Tag: blog

Posted in Psychology & Medicine

Analgesic Ladder

Posted on by Jinavie

Quite possibly the most common condition that a physician needs to treat is pain. Being the main way for the body to communicate that there is something wrong, pain can take various forms to make us suffer physically. The best way to make this pain go away is to treat the underlying cause, but often the cause is unclear and we need to manage the symptoms first.

Just as there are many kinds of pain, there are numerous different types of analgesics, or painkillers. Doctors and nurses take into account various factors to decide which analgesia to use, how much to give and how often to give it. For example, opioids (e.g. morphine) are one of the most effective pain-reliefs, but it comes with many adverse effects such as vomiting, constipation, drowsiness, slowing of breathing and potentially death. To facilitate this, the World Health Organisation created the concept of the “Analgesic Ladder”, establishing some simple rules to guide appropriate analgesia administration.

The ladder has been adapted to accommodate for new research and advancing pain-relief methods, but the general principle remains the same.

First, simple non-opioid medications should be given orally and regularly. Almost always, the first-line analgesia is paracetamol (acetaminophen in USA). It is an effective pain-relief, especially when it is taken regularly four times a day, while being extremely safe as long as it is not taken above the maximum dosage (4 grams/day). As effective as it is, people often neglect to take it regularly as directed, or take it too late when the pain has progressed to a severe level, hence the common misunderstanding that it is weak.

The next step of non-opioid medications are non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen or diclofenac. These medications work particularly well for musculoskeletal pain, muscle aches from viral illnesses and simple headaches. However, they are prone to causing stomach upsets, ulcers and kidney dysfunction. They can also exacerbate asthma in some patients. It should be taken in conjunction with paracetamol as they have a synergistic effect. Because of its gastrointestinal side effects, it is recommended to be taken after meals.

When paracetamol and NSAIDs are ineffective at easing the pain, a weak, oral opioid such as codeine or tramadol is added in. These medications are powerful, but often have undesirable side effects such as nausea and vomiting, constipation, confusion and agitation.

As we step up the ladder, we introduce stronger opioids. This includes oral options such as sevredol and oxycodone, to intravenous options such as IV morphine and fentanyl. As effective as these medicines are, they must be used with caution given the significant adverse effects such as opioid narcosis, where a patient can stop breathing or enter a coma.

Other than opioids, there are various other options of pain relief that may be explored as adjuncts. Neuropathic pain from nerve damage is notorious for being opioid-resistant, so medications such as gabapentin or tricyclic acids (traditionally an antidepressant) may be used. Ketamine is sometimes used as it has analgesic properties. A PCA (patient-controlled analgesia) pump with morphine or fentanyl may be more effective to optimise the timing of doses. Long-acting opioids such as methadone may be considered. Lastly, nerve blocks with local anaesthesia, such as epidurals, are often used in conjunction to reduce the need for opioids.

Pain is an extremely useful evolutionary tool as it allows as us to avoid harm, but it can create just as many problems. The analgesic ladder helps health professionals better manage pain so that patients do not have to suffer as much while they are being investigated and treated.

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Posted in Life & Happiness

Home

Posted on by Jinavie

What makes your home a home?

The definition of a home varies from person to person. For some, it is simply their current place of residence. But for many, a place must fulfil certain criteria before it could be considered a true “home”.

For some, a home is a place of rest. It is a peaceful place where they can lay their weary heads to rest. A place where the chaos and pains of the world cannot touch you. A place where you can feel safe in your own space.
For others, it is a place of connection. A place they share with the people they love, whether it be a significant other, family or close friends. It is a place where you can connect intimately with someone at the deepest level, as you would only invite someone you wholly trust to your sanctum.

Much like many questions, this is one where there is no one true answer. Everyone would have their own reason as to why their home is a true home. For myself, a home is a home when there is normal, day-to-day domestic things going on, such as someone cooking up a meal or resting to some music.

Whatever your reason may be, the question is worth pondering because once you have figured it out, you will never feel lost in life. 

For home is where your heart is.

Posted in Science & Nature

Antimatter

Posted on by Jinavie

Nature is surprisingly balanced. For every action, there is an equal and opposite reaction (Newton’s Third Law of Motion). Energy can change forms in an isolated system, but cannot be created or destroyed as the total energy must remain constant (Law of Conservation of Energy). Similarly, matter is balanced by the existence of antimatter.

