Sunday, August 16, 2009

紐約現代藝術館: 宋冬「物盡其用」

In psychiatry, sometimes patients do not want any help. Sometimes they positively refused help. At other times the help may not be all that good. As a result, children often had to grow up in very unusual environments. However, we sometimes get unusual outcomes as some individual can turn such an experience into something ……well, something quite extraordinary.

Obsessional Compusive Disorder (OCD) is one such condition that many families prefer to cope with secretly and often for many many years.

In a chapter in The Cockroach Catcher called: Who Is The Real Patient?

Wayne is a teenage boy I have been seeing because he could not face school:

“……After nine months, Wayne finally opened up to me.

Mother never threw away anything. Nothing at all!

Except wet waste, which was a relief.

This was a serious case of OCD (Obsessional Compulsive Disorder). It was still a great shock to have the full extent of the things that were kept detailed to you. Even a five bedroom house soon ran out of space.

Wayne told me that as far as he knew, mother had always been reluctant to throw away anything but it seemed to get out of control about five years ago when she discovered that father kept a woman in a port in the Far East. She moved out of the master bed-room and the rubbish moved in. Everything was neatly put in big rubbish bags and properly tied up. Some were in apple or other supermarket boxes. Even vacuum cleaner bags were kept.

Mother did a good job of it so that there was no bad smell at all, Wayne would reassure me. Just no space.

All these months, I had been thinking that the bullying was the cause of Wayne’s problem. Did I get it wrong? All the time I spent trying to improve his self esteem, was it time wasted? Was there something I could have done earlier? Why did he take nine months?

Perhaps he needed that time to find out if I was going to send his mother to an asylum. Perhaps he needed all that time to trust me enough to talk about the sickest person in the family. Perhaps he never had any plan but the secret just came out.

Perhaps these were all valid explanations, but what could we as a clinic do?”

Chapter 19 The Cockroach Catcher

Recently, I visited The Museum Of Modern Art ( MOMA)in New York and saw something that reminded me of my patient’s mother.

Mr. Song Dong is the artist and his mother is called Ms. Zhao.

紐約現代藝術館: 宋冬「物盡其用」

新浪周靜然紐約報道


Waste Not: Projects 90 MOMA /©2009 Am Ang Zhang

驟眼看上去,以為是拾荒者檢來人家的棄物,當這所有棄物整整齊齊地置放一起,充斥一片大空間後,就逞現了一種獨有的歷史味道,尤其是中國文化大革命時期的生活氣息,那一代人的生活種種。

  這是中國藝術家宋冬「物盡其用」(projects 90: Song Dong)的裝置藝術展,也是紐約現代藝術館(The Museum of Modern Art 簡稱MoMA)第一次為中國當代藝術家舉辦的個展。


Waste Not: Projects 90 MOMA /©2009 Am Ang Zhang

  專程從北京來紐約的宋冬不但把所展出超過千件物品運來紐約,而且展場中間的木屋,也是他一家曾經在北京四合院住過的一木一板房間。地下僻出每個角落放置數百對大大小小的舊鞋,陳舊的建築雜誌一堆堆,一張雙人床上放了數百件衣物,充滿歷史味道的衣柜上放了大大小小的暖水壺,也有數之不盡的膠水瓶,破舊的梳化椅放了很多過時的洋娃娃,最令人驚奇的是那一支支壓得扁平而直的牙膏和鈕扣整齊地放在一起,你能想到的生活用品,都可在展場看到.

