On saving lives... or not...

A recent locum at my general practise (who is worth a post in himself, but that's for another day) sent me a link to this article from The New Yorker, with a request for a response. The article itself is a discussion of how we manage end-of-life issues - it's long, but well worth reading, even if you don't think you're interested in the topic!

End-of-life issues are a difficult topic - emotionally charged and often polarising. I guess that's why we deal with it so badly - but it's so, so important. There are no easy answers here... no cookie-cutter solutions... every case - every person, every situation is different and answers must be found for each on their own terms and in their own time.

I think my grandparents were... lucky, perhaps? It doesn't seem like quite the right word, but what I mean is that they were spared excessive, invasive treatments and mostly spent little time in hospital. The slow degeneration of old age is not easy to watch, of course, but I believe they were cared for in a way that was appropriate for them and their needs and wishes.

Firstly, and briefly, there were some professional reminders in this for me - that sometimes medical treatment is not the answer. That, either way, good pain relief and symptomatic treatment are essential. And doctors sometimes need to just be more realistic!

But I found that the overwhelming message of this article was that we need to talk about end-of-life decisions. Doctors, nurses, health-care workers... and - more importantly - as parents, siblings, children, friends... we need to talk about what we want, and keep talking about it. Yes, it's difficult and confronting and we don't know how to raise the issue, but given the alternatives, how can we justify NOT doing it? Part of me knew this, and said "Of course we need to ask, duh" - but what this article pointed out for me was that it's not as simple as asking "would you like to be recuscitated?" That's not enough - we need to talk specifics: If this happens, what do you want us to do? What about if that happens? Would you like this treatment?

It reminded me that one day I will likely be confronted with these same issues for my own parents, and while I know that they have both written advance directives, I don't really know what they say - or what their scope is. I've never talked in detail to my fiancé or my brother about what they would want, or - for that matter - about what I would want. We're young, yes, and my parents are relatively healthy, so it will probably be a long time before we really have to confront the issue - but you never know. Better to talk about it now, while it's not in our faces and it's not so emotional. And keep talking about it - the answers change over time.

What about you? Do you know what your parents want? Your brothers and sisters? Your significant other? Your best friend? What Gawunde's article told me was to talk about it. Keep bringing it up, keep asking the hard questions. One day you'll probably be glad you did.

Thoughts, anyone? Did this article say something different to you? Do you have an experience or insight you'd like to share?

"In a way, the entire human being is in the hands"

Here is a lovely thing I found over at Mason Dixon Knitting and thought was worth sharing:

There is probably another post in the works, but it's not ready yet :) I have been making progress - albeit slow - on my Finish It! projects... there will be an update once I have something a little more substantial to show for it!

Lists and sets and tags, or - why I find flickr confusing

My flickr photoset for Broken Hill can be found here* :)

I've just come back from two weeks in Menindee. I stopped by the Menindee lake lookout on my way back yesterday and it was actually quite cool to see the lake almost full - a comparatively rare event!

Further to my previous post, my project list for Finish It! is here

My first item is a pair of socks (Ravelry link) I started this week.

After a couple of early false starts and changing the stitch pattern twice, I'm really pleased with how this is going.

*at great pains, because I don't use flickr much and find it hard to organise my photos properly

Finishing

So my friend Carolyn linked me to this post at Oh the Cuteness. Subtle, huh? ;)

The idea is called "Finish it!", and the point is to finish up those UFOs (unfinished objects) that most crafters seem to collect. I'll admit to having, um, quite a few UFOs sitting around and it would be good to clear some of that clutter. I'll also admit to saying I'll do things like this and never following through, but we'll see what happens!

My list of projects will be quite short, at least for now - most of my UFOs are halfway across the country (and in more than one place) so what I have with me in Broken Hill is actually pretty limited. I'll start with what I have and gather up some more along the way, depending how I go. I've always plenty of books to catch up on if I run out of knitting & spinning! listography list and photos will follow in a couple of days once I get back to the Hill. Feel free to kick me if I don't!

List of participants here

Flickr group here

Also the sentiment that 'I wish the word (acquaintance) weren't dying out.'