Antimatter is a substance that is the polar opposite of matter. For example, instead of positively charged protons and negatively charged electrons, anti-protons are negative and anti-electrons (or positrons) are positive. Much like matter, antimatter particles can interact with each other to form more complex particles, such as an anti-atom, meaning that it is conceivable that an entire world could be made out of antimatter.

When antimatter and matter collide with each other, they annihilate. Much like the equation 1 + -1 = 0, the two opposites cancel each other out. Conversely, to create matter out of nothing, you must create an equal amount of antimatter to balance it out. Strangely though, physicists have noted that there is a great imbalance between the two in the observable universe. There seems to be far more matter than antimatter, which does not make sense. The question of why this imbalance exists is one of the biggest unsolved mysteries in physics.

An interesting lesson we can take away from antimatter is the concept that to create something out of nothing, you must balance it out with “anti-something”. If you borrow money from the bank, you may have $1000 now, but you have also created a -$1000 debt. The total balance is still 0.

The same concept can be applied to happiness. If something makes you happy, then the possibility exists that the same thing can cause you an equal amount of grief. Let’s say you find a fulfilling relationship with a significant other who brings you extreme joy. This is balanced by the extreme grief that will be brought to you if the relationship is strained or ends abruptly. Ironically, the pursuit of happiness creates more room for potential misery, as grief comes from the loss of something we care about.

So what does this imply? Does it mean that we should avoid falling in love or caring about anything, because it will only hurt us in the end? Should we even bother trying to live a happy life if it is cancelled out by all the sadness that it can bring along the way? Of course, these are silly thoughts. How dull life would be if we did not have any ups or downs.

Instead, the lesson here is that we should be mindful that happiness is not free. Grief is the price we pay so that we can experience the wonderful moments of joy, love and connection that life can give us only if we reach out. If you avoided connecting with someone or taking a leap of faith due to fear of failure or loss, then your life would be empty. This philosophy allows us to be grateful for the joyful moments, while helping us endure grief as we know that is the price we must pay for true happiness.

You can’t let fear steal your funk. To quote Alfred Lord Tennyson: 

“‘Tis better to have loved and lost than never to have loved at all.”

Posted in Science & Nature

Car Keys

Posted on by Jinavie

There are times when you park your car, start walking away and you remember that you forgot to lock the doors. You click your remote car keys but you are already just far enough that the signal does not reach your car. Fortunately, there is a lazy way to extend your car remote’s range.

If your hold your remote against your head (such as next to your chin or your temple), you will find that suddenly, the remote works from a longer distance like magic. How can this be?

There are two explanations that factor in.

The first is very simple: height. The higher you hold your remote, the less barrier there is between you and the car, making the signal more likely to reach it. But this cannot be the only answer as the trick works when there is nothing between you and the car.

The second explanation is more technical. When you press the key to your body and click it, the electromagnetic waves that comprise the signal can cross past your clothes and skin into your body, which is mostly composed of water. The water acts as a capacitor as the signal starts to “charge” you, all the while the signal is being rapidly bounced back and forth between the remote and you. In essence, your body acts as a giant aerial that amplifies the signal, almost doubling the range of the remote.

Arthur C. Clarke once wrote: “Any sufficiently advanced technology is indistinguishable from magic”.
But even the simplest scientific principles can seem like magic until we bother looking under the hood.

Posted in Life & Happiness

Price Of Admission

Posted on by Jinavie

We are critical by nature. This is especially true when it comes to relationships, because we’d like someone as perfect as possible to accompany us on the journey of life. A large part of dating is meeting people, getting to know them better at a deeper level and trying to judge how compatible they are with us.

During this process, we might come across something that we consider a dealbreaker – that is, something that we find annoying, repulsive or unacceptable enough that we no longer desire that person. This may range from serious behaviours such as alcoholism or unfaithfulness, to benign but annoying behaviours such as chewing with an open mouth or being messy.

But with so many potential dealbreakers, how do we know which are legitimate and which are frivolous? Are we being too picky, meaning we will be forever alone, or are we trapping ourselves in a miserable, incompatible relationship, because we are not brave enough to leave the relationship?

An American columnist named Dan Savage answers this question with the concept of paying the “price of admission”. His process is extremely simple: if you cannot count the number of dealbreakers for you on one hand, then the problem lies with you. Choosing the right partner is a very important decision and you are encouraged to have a reasonable idea of what you want and what you don’t. But if your list of what you cannot live with is long and full of superficial things, then you will never find a happy relationship.

