This scenario psychoanalyses how you prioritise your life and what you place the most importance in.
You are out camping, but end up lost in the woods. It has become dark but luckily you find an empty cabin. Under the dim light, you discover the cabin is equipped with a fireplace, a stove, a lamp and a candlestick. In your backpack you only have one match.
What would you light first?
(Source: http://browse.deviantart.com/?q=match%20girl&order=9&offset=24#/d1dzl83)
CPR stands for cardiopulmonary resuscitation – or in plain English, artificially (and partially) restoring the function of the heart and lungs of an unconscious, pulseless person. As blood flow (perfusion) is critical in the survival of major organs such as the brain, this procedure can save lives by prolonging a victim’s life until the paramedics arrive to provide professional medical care.
When the heart stops beating, or becomes inefficient due to erratic beating, blood flow stops. In the case of the brain, this means that the cells will start dying after 4~5 minutes if perfusion is not restored. CPR can restore about 30% of perfusion, delaying the onset of brain death.
This may be critical when someone suffers a heart attack (myocardial infarction) and paramedics will not arrive for over 10 minutes. Ergo, this is one of the most important emergency skills one should know to help people in need as soon as possible.
There are different guidelines for CPR in many countries, but here is a standard procedure guideline (NZ).
It is summarised into the acronym: DR’S ABCD (doctor’s ABCD), and is a flowchart that goes from one step to the next (detailed explanation after summary).
The first rule of first aid is that you must not put yourself in danger. For example, if the patient is on the road, pull them to a safe area to minimise the risk to your own health.
Then, check for a response. The easiest way is to call loudly to them such as “Can you hear me”, and inflicting pain (such as rapping on their chest or shaking their shoulders) and see if they become conscious.
If they remain unconscious, immediately designate a person around you by pointing to them (otherwise they will be less likely to be responsible) to call the emergency service (111, 911, 119 etc.), alerting them the location and state of the patient.
This is the point when clinical skills come in.
Airway: An unconscious person may have their airway obstructed by vomit or their own tongue (which falls back by gravity into the throat). You must secure the airway by scooping out any material, and clearing the tongue out of the way. This is done by tilting the head back far (as if they are looking up), then using one hand to pull their chin out. This opens the airway up so that mouth-to-mouth becomes effective.
Breathing: Put one ear right next to the person’s nose and mouth and check for any breathing sounds or air flow. If they are breathing, check the pulse to see if they are pumping blood. If not, go straight to CPR.
Circulation: It is best to check the central pulses such as the carotid (side of neck, next to the Adam’s apple), brachial (squeeze inner side of biceps) or femoral pulses. The carotid is often the easiest as most people know how to take it. If you feel a pulse, put the patient in recovery position as they are just unconscious, breathing and has blood flowing. If not, proceed to CPR (as you do with when the patient is not breathing).
CPR is composed of two actions: chest compressions and mouth-to-mouth breathing. The former is the strong compression of the chest wall to squeeze blood in and out of the heart; the latter is breathing air into the patient’s lungs and letting exhalation come out naturally.
Chest compressions are often misrepresented in medical dramas, and is extremely important that you do it correctly. First find where the sternum is (centre of ribcage, between the nipples) and place the heel of your left palm on it, then spread your fingers out. Put your right hand over your left and close your fingers around it for a good grip. If the patient is lying flat on the ground (with head tilted back), kneel beside them and stoop over their chest with straight, locked arms (bent arms exert much less pressure).
You are now ready to begin chest compressions. Press down hard, until the chest wall is compressed to about 1/3~½ depth (the chest wall is a springy structure, and do not worry about broken ribs, as being alive is more important for the person), then ease pressure to let it bounce back up. Ideally the time pushing and the time letting it bounce back should be the same, giving a good rhythm. Repeat this 30 times at the beat of 100/min, or in easier terms: to the beats of the Bee Gee’s song Stayin’ Alive (scientifically proven).
After 30 compressions, tilt the patient’s head back, lift their chin up, and lock your mouth over their mouth and nose to make an airtight seal. It is crucial that you use a face shield to prevent the spread of disease. Be aware that breaths are less important than the compressions, so if you do not have a face shield, let someone else do the breathing and focus on chest compressions. Pinch the nose closed to ensure air does not escape.
