The Doctor's Consultation:
by Dr. Iain Corness
A bloody pain
in the bottom
Do you have
rectal pain and bleeding? That’s what I meant when I wrote “a bloody pain in
the bottom”. Embarrassing yes, but it’s usually a minor problem known as
Piles are one of the most common ailments around. Embarrassing and very
often a pain in the bottom, to use the very apt phrase! The medical term for
piles is hemorrhoids (hemorrhoids if you come from the left hand side of the
Atlantic), which shows why we don’t commonly use that name - too long and
too hard to spell! I have often said that the reason that the medical course
is six years is that it takes five years to learn how to spell the long
words, but then, I’m joking of course.
So just what are piles and do you get them from sitting on wet grass, as the
old wives will tell you? Let’s deal with the grass first. You do not get
piles from sitting on anything, be it grass, newly mown or otherwise. End of
the grass story. Piles are simply ‘varicose veins’ of the anus. You see,
around the edge of the anus there is a very rich plexus of arteries and
veins and it is possible for the veins to become distended and eventually
form a grape-like structure that can even protrude from the anus itself.
This is what is known as a classical “pile”.
The biggest problem with hemorrhoids is acute bleeding. Embarrassing as
mentioned before, but can actually be such as to run you out of iron and you
end up anemic. Other symptoms include local soiling and discomfort. You can
also get a thrombosis in one of these protruding piles that can be very
painful indeed. Ask anyone who has ever had one (or two).
There are lots of theories as to why we get hemorrhoids. Many women feel
that they are the result of pregnancy or straining during childbirth, but
since men get them as well that would appear to shoot that theory down in
flames. Both sexes can get piles. A lack of dietary fiber has also been
given the nod as a cause, but personally I am not convinced, as many people
with great fiber diets still get piles. Constipation and straining at toilet
does appear to have a bearing (bearing down?), but I honestly feel that the
real reason relates very simply to our stage of development in the history
My theory (Darwinian, I admit) is as follows - we used to walk on all fours,
like all the other quadrupeds. Look at our first cousins, the monkeys, and
they are still wandering around with knuckles in the dirt (and I have met
some people that still do this), but many moons ago after seeing our
reflections, we decided we looked better standing on our hind legs, so we
learned to walk erect. This was fine, other than the fact that the valves in
the veins in our legs and ano-rectal region were not up to the additional
pressure the column of blood was exerting from the heart, now a meter or so
higher than the valves. Straight out hydrodynamics.
Fortunately piles are relatively easy to fix, and the common rubber-banding
technique will be successful for most. The only real danger in this
condition is in ignoring the bleeding, thinking “It’s only piles.” As
mentioned before, this bleeding can lead to anemia, but the biggest problem
can be the fact that rectal bleeding might just be a symptom of something
more sinister, such as cancer, and not hemorrhoids, and it is possible to
have both complaints at the same time.
The answer is to never ignore bleeding (from any cause) and get your doctor
to check. It may be embarrassing - but it could save your life.
Heart to Heart
Could all this fat belly dancers gentlemen understand one day, how love
between young and beautiful girl work? First try to figure out you 60
years old falling in love with a 90 years old woman, is it possible?
It’s the same for a 20 years girl to fall in love with you. For the girl
you are only a sponsor. You put money on the girl and you got back
something, sometimes there is more than one sponsor and every one get a
part of the lady and maybe she might find a richer sponsor and let you
down that’s the way is life.
How lucky am I? Getting a famous French detective to come and unravel
the great mysteries of life in Thailand. Unbelievable! But ‘Ercule, mon
ami, you just might ‘ave made ze little supposition that may not be zo
correct, Cher Petal! Zere are men who ‘ave loved women much older zan
zey are. Zere are women who ‘ave loved men much older zan zey are too.
Ze big difference iz ze magic ingredient called “love”. Love overcomes
all barriers, but zere is a difference between “love” and ze financial
arrangements. By ze way, ‘Ercule, I seem to have lost my gold pen. Did
ze maid take it?
