The Doctor's Consultation:
by Dr. Iain Corness
Dx and DDx
Have you got a Dx or a DDx? It
is important to know. In ‘medico speak’ where we just love acronyms, Dx and
DDx are written to represent Diagnosis and Differential Diagnosis, probably
because we are too lazy to write the whole words. Whilst the Differential
Diagnosis concept may look obvious, it is often misunderstood by patients.
One reason why doctors have not been supplanted by computers is because we
are more clever and quicker at getting to the Dx than a computer is.
Honestly, man beats machine.
Many years ago I was involved in a trial of computer medicine. The patient
came in and was given a list of presenting complaints and had to click the
correct one. All very general like “cough” or “diarrhea” and the computer
took over from there with questions with multiple answers and click on the
most appropriate, like “How long?” and then 1 day, 1 week, 1 month, 1 year.
Taking “cough” as the example, it would then go into whether you had any
phlegm, click yes/no, and then color, quality, etc. After around 10 minutes
or so of read and click, read and click, the computer would spit out a
Differential Diagnosis DDx such as URTI, pneumonia, sinusitis, bronchitis,
lung cancer, etc., etc., etc. Along with the DDx would come a list of tests,
examinations, procedures to be done so that the computerized doctor could
order the tests and then pick the best diagnosis according to the results.
Quite frankly, it was pathetically slow, the patients did not like it, and
what I disliked most of all was the fact that the computer asked for
batteries of tests which were not necessary, as a good doctor has an ability
called ‘clinical acumen’ that allows him to pinpoint the correct Dx much
more quickly. After a careful history (written as Hx) and listening to the
chest, using the old-fashioned stethoscope (and still an important
diagnostic tool today, I might add) the switched on doctor would already
have been able to rule out URTI and sinusitis without a CT scan of the nasal
sinuses, and through knowledge of the history would be very close to making
the final Dx. A chest X-Ray and a Complete Blood Count would most likely be
enough. Dx pneumonia.
However, what you have to understand is that although your doctor is not a
computer, he or she still needs information to work on to narrow down the
DDx field. It is in your own best interest to give your doctor as full a
description as you can. Presenting with words like “Gotta cough” and leave
the doctor to drag further information from you is not as good as “Gotta
cough, had it for three days and I’m bringing up green stuff, and I’m
allergic to penicillin.” The more information your doctor gets, the quicker
the DDx, the fewer the tests, the quicker the Dx, and the less it costs you
in the end. And you are put on the correct definitive appropriate treatment
So that is the message this week. Your doctor goes through a series of go/no
go concepts with your signs and symptoms to come up with the list of
diseases (the DDx) that could produce that profile. To work out which is the
correct one (the Dx) will usually mean some investigations or tests. These
are not designed as a time-wasting, or wallet emptying, procedure, but as
the way to sort out what could be the cause.
Dx and its fore-runner DDx can be lifesavers - just remember to give a full
Heart to Heart
You may remember that you gently turned down my offer of marriage
recently but I have now recovered from my unbearable disappointment.
Many sleepless nights, sobbing into the pillow, though. But on to other
things. I’d like your view on what I did to please my second wife, an
intelligent, highly dangerous Buriram lady, who was a very good partner
indeed, and whom I still remember with fondness. Money was the issue.
First, having been here for some time, I know that a lady loses face if
she has to ask her old man for lashings of the old spondulicks, so I
opened a bank account for her, and provided her with her own ATM card. I
then asked her how much she thought she would need for the month - to
include rent, food, utilities, a personal allowance for her own private
use, laundry, travel for herself and an allowance for her mother, a
lovely old lady who chewed betel nut.
My wife thought carefully. If she asked for too little, then she would
not be able to squirrel anything away - if she asked for too much, I
might say no. She came up with a figure - I frowned and pretended to
faint. Then I said - “All right, my dear, but I think we need to give
you a little more - I’ll add on 3000 baht. But don’t ask for anything in
the middle of the month - you get paid into your bank account on the
first day of the month and that’s it.”
I knew what would happen - around the 20th she said she’d run short.
“I’m sorry my dear, but we did agree, didn’t we, that the first is
payday,” I said.
Crockery flew. My treasured first editions of Enid Blyton were ripped
up. I said nothing. She stormed out. She came back around midnight and
threw a dish at me. I did not respond. My apparent lack of a father was
mentioned. I said “I’m sorry, my dear, I can’t talk now. I must work.”