Forcefully breathe into them and look for the chest rising. Let go of the nose and pull away so that they can breathe out. Repeat once, then return to chest compressions.
After 2 minutes of CPR (30 compressions : 2 breaths, repeat 4 times), change places with another person capable of CPR, as otherwise you will tire out and become inefficient.
Defibrillation is only possible if you are near an AED (automated external defibrillator). Nowadays, AEDs are designed to be completely user-friendly so simply follow the instructions on the machine.
It is important to note that not all abnormal heart rhythms are “shockable” (see Flatline). Follow the AED’s instruction, as it will state whether shock is advised or not. Make sure that CPR is still happening continuously.
Repeat until help arrives.
As a final note, remember that the patient is dead whether you do CPR or not, so there is nothing to lose. Believe it or not, this will be of incredible help in calming your mind when struck with such an emergency. Even with CPR, there is a maximum 30% chance the patient will survive, 10% if it occurs outside the hospital. But if you do nothing, their survival chance will be 0%, so put all your energy into resuscitating them, and you may just save a life.
When people think of the word “flatline”, they immediately visualise a medical crisis where a patient is lying unconscious, with doctors and nurses shouting out medical terminology while administering drugs, all to the suspenseful music and apathetic monotone and single horizontal line on the ECG machine. The doctor then shouts “Clear!” and proceeds to shock the patient with two paddles. This is repeated until some structures appear on the ECG, symbolising that the crisis has been resolved.
Of course this is a scene from a typical medical drama. Television shows, especially medical ones, are notorious for sacrificing medical accuracy for the sake of drama and tension. The “flatline” is the most cliché, repeated mistake made by almost every medical television show ever made.
The proper terminology for a flatline (a colloquial term), is asystole. This means that there is no systole, or contraction of the heart. An ECG (electrocardiogram) measures electrical signals in the heart, and in asystole there is insignificant amounts of electric activity, and the classic QRS complex is not seen. In this state, the heart is not pumping any blood and is electrically silent, meaning that the patient is clinically dead.
When asked how to treat this condition, the majority of people (even medical students) will shout “Shock!” or “Defibrillate!”. Defibrillation is the administering of an electrical shock to try “reboot” the heart, and correct the fibrillation – the chaotic electrical signal interfering with the normal, rhythmic electrical activity. Unfortunately, this is completely wrong yet so often depicted on television and films.
As asystole is a state of no electrical activity, there is no fibrillation to remove, nor is there anything to reset. Defibrillation in this state may even cause harm, causing tissue damage and lowering the chance of survival.
The correct treatment is injecting adrenaline (epinephrine in the U.S.A, atropine may be administered also) and CPR. Unfortunately, asystole is a condition that cannot be reversed, unless the heart somehow restores its own electrical activity. CPR merely keeps the patient’s perfusion going to preserve the organs for a longer time. Ergo, asystole signifies certain death, especially after 5 minutes where the heart will not respond to any drugs or electric shocks. In fact, asystole is one of the conditions required for the certification of a patient’s death.
Another related example of a (potentially fatal) misrepresentation of medicine in the media is the adrenaline injection. As mentioned before, this is the treatment for asystole. However, it is administered intravenously (into a vein) and never directly into the heart as in Pulp Fiction. This is more likely to kill the patient than save them, as the heart muscles could be damaged and delicate coronary arteries may become ruptured.
So why is it that the media continues to depict such blatant errors, that set a “common sense” that affect even medical professionals? This is most likely due to the audience wanting to see a dramatic scene, in a gripping life-or-death situation with drastic, powerful action. For example, the audience would much rather see the use of paddles or a giant needle being stabbed into the patient than seeing continuous CPR with no showy movements.
The next time you watch a medical television show, count how many times the doctors try to defibrillate a flatline.
Dreams are wonderful things. Within a dream, nothing is impossible and the mind unleashes its full potential creativity. Is there a way to harness such power? The short answer is: yes.
Lucid dreams are defined as the state of being aware that you are in a dream. This means that unlike normal dreams, you know that you are dreaming. Although this may sound easy, it is quite hard to enter and stay in a lucid dream. Many people experience a lucid dream a few times in their life, but tend to pass it off as a normal dream or some paranormal event (many “out-of-body” experiences can be explained as lucid dreams).
