Antioxidants and cooking

In Chinese culture, food is important in the promotion of good health and much has been documented in Traditional Chinese Medicine textbooks.

The Cockroach Catcher however goes by what his mother taught him from an early age.

In Chinese cuisine, soup is often seen as an important part of a meal. The process of slowly cooking various ingredients is part and partial of that of producing something that is nutritious, delicious and revitalizing. To save energy, we invested in a highly efficient “shuttle chef”, which is basically a double pot, consisting of a smaller inner pot and a larger outer insulating chamber. You first of all heat up the food in the smaller pot, and then seal it in its insulating outer chamber to let the cooking process continue in a slow fashion for a few hours or over-night. Another doctor friend of ours discovered that she could achieve the same slow cooking by putting an ordinary pot into a cool box!

Imagine the disappointment when we first tried to make consommé with good quality meat and found an ever so slight rancidness setting in over-night. Something was not quite right. To solve this problem, we had to go back to basics. We tried adding one more traditional ingredient: gouqizi (derived from Lycium). Eureka! The presence of the antioxidant meant no more rancidness whatsoever.

Dried Gouqisi

Much has been written about gouqisi and some hail it as the new Blueberry. I also read somewhere it was one of the main ingredients in ancient Chinese sex tonic.

a bowl of delicious home made Granola (rolled oats, sunflower seeds, sesame seeds, almonds, raisins, cranberries, flaxseeds, honey)

My wife then applied the principle in Granola making, and it worked like a treat. The secret is to add a small cup of pomegranate juice.

Pomegranates on sale in San Francisco Farmers' Market

The French seemed to have got it right a long time ago. Wine is amongst the best antioxidants for cooking. No wonder Boeuf Bourguignon and Coq au Vin taste so good!

Burgundy wines that I recently bought on my recent trip to the Region

Talking about the essential Chinese soup, I should mention the wonderful Chinese Hot Pot recipe in the excellent World Foodie Guide that my wife recently discovered.

Happy cooking!

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Traditional Chinese Doctor

Yesterday I mentioned Traditional Chinese Medicine. In my book The Cockroach Catcher, I wrote:

“… in this cutting edge work everything counts and the trust and respect of your patient and his or her parents is of paramount importance, just like the trust and respect my parents used to have for the Chinese doctor that they used to take me to.”

When I was growing up, the Traditional Chinese Doctor was possibly the most respected person a child was ever going to meet. More so than his teacher, grand-father, or father. That was the pecking order of respect.

In the unfortunate event of a child having a fever and needing to visit a doctor, he would be taken to the consulting room of a Traditional Chinese Doctor. The room was generally sparsely equipped, with a redwood consulting desk in the middle, set with some calligraphy brushes, an ink well and Chinese rice paper. On the wall behind the doctor you could expect a giant calligraphy piece extolling his skills – literally translated as “kind heart, kind skills”. On another wall there would perhaps be a Chinese water-colour with a theme relating to doctoring. Doctors were said to have the “heart of a parent”.

This is a Chinese painting that used to hang in my consulting room. The Chinese characters can be translated as "the warmth of spring in almond groves". In the Chinese tradition, "almond groves" signify medicine, originating from a Chinese legend of a doctor who lived in the Three Kingdoms era. Instead of paying him, his patients were asked to plant almond trees, five for a serious illness cured, and one for a minor ailment and so on. Both the painter and calligrapher were leading figures in the literary/art world of their times.

The doctor himself usually had a solemn and yet kind look and wore a traditional Chinese costume. No, the mother did not have to tell him anything. All he had to do was to check the child’s pulse and his tongue. There would be no listening to the chest, or any other examination, and definitely no X-ray or ECG.The respected doctor would write his prescription of around ten to twelve medicinal herbs. The mother would thank him and then get the prescription from the Herbal Counter outside his consulting room. Each herb would be carefully weighed and individually wrapped in paper. Back home, the herb mixture would be boiled in water in special pots. Generally three bowls of liquid had to be reduced to eight tenth of a bowl. During the boiling process the pungent stench could be smelt from a block away.The sick child who was kept in his bed could certainly smell it. I always thought that was part of the treatment. A black bitter tasting liquid would eventually be presented to the sick child. How we ever managed to down these potions I was never quite sure. The one possible inducement could be the two preserved plums at the end, given as a sort of reward for the child who managed to drink the full portion. These preserved plums came from the Herbal Counter with the medicinal herbs.

