Thursday, July 31, 2008


As we enjoyed the RHS show at Tatton Park, little did we realise how the average gardener and allotment enthusiast has suffered recently in switching from chemical fertilisers to “organic” regimes.

These escaped!

Tatton Park Royal Horticultural Show 2008

It would appear now that staying with simple chemical fertilisers may indeed have been better off for some.
The problem is with “organic” manure.

Observer broke with the news a few weeks ago after gardeners approached the RHS and the government Pesticides Safety Directorate (PSD) with problems regarding distorted crops, particularly potatoes, tomatoes, peas, beans, carrots and lettuce.

Is any produce not affected?

“The Royal Horticultural Society (RHS) has been inundated with calls from concerned gardeners who have seen potatoes, beans, peas, carrots and salad vegetables wither or become grossly deformed. The society admitted that it had no idea of the extent of the problem, but said it appeared 'significant'. The affected gardens and allotments have been contaminated by manure originating from farms where the hormone-based herbicide aminopyralid has been sprayed on fields.”

I am not sure which is more palatable: deformed or withered. I doubt if I would eat either.

So the herbicide gets into hay, which is fed to farm animals, and the manure is now contaminated.

Dow AgroSciences, which manufactures aminopyralid, has posted on its website advice to allotment holders and gardeners. Dow was one of the companies that manufactured Agent Orange, the herbicide used in Vietnam.

“Aminopyralid is popular with farmers, who spray it on grassland because it controls weeds such as docks, thistles and nettles without affecting the grass around them. It binds itself to the woody tissue in the grass and only breaks down when exposed to bacteria in the soil.”

“Guy Barter, the RHS head of horticultural advisory services, said they were receiving more than 20 calls a week. He said, 'It is happening all over the country. A lot of cases we are seeing is where people have got manure from stables and the stables have bought their hay from a merchant, and the merchant might have bought hay from many farmers, possibly from different parts of the country. So they have no idea where the hay came from. So finding someone to blame is quite difficult.' Weedkiller in the soil should dissipate by next year, but in stacks of contaminated manure it might take two or more years to decay, he added.”

As the phenomenon is not localised I suspect we could be heading for another major food disaster.

First we had faked organic dishes, then 500 million faked organic eggs. Now manure.

Is anything safe anymore?

Monday, July 28, 2008

ADHD: Why?

I have in my travels met other psychiatrists who often ask why there is such a discrepancy in the diagnosis of ADHD in the US and the rest of the world.

Perhaps it is something they have in the diet.

Dietary causes have been popular for a while and we all know the kind of food American kids have.
Perhaps it is the television programmes they watch.            Scenes now change every few seconds – used to be every three minutes or so.

Perhaps it is something in their genetic make-up. But the US takes the gene pool from literally every country in the world.

Perhaps they have too many cars. But they took lead out before anybody even consider the harm lead can do.

What about vaccines? Please, we are not going there.

Up until recently American kids consume 90% of the world’s consumption of stimulants although Canada is now taking a bigger share.

The answer may not lie with environmental or genetic factors.

"Psychiatrists Top List in Drug Maker Gifts", reported the New York Times last year, citing disclosures by an unlikely state: Vermont.

I have been to Vermont and in the winter it is as beautiful as the photo shows.

Vermont officials disclosed Tuesday that drug company payments to psychiatrists in the state more than doubled last year, to an average of $45,692 each from $20,835 in 2005.”

The Vermont Attorney General’s office’s report: Pharmaceutical Marketing Disclosures was issued recently (8th of July).
Here is their top 10 drugs list:
Two ADHD drugs top the list.
Now we know.

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Sunday, July 27, 2008

Bottled Water for Dogs and Birds

All is not well with the nuclear industry.

This time the mishap was not in
Russia, but in France. During a draining operation at the nuclear treatment centre, about 75kg of uranium seeped into the ground and into the Gaffiere and Lauzon rivers which flow into the Rhône, according to the Guardian.

A field of sunflowers in front of the Areva Tricastin nuclear plant in in Bollene, in the south of France. Photograph: Fred Dufour/AFP/Getty images

After the incident there was a ban on drinking the groundwater, using it to water fields (as all local farmers do) or swimming or fishing in local lakes and streams. Men in green overalls from the nuclear site appear at local residents’ doors to collect the daily sample of water from their taps to analyse it for uranium. Levels have fluctuated daily.

A few days after the major incident, a tiny amount of lightly enriched uranium leaked but not beyond the plant. This week, about 100 staff at Tricastin's nuclear reactor number four were contaminated by radioactive particles that escaped from a pipe. EDF described the contamination as "slight".