Everybody must know by now if they read your column that there is a
difference between the girls who work in the bar and the girls who work
in regular jobs. What you say is for us to look for female company from
the regular job girls. What you don’t say is that the regular jobby ones
can’t speak English, are difficult to meet or get to know, while the
ones who work from the bars can speak English and are easy to meet and
are easy to get to know. For my money, give me the bar girl every time.
How astute of you, my Petal! Yes, there are great differences, and even
more than the ones you mention, even such things as educational level.
If all you are looking for is some female company, then the bar is the
right place, but the problem comes when the customer (guys like you)
then falls in love with their English speaking, easy to meet and know
girl. Thai girls do not choose to work out of a bar unless they are
looking for quick money, without having any necessary qualifications to
put them in high salary jobs. They are using their looks, their
(presumed) sexuality and their ability to get money from their
customers. ‘Ercule in the letter above yours calls it ‘sponsorship’, and
he is really quite correct. You are paying for a commodity by meeting
the sponsorship fees demanded. When you fall in love with someone who is
used to being fully sponsored, the relationship is not really on the
emotional plane, but in the financial one. And like all business deals,
you can get burned. And many like you do. As you wrote “For my money,
give me the bar girl every time.” And that’s what it is, Petal, your
money and you are entitled to spend it any way you please, but don’t
complain if you find it has all gone, and the girl’s “affections” with
I have a somewhat delicate problem, so you will forgive me if I do not
sign this fax to you. I am a single man, working in the Sand Box and I
come here regularly for many weeks at a time. On these trips here I
generally find that there will be a young lady who indicates that she
would like to take care of me, and a suitable arrangement can be entered
into. This is great for a bachelor like me, but I also want to play the
field a bit too. One young lady has really begun to sink the hooks into
me, and I can see a problem coming up, because I own my own condo here.
How do I get her to understand that this is not a lifetime relationship,
and when I go back to work I will want her to leave the condo? I have
four weeks left, Hillary, so a quick fix will be appreciated.
Sand Box Sam
Dear Sand Box Sam,
I think you have just found out that you can’t have your cake and eat it
too! The way around this problem is to bring it out into view and it
will cease to be such a worry for you. Since Hillary doesn’t know how
good your Thai is, it may be better for you to have an interpreter, as
it is important the young lady understands the situation. And
understands it right now, not two days before you leave. She has been
taking care of you, so now you must take a little care of her and her
feelings. Now is the time to spell it all out, my Petal. Your problem is
one that Francis (see above) will also have to face if he continues in
his current way of life.
Camera Class: by
Break the portrait rules
This week it is back to people photography - the kind of snaps
that most people take most of the time. There is really no
secret in taking good portraits and this column has been over
the “rules” many times. Here we go again, try to ensure that
your lighting is coming from above and slightly off to the side,
use a long lens (around 135 mm is ideal) and look out for
distracting backgrounds (see all my previous columns on
backgrounds). If you can, use a wide f stop (around f 4 is good)
and get the subject to turn his or her head slightly, while you
move around them, snapping away as the facial expression
changes. You will get a good shot doing just that. But it will
be a ‘good’ shot, not a ‘brilliant’ shot.
Here’s how. Sometimes you can get a brilliant shot, just by
breaking the “rules”. Take a look at this week’s photographs.
Portraits with plenty of punch, plenty of personality and a
sense of immediacy. Long lens? No! Lighting off to the side and
from above? No! Attention to the background? No! Yet these are
good portraits and all the rules have been broken. So what or
who do you believe?
Well, the first thing is to look again at the photographs. These
shots get their immediacy from the activity in the shot. One man
is half way through a large baguette, and has obviously been
interrupted during eating. In fact, in mid munch. The second
shot has violinist looking directly at the photographer, while
obviously in the middle of a number. Neither of these being
great “portraits” but both have that immediacy and action,
making the shot come alive.
