Monday, September 3, 2012

Gotham Village Exceptionalism

Recently I have been having nightmares. My therapist friend tells me that my fears of Obama the incumbent President of America loosing to Mitt Romney is unfounded and baseless after all the most important policy that which is tearing rendering America insolvent is identical.Also, they were both pro-choice. I felt like remonstrating and countering her argument but I remembered that I had a date with Lisa to see the latest biofilm of my hero Obama the Kenyan American. The movie was Obama 2016. I left the theatre utterly disapointed and feeling that my wrst fears had developed flesh ad blood. Lisa, trying to lift my mood, suggested that we go see another Obama movie she said it was a comedy and that I would enjoy the Obama Effect but just at that time I got the signal and had to leave Gotham City for Gotham Village. It would take me nearly twenty four hours to get there but Gotham needs me and anyways Obama will loose the 2012 elections because he does not believe in American Exceptionalism.

    Because he is widely travelled and exposed to many cultures (unlike most of the voting Americans) he is able to see that other parts of the world are also celibrities in their own field. There is a British exceptionalism,German, Nigeria, Greek as well as Chinese exceptionalism. This has rsulted in a dip in his ratings at the polls. Were there any chants of "USA!USA!" at the London Olympics? I was shocked to realise that There was also a variant called Gotham exceptionalism. This was clearly spelt out by the Pastor of Gotham Village Church. But what is exceptionalism.

 Gordon Wood an American Professor of history states that  "Our beliefs in liberty, equality, constitutionalism, and the well-being of ordinary people came out of the Revolutionary era. So too did our idea that we Americans are a special people with a special destiny to lead the world toward liberty and democracy."

  Simply put, exceptionalism is a belief that we are a chosen people set aside by the Supreme Being to rule and influence the environment. American Exceptionalism incorporates the belief that we are sent by God to bring liberty and freedom all over the world and to be Big Brother to the rest of the world while maintaining a special relationship with Britain and Israel.  American Exceptionalism is what makes me thick sorry I meant to say tick but really most of us Americans are thick in the head. We believe that the 'bigger the better'. Hence we order foreign cars which have to be larger than European or Japanese base models. We treasure a footlong whopper sandwhich. We believe that Columbia is the best place to live hence we make our legal entry points seem like a journey through purgatory to heaven. But because this is America we let 11 million ilegal immigrants in through porous borders. And no one seems to care about emigration from America. This is the New Rome and we don't want to be associated with those immigrants because we are first or second generation immigrants.We are very magnanimous the ethnic Americans who with our inadvertent pogroms we have reduced to 2% of the population. The Native Americans now live in Reservations thanks to their classification as an endengered variant of Homo sapiens.

 Poor Barry sees things differently. There uncomfired rports that Obama is a chrononaught. Others say he is the Anti Christ with his Obama Care. That is not why Obama can't rule next January. Neither is it because we just discovered that he is not a natural born American. It because he gives lip service to American Exceptionalism.

    December 2010, after playing soccer with a group of Nigerian Americans in Indy Community Indoor sports complex one of my teammates misplaced his digital watch and when I said I saw the watch but left it there on the bench he was indignant at me. He asked why "didn't you pick it up are you not a Nigerian?" Nigerian exceptionalism includes having over two hundred and fifty ethnic groups and all migrating all over the world. There is no country in the world that does not have a Nigerian as a Citizeen. And the exceptional  thing is that there would be no Nigerian Donald Trump captaining a birther movement against any citizeen of the world contesting the Nigerian Presidency as long as he has Nigerian Blood. That is Nigerian exceptionalism. The Nigerian Scam is held as proudly Nigerian by those who understand the ontology of the scam that is being perpetrated on the world today by te Global Eite.The policy is do what you are sent to do in this world but if you get caught you are on your own that is why many a Nigerian is executed in Indonesia for drug trafficking.