The major difference between a normal dream and a lucid dream is the ability to control your dream. This concept is explored in detail in the movie Inception, where characters utilise the creative power of dreamspace, tricking the victim that they are in reality to manipulate information out of them. Inception is actually a great example of what a lucid dream is like: the architect can manipulate the dreamspace to her wishes, even going as far as ignoring the laws of physics and conjuring objects out of nothing. This ability is not exclusive to movies – you too can exert this power within your own dreams, every night.
The most important point to remember is that lucid dreams are based on memory. Reason being, if you cannot remember the dream, then it might as well not have happened. Also, you need the ability to distinguish a dream from reality, as otherwise it will pass you by without you realising. There are a few tips and tricks that can help the induction of a lucid dream.
Firstly, keep a dream diary – a record of every dream you have in excruciating detail. This not only trains your ability to remember dreams in detail, but also lets you prepare for when a lucid dream comes. So every morning when you wake up, record whatever you can remember from the night’s dream. Many people complain that they never dream, but this is false – they are merely forgetting it. After keeping a dream diary for at least a couple weeks, you will find that the frequency of dreams increase dramatically, with increasing creativity.
Secondly, look for dream signs. You will notice from your dream diary that certain things appear often in your dreams. This may be a certain person, an impossible object (such as the staircase from Inception), meeting a deceased person or something happening (e.g. falling). A classic example is a clock. In a dream, when you look at a clock (preferably digital) and blink, time suddenly leaps around, such as 3pm suddenly becoming 6pm. Looking for these signs in your surrounding can easily alert you to the fact that you are dreaming.
Lastly, do reality checks as often as possible. These are actions that confirm that you are in reality, or conversely if the check fails, that you are dreaming. Reality checks are represented as totems in Inception, and although the risk of “getting lost in a dream” is close to nothing in a lucid dream, it is an extremely useful tool. Reality checks (RC) are based on the fact that the laws of reality do not function in dreams. For example, a common RC is bending your fingers backwards. In real life, your fingers will only go back so far. In a dream, the fingers can touch the back of your hand: a definitive proof that you are not in reality. Other examples include breathing through a pinched nose, pinching yourself (no sensation in a dream) and… anything creative actually. The general rule is: “habituate what is not your habit” – i.e. make a habit of something that is not usually your habit, so you can do it in a dream as a RC.
After a few weeks practising using the above skills, prepare your mind for a lucid dream. Every night before going to sleep, keep thinking “I will dream” or “I will stay awake in my dream”. Continuous reinforcement directly increases your chance of “waking up” in your dream, and allows you to begin your journey into lucid dreams.
As mentioned above, within a dream, you have almost godly powers as you can manipulate the entire dreamspace to your will. However, there is a catch: you have to control the dreamspace. This may sound absurd, but it will be relevant when you have your first lucid dream. Dreams are like wild mustangs – they will spiral out of control as soon as you try to take control. For instance, a novice lucid dreamer (or, in Greek, oneironaut) will find that as soon as they acknowledge that they are in a dream, they will instantly wake up. This is a form of defence mechanism as the boundary of reality and dream is faded, causing your brain to become confused.
There are methods to help your stay in dreamstate. It has been suggested that when you notice signs of waking up (e.g. the surroundings become blurred and slowly disappear), spinning on the spot can prolong the dreamstate. Rubbing your hands together also helps. The duration you stay in the dream becomes longer as you become more proficient in lucid dreaming.
This is only the first step. The more you manipulate your dream, the more your brain will “reject” your dream-self. Again, this is seen in Inception (it is actually quite an accurate depiction of lucid dreaming). You will find that through practice, you not only lengthen your lucid dream, but also increase the power to manipulate things. In the advanced stage, you will not only be able to completely recreate the world around you, but also achieve flying and the ability to summon people.
A final point to learn about lucid dreaming is that there are two ways into a lucid dream: DILD and WILD.
The first, and the most common, type is Dream-Induced Lucid Dream. This is by far the easiest method. In DILD, you “wake up”, or become self-aware, in a dream and then continue to dream the same dream (except now it is lucid). It is easier to achieve this during a nap or when you go back to sleep after waking up in the middle of the night.
