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Author Archives: robinengelman

the Eyes have it.

Toronto has long been a major medical center. Sick Kids Hospital is perhaps the most famous. Built to an open plan, Sick Kids doesn’t feel like a hospital and the caregivers make kids comfortable and just as important, the kids’ parents. Then there is Toronto General Hospital which is arguably North America’s pre-eminent center for brain research. Princess Margaret Hospital is Canada’s cancer treatment center and Mount Sinai Hospital’s emergency ward is the place you want to go when you do something stupid.

Starting in 2004 my hangout has been the Toronto Western Hospital’s Retina Clinic. It’s about 7 blocks north of me on Bathurst Street and houses the latest technology for detecting and treating eye diseases along with a crew of famous opthomologists including my man Mark Mandelcorn who was recently proclaimed Ontario’s Care Giver of the Year. Dr. Mandelcorn was a McGill University top graduate and along with his son Efrem whose practice is also in the Western clinic, is a leading member of Toronto’s retinal surgery community and faculty member at the University of Toronto.

I first met Dr. Mandelcorn soon after The Case of the Disappearing Automobile. The day had begun as any normal day.  The sky was clear and traffic sparse as my wife and I drove the four lane highway towards our home in Toronto.  I was in the passenger’s seat when an automobile passed us on the left. As it pulled back into our lane well ahead of us, it vanished. There were no off ramps or pullovers for miles. “It’s your macular hole” Dr. Mandelcorn said.  “I beg your pardon!”, came to mind, but I said nothing. One does not quibble with Dr. M., much less attempt double entendre.

After sedating me, Dr. M.  injected a bubble of gas into the back of my eye and told me to sit or lie face down every day for as long as possible. The weight of the gas would gradually close the macular hole. As the gas leached out, it appeared as a dark bubble floating in front of me, bobbing in space and growing ever smaller. When the gas was gone and the hole closed, Dr. Mandelcorn smoothed out the scar with a laser beam and removed some cataracts. Cataracts from my right eye were removed with ultrasound, the latest technology. Neat. I recall my grandmother’s experience with cataract surgery many years ago. It was successful, but she had to lie in bed on her back for 2 weeks with her head securely held in place by weights. In those days, cataracts were removed with a scalpel. I remember her eye glass lenses were very thick. How fortunate we are.

After my hole was closed, the years following became an education in the vagaries of cataracts, vision scientists, Charles Bonnet Syndrome, neurology, MRIs, retinal hemorrhaging, field of vision tests, laser and ultrasound surgery And macular degeneration.

There were many tests during the ensuing years. For some people, a needle injection is a simple matter. For me it’s a real pain in the arm. My veins are small, thus a pediatric needle is necessary when one plumbs for my blood. While waiting for test results, I’d watch people.  Patients with vision problems tend to be elderly and carry elderly odors. Perfumes, colognes, old clothes and strong tobacco scents join the normal hospital smells to create if you will, an olfactory potpourri. A woman came out of the bathroom and as she began rummaging about in her purse, launched a brief sotto voce fart. She didn’t seem to notice, nor did anyone else. Just another ingredient in an already complex recipe.

Last week, I brought the latest test results to Dr. Mandelcorn. He told me he would inject something into my eye, but I never really thought about it until I saw a syringe and needle on a white table next to me. The eyeball and razor scene in Louis Buñuel’s film un Chien Andalou (1929) came to mind. An assistant anaesthetized my eye and Mandelcorn administered drops of iodine, which he pronounced iodeen. I commented on his pronunciation of iodine and he abruptly said, “Don’t talk”. At that I chuckled and he said,”Don’t laugh.”  And then, as if to teach me a lesson, he leaned over and slowly brought the needle ever closer to my eyeball. After a small jab, Dr. M. finished injecting the Lucentis and was finished, as was I.

About one in1000 patients experience infections after having this procedure. His commands to not talk or laugh were not meant to be impolite, but rather to keep me from further polluting the air in the room. I told him he was perfect and I took no offense.  That’s not exactly what I meant to say but he smiled and said he’d see me in 6 weeks.

By the way, I have wet macular degeneration in the right eye and dry macular in the left eye. At this time dry macular cannot be cured, but mine is progressing very slowly and time might be in my favour. The wet macular may be impeded, even eliminated with periodic injections.

The reader can look up Charles Bonnet Syndrome. It’s really quite interesting and for some reason, most prevalent in Australia! For a few years I’ve been happy to tell people that I had Charles Bonnet Syndrome. It’s a great conversation starter, but alas I no longer have it. My problem has been bright pinwheels in the center of both eyes. These are caused by a malfunctioning nerve. They never go away and I can no longer drive an automobile or read a book. I cannot identify people until I’m almost on top of them. This can be a good thing. It’s handy during the annual Percussive Arts Society International Conventions where a lot of people know me, but my lousy memory prevents me from remembering their names. I’ve tried to get the word out that I have vision problems and that’s beginning to take care of the situation. Now people will say, “Hi Robin, it’s Bill”. I no longer have to pretend knowning their names as I try sneaking a peek at their name tags. Anyway, that gambit never worked.

 

A human eye projected on a computer screen by the Hawk USB Digital Microscope. The white circals are the microscope's lights.  Image by Bryce Engelman.

A human eye projected on a computer screen by the Hawk USB Digital Microscope. The white circles are the microscope’s lights. Image by Bryce Engelman.