  China is also  exceptional. China has  outperformed everyone in being the manufacturing capital of the world with a caste system of inferior goods, average quality brands and top of the range goods. This was achieved by the unwitting collusion with greedy American businessmen. China produces the knock-off before the original is in the market .Take the cloning of the iPhone 5 by a Chinese firm and  the copyright battle over the use of the name iPad in China. I think that is exceptionalism. Today you have Taikonaughts. Not synonymous wth Cosmonaughts and Astronaughts . I wonder when and if there will be Naijanaughts. You have to give it up to China. I used to wonder where the city of Beijing came from untill the 2008 Olympics which was the most wdely watched event in history. I never knew it was good old Peking. These yellow guys just woke up one morning and renamed their city just like Mumbai in India . You would think may be someday we will have the Republic of Naija or the Songhai again .No, only the Chinese are truly exceptional. I need not mention the exploits of Jackie Chan and Jet Li and Bruce Lee .

  Back to Gotham Village. This is a place in the middle of nowhere. From my high rise mansion I can see the horizon in all the compass  points. Rich Guinea Savanna, with lots of farmland for locals and immigrants that the Malthusian Theory is put to scorn. The society is cosmopolitan but traditional institutions and superstions are rife among the people. My peptic ulcer patient. Who is a farmer would not tell me how many cows he owned. He was willing to sell one to me for fifteen hundred dollars. but could not afford ten dollars for treatment. My interpreter said the cows were heirlooms and the detaills of such were not to be disclosed to strangers. Also,    
I attended to a young lady who was said to be pregnant but the husband who was translating for his wife and my interpreter who was then translating for me and the husband of the patient't get it twisted the wife did not understand the language of the interpreter at my service.

    That is not all. In Gotham there is no need for the Health Information Privacy Protection Act. It is a given that everyone knows the other persons anamnesis. The people of Gotham also believe so much in prayers. The case of burns returned before twelve hours to have the the plastic sheath I had improvised removed. This is seen as a bold step of faith. The wound is clean I hope it heals fast. In Gotham there is a police station and a magistrate court but I doubt if any cases are heard there. Another fantastic thing here is that althought there are no rights to bear arms one may say whatever he wishes as long as it is said respectfully with a lot of bending of the knee  by the ladies and prostration on the ground if you are male.

  The people are pro life that is interesting bearing in mind the pluralistic culture. I never knew there was a difference between the rhythm or calendar method of birth control and the natural method of birth control. The people of Gotham have to go to the next circle of civilization for basic tests like malaria test , PCV,  X-ray and ultra sound. What is exceptional is not that these facilities where oce available in the Village but are no longer there due to a lack of proper oversight. It is that these people carry on with thre ignorance.There is no daily market just once in five days. fiend that inconvinient but the Gotham Village life and "we like it".

  Michael Clarke Duncan rest in Peace . Why did you choose to die now and on my birthday? I take exception to that. Others may remember you for your outstanding performance in the green Mile but I remember your hilarious portrayal of a gay couple in tnd ahalf men. That reminds me Gotham Village exceptional in that there are no known gays.

Friday, August 31, 2012

Burns

Yesterday the batsignal went off. One of the buildings at the Lagos University  Teaching Hospital was on fire. The fire at the Directly Observed Therapy unit or teatment of the dreaded tuberculosis was controlled and files and documents salvaged from the prompt response of other vigilantes.

http://thenetng.com/2012/08/31/luth-fire-leaves-patients-and-staff-devastated/?utm_source=dlvr.it&utm_medium=twitter

This morning I got the signal again some lunatic near Gotham City succeeded in reducing the population by three. Also the same time three died a stampede in Kenya. That is nothing compared to the 1.4 billion at risk of dying at the hands of agent Cholera. We are so used to  agents malaria and HIV that we do not talk of it  news.
  At the time my pager went off I called the attendant at Gotham Village General Hospital. She answered at the first chime of her polyphonic ring tone,
 "Doctor we have an emmergency. Hot water burns and it is a small child!"she cried with urgency.
"What have you done?"
"Nothing, it just happened. We are waiting for you."
"Get lots of water and poor on the wound"