One thing was for sure. Children did not fake illness. Not often anyway unless they wanted to drink that black potion.

In my first ever visit to Beijing, one member of our tour group consulted a famous Traditional Chinese Doctor in the Capital City. Seeing that I was a doctor myself, he told me what happened. He was in awe. He really was. The doctor only checked his pulse and looked at his tongue. Then he told him he had gall bladder problem. My new found friend pulled out some X-ray films from his doctor in Reunion Island. There were gall stones.

I too was impressed.

Alas, I fear that the respect for and trust in doctors in today’s world is waning fast. In my book, I wrote:

“…. Those were the days when doctors in U.K. were amongst the top three most respected professions and Members of Parliament shared the bottom ranking with Estate Agents.

The doctor’s position had over the last ten years moved nearer the bottom end with no such counter moves by Politicians….”

I would love to hear from any reader who disagrees.

Tiger Woods and Breathing

It is appropriate today to congratulate Tiger Woods on his win at the Buick Invitational over the weekend. The CBS commentator revealed that Tiger used a special breathing technique on the course to slow his heart rate to around 50 plus, especially for his putting. It certainly worked, as there were some rather magical putts. A recent experiment showed that tour players generally have heart rate of around 100 at putting. I wonder what their heart rate might be when half a million dollars is at stake, as often happens in a major tournament.

Approaches that do not use chemicals always fascinate me, but unfortunately there are too many wild claims by some proponents that some practices have acquired a bad name. A few of my medical schoolmates are firm believers and more importantly active practitioners of some well known exercises that could be traced back to more ancient times and Traditional Chinese Medicine. I am all for gentle exercises and deep breathing but I will steer clear of the outrageous claims.

Do not do what the doctors tell you to do, do what they do.

No, I did not watch Tiger at Torrey Pines. I was too busy blogging. I watched the final day on CBS. This year the US Open will also be at Torrey Pines. In 2004, the US Open was at Shinnecock, and I did see Tiger at the practice round and took this picture.

I will go and practise my deep breathing now, and then my putting.

Happy golfing.

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Unwillingly to School

“All the world's a stage,
And all the men and women merely players:
They have their exits and their entrances…..

……And then the whining school-boy, with his satchel
And shining morning face, creeping like snail
Unwillingly to school……”

As You Like It:

William Shakespeare (Act 2, Scene 7)

We all need to be reminded by Shakespeare that all the world is a stage. Last week a headline in BBC World News caught my eye: a 10-year old boy who lives outside Monterrey super-glued his hand to his bedstead because he did not want to go back to school after the Christmas break. He had his 15 minutes of fame on the world stage. Or was it 15 seconds?

In my book The Cockroach Catcher, there are stories of a girl who pretended she was three and a half for nearly a year in order not to attend school; a boy who hiccupped for a long long time for the same reason; and a few others who had school attendance problems for one reason or another.

Now, have you ever heard of a child who glued himself to a bed in order not to go to a Pizza or Burger place? Do you wonder why?

Medicine and Snorkelling

The first modern snorkel was invented by none other than Leonardo da Vinci, apparently at the request of the Venetian senate. It consisted of a hollow breathing tube attached to a diver's helmet of leather.

You may wonder why I wrote about snorkels in my book The Cockroach Catcher. The evolution of the snorkel tube makes me think about progress in medicine.

“... In those days we had snorkels that had a Ping Pong ball at the top end – a sort of umbrella handle at the top with the Ping Pong Ball inside a little cage so that it floated up to stop water coming in. ….

Imagine the shock when we went to the Great Barrier Reef and were given snorkels that bore no resemblance to the ones I used in childhood . There was no Ping Pong ball in a cage and there was a drain at the bottom. The top was slightly curved with a clever design so that water from waves could not get in. Any water that managed to get in was drained away at the bottom. I looked at it and smiled. One must always question traditional beliefs. We can be blinded by what looks like a most sensible and reasonable approach – Ping Pong ball in a cage. ...

