Essays – Page 10 – The Creative Space

This Thing called Wisdom

“The desire to reach for the stars is ambitious. The desire to reach hearts is wise.” – Maya Angelou

Certain recent events in a land close to me yet ever so far has made me think of the word “Wisdom” all day. This thing called “Wisdom”…..what is it?
It is defined as “the capacity of judging rightly in matters relating to life and conduct; soundness of judgement in the choice of means and ends; sometimes, less strictly, sound sense, especially in practical affairs.”

Throughout history, it is a virtue that has always been sought by many and yet few seemed to posses. The Greeks even had a Goddess for it – the beautiful Athena. The Christian Bible says one gets it by fearing God even though I know some rather foolish people who fear God! The Quran says wisdom is given to whom Allah wills – Allah must be stingy! Psychologists try to measure it and anyone who seems to have gobs of it becomes an oracle. So what is this ephemeral quality called wisdom?
Well, wisdom seems to have to do with life. Now life is both biologic and interactional. Biologic in that a body has life and is alive. Interactional in that we live by interacting with others and our environment. A deep understanding and discernment of the environment is knowledge that enhances this interaction. In the same way, a deep understanding of the self and of other humans enhances life and it is this deep understanding of the self and of others that I think constitutes wisdom.
Per my argument, wisdom is then a thorough understanding of the self and of others. It is a deep understanding of the human condition, the human psyche. A knowledge of one’s strengths and weaknesses and appreciation of what makes humans tick. Our fears, hopes, egos, desires. The wise person understand these human traits really well.
So a wise person exploits his/her strengths and always seeks to minimize the influence of inherent weaknesses, then inasmuch as they are aware of their strengths, the wise will be the first to point out their limitations and seek help for those things in which they are weak.
In dealing with others, the wise person attempts to harness the others’ strengths even as he/she reduces exposure to their weaknesses. This is very much the opposite of what most unwise people do – exploit the weaknesses of others. The wise know that that ultimately never ends well.
A wise person lives by the Golden Rule – treat others as one wishes to be treated. (That is why maybe the Bible says “The Fear of God is the beginning of wisdom).
A good illustration of my theory is offered by the biblical story of the Judgement of King Solomon. Solomon was king of Israel probably from 970 – 931 BC and reputed to be the wisest king that ever lived. The story involves two women who lived together. They both had recently delivered. One slept on and suffocated her baby. On waking up and realizing her baby had died, she hid the body and then claimed the other woman’s baby was hers. This led to a fight and the case was brought before King Solomon. He offered to cut the baby in two and hand each woman one half. At that, the real mother asked him not to while the other woman wanted him to go ahead and divide up the baby. He handed the baby to the real mother. A deep understanding of a mother’s love helped the king make this amazing decision and illustrates his wisdom.

Thus if wisdom is a deep understanding of the human condition, then it surely can be acquired then understanding oneself and others is something than can be learnt. That is the good news. The bad news is that the majority of people do not know who they are and are unwilling to so much as understand the next person. Is it any wonder that wisdom is so scarce?
She is out there though…Wisdom is…trying hard to draw out attention…”crying out loud in the streets, at the city gate, even in the public square”…telling us to know ourselves and understand our fellow men and women…if only we would listen…

Dignity

“Dignity consists not in possessing honors, but in the consciousness that we deserve them.” – Aristotle