The second, and more advanced method, is the Wake-Induced Lucid Dream. WILD is when a lucid dreamer can go straight into a lucid dream from a state of alertness. This lets you enter a lucid dream anytime at will, and can be more powerful than a DILD. However, there is a catch. WILD easily induces sleep paralysis (see Sleep Paralysis) due to the forced induction of REM paralysis. This can be a horrifying experience for the unprepared, especially due to the nightmarish hallucinations it brings. But after practice and the correct mindset, you can easily vanquish this state with willpower, and freely enter a lucid dream. Sleep paralysis should not deter you from attempting lucid dreaming, for it is only a temporary side effect.
Lucid dreaming is one of the most useful skills one can learn. Not only does it let you explore your mind freely, you can go deeper to discover your subconscious (often through imagery), solve complex problems you couldn’t in real life and relieve the stress built up from reality. An interesting feature about dreams is that time is completely relative; this means you will enjoy a lengthy dream much longer than your actual sleep, giving you a better rested sleep. If you are lucky, you may even enjoy the delightful experience of a “dream within a dream” (or go even deeper).
Oneironauts, dream on.
This is the story of how one man’s choice lead to a great war.
One day, Zeus held a banquet to celebrate a marriage, but did not invite Eris, the goddess of discord, for obvious reasons. Infuriated, she came up with a cunning plan, in which she arrived at the banquet, tossed a golden apple at the crowd, and disappeared.
On the apple, it was inscribed: For the fairest one.
Three goddesses approached the apple, claiming that it belonged to them: Hera, Athena and Aphrodite. They demanded that Zeus be the judge of who was the fairest, but Zeus knowing it was a catch-22 delegated the task to a mortal: Paris of Troy. This shepherd-prince was approached by each goddess, who offered a bribe using their godly powers.
Hera, the queen of gods, offered to make him the king of Eurasia, symbolising power and wealth.
Athena, the goddess of wisdom and war, offered great strength and wisdom.
Aphrodite, the goddess of love and beauty, offered the most beautiful woman in the world: Helen of Sparta.
After some thought, Paris presented the apple to Aphrodite, giving her the title of the “fairest one”. This earned him not only the beautiful Helen – who became infatuated with him under Aphrodite’s powers and brought to Troy – but also the scorn of the other two goddesses. Using their influences, and the fact that Helen was the wife of Menelaus – king of Sparta – the Trojan War sparked as Sparta formed a Greek alliance force to attack Troy, to reclaim their queen and seek vengeance and blood.
This goes to show how a man’s life, or his nation in the case of Paris, can be destroyed by the basic instinct of lust.
A few years ago, a theoretical physicist studied population growth in cities to find the mechanism of how cities operate. What he found was an astonishing law.
Wherever the city, as the population doubled in size, the average income, number of patents, number of educational and research facilities and other important numbers all increased around 15 percent. Although it is normal for such statistics to increase as a city grows, it is interesting to see that almost all of them increasing at a similar rate, despite being so different sometimes.
More fascinating is the fact that not only do the above “good” statistics increase equally, but so do crime rates, pollution, smog occurrence, stomach flu and AIDS prevalence all increase approximately 15 percent.
Therefore, a city can be seen as a double-edge sword that is both the source of fast growth, wealth and ideas, but also waste, pollution, stress and disease.
Biologically speaking, an organism has a tendency to have slower growth and pace of life as it gets larger. For instance, an elephant’s heart beats slower than a mouse, and its cells do less work on average too. However, a city exhibits a snowball effect where it grows faster as it gets larger. To achieve this extremely high rate of growth, it must consume an immense amount of resources, which ultimately ends up as large quantities of waste and pollution. Also, as people get busier, the overall “quality” of the society falls, leading to increased stress and disease prevalence.
If so, should we abandon our current productivity and live a slow, village life and ignore our potential as a species? Or should we continue our exponential growth at the cost of using up nature’s well-maintained resources like no tomorrow?
There is a bamboo forest on a desert island. How can you use these?
The most important rule of survival is application.
As an addendum, bamboo is a grass (the largest in the world), not a tree.
