Leaning Tower of Pisa

Damn cheap architects!

In July/August, I went to Europe with my family. We visited London, Oxford, Paris, Geneva, Venice, Florence, Pisa, Rome and Vatican City.

It was interesting to visit the Leaning Tower of Pisa. Its construction began in August of 1173. It took about 200 years to build with couple of long interruptions. Towers inclination started when the third floor was built – it has eight floors. In the last couple of years, steps have been taken to reduce the inclination. It is again open to public. The tour guide told us that it is now good for another 300 years.

The more I looked at the Tower the more it reminded me of our health care system. It has been in crisis since I joined the system 17 years ago. Like the Tower, the health care system is expected to collapse anytime but continues to survive with lot of band-aid solutions and Royal Commissions. I would not be surprised if it outlasts most of the present generation of doctors.

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Holiday in Alaska – Boats, trains and helicopters.

There’s more than one way to see beautiful Alaska – and you don’t have to stick to just one.

I had been dreaming of an Alaskan cruise for a long time. Now that our children are a little older – Alia is 10 years old and Hussein is 12 – my wife Sabiya and I felt this was the best time to make this once in a lifetime trip.

I knew I wouldn’t be the first to travel to Alaska, of course – in 1725, a Russian explorer, Vitus Bering, became the first European to set foot on Alaskan soil. Since then much has changed.

In 1867, U.S. Secretary of State William Seward purchased Alaska from Russia for two cents an acre! Critics laughed and called it foolish. But soon Alaska surprised the world with its wealth of natural resources (gold, oil, tourism, fishing and lumber).

Alaska is the largest state in the U.S. It is 2.5 times the size of Texas, with a population of only 609,300.

Our cruise on the Norwegian Wind began on a Monday evening in Vancouver.

We boarded the 50,000-ton ship with significantly less fanfare than was seen during the departure scene in the movie Titanic. From the deck, we took pictures of a breathtaking Vancouver sunset as we headed out of the harbour.

Next it was time to explore the ship, which is really more of a floating city. It had everything we’d ever want in a week!

The cabins were cleaned twice a day (including changing of towels) and there was plenty of food – certainly enough for the 2,000 passengers and 625 crew members to last for more than a week. Food services started at 6 a.m. and ended with the midnight buffet.

Nor were all of the snacks necessarily “unhealthy.” Besides fresh fruits and vegetables, there are sugarless desserts and low-calorie items on the menu.

One thing they don¼t provide is the willpower to say „no¾ to unhealthy foods!

For fitness buffs, there was a fully-equipped gym with massage therapists. Many varieties of fitness classes were offered that range from beginners to advanced levels. Sauna, spa, aerobics, yogaãyou name it and they had it. There was a basketball area, a small driving range (with lousy clubs), table tennis, two small swimming pools, two hot tubs and walking and jogging areas.

Evening was a time for laughter and fun. There were outstanding Broadway-style shows, stand-up comedians and singers. The audience participation events were especially fun.

The ship offered babysitting arrangements, children’s programs and teen activities.

For gamblers, there was daily lotto, bingo and a casino.

There were two formal evenings when we dressed up in our best clothes. There was a beauty salon, and we could even have rented a tuxedo!

But of course, the strongest draw of cruising the Inside Passage is to be on deck, enjoying the open sea, fresh air, sunshine and blue skies (if it does not rain – this is, of course, the West Coast). Evenings on deck are majestic, calm and relaxing as one watches other beautifully lit cruise ships periodically sailing by.

The ship’s first stop was Juneau, Alaska’s capital city with a population of 26,800 which is inaccessible by road. Mountains, islands, saltwater bays, forested valleys and flatlands surround it.

With the few hours we had in Juneau, we had to decide whether we should go sea kayaking, canoeing, hiking, flying over a glacier by helicopter, panning for gold, sportfishing or to a salmon bake.

Our children decided we’d go glacier trekking by helicopter. Luckily, I had my plastic card as some of the on-shore options have a separate fee. The helicopter soared over Juneau’s wild backcountry and spectacular glaciers, covering 65 miles of Alaskan wilderness and making a brief glacier landing within the massive Juneau ice field. The view was spectacular.