Medical Schools should remember to teach future doctors that without breaking rules and old dogma, no progress would ever be made in medicine....”

My Point is that doctors sometimes need to “think outside the box”.

Snorkelling is one of my favourite hobbies. I find it so relaxing and therapeutic. Slow breathing, say for 15 minutes a day, is now proven to help reduce blood pressure by a clinically significant amount. What better way to do it than in the sea, surrounded by fish and corals? Here is a selection of some of the pictures that I took over the last six years.

©2008 Am Ang Zhang/Bauhinia Press
Grey angel (Pomacanthus arcuatus)

©2008 Am Ang Zhang/Bauhinia Press
French grunt (Haemulon flavolineatum)


©2008 Am Ang Zhang/Bauhinia Press
Peacock flounder (Bothus mancu)


©2008 Am Ang Zhang/Bauhinia Press
Tobago Cays

The Cockroach Catcher in Costa Rica

The Cockroach Catcher encountered other creatures in Costa Rica and took photos of them.

Strawberry poison dart frog (nicknamed Blue Jean frog)
- Dendrobates pumilio

Hercules Beetle - Dynastes hercules hercules

Green iguana (camouflaged) - Iguana Iguana

Please don't poison our children with stimulants

In yesterday’s NHS Doctor Blog, Dr Crippin drew the attention of readers to the fact that we need to stop poisoning our children. He wrote:

“The fashion I hate the most is Big Pharma driving bad psychiatrists and desperate parents (some but not all of whom have appalling parenting skills) to insert mind-altering medication into difficult children.”

I whole-heartedly agree with his sentiments. What I would like to add is that there are other factors driving this phenomenon. A diagnosis made on the basis of answers to questionnaires – one by the parents, and one by the teacher – is most dubious and unscientific. When Ritalin, the drug that was hardly used in the 80s in UK, suddenly made a comeback, the pharmas could not thank their lucky stars enough. The parents and teachers of course welcome the calming effect of the stimulants. Some of them do not have the time or inclination to deal with these kids otherwise. The “not guilty verdict” plays a part too. The kids’ upbringing, the family and school circumstances are not to be blamed. It is some chemicals causing the havoc! On top of that, a label brings about special state benefits. Now, do we still wonder why the disease is so popular?

In my book The Cockroach Catcher, I told the story about this boy with hydrocephalous who was referred to me. He had just started school and his teacher considered him hyperactive and wondered if he had this new disease called ADD/ADHD and should he be on Ritalin. This is what I wrote about the ADHD phenomenon in that chapter:

“A treatment that had a history of over fifty years, starting life under fairly relaxed FDA rules, was approved for a different purpose in 1980 under fairly dubious circumstances, based on minimal research data on some very small samples. The treatment never caught the imagination of the child psychiatrists of the time and was so rarely used that in 1986 the drug was withdrawn from the British market. Then suddenly it took off and if I say anymore about my personal view on how and why it took off, I might be faced with libel action from the main parties concerned.

The drug concerned is still hardly prescribed in France, a country well endowed with child psychiatric services and the French are rather fond of their medicament. There is no market yet in China which has a fifth of the world’s population and presumably also roughly a fifth of the world’s child population. It probably would not take long for China to adopt it though. Contrary to popular belief, admiration for all things American is endemic in China if not epidemic. You may not think so considering the rhetoric of the leaders. On a recent visit, I noticed one of their bottled water advertisements proudly saying “using the latest US reverse osmosis technology”. For now there are countries both in the first world and in the developing world that have not found it necessary to use the drug.

Most research showed that Ritalin would eventually lead to addiction; but there are some who prefer to insist there is no truth in that. The U.S. is the world’s No.1 prescriber of Ritalin and is also the world’s No.1 consumer of Cocaine. The other listed use of Ritalin is for Cocaine withdrawal.

Why then is there such a renewed demand and interest in diagnosis and drug treatment of ADHD.