Oddly, there seemed to be enough for food for the rest of the month,
although it was served to me on a paper plate and contained what I was
sure were Isaan-style beetles. I said nothing. But on the first day of
the next month she brought me a lovely present and smiled at me as if I
were Brad Pitt. She’d been to the bank and was happy again.
From that day on she budgeted perfectly and saved 80,000 baht in two
years - and I congratulated her on this. “All yours,” I said. And the
odd present came her way - birthday, Christmas and so on. My usual trick
of pretending to have a heart attack when we neared a gold shop worked
beautifully. It occurred to me that one must wrongfoot a woman - or she
will wrongfoot you. But it’s the eternal battle of the sexes, isn’t it?
And the girls usually win, don’t they! Reason. They’re much brighter
than us males are. They have to be and we all know why! Men are pigs!
And she got her own back later. I sat in a field in a Buriram, with a
bacon sandwich and my newspaper from England with some tasty pictures of
semi-naked tottie in it and only a nearby buffalo for company. A man at
peace. Seeing me she shouted, “Now two buffalo in field!” Ouch!
I am so pleased to read how satisfyingly sanctimonious you are. It must
be difficult even for you, living with yourself, let alone some poor
woman trying to. And Hillary thanks her lucky stars that she did turn
down your offer, gracious as it was, allowing your poor woman to save
around 3,500 baht a month, and all hers, too. Edwin, do you know how
much a bottle of Veuve Clicquot is these days? More than 3,500 baht, my
Petal. We could never have got on. We are totally incompatible.
I left my mobile phone in a hotel lobby and someone appears to have
stolen it. I had it “locked” but I don’t know if that is enough. Should
I just forget about it or what do you suggest?
Dear Phoneless Phoebe,
Don’t be so sure it was “locked” and the kamoy isn’t ringing Hong Kong
on your account. It doesn’t take much for these smart young fellows in
the markets to confuse your phone’s programs. However, all they will do
is get a new SIM card which costs a few thousand baht and they have a
cheap mobile phone. Really Phoebe, you should go down to the shop where
you bought it and tell them. You will also have to get a form from the
police. Take the person in whose name the phone is registered, if it is
not registered with the phone company in your name! Lots of luck. Be
prepared to waste half a day. Next time, keep it in your handbag –
that’s what you carry one for, Petal. That and being a convenient place
to store old shop dockets, three lipsticks, a couple of lippy pencils,
mirror, comb, several rubber bands, coins of several denominations and
countries, bottle opener and assorted business cards of people you can’t
remember ever meeting.
Camera Class: by
Flashing can be digital fun
week’s topic is good for anyone with a digital SLR, or even a
digital compact with a manual mode. Instant gratification is
just around the corner. Those still persevering with a film SLR
can also use the techniques; however, you have to wait till the
photo-processor gives you the results. It is not ‘instant’.
Just about every camera these days comes with its own built-in
flash, and fewer and fewer ‘hot-shoe’ flashes are used. To see
someone with a flash mounted on the camera almost always spells
pro-shooter, so such technical items as ‘guide numbers’ don’t
seem to matter any more. The camera does it all for you. But
there is always a downside to just letting the camera do all the
work. And that is you get what the camera thinks you want – not
what you might want.
Take the example where you are shooting indoors at night (always
a good time to use extra lighting), but you still want some of
the background to show up. Shooting people in a pub is a good
example. You want more than just ‘heads’, you want to show just
what kind of a place it really was.
To do this is tricky, but there are several ways. You can use
more than one flash (sometimes called ‘slaves’) and they fire
when they detect the flash burst from the primary flash, or you
can even link them all up with flash cables triggered by the
shutter on the camera. You set the slaves to light up the
background, while the main flash illuminates the subject.
Unfortunately, you have to lug around all the extra gear, and
people trip over the cables. That’s Option One.
Option Two is to use a tripod and the time exposure setting to
record the background and then pop the main flash to record the
subject in the foreground. Difficult, but possible.
Option Three is the simplest. Set the camera’s aperture to
around f5.6 and the shutter speed to 1/15th of a second. You can
even hand-hold at this slow shutter speed, as long as you lean
on something. The slow shutter and wide open aperture gives
enough light to get the background to show up on film, and the
flash burst is enough to record the subject. Try it. It works!
