Friday 3 October 2014

things i’ve learned from microbiology (of life, loss and love)

retrospect imparts insight in the most interesting and unexpected ways. when i was younger, i had thought that individuals grow with a linear and expectant outlook - that with maturity, we would only learn from the current, and use it to predict, anticipate, and prepare for the future. of course, what is to be gained from the past is not so easily deciphered, and what we garner from our experiences is not so easily interpreted. in fact, it was only in my late teens that i came to realise that even a single experience can teach us many times, as we can easily find different interpretations, meanings, and importances, weighted differently as we age. however, this preface has little to do with my subject beyond that something i learned early on in an academic setting would prove to have an extended educational value in everyday life. it is, however, something i wish to say, nonetheless, because the revisiting of prior experiences has brought me to many new outlooks on life, and is something that implore upon the reader (if there is any one), though i would stop myself short of sounding preachy or derogatory; the rest is up to the reader.

in any case, i have learned a great deal from and about microbiology and infectious diseases. this particular lesson, i had forgotten since my introduction to basic pathology in my first year, and would only encounter it again in my final year of my masters course (and again during a recent conference, which is what prompted this post). i believe, though, that simple as the message is, it is an indispensable and generalisable truth whose importance cannot be further underrated and whose use should be made more practical. when you or i become infected with an infectious disease, we are quick to jump to the thought that “clearly there must be something causing the disease, and to get better, i should rid myself of it”. there is no flaw to this logic, and indeed, many, if not most, clinical treatments do centre around this mode of action. however, at least of academic value, are two other contributors to the development and progression of disease, which are the host itself, as well as the environment.

1. life

as we’ve established, the most obvious, and perhaps the most influential contributor to disease is the infective agent itself; one does not miraculously contract malaria without contracting the plasmodium parasite (note that plasmodium sp. is a protozoa, which may be unfamiliar to the reader, but this is besides the point, except for being an interesting observation), just as much as one does not come down with a fever without contracting a disease of any, non-specific sort (the more informed reader will now be quick to point out that not all infections cause pyrexia, just as not all pyrexiae are caused by infections. this is true, but again, not the point being made). the point that is that a foreign being is cause to the disease / symptoms, and the correlation between the two is a direct one. i’m sure i don’t need to point out to the reader more than she already knows that life is indeed a culmination of external factors causing influence upon herself - or more accurately, living life is the experiencing of these external factors. there is the argument that we are merely products of our experiences - a construct begotten from a series of domino-like events set in motion upon our birth into the world, and is little more than an automaton that is refractory or reflective. i do agree that this is part of the experiencing of life, but this cannot be the whole of it. quite recently, i have questioned my ‘success’ in life more than i usually do; i used to believe heavily in effort-reward, and that there is little more that determines our progress in life. but there must be something to be said about fate, or destiny, or qadha and qadar. though i cannot say that it is something so metaphysical that influences our outcomes in life, but perhaps there is merit in being humble enough to think that the vast majority of our successes aren’t ours to claim at all - my entry to a prestigious university or being awarded a competitive scholarship are perhaps a statement more about the stringencies (or lack thereof) from the awarding entities than they are about me. and perhaps the saving grace of such belief is that the antagonistic countenance of success also obeys the law. our failures are not purely our own, either.

2. loss

my grandfather passed away earlier this year. in the parallel i make, this is where i would say that the ‘environment’ plays a role in that, and is severely underestimated for doing so. in the infection analogy, putting an infective agent with a(n in)competent host does not cause disease progression in 100% of the cases. doctors, for example, who are in constant contact with patients with tuberculosis, do not all go on to have tb themselves. is it because the doctors are immunologically healthy, or that the mycobacterium is sufficiently weak to only infect a specific cohort (of the elderly, young, or already sick)? yes, to all and more of these. but often overlooked is that the environment may be conducive, or insufficiently so, for the doctors to contract the disease. was the aeration in the ward negatively pressured such that the infective agent could not find a suitable host? was air conditioning set too low for the establishment of an initial colony? were antibiotics used, reducing the chances of bacterial spreading disease (or too lavishly so, such that they developed a nasty immunity to common antibiotics, causing infection to be more severe)? the environmental potential is limitless, but because of that, perhaps, is why we overlook them, and do not try to treat from this angle even once considered.

