Tough

It's a tough test ahead of me;
i must look at the matter in a large perspective
and show my true character
as i believed it appears in difficulties

6 Fixtures

The schedule til February 19th:

1-Sunday 31 Jan : Gasteroenerology Ward

2-Thuesday 2 Feb : Emergency Ward

3-Thursday 11 Feb : General Medical Ward IV

4-Friday 12 Feb : Rheumatology-Endocrinology Ward

5-Sunday 14 Feb : Emergency Ward

6-Wednesday 17 Feb : General Medical Ward II

ALS:A Bunch Of Muscles,Thinking !

Rolled on to the stage in an electric wheelchair,a blanket wrapped around his body so that all could be seen was his neck and head,to which breathing tube was attached like a bit of facial Tupperwave.

Allegoricly he says:"The last time anyone had seen me in public i'd been bouncing around the stage full of fitness and energy,now they saw this quadriplegic with plastic on his face."

A few weeks ago the English historian Tony Judt delivered a speech at his home in NYU .More than 1000 people turned up,and few left disappointed.

What they heard was classic Tony Judt :the lecture ,a plea for positive virtues of social democracy,was an erudite as might be from the autjor of Postwar ,his epic portrait of Europe since 1945,and as politically pointed as his contraversial writings on Middle East.

He was concerned about how his audience would react to the new-look him,and tried hard to make them feel at ease.It worked and at the end of the speech he received a standing ovation.

18 months ago Judt was,by his own description "a 61 year-old ,very healthy,very fit,very independent,travelling sports-playing guy".He had a slight shortness of breath walking up hills and found himself hitting the wrong keys when he typed,nothing more.

Then in September 2008 he was diagnosed with motor neuron disease,ALS(Amyotrophic Lateral Sclerosis),known as Lou Gehrig's disease after the legendary New York Yankees hitter who died in 1941.

ALS ravage Judt with astonishing speed.By December he had lost the use of his hands.By March he was in wheelchair .By May he was wearing the"the silly-looking facial tubing" as he puts it,because his diaphragm muscles were no longer strong enough to effect the bellows motion that induces breathing.

ALS is the most common form of progressive motor neuron disease.It 's a prime example of neurodegenerative disease and is arguably the most devastaing of the neurodegenerative disorders.

Cused by death of lower motor neurons (consisting of anterior horn cells in the spinal cord and their brainstem homologues innervating bulbar muscles)and upper or corticospinal,motor neurons.

Clinical manifestations of ALS are somewhat variable depending on the site of damaged neurons.With lower motor neuron dysfunction and early denervation,typically the first evidence of the disease is insidiously developing asymmetric weakness ,usually first evident distally in one limb.Recent development of cramping with volitional movements typically in the early hours of morning.Weakness is associated with progressive wasting and atrophy of muscles .

When the initial denervation involves bulbar rather than limb muscles onset is difficulty with chewing,swallowing and movements of the face and tongue.

Early involvement of respiratory muscles may lead to death before the disease is far advanced elsewhere.

Degeneration of the corticobulbar projections innervating brainstem rsults in dysarthria and exaggeration of the motor expressions of emotion.

It's characteristic of ALS that,regardless of wether the initial disease involves upper or lower motor neurons,both will eventually be implicated.

Even in the late stages of ALS sensory,bladder,blowel and cognitive functions are preserved.

Dementia is not a component of sporadic ALS.In some families ,ALS is co-inherited with frontotemporal dementia in some families..

ALS is relentlessly progressive ,leading to death from respiratory paralysis;the median survival is from 3-5 yeards .Several endemic foci of higher prevalence exist in the western Pacific.

The suddenness of the catastrophe in Judt's case would leave many people paralysed not just physically but emotionally.Judt's response was somehow different . He's embarked on a fascinating ,albeit involuntary,intellectual journey ;a forced march of the mind.

The product of this existential delving is a series of essays that Judt has written – or rather dictated – for the New York Review of Books (NYRB) that will be published over the next three months. One tackles his illness head on. In Night, reproduced here, Judt subjects his own deterioration to the same unsparing scrutiny as he would the Israel-Palestine conflict, say. Its absence of any self-pity makes for harrowing reading.

The other eight essays take us back in time to formative aspects of his childhood in England. He was born in 1948 to lower middle-class parents and spent six years living in Putney in south-west London – a location that forms the theme of one of the essays. In others he introduces us to Joe Craddock, his school German teacher, lamenting that Craddock's insistence on excellence ("Yer utterly useless!" he would shout at pupils) is unthinkable in today's pampering education system. He finds meaning in the melange of largely bad food he was served as a child and revels in his love affair with trains that is now deprived him by his immobile condition.

Taken together, the essays illuminate the many contradictions in Judt's make-up that give him such a distinctive voice. He is a Jew with no religion who has questioned the legitimacy of the state of Israel; a naturalised American citizen who is a consistent critic of overweening US power; a person of the left who subscribes to no leftist ideology.

He is, to use a phrase that Judt applied to Edward Said, a rootless cosmopolitan. "Today I'm regarded outside New York University as a looney tunes leftie self-hating Jewish communist; inside the university I'm regarded as a typical old-fashioned white male liberal elitist. I like that. I'm on the edge of both, it makes me feel comfortable."

His current intellectual preoccupation is with the role of the state in western societies – the subject matter of his NYU lecture. His thesis is that over the past 40 years, western democracies have forgotten the positive virtues of collective action. "What has gone catastrophically wrong in England and the States is that for 30 years we've lost the ability to talk about the state in positive terms," he says. "We've raised a generation or two of young people who don't think to ask, what can the state do that is good?"