This entry hit on some things that have been on my mind, on and off, but never quite figured out how to express for myself.

This is part of what struck a cord with me:

"The biggest myth about friendship is that it goes in one direction... You're not allowed to go from friends to graceful acquaintances. We do it all the time, but we don't talk about it or admit that it's okay."

http://rhubarbpie.typepad.com/rhubarb/2009/12/graceful-acquaintanceship.html

An existential crisis, of sorts

So there is this issue that has been bothering me, on and off, for – lets say the last couple of weeks. Here’s the thing.

I eat meat.

I like meat, I always have. I like vegetables and vegetarian food too, but I’ve never been able to come at the idea not ever eating meat. I can’t even imagine living without eggs or dairy.

All my life I have seen trucks carrying livestock; often they invoke a twinge of guilt/anger/sadness at the way we treat these animals – stuffing them in the back of a truck and shipping them off to an abattoir – but rarely any thought beyond that.

Last week I saw a truck full of cows just down the street from my house as I was driving home one afternoon. I wouldn’t have given it a second thought, except that – fair warning, this is gross, you probably don’t want to be eating right now – as it lurched off through the roundabout, there was liquid excrement running off the back of the trailer with every jolt and bump. Uhm, ew? And we treat sheep, cattle, chickens and who-knows-what-else like this all the time?

It got me thinking, and my problem is as follows:

How can I justify eating meat when we treat animals like this?

The more I think about it, the more this logic extends to other animal products. I mean, I buy free-range eggs – RSPCA or Animal Liberation certified if I can find them – but I never thought about how these animals are treated when they get old. To be quite honest, I have no idea and while I want to believe that free-range chickens are also treated well at the end of their life, I’m not sure I can take that for granted. The same applies to the cows who produce my favourite organic, bio-dynamic milk and yoghurt – what happens to them? I’m not so picky about cheese or butter or cream and have even less faith in the way those producers treat their animals.

It would be so much easier to just stick my head in the sand, but part of me wants to do the research and ask the hard questions so that I can make more informed decisions about what I eat. But I am scared of the answers, to be quite honest, and of the implications of those answers, and all too aware of the people I know who have gone vego/vegan for exactly these reasons.

And that doesn’t even touch on the ecological side of the debate, which is, well, complex and I can’t even begin to pretend to understand it.

So I guess I am asking for advice and opinion; what I am interested in is the ethical and ecological stuff. I have the resources and expertise to mostly figure out the health implications for myself. But I don’t know where to go for good ethical info and perspective, so I’d love some opinions and links :)

(I don't want to stop eating meat, but I'm worried that the price may be too high. What I’d love to find is that my certified free-range eggs and organic dairy come from animals who are treated ethically throughout their lifetime, or at least that those products are available to me. And that there is accessible, ethically produced meat out there and I can make an informed, ethical choice without having to stop eating meat altogether - even if it means considerably reducing my meat consumption. That’s my ideal.)

Op-shopping! and 100 ideas...

My housemate loves her op-shops, so when she saw a big one in Millicent last weekend she knew straight away she wanted to go back one day when they were open. Yesterday afternoon we both finished at uni in time to get down there before their 3:30pm close, so that's what we did :)

A very successful trip, I must say:

Black/grey jeans, purple v-neck 3/4 sleeve top, green strapless summer dress.

A bag of yarn - grey, wool/ wool blend, ~5ply. 7 balls, so enough for a small garment, I'm thinking maybe a cardi.

These dark green teacups were on the free table.

Pretty handkerchief, I think maybe hand-embroidered.

Total spent: $17.

Also, this week I came across Keri Smith's 100 ideas for a journal. Seemed like a fun idea, so I printed out the pdf and cut it up.

I've done one so far, and considering my options for the next. I was hoping for one a day, but time and creativity constraints have got in the way somewhat! There will be photos when I've done a couple more though.

In the mean time, here is my little stack of squares sitting on the kitchen table, waiting for their turns :)

Blue Lake

Blue Lake
Originally uploaded by imogenesis

You can find this and other photos from my Mt Gambier placement to date over on flickr :)

"The kindest Africans had not changed at all, and even after all these years the best of them are bare-assed."