Now you could get these shots with the long lens, but by using
one, you would stop the interaction between the subject and the
photographer, being so far away while you take the shot. By
using a wide angle lens, in this case a 24 mm, the subject was
surprised by the photographer with the closeness. The subjects
could not escape. They were caught by the photographer, like
rabbits in front of the headlights of a car. It is not
stretching your credulity to say that both photographs show that
startled look of, “Where did you just bob up from?”
Now the lighting. While the “ideal” is the light coming from
above at 45 degrees and slightly from the side, both these shots
were taken with a flash mounted on the camera. Nothing fancy in
any way. To have tried to set up the “ideal” lighting would have
meant that the subject became a knowing part of the photograph.
Immediacy? None! Surprise? Gone!
The moral of all this is simple. If you want “dynamic action”
portraits, break all the rules of classical portraiture. You are
really now in the realms of photo-journalism. This is the walk
up close, “in-your-face”, paparazzi style of photography. You
may, of course, get an earful of abuse from some subjects, but
you have to be brave and brazen it all out. After all, look at
the shot you may get.
Please note, however, that there is one rule that was not broken
- and that was to make the subject the “hero” and the dominant
part of the photograph. The subjects in these photographs fill
the frame, and with the wide angle lens that did mean walking in
close. Real close! Try getting in close this weekend. With the
Money Matters: Graham
Macdonald MBMG International Ltd.
Art for art’s sake or your wallet?
An interesting study of alternative investments in the second issue of
Opalesque A Squared looked at a couple of investments that, even with our
open-mindedness, we haven’t yet taken any exposure to - Fine Art and antique
The claim is that “good quality art work” that comes from good or great
artists and can often be acquired at a price that lends itself to an
appreciation at times of as much as 40% in a year or 100% within three
years. In general, in the art market, there does seem to be a correlation to
economics in that in boom times art prices increase and at others they can
fall. There now exist art indices - these serve as a good guide and provide
an overview of the market, but these, per se, do not imply a compelling case
for art as an investment class. Whether, at a micro level, asset selection
can generate significant out performance is the key question here - i.e., is
the art market so inefficient in its pricing that a smart art investor can
consistently outsmart the market and accumulate consistent gains through
well considered trades rather than just relying on an asset class that is
ultimately correlated to economic fundamentals?
One potential source of alpha is the ability to source art through
distressed sales. The correlations also vary from one art category to
another - contemporary art exhibits the closest correlation to boom & bust
cycles. There are 70 different categories - investing in “The Old Masters”
has the least correlation to equities as it tends to be driven by collectors
and museums that are willing to pick up the price tag even during economic
Similarities between the art and the specialist antique market are obvious.
Antique stringed instruments are every bit as unique and irreplaceable
items. The potential returns offered are virtually uncorrelated with any
other asset class, hold steady over as great works of art. The proponents of
investing in antique violins assert that the risks of doing so are low and
inexpensive to hedge. Correlations exist amongst the various makers, age and
condition of string instruments. As with old masters, the “antique value” of
a rare collectable is partially quantifiable - even at times when demand
falls there are never enough old Italian high end instruments around.
Similarly a speculative value, like that with contemporary art, surrounds
less known makers from this century - instruments dating back to the 1920s
have already experienced this - some investors believe that there is a
compelling case to “buy and hold” less familiar makers from the 1930s to
1960s until they also start to appreciate.
There are certain principles and factors used by professional art and
antique instrument investors - invest in a great work by a second rate
artist than a poor work by one of the greatest artists.
Have the means to acquire a diversified portfolio of high quality art
(ideally private investors should have at least USD 5-10,000,000 available
for allocation into their fine art holdings within their overall investment
portfolios). Smaller sums such as USD 100,000 could finance the acquisition
of one good painting but commensurately rolls up the risk as there is no
diversification. Specialist art funds generally require minima of at least
USD 250,000. For lower budgets, a minimum of USD 30,000 could be sufficient
to start to invest into antique string instruments, which can also be
acquired through syndicates or participation in an investment trust.
Specialists can structure syndicates as investment vehicles to support and
fund the acquisition of music instruments.