The French government has now ordered tests on the groundwater around all nuclear sites in France. The environment minister, Jean-Louis Borloo, said there were 86 level-one nuclear incidents in France last year and 114 in 2006.

According to the Guardian, President Sarkozy recently announced that France will build a second new-generation nuclear reactor, a European pressurised water reactor or EPR. He said nuclear power was France's best answer to soaring energy prices and global warming. France is of course wanting to be a major player in the building of UK’s new generation of Nuclear Reactors.

For now the Rhone wine industry is under the shadow of the Tricastin leak. Coteaux du Tricastin wanted to change their name.

The locals continue to be cautious. To wash up, locals go out to the yard and fill a bowl from a specially delivered plastic tank of purified water on a fork-lift tractor. They carry the water up to the bathroom to wash.

Even the dog drinks bottled water, and the same is left out for the birds.

Thursday, July 24, 2008

The File Snatching Sign

Not much in medicine is 100% and certainly not in Child Psychiatry.

The most recent addition to important medical signs is
The Sleeping Husband Sign, which, according to the Happy Hospitalist, can predict the lack of acute major illness in the spouse 100% of the time. While this is obviously useful in Emergency Rooms, perhaps it is not so in the practice of Child Psychiatry.

However, I do have a similarly ideal tool to detect malingerers in our practice.

Child Psychiatry is one rotation in Psychiatry that often reduces grown men to jelly. All that you have learnt at medical school and afterwards is suddenly of no use at all. Many juniors do not have problems dealing with adult patients. When faced with a child, some feels like being thrown a scalpel and told to get on with an operation that he or she has never performed.

Where do I even begin this story?

We have juniors from all parts of the world. I being Chinese, ethnic doctors find it easy to bond with me. The truth is that we often still share the same family values.

Now this new doctor comes from a culture where you can only address your parents as father or mother, in your language of course. I point out to him that children in England seem to be on Christian name terms even with their parents. Five years after his consultant appointment, he finally starts calling me by my given name.

He agreed though that he would just have to accept little kids calling their parents Sharon or Kevin.

So Sharon brought this boy to see him. It happened to be his first ADHD assessment. He came out to see me after an hour. He did not think the boy suffered from ADHD but every answer Sharon gave on Conners would point to that diagnosis.

Just spend some time with the boy, I told him.

He did, but the outcome was not what I expected.

In conversation with him, the boy suddenly said, “Sharon is not my mum, my mum is Sheila.”

He went to the waiting area to challenge Sharon.

Sharon tried to snatch his file from him. Luckily he has good reflexes but before he knew both Sharon and the boy disappeared.

So there you have it: The File Snatching Sign – 100% accurate too.

Tuesday, July 22, 2008

Grand Rounds at GruntDoc

MedBlogs Grand Rounds 4:44 The 200th Edition!

Posted by GruntDoc on July 21st, 2008
“The Cockroach Catcher advises how to get out of trouble:
Try Illness First, then Children (it didn’t work; read it anyway).”
Don’t miss
Third World Aid.

It is strange that in the US nobody wants to go into
family medicine. Just the opposite in England.

With our 4 hour A & E (ER to you) wait time, could we apply this

Can we really rely on what patients tell us even about their consumption of
fruit and veg?

Doctoring is fun.

Thanks GruntDoc.

Monday, July 21, 2008

Culture Bound Psychiatry: Plant Talks Back?

It is important to understand that certain behaviour can be acceptable to certain culture. In Indonesia during their Temple Festival many strong young men could get into a trance state as part of their annual ritual. They would even stab themselves with a short dagger but nobody should get too worried as there would be no bleeding.

When I first arrived in England, my first guru warned me not to take any notice of patients talking to plants. The British are fond of gardening and one of the reasons their plants do well is that they are talked to.

Now years later, I became a Consultant, for Child Psychiatry. That did not stop anyone consulting me about adults, especially not my secretary. She has always been sensible and down to earth and years of typing my letters has meant that her thinking is close to mine.

She has a neighbour who is a keen gardener and is in her early sixties. This lady has been in and out of mental hospital and has had a number of ECTs for whatever diagnosis she had. She has one of the best gardens and conservatories in the neighbourhood. Her daughter lives nearby and keeps a close eye on her. My secretary invariably keeps an eye on Mum when her daughter goes on holiday.

Mum talks to her plants all the time.

