‘upper class’ disease? planting racialism and classism amongst human sufferers in a world where All men are created equal!

Your primordial reaction should be one of downright disgust. How dare we plant racialism and classism amongst human sufferers in a world where All men are created equal! But are these thoughts merely snappish impertinences of useless intellectuals? Or smug imaginations of some quirky scientists bent on hacking the world into social pieces? Or do we have a rationale here

 let those who are ignorant of the federal constitution make fools of themselves...my humble request to pas is.....until and unless you can secure a 2/3 majority in parliament it would be counter productive if you keep harping on this issue....not ALL muslims are in favour of hudud.

DAP chairman Karpal Singh today warned the MCA to stop exploiting the hudud issue among Malaysians.Urging MCA to stop its act as it was a waste of time, he said, "In any event, it is not going to work".   Karpal was commenting on the reported quote by MCA central committee member, Loh Seng Kok, saying DAP leaders, with the exception of national chairman Karpal Singh, were mere "yes men" for PAS.  Loh also stated that DAP adviser Lim Kit Siang and his son Guan Eng may as well step down as they had failed to stop PAS from pursuing its goal of implementing hudud in the country.   Karpal Singh said the statement was unfair as DAP's stance was always against the hudud law and an Islamic state.   As to whether he would take any action against MCA if they carried on about the issue, Karpal Singh said "If they do not, then the people will stop them in the coming general election".  "Just like how the people almost eliminated the MCA in the last 2008 polls. The people can do it again. At that time, MCA was on the brink of elimination," he warned.  He added that DAP however accepted Islam as the official religion, provided for under the Federal Constitution. 

 Islam has proven itself to be a great civilisation for a long time. It is hardly possible to think of a civilisation that can survive, without being appreciative to rational inquiries and intellectual pursuits.For civilisation is nothing but the refinement of every aspect of human life through rational investigation and human experience within any framework of a worldview.In the case of Islam, although the development of its civilisation was inspired by the spirit of revelation and progressed within the framework of religious worldview with tawhid as the central theme, the gradual unfolding of its various civilisational aspects in history took place through diverse intellectual inquiries.This is reflected in countless great intellectual works of Muslim scholars throughout the Golden Age of Islam. In addition, science and philosophy flourished in the Muslim world while translations by Muslim scholars of great works from the zenith of reason at that time, the Greek civilisation, were very much active.Secondly, the Quran as the source of Islam is far from anti-reason.Replete with verses challenging human beings to use their reason, the Quran quite often ends some of its verses with phrases like “will you not use your reason?” and “so that you might use your reason” which are mainly directed at those who are inconsistent in their thinking and actions.In the same spirit, the Quran does not ever portray people who are reasonable and contemplative as bad and vile. On the contrary, they are described as those who are on the right path and are close to God.

Your primordial reaction should be one of downright disgust. How dare we plant racialism and classism amongst human sufferers in a world where All men are created equal! But are these thoughts merely snappish impertinences of useless intellectuals? Or smug imaginations of some quirky scientists bent on hacking the world into social pieces? Or do we have a rationale here?

Truth be told that there do exist diseases more inclined for the rich and affluent just as certain other diseases hog the limelight from the not so socially privileged. The immediate and easy reasons are social and directly related to economics. After all one of the cardinal indicators of health care status of a country is accessibility to health care, a direct outcome of socio-economic status. In a world of open privileges and secret connections, people with low income have neither and suffer both ways. They have neither the money to afford the very best of medicine nor do they know the right telephone numbers to access the right privileges. 

One quick example and the picture will shout out loud and clean. Take for instance, breast and cervical cancers. Both are invariably higher in the underprovided populations simply because they fail to access the screening tests of mammogram and Pap smear. Lack of education, time, and of course money form the fulcrum of many a potentially preventable disaster. And again, smoking and drugs…two vices that form the sine qua non of the socio-economically backward sections typically provide with all the ingredients of unexpected and premature cardiac and cerebral fatalities. 

We all know these. No rocket science behind this. It’s a global issue and spares no country. Even in United States, that represents one of the finest health care systems, discrepancies creep in. A certain taciturnity sets in whenever these disorders are noticed in the murky recesses of an otherwise good looking health care system. If you don’t have health insurances, you are in trouble. And if you attempt to socialize health system, you are barked at. Ask President Obama and you would know what I mean. Yet its implications are huge in terms morbidity and mortality.

But then let’s throw money out of the equation. Can we still have a disease that’s restricted to the upper class with or without money? According to many psychologists and to many of us…yes! Studies have shown that kids of lesser means actually do better emotionally. There’s a certain "psychosis" among upper middle class parents who are too wrapped up about where their children go to college. Getting a grade B is a disaster. Not getting into Harvard or Yale? It’s a crime! Social shame, peer pressure…and you have a nice cocktail of anxiety, stress, paranoid, depression and eventually in none too exotic situations – a plunge for the rope, the jump, or the pill. The origin of bulimia and other eating disorders sprouted from the concept of ‘thin ideal internalization’. None of these upper crust university students had any concept of hunger, for none of them never really missed a daily meal. On the contrary an over obsession for a perfect body image leads them to such compulsive purging or anorexic habits. 

