From the British Medical Journal
http://bmj.bmjjournals.com/cgi/content/full/328/7454/1458
BMJ 2004;328:1458 (19 June), doi:10.1136/bmj.328.7454.1458
Bush plans to screen whole US population for mental illness
Jeanne Lenzer
New York
A sweeping mental health initiative will be unveiled by President George
W Bush in July. The plan promises to integrate mentally ill patients
fully into the community by providing "services in the community, rather
than institutions," according to a March 2004 progress report entitled
New Freedom Initiative
(www.whitehouse.gov/infocus/newfreedom/toc-2004.html). While some praise
the plan's goals, others say it protects the profits of drug companies
at the expense of the public.
Bush established the New Freedom Commission on Mental Health in April
2002 to conduct a "comprehensive study of the United States mental
health service delivery system." The commission issued its
recommendations in July 2003. Bush instructed more than 25 federal
agencies to develop an implementation plan based on those recommendations.
The president's commission found that "despite their prevalence, mental
disorders often go undiagnosed" and recommended comprehensive mental
health screening for "consumers of all ages," including preschool
children. According to the commission, "Each year, young children are
expelled from preschools and childcare facilities for severely
disruptive behaviours and emotional disorders." Schools, wrote the
commission, are in a "key position" to screen the 52 million students
and 6 million adults who work at the schools.
The commission also recommended "Linkage [of screening] with treatment
and supports" including "state-of-the-art treatments" using "specific
medications for specific conditions." The commission commended the Texas
Medication Algorithm Project (TMAP) as a "model" medication treatment
plan that "illustrates an evidence-based practice that results in better
consumer outcomes."
Dr Darrel Regier, director of research at the American Psychiatric
Association (APA), lauded the president's initiative and the Texas
project model saying, "What's nice about TMAP is that this is a logical
plan based on efficacy data from clinical trials."
He said the association has called for increased funding for
implementation of the overall plan.
But the Texas project, which promotes the use of newer, more expensive
antidepressants and antipsychotic drugs, sparked off controversy when
Allen Jones, an employee of the Pennsylvania Office of the Inspector
General, revealed that key officials with influence over the medication
plan in his state received money and perks from drug companies with a
stake in the medication algorithm (15 May, p1153). He was sacked this
week for speaking to the BMJ and the New York Times.
The Texas project started in 1995 as an alliance of individuals from the
pharmaceutical industry, the University of Texas, and the mental health
and corrections systems of Texas. The project was funded by a Robert
Wood Johnson grant—and by several drug companies.
Mr Jones told the BMJ that the same "political/pharmaceutical alliance"
that generated the Texas project was behind the recommendations of the
New Freedom Commission, which, according to his whistleblower report,
were "poised to consolidate the TMAP effort into a comprehensive
national policy to treat mental illness with expensive, patented
medications of questionable benefit and deadly side effects, and to
force private insurers to pick up more of the tab"
(http://psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf).
Larry D Sasich, research associate with Public Citizen in Washington,
DC, told the BMJ that studies in both the United States and Great
Britain suggest that "using the older drugs first makes sense. There's
nothing in the labeling of the newer atypical antipsychotic drugs that
suggests they are superior in efficacy to haloperidol [an older
"typical" antipsychotic]. There has to be an enormous amount of
unnecessary expenditures for the newer drugs."
Drug companies have contributed three times more to the campaign of
George Bush, seen here campaigning in Florida, than to that of his rival
John Kerry
Credit: GERALD HERBERT/AP
Olanzapine (trade name Zyprexa), one of the atypical antipsychotic drugs
recommended as a first line drug in the Texas algorithm, grossed $4.28bn
(£2.35bn; {euro}3.56bn) worldwide in 2003 and is Eli Lilly's top selling
drug. A 2003 New York Times article by Gardiner Harris reported that 70%
of olanzapine sales are paid for by government agencies, such as
Medicare and Medicaid.
Eli Lilly, manufacturer of olanzapine, has multiple ties to the Bush
administration. George Bush Sr was a member of Lilly's board of
directors and Bush Jr appointed Lilly's chief executive officer, Sidney
Taurel, to a seat on the Homeland Security Council. Lilly made $1.6m in
political contributions in 2000—82% of which went to Bush and the
Republican Party.
Jones points out that the companies that helped to start up the Texas
project have been, and still are, big contributors to the election funds
of George W Bush. In addition, some members of the New Freedom
Commission have served on advisory boards for these same companies,
while others have direct ties to the Texas Medication Algorithm Project.
Bush was the governor of Texas during the development of the Texas
project, and, during his 2000 presidential campaign, he boasted of his
support for the project and the fact that the legislation he passed
expanded Medicaid coverage of psychotropic drugs.
Bush is the clear front runner when it comes to drug company
contributions. According to the Center for Responsive Politics (CRP),
manufacturers of drugs and health products have contributed $764 274 to
the 2004 Bush campaign through their political action committees and
employees—far outstripping the $149 400 given to his chief rival, John
Kerry, by 26 April.
Drug companies have fared exceedingly well under the Bush
administration, according to the centre's spokesperson, Steven Weiss.
The commission's recommendation for increased screening has also been
questioned. Robert Whitaker, journalist and author of Mad in America,
says that while increased screening "may seem defensible," it could also
be seen as "fishing for customers," and that exorbitant spending on new
drugs "robs from other forms of care such as job training and shelter
programmes."
But Dr Graham Emslie, who helped develop the Texas project, defends
screening: "There are good data showing that if you identify kids at an
earlier age who are aggressive, you can intervene... and change their
trajectory."
Related letters in BMJ:
Bush plans to screen whole US population for mental illness: Is road of
initiative paved with good intentions?
Woody Caan
BMJ 2004 329: 292. [Letter]
Bush plans to screen whole US population for mental illness: An unlikely
public healthcare initiative
John R Broomfield
BMJ 2004 329: 292. [Letter]
Bush plans to screen whole US population for mental illness: Bush's
sanity test is revealed
Archie W Julien
BMJ 2004 329: 292. [Letter]
Bush plans to screen whole US population for mental illness: Summary of
responses
Birte Twisselmann
BMJ 2004 329: 292-293. [Letter]
Other related articles in BMJ:
News
Whistleblower removed from job for talking to the press.
Jeanne Lenzer
BMJ 2004 328: 1153. [Extract] [Full text]
News
Whistleblower charges medical oversight bureau with corruption.
Jeanne Lenzer
BMJ 2004 329: 69. [Extract] [Full text]
News
FDA's counsel accused of being too close to drug industry.
Jeanne Lenzer
BMJ 2004 329: 189. [Extract] [Full text]
News
Bush launches controversial mental health plan.
Jeanne Lenzer
BMJ 2004 329: 367. [Extract] [Full text]
News roundup
Bush's plan to screen for mental health meets opposition in Illinois.
Jeanne Lenzer
BMJ 2004 329: 1065. [Extract] [Abridged text] [Full text]
Monday, November 29, 2004
Sunday, November 28, 2004
TRAVELLERS & MAGICIAN
In the Buddhist kingdom of Bhutan, nestled deep in the Himalayas, two men seek to escape their mundane lives. Dondup, an educated university graduate decides that he will be better off picking apples in the US than working as a government officer in a remote rural village. Tashi, a restless farm youth studying magic, cannot bear the thought of a life consigned to his village. Through a trick of his brother, he is delivered into a dream world of seduction and intrigue.
The two men embark on parallel, if separate, journeys. Their yearning is a common one ~ for a better and different life. Dondup, delayed by the timeless pace of his village, is forced to hitchhike through the beautiful wild countryside of Bhutan to reach his goal. He shares the road with a monk, an apple seller, a rice-paper maker and his beautiful young daughter, Sonam.
Throughout the journey the perceptive, yet mischievous, monk relates the story of Tashi. It is a mystical fable of lust, jealousy and murder, that holds up a mirror to the restless Dondup, and his blossoming attraction to innocent Sonam.
The cataclysmic conclusion of the monk's tale leaves Dondup with a dilemma ~ is the grass truly greener on the other side?
"A peach blossom is beautiful only because it is temporary."
"Hope causes pain."
The two men embark on parallel, if separate, journeys. Their yearning is a common one ~ for a better and different life. Dondup, delayed by the timeless pace of his village, is forced to hitchhike through the beautiful wild countryside of Bhutan to reach his goal. He shares the road with a monk, an apple seller, a rice-paper maker and his beautiful young daughter, Sonam.
Throughout the journey the perceptive, yet mischievous, monk relates the story of Tashi. It is a mystical fable of lust, jealousy and murder, that holds up a mirror to the restless Dondup, and his blossoming attraction to innocent Sonam.
The cataclysmic conclusion of the monk's tale leaves Dondup with a dilemma ~ is the grass truly greener on the other side?
"A peach blossom is beautiful only because it is temporary."
"Hope causes pain."
Saturday, November 27, 2004
WHAT IS TRUE LOVE?
It was a busy morning, approximately 8:30 am, when an elderly gentleman, in his 80's, presented to have sutures (stitches) removed from his thumb.
He stated that he was in a hurry as he had an appointment at 9:00 am.
I took his vital signs and had him take a seat, knowing it would be over an hour before someone would to able to see him.
I saw him looking at his watch and decided, since I was not busy with another patient, I would evaluate his wound.
On examination it was well healed, so I talked to one of the doctors, got the needed supplies to remove his sutures and redress his wound.
While taking care of his wound, we began to engage in conversation. I asked him if he had a doctor's appointment this morning, as he was in such a hurry.
The gentleman told me no, that he needed to go to the nursing home to eat breakfast with his wife.
I then inquired as to her health. He told me that she had been there for a while and that she was a victim of Alzheimer's Disease.
As we talked, and I finished dressing his wound, I asked if she would be worried if he was a bit late.
He replied that she no longer knew who he was, that she had not recognized him in five years now.
I was surprised, and I asked him, "And you are still going every morning, even though she doesn't know who you are?"
He smiled as he patted my hand and said... "She doesn't know me, but I still know who she is."
I had to hold back tears as he left, I had goose bumps on my arm, and thought, "That is the kind of love I want in my life."
True love is neither physical, nor romantic.
True love is an acceptance of all that is,
has been, will be, and will not be.
He stated that he was in a hurry as he had an appointment at 9:00 am.
I took his vital signs and had him take a seat, knowing it would be over an hour before someone would to able to see him.
I saw him looking at his watch and decided, since I was not busy with another patient, I would evaluate his wound.
On examination it was well healed, so I talked to one of the doctors, got the needed supplies to remove his sutures and redress his wound.
While taking care of his wound, we began to engage in conversation. I asked him if he had a doctor's appointment this morning, as he was in such a hurry.
The gentleman told me no, that he needed to go to the nursing home to eat breakfast with his wife.
I then inquired as to her health. He told me that she had been there for a while and that she was a victim of Alzheimer's Disease.
As we talked, and I finished dressing his wound, I asked if she would be worried if he was a bit late.
He replied that she no longer knew who he was, that she had not recognized him in five years now.
I was surprised, and I asked him, "And you are still going every morning, even though she doesn't know who you are?"
He smiled as he patted my hand and said... "She doesn't know me, but I still know who she is."
I had to hold back tears as he left, I had goose bumps on my arm, and thought, "That is the kind of love I want in my life."
True love is neither physical, nor romantic.
True love is an acceptance of all that is,
has been, will be, and will not be.
Sunday, November 21, 2004
Books By Writer Azlan Adnan Now Available at www.lulu.com
Dear Friends
Just a short email to let you know that I have published my works at:
http://www.lulu.com/azlan
They are going for as little as US$1 or US$2 for the e-book download version in pdf format. Many are beautifully illustrated in full colour.
I have already published 20 works on a variety of topics from business history, to meditation to romance and psychiatry and more will be uploaded in the coming weeks.
Thank you.
--
Azlan Adnan, MA International Business and Management
H/P: +60 12-383 1324
Fax: +60 3-2032 1128
E-mail: azlan088@gmail.com
http://geocities.com/azlan088
http://azlanadnan.blogspot.com
www.lulu.com/azlan
Saturday, November 20, 2004
The Nurse
She's a very attractive Malay girl. Petite, brunette and with a charming smile and warm glow to her blushing cheeks. I saw that they were operating on a large animal (could be a zebra) and could see they had just removed the liver, which had green spots on it. I thought that was unusual and asked my friend what's wrong with the liver. He kinda kept quiet. I thought he wanted to concentrate on whatever else he was removing next.
I glanced at the nurse who just gave me a warm smile. When I asked again, my friend still hesitated to tell me, but finally he gave me a bullshit answer: that the liver was polarised. Of course, that didn't make any sense. After the procedure, they all scrubbed up and had lunch. I gladly joined them, thinking it would be a good chance to be introduced to the nurse and "chat her up." But she went away.
As she was leaving, I asked her if she wasn't having lunch and she replied she wasn't having any because she was nauseous. I asked her if it was the operation.
She said, "Oh, no, I'm used to that. I have morning sickness."
Copyright 2003-2004 Azlan Adnan Legal Notice
Wednesday, November 17, 2004
FOR SALE: Ducati Monster
Ducati Monster, 600 c.c., 1994 model
Excellent condition, like new
Very well-maintained, low mileage weekend bike
RM21,000 or nearest offer
Contact: Azlan 012-383 1324
Notes:
Ducati's Monster 600 is the best-selling motorcycle in Italy, where it's considered an icon of contemporary design. Is this the sexiest beginner bike on the planet? At the very least it's the most exotic looking. Despite its name, the Monster is as welcoming to new riders as any 600 cc standard or sportbike on the market. Like all 600 cc motorcycles, though, it's for those who have mastered the basic maneuvers of motorcycling. If that's you, the Ducati's V-twin engine delivers power in an extremely friendly, usable manner, and the striking lattice frame offers excellent handling. And the engine makes that distinctive Ducati roar. Seat height: 30.3 inches.
Copyright 2003-2004 Azlan Adnan Legal Notice
Tuesday, November 16, 2004
Re: Message from Mrs Ruth w. Kabila
Dear Mrs Ruth w. Kabila
I'm surprised you are writing to me because your son James had already
contacted me last month and transferred the US$22 million into my bank
account last week.
Don't worry, the money is in safe hands, I'm keeping all of it.
> ----------------------------------------------------------------------
>On Tue, 16 Nov 2004 05:13:52 -0800, Mrs Ruth w. Kabila
ru_j2003_4@yahoo.co.uk wrote:
>
>
>
> From: Mrs Ruth w. Kabila. Please Contact here: ru_j2003_4@yahoo.co.uk
> confidential Reasons. MY Dear, I am Mrs.Ruth w. Kabila, from Democratic
> Republic of Congo. There is an imformation I would like you to keep very
> confidential There is sum ammount of money my Husband Late President Laurent
> Kabila, deposited in a security company Abidjan Cote d\'ivoire for safe
> keeping. Before he was killed by his Eldest Millitary Son. The squable
> happened as immediately we returned back from our London trip. My husband
> married us two.I am the second wife.I will not be able to give you the full
> details that led to that urgly incidents. The Eldest Son is the current
> President of our country now. For now I am staying in Abijdan, the capital
> of Republic of Cote d\'voire,just to save my life,with my three children.