Waste Not: Projects 90 MOMA /©2009 Am Ang Zhang

宋冬表示,這其實不單止是他的個展,而且是他與年初過身的母親趙湘源在2005年起共同創作的。他母親一向都不喜歡扔東西,所有不合用都收藏起來,而他有一個大家庭,宋冬與姐姐不但與父母及祖父母同住,更與叔伯親戚共住在北京四合院中,因此多年下來,所累積物品不計其數。宋冬表示,「物盡其用」的靈感始於2002年父親去世後,為了試圖令母親從悲痛中走出來,母親把曾經她家用過的東西一一安排的過程中,打開舊有的包袱,解開過程中賦予新生命。今年年初母親也過世,因此展覽場的牆上,以藍色霓紅燈寫上「爸爸,別擔心,我們和媽媽都挺好的。」流露了作者對親情的懷念。


Waste Not: Projects 90 MOMA /©2009 Am Ang Zhang

宋冬1966年生於北京,致力於影像、裝置及行為表演等具實驗性的藝術創作,其作品過去曾在紐約畫廊及亞洲協會展出過,紐約MoMA是世界重量級的現代藝術館,在國際藝術領域具重要影響力及學術地位,這次MoMA為宋冬辦個展,代表了宋冬多年來藝術生涯中一次重要的肯定。

Thursday, July 30, 2009

流感:雙城記


那是最美好的時代,那是最糟糕的時代

雙城記 查爾斯·狄更斯

In the Guardian a few days ago an article attempted to look at the contrast between London and Paris in terms of the Swine flu Pandemic and the cities' responses:


“Today, we seem to be experiencing A Tale of Two Cities in reverse when it comes to swine flu.

“On Thursday, the British government fired up a special swine flu website, designed to ease the burden for doctors and hospitals. It crashed within minutes as millions rushed to log on.

“On the same day in France, government introduced a change similarly aimed at helping the health service. People who believe they have swine flu are being directed to their general practitioner (GP) rather than the emergency room of the nearest hospital. The change was introduced without a murmur.”

The question was asked as to the difference in reaction between the two countries:

Swine Flu figures: UK: 100,000 VS France: 793

Population: each with around 60 million people, and are of similar prosperity.

And Britain and France are also neighbours, linked by all sorts of ties. You would expect a wave of flu in Britain to head across the Channel at some point and show up in France. Yet it hasn't happened yet.

The speculations:

Britain is more accurate than France in reporting the number of people with swine flu.

“But I for one am dismissive of this, given the excellence of the French health system (regularly ranked in the world's top three) and especially its alert system.”

“Are the British genetically more susceptible to swine flu than anyone else?” Perhaps not.

So assuming the data on both sides of the Channel are accurate, the Guardian article continued:

-- Britain was merely the first country in Europe to experience swine flu on a massive scale. The wave will eventually hit continental Europe with the same magnitude.

-- The massive spread of swine flu in Britain can only have occurred through patterns of contact that are not the same as in France.

-- The British government's flu awareness and prevention campaign didn't work for some reason.

“Finding out what happened is essential, as it will help flu experts to understand how and why flu propagates and how to better advise the public about how to prevent infection.”


The answer may indeed be elsewhere:

New H3N2 flu variant detected in HK

Medical science in Hong Kong is a match of the best in the world and ever since SARS in 2003 they have not been complacent at all.

衞生防護中心總監曾浩輝表示,本港發現變異的 H3N2流感病毒,源自布里斯本流感病毒。而目前本港出現的季節性流感, 43% H3N2流感, 49%屬甲型 H1N1流感。

曾浩輝又說,今年的流感疫苗配方,包括針對布里斯本流感,及對 H3N2流感,可發揮交叉保護作用。他建議高危人士,包括患有慢性疾病、長者及幼童注射。


The question must now be asked as Jeremy Clarkson did of Mercedes Benz on the A Class and the Elk Test Failure:

“Did they not know or did they not tell us? If they did not, they have no business making cars and if they did, well…….”

Perhaps the simpler question is:

“Did they Look?”

They did in Hong Kong.

Related:

EBM: Masks, Cathay Pacific Airline, SARS and Influenza A(H1N1)

Learning From History: 1918 Flu Pandemic, Hong Kong SARS, Swine Flu & Influenza A(H1N1) Swine Flu: WHO Level 5 & The 1976 Vaccine Disaster.

