The nameless epidemic

For some reason, I get a little testy when I hear the word “phobia” thrown around where it isn’t really appropriate. Several people I know have claimed to have a “phobia of heights” or a “phobia of fire”. I usually ask those people: Are you afraid of heights, or are you afraid of falling? Are you afraid of fire, or are you afraid of getting burnt? Usually, people would say that they were afraid of falling, or of getting burnt. I would then think that if they could rationalize the fear, it wasn’t a phobia. Just a petty case of “to-may-to/to-mah-to”? After some reflection, I think maybe not.

I’m not one to accept things without rationalization easily, but I do acknowledge the existence of phobias. I have some phobias myself that I can’t make sense of for the life of me. For example, I am afraid of reptiles, especially lizards. I do wish this was as simple as being afraid of being bitten or poisoned by those nasty creatures, but it isn’t. My fear has escalated to the point where the mere sight of a picture of a lizard, or even the mention of the word “lizard” makes me very uncomfortable. Heck, I can’t even open mail from GEICO with the mascot on the envelope without experiencing shivers down my spine. This fear of reptiles is definitely not a rational fear of getting hurt. They call it Herpetophobia. Whatever. I call it annoying. I know I also have at least one phobia that does not have a fancy name. I am scared of… big fonts. Strangely, big letters rattle me. I lose my head whenever I see the enormous Bed, Bath and Beyond sign at the storefront. I drive like a moron and get honked at whenever I see road signs that are bigger than normal (or lower than normal, giving the illusion of size). The point is that irrational fears do exist.

I have a theory as to why some rational fears tend to get perceived as phobias. My theory is that there is a particular fear that is prevalent, but not totally acknowledged. That fear is the fear of irony. I stumbled on this theory when I was thinking about superstitions. I have always believed that superstitious beliefs had their roots in perfectly unsuperstitious logic that was relevant at some point in time. I love thinking about myths and superstitious beliefs and trying to figure out how they came about. For example, I imagine that people started associating twitchy eyes with impending catastrophes because they were probably once an indicator that there was a lot of dust in the air caused by approaching invaders on horses. Eventually, I started thinking about why saying inauspicious things was taboo. I couldn't figure out why people would ever believe that there was a causal effect between saying inauspicious things and something untoward actually happening. That’s when I thought that maybe people were just afraid of irony. The more I thought about it, the more it made sense. I have personally seen people’s sadness surrounding an untoward event intensify when there is some irony surrounding it. I can therefore imagine that people are afraid to say anything that could introduce irony into the situation in case something were to actually happen. This leads me to think that rather than believing that saying inauspicious things could cause catastrophes, people are just afraid of the risk of intense regret that they would have to face in case what they say actually happens.

Although I have not personally known anyone to openly acknowledge this fear of irony, I think that people are aware of it at least on some level. Writers and filmmakers definitely exploit this fear to create heart-wrenching dimensions to their work. Would Steve Irwin’s death have been played up by the media as much if he weren’t an adventurer who had died during an adventurous pursuit? Would the Million Dollar Baby have been the same without the “Fly there, drive back” moment? Insurance companies also seem to prey on the fear of irony. Surely, insurance companies don’t expect clients to manage their risk based on daily activities and choose a policy accordingly. Neither do they expect clients to choose policies based on the practical value of how much they would need and how much they could claim during which events. Insurance policies are marketed as a “just-in-case” commodity to instill a fear of the irony of refusing coverage for a certain event that ended up taking place. It was interesting to think about how the fear of irony could take the form of superstition, creative expression, and even risk-averse sensibility and still never be explicitly identified.

If my theory is true, then the fear of irony is sometimes the insidious villain that makes phobias out of fears that would otherwise be completely rational. The fear of the irony of actually getting burnt despite being fully aware of the dangers of fire could turn a totally rational fear of fire into a phobia. I finally understand my testiness about the semantics surrounding the word “phobia”. I guess I was just afraid that being flexible about the definition of "phobia" could expose a fear of irony that could possibly spawn more phobias that I didn’t really need. Some would term this Phobophobia, the fear of phobias, but based on this much rationalizing, I think we can safely rule that out.

She liked his aftershave, and he liked her shampoo

His first handshake was firm and sincere. He exuded confidence, intelligence, ambition and an endearing sort of shyness. She was exhausted from 2 days of grueling interviews followed by a night sleeping upright at the airport, but she forgot all that the minute he came up and said hello. He made her smile, and he made her laugh. Several meaningful conversations and innocent gestures of tomfoolery later, companionship turned into love. He swept her off her feet, and she surrendered to the feeling of being accepted, the feeling of security and the feeling of not being able to resist temptation and addiction. This love that they shared and reciprocated seemed like it would endure the worst of odds. How did such a perfect love go wrong?