 

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Finland Appeals to its Vacationing Musicians

Finland is the 8th largest country in Europe and with 5. 5 million people it is the most sparsely populated in the European Union. Finland regularly earns highest ratings in education, economic competitivness, civil liberties, quality of life, human resources, and a 70% universal health coverage, paid maternity leave, the World’s highest standard of living, and full suffrage since 1901. Finland is considered by many people the best governed country in the world.

As a US citizen, I enjoy statistics such as these because they provide me a perspective when evaluating my nation. With a  tax base of over 200 million people and arguably one of the World’s wealthiest countries, the US will not provide universal healthcare, and that’s just for starters.

Prompting all the above were photographs from friends showing two of three vacation cottages owned by the Musicians Union of Finland. They are in southern Finland on a lake near the ocean and both are available via lotttery to union members for very low rates. Also available to members is Union owned housing in London and Berlin.

Given Ontarian’s obsession with their summer cottages “up north”, this might be an idea worthy of consideration by the Toronto Musician’s Association. Below are two union owned vacation homes in the south of Finland. My thanks and envy go out to Tiina Laukkanen, Principal timpanist Tampere Philharmonic; her husband Sami Siikala, trumpet, Lahti Symphony Orchestra and their two daughters, Lotta and Lilli Sisko for providing all the photographs.

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Views of a19th century home refurbished by the Musician's Union.by the Musician's Union in southern Finland's lake district.

Views of a19th century home refurbished by the Musician’s Union in southern Finland’s lake district.

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One of two cottages in this style.

One of two cottages in this style.

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ISIS

The Islamic State in Iraq and Syria-Levant

I’ve been wondering why a militant Arab organization chose an English acronym to advertise its jihadist movement. After all, if it feels obligated to occasionally kill co-religionists, shouldn’t it do so under a banner written in its own language: Al-Dawlah al-Islāmīyah fī al-ʻIrāq wa-al-Shām.?
Maybe ISIS thought its Arab name would not trip so lightly off the tongues of Englsh language television commentators, nor prove to be a memorable catch phrase with western audiences. Tis indeed a mouthful for non-believers.

Regardless, I have for too long been subjected to the shenanigans of Hamas, Mossad,Taliban, Israel, Palestine, Iran, Syria and all the Arabs and Jews who perennially kill each other, without regard for collateral damage. ISIS is only the latest and most virulent of the lot. As George Orwell predicted, war, in this case terror, has become a constant presence, distracting us from the unquenchable greed and insufferable stupidity of those who find chaos politicallyuseful and profitable. Religion, politics and money are fracking civilians. War has become boring and death mundane.

Which brings me to our own shenanigans. We are as militant as Jihadists and Jews. Rather than kick our bloviating politicians in their asses, the dictators of our publicly owned airwaves are allowed to maintain a 24 hour  middle-east Jamboree. So screw our fellow citizens, those who lost their homes and dignity in New Orleans, our young students and their parents strung too tightly by usurious fees and our middle-class wealth subsumed in the maw of Wall Street. These are too depressing for western television and, methinks, too dangerous. Our media provide suicide bombers, rockets and amputees as diversions from our home land casualties.

So, what’s to be done?  In his book The Limits of Power, the End of American Exceptionalism , Andrew J. Bacevich [1.] suggests, among other things, the United States dissengage itself from the middle east and allow them to get themselves sorted out without any intervention from us or anybody else, Much like the Russians and the Chinese have done and Christianity did during its Reformation.

Bacevich’s strategy reminds me of the New York City policeman who, when asked if he was concerned about a spate of mob killings, said, “As long as they’re killing each other I don’t see any reason to interfere.”

Apologists for imperialism stress a need to bring freedom to millions of people oppressed by malevolent dictators. Their impetus is merely a version of The White Man’s Burden (1899), subtitled The United States and the Philippine Islands, a poem by Rudyard Kipling in which he expresses a vision of men like himself civilizing the world. Today our burden has been updated to favour oil companies and  armorers, otherwise the goal remains unchanged. Take all the natural resources we can use. That’s what the Brits did and it’s what we’re doing now. A profit motivated aggression hidden behind obfuscation, disambiguation and a war on terror.

An intense loathing by much of the world has been our reward. Now the world’s un-washed are fighting back and the only answer we can muster is, “Let’s drop the big one now. They don’t like us anyhow”. [2.]

“It should, it seems to me, be our pleasure and duty to make those people free, and let them deal with their own domestic questions in their own way. And so I am an anti-imperialist. I am opposed to having the eagle put its talons on any other land.”

-Samuel Langhorne Clemens aka Mark Twain, on US policy viz a viz the Philippine Islands, New York Herald, October 15,1900. [3.]

 

[1.] Henry Holt & Co. – 2008. Andrew J. Bacevich, Jr.(1947-) is an American political scientist specializing in international relations, security studies, American foreign policy, and American diplomatic and military history. He studied at West Point Military Academy and Princeton University and is a retired U.S. Army Colonel. He teaches International Relations and History at Boston University. His son, also an officer in the U.S. Army, was killed in 2007 in Iraq.

[2.] From the Song, “Political Science” © 1969 by Randy Newman, BMI.

[3.] The 1898 Treaty of Paris, surrendered control of Cuba and ceded Puerto Rico, parts of the Spanish West Indies, the island of Guam, and the Philippines to the United States.

 
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Posted by on July 16, 2014 in Commentaries & Critiques, History

 

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