Of course, to do this you have to take the camera out of Auto
mode and into manual. In fact, if you want to try something, go
down to the pub and shoot the likely lads at 1/8th, 1/15th and a
1/30th and see the differences you will get. The subject will be
OK in each, as the lighting for the foreground depends only on
the flash power, while the background depends on the ambient
light, and the longer the shutter is held open, the more
background details you will get.
Another trick you can do with any camera that has a flash, be
that built in or bolted to the top of it, is to throw colour at
your subject. The important item of equipment is coloured
celophane paper (sometimes called ‘gels’ in the industry). Put a
blue gel over the flash head and you will get a very ‘cold’
photograph, especially if you are taking pictures of people.
Conversely, put an orange gel over the flash and you will get a
wonderfully warm person in the foreground.
For an even wilder result, if you can take the flash off the
camera, shoot the subject side lit with a coloured gel over the
major flash. Experiment with blue, red, green, orange, yellow -
we are not looking to reproduce reality here, we (that’s you)
are trying to produce an artistic effect.
Most keen amateur photographers will have heard of the term
“Fill-in Flash”. This refers to a reduced output flash burst,
used to lighten shadows in harsh daylight, or to illuminate the
front of a back-lit subject.
With many of the modern cameras, fill-in flash is simple,
because the camera is programmed to do this automatically. Try
setting your digital SLR on fill-in flash at night. You might
just find that you get the background and the foreground. Try
Money Matters: Paul Gambles
MBMG International Ltd.
One to watch?
We recently came across an interesting quasi-quantitative
investment approach designed to reduce volatility which has produced a 32
percent average annual return in the past five years. In 1994, David Stein
of Seattle-based Parametric Portfolio Associates set out to devise a
strategy for investing in emerging markets that would smooth out the price
swings of individual markets such as Brazil or Malaysia. The $937 million
Eaton Vance Tax-Managed Emerging Markets Fund that Parametric Manages is now
ranked the third-best performer among the 99 U.S.-based funds that invest in
emerging-markets stocks, according to data compiled by Bloomberg.
By way of background, Parametric Portfolio Associates manages more than $20
billion, most of which is in 9,000 segregated accounts. South African-born
Stein, who holds a Ph.D. in applied mathematics from Harvard University,
sought to develop a structured approach based around a mathematical rather
than economic approach to investment. With emerging markets adopting a
passive approach that slavishly follows indices is even more flawed than
adopting such an approach to major markets because replicating a
capitalization-weighted index such as the S&P/IFC Emerging Markets
Investable Composite Index means investing as much as 70% into just a tiny
handful of largest emerging countries. To his credit, Stein immediately
recognised this and sought to create a method that increased the
diversification of the portfolio by underweighting the big countries and
overweighting the small countries relative to the index.
That’s fine in theory but if you’re not applying research driven economic
principles in determining your individual country exposure and you’re
eschewing market cap as the basis, then how exactly do you arrive at your
portfolio weightings? From a qualitative point of view, assigning equal
weighting to each emerging market is just as random as assigning values
based on market cap. At the outset, the firm used two tiers of weighting
which it has now increased to 4 - in short the largest markets, such as
Brazil, China and Russia, receive twice the weighting or markets like
Thailand, 4 times the weighting of markets the size of Morocco and 8 times
the allocation of the smallest markets like Saudi. Therefore the target
weightings become simply a mathematical reflection of the number of
countries that the fund invests in and the relative tiering of these
countries. As we write this, we’re looking at data that shows that the fund
owns 1,265 stocks in 40 countries.
Although this doesn’t apply any qualitative criteria it does increase
diversification and reduce the internal correlation of the fund - a massive
run-up in the Botswana market doesn’t typically spill over into stocks in
Romania. It does, however, allow the fund to use another risk monitoring
technique, rebalancing the portfolio. If stocks in a particular country rise
so that the market’s weight in the fund increases to 50 percent above the
relevant tier allocation target, the fund reduces exposure back to the tier
target percentage and use the proceeds to increase the exposure of a market
that’s below target.
Saudi Arabia is a good example - in 2005, the Tadawul All Share Index rose
106 percent. As the Saudi market rose above 50%, the fund trimmed exposure.