He won her over with affection. He was truly the most affectionate person she had ever met. However, she knew that affection was only ephemeral no matter how deep the love was. She knew that she couldn’t count on this affection forever like he claimed. He interpreted her reluctance to indulge in the affection as rejection, although she was only trying to protect herself from getting hurt. She eventually went against her better judgment and started to delve in the affection and believe that love would last forever. She was severely punished for that. The affection did fade away, and she was left with only her tears for comfort. He soon became drunk with power and money, and once he reprioritized his life, she did not fit in anymore. She could not compete with a million dollars. She saw this coming all along and tried to escape several times. He wouldn’t let her escape while she was still strong enough to recover. He just drifted further and further away into his own world until she realized that he was gone.

He claimed that he understood women. He thought she wanted a Latin Lover by her side. He thought he could dazzle her with dramatic professions of love and spectacular gifts. He gave her everything he thought women wanted. However, already smitten by his good looks and sensuous charm, she just wanted the little things. She wanted to be part of the key moments of his life. She wanted a companion to unwind with after a rough day at work. She wanted a dependable friend she could count on to lift her spirits. Above all, she wanted someone she could pamper. She wanted someone who leaned on her as much as she leaned on him. She so badly wanted to fulfill his needs, but she never figured out what they were. She wanted to feed him and take care of him, but he had family for that. She wanted to be his friend, but he had plenty of those. She was there to be his source of comfort and advice, but he didn’t need that. She was there to believe in him and encourage him to achieve his dreams, but his power-drunkenness at work took care of that. She felt crippled, because she had no way of showing him how much she cared for him.

This disparity in needs led to fights on many occasions. One day, they both stopped fighting. They stopped fighting against each other, but they also stopped fighting for each other. They could have saved this relationship if they had tried. They could have communicated better. They could have committed more. Their relationship could have weathered all those storms and more. Too bad he couldn’t afford the time and she ran out of strength.

If only he knew how much she needs him and pines for him. She would give anything for things to be back they way they were before the relationship started to crumble. She was the one who chose to end it, but he had drifted away far from her reach long before that. Alas, now he is just one more bottle of anger she will store in her heart forever with all the other bottles of anger. This bottle is particularly explosive, because of the sparks of deep, hopeless love at the bottom of all that anger.

His world keeps on spinning like nothing ever happened, but she never stops thinking about her first love that she let go of. She wonders what could have been if she were strong enough to accept love that special. For all she knows, she may just have been cut out for love that is not as special; “love” based on arcane theories of cosmic interaction; “love” that allows merciless and unfair judgment of a person based on superficial knowledge; “love” between two perfect strangers with too many expectations and hardly any understanding…

The mother of all analogies

So… most of you know that I have an analogy for everything. I know that at least one of you is convulsing in giggles right now while pretending to let out a huge groan. (Oh get a grip already… you know who you are…) This one’s different, though. I promise.

Once, I was driving home on Highway 101 late at night. It was drizzling, and it was a torrent of really tiny raindrops as opposed to a few huge ones. It seemed like a thick, wet fog that perpetually covered my windscreen even with the wipers on. As I drove up the peninsula across city lines, there were areas with a fair amount of lighting, and areas with very poor lighting. In the darker patches, the rain on my windscreen was practically invisible, and I could see fairly clearly. However, when the lighting got better, visibility went down because of the translucence of the raindrops. I could barely see what was in front of me, because the water droplets on my windscreen seemed to reflect most of the light away.

Scientifically, this was intuitive, but philosophically, it somehow seemed fascinatingly unexpected and quirky. The presence of street lighting had actually been counter-productive to visibility in this case. I was sure that this would someday be a wonderful analogy for something or other. After all, light and darkness could be so easily and elegantly analogized to many things- knowledge and ignorance, truth and deception, happiness and misery, etc…

I pondered over this for a long time. In what context could “darkness” cause something to appear more lucid than “light” would? I experimented with several concepts, but no matter how hard I tried, I could not deliver a smooth, punchy analogy that I could apply the windscreen story to. Why was I having such a hard time assigning a philosophical context to an anecdote that seemed to be a perfect candidate for an analogy?