> The money in question, is 22, Million U.S.Dollars. I can not make the
> withdrawal of this fund, because my husband registered the Beneficiary of
> the fund as his (Foriegn Bussiness Patner) and also (Family valuables as the
> content of the deposit) The documents of the deposit are with me. What I
> would want you to do, is to assits me to get the consignment withdrawn from
> the security company, and we shall open a small account in a Bank here in
> your name, and transfer the money to your country, through the account .We
> shall replace the name Foriegn Patner to your own name, because the code was
> used for security reason. I will give you the 10% of the money for your
> assitance.Ther is no risk in this transaction. I will use the remain balance
> of the money for an investiment in your country for the future of my
> children. If you are intrested, and can maintain the very confidential of
> this transaction,you e-mail me immediately for more clearification, and also
> note that I am a refugees in Abidjan, Cote d' lvoire becuase of the
> assasnation of late husband,and the civil war going on in our
> country,Democratic Republic of Congo. I can speak little english, and my son
> also speaks english very well his name is James and his tell is:00225 07 17
> 70 22.you can call him for more information. Thank you very much. Mrs.Ruth
> w. Kabila. Please Contact here: ru_j2003_4@yahoo.co.uk confidential Reasons.
>
> ----------------------------------------------------------------------
I'm surprised you are writing to me because your son James had already
contacted me last month and transferred the US$22 million into my bank
account last week.
Don't worry, the money is in safe hands, I'm keeping all of it.
> ----------------------------------------------------------------------
>On Tue, 16 Nov 2004 05:13:52 -0800, Mrs Ruth w. Kabila
ru_j2003_4@yahoo.co.uk wrote:
>
>
>
> From: Mrs Ruth w. Kabila. Please Contact here: ru_j2003_4@yahoo.co.uk
> confidential Reasons. MY Dear, I am Mrs.Ruth w. Kabila, from Democratic
> Republic of Congo. There is an imformation I would like you to keep very
> confidential There is sum ammount of money my Husband Late President Laurent
> Kabila, deposited in a security company Abidjan Cote d\'ivoire for safe
> keeping. Before he was killed by his Eldest Millitary Son. The squable
> happened as immediately we returned back from our London trip. My husband
> married us two.I am the second wife.I will not be able to give you the full
> details that led to that urgly incidents. The Eldest Son is the current
> President of our country now. For now I am staying in Abijdan, the capital
> of Republic of Cote d\'voire,just to save my life,with my three children.
> The money in question, is 22, Million U.S.Dollars. I can not make the
> withdrawal of this fund, because my husband registered the Beneficiary of
> the fund as his (Foriegn Bussiness Patner) and also (Family valuables as the
> content of the deposit) The documents of the deposit are with me. What I
> would want you to do, is to assits me to get the consignment withdrawn from
> the security company, and we shall open a small account in a Bank here in
> your name, and transfer the money to your country, through the account .We
> shall replace the name Foriegn Patner to your own name, because the code was
> used for security reason. I will give you the 10% of the money for your
> assitance.Ther is no risk in this transaction. I will use the remain balance
> of the money for an investiment in your country for the future of my
> children. If you are intrested, and can maintain the very confidential of
> this transaction,you e-mail me immediately for more clearification, and also
> note that I am a refugees in Abidjan, Cote d' lvoire becuase of the
> assasnation of late husband,and the civil war going on in our
> country,Democratic Republic of Congo. I can speak little english, and my son
> also speaks english very well his name is James and his tell is:00225 07 17
> 70 22.you can call him for more information. Thank you very much. Mrs.Ruth
> w. Kabila. Please Contact here: ru_j2003_4@yahoo.co.uk confidential Reasons.
>
> ----------------------------------------------------------------------
Re: [enquiry] Viagra - 75% OFF
No thanks, Richard K. Lee!
Unlike you, I don't need any help in that department, Mr Flaccid!
Ha! Ha!
On Tue, 16 Nov 2004 12:27:17 +0000, Richard K. Lee
hongtao@1singaporeonline.com wrote:
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VIAGRA:
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Unlike you, I don't need any help in that department, Mr Flaccid!
Ha! Ha!
On Tue, 16 Nov 2004 12:27:17 +0000, Richard K. Lee
hongtao@1singaporeonline.com wrote:
Stable & rock hard erections
Increased stamina & endurance
No. 1 men's health drug
No prescription needed
VIAGRA:
http://www.platinummed.biz
Choose the manufacturer you can trust!
Discreet shipping to any location
To change your mail details, go here: http://www.platinummed.biz/uns.htm
Sunday, November 14, 2004
3Cs GUIDELINES TO PROPER MOTOR INSURANCE COVERAGE
The General Insurance Association of Malaysia (PIAM) offers a simple 3Cs Guideline to help motor vehicle owners and drivers ensure that they are indeed properly insured.
Consumers are advised to:
1) Complete their motor insurance proposal forms honestly and accurately before signing it.
2) Check their policies upon receipt to ensure the information stated is accurate.
3) Contact their insurers if the information in their policies is inaccurate or they need to update the information in their existing policies.
Whether it is buying a new or renewing an existing motor policy or when submitting a claim, PIAM's Executive Director C.F. Lim said that it is critical that consumers provide the following information accurately:
* New IC number of Policyholder/Driver
* Make and Model of Vehicle
* Year of Manufacture of Vehicle
* Capacity of Vehicle
* Gender of Policyholder/Driver
* Age of Policyholder
* Residential Address of Policyholder/Location where Claim Occurred
Lim also advises consumers to never sign blank proposal forms. The information contained in the proposal forms the basis of the insurance contract and, if not accurate, may result in the contract being repudiated in event of a claim. This is an important responsibility on the part of the consumer in ensuring that they receive the cover that they pay for.
Consumers are also advised to check through their policies upon receipt to ensure that the information provided in the proposal form have been correctly transferred to the policy document. The policy is the official contract between the consumer and the insurance company and hence, must be accurate and updated.
Furthermore, consumers, to safeguard their own interest, must report any discrepancies in either their proposal forms or the policy documents to their insurers.
"There have been cases where the consumers have had their cars stolen and filed their claims with their insurance companies only to discover that they have third party and not comprehensive insurance covers,"
says Lim.
Besides strongly urging consumers to provide accurate information and checking their documents to ensure that they receive the cover that they have paid for, Lim says that PIAM also collates this data from its member companies for statistical analysis so as to continue its work towards a fairer and more equitable motor premium rating. The information is also used in identifying and combatting incidences of motor insurance fraud.
PIAM is the national trade association of all the licensed general insurance companies in Malaysia. Currently, PIAM has 54 member companies.
You have just bought your own set of wheels and can't wait to "get your motor running" on our spacious highways. Before you rev that engine up and hit the road, the law requires drivers of motor vehicles to buy motor insurance.
The latest motor accident statistics reveal that over 215,000 motor vehicles were involved in accidents in 1997, a 14 per cent increase from the previous year. Moreover, with more than one out of four Malaysians owning either a motorcycle or a motorcar, it is no wonder that motor insurance is a mandatory requirement.
It is also for this reason many of us do not comprehend the role motor insurance plays in protecting us against a loss or accident which may result in serious damage to our motor vehicles or injury to another person. When we purchase a motor insurance, we are in fact protecting our investment, which, at today's prices, is probably the second most valuable asset after our home.
How do we receive protection from our motor insurance?
To receive this protection, we, as policy holders, pay a premium to our appointed insurer. The insurer will then accumulate all premiums collected into a fund which is then used to compensate any policyholder who is unfortunate enough to suffer a loss from a motor accident. Thus, a loss is paid from the premiums made by the unfortunate policyholders and by all the other policyholders who have not met with an accident.
What are the types of motor insurance covers available?
Choosing the right insurance policy is much like choosing the right motor vehicle. It is required to fit our individual needs and lifestyle but at the same time be within our budget. Although, the Road Transport Act 1987 requires us to have a minimum third party liability coverage, other types of coverage are usually optional.
The key to finding which coverage is best for you involves learning about the three types of motor insurance covers in Malaysia. They are the 'Act Only', 'Third Party' and 'Comprehensive.'
Act Only
The Act Only motor insurance policy provides the minimum cover required by the law, thus giving rise to the name. Under this Act, drivers of motor vehicles have to buy motor insurance to ensure that drivers can meet their liabilities if they injure or cause the death of other people in an accident. Act Only policies are rarely purchased as the insurance protection is quite limited.
Third Party
Third Party motor insurance is wider than 'Act Only' insurance. Besides giving cover against death and injury to third parties, it provides protection against other legal liabilities such as damage to the property of a third party (usually somebody else's car or motorcycle or a neighbour's gate) and certain specified legal costs.
Under the Third Party cover, a policyholder may opt to include protection for loss or damage to own vehicle due to fire or theft only (known as Third Party Fire & Theft). However, most policyholders have found it is more cost-effective and worthwhile to pay a little bit more and be protected under the Comprehensive motor insurance policy instead.
Comprehensive
While Comprehensive motor insurance policy is the widest form of cover available, it does not provide cover for every conceivable type of risk. In addition to that covered in Act Only and Third Party motor insurance, the Comprehensive insurance policy also gives a number of other types of protection including loss or damage to the motor vehicle as a result of fire or theft. More importantly, this policy covers accidental damages to the insured's own vehicle. This additional cover enables the vehicle owner to have his vehicle repaired, reinstated or replaced in case of accidental damage or loss.
On top of these three main categories of motor insurance policies, other additional coverage are available for:
1) Breakage of glass in windscreens or windows
2) Floods, landslide, landslip or other convulsion of nature
3) Legal liability of passengers for acts of negligence (such as the passenger opening his car door and causing an accident with an moving vehicle)
4) Use of private cars for tuition purposes (such as teaching a novice driver how to drive using one's private car)
Car owners are advised to enquire with their agents or insurers on these additional coverage and others as these usually involve additional premiums.
What are the steps to take when making an accident claim?
If an accident occurs, you must follow certain procedures to protect yourself.
Firstly, you must stop your vehicle and exchange particulars with all the other people involved in the accident. In particular, you should:
1) Obtain name(s) and address(es) of other driver(s) involved.
2) Note their vehicle registration number(s) and make of vehicle.
3) Ask for the name of their insurers and their policy or certificate number.
4) Note names and address of independent witnesses and make a rough diagram of the accident.
5) It is your duty to produce your Certificate of Insurance when required to do so by the police.
6) If this information is not available at the scene of the accident, you will be required to produce it to the police within five days.
7) If there is injury to any person or damage to another vehicle, or other property, give your name and address of the owner of the vehicle you are driving and its registration number to anyone who has reasonable grounds of wanting them.
8) Do not discuss whose fault it was as this may create difficulties for your insurers in their handling of your claim. In particular, DO NOT ADMIT LIABILITY even if you think you are in the wrong. It not for you to determine this. Leave it to the loss adjuster or the court to decide, once all facts of the case and sides of the story are considered.
9) Inform your insurers as soon as possible even if you do not intend to make a claim. This is a condition of your policy.
10) Fill in the insurer's accident report form completely and include any additional relevant information not given in answer to direct questions. It is your legal duty to DISCLOSE ALL MATERIAL FACTS.
Once you have reported an accident and your car has been towed to the nearest police station or panel workshop approved by your insurer, your insurer will send a loss adjuster to assess the damage to your car and identify the circumstances of the accident.
A loss adjuster is a specialist whose job is to find out what really happened and how it happened. He will recommend to the insurer how much to settle a claim for in each particular case.
To take advantage of my Free Road Tax Renewal Reminder Service, click here. Please direct your questions on motor or general insurance to:
Azlan Adnan
Tel: 012-383 1324
E-mail: azlan.aig@gmail.com
Consumers are advised to:
1) Complete their motor insurance proposal forms honestly and accurately before signing it.
2) Check their policies upon receipt to ensure the information stated is accurate.
3) Contact their insurers if the information in their policies is inaccurate or they need to update the information in their existing policies.
Whether it is buying a new or renewing an existing motor policy or when submitting a claim, PIAM's Executive Director C.F. Lim said that it is critical that consumers provide the following information accurately:
* New IC number of Policyholder/Driver
* Make and Model of Vehicle
* Year of Manufacture of Vehicle
* Capacity of Vehicle
* Gender of Policyholder/Driver
* Age of Policyholder
* Residential Address of Policyholder/Location where Claim Occurred
Lim also advises consumers to never sign blank proposal forms. The information contained in the proposal forms the basis of the insurance contract and, if not accurate, may result in the contract being repudiated in event of a claim. This is an important responsibility on the part of the consumer in ensuring that they receive the cover that they pay for.
Consumers are also advised to check through their policies upon receipt to ensure that the information provided in the proposal form have been correctly transferred to the policy document. The policy is the official contract between the consumer and the insurance company and hence, must be accurate and updated.
Furthermore, consumers, to safeguard their own interest, must report any discrepancies in either their proposal forms or the policy documents to their insurers.
"There have been cases where the consumers have had their cars stolen and filed their claims with their insurance companies only to discover that they have third party and not comprehensive insurance covers,"
says Lim.
Besides strongly urging consumers to provide accurate information and checking their documents to ensure that they receive the cover that they have paid for, Lim says that PIAM also collates this data from its member companies for statistical analysis so as to continue its work towards a fairer and more equitable motor premium rating. The information is also used in identifying and combatting incidences of motor insurance fraud.
PIAM is the national trade association of all the licensed general insurance companies in Malaysia. Currently, PIAM has 54 member companies.
You have just bought your own set of wheels and can't wait to "get your motor running" on our spacious highways. Before you rev that engine up and hit the road, the law requires drivers of motor vehicles to buy motor insurance.
The latest motor accident statistics reveal that over 215,000 motor vehicles were involved in accidents in 1997, a 14 per cent increase from the previous year. Moreover, with more than one out of four Malaysians owning either a motorcycle or a motorcar, it is no wonder that motor insurance is a mandatory requirement.
It is also for this reason many of us do not comprehend the role motor insurance plays in protecting us against a loss or accident which may result in serious damage to our motor vehicles or injury to another person. When we purchase a motor insurance, we are in fact protecting our investment, which, at today's prices, is probably the second most valuable asset after our home.
How do we receive protection from our motor insurance?
To receive this protection, we, as policy holders, pay a premium to our appointed insurer. The insurer will then accumulate all premiums collected into a fund which is then used to compensate any policyholder who is unfortunate enough to suffer a loss from a motor accident. Thus, a loss is paid from the premiums made by the unfortunate policyholders and by all the other policyholders who have not met with an accident.
What are the types of motor insurance covers available?
Choosing the right insurance policy is much like choosing the right motor vehicle. It is required to fit our individual needs and lifestyle but at the same time be within our budget. Although, the Road Transport Act 1987 requires us to have a minimum third party liability coverage, other types of coverage are usually optional.
The key to finding which coverage is best for you involves learning about the three types of motor insurance covers in Malaysia. They are the 'Act Only', 'Third Party' and 'Comprehensive.'
Act Only
The Act Only motor insurance policy provides the minimum cover required by the law, thus giving rise to the name. Under this Act, drivers of motor vehicles have to buy motor insurance to ensure that drivers can meet their liabilities if they injure or cause the death of other people in an accident. Act Only policies are rarely purchased as the insurance protection is quite limited.
Third Party
Third Party motor insurance is wider than 'Act Only' insurance. Besides giving cover against death and injury to third parties, it provides protection against other legal liabilities such as damage to the property of a third party (usually somebody else's car or motorcycle or a neighbour's gate) and certain specified legal costs.