The Olympic Games ended tonight and I enjoyed every minute of them. I know most Brazilians in the favelas that dot the Rio landscape were unwelcome guests at a party in their own city. That is sad but a true fact of life in a world where many find themselves as unwelcome guests. In spite of all that, the games offered not only entertainment but several life lessons.
For me, one of the most compelling is the lesson taught by the dignity and poise of the US track star, Allyson Felix.
In July, due to a nagging ankle injury she suffered in April, she lost in the 200 m qualifying race. The athlete who beat her fell/dove across the finish line. Her dream to defend her Olympic gold medal from 2012 was dashed. She held her head high and consoled herself with the 400m, 4x400m and the 4x100m relays.
On Monday, August 15th, she lined up to run the finals of the Women’s 400m. Running in Lane 4, she had the chance to cross the finish line and claim a gold medal when the Bahamian star, Shaunae Miller, fell/dove across the finish line to claim the gold. Allyson was beaten by 0.07s. She was devastated but kept her head high.
Three days later was the women’s 4x100m heats. Allyson was in at the 3rd spot. Just as she got ready to hand the baton over to English Gardner, she was bumped by the Brazilian runner in the next lane causing her to lose her balance and miss the exchange. Even with that, she kept her composure and asked English to finish the race. She did and the US team appealed. They won the appeal and got the opportunity to rerun the race. They qualified and ended up wining the gold.
Dignity in the face of adversity is something few can muster. Those who do it always shine as bright as the morning sun, showing us all that it is possible.
Allyson injured her ankle in April, lost her dog in June and her grandfather in July. Still, she worked towards her goal. The 400m final loss would have discouraged many and yet she kept on. The 4x100m bump should have put the nail in her coffin and yet she had the presence of mind to tell English Gardner to finish the race.
She faced all these adversities with poise and class, always displaying a certain strength of character and dignity. That poise and dignity even translated to how she ran – graceful and effortlessly.
So what is dignity and why does it matter?
Well, dignity keeps one above the fray of life and gives mental clarity to the daily chaos. It is defined as having self-respect and a sense of pride in oneself.
Life is hard and most of the time, people and experiences seek to strip away this sense of pride in one’s self. It is up to the individual to constantly reinforce a sense of self-respect. It is worth reinforcing because it shows that even though one may not possess the honor, it is something that is deserved. So since one behaves like being deserving of the honor, sooner or later, the honor comes along. If dignity is lost, it is like saying that one does not have the honor and does not deserve it. How sad!
Thus even though she lost by a hair in the trials, lost by 0.07s in the 400m and was bumped in the 4x100m, she didn’t despair. She knew that no matter what happened, she deserved the honor and the honor will come. And did it come!
After 16 days, the games are over and life goes on. The lessons learnt this week will stay with me and should I trip and fall, I hope I pick myself up with dignity and class. Just like Allyson Felix would.

In the Simulator

There is something irreversible about acquiring knowledge; and the simulation of the search for it differs in a most profound way from the reality.”
– J. Robert Oppenheimer

A Simulator is defined as:
– a machine with a similar set of controls designed to provide a realistic imitation of the operation of a vehicle, aircraft, or other complex system, used for training purposes.
– a program enabling a computer to execute programs written for a different operating system.
Simulators are used extensively in the military, aviation, medicine and other industries for training purposes. With or without actors, they can be used to create scenarios for training. Each scenario is usually managed by the person or team who created the scenario and can be watched live and/or videotaped to be watched later for evaluation. Events in the scenario can be altered to challenge the participants.
Simulators are now used extensively in medical training. They are also required some specialties for recertification and for continuing education.
Being old-school, I wasn’t a big fan of the whole simulation thing. I believed and still do that, for training purposes, a real live scenario beats a simulated one hands down. However a real live scenario is not always available. That is where a simulated scenario is invaluable for training purposes. It is also great for testing one’s reaction and for revising training. For my recertification a few years ago, I had to spend some time in a simulator and in the process, became a believer. It surely has it’s place.
Recently, I have been thinking of taking another simulation course. As I reviewed the available options, I had a thought. We are in the mother of all political seasons. The presidential elections are around the corner and with that the debates. I thought of how we choose who we think deserves to occupy the highest office in the land.
I am sure people vote along party lines, by race, by looks (I’m not kidding!), by their stand on social issues like abortion and gay marriage and so on. Sometimes their experience may sway us. This year, it’s crooked versus crazy!
Even though what they say and promise should not be that important in our decision making, even though words are cheap, they do play a huge role. Unless it is an incumbent, no one has had the prior experience being a president so we are really dealing with the unknown.
So then I kept thinking – what if we could get our presidential hopefuls into a Simulator and have then manage some “crisis” situations?
So, back to my candidates.
We get a simulator and create scenarios that mimic crisis situations for a US President.
We get actors to play all the different parts – Congress, the Supreme Court, the Tea Party, Teachers’ Union, Putin, ISIS etc.
We get the candidates, one after the other to manage these scenarios and see how they perform.
The candidates will know to put their best food forward since the whole world would be watching. It would be impressed upon them to take the scenarios seriously.
Having been in a simulator myself, I can honestly say that it is rather difficult to mask your real abilities during these scenarios.
If they are well written and planned, they can be so real as to elicit reactions from the participants that reflect who they really are in crisis situations.
Remember Hilary’s “3-am ad” against the then Obama? Well we could simulate that.
We could simulate an economic crisis, wars, attacks, conflicts with Congress, natural disasters and so on.
It might just be a better measure than empty words and promises.

