, what comes in our mind? SEX! I am not sure why people made this association, but yeah, GAY-SEX-HIV-SATANIC are kind of synonymous? No for me while YES for those who not concern enough.

Ok, let me illustrate how human behaviors shaped our health and affects the human-pathogen relationships. To start off, I would illustrate that there are microbes all around us and all over our body, which is known as normal flora. The relative distribution and abundance of normal flora would depends on the local factors, such as humidity, pH, temperature and so on. Well,normal floras are "normal", most of the time, but if they went left astray to some odd parts of the body where they not usually belong to they are not so "normal" after all. Speaking of sex, let me mention that the warm and humid condition of anogenital region of human being serve as a good paradise or vocation spots for many microbes, they are simply having party there.

While they longing a  bacchanal, human too are having parties, where a lots of bodily interaction can occurs to satisfy our bodily lustful desire and will sometimes end up with the intimacy of sex-homosexually or heterosexually. Phallic-vaginally, Phallic-cephalic, Phallic-anally. Choices are there. Don't assume anal sex is the privilege of gay people, man and woman can have such mode of sexual activity. OK, now, sexual activity can be viewed as the grand migration of microbes having party. Two human being at sexual intimacy, be it same sex or opposite sex, we are exchanging microbes all over with our partner, be it temporary or permanent. Well, I would like to add on that love is blind, we tends to accept everything and every bits of our lovers, then should we welcome also all the bacteria and viruses into our body with each thrust and stroke, each moans and groans. Penis, Anus, Vagina, Mouth are heavily housed by enormous microbes.

Back to gay. people having stigmas with these group of people because historically, the they are first group of people who were documented to be suffered from AIDS, well, sometimes being the first is not so good after all. But now, of 3 millions of people who had infected with HIV, most are people who practice heterosexuality. 

In my opinion, human behaviors and stigmas will continue to worsen infection diseases spread, not only HIV but also others Sexually Transmitted Disease. Also, the openness and attitude of physicians and a country to notify the world about an ongoing or emerging infections is important to break the chain of transmission of communicable disease. The worst sometimes go to health care workers that is not concern with the hygiene in clinical practice. Poor hygiene is related to prolonged hospital stay, secondary infection with hospital bugs, poor clinical outcomes and increase hospital burdens. With many evidences to illustrate the effectiveness of hand hygiene, the compliance rate of this practice is not 100%. Well, we should start to think twice when we complaining that patients are not compliant, as we too are stubborn, this is perhaps the reality of human being. Health care workers, are we given the power to kill or to heal? 

There had been one occasion where I attended a talk entitled "no more option" that discuss about the emergence of multi-drug resistant pathogen as human succumb our strategies of infection control to use of various antimicrobial drugs. The over-emphasized of treatment rather than prevention had it place for this problem. The awareness on prevention is not deep where a doctor actually ask the panel about the effectiveness and evidence of hand hygiene in controlling health care acquired infection. How ignorance, well, historically, Dr. Ignaz Semmelweis had shown us how tragedic and arrogant people can be. Read the evidence here .The ignorance among Dr.s also shown in the talk when everyone who were at least a clinical specialist or specialist-to-be tried to run off when the main speaker suggest that everyone stayed back for 5 minutes at the end of the session to learn proper hand washing techniques with the nurses. Well, Dr. I know you're Dr, but do you know you're Dr. ?

Going back to stigma, if we keep stigmatized those who are HIV positive, chances are they will find their own way to hide themselves out. It is a good thing, you would think. However, what if, one day, when you're in the same party as they are, and at that time your heightening urging libidos that drives you almost crazy, lead you to have sexual intimacy with one of them? Of course, they won't admit they are HIV positive if you're going to judge them. Also, at the emergency and burst of sexual urge, how many of us would bother to wear a condom as a protective barrier? At the end, the stigmas hurts everyone. Those who stigmatize get the disease, those who being stigmatized being torture psychologically. What for?

Well, this essay is written ad lib in a sleepless night, so you might not find any continuity, I do hope some of you might get some of the main idea. Well, ESBL - Extremely Seductive Boy's Love I would say(in my opinion). Still, I am not sure why gay is being depicted in an exotic sexual way, even most of the gay people "communicate" solely with each other in a bodily way. If it is a true love (haha, again, love is blind, we have to accept every part of our lovers?), there should have a emotional and spiritual aspects that we can go for. I know social pressure had led LGBT community being peripherized from the norm and development of the society, but I do hope one day, we can be more open-minded to these group of people. I am not encouraging people to be homosexual, but asking yourselves/pondering about it, can sexual orientation be encouraged? How many straights out there would volunteered or be encouraged to be "bent" ? LoL. We are simply born this way. Perhaps social stigmas towards LGBT society can be liken the antimicrobial selection pressure on microorganisms, eventually resistance and highly virulence strains emerged and neither human and pathogen can live with ease. Peace is the way, not the destination or result of assimilation. Things that make sense and created by straights are not necessary meant the same to LGBT, not to mention there is always some discrepancies among same group of people too. This is life, embrace the variations and celebrate the diversity, this is make what we are human.