Our pilot/guide showed us a bit of the beauty and mystery of the area by walking us through some interesting spots which require special boots. Juneau ice field is North America’s fifth largest ice field. It covers more than 1,500 square miles of land. The ice field¼s snow and ice depth are estimated to be from 800 to more than 4,500 feet deep. Annual snowfall on the Juneau ice field exceeds 100 feet.

During the flight, we caught tantalizing glimpses of mountain goats. The goats favour the high ridges surrounding the ice field during the summer months.

Then, too quickly, it was time to board the ship again. In the next couple of days, we disembark at Skagway (population 700), Haines (population 1,200), and Ketchikan (population 8,300).

Each has its own history and beauty. But there is something special about Skagway and its 100-year-old connection to the Klondike Gold Rush.

In Skagway, for our off-ship adventure, we took a trip on the White Pass Scenic Railway and saw some of the most spectacular scenery we’d ever hope to see. The train (some train cars are straight out of the 1890s) leaves Skagway (elevation: 0) on a narrow-gauge railroad (built 1898), climbs through the coast mountains in Tongass National Forest and through mountain tunnels to the White Pass Summit (elevation: 2,865 ft).

The last of the spectacular scenery before heading back to Canada was Glacier Bay. Naturalist and adventurer John Muir is credited with discovering the bay in 1879 but it continues to remain isolated and undeveloped. We entered Glacier Bay and cruised along shorelines covered by ice. As water undermines some ice fronts, great blocks of ice break loose and crash into the water. It was a beautiful sight to cherish.

Then it was time to cruise back to Vancouver and the real world. In the end, it was an unforgettable experience.

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I SAY, I SAY: Change is inevitable

My friend Bill – not his real name – says what is happening to him in his personal life is similar to what is happening in the health-care system. Now he regrets he did not anticipate or prepare for these changes.

Changes in life are inevitable. Sometimes they are good, sometimes not so good. Sometimes they come suddenly, sometimes slowly. But things change all the time. What counts is how we anticipate, plan for and handle change.

Let us look at Bill’s true-life story.

Three years ago, Bill celebrated his 50th birthday. He was married with two children, a boy, nine, and a girl, seven. Bill was at the peak of his practice as a surgical specialist. He had plans to retire at 55. In fact, his financial advisor had made plans for Bill’s retirement in year 2002.

Bill’s main consideration was his children. They were very young and he wanted to put some money away for their education. He felt confident that with another five years of hard work he would be home free.

Well, people or nature can sabotage even the best-laid plans. That is what happened to Bill. A few months after his 50th birthday, he developed health problems. This put a significant scare in his head and he realized nobody is guaranteed immortality in this world – young or old.

Bill had to make significant changes in his practice, resulting in a major financial loss. His disability insurance did not kick in, as he was physically thought to be well enough to work. Mentally, he felt very insecure. He wanted to reduce the risk factors in his life to prevent deterioration in his health. Cutting down on stressful work was one way to do it.

Three years have gone by. Mentally and physically Bill has not done badly. He has curtailed his expenses (cutbacks) and managed to survive with limited income. But his children are now 12 and 10. Their needs and expectations keep mounting according to market popularity (peer pressure).

This is what is happening in the health-care system. The governments and health authorities may survive or limp along with cutbacks and limited resources, but people’s needs and expectations do not diminish. In fact they increase as new ways of diagnosis and treatment enter the market.

As we know, this is where governments have failed. They have no political will to change people’s expectations in a changing environment of “fiscal responsibility.” The burden falls on the physicians who are “independent practitioners” but still have the responsibility to do governments’ dirty job of rationing health care.

How can we be “independent practitioners” when we are controlled by two masters – the governments who pay the piper and patients who call the tune?

Physicians are angry and totally demoralized, as we did not anticipate the speed or prepare for the changes in the health-care system. These changes have been coming fast. And there is promise of more to come. But we – and our leaders – continue to fight change instead of becoming part of it.

Like stress, change is part of our lives. It is not going to go away. The question is: How do we plan to handle it?

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