Are We to Blame

I see this in my hospital all the time and I am sure it is seen by anesthesiologists all over the US – how much sicker our patients are.
It is also evident that surgeons are pushing the envelope further and further. Patients are sometimes showing up for surgery whose short-term prognosis (don’t even consider the long term) makes one question the wisdom in a surgical intervention.
Then is the rather formidable (no pun intended) issue of morbidly obese patients who need their day in the OR.
We as anesthesiologist seem to take all these challenges in stride and in most institutions, the daily schedule is hardly affected as these challenging cases are shuffled through.
We complain about the wisdom of surgically intervening in these instances but since the show must go on, we do what we have to.
I dare to blame us though for these circumstances. Bear with me and I’ll make myself clear.
Imagine an institution where the anesthesiologist cannot manage ASA IVE cases or secure the airway in that 550 lb patient or get that patient through an exploratory laparotomy who just had a myocardial event. Just imagine!
What do you think the surgeons are going to do? Three options – take their cases elsewhere, stop taking these patients to the OR or hire an anesthesiologist who can or is prepared to do these cases.
What if this was a national phenomenon with all anesthesiologist? Maybe the sickest patients will not show up for surgery!
However, we have a specialty that prides itself in being progressive, being evidence-based and seeking to constantly improve itself.
We attract the smartest and most innovative minds.
We seek and employ CRNAs who are bright, focussed and unafraid.
The results – the ability to manage whatever the surgeons pitch at us! So they keep throwing and we as trusted batters, always hit the home run.
600 lb? Bring it on!
EF of 15%, cirrhotic and anuric? Bring it on!
Hematocrit of 15? We’ll fix it intro!

I think the realization has hit us so most anesthesiologists have stopped complaining and are just keeping on because maybe, just maybe, we are to blame, but in a good way.
No matter what we allow into an OR though, we always have to bear this in mind:
“I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witness, that I will fulfill according to my ability and judgment this oath and this covenant…I will apply…(treatment) for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”

That “It”

Sure, it’s in you! You can do it! You are greater than who you now are!
Over the years, I guide my life with a set of principles.This is one of them and as I watch the Olympics, I cannot help but see that principle in every instance. That is why I love watching the games and I bet that is why the majority of you do too.
Sure, patriotism, nationalism, girls in bikinis playing volleyball, girls with six-packs so tight you wonder if they eat, the swag of Bolt, the indomitability of the Phelps…sure all that but at it’s core, what draws us to the games is the chance to marvel at the fact that these athletes found “it”. They surely found it and it made them believe they could win, break that record, jump as high…that “it” that said, “You are greater than who you think you are so go for it!”
So we watch them and realizing they are just as human, somehow gloat in the feeling that just maybe, we can find that “it” too. We return each night to take a toke from that joint of “it” and revel in the high of knowing, it might be in us too after all, and it is. As sure as the fact that the sun will rise tomorrow, so is that “it” in us and if we look, we can find it.
Thus in spite of all her troubles, Brazil found it in herself to stage the Olympics Games for the world, Phelps did it again, Ledecky left everyone behind, Bolt accelerated and Biles soared.
So in spite of whatever, you can find it in you to quit smoking, get that degree, stop drinking, spend more time with the family, listen more, be empathic, appreciate, work out, kiss your wife more or just smile.
You can! It’s in there! Find it!