In 2006 the Tadawul All Share Index dropped 53 percent. Therefore holding
the index over the entire two-year period would have earned a zero return
albeit with a lot of volatility. By twice taking profits out at the 50% gain
level, Parametric would only have had their target allocation suffer the
fall back and would have already, in 2 stages, withdrawn an amount
equivalent to the original stake for investment into other markets. This
banking of profits would have turned a zero return into a 49.8% gain. One of
our many criticisms of index funds is that by their inherent nature they are
designed to buy high and sell low but this form of allocation goes some way
to removing that problem - it adds what Stein calls a ‘rebalancing alpha’.
The approach isn’t only used in terms of country selection, it’s also used
to select individual stocks within a country. The fund invests in five areas
including materials, industrials, utilities and communications. Originally
the fund weighted these sectors equally but it now applies a more contrarian
approach, eking out value in the markets by buying less of sectors that
predominate in a given country in favour of less-prominent areas. In Brazil
50 percent of the market is in basic materials (Stein cites the example of
companies such as Rio de Janeiro-based Cia.Vale do Rio Doce, the world’s
largest iron ore exporter) but within Parametric these companies account for
a much smaller allocation - rather less than 20 percent of the fund’s
Stein’s focus here is on finding a methodology for making good decisions
amid uncertainty. He compares the markets to a game of bridge - a
nondeterministic, in which you don’t know the outcomes of the cards you
We’d say that the value of this approach is that while in some markets
(overall global portfolio allocation) there is no substitute for informed,
active asset allocation, in global emerging markets, where real standout
managers are hard to find and too much money is managed by closet bench
markers then this approach is ironically more active, more adaptive and more
impartial than many so called actively managed funds.
We’ll be watching this one carefully for inclusion within the portfolio when
we feel that the next emerging market buying opportunity arises.
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 Paul Gambles on
Life in Chiang Mai:
by Mark Whitman
Is it my imagination or is there an increase in police
activity in Chiang Mai in respect of traffic offences, especially the
relentless non-wearing of crash helmets. Possibly the recent figures giving
the appalling death toll on the roads have made this country wise up. Also
the number of barriers and bollards at junctions seems to have grown and the
work on the moat and Thapae Gate area proceeds, albeit at a seemingly slow
I read that the Mayor is holding meetings in an effort to co-ordinate anti
pollution measures, which are to include stricter controls on car emissions
–particularly the red trucks and tuk-tuks and hopefully the many pickup
vehicles and other gas guzzlers, the latter so often favored by farangs.
Also an education program in the hopes of stemming the burning of rubbish
and crops on arable land is being set up. Let’s hope that all this makes
Chiang Mai a safer and cleaner place, although I guess we will be waiting a
long time for real improvements. Not an easy task.
Mentioning traffic violations reminds me that I committed a stupid one
recently. So a word from the now wise. I spied a parking space near AUA on
the side of the road where parking was permitted. Worried about losing it I
parked quickly- facing the wrong way. After breakfast at the Arts Café I
returned to find the car clamped.
A passing tuk-tuk driver examined the ticket and offered to take me to the
appropriate police station to pay the fine. There seemed to be around 100
people waiting but I was advised to put the notice on a spike and wait it
out. Meanwhile I asked my Thai friend to collect me. By the time he arrived
I was ready to sign for release, paid the 200 baht and we headed back for
the car where a policeman was already waiting. We exchanged smiles. I
promised not to be so thoughtless next time and we went our ways. Irritating
of course, but fairly painless compared with the 5 hour wait and 80 pound
fine (5600 baht) which a similar offence would generate in the U.K.
And staying on cars and road - I recently paid for a young Thai friend to
have driving lessons. He already had limited experience back home and
naturally can ride a motor-cycle. He passed his theory test quickly and the
following day went for his actual driving test, which he also passed. He now
has a license. In my opinion it is 007 style.
I expressed some incredulity and pointed out that he had not even completed
the series of driving lessons that had been paid for. No he had not. But he
was going to. Tomorrow the driving instructor was giving him a two-hour
lesson in Chiang Mai traffic. So far he had not been on the roads and the
test had been taken in confined conditions which simply demanded control of
the vehicle not traffic awareness. Truly it pays to look both ways in a one
way street. And before you ask -yes he will be taking further lessons. It’s
the least I can do for your safety.
By the time you read this I shall be in India, in the beautiful southern
most state of Kerala which I have visited before. I’ll report on it later
but you’ll be relieved to know that I am not going there for a hip operation
unlike my colleague Scott Jones.
As it happens the main hospital in Trivandrum would have suited him fine
since it is one of the most modern and efficient anywhere in Asia and was
built by Saudi Arabia. The British government actually sends people out of
the UK for such operations and you will see many heading home from Kerala
very content with their stay and operation.