I have been travelling a fair bit recently; I will spare you the details as they are pretty mundane, suffice to say that I have been in Mt Gambier for 4 weeks on a university placement and this weekend will be the first one I have actually spent in the town. In fact today was the first Friday I have spent at the hospital…

I have been reading Paul Theroux’s Dark Star Safari on aeroplanes and at airports… two sets of flights to Canberra and back was enough time for me to finish it. The book is subtitled “Overland from Cairo to Capetown”, but this is as much a book about Africa itself as it is about travelling, and about the writer re-discovering the continent where he had lived and worked 40 years before this safari.

Theroux writes in a way that I find evocative and engaging without being wordy; he makes me want to visit Africa and Egypt – which is ‘not Africa’. He keeps the distance and observer role of a journalist, but seems to have a talent for talking to people, for drawing their stories out of them. He is also not afraid to ask questions about the political situation, a thing that should be done carefully in some countries!

Overall, I would have to say that the picture Theroux paints of much of Africa is pretty bleak. It seems to be a continent of corrupt governments, dependant on foreign aid – even propped up by it. Too many people have ‘inherited’ this same dependence and feel entitled to assistance from white people with no effort on their own part. Theroux’s view of foreign aid workers and missionaries is dim; to put it a little harshly, they feed nothing but the culture of dependence and their own egos. His portrait of Robert Mugabe is almost terrifying, and his depiction of Zimbabwe at that time nothing short of tragic… in the 10 years since, little seems to have changed.

Perhaps most depressing of all is that he does not find the situation improved in the 40 years since he was a teacher in Malawi. In fact he finds it worse – the school where he once taught is falling over, the library devoid of books (they have been stolen by students) and few of his former pupils have made much of their lives. Throughout Africa he finds the same thing – Western-built infrastructure is falling apart and there is nothing to replace it. Indian immigrants have been scared away, their shops closed and no Africans have the ability/ willingness to open new businesses in their place – rows of shops in countless towns lie empty and abandoned. There are many other examples of this sort of degeneration.

Theroux’s eventual conclusion with respect to foreign aid seems to be this: for hundreds of years, Westerners have been doing more harm than good in Africa. We should get the heck out of there, and let Africans fix their own problems in their own way*. And herein lies the ray of hope. The idea that “the best of (Africans) are bare-assed” (usually literally) runs strongly throughout this book. Despite the apparent hopelessness of the situation, there are many good and kind Africans. There are those who are willing to work against the status-quo and even their own governments to improve their countries. Despite everything, he seems to see a ray of hope for Africa.

*My words, his ideas.

December Declutter

The lovely Emma over at My House Smells Like Vanilla posted a "10 things gone!" list/ challenge today, so in the unending quest to declutter my house (& indeed my life, I suppose), I've decided to take on the challenge.

Here's Em's list:

1. ten pieces of clothing
   
2. ten books
   
3. ten craft supplies
   
4. ten useless pieces of paper
   
5. ten pieces of kitchen crap
   
6. ten cosmetic/grooming supplies and
   
7. ten things from your "study / basement / laundry / shed" or wherever things go to never be seen again
   
8. ten pairs of shoes or socks
   
9. ten toys
   
10. ten things out of your bathroom
    

The challenge lasts a month; I will be starting on Monday and therefore ending on Christmas Eve.  I'll be posting my efforts, as will Em, and I'd encourage you to join us.

"Disillusion and opportunity"

This editorial popped up in UK medical journal The Lancet recently. It had some good things to say, and I think is worth a read. (But then, I think we've established that I'm interested in this issue)

I particularly like these points:

"Between 1994 and 2003, the number of children in the USA diagnosed with bipolar disorder increased 40-fold. Are we pathologising normal feelings and behaviour? Worse, our methods locate the fault (typically presumed to be neurochemical or genetic) in the child—rather than the environments that create distress and misbehaviour."

"If psychiatry is to retain its claim to rationality, it must allow patients, including children, to be heard, and not merely drugged."

Bet you can't guess why!

I found a totally fun tool today: COLOURlovers (via Design*Sponge) and have been playing around with a couple of colour palettes.