People are far from perfect, but we try to hide that fact. On a first date, we try to present an idealised version of ourselves to impress each other. We dream of finding “The One” – someone who is perfect for us. We set unrealistic expectations in our head and use it as an excuse, lamenting that we cannot find the right person while turning away potential partners because of trivial reasons. These delusions distract us from the harsh truth that no two people are perfect or fully compatible for each other from the get-go.

So if your partner has a characteristic that you dislike and it is not one of your core, serious dealbreakers, then ask yourself the question: is it worth it? Does this outweigh all of the good qualities they possess? If you believe it is, then you may leave the relationship, but you must accept that this was your choice and not your partner’s fault. If it isn’t that big of a deal, then this is a price of admission to this relationship. This is the price you must pay for the privilege of the joy, the laughter, the connection and the love your partner could provide you through the relationship.

When you see it this way, it becomes easier to accept their bad qualities. We can be angry and frustrated and annoyed, or we can choose to accept our partners for who they are – flawed, but wonderful people who are worth the trouble. Of course, you can communicate with your partner to see if you can compromise on some grounds, but this should not be an ultimatum and you cannot expect your partner to forcibly change who they are.

Lastly, remember that just as you find some qualities to be suboptimal, your partner will also feel the same way about certain parts of you. So hopefully, both parties can understand that every relationship has a price of admission that must be paid. Then, they can work on smoothing out the rough edges through communication and compromise to produce a strong, healthy long-term relationship.

The secret to a fulfilling relationship is not expecting to find The One, but instead striving to become The One for each other by rounding up.

(Image source: Puuung http://www.grafolio.com/puuung1)

Posted in Life & Happiness

How’s The Water?

Posted on by Jinavie

Two young fish are swimming along when they happen to meet an older fish swimming the other way, who nods at them and says:

“Morning, boys. How’s the water?”.

The two young fish swim on for a bit, and then eventually one of them looks over at the other and goes:

“What the hell is water?”.

This is a humorous analogy that writer David Foster Wallace told at the beginning of his commencement speech to Kenyon College’s graduating class of 2005. Although it is short, it can be unravelled to reveal many important guiding truths regarding adult life.

Much like the younger fish, many of us are not aware of the “water” that surrounds us. Although we live in it, reality is hard to process because it is made up of so many different layers of complexity. To make it easier to live our lives, our brains protect us from being aware of our reality, much like how people are not aware that they live in a simulation in The Matrix.

Even when we are aware that we are swimming in water, we keep asking ourselves “What the hell is water?”. We search desperately for the wise, older fish who can enlighten us – someone who can teach us what water is.

Many of us will be swayed by countless teachers, mentors, gurus, politicians and religious leaders who tell us to follow them to learn what water is. Many of us will firmly believe that we have grown up to become the older, wiser fish, and fight stubbornly against others who have different views on what water is. Some us may even choose to ignore that the water exists at all.

At every stage of our lives, many of us fall in the trap of believing that we have things “figured out”. Teenagers will rebel against adults, thinking that they will reinvent the world. Young adults will believe that now that they are working members of society, they are entitled to their “educated”, “mature” opinions. The middle-aged believe they have been adults long enough that surely they must have gained enough experience and wisdom on the way. And if we don’t feel confident that we know what water is, we seek the answer from those who claim they know it.

In short, we are always searching for the answer, or claim to have the answer. But that is not the lesson to take away from the parable of the fish in water.
It is not the answer that is important, but the question.

It is hubris to think that we can possibly understand how the world works completely within our lifetime. Instead, we should continue questioning what water is. Otherwise, we are just pretending to be enlightened, all the while becoming dimmer as we shut off our ability to learn and see things from a new perspective.

Consider the countless complexities that make up our reality: physical laws of the universe, the historical context, political climate, shifting cultural norms, societal pressures, chaos theory, our connections to other people… Even if you were to make sense of all this, you will never understand the reality that other people live in, as believing in only your reality stops you from being empathic and compassionate. Remember that water is a great environment for fish to live in, but a person would drown if left underwater.

This is why the parable does not tell the story of the older fish teaching the younger fish what water is. Instead, he is asking them how the water is. He is encouraging them to be aware of the context they live in and to keep question it and learning about it, while he himself stays curious as to how other fish experience the water.

So, how’s the water?

Posted in Philosophy

The Meaninglessness Of It All

Posted on by Jinavie

What is the meaning of life? This has been one of the greatest philosophical questions of all time, pondered by almost every human being at some stage in their life. In the early days, the meaning of life was simple: survive. We had to use all of our resources to feed and warm ourselves, while defending ourselves from the various creative ways nature can kill us. But as civilisation developed and we had more luxury of food, time and thought, we began to wonder more and more: why are we here?