I hurriedly put on my clothes and bolted out. There was no Batsmobile. I remembered two years ago someone made away with my Pontiac Transport and Detective Burns of the IMPD had no clue about it. So I got into my Leggedese Benz and made it in ten minutes. That did not stop this lady from calling me again while I was at the entrance of the facility. The gate and some sections of the walls had gone AWOL.
   I met my attendant still in her nightie pouring water on the wound with another first aid amateur fanning the injury with a piece of hard paper. I quickly assessed the damage. Second degree burns, 20% body surface area, 18 months old female. I started trying to remember Parkland's formula for estimating the fluid requiremejnts. Then it hit me. There was no nurse on duty, neither was there any Lactated Ringer's nor normal saline! It wasn't practical to admit his child and it was not possible to convince these poor folks to take care of this case successfully on their own. Giving them a referral to another centre will be a death sentence.
I prayed for a miracle. I figured our greatest problems where fluid loss and infection. I sent for honey and eggs and polythene bag and guaze. the attendant had sent for procaine pennicilin and petroleum jelly. There was no rectal diazepam so this child received 5mg of tablet diazepam after grinding to form  suspension. this was repeated twenty minutes later. Oral Rehydration Therapy was the only plan for fluid eplacement. The child was wrapped in plastic and held firm with gauze. A slit was made in the groin area for number one and number two.
    I spent time lecturing both parents and their Pastor who came to sympathise with them on the salient points in caring for this child. I touched on issues like birth control but this sounded Greek to them.

   Accidents will occur in the best-
regulated families; and families not regulated by that pervading ifluence which sanctifies while it enhances them I would say, in short, by the influence of Woman, in the lofty character of Wife, they may be expected with confidence and must be borne with philosophy.

So said Mr. Micawber elaborating on an anonymous prover in Charles Dickens David Copperfield. You need to go back to the time of Dickens to appreciate this saying. Accidents are the reason for having insurance companies. In the abscence of that we have only God to look up to. That is why the pastor part of the conversation. He has to be educated about the direness of the situation.

  What is the level of awareness for accident preparedness?
Some women get pregnant without realising that although this is a physiologic (normal) process complications can and do occur. In a health system that has patients pay out of pocket it is wise to curtail the family size. Women should save money before getting pregnant. That is the meaning of family planning.
  In the index case, the farmer(subsistence level) and his petty trader (once in five days) wife had two boys and two girls and the lady still has a lot of eggs waiting to be fertilised each month at a particular time. They don't know it.
"Doctor, children come from God" The pastor solemnly reminded me.

Thursday, August 30, 2012

"She get Rival ! "

 Thrush is known medically as candidiasis because Candida albicans is the microscopic fungus which is responsible for thrush. While this organism ordinarily lives in the intestinal tract of men and women, nearly one out of three women have Candida albicans present in their vagina. This can become a problem when its numbers outgrow the good bacteria – it’s a battle of the good microbes with the bad microbes and the rival with the most survival attributes wins.

During pregnancy, the vagina becomes rich in a form of sugar named ‘glycogen’, which feeds the growth of Candida albicans. It’s believed the higher levels of glycogen occurs due to increased oestrogen levels and reduced acidity in the vagina. This is why a pregnant woman is ten times more likely to get thrush than normal – instead of being a nice cosy home for thrush, the vagina is now a five star hotel!

Other things which can kill good pro-biotic bacteria include:

Antibiotics
Birth Control Pills
Steroidal/hormonal drugs
Fluoride
Chlorine
Coffee/Tea/Carbonated Drinks
Synthetic vitamins
Radiation
Stress
Additives
Pesticides
Fertilisers
A high acid diet can also cause havoc with good bacteria in your body and allow bad bacteria to thrive. Switch to more alkaline foods in an alkaline diet – you’ll feel so much better with so many aspects of your health, from good bacteria, to energy and less headaches.