Then one day when the daughter was away on holiday, Mum came over to my secretary to say that one of her new plants talked back to her. My secretary was not one to jump to conclusions and yet this might well be a relapse, she thought, brought about by life stress factor like daughter being away and so on and so forth.

My secretary did not really want to disturb her friend on holiday.

“I know it was probably the wrong thing to do, but I decided to go and listen.” She knows I always advise that if a child says he sees a ghost, the mother should not go and look for it.

So she went.

The plant talked to her.

Am I losing my secretary too?

She has a friend who works at Wakehurst Place, the Royal Botanical Gardens in West Sussex. If anyone is to know about a plant that talks to you, it would be them. She called her.

I have always maintained that one should have a good grounding in subjects way beyond one’s specialist field.

"Perhaps she knows about plants and mental illness!"

She assured her that she would be sending a team as soon as possible. In the meantime the lady should keep the plant in the conservatory.

Soon a white van turned up at the lady’s front door. The botanist and two others, all kitted out like they were going to the moon, got off the van.

They were not coming after the gardener. They came for the plant. It was secured in some black nylon case and properly taped up and loaded into the van. The team left.

None of the other plants talked.

A call came later. The plant was a Yucca, and Yucca does not normally talk. However, this particular Yucca was imported in a pot, together with a family of Goliath Tarantula. This specimen is bird eating and one special characteristic being:

Goliath Tarantula

Theraphosa blondi (SmithsonianZoo)

“It makes noise—not with vocal cords like dogs, cats, birds, or humans—but by rubbing together the bristles on its legs! This hissing noise called stridulation is loud enough to be heard up to 15 feet away.”

The old lady was not suffering from a relapse of her illness after all – no re-admission to hospital then.

My secretary’s botanist friend happens to have spent a year in Central and South America, and so she is knowledgeable about tarantulas. Although some tarantulas are kept as pets, this particular species can hurt by shooting hairs (actually hairlike setae) from its body at any creature—including a human—it perceives as a threat. The tiny, almost invisible hairs can be extremely irritating to skin, and can cause real problems if they get into delicate mucous membranes around the eyes or mouth.

Wakehurst sent the neighbour a new Yucca plant, straight from Kew’s own stock. Nice touch.

Sometimes it pays to listen!

We do what we do because of our interest and sometimes we are glad we do not even have to do anything.


Sunday, July 20, 2008

Try Illness First, then Children

Le Rêve ownership trail

It is fascinating how research on the World Wide Web can throw up amazing things from different corners of the globe.

When I tried to look up who owned Picasso’s Le Rêve before Steve Wynn, something interesting showed up. From the Guardian (July 2007):

“He was a serially rich hedge fund manager, a New York socialite married to the granddaughter of ex-US president Dwight D. Eisenhower; the owner of four dozen works of art by Degas, Renoir and Cézanne, he paid $244m (£120m) in 1998 for Van Gogh's ‘Dr Gachet’ and Picasso's ‘Le Rêve’.

This week he is sitting with eight others in the dock in Vienna accused of breach of trust and fraud in one of Austria's biggest corporate scandals.”

Wolfgang Flöttl is his name. The scandal broke in 2006 and he was alleged to have carried out speculative dealings, sparking Bawag losses of almost 1bn euros (£690m). Interestingly Flöttl is the son of the Bawag’s former head, and Bawag, which used to be owned by the Austrian Labour Federation, is a bank set up in 1922 in Austria for waiters and carpenters.

For waiters and carpenters, indeed there is money to be made everywhere!!!

Flöttl also had close personal and business association with the ex-chief of Refco, Phillip Bennett, a British citizen. Refco, a major US commodities brokerage firm and one of the world’s largest, went public in August 2005 and filed for bankruptcy protection just weeks later – after disclosing that a $430 million debt owed to Refco by a firm controlled by Mr. Bennett had been concealed, and after securing a $350million loan from Bawag only a few days earlier, via Flöttl.

“In stifling heat the court has heard from prosecutor Georg Krakow how ‘everything has gone’ from the €1.4bn Bawag invested in ‘forbidden speculations’ and ‘disastrous clandestine deals’ run by a ‘little clique’. Krakow, armed with 70,000 pages of documents, is seeking up to 10 years in jail for the accused, including two ex-CEOs, Helmut Elsner and Johann Zwettler….

Elsner, a 72-year-old who fled to his sumptuous villa on the Côte d'Azur when the scandal broke but was extradited in February despite heart surgery and pleads innocence, was said by his lawyer Wolfgang Schubert to be ‘a loving family man who sits with his granddaughter on his lap and reads her stories’”.