Under the Third Party cover, a policyholder may opt to include protection for loss or damage to own vehicle due to fire or theft only (known as Third Party Fire & Theft). However, most policyholders have found it is more cost-effective and worthwhile to pay a little bit more and be protected under the Comprehensive motor insurance policy instead.
Comprehensive
While Comprehensive motor insurance policy is the widest form of cover available, it does not provide cover for every conceivable type of risk. In addition to that covered in Act Only and Third Party motor insurance, the Comprehensive insurance policy also gives a number of other types of protection including loss or damage to the motor vehicle as a result of fire or theft. More importantly, this policy covers accidental damages to the insured's own vehicle. This additional cover enables the vehicle owner to have his vehicle repaired, reinstated or replaced in case of accidental damage or loss.
On top of these three main categories of motor insurance policies, other additional coverage are available for:
1) Breakage of glass in windscreens or windows
2) Floods, landslide, landslip or other convulsion of nature
3) Legal liability of passengers for acts of negligence (such as the passenger opening his car door and causing an accident with an moving vehicle)
4) Use of private cars for tuition purposes (such as teaching a novice driver how to drive using one's private car)
Car owners are advised to enquire with their agents or insurers on these additional coverage and others as these usually involve additional premiums.
What are the steps to take when making an accident claim?
If an accident occurs, you must follow certain procedures to protect yourself.
Firstly, you must stop your vehicle and exchange particulars with all the other people involved in the accident. In particular, you should:
1) Obtain name(s) and address(es) of other driver(s) involved.
2) Note their vehicle registration number(s) and make of vehicle.
3) Ask for the name of their insurers and their policy or certificate number.
4) Note names and address of independent witnesses and make a rough diagram of the accident.
5) It is your duty to produce your Certificate of Insurance when required to do so by the police.
6) If this information is not available at the scene of the accident, you will be required to produce it to the police within five days.
7) If there is injury to any person or damage to another vehicle, or other property, give your name and address of the owner of the vehicle you are driving and its registration number to anyone who has reasonable grounds of wanting them.
8) Do not discuss whose fault it was as this may create difficulties for your insurers in their handling of your claim. In particular, DO NOT ADMIT LIABILITY even if you think you are in the wrong. It not for you to determine this. Leave it to the loss adjuster or the court to decide, once all facts of the case and sides of the story are considered.
9) Inform your insurers as soon as possible even if you do not intend to make a claim. This is a condition of your policy.
10) Fill in the insurer's accident report form completely and include any additional relevant information not given in answer to direct questions. It is your legal duty to DISCLOSE ALL MATERIAL FACTS.
Once you have reported an accident and your car has been towed to the nearest police station or panel workshop approved by your insurer, your insurer will send a loss adjuster to assess the damage to your car and identify the circumstances of the accident.
A loss adjuster is a specialist whose job is to find out what really happened and how it happened. He will recommend to the insurer how much to settle a claim for in each particular case.
To take advantage of my Free Road Tax Renewal Reminder Service, click here. Please direct your questions on motor or general insurance to:
Azlan Adnan
Tel: 012-383 1324
E-mail: azlan.aig@gmail.com
Road Traffic Safety Tips
Focus on your driving
Drive with a large "anticipation zone." Look down the road far enough to get a big picture of what's ahead.
Keep your radio at a reasonable volume.
Do not drive when under stress.
Don't talk to passengers too much and if need be, ask them to help navigate.
Do not day dream.
Make sure you can see clearly.
Get annual eye check-ups.
Clean the inside and outside of your windshield and windows. Clean the mirrors and headlights, too. Dirt can reduce headlight output by as much as 70 per cent.
Turn on your lights when driving in the rain, no matter what time of day it is. Slow down in rainy weather.
Always turn lights on when driving during the half hour before sunset and the half hour after sunrise.
Do not wear tinted glasses or sunglasses when driving in low light.
Take extra steps to be a cautious driver
Always tell other drivers what you intend to do. Use your directional signals. Position your car in the proper lane. When necessary, use your horn to show your intentions.
Check your mirrors frequently.
Glance over your shoulder, and in your mirrors, before changing lanes. Do not assume that only using turn signals will make the move safe.
Always look behind before putting the car in reverse.
Watch for flashing lights from emergency vehicles, as you may no always hear the siren.
Adjust the headrest so that the top of the headrest is aligned with the top of the driver's head. This prevents incidence of whiplash in event of collision.
Copyright 2001-2004, Persatuan Insuran Am Malaysia
The Importance of Financial Literacy Among Women in Asia
Bank Negara Malaysia Governor's Special Address
at the Citigroup-INSEAD Women's Financial Education Summit 2004
Speaker: Governor Tan Sri Dato' Sri Dr Zeti Akhtar Aziz
Venue: Hong Kong
Date: 02 November 2004
Language: English
Introduction
Asia represents the fastest growing region in the global economy. Of
significance, is that more than half the population in Asia are women.
The participation of women in the economy would therefore not only
enhance their own economic well being but would also contribute
towards raising further the economic potential of Asia. Women are
already engaged in both the informal and formal sectors and are
increasingly emerging as a more important force in the economy. The
effective participation, however, needs to be an informed
participation. Financial literacy among women becomes an important
part of this process, regardless of the income constituency to which
they belong. There needs to be a better understanding of their
financial rights and responsibilities, and their opportunities for
income generation and the associated risks and costs involved. This
is particularly important for Asia, where rapid economic and financial
transformation is occurring. Financial literacy among women is thus a
vital part of this process, not only to promote greater engagement of
women in the current economic environment, but also to prepare them
for the future.
It is my great honour and pleasure to be here today to speak on the
importance of financial literacy among women in Asia. My remarks
today will first discuss some of the major structural and cultural
transformations in Asia that are changing and impacting the economic
environment faced by women in Asia, and their rapidly changing role in
the economy. I will also touch on aspects of the challenges faced by
women in Asia in their endeavour for greater economic engagement.
This will be followed by a discussion on the important enablers for
enhanced financial literacy and to share with you Malaysia's
experience in driving a more financially literate society in
particular, that enhances the inclusion of women in the economic
mainstream.
Ladies and Gentlemen,
Asia is being transformed. For more than two decades now we have seen
unprecedented structural and cultural changes in Asia that have
resulted in the transformation of the environment faced by women.
Asia has emerged as the fastest growing region in the world with GDP
in Asia now accounting for 23% of the world economy, compared to 17%
in 1980. Per capita income during this period has more than
quadrupled. If these trends continue, by the year 2020 Asia will
account for about 27% of the world economy while the income per capita
would have further tripled. These dynamic changes have made financial
literacy among women even more vital.
Indeed, against these favourable trends, there has been a growing
participation of women in the growth and development process in Asia.
In particular, there has been a strong migration from the informal to
the formal sector, following the modernisation and industrialisation
process. The increase in the relative significance of the financial
sector in most Asian economies can be seen in terms of the momentum in
the financialisation of savings and the increase in the volume of
financial transactions being conducted through the formal financial
sector. These trends are being reinforced by the shift of activities
that is taking place from the traditional sectors to the industrial
and services sectors. On average, the industrial and services sector
now accounts for 74% of the economy in Asia, compared to 60% in 1980.
In contrast, agriculture now accounts for 12%, compared to 26% in
1980. Involved in this transformation, women have demonstrated a high
degree of mobility, participating in all segments of economic
activity. Most discernable is the increasing participation of women in
the services sector. Here in Hong Kong, the percentage of women in
the services sector relative to the total population increased from
43% in 1980 to 87% in 1999. Similarly in Indonesia, the rise was from
32% to 42%, and in Malaysia, it was from 33% to 57% and in Thailand,
from 18% to 34%.
In Asia, the demographic structure also reinforces the economic
potential of Asia. The population in Asia continues to grow at a
relatively high and stable rate to account for more than half the
world's population. Of significance is the relatively young
demographic structure in Asia. More than 50% of women fall in the age
group 15 to 49 years, similar to that for men. This demographic
structure thus not only contributes to enhance the potential of the
economy but combined with rising incomes and improved standards of
living, has resulted in increases in consumption spending. This
resultant increase in purchasing power has strengthened domestic
demand, making it an important driver of growth in the Asian
economies. Indeed, these trends have strengthened the sustainability
of consumption-based growth. As part of this process, women have
become an important consumer target group with enhanced purchasing
power. In fact, in several of the Asian economies, women are emerging
as a key target market. This greater capacity for earning, spending,
saving and investing requires ability for financial management, and
hence the urgency for greater financial literacy
While financial literacy is important, regardless of economic status,
it becomes even more important for those that are less privileged.
For those that have less to manage, it becomes more vital to manage
the finances even more effectively. It is also those that have been
under-served by the financial system that need to be more aware of the
financial services that they should be able to access, and the
benefits that can be drawn from the various options available. They
too have the same need for maximising the benefits from their limited
resources, and to achieving financial and economic security.
Strengthening their financial position becomes even more important for
this target group. There needs to be awareness of the alternative
assets that can be accumulated not only to generate an income stream
but also towards building wealth. Of equal importance is to draw
those operating in the informal sector into the formal sector, where
their financial requirements, whether households or businesses can be
better served.
A further phenomenon taking place in Asia is the increased regional
economic and financial integration that is taking place. This has
manifested itself in increased intra-regional trade, investment flows
and the increased intra-regional presence of corporations and
financial institutions. A more recent phenomenon is the increased
mobility of labour in the region. Of significance is the number of
women who have ventured beyond their own borders in search of new
employment opportunities. While data on this is not available, the
statistics on remittances of income show this is a growing trend.
Overseas employment is particularly evident in the manufacturing and
services sectors. Financial literacy under these circumstances
becomes even more vital. In venturing to new areas where different
systems, languages and cultures prevail, it becomes important to have
knowledge of the basic financial matters so as to maximise the
benefits the new employment is expected to yield.
As the formal economies of Asia prosper and grow, there is a greater
need to integrate the informal sectors of the economy with the formal
sector. There are millions of women in Asia involved in a wide range
of economic activities from the home, making handicraft, assembling
parts for international brand names and working in the fields. They
work for a small income, and generally in difficult circumstances.
Deliberate actions to integrate the informal economy into the formal
economy will give this segment of society increased opportunities. In
many countries, the success of various national and international
socio-economic reform programs have resulted in women becoming an
increasing part of the formal economy. Through the concerted efforts
of women's rights movements, economic policy intervention and gradual
shifts in cultural norms, women today have more opportunities for
education, careers and political representation. However, in many
instances the increase in participation in the formal economy has not
come with a commensurate level of sophistication in financial
literacy. As a result, women continue to face special challenges in
their endeavour to be active participants in the economic system.
Challenges women in Asia face in financial literacy
Let me now turn to discuss some of the challenges faced by women in
Asia in their endeavour to become more financially literate and
financially independent.
1) Firstly, with the socio-economic environment in Asia
changing rapidly, there is greater uncertainty and volatility which
represents a challenge even for financial experts. The financial
system has also become more complex, with new risks emerging. This
increased sophistication thus makes it increasingly difficult for
those who are less financially literate to make sound decisions.
2) Secondly, the advances in technology has led to a
proliferation of financial products and services. There needs to be a
greater understanding of the basic concepts and practices of banking,
insurance and equity so as to know how to make choices from the wide
range of financial products available, and to assess the respective
risks, costs and returns. Also important is the basic principles of
debt management, wealth management and personal budgeting to be able
to understand the importance of long-term savings in funding future
requirements.
Financial literacy involves being able to identify and understand the
opportunities for income generation, access to funding, and learning
how to make the most of the range of financial products available. It
also involves learning how to manage financial risks in an environment
where the financial infrastructure may be under developed. This may
relate to the laws and procedures in the country. Also important is
the need to be able to recognize illegal schemes and other
exploitative practices such as predatory lending.
3) Thirdly, while women in Asia are being less stereotyped and
given greater opportunities for entering into the economic mainstream,
nonetheless the working conditions for women in many countries have
tended to be less favourable. The exploitation of labour in the
informal sector in some instances are particularly bad, not only for
women, but also for children and minority groups. Women who are
disadvantaged in this manner have found it difficult to escape from
the trap of indebtedness.
Frequently, the disadvantaged and those who are not able to access the
formal financial system have resorted to the informal financial
systems. Recourse to these financial sources have also been due to
the lack of awareness. These may be in the form of deposit schemes
that entail high risk, access to financing from sources that are
highly costly, and almost inevitably against high collateral. Very
often, the practices are unfair and deceptive. Examples in predatory
lending are found to be unscrupulous and highly disadvantageous to the
borrower.
4) Fourthly, in some Asian societies, traditions continue to
create cultural pressures that restrict a woman's choices and
liberties. Though there is increased freedom for women to pursue
education and careers, in some societies, cultural pressures still
make it more difficult for a woman to get the exposure on financial
matters. In addition, the increased incidence of divorces and single
parenthood mean that more women are left to fend for themselves and
their children. In certain Asian societies, single women may face
unusual difficulties in arranging their finances. In some cases, a
woman may even have difficulty claiming her legal rights in a
contract, even though the law does not dispute such a right. Deeply
entrenched human behaviour is not able to change as rapidly as the
financial system is evolving.
5) Fifthly, statistics on life expectancy confirm that women
tend to live longer. In segments of society where women earn less than
men, combined with the fact that they may live longer, it is crucial
to have financial acumen in order to increase the financial
independence of women. This trend also magnifies the need to plan for
retirement especially in an era of rising medical costs.
Ladies and Gentlemen,
Enabling Environment for Financial Literacy
The promotion of greater awareness and understanding in financial
issues in a dynamic and constantly changing environment has to be a
continuous process. The effort needs to focus not only on providing
education programmes but also on putting in place the supporting
infrastructure to enhance the access to financial services, to ensure
an environment of financial transparency and disclosure as well as
adequate consumer protection. Enhanced financial literacy is about
bringing people into the financial mainstream so that they are able to
make well informed decisions regarding their earnings, spending,
savings and investments. The effort thus has to encompass a
comprehensive set of strategies including the education process
reinforced by the supporting infrastructure.
The goal of any financial education programme is to increase awareness
of the value of effective financial management, to show how it can
contribute to financial security and improvement in the economic
well-being. The most effective of programmes have been those that are
targeted to specific groups. Fundamental education for greater
financial literacy that will have most sustainable impact are those
through the school system. Such educational programmes would provide
the education to women from an early age. Essentially, it would not
result in the marginalisation of anyone target group, in particular
women. Such programmes would therefore best serve its purpose as part
of the core curriculum. Indeed, the national education system can play
a pivotal role in financial literacy within a country.
The responsibility of promoting economic and financial literacy needs
to be a collaborative effort amongst the authorities, the financial
service providers and the community to connect to the different target
groups including all social groups. These would include the lower
income groups, workers and businesses. Important are programmes
directed to families where women have an important role and to engage
those we have not been able to participate fully to benefit from the
favourable economic environment prevailing in the region.
Among the successful financial education programmes are those with
specific objectives that are tailored to meet particular needs. This
includes programmes to promote savings for specific objectives; for
education; or for retirement. The education programmes can also be
linked to other objectives such as good health, house ownership and so
on. Financial products can be tailored for such purposes to not only
to promote interest but to also meet these objectives.
All distribution channels need to be relied on to maximise the
effectiveness of financial education programmes. Formal training
programmes can be reinforced by web based content via the Internet.
The World Wide Web offers dramatic economies of scale in terms of
distribution of content at low cost. Connectivity to the Internet can
serve to bring information from all over the world to the local
education system. Iterative programmes can be useful to encourage
participation. Web based programmes while requiring computer literacy,
has a wider outreach and allows for flexibility of time that is of
particular importance to women.