As it happens I had the same procedure – hip resurfacing – but in the U.K.
itself where we are lucky enough to have had a health service free at the
point of need for some 60 years. This was one of the many great things
introduced by the reforming government led by Clement Atlee from 1945 until
1951, which so changed Britain into a welfare state. They also granted
independence to various countries, notably India, Sri Lanka and Burma. So
perhaps not every story has a happy ending. But one day it will do. Remember
the story of King Canute who was convinced that he could turn the tide back.
Of course, he failed.
Let's Go To The Movies:
Now playing in Chiang Mai
Opapatika: Thai Action/Fantasy – A murky supernatural action film
about certain Thai entities – the Opapatika – whose human varieties are born
fully formed out of nothing. They are supposedly immortal, but in this movie
they seem to keep dying. Go figure! Good CGI now and again, but what is
supposed to be happening is a mystery to me. It’s incredibly muddled,
especially in its Buddhist underpinnings, requiring a disclaimer at the end
saying this is all really not approved Buddhist thought. A very murky muddle
indeed. Director: Thanakorn Pongsuwan.
Balls of Fury: US Low Comedy – I’m sorry to report that the film just
doesn’t have enough laughs. It’s too bad, because the potential was
certainly there. The film boasts some fantastic performers, but here hey are
only amusing, sometimes boring, rarely inspired. I also was not enamored of
the putative star of the movie, Dan Fogler. I thought him peculiarly lacking
in talent or charisma; perhaps it’s just me. But I like Christopher Walken,
and enjoy his inimitable delivery of dialogue. I just wish everything were
better! Generally negative reviews.
Stardust: UK/US Adventure/Fantasy – Robert De Niro is a flying pirate who
dances and tries to outdo Johnny Depp – a performance not to be missed! It’s
a delightful fairy tale for everyone, funny and romantic, and I thoroughly
enjoyed it. It has enough visual razzle-dazzle, humor, and well-drawn
performances to create a lively, fantastical experience. Michelle Pfeiffer
in particular gives a wild, wicked portrayal as the witchiest of the three
witches. Not at all just for kids. Highly recommended for people who enjoyed
Pirates of the Caribbean and the like. Generally favorable reviews.
The Kingdom: US Drama/Thriller – Jamie Foxx. Terrorism against the US inside
Saudi Arabia, and the FBI tries to export its finesse in fighting terror to
a foreign land. Good, quite exciting, muddy politics. Rated R in the US for
intense sequences of graphic brutal violence, and for language. Mixed or
Black Family (Krobkrua Tua): Thai Ultra-low Comedy – Thai family robs bank
to save farm. Quite popular.
Body #19 (Body Sop 19): Thai Thriller/Horror – Man gets some clues in his
nightmares that lead him to morgue drawer #19, and to gradually unraveling
the mystery of the dead body inside. A first-time effort by director Paween
Purijitpanya that is mostly standard Thai horror with some interesting
twists, slow, sometimes beautifully shot, usually with excellent camera
work, and which has some nice evocations of mood. A director, I think, to
Resident Evil 3: Extinction: US Action/Sci-Fi – Unaccountably popular in
Thailand, raking in huge amounts of cash. It feels very much like a video
game, with rooms to explore and levels to achieve and zombies to shoot.
Great moody desert vistas, a creepy ghost town Las Vegas, fascinating
underground grid structures, scary laboratories where icky research is being
performed – it’s all perfectly lovely to look at! See it if you’re into a
lot of senseless action. Rated R in the US for strong horror and non-stop
violence throughout, and some nudity. Mixed or average reviews. Thai-dubbed
at Vista, English at Airport Plaza.
Unlimited Love (Rak Mai Jam): Thai Romance/Drama – Boy loves girl. Girl
dies. Girl comes back as boy. Boy is conflicted.
The Reef (Shark Bait): US Animation – “Absolute carp.” Thai dubbed version
only, and only at Airport Plaza.
Surf’s Up: US Animation/Family – Postponed from last week. This is a laid
back, visually stunning animated movie presented in a witty mockumentary
format, complete with virtual crew and “handheld” cameras. Splendid CGI
effects. An absolute charmer, say the generally favorable reviews.
Game Plan: US Family/Comedy – Starring Dwayne “The Rock” Johnson, the former
pro wrestler. Critics say that despite The Rock’s abundant charisma, this is
just another run-of-the-mill Disney comedy. There is less of a story here
than a series of gag situations. Mixed or average reviews.