To get sympathy, always try illness first, and then for character reference, add children for good measure.

In Austria Elsner was known for his lavish lifestyle, passion for sports cars and penchant for smoking large, expensive cigars while walking his dog.

But the Guardian did not think that judge Claudia Bandion-Ortner would be buying into that old chestnut.

The report continued:

“But Flöttl, who fell out with Elsner at a meeting in London in late 2000, has been singing to the authorities, according to his lawyer, Herbert Eichenseder, who proclaimed his innocence and said he had supplied 70% of the evidence.”

In times like this you sure know who your friends are.

Was justice done in the end?

Earlier this month, all nine defendants were found guilty and sentenced by Judge Claudia: Elsner to nearly 10 years behind bars and Flöttl two and half years, most of that suspended.

Bennett, the ex Refco chief, was sentenced in US to 16 years in prison.

The judge commented: Mr. Bennett and others like him who break the law in their zeal to be among the world’s richest people are “staggeringly arrogant.”

The Refco lawyer was also indicted. From WSJ (December 2007):

“In a rare case of a lawyer being charged in connection with the alleged wrongs of a client, Chicago lawyer Joseph Collins was indicted today on fraud and other charges in connection with the 2005 collapse of Refco.”

What an intriguing web of corporate greed and fraud, and yet we owe it the story of Le Rêve!

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Saturday, July 19, 2008

The Open and The Brain

“If you have a 10 handicap you would have shot 130 today.”

Credit: John Biever/SI

That was the comment made today by one of the Golf Channel commentators at Royal Birkdale on the third day of the 137th Open Championship. The wind was brutal on this Links course. A real test not of strength and distance but of skill and course management.

Credit: John Biever/SI

Greg Norman, the 53 year old newly wed will be going into the final day as the leader, seeking golf’s most sought after title.

Credit: John Biever/SI

He is of course married to Chris Evert the tennis legend and if he should win tomorrow he would become the oldest man to have won a Major, not to say The Open. He has not even played that much golf recently. Yet on the first two days he single putted 17 holes including a 50 footer. Perhaps his brain has been well primed by years of putting, more years than any of the other players.

We shall know soon enough.

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Friday, July 18, 2008

Honey Money Money

Photo: AFP Saul Loeb

As we settled into our holiday condo I noticed that the porch was covered in a think layer of yellow powder. Normal dust is black. The tennis courts have green artificial clay, and as we are on the third floor not much of that works its way upstairs. What can this yellow powder be?

I turned on the television and after some channel hopping, found a Nature program. It reports that the Chinese are now artificially pollinating their pear trees. Wow. Just how many flowers are there on each tree? Well, China is not short of this kind of manpower.

All this is of course to do with mysterious bee disappearances and CCD – short for Colony Collapse Disorder. When it was first noted, many theories were put forward. Was it due to a change to nicotine based pesticide? Was it due to the mobile/cellular phone transmitters? Or was it the effect of global warming?

An analysis of nectar collected by bees showed alarming results. In one sample, 40 different pesticides were identified.

Until now, I have thought that honey is the healthiest food around and that it can keep forever because of the antibiotics added by the bees. Maybe I need to revise my knowledge base.

Yes, China did admit to using a lot of pesticides. After the last crop failure, they decided to collect the pollens and fertilise pear flowers by hand, using feather brushes.

By the way, when the pears are formed, every single pear on the tree is wrapped in a paper bag by hand. I remember doing the same years ago in our village home to protect the guava and loquat fruits. We only had a single loquat and two guava trees though.

Then, towards the end of the programme, all were revealed in a conference: CCD is caused by a virus (Israeli Acute Paralysis Virus -IAPV) originating from Australia. As Australia export their bees to the US mainly, there is a serious money issue.

Where was the conference? Melbourne, Australia. Who made the discovery? USA. Now, that could cause even more problems.

So, the cause of CCD is not pesticide, electrical waves or even global warming. Just a virus.

At least I know what caused my little local problem: as the bees are not collecting the pollens, the pollens get blown to our porch. The remedy: the well tested Chinese manual method. I proceeded to fill my bucket with water and fetch my microfibre mob.

Yet a couple of months later, Australian bees were cleared by the USDA. The bees were not dropping dead like they should but just ran away from their colonies.

Wow. We still do not know.

However, if the problem continues and American orchards need to pollinate like the Chinese do, the labour cost would be US $60 billion per year in California alone, not including Oregon or Washington States.

Bees did it for free and we even took their honey.