This is because its stalk has become hardened yet still hollow, making it look like a tree. However, it has segments, shallow roots and dies after flowering (which can take decades) that are features of grass.
A wise man points at the moon, but the fool looks at the finger. (Chinese proverb)
The wise man explains that his finger is not important and what should be looked at is the moon, but the fool carefully listens to him and thinks that he is a very good speaker. (a modern adaptation of the proverb)
The wise man pleads the fool to look at the damn moon, but the fool is only afraid and does not look up. (a very modern adaptation of the proverb)
The wise man finally gives up talking about the moon and instead starts talking about his finger, which he thinks the fool will be more interested in. The fool then says to himself, that the wise man is someone who is able to explain his own stories to others in an easily understandable manner, and that he can talk about any subject – even a random thing such as a finger. (an even more modern adaptation of the proverb)
When the wise man dies, the fool asks himself: “So really, what was it the wise man tried to explain to us lifting his finger so high?” (the ultimate adaptation of the proverb)
(from Paradise by Bernard Werber)
Sometimes just before you fall asleep, or just after you wake up, it is impossible to move any muscles. The panic caused by this sudden paralysis is soon followed by a sense of impending doom and unknown horror. When trying to look around to figure out what is happening, you see a ghost or demon sitting on your chest, pinning you down.
This is a typical scenario of sleep paralysis. It occurs when the mind wakes up before the body (in loose terms) and is experienced by everyone at least once throughout their life.
Sleep is divided into two phases: REM (rapid eye movement) sleep and non-REM sleep. These two phases cycle to make up sleep at a 1:3 ratio (i.e. about 90 minutes non-REM, 30 minutes REM, repeat). NREM sleep is often thought of as “shallow sleep”, but this is incorrect as the third phase of NREM is literally “deep sleep”. This is followed by REM sleep, characterised by relaxation of muscle tone and the eyes darting in all directions (rapid eye movements). The brain cuts off motor signals to the body during REM sleep to prevent it acting out the movements in a dream (without this, many people would injure themselves or others during sleep). For example, patients suffering from diseases such as Parkinson’s disease with REM sleep disorder show vigorous movements during sleep, often hitting their partners in the process.
The problem occurs when the onset of REM atonia (relaxation) comes before the person fully falls asleep, or fails to disappear after waking up. As the motor system has been shut down, the muscles cannot be moved yet the person has regained consciousness. The more frightening thing is that sleep paralysis is usually accompanied by an intense visual and auditory hallucination, which is almost always related the person’s worst nightmares and fears. This explains why so many cultures associate it with demons and ghosts, and it is also possibly the cause of alien abduction experiences and ghost sightings. Reason being, the hallucination is so vivid the person easily believes that it actually happened.
Sleep paralysis can be caused by excessive drinking, stress or the induction of lucid dreams, but tend to be spontaneous and can happen to you on any day.
The unicorn is pictured as a white stallion with a single, prominent horn on its forehead. It is still loved and is one of the most well-known mythical creatures. As with any mythical beasts, there are interesting stories related to the unicorn.
The horn is the source of the unicorn’s strength – the infinite fountain of magical power that grants the unicorn unmatched strength and speed. If it meets an enemy it either sprints and disappears, or uses its large weapon to impale even the hardest armour. This makes it extremely hard to capture.
Medieval people believed the horn of the unicorn to be a highly valuable magic ingredient, with extremely potent cleansing properties that could purify even lakes and seas. But as the only way to attain the horn is to capture a unicorn, it was an extremely rare commodity.
To catch a unicorn, one must know its most important (yet not well-known in the modern age) trait. Although they are wild beasts with a savage temper, they calm down like lamb in front of one group of people – virgin maidens. If it detects even the faintest scent of a virgin, it rushes towards her and places its head on her lap, soundly falling asleep. Due to this characteristic, it is often portrayed as a symbol of purity and chastity, and also Jesus Christ and the Virgin Mary.
According to notes written by Leonardo Da Vinci himself, hunters used this trick to capture unicorns that would fall asleep on a virgin’s lap (whom they brought with them to aide in the hunt). Even a mighty beast has a weakness that can be exploited.
On a side note, it is also written that if the unicorn senses that the maiden is not a virgin, it would instantly use its large weapon to impale her until death.