This frustration that I felt reminded me of how engineers have the tendency to form a hypothesis and then to design experiments around that hypothesis to collect data to support it. This tactic works for the more experienced engineers would have “superpowers” that enable them to figure out the right hypotheses right off the bat that the experiments would then proceed to support. This level of intuition comes with experience. Other engineers like me, who have not developed that level of intuition, have a much harder time proving their initial hypotheses, no matter how logical the hypothesis sounds. Personally, I have a really hard time moving away from my hypotheses even after my experiments turn out to be inconclusive. How can something that sounds so logical turn out to be so hard to prove? Over time, I have learnt to let go of my technical hypotheses that I can’t prove at work and open my mind up to new hypotheses and solutions. Maybe it is now time for me to let go of my obsession with trying to fit every natural phenomenon into an analogy. The rules of optics surrounding rain on windscreens shall be the first to escape the need to feature in one of my analogies.

Last week, I was on Highway 101 once again when I noticed the reflectors that helped drivers see the lane markings better at night. However, during the day, those reflectors were nearly invisible. What did I learn from that? Not much. I’ll just keep this in mind in case I get to design highways someday.

Anatomy of a Miracle

This post is dedicated to a fine young man who recently eluded medical miracles and left behind many, many people who love him dearly.

Not all medical miracles are inexplicable. Working for a company that makes endovascular devices, I can see the world of medical miracles becoming more navigable. As an investigator with the Quality Engineering group, I encounter more medical mishaps than medical miracles. It is only when our medical devices fail that I am tasked with figuring out what happened and following up accordingly. I peruse the gory details in the case files about unsuccessful vessel closures or incomplete stent deployments until I find the root cause of the failures so that I can prevent future mishaps.

One of my first cases was a “medical mishap” involving a device designed to close up the puncture site in a blood vessel. Unlike a traditional suture, this device works like a stapler. After the device is inserted into the body, “wings” are opened to locate the wall of the punctured vessel. Then, a tube is advanced until it is positioned against the wall. Finally, a circular clip is fired from the device, crimping the hole shut. Simultaneously, the wings collapse and the device can then be safely removed from the body. In this particular “mishap”, the physician was unable to remove the device from the puncture site after he had fired the clip. The wings had not collapsed, so they were stuck in the vessel under the clip. A “control wire” had also snapped, so when the doctor pulled the device away, the control wire was still attached to the vessel locator wings in the body. The doctor had to literally wiggle the rest of the device out of puncture site. Fortunately, the clip had fired successfully and surgery was not necessary.

The device that the physician sent back with his complaint was a mess. There was severe nylon carving, there was misalignment of parts all over and there was evidence of incomplete component deployment at every step. There was a long list of anomalies that could be observed just by looking the device. It was my job to make sense of the list of anomalies and to explain what happened. After several experiments and failure recreation attempts, I finally fit the puzzle pieces together into a sequence of events that was both probable and consistent with the symptoms.

It all started when the physician held the device at a wrong angle and caused the nylon tubes to get carved. The carving was so intense that the nylon blocked the path of the tube and the device did not align the way it was supposed to. However, the tubes had advanced just enough for the trigger to be functional. So, when the trigger was pressed, the clip fired and closed the hole, but the impact from the firing snapped the control wire that was exposed as a result of the misalignment. Meanwhile, the intense nylon build-up had held the wings flat, so they did not collapse like they should have.

Then I took another look at the evidence, and the pronounced sequence of events. Besides the several things that went wrong with the procedure, one thing bewildered me. How the HECK did the clip manage to fire? Carving by itself usually leads to the device getting stuck in the middle of the procedure. Misalignment of components usually leads to the device “pinching” the vessel. Blocked tubes usually lead to the clip getting stuck in the device. None of these scenarios would have ended in a successful procedure. However, amidst all this drama, the clip in this procedure had somehow found its way to the puncture site and had successfully closed the hole. My formal investigation was over, but I ran some more tests in the hope of finding something I could marvel at. Sure enough, I saw that the carving had somehow occurred just past the trigger, so when the device did get stuck, it was not an issue. The carving had then blocked the tubes and caused the incomplete advancement of the device. However, the doctor was holding the device at a wrong angle, so the misalignment of the device in the body prevented the “pinching”. The incomplete device advancement had also caused the tip of the device not to “flare out” like it should have. The edge of the tube would have sliced the vessel like a cookie cutter, but that did not happen, since the control wire had snapped after the trigger was pressed. Therefore, the major part of the device could be removed, leaving behind just a wire. It was also fortunate that the wings did not collapse, as they would have gotten stuck in the clip. Somehow, all these “wrongs” had somehow made a right. Of these failure symptoms that had coincidentally co-existed, if even one of them had been absent, there would have been serious consequences. Marvelous indeed.