So, there you are…even in disease, we stand divided. Is it the money or the mind? Or a bit of both? What do you say?

There are essentially three types of diseases. Quite like our personalities. One type fumes. They are like the monarchs. They announce their advent, they barge in, they trample. We humans either hurl defiances or we yield. The other flaunts. They flutter their wings, tease a wee bit, and then they depart. Quite like the socialites. There is a third type though. The unknown devils. The serpent in the grass…the slow wriggle, the blinkless stare, before the final smack. These are the ones patients are unaware of, and these are the ones we physicians are wary of.

Fatigue forms the epitome of this third type. Trashed and dismissed as tiredness and with a 'get your butt of your chair' kind of attitude, fatigue is that seemingly innocent bystander who with minimum flair would inflict the most decisive hack. Rhetoric  aside, we will deal with the facts.

As a clinical entity fatigue comes in many shades, present to variable degrees in individual patients. A common presentation is an inability to initiate activity (perception of generalized weakness, in the absence of objective findings). Closely following this is the reduced capacity to maintain activity, otherwise called easy fatigability. And then the worse. Difficulty with concentration, memory, and emotional stability… what we call as mental fatigue. So whether it's a recent fatigue, prolonged fatigue or a chronic fatigue they are almost always the harbinger of an occult happening.

Let us then address the ones hidden just beneath the surface. Depression with its entire aura of inexplicability frequently comes out as fatigue. Long long before the hair tear begins, the desire for the rope sinks in, extreme, relentless fatigue becomes the frontline feature. Same with anxiety. And more importantly, domestic abuse. Literature is explicit that victims of domestic abuse often tucks themselves in a quiet corner, reluctant to release. What pours out is fatigue.

And of course malignancy. Any and every cancer hides beneath the cover of fatigue. And while we sprint around, shopping for over the counter energy pills, or worse, herbal remedies, it spreads wide and deep. We will remind ourselves that of all diseases, cancer is one disease where time is like a diamond. Yet the delay, while fatigue feigns unnoticed and unchallenged.

The list is long. From thyroid, to heart to diabetes to drugs, fatigue is all what we suffer from until the Pandora box opens and spills the beans. 

Thus realization. Realization of a single thorn that can encompass a harvest. From realization will come awareness. Awareness that fatigue is a formidable foe that must be addressed, respected and taken into consideration. 

If you ever flip through the annals of human sufferings, you will come across certain diseases that are set in stone. And certain others that are constantly evolving… ever restless, ever dynamic. The more you probe, the more you discover, the more they evolve. Diabetes, without any hesitation tops the list.

One of the worst fears we harbored as a student was a topic concerning Diabetes. For, anything and everything can come from this dreaded question. Banter apart, this is one disease that can attack any place of our body, can kill in any number of ways, and more importantly can flaunt or hide like a perfect charmer.

Give me one more disease that is so catholic. From the very young to the very old, from the very royal to the very pedestrian, this is one disease that really doesn’t care who or what you are. Very few diseases can claim to be so protean in nature. So diverse, yet so deep.

Thus, if one is diabetic and is persistently tired, it can be anything from an impending heart attack to a well settled kidney failure.  For diabetes is not the eagle that swoops and flies. It’s the serpent in the grass that crawls, chooses and chews cell by cell. And by the time we feel its expressions, the damage is done.

Silence is another catch phrase of Diabetes. Silent heart attacks, silent Aortic Dissections, are true nightmares on silent nights. In other words, one does not have the pain, yet one feels the gloom inside. Outcome? Pretty much fatal, for with no crushing pain, we tend to tough it out.  And with disastrous consequences.

So, what are the buzz words? Blurred vision (retinopathy), facial and pedal swelling (nephropathy), numbness (neuropathy), chest pressure (coronary artery disease), all form the center stage. Some of us know these. Yet it doesn’t harm us to remind ourselves how life threatening this disease can be, if allowed to prosper. But as I wrote before, Diabetes is much more than this. From diminishing sexual drive, to relentless tiredness to constant skin ulcers, this disease loves our body.

Do we have a remedy? Can we get on top of this disease? The answer is an absolute yes! For, despite genetic compulsion, one gracious truth that emerges from our ruthless battle with Diabetes is an understanding that a lot of it is created by us. And hence can be cured by us.

The problem is we Malaysian, we Asians, we sojourners of this plant are one big calorie eating race. There’s calorie everywhere…rice, coke, pizza, cheese…the list is endless and still growing. Cut down the calories and you have won half the battle. The governments are doing no good in allowing such high calorie substances to flourish all around us.

In New York City, Mayor Bloomberg has drawn a lot of flak in attempting to curtail soda intake. I don’t support these so called liberals. My view point is straightforward. If we have officially restricted cigarette smoking, we should do the same for calorie intake. For both are dangerous. In matters of health there is little to opine.

Couple this with daily exercise (one doesn’t have to learn aerobics, simple walks will do) and we can beat this beast. Not that we are unaware of these remedies, but we got to walk the talk. More importantly this realization that this disease can be silent and fatal should be our first step of management. In most cases, awareness forms the fulcrum of disease treatment.