Well, what ESBL meant to you? If I am gay, would you date me? hahaha. Don't judge! I am just a bit hyper, sleepless and imbalance for my friends are having holiday and vacation and I stuck in university, alone, wondering where's my next meal.


Well, girls don't emo, most hot, good looking guys in the market are gay? a weird phenomenon to me, or maybe it is just meant for creating the dramatic effect in gay film industries? I am confused, while people are celebrating LGBT in straights' films(do we need to categories strictly? aren't they should be just films to entertain us and to spend our past time with our love ones?), like depicting and make fun of sissies in movie scene, why when discussing about LGBT issue in society, they turn their eyes like the are not even involved/be responsible of !?

Well, good night and I hope I am sleepy, while in fact, I am not.

Friday, October 3, 2014

我的医学系第一年 :疯狂+ 那为别人生活的日子?

傻乎乎、呆头呆脑挤进医学系。那不知天高地厚的我不知道在得到什么勇气下选择了这个少有的决定——回顾小时候,我的第一个志愿是当个厨师,接下来就是就是迷上了交响乐团,想当个指挥家抑或演奏家。即将中学毕业是,觉得临床心理学家还不错,工程师也不赖。就怎么也都不想选择读医的这条路。

大学报考截止日期前几天,我把全部科系空档都填满了医学系。老实说,我以前是那种有理想不过不敢去追的青年,医学系的选择完全是因为一向来成绩不错,所以认为成绩好的人不选医学系有点浪费的心态而选下来的。结果我现在就必须为我的选择,为我种下的因,承受医学系的种种。

我的医学系第一个星期,现在回想起来我真的不知道讲师在讲些什么。我上课打盹,基本上是完全不懂为什么我需要学这个学那个。读书方法也是背的,超级辛苦!记忆力 根本不及人家。生物学又不是自己怎么喜欢的科目。再加上 自己是不明原因进来的,而且又有活在哥哥昔日辉煌成就的影子下。可以说是挺压力的。

医学系里的第一次考试,是最容易也是最困难的人生考试——我是有“背”而来的。基本上我花了两个星期去把笔记的资料完全复印进去脑子里。每天 像僵尸活着,抑或是存在,没晒到一个星期的太阳。还在考试前一天失眠加心跳急促。考试我是没有原因不会做的,因为,我都说我是有背而来的。我拿到医学系里第一个A不过我并不为此感到开心。如果要我那么压力地度过 医学系生活倒不如,走人吧!

如果你是没有愿因进来的, 那么 你最好是有留下来的原因。当年我也像其他人,都想在科系里当高材生,那高材生的骄傲光环无法抵挡。不过我很庆幸我在适当的时候遇到邱学长。他可是影响我医学系生涯 最大的学长。他让我知道第一年怎么过。医学系怎么读。没有他的帮忙,也许我现在只是一直在烦恼书怎么读的中下等学生。身为最后一年学长,我真的很感谢邱学长,不曾嫌弃那个呆头呆脑的我去问些无聊的问题。每每有想不通的问题,我都会去登门造访,一星期定时几次。

学长的指引与自身的努力是成功的踏脚石。学长可以在不同的角度上帮助 我们,教会我们生活的学长要比教会我们课业的来得更重要。只有在把大学课业融入到现实中,我们才能够学以致用。

表演——说实在,在我大学里的医学系学生可说是全职表演者,兼职学生。太多活动,来自各方的压力,让自己理所当然地也要有这个责任与大家忙了起来。别让人们发现你的表演技能,除非你乐意演出,并懂得适当拒绝。当年,傻傻的,我说了,我懂演戏。样子长得抱歉些,说要演戏只有丑角的戏份,愚弄自己,取悦他人。

卖过直男同志都吃不下的“叉烧包”,演过不可一世的Uncle Roger, 当过龌龊的“妓男”相声演员,最气愤的应该说是在大学里所谓被誉为最大的华人活动里,当了侮蔑传统的“疯癫道士”荼毒了人们对道士的印象。没关系,纵横这几年的表演,我们都倾向于扭曲传统的美妙。我可是看过至少10届的表演纪录,听过哥哥当年诉说的故事。自以为是的人们。

你会想一年里,演那么多角色,不必读书吗?时间是自己安排的,挤牙膏般地腾出时间温习功课,所幸一路上有贵人相助。不过,基本上,半年后,我可说是虚脱了。

表演——图得到的名气,将会是你往后孤寂空虚的筹码。各个角色都深入人们的印象,在人家眼中,他很会演戏哦,也许就只有这样,完了。很少人看得清傻里傻气背后的认真?就如鲜少人能够体会,成功背后的付出。没关系,自己懂。

半年后,大家开始忙了。大考的大考,结业的结业,实习的实习——大一的小弟小妹们这才真正体验到全职学生的趣味。这不然,平静的日子才不久,第二年的学长这又物色交棒人选,希望能够把那责任传承下去。这下可好,又要开始忙了!