At the end of the lecture he was struck by how many young people came up to him expressing amazement at ideas they had never heard before. "This is the second generation of people who can't imagine change except in their own lives, who have no sense of social collective public goods or services, who are just isolated individuals desperately striving to better themselves above everybody else."

Judt now intends, in the time he has left, to devote himself to writing a book to help young people think collectively again. "It could really have an impact if I get it right. Something that will get the next generation to see there is a way to think about politics that is not just the way we've been habituated to do it. I care about that and I think I can do it."

Judt is already working on the book, using the same memory technique that he deployed for his NYRB essays. During the night he builds in his mind a Chinese memory palace – or in his case a modest Swiss house – and into each of its rooms he imagines placing a paragraph or theme of the piece he is composing. The next day he recalls each room in sequence, unloading its contents by dictating it to his assistant.

Some people have tried to comfort him with the thought that such mental discipline renders Judt's condition bearable. How wrong they are. "There have been people who have said to me, 'Tony, you are so lucky. More than anyone you live the life of the mind. It could have been so much worse.'"

To which he replies: "Hello! Are you from Planet Zurg? This is one of the worst diseases on Earth. It is like being in a prison which is shrinking by six inches each day."

It is true that he has exceptional mental strength. Against that, there are torments that come with this disease. An intensely independent and proudly autonomous man, he can now never, not for a second, be left alone.

The overriding truth, he says, is that "this is just hell. Because there is no hope, no help, and you know what the ending is going to be, each day is going to be like the last day only maybe a little bit worse. Sisyphus-like, you are going to have to roll this bloody rock up the hill tomorrow in exactly the same way."

We've been talking now for more than an hour, and Judt asks his assistant to move his legs and arms into a new position. He lets out a faint groan of relief. Being motionless for so long, his body hurts; it also grows cold from lack of blood circulation, which explains the sweltering heat in the room.

His ALS has come upon him so swiftly that, under usual expectations, he would be dead within months. But the degeneration of his upper motor neurones, which control his head and voice, appears to be occurring very slowly, raising the hope – or is it fear? – that he may stay as he is for quite a while. Inevitably, though, he will lose all power of communication, bar the ability to wink.

So does he think of euthanasia, of putting an end to an existence that he calls "cumulatively intolerable"?

"There are times when I say to myself, this is so damn miserable I wish I was dead, in an objective sense of I wish I didn't have to get up this morning and do it all over again. I've thought about euthanasia a lot, not for tomorrow, but one has to plan for it because the likely trajectory is that you lose your capacity to express yourself long before you die.

"No one wants to live in a wheelchair unable to talk, only winking once for yes and twice for no. It's perfectly reasonable that there will come a point where the balance of judgment of life over death swings the other way." At that point, he says: "The biggest thing to take into account is not your own feelings but your family's."

All that lies ahead. For now though there is the daily rock to be rolled up the hill, the Swedish house to be filled with night-time compositions, the book to be completed. Tony Judt is in hell. But he's by no means yet defeated.

Reference : Guardian(Ed Pilkington),Harrison

Cold Caress

It's more than music;more than simple hobby,when the sound targets deeper layers of cognition,it's a rare classy experience nowadays;finding the pure revelation of what goes inside.

I lived with the growls,i felt the agony the bleak atmosphere ...it's all familiar to what i've felt,all these years ,every 5:30 morning rise-up,every moment of mine being secluded...

Solitude;a key element of my life...now i really adore this kingdom of mine;to share this with people who ruin all the senses,denying all the beauty with their color blind eyes?

This was the honest sound;ringing in my ear...and i am to listen to them...to feel them

It's a privilege to understand the difficult distorted screams;the inoccent who don't find another way to express their pale existence .

It's a honor belonging to a minority ...

By Choosing Death

i am wondering

wether it's a sophisticated angle

to condemn life

for failure we've made

for chances we've missed

all i can feel is that

there's nothing holier than life

i don't believe in words of prophecy

i believe in my will and thirst

enough with images of death

i visit the old man in the lobby almost every day

looking at me; i can see the the hatred in his eyes

whispering words like this:"punks,idiots,..."

the old man serves me fueling streak of life in my veins

His sulk is easy to forget ; thrashed by images of ethereal impunity

Ready to face the fraud

"....arbitrary

...Absurd"

whatever you call

i won't swap a second of this succulent endeavor

I let this flimsy rope save me

and you let the sullen troll swallow

we'll see who's under illusion

who's on the up

we'll wait and see

Pedram

Jan 16th 2010

As You Pray For Me

And you pray

for me

to fall

to fail

big fish: hooked

Nemesis flourished inside

lonely child

gazing at the sky

as pure as snow

visions of innocence

turned black

as you prayed for me

Pedram 12 jan 2010

Photo : Maciej Tyszeck

The Invention of Solitude

I'm busy reading Paul Auster's debut book "The Invention Of Solitude",it's the 4th Auster's book in my shelf after:"New York Trilogy","Leviathan" and "In The Country Of Last Things" .I have to say it's been really touching so far.

key phrases i faced"Invisible to others and most likely invisible to himslf as well"

Underneath...

Underneath the growing grass,

Underneath the living flowers,

Deeper than the sound of showers:

There we shall not count the hours

By the shadows as they pass

Youth and health will be but in vain,

Beauty reckoned of no worth:

There a very little girth

Can hold round what once the earth

seemed too narrow to contain

Christina Rossetti