A further means by which financial advice is provided is through
financial advisors. Financial advisors are able to address the issues
for the more sophisticated investors. Similarly, infrastructure for
advisory services for small businesses is key. This can in particular
be provided by financial institutions. Systems need to be in place
where consumers and businesses are explained their rights and
responsibilities. Micro credit institutions have also been highly
successful in many countries in providing access to financial services
to microenterprises. This will contribute towards greater reliance on
the formal financial infrastructure and less on the informal
structures.
Higher level of consumer education and financial literacy must be
complemented with effective disclosure regime, fair and transparent
market practices, simplification of financial products and enhanced
communications in the marketplace to minimise information asymmetry.
While efforts may be taken to enhance transparency and disclosure by
service providers, and while programmes for enhanced literacy can
produce positive results, consumer protection is still needed. Given
the asymmetry of information, consumers often do not have enough
information to be completely protected. Building the confidence of
consumers also requires that there be adequate avenues for consumers
to seek redress to enable consumers to resolve conflicts through an
equitable process. Also important are the requirements for complaints
to be handled promptly by financial institutions.
Ladies and Gentlemen,
The Malaysian Experience
Let me briefly take a moment to share with you the experience of
Malaysia in developing an enabling environment to promote financial
literacy.
For several decades, Malaysia has made significant economic progress.
The economy grew by an average of 7% per year, while the per capita
income has increased from USD300 in 1970 to USD4,236 in 2004. From a
commodity-based economy, Malaysia now has a highly diversified
economy, with significant contribution from the manufacturing and
services sectors. Women account for about half of Malaysian
population, and have played an important role in this economic
transformation process. Women account for about 45% of the labour
force, with increasing representation at the professional, managerial
and technical levels. Such progress is achieved following increased
educational opportunities that have been made available to women.
Female primary and secondary students account for half of total
enrolment, while at public universities, female students account for
55% of total enrolment. While women continue to play a major role in
household financial planning, a new generation of women who are
financially independent and sophisticated is emerging.
The financial sector in Malaysia has also experienced significant
progress, with greater diversity of players, products as well as
delivery channels with extensive distribution nationwide. The
widespread distribution of financial institutions has been a conscious
and deliberate policy to ensure the widest reach of financial services
to both the urban and rural areas. With the improved access of
consumers and businesses to financial products and services, consumer
education on financial matters is an important priority for the
Central Bank.
Consistent with the belief of the importance of instilling financial
awareness at an early age, Bank Negara Malaysia introduced a pocket
money book to inculcate smart financial management habits among
students in 1996. The programme also included Household Account Books
to assist families in the management of household income, savings and
investments. This was distributed to cover a wider group, including
women, teachers and workers.
Following this, in 1997 together with the Education Ministry, the
Central Bank embarked on a School Adoption Programme. Through this
programme, more than 7000 schools have been adopted by banking
institutions to play a leading role in educating school children on
basic financial knowledge. In October this year, an online interactive
version of the Pocket Money Book to be used in the School Adoption
Programme was launched.
The Central Bank of Malaysia has also laid out a blueprint known as
the Financial Sector Master Plan that charts the development of the
Malaysian financial system over a ten year period commencing in 2001.
A key component of that plan is the 10-year Consumer Education
Programme for the banking and insurance sectors. This programme is
known as BankingInfo and InsuranceInfo, and was launched in 2003. To
reach a wide spectrum of the population, various channels are being
employed to disseminate information, including through media, road
shows, information brochures and a dedicated web site. There is also a
dedicated outreach programme aimed at specific target groups, which
includes women in rural areas, low income earners and disadvantaged
women such as single mothers. To date, the BankingInfo website has
received an overwhelming response - about 14 million hits and more
than 2.5 million booklets were taken up by the public. In the
insurance sector, over 1.4 million hits have been received on the
InsuranceInfo website, and more than 1.3 million insurance
info-booklets have been disseminated by the insurers to the public.
Ladies and Gentlemen,
Similar to many other Asian economies, microenterprises in Malaysia
are a substantial contributor to employment. Women are extensively
involved in microenterprises, often operated as family run businesses.
To support the growth of microenterprises, dedicated agencies and
funding mechanisms have been established. In order to equip the
microenterprises with proper knowledge, education materials were
developed on the fundamentals of starting a business, specifically
addressing issues of getting access to appropriate financing within
the constraints faced by microenterprises. Dedicated agencies,
including specialist development financial institutions, were
identified to provide training and advisory services to complement
these initiatives.
In addition to the consumer education programmes, the Central Bank has
put in place a consumer protection framework. In collaboration with
the financial industry the Central Bank has established a Financial
Mediation Bureau. The Financial Mediation Bureau aims to serve as a
one-stop center for the resolution of retail consumer complaints
against financial institutions regulated by the Central Bank. The
Central Bank is also establishing a one-stop service centre in the
Bank that will function as a Public Information Centre for the
promotion of financial literacy among the Malaysian public. The
service centre will provide advisory services on financial matters to
small and medium enterprises.
Ladies and Gentlemen,
Concluding Remarks
Financial literacy among women is all about having sufficient
awareness of financial matters to enable women to protect and prosper
for themselves and their families in a world that is becoming
increasingly more complex and uncertain. To be an effective
participant in this modern economy, we cannot take financial literacy
for granted. It is a knowledge and skill that must be deliberately
pursued. From a national and institutional perspective, promoting
financial literacy must be an integral part of the overall agenda for
financial and economic reform and development.
Let me conclude with the words of Jawaharlal Nehru, "We talk of
revolutions, political and economic. And yet the greatest revolution
in a country is the one that affects the status and living conditions
of its women. It is in so far as our revolution has affected our
women that it is basic."
Thank you.
Copyright Bank Negara Malaysia, 2004. All rights reserved.
at the Citigroup-INSEAD Women's Financial Education Summit 2004
Speaker: Governor Tan Sri Dato' Sri Dr Zeti Akhtar Aziz
Venue: Hong Kong
Date: 02 November 2004
Language: English
Introduction
Asia represents the fastest growing region in the global economy. Of
significance, is that more than half the population in Asia are women.
The participation of women in the economy would therefore not only
enhance their own economic well being but would also contribute
towards raising further the economic potential of Asia. Women are
already engaged in both the informal and formal sectors and are
increasingly emerging as a more important force in the economy. The
effective participation, however, needs to be an informed
participation. Financial literacy among women becomes an important
part of this process, regardless of the income constituency to which
they belong. There needs to be a better understanding of their
financial rights and responsibilities, and their opportunities for
income generation and the associated risks and costs involved. This
is particularly important for Asia, where rapid economic and financial
transformation is occurring. Financial literacy among women is thus a
vital part of this process, not only to promote greater engagement of
women in the current economic environment, but also to prepare them
for the future.
It is my great honour and pleasure to be here today to speak on the
importance of financial literacy among women in Asia. My remarks
today will first discuss some of the major structural and cultural
transformations in Asia that are changing and impacting the economic
environment faced by women in Asia, and their rapidly changing role in
the economy. I will also touch on aspects of the challenges faced by
women in Asia in their endeavour for greater economic engagement.
This will be followed by a discussion on the important enablers for
enhanced financial literacy and to share with you Malaysia's
experience in driving a more financially literate society in
particular, that enhances the inclusion of women in the economic
mainstream.
Ladies and Gentlemen,
Asia is being transformed. For more than two decades now we have seen
unprecedented structural and cultural changes in Asia that have
resulted in the transformation of the environment faced by women.
Asia has emerged as the fastest growing region in the world with GDP
in Asia now accounting for 23% of the world economy, compared to 17%
in 1980. Per capita income during this period has more than
quadrupled. If these trends continue, by the year 2020 Asia will
account for about 27% of the world economy while the income per capita
would have further tripled. These dynamic changes have made financial
literacy among women even more vital.
Indeed, against these favourable trends, there has been a growing
participation of women in the growth and development process in Asia.
In particular, there has been a strong migration from the informal to
the formal sector, following the modernisation and industrialisation
process. The increase in the relative significance of the financial
sector in most Asian economies can be seen in terms of the momentum in
the financialisation of savings and the increase in the volume of
financial transactions being conducted through the formal financial
sector. These trends are being reinforced by the shift of activities
that is taking place from the traditional sectors to the industrial
and services sectors. On average, the industrial and services sector
now accounts for 74% of the economy in Asia, compared to 60% in 1980.
In contrast, agriculture now accounts for 12%, compared to 26% in
1980. Involved in this transformation, women have demonstrated a high
degree of mobility, participating in all segments of economic
activity. Most discernable is the increasing participation of women in
the services sector. Here in Hong Kong, the percentage of women in
the services sector relative to the total population increased from
43% in 1980 to 87% in 1999. Similarly in Indonesia, the rise was from
32% to 42%, and in Malaysia, it was from 33% to 57% and in Thailand,
from 18% to 34%.
In Asia, the demographic structure also reinforces the economic
potential of Asia. The population in Asia continues to grow at a
relatively high and stable rate to account for more than half the
world's population. Of significance is the relatively young
demographic structure in Asia. More than 50% of women fall in the age
group 15 to 49 years, similar to that for men. This demographic
structure thus not only contributes to enhance the potential of the
economy but combined with rising incomes and improved standards of
living, has resulted in increases in consumption spending. This
resultant increase in purchasing power has strengthened domestic
demand, making it an important driver of growth in the Asian
economies. Indeed, these trends have strengthened the sustainability
of consumption-based growth. As part of this process, women have
become an important consumer target group with enhanced purchasing
power. In fact, in several of the Asian economies, women are emerging
as a key target market. This greater capacity for earning, spending,
saving and investing requires ability for financial management, and
hence the urgency for greater financial literacy
While financial literacy is important, regardless of economic status,
it becomes even more important for those that are less privileged.
For those that have less to manage, it becomes more vital to manage
the finances even more effectively. It is also those that have been
under-served by the financial system that need to be more aware of the
financial services that they should be able to access, and the
benefits that can be drawn from the various options available. They
too have the same need for maximising the benefits from their limited
resources, and to achieving financial and economic security.
Strengthening their financial position becomes even more important for
this target group. There needs to be awareness of the alternative
assets that can be accumulated not only to generate an income stream
but also towards building wealth. Of equal importance is to draw
those operating in the informal sector into the formal sector, where
their financial requirements, whether households or businesses can be
better served.
A further phenomenon taking place in Asia is the increased regional
economic and financial integration that is taking place. This has
manifested itself in increased intra-regional trade, investment flows
and the increased intra-regional presence of corporations and
financial institutions. A more recent phenomenon is the increased
mobility of labour in the region. Of significance is the number of
women who have ventured beyond their own borders in search of new
employment opportunities. While data on this is not available, the
statistics on remittances of income show this is a growing trend.
Overseas employment is particularly evident in the manufacturing and
services sectors. Financial literacy under these circumstances
becomes even more vital. In venturing to new areas where different
systems, languages and cultures prevail, it becomes important to have
knowledge of the basic financial matters so as to maximise the
benefits the new employment is expected to yield.
As the formal economies of Asia prosper and grow, there is a greater
need to integrate the informal sectors of the economy with the formal
sector. There are millions of women in Asia involved in a wide range
of economic activities from the home, making handicraft, assembling
parts for international brand names and working in the fields. They
work for a small income, and generally in difficult circumstances.
Deliberate actions to integrate the informal economy into the formal
economy will give this segment of society increased opportunities. In
many countries, the success of various national and international
socio-economic reform programs have resulted in women becoming an
increasing part of the formal economy. Through the concerted efforts
of women's rights movements, economic policy intervention and gradual
shifts in cultural norms, women today have more opportunities for
education, careers and political representation. However, in many
instances the increase in participation in the formal economy has not
come with a commensurate level of sophistication in financial
literacy. As a result, women continue to face special challenges in
their endeavour to be active participants in the economic system.
Challenges women in Asia face in financial literacy
Let me now turn to discuss some of the challenges faced by women in
Asia in their endeavour to become more financially literate and
financially independent.
1) Firstly, with the socio-economic environment in Asia
changing rapidly, there is greater uncertainty and volatility which
represents a challenge even for financial experts. The financial
system has also become more complex, with new risks emerging. This
increased sophistication thus makes it increasingly difficult for
those who are less financially literate to make sound decisions.
2) Secondly, the advances in technology has led to a
proliferation of financial products and services. There needs to be a
greater understanding of the basic concepts and practices of banking,
insurance and equity so as to know how to make choices from the wide
range of financial products available, and to assess the respective
risks, costs and returns. Also important is the basic principles of
debt management, wealth management and personal budgeting to be able
to understand the importance of long-term savings in funding future
requirements.
Financial literacy involves being able to identify and understand the
opportunities for income generation, access to funding, and learning
how to make the most of the range of financial products available. It
also involves learning how to manage financial risks in an environment
where the financial infrastructure may be under developed. This may
relate to the laws and procedures in the country. Also important is
the need to be able to recognize illegal schemes and other
exploitative practices such as predatory lending.
3) Thirdly, while women in Asia are being less stereotyped and
given greater opportunities for entering into the economic mainstream,
nonetheless the working conditions for women in many countries have
tended to be less favourable. The exploitation of labour in the
informal sector in some instances are particularly bad, not only for
women, but also for children and minority groups. Women who are
disadvantaged in this manner have found it difficult to escape from
the trap of indebtedness.
Frequently, the disadvantaged and those who are not able to access the
formal financial system have resorted to the informal financial
systems. Recourse to these financial sources have also been due to
the lack of awareness. These may be in the form of deposit schemes
that entail high risk, access to financing from sources that are
highly costly, and almost inevitably against high collateral. Very
often, the practices are unfair and deceptive. Examples in predatory
lending are found to be unscrupulous and highly disadvantageous to the
borrower.
4) Fourthly, in some Asian societies, traditions continue to
create cultural pressures that restrict a woman's choices and
liberties. Though there is increased freedom for women to pursue
education and careers, in some societies, cultural pressures still
make it more difficult for a woman to get the exposure on financial
matters. In addition, the increased incidence of divorces and single
parenthood mean that more women are left to fend for themselves and
their children. In certain Asian societies, single women may face
unusual difficulties in arranging their finances. In some cases, a
woman may even have difficulty claiming her legal rights in a
contract, even though the law does not dispute such a right. Deeply
entrenched human behaviour is not able to change as rapidly as the
financial system is evolving.
5) Fifthly, statistics on life expectancy confirm that women
tend to live longer. In segments of society where women earn less than
men, combined with the fact that they may live longer, it is crucial
to have financial acumen in order to increase the financial
independence of women. This trend also magnifies the need to plan for
retirement especially in an era of rising medical costs.
Ladies and Gentlemen,
Enabling Environment for Financial Literacy
The promotion of greater awareness and understanding in financial
issues in a dynamic and constantly changing environment has to be a
continuous process. The effort needs to focus not only on providing
education programmes but also on putting in place the supporting
infrastructure to enhance the access to financial services, to ensure
an environment of financial transparency and disclosure as well as
adequate consumer protection. Enhanced financial literacy is about
bringing people into the financial mainstream so that they are able to
make well informed decisions regarding their earnings, spending,
savings and investments. The effort thus has to encompass a
comprehensive set of strategies including the education process
reinforced by the supporting infrastructure.