没有华丽堂皇的结局,只有待续的期待——我的医学系第一年 :疯狂+ 那为别人生活的日子!

逝去的21……

若有一天,你知道你只剩下1年寿命,你会怎么办?
若有一天,你知道你只剩下1个月的寿命,你会怎么办?
若有一天,你知道你只剩下1天的寿命,你会怎么办?
若有一天,你知道你只剩下1小时的寿命,你会怎么办?
若有一天,你知道你只剩下1分钟的寿命,你会怎么办?

你是否还会在意自己长得不美?你是否还会在意自己的事业不够成功?你是否还会在意人们的是是非非?你是否还会在意他人亏欠你的种种?你是否会在意前些日子所贪得的小便宜?你是否会在意曾经拥有的享受?那澎湃的欲望,膨胀了,淹没了自己。人,本来都是纯洁的。待无知的人们被幻影蒙蔽后,选受苦的抉择,我们都是罪人!或深或浅,我们都必须接受我们的罪行——祈求圣人的救赎……

那天,医生手里拿着报告,很严肃的告诉我,那是急性肝脏衰竭。器官衰竭,不自然的结合品,被加冕在我身上的感觉,打翻了所有情绪罐子。那柠檬黄的眼睛,纤瘦的身子,看着医生的身影慢慢加大,那阴森的影子简直就快要把我给覆盖了。“一个月”,行刑令一下,手无缚鸡之力的囚犯,只得素手就擒,伸长脖子," 咔喳" 一下,人头落地。身首异处的躯体,慢慢的黑红色的血液渗透了每个毛孔,躺在血泊中,眼睛张着看着那无助的躯体,废掉的。灵魂破碎的时刻,侩子手骄傲地挥舞着血刀——有朝一日他也会受刑的,孤零零的头颅想。碎掉的,还是自己?还来不不及得到答案,蛆虫已经长满,入侵每个我曾引以为傲的身子。不!停!请别带走我的躯体!我哭求着。

灰黄色的骷髅,零零散散地,给这大地,添增一个黑色幽默。每个看到那未来的自己,都害怕得颤抖,我飘在风中,嘲笑无知的曾经……傻笑,狂笑,歇斯底里,谁会在无声的世界,感受到这绝望的求救?

我是实实在在的瞠着,被这突如其来的消息吓坏了。我根本不懂死是那么接近自己,毫无防备。在死神面前,我是渺小的。心情是糟透了,慢慢腐烂的心灵,快让它瓦解吧!倘若要用一种颜色来描绘那种情况,这将会是阴森的黑色。

面对着无知的,未知的世界,那死后的世界。其实,自己以往一直吹嘘,自己对死亡是多么的看得开,不过我是实实在在地感受到那个“怕”。心沉下去,刺骨的寒冷在身体传送了一遍。

那无助,真希望在临走前能抓些什么的,显然什么都带不走。越是挣扎,自己越是深陷黑色的泥泞,毫无翻身的机会。我还很年轻,我不可以这么就去了。这时的世界,光速般地离开我,我还没留下我曾经存在的印记,我就快要去了。21年的时光里,旧黄影带的重播,我看到了来龙去脉,太迟了,赤裸裸地我来到这世界,自以为是的,战战兢兢的;兴致勃勃地我走了这趟奇特的旅程,落魄的我被白色死神判下绝刑,离开了,毫无预告,一切就是那么的毫无选择。不舍不甘,我想重来,这是过多的奢望。左看看,右望望;大家何尝不是来去唐突?

前些日子,身体不适,总觉得那是小毛病。直到上个星期身体瘫痪了,罢工了,皮肤发黄,炽热的身体散发着难闻的异味,殊不知那是死亡的味道。太突然了,谁会预测灾难的来临,自己的末日。

那次被针孔扎着的意外,没想到是死神的邀请函。

我是没有什么理由不去赴约的。

一个月——想给21岁的自己为自己的生活做个总结,就好像小时后写作文,总结是必须的。我死后,我希望大家会记得我的笑容,那风中的莞尔也许能证明我曾经存在。我切切地为我曾经犯下的错误忏悔,我希望我的离去,留下的心灵能够释怀,不再为昔日的纠结而心烦。即将逝去的我,希望大家把恩怨寄予我那污秽的灵,让留下来的人继续前进,我也已经得到我的惩罚。爱我的人,请继续用给我的爱继续过活,我会好好的,希望你也是。至于许多未完成的梦,我是惋惜的,还留在世上的朋友,你们还等什么?去寻梦吧!

我多么希望当初我是时刻能感受到死亡的存在……至少现在我不是懵懂的。

今天你在风中伸出你的手,幼嫩的树叶在风中稚嫩的飘扬,

他日风中的那双手已成为幻影 ,枯黄的落叶迷茫地找寻在风中接待它的归宿。

21年的人生是场梦,惺忪朦胧中,傻笑这一切空无所实……





Wednesday, October 1, 2014

The Road to Professionalism: A Life Long Journey

http://www.youtube.com/watch?v=2R8m1jtAxVQ&index=5&list=PLF62512BCDB6EBAFD