but, regarding old grandpa, i do not know to what extent the environment can be blamed for his passing. i was not even here for the event, the funeral, or the subsequent mourning (which i, quite unfortunately, did not proceed to partake in during my absence for unknown reasons). would i to blame him for his death? perhaps not. were i to blame those who cared for him during the time leading up to it? definitely not, as i observed my own family take care of him better than i could hope to have myself taken care of in my twilight. but to blame circumstance, or conditions, or unassignable variables - perhaps the beauty or solace in such lies in the indispensable comfort of ambiguity. that knowing that the ‘environment’ was all-encompassing and ready enough to embrace fault (for it is a conglomerate of factors, enough to distribute the blame thinly as to not bear enough conscience upon a singular being), or that it is so diffuse as to become inanimate and impersonal. who knows? and i do not pretend to want to, definitely not beyond the ignorance that loss, and gain; beauty and bewitchingness; poignance and insanity; can all be explained in terms of self, and others. and that which cannot be reconciled? well, for that, there is the environment.

3. love

i am fond of the expression that ‘we all makes decisions, but as importantly, our decisions make us (who we are)’ (or something to that extent). to a large extent, we are not only products of how the environment has shaped us, how others have influenced us, but also how we have acted and reacted against everything external - and this is the counterweight, the balance, the yin and/or yang to the fatalist; and is not something for the lighthearted or the careless to succumb to. and perhaps, it is hardest to acknowledge that we are, though not masters of our fate, captains of our own vessels, generals of our own armies, and most importantly masterminds of our own demises. the same way that a large cohort of persons who come down with a disease are not because the disease is so virulent, but because they are more susceptible to disease (in general) than your average, healthy person; the immunocompromised, those with genetic predispositions, co-infected hosts, etc. and this is what i’ve learned of love:

sometimes, you could do all the right things, like wait for her in drenching rain,
and other times you’ll comfort her through times of unrelenting pain;
get her chocolates for her birthday, even when you’re out of cash,
let her scream (it’s not your fault) when she just needs a time to lash.
and when it comes time for romance, you’ll dance with her upon the beach,
at her wedding you might even stand, deliver a whole-hearted speech;
but most important isn’t the things you’ll do, i think you know of this by now,
it’s all the things you refrained from, especially when you don’t know how.

the apex of all you could give, perhaps is what she’ll never know,
that when it came for time to love, you reluctantly let her go.

so perhaps, as with all young men who think they know all there is to know about love, and just as well, think they could offer all that other men could not, it can be said that, yes, we are not only responsible for the things we do right, but also that which we do wrongly. though it is easy to blame another for our own shortcomings (and it is all too easy to justify that we’ve taken the righteous road, the best of decisions, the most amiable of assumptions), maybe what love taught me is that it’s not another’s fault if you cannot love they way you idealised (and, you are free to substitute the word ‘love’ for any other). it is not only expected upon you to own up to your mistakes, but more pertinently, to let the fault be your own, and move on, instead of trying to fix that which cannot be fixed, not only in the eyes of others, but inherently to yourself. such things are easier to say when one believes that there is an objective thing, such as love, waiting as an eventuality, but i cannot say that this is the lesson that i’ve come to appreciate thus far.

Wednesday 1 October 2014

thank you

i shalt not want for other things,
that were not destined for mine own;
like love and lost, of queens and kings,
and hope for sitting 'pon thine throne.

or perhaps to loft on spread wings,
with strength of sinew, blood and bone;
i could not want for other things,
how fair to reap what i've not sown?