It is a sad reflection of our times that we demand fast responses. Being patient is no longer seen as a virtue. Have you not noticed that with faster and faster computers we still consider them slow and therefore manufacturers can continue to sell us “faster” ones? TV and computer games have conditioned kids so that they can rarely hold their concentration for more than three seconds. Even the term “three minute culture” is now out of date – no modern day television or film scene must last longer than ten seconds. How many children nowadays can withstand five hours of waiting at the fishing rod without catching anything? How many mothers have to cope with lines like: I am thirsty, mummy, I want my juice now, please. Are they really going to die of dehydration if mother makes them wait a bit?

Concentration like most other things in our modern society is no longer something that is packaged by our Maker. People need to acquire it and one way is by taking a stimulant such as Ritalin.

Ritalin has also become popular because it takes the blame away from those responsible for the child – the parents and often the teachers as well. Some parents who do not wish for their child to go on Ritalin are often put under tremendous pressure by the teachers. Very few have even bothered to find out if there is any non drug related method at all.”

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Anhinga in Costa Rica - Faking Is Not All Bad

On a trip to Costa Rica last year, we had a most memorable experience in the Tortuguero National Park, watching an Anhinga fishing.

Let me quote you the description of this scene in my book The Cockroach Catcher:

“One of the most exciting birds to watch is the Anhinga. In Costa Rica, they are fairly easy to spot as they dry themselves on a branch or tree stump over the water after their fishing endeavour. The reason it has to dry itself is because it has no oil gland. Some commentators say that the bird is primitive and has not really evolved. Is that so? Without oiling its feathers like most other birds do, it can swim underwater without trapping air and causing a turbulence to slow itself down and to disturb the fish it tries to hunt. Why fix something when it is working well? Unlike the eagle, it does not need to be circulating on top of thermals. To be able to catch fish is more important than anything else.

Its ability to swallow fairly good size fish has been observed and with fish stock not always available, it has the uncanny ability of swallowing a fairly high number of fishes. However, they seem to prefer to kill the fish first. A struggling fish in the stomach may not indeed be the most pleasant thing even for the Anhinga.

There seems little the poor fish can do when faced with such advanced credential in the evolutionary war. That the Anhinga has survived without much evolving is a clear endorsement of its hunting skills. I wonder if its stripy wings mimic shoals of fish under water thus giving the real fish a false sense of comradeship.

In Tortuguero National Park of Costa Rica, we were fortunate enough to observe a catch by the Anhinga. A seven inch fish was the latest victim. The said Anhinga found a little piece of river bank and started to flick the fish. The neck of the Anhinga is strong. I suppose it has to be with all the work-outs under water. The fish seemed exhausted. You could see from the way it looked. Another flick and all was quiet. Cameras clicked and videos zoomed to get a good view.

The fish looked truly dead. In normal circumstances, one flick was enough. It had two. Or was it three?

The bird was now relaxed. Why rush when you can wait till the previous fish is fully down? Spread your wings a bit – there is a huge audience of tourists. It was a beautiful sight – a female Anhinga spreading out its wings. It was indeed a sculpture of exceptional beauty. More cameras clicked and more video whined.

Suddenly. Very suddenly. The little fish came to life. Made a couple of strong wriggly movements, slid into the water and swam off. By the time the Anhinga realised, it was a split second too late. The fish disappeared into the mangrove roots.

We all spontaneously clapped. Support the “under-dog”. Or should it be “under-fish”?

The oldest defence: faking. Not just faking, but faking death.”

Richard Dawkins wrote in his famous book Selfish Gene:

“We are survival machines, robot machines, blindly programmed to preserve the selfish molecules known as genes.”

As an illustration, he observed:

“The parent bird limps away from the nest, holding out one wing as though it were broken. The predator, sensing easy prey, is lured away from the nest containing the chicks. Finally the parent bird gives up its pretence and leaps into the air just in time to escape the fox’s jaws.”

In my child psychiatric practice, I came across a number of children who seemed to have made good use of faking. (In The Cockroach Catcher, there are stories of a limping boy, a boy with non-stoppable hiccup, and a 12-year girl who suddenly thought she was only 3 ½.) I have now come to realise that the human brain is often well equipped to protect its owner and wonder about the role of our intervention.