Hong Kong: SARS and Swine Flu


一百八十九宗新增確診人類豬型流感個案

流感網頁

缳生防護中心正監測變異流感H3N2病毒

流行性感冒

Wednesday, July 29, 2009

醫療 歷史: 豬流感與抗生素

With so much emphasis now on not using antibiotics it may be time to look at the evidence in the current pandemic of Influenza A H1N1 (to Who) and to the UK- Swine flu. News of death from Streptococcal septicaemia of a girl is reported in the Times. Should we not look at the role bacteria might play? Given a choice would you rather have Tamiflu or a broacd spectrum antibiotic?

Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness

David M. Morens, Jeffery K. Taubenberger, and Anthony S. Fauci

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland

Background. Despite the availability of published data on 4 pandemics that have occurred over the past 120 years, there is little modern information on the causes of death associated with influenza pandemics.

Methods. We examined relevant information from the most recent influenza pandemic that occurred during the era prior to the use of antibiotics, the 1918–1919 “Spanish flu” pandemic. We examined lung tissue sections obtained during 58 autopsies and reviewed pathologic and bacteriologic data from 109 published autopsy series that described 8398 individual autopsy investigations.

Results. The postmortem samples we examined from people who died of influenza during 1918–1919 uniformly exhibited severe changes indicative of bacterial pneumonia. Bacteriologic and histopathologic results from published autopsy series clearly and consistently implicated secondary bacterial pneumonia caused by common upper respiratory– tract bacteria in most influenza fatalities.


Also: NIH Review, NPR, PBS

News: Times. Swine flu misery.

Learning from SARS : Dr Yannie Soo, Tom Buckley.

Useful link: Hong Kong Chinese University Recommendations. CDC CNN

Related:

EBM: Masks, Cathay Pacific Airline, SARS and Influenza A(H1N1)

Learning From History: 1918 Flu Pandemic, Hong Kong SARS, Swine Flu & Influenza A(H1N1)
Swine Flu: WHO Level 5 & The 1976 Vaccine Disaster.

Hong Kong: SARS and Swine Flu

SARS and Quorum Sensing

Hospital Infection: Quorum Sensing

Saturday, July 25, 2009

EBM: Masks, Cathay Pacific Airline, SARS and Influenza A(H1N1)

Cathay Pacific at Hong Kong International Airport Wikimedia Commons

Hong Kong's main airline, Cathay Pacific, on Saturday backed down on its refusal to allow its flight attendants to wear face masks to protect themselves against swine flu. The change of policy came after the confirmation of East Asia's first swine-flu case in Hong Kong on Friday night and an appeal from the city's health secretary, York Chow. AFP/Standard

It is claimed that there is no evidence that the wearing of face mask is useful. So I tried to search for the evidence.

New Scientist
Face masks are best protection against SARS
02 May 2003 by Shaoni Bhattacharya

"Face masks offer the best protection in the fight against SARS, reveals a new hospital-based study from Hong Kong.

SARS HK 2003 Medical Staff in Hospital Virgin Media

"Wearing a mask can give a person dealing with SARS patients in hospital up to 13 timesmore protection compared with not wearing one, says Wing Hong Seto, study lead and chief microbiologist at the Queen Mary Hospital in Hong Kong.

"However only surgical masks and N95 masks - designed to block airborne particles - will work. These masks protect the face from droplets coughed out by infected people, which the team believes is the primary mode of spread. Seto says droplets are probably the main mode of transmission of SARS outside hospitals as well. He says the findings confirmed SARS is not spread through the air - if so only the N95 masks would have been protective.

"Face masks have become a morbid symbol of the impact of SARS in the worst-hit parts of the world. The virus has now killed 416 people across the globe, with over 6000 infections in 29 countries.

"Wearing masks in public places has become commonplace in the Hong Kong and the Chinese mainland, where the disease first emerged. But their effectiveness has been controversial and some commentators say their use has helped stoke an atmosphere of panic.

"But Seto told New Scientist: "Masks seem essential for protection. This finding fits well with droplet transmission, because droplets are generated at the face level."

Statistically significant

"Seto and colleagues from five Hong Kong hospitals and the University of Hong Kong, surveyed over 250 hospital staff exposed to 11 SARS patients between 15 March and 24 March.