Olympiosis

I am suffering from severe case of Olympiosis.
Symptoms are quite prevalent in the mornings but are felt all day long – tiredness, yawning, red eyes, arthralgias, headache, deafness to alarm clocks and gross irritability. It can be confused with a hangover. The difference is found by measuring the blood alcohol level in most patients.
Cause is thought to be inability to extract the human mass away from a television set during the Olympic games. It was first described in the 1970s.
Most experts attribute the pathology to pure wonder at athletic prowess. Game and his team in a seminal paper postulate that the sheer determination exhibited by the athletes induces heightened admiration leading to insomnia. Track et al measured the level of light emitted from the medals the athletes receive and noticed a high correlation between the amount of gold won and the severity of Olympiosis and laryngitis.
Cases of Olympiosis spike during the Swim, Track and Beach Volleyball events. Men seem to be particularly afflicted during the Beach Volley Ball events. This year, the CDC is reporting that doctors are seeing a spike around the Ladies Gymnastics events too.
Four years ago, researchers in London isolated two viruses called the Phelps and the Bolt that might play roles in the severity of Olympiosis. This year, scientists in Rio de Janeiro have isolated two more viruses – the Ledecky and the Biles. A group outside Rio reported on a variant called the Manuel. A team at the NIH is working on vaccines.
Olympiosis might be contagious, a fact that the experts cannot seem to agree on.
Treatment is avoiding television sets. A good televisionicide will do the trick. Also, one should avoid contact with the internet in all it’s forms. Symptoms usual subside after about 3 -5 days of avoidance.
Failure to treat leads to a chronic state that is incurable. The long term prognosis is dire. It seems to lead to sundaynightfootballiosis, modaynightfootballiosis or even EPLiosis. Most chronic patients end up in rehabilitation centers, where they spend the rest of their lives watching TV and drinking beer or knitting.
A select group of patients seem not to progress to the chronic stage and I think I belong to that group so for now, Olympiosis, bring it on!

The Mad Doctor

“For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.”
– Matthew 25:35

I dedicate today’s post to an amazing man and physician that I only recently heard about and for that, shame on me!
Dr David Fuseini Abdulai.

Dr Abdulai, born in the Northern Region of Ghana, was one of 11 children. He is the only one still alive. His siblings and parents died from poverty-related diseases. His dad contracted leprosy (Hanson’s Disease) later in life and his mum had to beg for food for the family.. After he lost his family, he lived on the streets where he often went without food. That experience proved critical in what he was going to devote his life to.
Through the help of the Catholic Church, he managed to go to school and then to Ghana Medical School. After graduation, he practiced at Korle-Bu and 37 Military hospitals till 1989 when he decided to move back to the Northern Region to give back.
And has he given back!
He founded the Shekinah Clinic for the indigent and the destitute. He founded the clinic to serve the Very Important People (VIPs, like he calls them) in his life – lepers, the mentally challenged, the crippled, in short any one who society had cast out. In parts of Ghana, lepers, the mentally challenged and the crippled are often homeless. From his childhood experience, he remembered how hungry these people were so he fed them. He still feeds them, houses them, clothes them and treats them when they fall ill.
They come to him in droves, willingly and he goes out to find them too.
All the care is for free, financed by donations and volunteers. His mantra is “God Will Provide”. He hasn’t ever drawn a salary.
He also operates a “meals-on-wheels” service that feeds the destitute and homeless in a 65-km (40 mile) radius. His target here also are the mentally challenged, who live on the streets and are often hungry plus poor families who do not have enough to eat. He has been doing this since about 1992 and has never missed a day.
Every Christmas, he has a party for every destitute person in Gurungu, where his clinic is, and it’s environs.
He has since opened a second clinic.
Besides his VIP patients, he also takes care of the poor who need medical care – for free.
He is assisted by 27 volunteers and serves about 120 people daily.
What a man!
For his efforts, he was affectionately called “The Mad Doctor”.
Life sometimes calls upon us to serve our fellow men. Few recognize this challenge and even fewer are able rise up to this challenge. To the few who can, it is forever an honor and a blessing. To us who can only look on, it is a constant source of amazement and awe and it forces something out of us. It forces our better selfs to the surface, forcing us to rise and be better people.
Most of us became doctors hoping to one day heal the world. Along the way, life gets in the way and we forget our ideals. Dr Abdulai never forgot his ideals. He is out there healing the world.
Dr Abdulai, thank you!