The William Tell Mom and Peas

Be a bad parent. It is easier for your children.

Now that is a bombshell. Why?

In the book “The Cockroach Catcher”, there is a story about this 12-year old girl who tried to hang herself in her boarding school. This is a quote from that chapter:

“ ……..Bad parents are generally easier to deal with. It is easier for children to know from early on that they are better off not taking any notice of them and they will, at least the resilient ones will, survive. Many children of psychotic parents become independent and tough from an early age. Good parents are more difficult to handle and if they already have a position in society, what are the poor children supposed to do?......”

I enjoyed the performance of The Mom Song Sung to William Tell Overture with Lyrics (everything a mother says in one 24-hour period put to the music of the William Tell Overture), possibly the most watched on Youtube right now. The William Tell Mom is good. She does not try to justify to her children why they have to do as they are told.

“You don't need the reason why because I said so. I am the Mom.”

How often do mothers get into trouble by being too reasonable?

In “The Cockroach Catcher”, there is a story about a toddler who liked to his “big job” behind a sofa in the living room. One day his mother finally plugged up courage to be very firm with him and accomplished what she could not achieve for a long time.

The William Tell Mom sang:

“But right now, I thank you NOT to roll your eyes at me
Close your mouth when you chew
Would appreciate
Take a bite, maybe two
Of the stuff you hate”

Well, don’t be shocked when your child listens and starts washing behind his ears, making his bed and eating what he used to hate.

Let them change!

Sometimes we need to let our children change. There is story about entrenchment in “The Cockroach Catcher”. The mother of an autistic child was so shocked to see her child one day eating peas. He used to hate them.

Here is an extract describing the scene:

A mother was shocked on a lunch time visit that her little Gerry was eating peas.

“Darling, I thought you didn’t like peas.”

“I like them now.”

Mother, now finding it difficult to save face, turned to one of the nurses and said, “Honest – he would be sick”

“He will be fine, he has been having peas for days,” said the nurse.

“These are good,” the autist added, without even looking up at mum.

The William Tell mom had better watch out though, now that she is famous…….

“….Good parents are more difficult to handle and if they already have a position in society, what are the poor children supposed to do?......”

Bauhinia blakeana and other health warnings

The book “The Cockroach Catcher” is published by Bauhinia Press. Bauhinia blakeana is named after one of the British Governors of Hong Kong (Sir Henry Blake-1898 to 1903). An enthusiastic botanist, he discovered it in 1880 near the ruins of a house on the shores of Hong Kong Island near Pok Fu Lam. It is now the floral emblem of Hong Kong. The flower in fact looks like an orchid and is often referred to as a tree orchid. As such it is a mirror symmetrical flower.

Keen observer may notice that the emblem used for the Hong Kong Special Administrative Region does not depict it so but rather as rotationally symmetrical.

The plant is usually sterile and can only be propagated by cuttings or root layering. However, one tree has been found that produces seeds and research is ongoing to settle the hybrid/species debate.

Health Warning:

Any material regarding treatment in this blog and the book “The Cockroach Catcher” carry the usual warning. Do not try it at home. If in doubt, consult your doctor, as long as he has not turned into a monkey. Some material is meant to be light hearted in nature and if you take it seriously, you may need to see your psychiatrist, or maybe not.

Anyone who happens to be faking illness should think twice before consulting his or her doctor or psychiatrist. What the doctor prescribes may indeed be harmful, especially if the person concerned does not need it.

Monkeys and NHS

At least the Cockroach Catcher was no monkey. Those who have read Chapter 1 – The Seven Minute Cure of the book “The Cockroach Catcher” will have to agree. Dr Crippen in his NHS BLOG DOCTOR noted on January 18 that:

“The medical profession has not been allowed to do its job. The government has forced doctors to implement focus group predicated health care. Professional judgment is neither respected nor required. Doctors' morale is at an all time low. Medical care is now all protocols and process. Protocol driven medical care can be done by monkeys, and often is.”