Targeted returns from art tend to be stated as between 10-15% annually
compounded over a span of 3 - 7 years. With investments in contemporary art
- returns can be between 20% and 100% in a year. Since launch in 2004, the
Fine Art Fund has achieved an annual return of 58%. Over the past 50 years,
investment into string instruments is claimed to have returned an average of
Investors in art should be prepared to ride out the vicissitudes of fashion
as well as economics, and the minimum holding period should be at least 3 to
For private investors the spread between buy & sell price can be as high as
30% per transaction, making it extremely difficult to generate net returns
in the short to medium term - for institutional investors this can be
reduced to 5% or less.
Many art funds have failed to assemble and maintain a team of good and
independent experts. One fund claims that, “There are 50 sought after
experts, of which we have 8. It is rather difficult to get more than a few
of them to work together.” Adequate critical mass is, for want of a better
word, critical. According to one leading art fund manager, the art market is
not going through a bubble. Although he states that, “some of the top 200
artists have peaked ... there are thousands of artists out there.” Gerhard
Richter, Sigmar Polke and Georg Baselitz are all popular at the moment at a
There is an element of self-fulfilling investment due to the relatively
small size of the art market - with an estimated amount of USD30bn invested
in art, institutional investors making allocations of USD 1.5bn have the
capacity to directly influence the market. The market for fine instruments
is similar - presently valued at approximately USD22 billion, but,
surprisingly perhaps, growing as instruments made by newer makers have
become more prominent.
Art critiques can affect prices to some extent - therefore it’s vital to be
in tune with the more influential museum curators and art dealers. The
market is certainly open to anyone with an interest in diversifying their
portfolio. All of which is very interesting but hasn’t yet appeared on the
MBMG ‘buy’ radar.
The above data and research was compiled from sources believed to be
reliable. However, neither MBMG International Ltd nor its officers can accept
any liability for any errors or omissions in the above article nor bear any
responsibility for any losses achieved as a result of any actions taken or not
taken as a consequence of reading the above article. For more information please
contact Graham Macdonald on [email protected]
Your Health & Happiness:
Thailand saves 1 billion Baht
annually in low-cost medications
Thai Public Health Ministry’s decision to issue compulsory licenses for
two HIV-AIDS pharmaceutical treatments and a heart disease drug is able
to help low-income patients to gain access to quality drugs, while the
national economy is able to benefit by more than Bt1 billion yearly in
savings from imports, a senior ministry official said.
Dr. Sanguan Nitayarumphong, secretary general of the National Health
Security Office (NHSO), said compulsory licenses for the heart disease
drug Plavix, made by Bristol-Myers Squibb and Sanofi-Aventis, and Abbott
Laboratories’ Kaletra to treat HIV/AIDS, both issued by the ministry in
January, and another drug for treating HIV-AIDS, Efavirenz, manufactured
by Merck and which was given a mandatory license in Thailand last
November, could help save Thailand in foreign exchange of not less than
Bt1 billion annually.
Most importantly, it allows poor people suffering from these diseases to
have access to the medicines as they are now becoming less expensive and
hence have a better quality of life, said Dr. Sanguan.
For example, the price of Efavirenz is cheaper by about half the cost of
the imported pharmaceutical, while Kaletra is about 40 per cent cheaper
and could as a result now treat some 12,000 patients this year, up from
8,000 patients estimated earlier, he said.
In addition, the price of Plavix is about six times cheaper than the
imported, patented drug.
The compulsory licenses which Thai health officials said earlier would
spare the country from significant foreign exchange costs drew praise
from AIDS activists but flak from the United States government and the
drug industry, which are urging the ministry to rescind them.
The three foreign pharmaceutical companies complained they were caught
by surprise as the government overruled their patent rights without
prior consultation or negotiation – a point strongly denied by public
health officials who claimed they have held repeated talks with the
patent holders over pricing, but without real progress.
In contrast, the compulsory licensing in November has allowed the
state-owned Government Pharmaceutical Organization to build up stocks of
imported generic versions of AIDS medication Efavirenz – about 16,000
bottles so far. (TNA)