Heartbreak Kid: US Comedy – With Ben Stiller. This is a remake of the very
good Neil Simon-penned, Elaine May-helmed 1972 original. Some reviews call
it an uproarious romp, grounded in believable if gleefully implausible human
behavior, and a model of comic timing. Others say it’s mean-spirited and
misogynistic. Rated R in the US for strong sexual content, crude humor, and
language. Mixed or average reviews.
Life in the laugh lane:
by Scott Jones
Hand grenades and meat cleavers
My mate Joom and I say farewell to our friends, most of who are shocked I’m
off to starving, over-populated India for major hip surgery and assume
they’ll never see me again. With tickets in hands at the ends of arms
throbbing with germ cocktail vaccinations, we head to the Chiangmai airport
with plenty of time to board only to be removed from the plane for two hours
while they fix one of the engines. Passengers grumble in the terminal but
I’m always happy they find engine problems before the plane leaves the
ground. In Bangkok, our Air India flight to Chennai is delayed because “the
pilots are tired and have to sleep.” I’m all for pilots who are wide awake
and we optimistically muse that India is a mellow place where time stands
still during mandatory siesta periods. Once experiencing the frenetic pace
of India for a few hours, we realize that all pilots are probably just
terminally exhausted from living there. The flight is roughly comforting
because the intense turbulence keeps the pilots awake and they execute a
marvelous landing on one tire and one wing. After a few days of limping
through streets lined with litter dropped before the birth of Buddha and
teeming with treacherous traffic that makes Bangkok seem relaxed, we head
inland to the hospital in Coimbadore.
We arrive at the Chennai airport in plenty of time to marvel at the security
warnings on the overhead LCD screens. In most countries, a photo of
restricted items is displayed with a list including scissors, box cutters,
aerosol cans and the like, “common” stuff that would fit into carry-on
luggage that meet the airline’s dimension requirements. In Chennai the list
includes items I’d never considered taking on a plane anywhere: “portable
power saws and drills, sabers, swords, crowbars, darts” and—I’m not making
these up—“spear guns, shot guns, automatic weapons, ice picks, blasting
caps, baseball bats, pool cues, hatchets, axes and hand grenades.” And damn,
I couldn’t even bring my “meat cleaver” that is essential for cutting up
airline mystery meals. “Dynamite” is listed right next to “chili powder,
spices and pickles,” which gives us an idea how hot the food might be.
Are they expecting the extended Osama Bin Laden family to travel through
town? “Officer, you must understand! We couldn’t put the meat cleaver and
automatic weapons in our checked baggage because we need to destroy infidels
immediately upon landing! Okay, Honey, give the nice man the hand grenades
in your purse. Oops! Sorry, sir. One of the pins came out…”
Once scanned, patted down and released into the waiting area, we don’t know
where to go—our boarding pass has no gate listed and there are no airline
agents near, just security guards and streams of travelers. Flight
announcements are broadcast in Tamil and English, not readily decipherable
English, which squawk out of speakers reminiscent of drive-thru windows at
McDonald’s. “Flight two-crackle scratch-saven-tane will
something-buzz-whenever from gate unintelligible-squelch-hiss. Would you
like fries with that?” After watching monitors not tell us what to do as our
departure time has passed, I finally show our boarding passes to a guard
herding a crush of people out some gate. His eyes widen and arms flail and
we’re swiftly whisked onto a huge bus carrying only us. Joom asks, “Where
are the other passengers?” We careen across runways toward parked airplanes,
approach one, hesitate and then lurch off to another that’s already fired up
and ready to launch. They roll the walkway back to the door; we race up the
stairs and slump sheepishly in our seats, scrutinized by a 160 stares as the
plane speeds down the tarmac.
On the trip back after surgery, I’m armed with an official letter certifying
that I have metal in my hip guaranteed to set off airport alarms and copies
of my before-and-after X-rays to prove there’s a new, shadowy, white shape
inside my groin area. Although it looks like an internal bomb used by
suicide commandos on a jihad mission, I’m hoping the photo will help me get
out of India.
An elderly friend, who survived a major car wreck requiring 34 permanent
screws to hold her together, carried a miniature X-ray of her entire body.
She’d hand it to the security guard and say, “The doctor put me to sleep and
screwed me 34 times.”