The goal of any financial education programme is to increase awareness
of the value of effective financial management, to show how it can
contribute to financial security and improvement in the economic
well-being. The most effective of programmes have been those that are
targeted to specific groups. Fundamental education for greater
financial literacy that will have most sustainable impact are those
through the school system. Such educational programmes would provide
the education to women from an early age. Essentially, it would not
result in the marginalisation of anyone target group, in particular
women. Such programmes would therefore best serve its purpose as part
of the core curriculum. Indeed, the national education system can play
a pivotal role in financial literacy within a country.
The responsibility of promoting economic and financial literacy needs
to be a collaborative effort amongst the authorities, the financial
service providers and the community to connect to the different target
groups including all social groups. These would include the lower
income groups, workers and businesses. Important are programmes
directed to families where women have an important role and to engage
those we have not been able to participate fully to benefit from the
favourable economic environment prevailing in the region.
Among the successful financial education programmes are those with
specific objectives that are tailored to meet particular needs. This
includes programmes to promote savings for specific objectives; for
education; or for retirement. The education programmes can also be
linked to other objectives such as good health, house ownership and so
on. Financial products can be tailored for such purposes to not only
to promote interest but to also meet these objectives.
All distribution channels need to be relied on to maximise the
effectiveness of financial education programmes. Formal training
programmes can be reinforced by web based content via the Internet.
The World Wide Web offers dramatic economies of scale in terms of
distribution of content at low cost. Connectivity to the Internet can
serve to bring information from all over the world to the local
education system. Iterative programmes can be useful to encourage
participation. Web based programmes while requiring computer literacy,
has a wider outreach and allows for flexibility of time that is of
particular importance to women.
A further means by which financial advice is provided is through
financial advisors. Financial advisors are able to address the issues
for the more sophisticated investors. Similarly, infrastructure for
advisory services for small businesses is key. This can in particular
be provided by financial institutions. Systems need to be in place
where consumers and businesses are explained their rights and
responsibilities. Micro credit institutions have also been highly
successful in many countries in providing access to financial services
to microenterprises. This will contribute towards greater reliance on
the formal financial infrastructure and less on the informal
structures.
Higher level of consumer education and financial literacy must be
complemented with effective disclosure regime, fair and transparent
market practices, simplification of financial products and enhanced
communications in the marketplace to minimise information asymmetry.
While efforts may be taken to enhance transparency and disclosure by
service providers, and while programmes for enhanced literacy can
produce positive results, consumer protection is still needed. Given
the asymmetry of information, consumers often do not have enough
information to be completely protected. Building the confidence of
consumers also requires that there be adequate avenues for consumers
to seek redress to enable consumers to resolve conflicts through an
equitable process. Also important are the requirements for complaints
to be handled promptly by financial institutions.
Ladies and Gentlemen,
The Malaysian Experience
Let me briefly take a moment to share with you the experience of
Malaysia in developing an enabling environment to promote financial
literacy.
For several decades, Malaysia has made significant economic progress.
The economy grew by an average of 7% per year, while the per capita
income has increased from USD300 in 1970 to USD4,236 in 2004. From a
commodity-based economy, Malaysia now has a highly diversified
economy, with significant contribution from the manufacturing and
services sectors. Women account for about half of Malaysian
population, and have played an important role in this economic
transformation process. Women account for about 45% of the labour
force, with increasing representation at the professional, managerial
and technical levels. Such progress is achieved following increased
educational opportunities that have been made available to women.
Female primary and secondary students account for half of total
enrolment, while at public universities, female students account for
55% of total enrolment. While women continue to play a major role in
household financial planning, a new generation of women who are
financially independent and sophisticated is emerging.
The financial sector in Malaysia has also experienced significant
progress, with greater diversity of players, products as well as
delivery channels with extensive distribution nationwide. The
widespread distribution of financial institutions has been a conscious
and deliberate policy to ensure the widest reach of financial services
to both the urban and rural areas. With the improved access of
consumers and businesses to financial products and services, consumer
education on financial matters is an important priority for the
Central Bank.
Consistent with the belief of the importance of instilling financial
awareness at an early age, Bank Negara Malaysia introduced a pocket
money book to inculcate smart financial management habits among
students in 1996. The programme also included Household Account Books
to assist families in the management of household income, savings and
investments. This was distributed to cover a wider group, including
women, teachers and workers.
Following this, in 1997 together with the Education Ministry, the
Central Bank embarked on a School Adoption Programme. Through this
programme, more than 7000 schools have been adopted by banking
institutions to play a leading role in educating school children on
basic financial knowledge. In October this year, an online interactive
version of the Pocket Money Book to be used in the School Adoption
Programme was launched.
The Central Bank of Malaysia has also laid out a blueprint known as
the Financial Sector Master Plan that charts the development of the
Malaysian financial system over a ten year period commencing in 2001.
A key component of that plan is the 10-year Consumer Education
Programme for the banking and insurance sectors. This programme is
known as BankingInfo and InsuranceInfo, and was launched in 2003. To
reach a wide spectrum of the population, various channels are being
employed to disseminate information, including through media, road
shows, information brochures and a dedicated web site. There is also a
dedicated outreach programme aimed at specific target groups, which
includes women in rural areas, low income earners and disadvantaged
women such as single mothers. To date, the BankingInfo website has
received an overwhelming response - about 14 million hits and more
than 2.5 million booklets were taken up by the public. In the
insurance sector, over 1.4 million hits have been received on the
InsuranceInfo website, and more than 1.3 million insurance
info-booklets have been disseminated by the insurers to the public.
Ladies and Gentlemen,
Similar to many other Asian economies, microenterprises in Malaysia
are a substantial contributor to employment. Women are extensively
involved in microenterprises, often operated as family run businesses.
To support the growth of microenterprises, dedicated agencies and
funding mechanisms have been established. In order to equip the
microenterprises with proper knowledge, education materials were
developed on the fundamentals of starting a business, specifically
addressing issues of getting access to appropriate financing within
the constraints faced by microenterprises. Dedicated agencies,
including specialist development financial institutions, were
identified to provide training and advisory services to complement
these initiatives.
In addition to the consumer education programmes, the Central Bank has
put in place a consumer protection framework. In collaboration with
the financial industry the Central Bank has established a Financial
Mediation Bureau. The Financial Mediation Bureau aims to serve as a
one-stop center for the resolution of retail consumer complaints
against financial institutions regulated by the Central Bank. The
Central Bank is also establishing a one-stop service centre in the
Bank that will function as a Public Information Centre for the
promotion of financial literacy among the Malaysian public. The
service centre will provide advisory services on financial matters to
small and medium enterprises.
Ladies and Gentlemen,
Concluding Remarks
Financial literacy among women is all about having sufficient
awareness of financial matters to enable women to protect and prosper
for themselves and their families in a world that is becoming
increasingly more complex and uncertain. To be an effective
participant in this modern economy, we cannot take financial literacy
for granted. It is a knowledge and skill that must be deliberately
pursued. From a national and institutional perspective, promoting
financial literacy must be an integral part of the overall agenda for
financial and economic reform and development.
Let me conclude with the words of Jawaharlal Nehru, "We talk of
revolutions, political and economic. And yet the greatest revolution
in a country is the one that affects the status and living conditions
of its women. It is in so far as our revolution has affected our
women that it is basic."
Thank you.
Copyright Bank Negara Malaysia, 2004. All rights reserved.
Sihat Malaysia in Unhealthy State
According to the November 29, 2004 issue of Personal Money, soon after the February 18, 2000 launch of Sihat Malaysia, RM130 million worth of premiums were signed up and the number of hospitals on its panel stood at 72.
By August 31 2004, RM130 million in claims have already been paid out. In the intervening time, the number of hospitals on its panel was reduced to 60 in April 2002 and also the premiums were gradually increased in stages; by 20% in April 2002 and by another 15% to 50% in April 2003. The effect of the increased premiums and reduction in the number of hospitals on its panel was a slow-down in sales.
In 2003, only RM53 million in premiums were collected, compared to RM60 million in 2002 and RM130 million in 2000 and 2001 combined. Premiums from November 1999 to September 2004 have amounted to RM217 million. [Editor's Note: I know the figures don't add up but that was how it was reported in Personal Money.]
Complaints from policyholders about problems during admissions also contributed to Sihat Malaysia's decreasing popularity. However, the single biggest weakness of Sihat Malaysia is that it exercises the right not to renew a policy because of a single large claim made, even if the policyholder has been a customer for many years.
Other, more reputable, insurance companies which sell guaranteed renewable medical insurance are taking away Sihat Malaysia customers. Despite having comparable, or slightly higher premiums, they provide medical insurance products with better coverage and with more clinics and hospitals on the panel.
MediExpress (M) Sdn Bhd CEO Paul Cheok admitted there is a need for further improvements in the Sihat Malaysia programme.
Copyright 2003-2004 Azlan Adnan Legal Notice
Jihad for Jerusalem
M.A. Muqtedar Khan
Table of Contents:
Introduction: A Divided Discipline
A Genealogy of Agency
Reforming a Paradigm
A Rational Constructivist Theory
Jerusalem: The Unsubstitutable Core Value
Jihad for Jerusalem: Israel the Tiger, 1967-1997
Jihad for Jerusalem: Iran the Cub, 1967-1997
Jihad for Jerusalem: Saudi Arabia the Paper Tiger,1967-1997
Jihad for Jerusalem: Jordan the Mouse, 1967-1997
Conclusion: The Future of Jerusalem
Bibliography
Copyright 2003-2004 Azlan Adnan Legal Notice
Bipolar Disorder, Schizophrenia Key Found
Stress-Activated Molecule Triggers Mental Disturbance
By Daniel DeNoon, WebMD Medical News
Reviewed by Brunilda Nazario, MD
on Thursday, October 28, 2004
Oct. 28, 2004 -- A stress-activated molecule underlies many of the
symptoms of some mental illnesses, a new study shows.
We control our behaviors, thoughts, and emotions via an important part
of the brain: the prefrontal cortex. People with injuries to this part
of the brain become impulsive, distractible, and have poor judgment.
Major damage to the prefrontal cortex can cause thought disorders and
hallucinations.
These symptoms are also seen in people with bipolar disorder and with
schizophrenia. These mental illnesses worsen with stress.
Recent studies also link worsening bipolar disorder and schizophrenia
with changes in brain signaling by a molecule called protein kinase C
or PKC.
In rat and monkey studies, Yale researcher Amy Arnsten, PhD, and
colleagues delivered PKC directly to the prefrontal cortex of rats and
monkeys. Sure enough, PKC impaired the animals' mental functioning.
Drugs that block PKC restored mental functioning. Some of these drugs
include medicines commonly used to treat mental illness, such as
lithium and valproate.
Arnsten and colleagues report their findings in the Oct. 29 issue of
Science.
"Excessive PKC activation can disrupt... regulation of behavior and
thought, possibly contributing to signs of prefrontal cortical
dysfunction such as distractibility, impaired judgment, impulsivity,
and thought disorder," Arnsten and colleagues write.
It's possible that new drugs with improved PKC-blocking activity could
lead to better treatment of bipolar disorder, schizophrenia, and
perhaps other mental illnesses.
Interestingly, PKC plays a role in lead poisoning. The findings,
Arnsten says, could lead to a better understanding of the symptoms of
distractibility and impulsivity seen in children with lead poisoning.
SOURCES: Birnbaum, S.G. Science, Oct. 29, 2004; vol 306: pp
882-884. News release, Yale University.
By Daniel DeNoon, WebMD Medical News
Reviewed by Brunilda Nazario, MD
on Thursday, October 28, 2004
Oct. 28, 2004 -- A stress-activated molecule underlies many of the
symptoms of some mental illnesses, a new study shows.
We control our behaviors, thoughts, and emotions via an important part
of the brain: the prefrontal cortex. People with injuries to this part
of the brain become impulsive, distractible, and have poor judgment.
Major damage to the prefrontal cortex can cause thought disorders and
hallucinations.
These symptoms are also seen in people with bipolar disorder and with
schizophrenia. These mental illnesses worsen with stress.
Recent studies also link worsening bipolar disorder and schizophrenia
with changes in brain signaling by a molecule called protein kinase C
or PKC.
In rat and monkey studies, Yale researcher Amy Arnsten, PhD, and
colleagues delivered PKC directly to the prefrontal cortex of rats and
monkeys. Sure enough, PKC impaired the animals' mental functioning.
Drugs that block PKC restored mental functioning. Some of these drugs
include medicines commonly used to treat mental illness, such as
lithium and valproate.
Arnsten and colleagues report their findings in the Oct. 29 issue of
Science.
"Excessive PKC activation can disrupt... regulation of behavior and
thought, possibly contributing to signs of prefrontal cortical
dysfunction such as distractibility, impaired judgment, impulsivity,
and thought disorder," Arnsten and colleagues write.
It's possible that new drugs with improved PKC-blocking activity could
lead to better treatment of bipolar disorder, schizophrenia, and
perhaps other mental illnesses.
Interestingly, PKC plays a role in lead poisoning. The findings,
Arnsten says, could lead to a better understanding of the symptoms of
distractibility and impulsivity seen in children with lead poisoning.
SOURCES: Birnbaum, S.G. Science, Oct. 29, 2004; vol 306: pp
882-884. News release, Yale University.
Saturday, November 13, 2004
When Are You Too Old
for Pregnancy?
35-45 Not Too Late If You're Healthy (and Lucky)
By Daniel DeNoon, WebMD Medical News
Reviewed By Brunilda Nazario, MD
on Wednesday, November 03, 2004
Nov. 3, 2004 -- Late pregnancy is an option, but after age 40, you'll
need both health and luck. And after 45, you'll need wealth, too.
Since women can't count on luck or wealth, those wanting to become
pregnant should do so before age 45, argues Linda J. Heffner, MD, PhD,
in the Nov. 4 issue of The New England Journal of Medicine.
Faced with career advancement or the dreaded "mommy track," more and
more women are delaying pregnancy. First births to women aged 40 to 44
jumped 70% between 1991 and 2001, notes Heffner, professor and
chairwoman of obstetrics and gynecology at Boston University.
"The great news is that if you are in the 35-45 age group and have not
been in a position to have children - if you do get pregnant and stay
pregnant past the first trimester - you have every reason to expect a
good outcome," Heffner tells WebMD. "But the issue is that by your
late 30s and early 40s, your ability to become pregnant is diminishing
and your miscarriage risks are increasing."
Late Pregnancy: Modern Medicine vs Age-Old Biology
When it comes to pregnancy, what does "late" mean? Women obviously are
physically ready to have children in their teens. But in today's
world, that's not always the best time for the woman or the child.
There's a trade-off between when a woman's at her physical peak, and
when it's the best social and psychological time for her to raise
children.
"From a medical perspective, the safest time to have children is in
the earlier part of your reproductive life," Heffner says. "And when
education is an issue -- whether you intend to have a career or to
provide that kind of environment for the children you will raise --
looking to your early to mid-20s is very reasonable. And for those
with careers, that period between 25 and 35 is really ideal, all
things considered."
Readers of celebrity magazines may be inspired by stories of movie
stars in their late 40s having children. But the American Society for
Reproductive Medicine recently issued a warning that most women can't
expect to remain fertile that long.
Some women still don't understand that advice, says Richard J.
Paulson, MD. Paulson is professor of obstetrics and gynecology and
chief of the division of reproductive endocrinology and infertility at
the University of Southern California Keck School of Medicine, Los
Angeles. He's the author of Rewinding Your Biological Clock:
Motherhood Late in Life: Options, Issues, and Emotions.