Thrush is not a sexually transmitted infection (STI)


Thrush is not a sexually transmitted infection (STI) because many people already have small amounts of the candida fungus in their bodies. The fungus does not usually cause any harm because the body's immune system keeps it under control.
However, anything that weakens your immune system, such as an illness, like depression, or antibiotic medication, may cause the candida fungus to multiply, increasing your likelihood of developing thrush.

(http://www.nhsdirect.nhs.uk/en/sitecore/content/ExternalLinks/NHS%20Choices%20-%20Pregnancy%20and%20thrush)

I first learnt how to manage  thrush in pregnancy from a great rival of mine. He was a Senior Registrar ( Chief Resident ) and the rivalry was over the beautiful female medicos. I don't recall having learnt any other thing through him. You see
a little knowledge is dangerous.



"A little learning is a dang'rous thing;
 Drink deep, or taste not the Pierian spring.
 There shallow draughts intoxicate the brain,
 And drinking largely sobers us again."

The full text of Alexander Popes poem is so long and beautiful that I can't resist copying and pasting some of it.


And drinking largely sobers us again.
Fir'd at first sight with what the Muse imparts,
In fearless youth we tempt the heights of Arts,
While from the bounded level of our mind
Short views we take, nor see the lengths behind;
But more advanc'd, behold with strange surprise
New distant scenes of endless science rise!
So pleas'd at first the towering Alps we try,
Mount o'er the vales, and seem to tread the sky,
Th' eternal snows appear already past,
And the first clouds and mountains seem the last;
But, those attain'd, we tremble to survey

The full text can be found at http://en.m.wikisource.org/wiki/An_Essay_on_Criticism

  For me Medicine with all its branches is the Pierian spring. drinking deep means a lifetime of study. I had a lot to learn when I challenged the senior doctor about contact tracing and treatment for fungal trush in pregnancy. My interpreter was just making the same mistake I made several years ago.

  She has got a rival for her husbands number one but we will not spend scarce resources chasing after immunocompetent persons. She also has a rival living in her uterus and this was the cause of her problem. She will get better after she is delivered of the products of conception. She had got the condition in the past and got some herbal treatments which did not help her until after the birth of her first child. In pregnancy the products of conception are actually  foreign  body whose tolerance can only be achieved by a slight immunosupression. We all have rivals but she has one too many.
.
Concluded

Wednesday, August 29, 2012

" She get (has got a) rival ! "