When we are babies, the world revolves around us. Parents exist to feed us, what we see are the extension of our minds and what we cannot see does not exist. This belief carries on to adulthood somewhat. We see this in old beliefs that the universe revolves around the Earth, and religions telling us that everything on Earth was created for mankind. The concepts of destiny and divine will provided us with purpose in this world. We felt important and valuable because we felt that we were part of something greater and our lives mattered.

But as science developed, we came to learn that the universe does not exist for us. Things don’t happen because they are scripted as an intricate chain reaction as part of a grand story; they just happen thanks to random chance. Biology teaches us that life is a product of a series of accidents and mistakes, to create better adapted beings. Statistics teaches us that we are not special; just a point on a bell curve. Psychology teaches us how flawed we are in interpreting cause and effect, thanks to our brain’s tendency of seeking patterns resulting in cognitive biases.

In short, there is a real possibility that there is no meaning of life. We are simply happy accidents amidst the course of the universe’s timeline.

Yet we cling to the idea that we need to find our purpose. We cannot bear the thought that we have no celestial guidance as we navigate through life, or that our choices and actions play no role in how the world spins on. We fear that without purpose, we are worthless. The thought that life is meaningless invokes existential dread and we wonder what’s the point of doing anything in life.

However, consider the opposite. If we are not bound by fate or some calling, then our lives are truly ours. We are not chess pieces following every instruction of an unseen player. Instead, we have the freedom to make our own choices and write the story of our lives however we want. This is no doubt scary, because we have little guidance along this journey. Nevertheless, it is our story, our choices, our life.

Instead of lamenting that we serve no purpose, we can create our own purpose. We won the lottery and got to experience consciousness. How will you use that gift? Will you waste it away by doing nothing, or will you make the most of it by enjoying it? If we don’t have some mission to accomplish, then we can use our time to enjoy our passions (given that it does not harm anyone) and challenge ourselves to be better people.

The pursuit of happiness, to be the best version of yourself, to help others lead a happier life… However you want to make use of your life, as long as you are content with it and accept that it is your choice, that is the true meaning of life. Hopefully, it is something positive and constructive, rather than something harmful or something that you would regret in your final moments.

You are not worthless because you have no purpose. You are priceless because there are no expectations or plans or predestined path for you. Life is like a blank canvas with little restriction on what you can do with it. You might as well get the most value from it by painting the best damn picture you can – something for you to smile upon and be proud of, while inspiring others to paint their own beautiful pictures.

Enjoy the meaninglessness of life.

Posted in History & Literature

Rosetta Stone

Posted on by Jinavie

In 1799, during Napoleon’s campaign in Egypt, a French officer named Pierre-François Bouchard came across a granite slab a couple of miles from a port city named Rosetta. The slab – about 112cm by 75cm in size – was densely filled with ancient inscriptions on one face of it. But strangely, there were three distinct languages written on the slab: Egyptian hieroglyphs, an unknown script and Greek.

The discovery of this stone sparked immediate scientific interest. Up until this point, no scholar had been able to decipher the Egyptian hieroglyphs. The hieroglyphs had not been used formally for almost 1800 years, so the way to read it had been lost to time. Europe was going through an “Egyptomania” at the time, with great interest in this ancient civilisation. However, little was known about the culture as the ancient texts could not be read.

People quickly noted that there was a strong chance that the so-called “Rosetta Stone” contained the same text in three different languages, which meant that if you could translate one of the languages, then you could decipher the alphabet of the other two. This proved to be true, with the text being a royal decree exempting priests from taxation. Numerous scholars from all over Europe pored over the Rosetta Stone to solve the mystery of Egyptian hieroglyphs.

The first step was to translate the Greek version, as ancient Greek had already been studied in depth by scholars.
Around a similar time, a Swedish linguist named Johan David Åkerblad figured out that the middle, unknown script was Demotic, a cursive script used in ancient Egypt. Åkerblad was able to decipher the Demotic alphabet by comparing it to the Greek script, particularly through comparing names, as both languages were largely phonetic, meaning the characters used to write the name will have the same sounds in the two languages.

The final step – deciphering hieroglyphics – proved to be much harder. It was theorised that hieroglyphs were not phonetic, but ideographic, meaning each letter represented a whole word or concept (similar to Chinese) rather than a sound. If this is true, then it is impossible to decipher the hieroglyphic alphabet just by comparing it to the phonetic Demotic and Greek scripts.