Thursday, July 17, 2008

Grand Rounds (4) 43 from Unprotected Text

Thank you Unprotected Text for hosting Grand Rounds 4.43.

The second year medic could smell a RAT in my post: It May Not Be All In The Mind.

The selections gave me hope regarding the next generation of doctors.

We however had ample warning of the bad apple amongst us from Dr Crippen. We also had a glimpse of how things might turn out for our National Health Service from TBTAM.

Friday, July 11, 2008

It May Not Be All In The Mind

In The Cockroach Catcher and in the Chapter with the same title:

“I have often wondered if it would be such a disservice to mankind if doctors were not so understanding of the psychological side of things.

The possibility of a serious illness being missed is of course a major concern when a patient seeks help for one reason or another. To put psychological conditions at the top of the list of possible diagnosis is dangerous.”

My good friend told me about a case that was first thought to be a psychiatric one. It was a severe case of Trichotillomania (hair pulling disorder) that had to be admitted to a mental institution compulsorily.

This is the same friend who alerted us to the radiation dose of some routine health checks.

Trichotillomania is not a condition that requires compulsory admission, so why in this case?

"The patient was sure someone was trying to harm her."

Oh! Acute paranoid psychosis. That makes sense. Anything else? I suppose she had to be on the most up-to-date anti-psychotic and anti-obsessional drugs.

No, before they could pump these drugs into her, her friend bailed her out, against medical advice, and got my friend to see her.

Great friend!

But what could have caused the hair loss?


No way, she was not a spy!

Yes, it was poisoning, not by Polonium, but by Thallium. That was what my friend’s investigation showed.

Thallium has been a noted poison favoured by Secret Services and one famous Graham Young in England. He poisoned his stepmother at the age of 14 and then other members of his family. He was caught and sent to Broadmoor, a maximum security mental hospital in England.

Miraculously he was declared “cured” and released. Nice justice as my friend’s patient was detained by being a victim and they let the perpetrator go despite his diary claiming he planned to kill one person for every year he spent in Broadmoor!

Young then proceeded to find employment as a shopkeeper at Bovingdon, Hertfordshire, where his co-workers were one by one struck by a mysterious illness nicknamed “the Bovingdon Bug”. One died but Young’s arrogance brought his downfall. He challenged the doctor dealing with the “Bug” in a public meeting as to why Thallium poisoning was not considered!

At one time, Thallium was used as a rat poison as even the rats could not detect it by taste. Now it has been banned in most countries but still poses a health risk.

As recently as 2007, two women, a mother and a daughter, who were both born in Russia but became American citizens, had Thallium poisoning on visiting Russia. They survived. The mother is a medical doctor.

It turned out that my friend’s patient was being poisoned by her partner. Prussian Blue was prescribed as the remedy and she survived, sort of, with residual neurological damage due to delay in diagnosis and appropriate treatment.

Paranoid psychosis indeed!

Just remember: it may not be all in the mind.


Thursday, July 10, 2008

Autism: Gene Disruption?

National Institute of Mental Health (NIMH) Press Release today:

"Common Mechanisms May Underlie Autism’s Seemingly Diverse Mutations"
"A research team led by Christopher Walsh, M.D., Ph.D., and Eric Morrow, M.D., Ph.D., of Harvard University, found two large sections missing on chromosomes in people with autism and traced them to likely inherited mutations in such genes regulated by neuronal activity. They report their findings in the July 11, 2008 issue of Science.

The study breaks new ground for complex disorders like autism, taking advantage of a shortcut to genetic discovery by sampling families in which parents are cousins. The researchers found genes and mutations associated with autism in 88 families from the Middle East, Turkey and Pakistan in which cousins married and had children with the disorder."

Associated Press tried to put through the good news about this finding:

“.......the missing DNA didn't always translate into missing genes. Instead what usually was missing were the on/off switches for these autism-related genes. Essentially, some genes were asleep instead of doing their synapse work.”

Walsh agreed: "Autism symptoms emerge at an age when the developing brain is refining the connections between neurons in response to a child's experience, whether or not certain important genes turn on is thus dependent on experience-triggered neural activity. Disruption of this refinement process may be a common mechanism of autism-associated mutations."

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Tuesday, July 8, 2008

Grand Rounds from The Blog That Ate Manhattan

Blogging is GOOD for you! It's official!

Grand Rounds from Manhattan we have free association in full swing, with all the collections of Seinfeld.


“Most things in life can be related, one way or another, to an episode of Seinfeld.”

Thank you for including Plums in the selection. Kramer should really try some Chinese Preserved Plums for the reasons outlined in my post: Ancient Remedy: Modern Outlook.