"Most of the 13 staff who became infected did wash their hands, and a handful also wore gloves or a paper mask, but none had used a surgical or N95 mask. Analysis of the data showed that the use of surgical or N95 masks was the only measure to give statistically significant protection.

"Paper masks offered little protection, says Seto. 'Such masks, being easily wet with saliva, are never recommended as a precaution against droplets.'

"However, not one of the 69 staff who had used all four recommended protection measures - wearing a mask, gloves, gowns and washing their hands - contracted the virus."

"Seto believes the risk of contracting SARS in public places is 'very low' and so does not wear a mask himself. 'However, I have it ready if I am in a crowded place,' he says. 'I see someone consistently coughing, then I put it on. If I see he is febrile, I strongly advise him to go home and see a doctor. Then I wash my hands and take a good shower on coming home.'

Journal reference:
The Lancet (vol 361, p 1520)

It has to be accepted that there is virtually no rubbish collecting facility in public places in the UK due to worries about bombs and there are no hand washing facilities on buses and other public transports. See NHS Direct Advert.


In any case, Hong Kong has now a second case of of Influenza A (H1N1); a passenger on Cathay Pacific flying in from the US. There has been no local spread so far.

WHO H1N1 UPDATES

SARS ACCOUNTS: Dr Yannie Soo, Tom Buckley.

Useful link: Hong Kong Chinese University Recommendations. CDC CNN

Other Posts:

Learning from History: Swine Flu & Antibiotics

Learning From History: 1918 Flu Pandemic, Hong Kong SARS, Swine Flu & Influenza A(H1N1)
Swine Flu: WHO Level 5 & The 1976 Vaccine Disaster.

Hong Kong: SARS and Swine Flu

SARS and Quorum Sensing

Hospital Infection: Quorum Sensing



Thursday, June 4, 2009

Lulu


Royal Opera House, London
Andrew Clements
Published onFri 5 Jun 2009 19.01 EDT
T
he Royal Opera was quick off the mark after the complete version of Lulu was heard for the first time in Paris in 1979. Within two years, the British premiere had been staged at Covent Garden, and even revived in 1983, but since then Berg's masterpiece has been out of the repertory. It would be satisfying to report that the new production directed by Christof Loy had been worth the long wait, but while the evening does bring major musical rewards, both dramatically and theatrically it is a nothing.
What we get is a wonderfully detailed account of this rich, teeming score from conductor Antonio Pappano. He, the cast and the orchestra have obviously prepared this formidably difficult music with great care, and the hard work shows in the diaphanous orchestral textures and the security of the singing. Perhaps Pappano's approach could have been more dramatically incisive, especially in the final scene where the music almost congeals as the tension ratchets up. Yet with so little intent, let alone intensity, coming back from the stage, it's easy to understand why he seemed to be holding back.
Many concert performances have more dramatic interest than the wretchedly minimalist production Loy has concocted. Herbert Murauer's "set" is a series of translucent screens; the costumes (by Eva-Mareike Uhlig) are anonymous and contemporary. There is no sense of time or place, very few props (not even Lulu's portrait, which is one of the dramatic leitmotifs of the work) and little depth of character except from those more experienced performers - such as the outstanding Michael Volle (Dr Schön), and Philip Langridge, who doubles as the Prince and Marquis - for whom creating an onstage persona comes as second nature.
Loy's purpose in stripping down this complex and many-layered work escapes me. Agneta Eichenholz's Lulu may be efficiently sung, but psychologically she is a blank sheet, not so much a femme fatale as a femme fatally flawed - a victim of the most passive kind. That is one way of reading the character, certainly, but when there is so little supporting detail surrounding her, it leaves a gaping void around which Jennifer Larmore's glamorous Countess Geschwitz, Klaus Florian Vogt's unpleasantly crooned Alwa and Gwynne Howell's mysterious Schigolch orbit purposelessly.
The unique dramatic mix of Lulu, with its elements of black farce and grand guignol, is comprehensively destroyed. I never imagined I could be bored by what was happening on stage in this supremely great work, but Loy's production, unforgivably, manages it.