But then, one scholar named Silvestre de Sacy realised that foreign names would have been written phonetically, much like Chinese scripts. This allowed him to zero in to Greek names in each script, such as Ptolemaios, thus creating a skeleton for the phonetic alphabet for both  Demotic and hieroglyphs. Scholars could then use the phonetic reading of hieroglyphs to make more headway into reading the Rosetta Stone.

After 20 years of exhausting research, the Rosetta Stone was finally fully deciphered. The Rosetta Stone is famous because it was the key required to decipher the entire Egyptian hieroglyph system, while birthing the new field of Egyptology. Being able to read hieroglyphs allowed us to better understand the ancient Egyptians’ way of life. Nowadays, the term Rosetta Stone is also used as a symbol of a key to understanding an entirely new field of knowledge.

Posted in History & Literature

Designing Under Constraint

Posted on by Jinavie

You would think that the more freedom the designer has, the more their creativity can flourish and they can produce more original, greater ideas. But it is a well-known fact in the design world that the the best designs are produced when designing under constraint.

Consider the beauty of the canal houses of Amsterdam. In the 17th century, plots of land by the canal were allocated in narrow (but deep) portions to maximise the number of houses. Architects worked around this restriction, resulting in the narrow, tall houses of various shapes and colours that we see today. Another architectural example is Florence and Santorini, where building materials were limited to red bricks or stone painted in white and blue respectively, meaning the buildings shared a consistent colour scheme, while varying in shape – the ideal combination for building a beautiful city.

We see the same in other fields. Photography is limited in the realm of time, as you can only take a snapshot. But by using long-exposure or composite images, time can be represented in unique, beautiful ways. The artistic restriction of painting led to Pablo Picasso pioneering cubism, which attempts to represent the many faces of a three-dimensional object on a two-dimensional medium. Great literature can be produced from limitation also, such as haikus or flash fiction, such as the infamous six-word story by Ernest Hemingway: “For sale: baby shoes, never worn”.

There are many reasons why designing under constraint results in greater works.

Firstly, choice and freedom can be paralysing. When we have absolutely no restricitons, rules or guidance, we have difficulty processing the sheer number of possibilities, because there are too many things to consider. We find it much easier to make a decision and proceed when there are a limited number of choices.

Secondly, constraint often comes in the form of consistency. One of the basic rules of graphic design is to limit your colour palette and font types to avoid clutter and messy design. A consistent theme is much more aesthetically pleasing. This is a core principle of minimalism.

Lastly, limitations encourage creativity as the designer has to come up with a way to overcome the restriction only with the available resources.

A fine example is Gothic churches. It was very difficult putting in large windows in church walls as they would cause structural instability. So architects devised flying buttresses to help bear the load. But even then, the technology for building large, transparent glass windows had not been developed. So instead, they pieced together small, coloured glass pieces to make stained glass windows, introducing light in to the church while telling stories from the Bible.

Ironically, limits and restrictions can be the catalyst for something better. Instead of rebelling and fighting against constraint, try adapting and coming up with a creative way to overcome it.

Posted in Philosophy

Changing The Past

Posted on by Jinavie

If time travel was possible and you could go back in time to change one thing in the past, what would you change?
Would you try to change the world by attempting to kill Hitler before World War 2 starts? Would you buy stock of a company you know is doing extremely well in the present? Would you take a leap of faith that you never did, such as asking out someone you didn’t have the courage to, or moving to a city that you always wanted to live in?

If we ignored the numerous hypothetical troubles that come with time travel, such as the grandfather paradox and chaos theory, the possibilities seem endless. This is because hindsight is 20/20 and we have a tendency to obsess over roads not taken and missed opportunities. Even though we cannot change the past, we lament how if we had the choice, we’d make so many changes to make our present and future better.

Now ask yourself this question: if you from the future could travel back in time to now, what changes do you think they’d want to try to make? The thing with time is that it marches on linearly, making every moment a past of the future. A major difference in this scenario is that unlike the first scenario, we actually have the power to change in the present and the future.

So whenever you catch yourself regretting how life would be different if you had made different choices in the past, change your frame of mind. Instead, consider what changes you could make now to make your future self have less regrets. Maybe it is treating yourself (within reasonable limits), or finally taking that trip you always dreamed of, or taking a chance on something you are unsure or anxious about, or keeping resolutions on living a healthy, better life.

Although physics (currently) dictates that time travel is impossible, our minds have the power to travel in time virtually from the future to now, letting us make choices and take actions so we can live with less regrets.

(Image from the movie About Time)