The website has this neat feature where you can point it to a picture online, and it will give you a selection of colours from that picture, which you can use to create a colour palette; plus it also gives you tools to adjust the colours and suggestions of similar colours.

My first attempt was based on this picture (also via D*S):



but, well, it sucked. The blue was too bright & clashed with the pink, which was also too bright...you get the idea. It eventually morphed into this, which is better:



but I'm still not sure about the pink, and it was a struggle just getting it to this. I was having serious issues getting the red right, too.

Anyway, then I plugged in this gorgeous picture:

(UK Vogue July 2008, courtesy m.writes

and got this:


which took about 5 seconds to come together! I swapped out the green for this softer one, but otherwise I think all the colours are ones the website pulled out of the photo. I was surprised that it didn't pick up any of the blues from the girl's dress. The result is quite nice anyway, no?

Anyway, that was my exercise in procrastination for the day :)

Research, drug companies, and income reporting...

Has anyone else seen this article* about some eminent US child psychiatrists failing to fully report income from drug companies?

"A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators."

It's not clear at this stage whether Dr Biederman and his colleagues' research has actually been compromised, but given the subjective nature of psychiatry in general, this is very concerning - especially given that this involves treatment of children with powerful psychiatric medications. Many children all over the world have been prescribed medications because of these doctors' work, and now we find there is a possibility that the research on which these decisions were based was invalid, or that the conclusions were invalid. Critics certainly believe this may be the case:

"The group published the results of a string of drug trials from 2001 to 2006, but the studies were so small and loosely designed that they were largely inconclusive, experts say. In some studies testing antipsychotic drugs, the group defined improvement as a decline of 30 percent or more on a scale called the Young Mania Rating Scale — well below the 50 percent change that most researchers now use as the standard.

Controlling for bias is especially important in such work, given that the scale is subjective, and raters often depend on reports from parents and children, several top psychiatrists said."

I'll be clear here - in general, I am pro-psychiatry. I think the work they do is vitally important, and that it can genuinely improve people's lives. But I also think that medicine generally, and psychiatry in particular, has come to rely too heavily on pharmaceuticals, and often fails to see people as whole people. Oftentimes we need to think harder about the implications of our treatments, and how we deal with the adverse effects/side effects.  This story also highlights some issues about the relationships between doctors (and medical students) and drug companies.

At best, this is a blow for the credibility of psychiatry, and especially child psychiatry, a speciality that has already faced a lot of controversy and can ill-afford this kind of bad press. At worst, it brings the validity of much of the field into question. It certainly highlights inadequacies in the reporting of researchers' income and checking in the accuracy of this reporting.

*props to the education rep who posted this on the student discussion board, & for getting on his own soap box about the matter.

Is this art, or just a by-product of construction?

What do we think?

(I actually wish I'd taken a photo of this building when I first saw it like this - I think there were more)

It always makes me wish I could sing like that

The Idea of North, and Adelaide Chamber Singers are two of my favourite acts to see live, so it's been great to see them both at the Fringe recently after not going to any concerts for a while.

I could wax lyrical about both these groups for ages - the skill of the singers in both groups is amazing.  The Idea of North are fantastic fun, and I'm constantly in awe of their ability to sing those tricky jazz harmonies.  Adelaide Chamber Singers do a lot of genuinely beautiful music, and the blend of sound they achieve as a group is amazing, especially when you consider that this is not their day job: while there are a number of up-and-coming or aspiring professional singers in the group, many of them have completely unrelated day jobs.

That said, I must confess to a sense of disappointment with the ACS concert last night.  It's not that they didn't sound good.  Although I did think that I've heard one of the soloists sing better than she did yesterday, and I maintain that counter-tenors are odd beasts, the group as a whole maintained their usual lovely, blended sound.  Part of the problem was the stifling heat and complete lack of any air flow in the cathedral last night, but for me, the real difficulty came with the choice of music for the concert.  Specifically, the major work, Arvo Pärt's Miserere.