You will find similar sentiments in this extract from the chapter “The Seven Minute Cure” of my book “The Cockroach Catcher”:

“ I am no coward. So let us wait.

Adolescent Units are notorious for making life difficult for authority figures. This is perhaps due to severe professional rivalry. To most of the nursing staff, the only difference between the psychiatrist and them is that the psychiatrist is licensed to prescribe. If a patient is not on medication a psychiatrist would barely be needed. Over time various mechanisms have been introduced to minimize the input of the psychiatrist even when he is supposed to be in charge. Many psychiatrists gave up the fight a long time ago just to survive. A patient’s stay in hospital involves a large number of multidisciplinary meetings that often lead to half-baked treatment plans that have little hope of success. Surprises are unwelcome and generally discouraged.

I have found this kind of ‘consensus’ approach a serious problem. It is simply not my style. Perhaps one of the reasons I stayed as an outpatient consultant all these years was to continue to enjoy the independence from such approach.”

The monkey was in Kruger National Park, South Africa. One day he may be all you would see.

Or perhaps this one from Costa Rica is better. He is a rare species of golden monkey we saw in the Caño Negro wildlife refuge of Costa Rica. He looks more thoughtful.

Yunnan

Now The Cockroach Catcher knows. Yunnan, my birthplace, is one of the most important provinces of China for its bio-diversity. This is a view of its mountains.

©2007 Am Ang Zhang/Bauhinia Press

Occupying only 4.1% of the total area of China, it has over 70% of country's protected wild animals and and over 50% of its high altitude plant species. Geographically, it is north of Vietnam and east of Tibet. You can find more than 400 different kinds of flowers in Kunming, the capital of the province nicknamed "city of spring". I took the photo of this cymbidium orchid there.

©2007 Am Ang Zhang/Bauhinia Press

It might turn out one day that plants are more important than animals in terms of service to mankind. Two most important drugs mentioned in the book are derived from plants. Vincristine in VAMP treatment for leukaemia is derived from the Madagasca Periwinkle. Artemisinin from Artemisia annua was noted in The Ancient Chinese Pharmacopoea dating back to 200 b.c. for the treatment of Swamp Fever. The WHO has now approved an Artemisinin based combination treatment for malaria. By chance Artemisia annua was found growing by the banks of the Potomac River, Washington D.C. and the rest so to speak was history. The world was fortunate that herbicides have not been widely applied around the Capital City of the United States. Unfortunately for medicine, politics dictate what could and could not be shared. For mankind's sake let us hope that "medecins sans frontiere" is really without frontier.

The Naxi tribe of Yunnan had a long tradition of passing on their history verbally through thousands of years of story telling. Their insight into the creation of the universe and more locally of mountains and rivers are now subject of academic research. We saw them performing at the World Heritage Site of Lijiang.

©2007 Am Ang Zhang/Bauhinia Press

Hiccup Boy

A boy was referred to me because he had been having non-stop hiccups for the better part of six months. (For full story, read The Cockroach Catcher - Chapter 13: Hiccup Boy)

Now hiccups may seem a simple enough problem, but the BBC reported in July 2007 that a man in Belfast had it for 5 years:

“An east Belfast man who has suffered from hiccups for five years is hoping a new surgical technique pioneered in the US will give him his life back.

David Willis, who suffers from an incurable condition known as intractable hiccups, hopes a £9,000 operation will end his misery.

The operation involves implanting a vagus nerve stimulator into his upper chest cavity.

He has also tried acupuncture, hypnotherapy as well as numerous other remedies such as drinking water from the wrong side of a glass to blowing into a paper bag, but all to no avail.”

extracted from BBC website: http://news.bbc.co.uk/1/hi/northern_ireland/6907540.stm

No, David Willis was not one of my patients.

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Turtles in Barbados

Barbados is where I first encountered the turtles. This is the photo I took at Accra Beach of a baby turtle that had just hatched.

©2007 Am Ang Zhang/Bauhinia Press

This older one I saw feeding in the sea off Accra Beach.

©2007 Am Ang Zhang/Bauhinia Press