"Now I will still see a patient at age 45 who says, "You know, doctor,
I am thinking of getting pregnant," Paulson tells WebMD."She has no
idea that the idea of a pregnancy with her own eggs is quite remote,
even with in vitro techniques. Most of these women are menstruating,
but nearly all are quite infertile. That is a relatively common
misconception, that regular periods mean you are still fertile."
Next: How Late Is Too Late?
Even Heffner's good news for women age 35-45 should be qualified, says
Alan H. DeCherney, MD, professor of obstetrics and gynecology and
chief of the division of reproductive endocrinology and infertility at
UCLA's David Geffen School of Medicine. DeCherney's 1982 NEJM
editorial, "Female Fecundity and Age," foreshadows many of Heffner's
current arguments.
"A woman's chance of becoming pregnant at age 35 to 40 is better than
it is at age 40 to 45," DeCherney tells WebMD. "For young women, the
longer they wait, there is a steady decline in fertility. But there is
more to life than just getting pregnant. If a woman has a career and
wants to delay pregnancy, she has an 85% chance everything is going to
be great."
Late Pregnancy: How Late Is Too Late?
Heffner, Paulson, and DeCherney agree that by age 45, most women are
no longer fertile.
"Past age 45, successful pregnancy requires health and wealth,"
Heffner says. "Of course there are some individuals who, at this age
and older, retain their ability to become pregnant. But a lot of women
don't. The great news is the biology is no longer totally limiting.
But you have to keep in mind, if you are counting on that, that there
still is an element of health -- and unfortunately, wealth. If you do,
indeed, end up in a donor-egg program, it has to be paid for."
Health in this case means no heart disease, no diabetes, and no high
blood pressure. Wealth means being able to pay for expensive
procedures because few insurance programs cover the costs of egg
donation. And Heffner notes that even among healthy women aged 45 and
older, there is a high rate of pregnancy complications.
And there are, of course, psychological issues. Heffner warns in her
editorial that couples who choose to have a baby in their late 40s
must be prepared to face the issues surrounding their child's
adolescence at the same time they face issues of their own retirement.
Paulson, however, says he's not too worried about the ability of older
couples to understand what they're getting into.
"We've found this idea of raising children during a couple's older
years to be not much of an issue," he says. "In many societies,
grandparents do much of the child raising. And people who choose to
become parents at 50 are smart and can make decisions for themselves.
We trust 50-year-olds to be presidents and run the world. We can trust
them to make decisions about their own future and how to spend the
next 20 years. Yes, they know what it is like to raise children --
probably more than most 20-year-olds."
SOURCES: Heffner, L.J. The New England Journal of Medicine,
Nov. 4, 2004; vol 351: pp 1927-1929. DeCherney, A.H. and Berkowitz,
G.S. The New England Journal of Medicine, Feb. 18, 1982; vol
306: pp 424-426. Linda J. Heffner, MD, PhD, professor and chairwoman,
obstetrics and gynecology, Boston University. Richard J. Paulson,
professor, obstetrics and gynecology; chief, division of reproductive
endocrinology and infertility, University of Southern California Keck
School of Medicine, Los Angeles; author, Rewinding Your Biological
Clock: Motherhood Late in Life: Options, Issues, and Emotions,
W.H. Freeman & Co., 1998. Alan H. DeCherney, MD, professor, obstetrics
and gynecology; chief, division of reproductive endocrinology and
infertility, David Geffen School of Medicine, University of
California, Los Angeles. American Society for Reproductive Medicine.
By Daniel DeNoon, WebMD Medical News
Reviewed By Brunilda Nazario, MD
on Wednesday, November 03, 2004
Nov. 3, 2004 -- Late pregnancy is an option, but after age 40, you'll
need both health and luck. And after 45, you'll need wealth, too.
Since women can't count on luck or wealth, those wanting to become
pregnant should do so before age 45, argues Linda J. Heffner, MD, PhD,
in the Nov. 4 issue of The New England Journal of Medicine.
Faced with career advancement or the dreaded "mommy track," more and
more women are delaying pregnancy. First births to women aged 40 to 44
jumped 70% between 1991 and 2001, notes Heffner, professor and
chairwoman of obstetrics and gynecology at Boston University.
"The great news is that if you are in the 35-45 age group and have not
been in a position to have children - if you do get pregnant and stay
pregnant past the first trimester - you have every reason to expect a
good outcome," Heffner tells WebMD. "But the issue is that by your
late 30s and early 40s, your ability to become pregnant is diminishing
and your miscarriage risks are increasing."
Late Pregnancy: Modern Medicine vs Age-Old Biology
When it comes to pregnancy, what does "late" mean? Women obviously are
physically ready to have children in their teens. But in today's
world, that's not always the best time for the woman or the child.
There's a trade-off between when a woman's at her physical peak, and
when it's the best social and psychological time for her to raise
children.
"From a medical perspective, the safest time to have children is in
the earlier part of your reproductive life," Heffner says. "And when
education is an issue -- whether you intend to have a career or to
provide that kind of environment for the children you will raise --
looking to your early to mid-20s is very reasonable. And for those
with careers, that period between 25 and 35 is really ideal, all
things considered."
Readers of celebrity magazines may be inspired by stories of movie
stars in their late 40s having children. But the American Society for
Reproductive Medicine recently issued a warning that most women can't
expect to remain fertile that long.
Some women still don't understand that advice, says Richard J.
Paulson, MD. Paulson is professor of obstetrics and gynecology and
chief of the division of reproductive endocrinology and infertility at
the University of Southern California Keck School of Medicine, Los
Angeles. He's the author of Rewinding Your Biological Clock:
Motherhood Late in Life: Options, Issues, and Emotions.
"Now I will still see a patient at age 45 who says, "You know, doctor,
I am thinking of getting pregnant," Paulson tells WebMD."She has no
idea that the idea of a pregnancy with her own eggs is quite remote,
even with in vitro techniques. Most of these women are menstruating,
but nearly all are quite infertile. That is a relatively common
misconception, that regular periods mean you are still fertile."
Next: How Late Is Too Late?
Even Heffner's good news for women age 35-45 should be qualified, says
Alan H. DeCherney, MD, professor of obstetrics and gynecology and
chief of the division of reproductive endocrinology and infertility at
UCLA's David Geffen School of Medicine. DeCherney's 1982 NEJM
editorial, "Female Fecundity and Age," foreshadows many of Heffner's
current arguments.
"A woman's chance of becoming pregnant at age 35 to 40 is better than
it is at age 40 to 45," DeCherney tells WebMD. "For young women, the
longer they wait, there is a steady decline in fertility. But there is
more to life than just getting pregnant. If a woman has a career and
wants to delay pregnancy, she has an 85% chance everything is going to
be great."
Late Pregnancy: How Late Is Too Late?
Heffner, Paulson, and DeCherney agree that by age 45, most women are
no longer fertile.
"Past age 45, successful pregnancy requires health and wealth,"
Heffner says. "Of course there are some individuals who, at this age
and older, retain their ability to become pregnant. But a lot of women
don't. The great news is the biology is no longer totally limiting.
But you have to keep in mind, if you are counting on that, that there
still is an element of health -- and unfortunately, wealth. If you do,
indeed, end up in a donor-egg program, it has to be paid for."
Health in this case means no heart disease, no diabetes, and no high
blood pressure. Wealth means being able to pay for expensive
procedures because few insurance programs cover the costs of egg
donation. And Heffner notes that even among healthy women aged 45 and
older, there is a high rate of pregnancy complications.
And there are, of course, psychological issues. Heffner warns in her
editorial that couples who choose to have a baby in their late 40s
must be prepared to face the issues surrounding their child's
adolescence at the same time they face issues of their own retirement.
Paulson, however, says he's not too worried about the ability of older
couples to understand what they're getting into.
"We've found this idea of raising children during a couple's older
years to be not much of an issue," he says. "In many societies,
grandparents do much of the child raising. And people who choose to
become parents at 50 are smart and can make decisions for themselves.
We trust 50-year-olds to be presidents and run the world. We can trust
them to make decisions about their own future and how to spend the
next 20 years. Yes, they know what it is like to raise children --
probably more than most 20-year-olds."
SOURCES: Heffner, L.J. The New England Journal of Medicine,
Nov. 4, 2004; vol 351: pp 1927-1929. DeCherney, A.H. and Berkowitz,
G.S. The New England Journal of Medicine, Feb. 18, 1982; vol
306: pp 424-426. Linda J. Heffner, MD, PhD, professor and chairwoman,
obstetrics and gynecology, Boston University. Richard J. Paulson,
professor, obstetrics and gynecology; chief, division of reproductive
endocrinology and infertility, University of Southern California Keck
School of Medicine, Los Angeles; author, Rewinding Your Biological
Clock: Motherhood Late in Life: Options, Issues, and Emotions,
W.H. Freeman & Co., 1998. Alan H. DeCherney, MD, professor, obstetrics
and gynecology; chief, division of reproductive endocrinology and
infertility, David Geffen School of Medicine, University of
California, Los Angeles. American Society for Reproductive Medicine.
Siapa Dalam?
Psycho-Drama by Azlan Adnan
It was a hot Sunday afternoon. I was having a nap after a heavy lunch
at my in-laws' house in Jalan Setiaraya when I was rudely awakened.
Six strange men were upon me, one holding down each limb and another
who put a black hood over my head. I had just enough time to catch a
quick glimpse of their leader, an elderly man wearing a battered
songkok, who kept circling us, taking care not to be seen by me.
"Siapa Dalam?" the leader, whom I took to be the bomoh-in-charge,
asked me repeatedly. This time he had come around so that he was just
next to my right ear.
I figured I ought to appease him and say something plausible.
"Azlan," I answered, truthfully.
"Jangan tipu, siapa dalam?" he retorted.
"Boy, the truth is certainly not what he's looking for," I thought. He
clearly wanted some demon in me to answer him. But honestly, there
were no demons lurking in the labyrinths of my psyche, just me. I
decided to play some reverse psychology on him and decided to keep
answering him with just a simple "Azlan."
"Siapa dalam? Saya cabar kau, keluar sekarang!" he shouted.
"Boy, is he going to be disappointed," I thought. I decided to stay
cool and recited the Al-Fatihah in a soft, but slow and steady voice...
"Bismillah..."
"Siapa dalam?" he asked again, this time with some frustration setting
in. At some stage, about an hour into the proceedings they removed the
hood and I could see my sisters- and brothers-in-laws sitting around
me watching the goings-on like some kind of bizarre spectator sport.
"The bastards," I thought as they just sat there as if brutal
assailants performing an exorcism were part and parcel of their
weekend. Needless to say, they hardly lifted finger to help me. My
wife had gone downstairs, too distressed, to observe the proceedings
of this bizarre spectacle.
Finally, after what seemed like hours, the bomoh gave up, and told my
mother-in-law, "Baik bawak dia pergi hospital."
My assailants helped me up and hand-cuffed me ("Were they policemen?"
I asked myself). I was bundled onto an orange Mitsubishi Galant and
driven to University Hospital. At one point, somewhere along Jalan
Damansara, I felt like putting my hands over the driver's head and
strangling him, but thought the better of it.
At UH, they took me through to see a medical officer, Dr John Teoh,
but not before one of them gave me a punch in the left eye, the
bastards. It made a percussive impact that sent sparks and stars
flying in my head. I was sure Dr Teoh saw them punch me but he
remained outwardly oblivious. Even when I complained to him of the
"police brutality" he remained unconcerned and dismissive. He didn't
seem interested in anything I had to say and was clearly more
interested in what "the policemen" had to say.
But what do they know? Besides my name, I didn't give them anything.
It was at this point that I gave Dr Teoh his nickname, "The Bastard."
Soon I found myself in Ward 5, restrained to a bed as I was obviously
not in favour of spending any more time in this nuthouse and wanted to
go home.
Eventually, I spent about a month in Ward 5. I couldn't get along with
Dr Teoh for obvious reasons and a lecturer, Dr Goh, who had much more
empathy, took over my case.
As expected, I was heavily sedated and my regime consisted of 250 mg
chlorpromazine, 10 mg haloperidol four times a day with some benzhexol
to counter some of the worst side-effects of these medications.
### 610 words ###
It was a hot Sunday afternoon. I was having a nap after a heavy lunch
at my in-laws' house in Jalan Setiaraya when I was rudely awakened.
Six strange men were upon me, one holding down each limb and another
who put a black hood over my head. I had just enough time to catch a
quick glimpse of their leader, an elderly man wearing a battered
songkok, who kept circling us, taking care not to be seen by me.
"Siapa Dalam?" the leader, whom I took to be the bomoh-in-charge,
asked me repeatedly. This time he had come around so that he was just
next to my right ear.
I figured I ought to appease him and say something plausible.
"Azlan," I answered, truthfully.
"Jangan tipu, siapa dalam?" he retorted.
"Boy, the truth is certainly not what he's looking for," I thought. He
clearly wanted some demon in me to answer him. But honestly, there
were no demons lurking in the labyrinths of my psyche, just me. I
decided to play some reverse psychology on him and decided to keep
answering him with just a simple "Azlan."
"Siapa dalam? Saya cabar kau, keluar sekarang!" he shouted.
"Boy, is he going to be disappointed," I thought. I decided to stay
cool and recited the Al-Fatihah in a soft, but slow and steady voice...
"Bismillah..."
"Siapa dalam?" he asked again, this time with some frustration setting
in. At some stage, about an hour into the proceedings they removed the
hood and I could see my sisters- and brothers-in-laws sitting around
me watching the goings-on like some kind of bizarre spectator sport.
"The bastards," I thought as they just sat there as if brutal
assailants performing an exorcism were part and parcel of their
weekend. Needless to say, they hardly lifted finger to help me. My
wife had gone downstairs, too distressed, to observe the proceedings
of this bizarre spectacle.
Finally, after what seemed like hours, the bomoh gave up, and told my
mother-in-law, "Baik bawak dia pergi hospital."
My assailants helped me up and hand-cuffed me ("Were they policemen?"
I asked myself). I was bundled onto an orange Mitsubishi Galant and
driven to University Hospital. At one point, somewhere along Jalan
Damansara, I felt like putting my hands over the driver's head and
strangling him, but thought the better of it.
At UH, they took me through to see a medical officer, Dr John Teoh,
but not before one of them gave me a punch in the left eye, the
bastards. It made a percussive impact that sent sparks and stars
flying in my head. I was sure Dr Teoh saw them punch me but he
remained outwardly oblivious. Even when I complained to him of the
"police brutality" he remained unconcerned and dismissive. He didn't
seem interested in anything I had to say and was clearly more
interested in what "the policemen" had to say.
But what do they know? Besides my name, I didn't give them anything.
It was at this point that I gave Dr Teoh his nickname, "The Bastard."
Soon I found myself in Ward 5, restrained to a bed as I was obviously
not in favour of spending any more time in this nuthouse and wanted to
go home.
Eventually, I spent about a month in Ward 5. I couldn't get along with
Dr Teoh for obvious reasons and a lecturer, Dr Goh, who had much more
empathy, took over my case.
As expected, I was heavily sedated and my regime consisted of 250 mg
chlorpromazine, 10 mg haloperidol four times a day with some benzhexol
to counter some of the worst side-effects of these medications.