Three days ago(on the 26th of August) a group of women staged a protestin New York to draw attention to the situation of inequality in topless rights. Their argument is that it is sexist and discriminatory to put women in jail for showing their nipples. Thus they marched topless around the city where it is legal to go topless. Back in high school a friend of mine had suggested that boys should also get special the sanitary pads that were distributed to the girls. This week, Apple's top executives and lawyers smiled out of the courtroom with a billion dollar jury verdict against Samsung. This also represents a victory over Google their arch rival. Steeve Jobs must  be pouring Champagne now because his promised "thermonuclear war" against Google is picking up steam. Samsung is just an unfortunate little fry in this epic battle of the big fishes. Samsung and a hosbt of other tech companies use the Android platform developed by Google which Apple claims stole Apple patented technologies.
   Rivalry is a natural instinct of competition existing between similar  entities. It is as old as creation. The first recorded case of rivalry was that between the beautiful and proud Angel and the Supreme Being.
This event has led to a lot of catastrophic and phenomenal events and this will continue as firetold in eschatological prophecies.
This rivalry is eternal, ad infinitum, it will last till a time of the large infinity and was there at the time of the small infinity.
   At face value it would seem like the lesser rival is gaining an upper hand. This entity is winning a lot of souls to his side via a lot of strategies. The divine rivals seem to be contesting the title of the Light. It seems like the handsome Angel had this title initially but was stripped of it when she lost the first Great Battle. Lucifer's agents still call him the bringer of Light although the Christ the Son of the Supreme One pronounced Himself The Light of the World, The  Bright Morning Star.
 This rivalry rages on . There is so much confusion in the world today because of this ancient rivalry. Thus it is only a thin line between Good and Evil. Jesus who mostly spoke in parables for whatever reasons gave us one clear tip: that by their fruits you shall know them but these entities fruits can take a timescale which is divine to mature. This divine time scale is outside the dimensions of Space-Time. It took perhaps a 425 years perhaps 13.7 billion years  before Jesus Christ corrected or remedied one of the catastrophes of this enduring rivalry. Two thousand years later the true light bringer is elusive. The Jesuits are accused of everything contrary to their name and New Agers speak about peace and love and light more than the Vatican that considers it a false religion.Some muslims kill their rivals in the name of the Supreme Being while we allopathic medical doctors battle for patients with our alternative medicine rivals.
    At Clinic today, I saw a patient who complained of passing blood via the number two. I made a diagnosis of NSAID induced bleeding peptic ulcer. This lady believed that her enemies who wanted to kill her were after her. She had presented to a city clinic in Lagos where she was placed on the standard anti ulcer regimen but failed at compliance. She resorted to herbal medication which caused the bleeding per rectum. She
  was so pale that I had to place her on bed rest on admission.
    A pregnant woman gave me a  start when I saw that prominently placed on her gown over her protruding abdomen was a large shiny office pin. My fear was that she could puncture her abdomen with the pin since the sharp point ws oriented inwards. My interpreter said she had the pin on or protection against her enemies.
   The next patient I saw was also pregnant. This woman had profuse milky discharge from number one. I had a Nurse and an interpreter attending the woman at the same time. The attendant who had nineteen years of service to her credit acting as health worker where there is no doctor was superconfident because is aware of the guidelines of managing sexually transmitted infections. The nurse felt she could not manage the patient. I prescribed topical antifungal cream and my interpreter said " Doctor she get(patient has) rival o!" . I did not get it right away. She repeated her statement and the nurse (God bless her) trying to remind me to do sexual contacts tracing etc.
To be continued.

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Tuesday, August 28, 2012

The New Batman

It seems like the Summer Olympic games of 2012 or rather of ZION is over. The Dark Knight Rises is doing well in the theatres despite the shootings that tarnished its premier. The $230 million blockbuster would have earned a billion dollars in ticket sales before I conclude this debut of mine as a blogger.
    Yesterday, I met Samson who I last saw fourteen years ago. I met him on the way to the hospital. He was on his commute to deliver a 9:00 a.m lecture so we couldn't yak as much as I would have loved to. At ward round I attended a lady who had twins but lost one as a fresh still birth. I wonder if could have done anything to save that life. Anyways the patient who was not even stable with fever and bilateral leg edema up to the knees was itching to go home. I wouldn't have that. Admission at the hospital was free so I see no reason to let her go. The baby was perfect but I stressed the importance of monitoring her baby. At the moment it was baby boomers 1: 1 sustainable developers.
  The story of batman is said to be concluded with the July 20th release of this much anticipated thriller. Fandango claims it earned only $  7.2 million. I don't know if those stats are for Aroura alone. Well there seems to be an indication that Batman will continue to be but played by another hero. I think I know who that is.
   There are a lot of similar occurences between the old and the new Batmen. They are apparently rich and sophisticated reclusive bachelors with a love for techies. At this village I am living all alone in a mansion. I am brave enough not to be scared of whatever bird that is outside in the vacant slot in the wall for an aircondition unit. Conversely, I am repulsed at the stench oozing off my X-Ray Room at the hospital. The hundreds of bats there are reminiscent of a new hesitant batman at a Batcave!