As an aside, I blog for a selfish reason, as given in
Sharp Brains:
“To increase neuroplasticity (the continual ability of the brain to "rewire" itself) and neurogenesis (the formation of new nerve cells), brain stimulation is vital. All types count including school work, occupational endeavors, leisure activities and formal brain training. The key in any activity is to include novelty (to encourage thinking outside the box), challenge and variety.”

Blogging is therefore good for you, especially if you think outside the box. It should be fun, most of the time.

Just don’t overdo the
watermelons, which are said to relax the blood vessels and likely to increase Libido.

Monday, July 7, 2008

G8: Carbon FOOD Print

Gordon Brown wasted little time on his long flight to Hokkaido: he told his beloved British people not to waste food.

The Japanese people were hospitable and were proud that their Michelin starred chef produced an elaborate eight course menu.

The G8 Dinner Menu: The translation is from the Japanese Government according to the Daily Telegraph.

Hokkaido, Blessings of the Earth and Sea

First course:
Corn stuffed with caviar
Smoked Salmon and Sea Urchin "Pain Surprise style"
Hot Onion Tart
Winter Lily Bulb and Summer Savory
Second course:
Folding Fan Modeled Tray decorated with Bamboo Grasses for Tanabata Festival
Kelp-flavoured cold Kyoto Beef shabu-shabu, asparagus dressed with sesame cream
Diced fatty flesh of Tuna Fish, Avocado and Jellied Soy Sauce, and Japanese Herb "Shiso"
Boiled clam, tomato, Japanese Herb "shiso" in jellied clear soup of clam
Water Shield and Pink Conger dressed with Vinegary Soy Sauce
Boiled Prawn and Jellied Tosazu-Vinegar
Grilled Eel rolled around Burdock strip
Sweet Potato
Fried and Seasoned Goby with Soy Sauce and Sugar
Third course:
Hairy Crab "Kegani" Bisque Style Soup
Fourth course:
Salt-Grilled Bighand Thornyhead with Vinegary Water Pepper Sauce
Fifth course:
Poele of Milk Fed lamb from "Shiranuka" flavoured with aromatic herbs and mustard Roasted Lamb with "cepes" and Black Truffle with emulsion sauce of Lamb's stock and pine seed oil
Sixth course:
Our special selection Cheese, lavender honey and caramelized nuts
Seventh course:
G8 Fantasy dessert
Eighth course:
Coffee served with Candied Fruits and Vegetables
Le Reve Grand Cru Brut/La Seule Gloire Champagne
ISOJIMAN Junmai Daiginjo Nakadori (Sake)/Isojiman Shuzo Shizuoka
Corton Charlemagne 2005/Louis Latour Bourgogne
Ridge California Monte Bello 1997
Tokaji Essencia 1999 from Hungary

The Cockroach Catcher's review:

Corn stuffed with Caviar: People have been trying to make bio-fuel with corn. Now corn is deemed to be good enough to match Caviar.

Sea Urchin "Pain Surprise style": You sometimes wonder about Japanese Chefs. They have a wonderful sense of humour. Maybe this Japanese chef is with us. To step on a sea urchin is a painful experience as your flesh is connected to the outside world for days if not weeks. But it may just be the translation.

Kyoto Beef shabu-shabu: In Kyoto this is served straight from a boiling hot broth on the table. This I presume is pre-cooked and presented cold.

Fatty flesh of Tuna: This is the belly part of the Tuna that is highly valued by the Japanese and generally costs four to five times more than other cuts. I am not sure if they specifically tested these, but the higher fat content usually means higher mercury content too. Maybe the G8 submit guys don't worry too much about that.

Pink Conger, grilled eel: It shows how much the Japanese love eel. Conger eel is a lovely creature to see on snorkeling. I hope they leave some .

Bighand Thornyhead: This is a fish, very much like the Red Snapper.


Le Reve Grand Cru Brut/La Seule Gloire Champagne: What! The first is Picasso's painting owned by Wynn and so must be Californian. The second is in fact Japanese. The Japanese never waste any opportunity to promote their products. What is wrong with good old Monk’s fizzy?

Tokaji, not d’Yquem: For the French to be snubbed once is bad, but twice on the wine list? What has Sarkozy done to the Japanese, I wonder.

You may also think that I am in competition with Foodie sites. Do not worry, I am only a Cockroach Catcher, and I expect many non-foodie sites will be blogging the G8 menu.

On the official G8 Website:

“The volume of the image files is controlled to reduce electricity consumption.”