The wonderful story of Dr Abdulai has however taken a sad turn. In May, he was diagnosed with advanced thyroid cancer and is now reportedly fighting for his life. It sounds like he hasn’t had any form of treatment since his diagnosis and is having complications. He was recently flown down to Accra for radiation therapy. He may need further medical care. Also, his work needs to continue. To these ends, a GoFundMe campaign has been started for the dear doctor and his clinics. If you care to donate, please go to:
https://www.gofundme.com/2xbgkzac
His story came to my attention through FB posts of friends and people I follow.
To Pakwo Shum, Kobby Blay, Nana Awere Damoah, Nana Ama Agyeman Asante, Ama Opoku-Agyemang and Christa Sanders, ayekoo!
To President Mahama and Dr Victor Bampoe for facilitating his transfer, thanks!

The Rant

“Don’t judge a man until you’ve walked a mile in his shoes”.
– an Old saying of controversial origin.

Somewhere in Middle America….

What the heck is going on here?
I can hardly recognize this place anymore! Everywhere I go, I hear and see strange people! Where did they come from? Walk down Main Street. Half the stores have names I cannot even pronounce.
Thirty years ago, we were 85% of the population. Now we are only 60%! Let that sink in – 60%. At this rate, we will be an endangered species in 50 years!
They are coming from everywhere, taking our jobs here and shipping the rest out. Look at our towns – deserted landscapes of boarded-up homes and factories!
Together with those bleeding hearts, they even made one of them President and he wasn’t even born here. Consider that! Even worse, I hear he worships differently! And he is President!
He wants to take our money and our guns. He wants to weaken us so he can rule forever.
Now they march around openly claiming they matter more than we do. The nerve! The absolute nerve!
Even scarier are those who want to kill us off, change how we worship and replace our laws. I say, stop them all from coming in. We need some law and order now!
We built this country with our sweat and blood. We fought for it. Our ideas made it what it is. It is ours. We want it back! We need to take it back! We used to be the greatest. Now, we are but a shadow of who we are. I say, we need that greatness back now!
I sit and listen to all theses clowns wanting to be president and wonder if any of them sees things the ways I do and has the guts to say what needs to be said!
I wonder, I really do…

Thoughts from the 2016 DNC

I’ve long been guided by this saying by George Bernard Shaw:
“I learned long ago, never to wrestle with a pig. You get dirty, and besides, the pig likes it.”
I guess the Obamas believe in the same thong and that’s why the FLOTUS said:
“…How we explain that when someone is cruel or acts like a bully, you don’t stoop to their level. No, our motto is, when they go low, we go high.”

Michelle

I’ve always sought to reconcile how this country was founded and the ideals she was founded on. Monday night, Sen Cory Booker of NJ said these words that got me thinking:
“But our founding documents weren’t genius because they were perfect. They were saddled with the imperfections and even the bigotry of the past…
But those facts and ugly parts of our history don’t distract from our nation’s greatness. In fact, I believe we are an even greater nation, not because we started perfect, but because every generation has successfully labored to make us a more perfect union.”
The US is a great nation not only for what she has been, what she is now but the potential she still holds. Change and progress have come in fits and starts but come they have. I look at how divided the nation is now and wonder if it is a fit or a start. I hear the vitriol and rancor and wonder if we can really get it right this time!
History is an interesting thing. If it is not revised, it is a great tool….
After Michelle Obama’s speech on Monday, there was a claim by Bill O’Reilly of Fox that the slaves who worked on the White House were “well-fed”.
Well, there is actually a first hand account that disputes this claim and is from no other than Abigail Adams, the wife of the John Adams, the 2nd President of the US. She moved into the WH while it was still under construction. David Graham has a piece in the Atlantic about this so I pulled up the reference, which is a letter Abigail Adams wrote. It can be found in the National Archives.