### 610 words ###
Spring Has Sprung
Psycho-Drama by Azlan Adnan
It was late March 1979. The drab winter with its grey skies
was dragging on in London and spring was nowhere in sight.
I was a 20-year-old university student in my first year of studies.
One evening, I had a cold, or, more technically, as I
learnt later, a post-nasal infection and I went to the
university clinic but they were closed for the day and it
being Easter vacation my regular doctor, Dr Sedgwick, was
on leave. I had to phone for the doctor-on-call who came to
my room in the hall of residence at about 10 pm to examine me.
The doctor spent a total of, say, two minutes giving me a
cursory look-over with his stethoscope and thermometer. Yes,
he was a man in a hurry indeed, with many more calls to
make that cold winter night.
He gave me some antibiotics to take and said "take three
tablets a day and don't drink. Give this note to your
(regular) doctor in the morning" and left in a flash.
Now, I was studying Building Technology and the subject I
was covering just before the Easter break was known as
Daylighting which has implications for fenestration and
such like. For us builders and architects, a "day" means 12
hours; and "night" is another 12 hours. For laymen, a "day"
of 24 hours is our "day" and a "night."
So you can guess what happened. I overdosed on the
antibiotics, taking twice the amount necessary, a tablet
every four hours, instead of every eight.
There was one other communications failure. He said, "Don't
drink." Being a teetotaler, it simply didn't occur to me
that he meant don't drink alcohol. I just thought he meant
don't take fluids while I was on the medication. Which
meant I was soon dehydrated as well as overdosed on the antibiotics.
The next morning, some friends drove me to another doctor's
clinic. He was Dr Hunt and was covering for Dr Sedgwick in
the latter's absence. He wasn't based at the university
clinic but at his own surgery, some distance away from campus.
He took the note from the doctor-on-call, read it and gave
me some medication. He did not even examine me or talk to
me. The note from the doctor-on-call stated his diagnosis
(post-nasal infection) and on it was a prescription.
Apparently, the doctor-on-call didn't have the correct
antibiotic for my post-nasal infection and had given some
something similar to cover me in the interim.
So, Dr Hunt gave me another type of antibiotic and again,
it was supposed to be taken three times a day. But as you
know, I still didn't realise it was meant to be a 24-hour day.
So, that night or the night after--I can't remember
exactly, the memories are all one blur--I was sleeping and
had a vivid nightmare. I also had pyrexia from the postnasal
infection and was delirious. The nightmare was very
frightening; it had to do with my friends at university and
the occult: the devil, evil, flames, chanting, night,
darkness, ritual sacrifices, blood...
I woke up with a start in a pool of sweat. It was 4.30 am.
I was confused and in a state of fear. I needed help. I ran
to the door of the sub-warden's room at my hall of
residence and knocked. He was a black man, a Negro. He
opened the door with a peeved expression on his face. He
was naked and covered himself with a blanket. In his bed
was a blond, white woman, naked under a duvet. It was
obvious he was in the midst of screwing her.
The image of a black man screwing a white woman somehow
associated with my nightmare. More evil. In my confused
state, I associated him with the devil, perhaps because the
colour black was associated with evil.
He said, "Let me get dressed. Wait for me at Security."
"Yes, Security," I thought, "I should be safe there."
I ran as fast as I could to Security. I arrived in a state,
panting breathlessly. The guards asked me what was wrong
but by then I was incoherent. Confused ramblings poured
forth from my mouth. I managed to write down my name and
room number. They dialed for an ambulance. They thought I
was high on drugs. It was not uncommon in the late
seventies for students in the U.K. to get high on LSD.
In the meantime, the sub-warden arrived but I was terrified
of him. Seeing that, the guards put him in a wrestling hold
and interrogated him. He gave them the name of a mutual
friend of ours, Miss Yim, who happened to be his
course-mate. The guards phoned for her and she arrived just
as the ambulance came and so she accompanied me in the
ambulance to the Emergency Room of Hillingdon Hospital.
There, they took off all my clothes, examined my body
closely for puncture marks, as evidence of drug-taking.
They took urine and blood samples. And then, without a
word, everyone disappeared.
I was alone, naked under a blanket, on an operating table.
Bright lights glared at me from above. I was worried. "What
are they going to do to me?" I asked myself, rhetorically.
Then, in came two figures. They both wore thick spectacles,
surgical masks and were dressed in green operating gowns.
One was tall and thin whilst the other was short and fat.
It was obvious from their manner that the tall, thin one
was in charge, and the short, fat one took his orders.
The short, fat one asked me to sit up and gave me a thick,
brown, sickly sweet syrup to drink (I later learnt it was
chlorpromazine syrup). The short, fat one did all the
talking.
"Are you a good Muslim?" he asked in a thick Greek accent.
I didn't know how to answer. What if I said "Yes" and this
guy was Cypriot and he hated Muslims? Was he going to kill
me? As my fear mounted, I decided to hedge my bets...
I recited the names of as many prophets as I could
remember: "Adam, Mohammed, Jesus, Abraham, Solomon, David,
Joseph..." Threw in Confucious and Buddha for good measure.
The short, fat one said, "Oh, shut up!"
He gave me an injection (more chlorpromazine as it turned
out) on my right outer thigh. I twitched in reaction to the
needle prick.
"Be still or else I'll shoot another one up your arse as
well!" he snapped.
Then they both disappeared. The ambulance drove me, naked,
to Windsor Ward. Miss Yim was nowhere to be found. At the
reception counter, I covered my privates with my hands as I
asked the pretty receptionist (I wished I met her under
different circumstances) as nonchalantly and as coolly as I
could muster, "Can I have my clothes back, please?"
"I dunno, love. You'll have to ask your doctor. Who's your
doctor?" she replied to my question with a question. Little
did I know that I was soon to get more of this runaround,
over the coming months.
"I dunno," I replied.
Then this short, fat figure comes walking by in a three-piece
suit, looking spivvy with a red necktie and waist-clock
on a chain. He wore thick spectacles and shouted at
me, "What are you doing here, walking around starkers like
that?" before I could even ask him for my clothes back.
"Get him to his room," he barked to the orderlies.
"Room? If I can just have my clothes back, I'll find my way
home..." I said, falteringly, as he was in no listening mood.
I recognised his gruff voice with the thick Greek accent
from the Emergency Room. He was the short, fat one. His
name was Dr Kalkavarous. He was a psychiatrist. He was not
the sort of man with whom one could get a word in edgewise.
When I reached my room, I passed out. When I woke up three
days later, I noticed I had two pairs of bedroom slippers,
three toothbrushes and some bars of soap. Miss Yim and my
other friends had left them when they visited me but
obviously I was in a state of oblivion, so they left.
The chlorpromazine had knocked me out and "paralyzed" me. I
wouldn't move a muscle. Could hardly lift up my head, let
alone talk. I could just manage opening my eyes. I couldn't
even focus my eyes as the major tranquillizer had knocked
out the accommodation of my eye muscles, along with
everything else. I lay there, supine and comatose, for the
next two weeks. Even my peristalsis stopped: I didn't shit
for a fortnight.
The psychiatrists couldn't find any traces of drugs in me
and so, by elimination, they decided my vivid nightmare
were hallucinations that were caused by a mental disorder.
"Acute schizophrenic-form psychosis" was their diagnosis.
They also noted that my blood test had reported a very high
ESR (Erythrocyte Sedimentation Rate) of 37 (4 to 7 is
normal) indicating an infection, but had dismissed it as
insignificant. If they had bothered to ask me, or rather if
they had not sedated me and I was in a state to tell them,
I would have informed them about the post-nasal infection.
As it was, they didn't have a clue about that or of the
antibiotics or of their overdose.
To further confuse the issue, my taking the antibiotics in
such high dosage had cleared the post-nasal infection so
completely that by the time I was hospitalised there wasn't
a trace of the infection left.
When my friends came to visit me, I was painfully reminded
of the nightmare I had that featured them ever so vividly
and this got me into a bit of a state. The nursing staff
noticed that and hence banned my friends from visiting me.
I was put on 250 mg of chlorpromazine and 10 mg of
haloperidol four times a day as well as procycledine to
counter the side effects of these major tranquillizers.
I was heavily sedated and all alone in my room. My body had
stopped functioning and wasn't taking orders from my brain.
I could listen and I could think, but that was just about
all I could do. I was a zombie that existed in my mind only
for the next couple of months, until I slowly developed a
tolerance to the medication and regained my psychomotor
skills.
I gained 60 pounds in the next six months I was in
hospital, mostly from lack of exercise. I learnt that the
tall, thin one with the thick glasses was Dr Stanley
Wiseberg, FRCPsych, the Consultant Psychiatrist. Dr
Kalkavarous was under training from Wiseberg, hoping to
earn his MRCPsych and was therefore eager to please him.
After I left Hillingdon Hospital in October 1979 and for
the next ten years, I was gradually weaned off the
medications: given other medications to counter the side
effects of the former medications and given less potent
medications and in slowly decreasing doses. As far as I was
concerned, those ten years were nonsensical. All I suffered
during those ten years were the effects and side effects of
these medications. I didn't have a mental illness as such.
You may say I'm in a state of denial, but I think I was
never crazy in the first place. Misunderstood certainly,
but never crazy.
It was late March 1979. The drab winter with its grey skies
was dragging on in London and spring was nowhere in sight.
I was a 20-year-old university student in my first year of studies.
One evening, I had a cold, or, more technically, as I
learnt later, a post-nasal infection and I went to the
university clinic but they were closed for the day and it
being Easter vacation my regular doctor, Dr Sedgwick, was
on leave. I had to phone for the doctor-on-call who came to
my room in the hall of residence at about 10 pm to examine me.
The doctor spent a total of, say, two minutes giving me a
cursory look-over with his stethoscope and thermometer. Yes,
he was a man in a hurry indeed, with many more calls to
make that cold winter night.
He gave me some antibiotics to take and said "take three
tablets a day and don't drink. Give this note to your
(regular) doctor in the morning" and left in a flash.
Now, I was studying Building Technology and the subject I
was covering just before the Easter break was known as
Daylighting which has implications for fenestration and
such like. For us builders and architects, a "day" means 12
hours; and "night" is another 12 hours. For laymen, a "day"
of 24 hours is our "day" and a "night."
So you can guess what happened. I overdosed on the
antibiotics, taking twice the amount necessary, a tablet
every four hours, instead of every eight.
There was one other communications failure. He said, "Don't
drink." Being a teetotaler, it simply didn't occur to me
that he meant don't drink alcohol. I just thought he meant
don't take fluids while I was on the medication. Which
meant I was soon dehydrated as well as overdosed on the antibiotics.
The next morning, some friends drove me to another doctor's
clinic. He was Dr Hunt and was covering for Dr Sedgwick in
the latter's absence. He wasn't based at the university
clinic but at his own surgery, some distance away from campus.
He took the note from the doctor-on-call, read it and gave
me some medication. He did not even examine me or talk to
me. The note from the doctor-on-call stated his diagnosis
(post-nasal infection) and on it was a prescription.
Apparently, the doctor-on-call didn't have the correct
antibiotic for my post-nasal infection and had given some
something similar to cover me in the interim.
So, Dr Hunt gave me another type of antibiotic and again,
it was supposed to be taken three times a day. But as you
know, I still didn't realise it was meant to be a 24-hour day.
So, that night or the night after--I can't remember
exactly, the memories are all one blur--I was sleeping and
had a vivid nightmare. I also had pyrexia from the postnasal
infection and was delirious. The nightmare was very
frightening; it had to do with my friends at university and
the occult: the devil, evil, flames, chanting, night,
darkness, ritual sacrifices, blood...
I woke up with a start in a pool of sweat. It was 4.30 am.
I was confused and in a state of fear. I needed help. I ran
to the door of the sub-warden's room at my hall of
residence and knocked. He was a black man, a Negro. He
opened the door with a peeved expression on his face. He
was naked and covered himself with a blanket. In his bed
was a blond, white woman, naked under a duvet. It was
obvious he was in the midst of screwing her.
The image of a black man screwing a white woman somehow
associated with my nightmare. More evil. In my confused
state, I associated him with the devil, perhaps because the
colour black was associated with evil.
He said, "Let me get dressed. Wait for me at Security."
"Yes, Security," I thought, "I should be safe there."
I ran as fast as I could to Security. I arrived in a state,
panting breathlessly. The guards asked me what was wrong
but by then I was incoherent. Confused ramblings poured
forth from my mouth. I managed to write down my name and
room number. They dialed for an ambulance. They thought I
was high on drugs. It was not uncommon in the late
seventies for students in the U.K. to get high on LSD.
In the meantime, the sub-warden arrived but I was terrified
of him. Seeing that, the guards put him in a wrestling hold
and interrogated him. He gave them the name of a mutual
friend of ours, Miss Yim, who happened to be his
course-mate. The guards phoned for her and she arrived just
as the ambulance came and so she accompanied me in the
ambulance to the Emergency Room of Hillingdon Hospital.
There, they took off all my clothes, examined my body
closely for puncture marks, as evidence of drug-taking.
They took urine and blood samples. And then, without a
word, everyone disappeared.
I was alone, naked under a blanket, on an operating table.
Bright lights glared at me from above. I was worried. "What
are they going to do to me?" I asked myself, rhetorically.
Then, in came two figures. They both wore thick spectacles,
surgical masks and were dressed in green operating gowns.
One was tall and thin whilst the other was short and fat.
It was obvious from their manner that the tall, thin one
was in charge, and the short, fat one took his orders.
The short, fat one asked me to sit up and gave me a thick,
brown, sickly sweet syrup to drink (I later learnt it was
chlorpromazine syrup). The short, fat one did all the
talking.
"Are you a good Muslim?" he asked in a thick Greek accent.
I didn't know how to answer. What if I said "Yes" and this
guy was Cypriot and he hated Muslims? Was he going to kill
me? As my fear mounted, I decided to hedge my bets...
I recited the names of as many prophets as I could
remember: "Adam, Mohammed, Jesus, Abraham, Solomon, David,
Joseph..." Threw in Confucious and Buddha for good measure.
The short, fat one said, "Oh, shut up!"
He gave me an injection (more chlorpromazine as it turned
out) on my right outer thigh. I twitched in reaction to the
needle prick.
"Be still or else I'll shoot another one up your arse as
well!" he snapped.
Then they both disappeared. The ambulance drove me, naked,
to Windsor Ward. Miss Yim was nowhere to be found. At the
reception counter, I covered my privates with my hands as I
asked the pretty receptionist (I wished I met her under
different circumstances) as nonchalantly and as coolly as I
could muster, "Can I have my clothes back, please?"
"I dunno, love. You'll have to ask your doctor. Who's your
doctor?" she replied to my question with a question. Little
did I know that I was soon to get more of this runaround,
over the coming months.
"I dunno," I replied.
Then this short, fat figure comes walking by in a three-piece
suit, looking spivvy with a red necktie and waist-clock
on a chain. He wore thick spectacles and shouted at
me, "What are you doing here, walking around starkers like
that?" before I could even ask him for my clothes back.
"Get him to his room," he barked to the orderlies.
"Room? If I can just have my clothes back, I'll find my way
home..." I said, falteringly, as he was in no listening mood.
I recognised his gruff voice with the thick Greek accent
from the Emergency Room. He was the short, fat one. His
name was Dr Kalkavarous. He was a psychiatrist. He was not
the sort of man with whom one could get a word in edgewise.