How much greener can you get?

A mere 40,000 Japanese Policemen were involved in ensuring the comfort of the participants during dinner. Only US $ 480 was spent for the whole summit. Oh, millions I mean.

Friday, July 4, 2008

An Entrepreneur!

In the WSJ two days ago there was a report:

“……UnitedHealth Group Inc. (UNH) agreed to pay $912 million to settle two class-action lawsuits regarding its stock-options practices……”

Rewind to last year in the
New York Times:

“In one of the largest corporate pay give-backs ever, William W. McGuire, the former chief executive of UnitedHealth Group, has agreed to forfeit at least $418 million to settle claims related to back-dated stock options.”

How very sad! $418 million is a lot of money!

“The payback is on top of roughly $198 million that Mr. McGuire, an entrepreneur who built UnitedHealth, had previously agreed to return to his former employer.”

An entrepreneur! This reminded me of Dr Crippen’s blog about NHS entrepreneurs, and I duly alerted him. UnitedHealth is said to cover the Health Insurance of 70 million US Citizens.

“As part of the settlement with the S.E.C., Mr. McGuire will pay a $7 million fine and will be barred from serving as a director of a public company for 10 years.”

Oh, no, another $7 million and 10 years! You must feel sorry for him.

“He will, however, be allowed to keep stock options valued at more than $800 million, including many that have been sharply criticized.”

Thursday, July 3, 2008

Ancient Remedy: Modern Outlook

As the heat wave struck the west coast of America, farm workers had to cope with temperatures upwards of 90+°F. Many such workers are what they euphemistically called undocumented, a term describing illegal immigrant workers who has helped to keep fruit and vegetable prices at about half of that of the UK and most of Europe.

Disaster struck last week, one such 17 year old girl collapsed with heat stroke and died two days later. She was said to have a core temperature of 108°F when admitted, and also found to be pregnant. Her employers instructed the family to tell the hospital staff that she was out jogging. In a vineyard in California. How creative!

Governor Schwarzenegger attended the funeral and said: “This land gives us a lot of opportunities but gave her death, and we have to make sure this doesn't happen again."

Such happenings are not limited to the US. In 2004 some illegal migrant workers from China drowned while picking cockles at Morecambe Bay in England.

Chinese farm workers have always worked in the heat of the fields but heat stroke seems to be rather uncommon. I wonder if our dried preserved plum has something to do with this.

Preserved Plum---Batou
The Chinese preserved plum is said to quench thirst, and as a child I could never really understand the rationale. Now I know. It is preserved with salt, sugar and herbs such as licorice by a complex process. If you suck one of these plums and then drink water, you have the combination of sugar and salt that carries the salt back into the system. Why plums? Like a lot of fruits, plums contain potassium. This is oral rehydration therapy (ORT) the ancient Chinese way, before the science of modern ORT.

It has to be said that the diet of many such Chinese workers was generally higher in sodium, from dried salted fish and vegetables. It is likely that the serum sodium of many such workers would have been at the high end of the normal range. Modern advice on cutting down sodium often does not take account of sweating in hot countries. A friend of mine with hypertension had an epileptic seizure when he went to work in Singapore. Luckily the medical services there were alert to the problem and he survived. He was on a low sodium diet and on diuretics amongst other medications.

I also remember one very hot August day when we hiked down Grand Canyon to Angel Point. There were warnings everywhere of the risks and even fatalities on such walks. The National Park did have clean drinking water taps along the way and one particular girl overdid the drinking. She had a narrow escape, as the Ranger fortunately knew a thing or two about rehydration. He put some salt in a can of Sprite and reverted a potentially serious situation.

When the first public golf course was opened on the beautiful island of Kau Sai Chau in Hong Kong, drinking water was provided along the course. One player drank so much that he nearly died of water intoxication (result of drinking excessive amounts of plain water which causes a low concentration of sodium in the blood leading to amongst other problems: ‘brain’ swelling---cerebral oedema). Marathon runners are at greater risk than most as reported by the New England Medical Journal. There have been other notable cases of water intoxication elsewhere. I remember one of my professors telling us: the body survives dehydration much better than drowning. How right he was, as water intoxication is in a sense a kind of drowning.

The first time we went to Thailand the most amazing dip was simply a bowl of sugar that has been mixed with salt and some chopped chilies for good measure. This dip was used for serving unripe mangoes, papayas, guavas and other local fruits, and gave me a taste sensation that was unforgettable. Same principle as ORT.