This just turned out to be a piece of music that I couldn't really appreciate.  Pärt's music is frequently, uh... challenging, in the sense of unusual, pushing boundaries; but personally I couldn't even say that much for the Miserere .  I can appreciate how this could be a really atmospheric work in the right conditions, but I found it "long and tedious", to borrow my dad's words.   It's a pity, because I wanted to enjoy it, and it closed out the concert after some really lovely music in the Victoria Lamentations of Jeremiah for Maundy Thursday, and the MacMillan Christus Vincit.  Because it was the final work, it unfortunately put a bit of a dampener on my impressions of the concert, because for me, it was just a bit...nothing.  A little boring, to be blunt.

Despite not enjoying the Pärt itself, I did enjoy hearing some choir members sing solos, who I've not really heard individually before.  It was great to see some of the younger/ less prominent choir members get that opportunity.  There were also some singers last night who I've never seen sing with ACS before, and in particular it was great to see some singers who I recognise from a Conservatorium choir I sing in - it's nice to see them begin to move through into a high-profile choir like ACS.

Friday last week was the Idea of North's final Fringe show, and it was the first time I've seen Idea with their new soprano, Sally (I don't know her last name).  They've just announced that she will be permanently replacing Trish Delaney-Brown, who's still listed as the soprano on their website, but has decided not to return from maternity leave.

I must admit it was weird at first; you just expect to see the same people on stage every time.  But having got past "but...that's not Trish!"  I was impressed.  Sally seems to have slotted in to the group really well: she's certainly got the skill as a jazz/ a cappella singer, she blends (in terms of her sound) really well with the rest of the group, and she was having fun on stage.  All vital for an Idea member, in my opinion!

The other change as a result of Trish leaving the group, is that Naomi Crellin (alto) has taken over a lot of the female vocal solos that Trish used to do.  As an alto and an Adelaide girl myself, I thought this was fantastic ;)  She's taken this role on really well and it sounds great.  It was also great to see Idea in a small venue again,  this time the Promethian - the smaller, more intimate space really suits their easy, relaxed style on stage.  Overall a fantastic concert, as always.

a totally predictable post

Now, I'm not going to claim to be a fashion expert here.  I've just pulled some photos/ dresses that jumped out at me.  Enjoy :)

Laura Linney... isn't she lovely?

Nicole Kidman - I do think that "Our Nic" is one of the most beautiful women on the planet.  And that dress!! And the diamonds!! just... wow.  Can I borrow that to get married in?

Plus, she and Keith are very cute together.

There were a number of unfortunate dress choices I could point out, and one or two "What was she (or he) thinking" moments, but it's all been said, so I'll stick to just this this one:
Jennifer Hudson, taking out the "So near, but yet so far" category.  It's not a dress I would choose, but she could have looked great.  Honey, next time, please just make sure your dress fits you before leaving the house.  It's all we ask.

As we all know, there were a number of baby bumps on show at the Oscars this year, but Jessica Alba was the standout for me.  I lovelovelove that colour!  The dress is pretty and flowing, and she has that pregnant radiance about her.  Overall, I think she looks fantastic.

I just adore this pic of George Clooney and his girlfriend Sarah Larson.  I'm not sure exactly what it is; I suppose its that this is such a candid shot, and yet there is no question that they both absolutely belong on that red carpet.  She's beautiful, he's suave and sexy - they just own it!

And lastly, in the "Only a supermodel could pull this off" category, is Heidi Klum.  It's hardly the most outrageous dress ever seen at the Oscars, but there's not a lot of women who could look this great in a dress like that.  Heidi totally pulls it off, despite the slightly dubious accessorising.

Food is much easier to photograph

So, here's what I was going to show off today:

An easy and pretty salad, inspired by the idea of a 'chop salad' - with credit to Jamie Oliver.  It was followed by a simple roast, making a great dinner.

But when I opened up iPhoto, I discovered my half-forgotten photos from the final stage of the Tour Down Under, and I thought - "Hey, I should post them."

But then I realised that, to be honest, it's a bunch of mostly rather ordinary photos:

Only slightly redeemed by some better ones like these:

So someone remind me why I take the camera??

moving through the ether

I'm in love.

Maybe in that pretty veriegated  green bamboo?  Mmm yum.

(Pattern is 'Ether' from Rowan Mag #43.  Photo courtesy of Mason-Dixon knitting)