The funny thing is that the doctor and the patient will probably never know how lucky they were. The patient is probably lamenting the soreness he must have felt from the traction that was used to pull the wire out. The doctor probably feels like the procedure was botched. They have no idea that the success of the actual clip application was a fluke that defied all kinds of odds. This incident is probably a medical mishap in the books of both the doctor and the patient, when, in fact, it is a miracle that so many potentially catastrophic circumstances canceled each other out like that.

Maybe there is actually no such thing as a medical mishap. A medical mishap is just… a medical miracle that didn’t happen exactly the way we expect. Even when technology thins the line between medical efforts and miracles, a miracle is a miracle. Whether a physician can explain it or not, a miracle is a miracle. Miracles happen because of the skilful use of medical equipment, or it happens by accident. No one is entitled to miracles. Sometimes they happen. Sometimes they don’t. More often than not, they are subtly present and conspicuously absent.

Augenblick

When I boarded a Portland-bound flight from San Francisco recently, I didn’t realize it would be the kind of flight I’d want to immortalize by writing about. It was the most enjoyable flight I remember being on. My eyes were blissfully glued onto whatever I saw outside the window.

It started with the cargo trailers meandering through the runway. There was something about the way the trailer snaked a couple of times in front of the aircraft door to get as many compartments as close to the plane as possible that was so… so… scientific. And so… so… hypnotic.

Then I looked up at the sky and saw something I’d never bothered to watch out for before. There were planes flying towards the runway to land. They all started out as tiny glimmers that I could hardly notice. At first, I thought they were sunspots. However, the glimmers became bigger and more pronounced. Eventually they morphed into planes and landed on the runway. For the next 30 minutes or so, I amused myself with spotting the glimmers right when they first appeared, and watching them become planes.

The plane took off and soon we were high enough to be able to have an aerial view of the mountainous part of Oakland and San Francisco. The variety in landscape was refreshing. There were the lush green parts of the mountains, the pink soft-rock areas, the solid ochre toned areas, and of course, the occasional snow capped summit. It was also amazing to see the settlement patterns in those remote mountainous areas. The dwellings were scattered in a manner that was both random and artistic when viewed from above. At times, I could have sworn that I saw Chinese letters being formed by the arrangement of the cottages. I have read about crop circles being engineered, but I didn’t think that this interesting arrangement had been engineered in any way.

Eventually, the plane wound around its route and embarked on its southern leg directly over the Pacific Ocean. It was like entering a new world. There were swirls of every shade of blue imaginable. I was thoroughly enjoying this delightful display of bluish tones.

Sunsets are always magical, but a dash of sunset colors on sparkly blue waters and majestic mountain ranges in the distance was pure bliss. I couldn’t tell where the horizon was, as the blue from the sea merged so seamlessly with the crimson skies with a beautiful blend of mauve in between. The twilight rays also gave the mountains in the distance some streaks of highlights that enhanced their beauty.

By the time we were ready to land in Oregon, it was nighttime. That meant a brilliant kaleidoscope of brightly colored city lights. Bolder in some areas and softer in others, Portland stood out like embellished artwork against the silky bareness of the surrounding sea and vacant highlands.

After the plane landed, the cargo trailers reappeared. This time, they were accompanied by people wielding colored light sticks.

Finally, the spectacular display of beauty was punctuated by the sight of a wispy crescent against a clear sky with a light dusting of stars.

Such a moving experience wouldn’t be complete if it didn’t lead me to muse about an abstract philosophical concept. This time, I ended up reflecting on heaven. I am sure that different people associate heaven with different things, but I associate heaven with beauty. To me, heaven is a beautiful place. Beauty is what distinguishes heaven from any other place. Not necessarily wealth or comfort. Just beauty. Wealth may or may not be part of the beauty of heaven, and comfort may or may not be a consequence of being in heaven. To me, however, beauty is the one thing that makes my mind “float” and enter a state I choose to define as heaven.

So what did this stunning display of beauty teach me about heaven? It taught me that I’ve been living in heaven all my life. At some point or other, I’ve been in that glimmer in the sky, or in that city by night. Why did I only enter the “heavenly” state of mind only when I was looking at beauty from a distance?

Maybe it doesn’t matter where heaven is, so long as I can find a place I can see heaven from. Would I recognize heaven if I were in it? Do I want to be in heaven, or do I simply want to be able to see it?

Not everyone sees heaven the same way, but this thought could extend to other tangible and intangible aspects of people’s own “heaven”. For example, would we recognize wealth if we weren’t able to step back and “see” wealth, say, on a tax form? What about comfort? Would we only recognize comfort only if we specifically sought it? All in all, would we take the time to notice the little things that surround us that make heaven a place on earth if we didn’t have something external drawing our attention to them?