In Thailand, workers in rice fields, fruit orchards and vegetable patches manage to survive temperatures of over 100°F.

Governor Schwarzenegger did legislate in 2005 and had stringent rules for farmers regarding health provisions such as toilets and water stations for their workers. However, rules get broken often because of cost. Technology is there for safe rehydration. Remember Gatorade? If Governor Schwarzenegger was to legislate for the employers to supply Gatorade, imagine the impact on the price of fruits, vegetables and wines: probably doubling or tripling!

On the other hand, Chinese dried plums are such neat, little, easy to carry things. Perhaps we should try to popularize this ancient remedy for the benefit of all. Be warned, only those made with sugar and salt work, not the ones with artificial sweeteners.


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Wednesday, July 2, 2008

Hot Brain

PLoS Biology
In today’s New York Times:
“The new report, published in the free-access online journal PLoS Biology, provides the most complete rough draft to date of the cortex’s electrical architecture, the cluster of interconnected nodes and hubs that help guide thinking and behavior. The paper also provides a striking demonstration of how new imaging techniques focused on the brain’s white matter — the connections between cells, rather than the neurons themselves — are filling in a dimension of human brain function that has been all but dark.”
PLoS Biology
This is literally a wiring diagram: a new tool for psychiatrists perhaps? This professor is really excited:
“This is just about the coolest paper I’ve seen in a long time, and forward-looking in terms of where the science is going,” said Dr. Marcus E. Raichle, a professor of neurology and radiology at Washington University in St. Louis.
The study was a collaboration that included the University of Lausanne in Switzerland, Harvard and Indiana University using a new technique called diffusion spectrum imaging.
PLoS Biology
For those interested read the full article in PLoS Biology and they should have the last words:

Future improvements in diffusion imaging and tractography, as well as computational network analysis, will no doubt reveal additional features of the connectional anatomy of the human brain. It will be important to include major subcortical regions, such as the thalamus, into future network analyses. Another advance would be to parcellate cortex not on the basis of sulcal and gyral landmarks, but rather on the basis of regularities in functional connections that are observed in individual participants [49,50].

Our data provide evidence for the existence of a structural core in human cerebral cortex. This complex of densely connected regions in posterior medial cortex is both spatially and topologically central within the brain. Its anatomical correspondence with regions of high metabolic activity and with some elements of the human default network suggests that the core may be an important structural basis for shaping large-scale brain dynamics. The availability of single-participant structural and functional connection maps now provides the opportunity to investigate interparticipant connectional variability and to relate it to differences in individual functional connectivity and behavior.

Golf and Disability

Many disabled people overcome their disability and compete in sport events to a high level – a testament to the power of human resilience.

Stacey Lewis - Scott Halleran / Getty Images

In the US Women Open last week, Stacey Lewis, who led into the final day and in the end just missed being joint second by one stroke, suffers from scoliosis and has a metal rod and five screws to support her vertebrae. You may think it is not so bad except golf is all about twisting your spine. For four months after surgery, she was only allowed to chip and putt and nothing else. That must have improved her short game a lot.

Unfortunately she had such a bad break on the final hole, landing her ball in the bunker such that it was impossible to get any stance that would have enabled her to get the ball to any reasonable proximity to the hole. She did her best under the circumstances, managed a par.

Inbee Park US Women Open 2008 - Golf Channel

Inbee Park made history by being the youngest to win the US Open at the age of 19, just under ten years after starting golf. On one of LPGA’s longest tournament course, Park, herself not a long hitter, proved yet again that one putts for dole. I feel sorry for some talented players that shall remain nameless being pushed to drive some further yards by their coach. For what, I asked: for show, obviously.

The other Park, Angela, who I followed on the second day of the recent Ginn Tribute, led on the first day and was joint third with Stacey and In-Kyung Kim. Her short game was good too.

Kelli Kuehne on Diabetes Treatment - LPGA

One of the veterans, Kelli Kuehne, suffers from diabetes from age 10 and she now wears an insulin pump. She has not done too well for a while but seems to have got better recently.

And then there is Butch Lumpkin, the Thalidomide sufferer. Here is the video from the Golf Channel.

He plays off an eight handicap and drives 260 yards. But watch his putts. He is known as the man with no arm. He plays tennis too. He just does not complain and rises to every challenge. "Life is all about adapting to what lies ahead," he said.

His ambition is to play Tiger Woods for his usual wager, a Chipote ice cream. Come on, Tiger, for charity.

Golf Posts:
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Ancient Remedy: Modern Outlook
Golf and Health
Tiger Woods and Breathing

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