“In the letter to her uncle, a Dr Cotton Tufts, she writes:
From Abigail Smith Adams to Cotton Tufts,
28 November 1800
Columbia City of Washington Novbr 28 1800
Dear Sir
…. The effects of Slavery are visible every where; and I have amused myself from day to day in looking at the labour of 12 negroes from my window, who are employd with four small Horse Carts to remove some dirt in front of the house. the four carts are all loaded at the same time, and whilst four carry this rubish about half a mile, the remaining eight rest upon their Shovels, Two of our hardy N England men would do as much work in a day as the whole 12, but it is true Republicanism that drive the Slaves half fed, and destitute of clothing…whilst the owner waches about Idle, tho his one Slave is all the property he can boast, Such is the case of many of the inhabitants of this place…”

I guess they were not that well-fed after all!

In all, I thought the black man who had more reason to be cynical and dark rather exuded more brightness and hope than the billionaire who exuded darkness and cynicism a week ago in Cleveland. Question is, who will the people listen to?

What Do You Have to Offer?

It was around 1996 and the specter of the Clinton Health Plan was scaring US doctors and medical students alike. A lot of programs in specialties like Anesthesiology and Internal Medicine, couldn’t find residents to fill the needed slots. So several top US programs got together and headed to Europe to find young doctors.
I had finished medical school in Germany two years earlier and after my internship, couldn’t find a job. No one wanted to hire an African! Returning to Ghana was not yet an option as I wanted to finish residency.

One winter night, as I left the Genetics lab where I was working on a project, I saw a flyer. It offered the chance to doctors to go work in the US if one had passed the USMLEs. There was a meeting scheduled for the next evening in an auditorium in the building where the lab was. I made it to the meeting. I met the head of the agency who was organizing the search by the top US programs for residents in Europe. I registered for the interview.

Sometime in the summer of 1996, I headed to Munich for the interview. It was an overnight trip from Berlin. I changed into my only suit in a restroom stall at the train station when I got to Munich. I headed to the venue.
I entered a large hall with lots of people. Each program had it’s table. I registered again, got my name badge and headed to the first table.
For the last two years, I had traveled over Germany begging and groveling for a job. Somehow, my transcript from medical school was just not enough. Somehow what I had to offer was not good enough.
I stood there at the first table, hopeless and expecting disappointment. The words I heard changed everything.
“Dr Ghansah, what do you have to offer our program? Sell yourself!”, the gentleman behind the table said.
I was dumbstruck!
Me? What did I have to offer? Me? A poor African doctor no one wanted but who had a thousand dreams? I was dumbstruck!
“Dr Ghansah, we are waiting!”
Right then, I knew the US was different. Right there, I got hopeful.

I’ve been thinking of this a lot lately as I listen to two very distinct depictions of this country. One is dark and cynical. The other is bright and hopeful.
This country is different. The US hasn’t always done right by all, but man, is this an amazing experiment!
It is a given that there are many for whom life is a daily struggle. It is a given that there are many who are shut out from reaping the opportunities this country has to offer. It cannot be denied that racial bias is still an impediment to some.
In spite of all that, I’ll go with the vision of hope then no other country offers it in spades like the US does. I’ll go with hope because cynicism and darkness never helped anyone.

As an immigrant, I am always grateful for what this country has given me and I can say that about all the immigrants I know. Like me, they all heard that question:
“What do you have to offer?”
That day in Munich, my answer was: “Hard work”.
That is the answer of all immigrants – Hard work. You see, when you offer hope and opportunity, you get a lot back. Hard work, perseverance, creativity, new businesses, entrepreneurs, artists and on and on.

Maybe Americans born and bred here in the US do not see what I see. Maybe they expect more. Maybe their standards are higher. That is fine. However, if you would indulge me, I would like to ask a few questions:
“What does cynicism and darkness get you?
What do they have to offer?”