Vol. VI No. 36 - Tuesday
October 30, - November 5, 2007



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by Saichon Paewsoongnern


Columns
HEADLINES [click on headline to view story]:

The Doctor's Consultation

Agony Column

Camera Class by Snapshot

Money Matters

Life in Chiang Mai

Let's Go To The Movies

Life in the laugh lane

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 much quicker.
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 Hx!

 

Heart to Heart  with Hillary

Dear Hillary,
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!
Edwin
Dear Edwin,
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.

Dear Hillary,
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?
Phoebe Phoneless.
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 Harry Flashman

Flashing can be digital fun

This 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 it.


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 Brazilian holdings.
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 play.
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 [email protected]


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 pace.
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: Mark Gernpy

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 average reviews.
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 watch.
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.
Scheduled for
Thursday,
November 1

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.”



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