When I reached my room, I passed out. When I woke up three
days later, I noticed I had two pairs of bedroom slippers,
three toothbrushes and some bars of soap. Miss Yim and my
other friends had left them when they visited me but
obviously I was in a state of oblivion, so they left.
The chlorpromazine had knocked me out and "paralyzed" me. I
wouldn't move a muscle. Could hardly lift up my head, let
alone talk. I could just manage opening my eyes. I couldn't
even focus my eyes as the major tranquillizer had knocked
out the accommodation of my eye muscles, along with
everything else. I lay there, supine and comatose, for the
next two weeks. Even my peristalsis stopped: I didn't shit
for a fortnight.
The psychiatrists couldn't find any traces of drugs in me
and so, by elimination, they decided my vivid nightmare
were hallucinations that were caused by a mental disorder.
"Acute schizophrenic-form psychosis" was their diagnosis.
They also noted that my blood test had reported a very high
ESR (Erythrocyte Sedimentation Rate) of 37 (4 to 7 is
normal) indicating an infection, but had dismissed it as
insignificant. If they had bothered to ask me, or rather if
they had not sedated me and I was in a state to tell them,
I would have informed them about the post-nasal infection.
As it was, they didn't have a clue about that or of the
antibiotics or of their overdose.
To further confuse the issue, my taking the antibiotics in
such high dosage had cleared the post-nasal infection so
completely that by the time I was hospitalised there wasn't
a trace of the infection left.
When my friends came to visit me, I was painfully reminded
of the nightmare I had that featured them ever so vividly
and this got me into a bit of a state. The nursing staff
noticed that and hence banned my friends from visiting me.
I was put on 250 mg of chlorpromazine and 10 mg of
haloperidol four times a day as well as procycledine to
counter the side effects of these major tranquillizers.
I was heavily sedated and all alone in my room. My body had
stopped functioning and wasn't taking orders from my brain.
I could listen and I could think, but that was just about
all I could do. I was a zombie that existed in my mind only
for the next couple of months, until I slowly developed a
tolerance to the medication and regained my psychomotor
skills.
I gained 60 pounds in the next six months I was in
hospital, mostly from lack of exercise. I learnt that the
tall, thin one with the thick glasses was Dr Stanley
Wiseberg, FRCPsych, the Consultant Psychiatrist. Dr
Kalkavarous was under training from Wiseberg, hoping to
earn his MRCPsych and was therefore eager to please him.
After I left Hillingdon Hospital in October 1979 and for
the next ten years, I was gradually weaned off the
medications: given other medications to counter the side
effects of the former medications and given less potent
medications and in slowly decreasing doses. As far as I was
concerned, those ten years were nonsensical. All I suffered
during those ten years were the effects and side effects of
these medications. I didn't have a mental illness as such.
You may say I'm in a state of denial, but I think I was
never crazy in the first place. Misunderstood certainly,
but never crazy.
Sally's Scandal
by Azlan Adnan
A short story inspired by Shahriza Nor Hosni
It was a Tuesday evening in late November when I first set eyes on
her. The committee meeting was about to commence when she breezed into
the function room at the Prince Hotel. Our eyes met and I was
love-struck. Her eyes had spoken to me in a way words can never equal.
Through the placid pools of her limpid eyes I had a glimpse into her
very soul.
She sat down next to me, to my right. I noticed she was adorned in a
black long-sleeved figure-hugging top and beige slacks. After the
usual pleasantries, I offered to make her a cup of honey lemon tea.
She graciously accepted my offer and the rest--as they say--is
history.
She gave me her business card which spelt out her name in full but
implored I called her simply Sally. She was a marketing executive with
an event management company.
At our next meeting two days later, Sally wore a short, knee-length
black skirt which showed her lovely legs to their full advantage. She
had slender calves that looked decidedly ravishing.
Sally is petite. 45 kg or so. 5 feet 1 inch. Her body is well
proportioned--her torso is short and her legs relatively long. She
possessed lovely, pert, well-separated breasts that were neither too
large nor too small. She had broad hips for her size, which emphasized
the sexiness of her bottom, which was full, well-rounded and firm.
We had our first date--alone together at last--the following Tuesday.
It was 6.20 pm when we were driving down the road towards the traffic
lights. As we were held up in the bumper-to-bumper traffic Sally asked
me if I wasn't going to ask her if she had a boyfriend. I told her I
deduced she hasn't because if she did, she wouldn't entertain me out
of loyalty to her boyfriend. I said I'd expect she'd be faithful to
him, if she had one. She confirmed she hadn't a boyfriend although
there was this one guy, Gary, who has been pestering her. But she
wasn't in the least romantically interested in him, she said. My heart
sang with joy!
Sally asked me what I was looking for. I said " Romance ."
Bemused, she tittered and interrupted me. I was about to add--" and
sex would be nice, too "--but held my tongue. I figured prudence would
be better at this early stage of our relationship. I told her it is
nice to have someone to love and even nicer to be loved. She agreed it
was nice to be loved.
I ordered a King-sized spare rib, which I told the waitress we
intended to share. She ordered a mushroom soup and I a guacamole dip.
We shared each other's starters: How romantic! Sally assured me she
didn't have HIV but I didn't care, or rather, I took it as a given. In
any case, you can't get HIV from sharing food. Hepatitis, yes, but
I've already taken my booster jab.
For drinks, she had hot lemon tea and I had a hot honey lemon. It
reminded her of the honey lemon tea of our first meeting and she
laughed, displaying her lovely set of teeth and her ready, sweet
smile.
I told Sally I was enjoying her company and for a first date I was
very pleased with how it was progressing along. She expressed an
earlier anxiety that she had--given our age difference (I'm 44)--she
was worried we might have nothing in common to talk about. She was
glad we had nothing to worry on that score.
Sally asked me about my divorce. I told her I was not comfortable
discussing the reason as I was still on good terms with my ex. Talking
about the divorce was like betraying her trust and the private nature
of a relationship. She agreed when I suggested that she would not like
it if whatever happened between us was blabbered to other people.
Sally said she understood. Maybe when the time was ripe and if it was
relevant, I'd confide in her. But not just yet--I needed to know her
better.
Sally was quite clear that she wants me not to expect anything. I
guessed, correctly, that she did not want to rush into things and
would like things to take their course.
She asked me what I had been doing. I said my last job was as CEO of a
medical supply company. She expressed surprise that an obviously
"successful" person, a CEO no less--would take a romantic interest in
her. Her humility and total lack of vanity was the very essence of her
charm. I told her as such. She was bemused, expressing disbelief,
probably thinking I was telling her a line.
The lighting in the restaurant gave a warm glow to her cheeks and
before I could comment on it she said that the lighting made my face
look handsome. We laughed. I had a warm tingling sensation in my
cheeks ever since I realised I was in love with her. I certainly had a
buzz and she made me high.
Sally drove me home and asked if she'd like to take my dog for a walk.
I was greatly pleased when she said she would love to do so and
although she was a little afraid of Speedy who is huge in comparison
to her slight body, she eagerly accepted the idea of walking Speedy.
Speedy excitedly jumped on her a couple of times and I naturally took
the opportunity to hug and touch her to protect Sally from Speedy's
enthusiastic slobbering. We walked the length of my street and as I
was still not contented, we walked round the block as well. At some
point I asked her if it was too much to hold her hand and she promptly
replied in the affirmative. So its hands-off for now.
Our next meeting was at a more public occasion, but was lovely to see
her again and we did manage a few quiet moments to ourselves. Sally
wore beige slacks that slipped and bared her black panties. I made a
jocular remark about them--( Why do women wear black panties? In
memory of all those who were buried here )--to which she responded
with rowdy laughter.
At some stage she was seated on a barstool and I was behind her. I
eyed and admired her voluptuously broad butt. I told her I noticed
from the back that she had curvy hips. She said I was naughty to
notice such things and laughed.
We met next at a Christmas Tree Lighting ceremony on December 2. I
passed Sally a hand-written journal I had been keeping since we had
first met--it contained 40 pages of entries. Then, she said she had to
go away for about two weeks...
I only saw her briefly on Dec 11 at a gala charity dinner when I just
managed to pass her a " I Miss You! " card. She had returned
specifically for that dinner as she had to go on stage to receive an
momento as her company had managed the event.
Not being able to see her for weeks--she was hundreds of miles
away--was driving me crazy. I wanted to surprise her and made a fan
club website devoted to her and uploaded some photographs of
her--taken by a friend on Dec 11 when she went on stage.
Also, I had wanted to write in my journal and not elsewhere as I had
wanted it all in one location. Keeping my emotions and thoughts from
running around wild in my mind was driving me crazy. In retrospect, I
should have started another journal and not wait for the original.
On Tuesday, Dec 17 I received a very angry email from her demanding
that I delete the website. How dare I published her photos on the
Internet without her permission? I was so stunned, I did as she
commanded without a moment's hesitation. I phoned her at 1 pm (we
spoke for 5 and a half minutes) to let her know that I did as she had
demanded. She was pleased that I complied and immediately let it be
known that I was on probation--I was not permitted to call her, only
emails were allowed. While she was away, I had been permitted to call
only once a day. That night I took 50 mg of chlorpromazine at 1.30 am
as I was anxious not to lose any sleep over this incident less it
trigger a depressive episode.
It so happened we met again Wednesday night at a business dinner with
a mutual client. Again, we did manage to have a few quiet words
together. She forgave me for my audacity but made it clear that I was
still on probation--I was so pleased --I told her that I had felt
awful the past 48 hours--like I had been walking on egg-shells and my
tummy was turning, churning. On her part, she agreed to return my
journal which I had lent her to read at the beginning of the month.
She, however, informed me that she didn't now need the settee she had
earlier requested from me. This was in response to my asking whether
she received the SMS giving the width of it--153 cm. She had wanted to
know its dimensions because she needed a relatively small settee to
fit in her apartment. I was crest-fallen, but perked-up when the
conversation eventually turned to less serious matters.
I left at 10.40 pm with a load taken off my shoulders.
What I need to know is what should I do next? I posted (snail-mail)
cards apologising for my error. In mitigation, I said I was driven by
my enthusiasm and the intensity of my affection for and devotion to
her and I had wanted to surprise her. I told her I had no intention of
hurting her--that was the last thing on my mind. I had learnt my
lesson and would not pull a stunt like that again.
Would flowers help? I need a woman's perspective on this. Should I
back off until Sally contacts me? If she doesn't, does it mean I blew
it? How much space does Sally need? How will I ever know when I can
get in touch again? Help!
On the night of Monday, January 6 2003, I had a meeting with Sally and
her now boyfriend, Gary. It was a business meeting with two other
colleagues of mine, but I did manage a few private words with her as
usual.
On Dec 31, when Sally SMSed me that she was already taken, she didn't
tell me who her boyfriend was, only that he was someone I knew. I
suspected it was Gary but this puzzled and confused me. On our first
date, Sally had told me that she had told Gary repeatedly--
berkali-kali --that she was not in the least romantically interested
in him. So what gives? By Monday, I had realised that Sally, like any
other woman, has the right to change her mind.
Also, on Monday night, Gary spoke of his religious convictions. He
unabashedly claimed that he had none and that he worshiped money. How
Sally could go out with him is beyond me and in that manner, she has
gone down in my estimation of her.
She looked sad and tired; and definitely a far cry from the Sally I
had met and fell in love with in November. Then, she used to smoke 3
cigarettes a day. Now she smokes much more.
Earlier that day, a mutual friend of ours, Don, had surreptitiously
witnessed a shouting match between Gary and a young lady Don did not
know. Gary was yelling and saying that he had already cancelled the
supplementary credit card he had given to his wife. It was an ugly
scene. So, Gary was married and Sally was his extra-marital affair!
One thing I know for a fact, Gary is Sally's first boyfriend and we
all know from experience that first relationships almost always don't
work out. It turned out that Gary had formed a business--a partnership
with Sally and her sister, who backed the venture financially--and is
using Sally's flat address as the business address. This was
convenient because they were living together there. Sally had resigned
her job with the event management company to work with Gary full-time.
I suppose she was impressed with the money he had thrown at her--the
"working holidays" over Christmas and New Year, gallivanting at
various resort towns (Penang, Kuantan, Malacca and Kuching) and
travelling first-class.
Of one thing I am certain--patience has its rewards--in time, God will
deliver someone better into my arms. It could be Amanda, a new
acquaintance, or even someone I haven't even met yet, but if I am true
to myself, in time I shall reap the rewards of my patience.
I hadn't expected closure over Sally to be so unperturbing. Maybe it's
the carbamazepine, a mood stabilizer I was on, but whatever it is, its
her loss, not mine.
Three months later, Don received an SMS from Gary. It read that Sally
had left him and Gary was about to commit suicide. Don immediately
called Gary. It transpired that Sally's conservative parents had
learnt of their affair and were aghast that she had lost her virginity
before marriage to a married man who was co-habiting wth her in her
apartment. Gary had spent all the money Sally's sister has invested in
the business, taking Sally on those "business trips" all over the
country with nothing to show for it. It was a scandal!
Needless to say, Sally didn't attend Gary's funeral. Neither did I,
for that matter.
A short story inspired by Shahriza Nor Hosni
It was a Tuesday evening in late November when I first set eyes on
her. The committee meeting was about to commence when she breezed into
the function room at the Prince Hotel. Our eyes met and I was
love-struck. Her eyes had spoken to me in a way words can never equal.
Through the placid pools of her limpid eyes I had a glimpse into her
very soul.
She sat down next to me, to my right. I noticed she was adorned in a
black long-sleeved figure-hugging top and beige slacks. After the
usual pleasantries, I offered to make her a cup of honey lemon tea.
She graciously accepted my offer and the rest--as they say--is
history.
She gave me her business card which spelt out her name in full but
implored I called her simply Sally. She was a marketing executive with
an event management company.
At our next meeting two days later, Sally wore a short, knee-length
black skirt which showed her lovely legs to their full advantage. She
had slender calves that looked decidedly ravishing.
Sally is petite. 45 kg or so. 5 feet 1 inch. Her body is well
proportioned--her torso is short and her legs relatively long. She
possessed lovely, pert, well-separated breasts that were neither too
large nor too small. She had broad hips for her size, which emphasized
the sexiness of her bottom, which was full, well-rounded and firm.
We had our first date--alone together at last--the following Tuesday.
It was 6.20 pm when we were driving down the road towards the traffic
lights. As we were held up in the bumper-to-bumper traffic Sally asked
me if I wasn't going to ask her if she had a boyfriend. I told her I
deduced she hasn't because if she did, she wouldn't entertain me out
of loyalty to her boyfriend. I said I'd expect she'd be faithful to
him, if she had one. She confirmed she hadn't a boyfriend although
there was this one guy, Gary, who has been pestering her. But she
wasn't in the least romantically interested in him, she said. My heart
sang with joy!
Sally asked me what I was looking for. I said " Romance ."
Bemused, she tittered and interrupted me. I was about to add--" and
sex would be nice, too "--but held my tongue. I figured prudence would
be better at this early stage of our relationship. I told her it is
nice to have someone to love and even nicer to be loved. She agreed it
was nice to be loved.
I ordered a King-sized spare rib, which I told the waitress we
intended to share. She ordered a mushroom soup and I a guacamole dip.
We shared each other's starters: How romantic! Sally assured me she
didn't have HIV but I didn't care, or rather, I took it as a given. In
any case, you can't get HIV from sharing food. Hepatitis, yes, but
I've already taken my booster jab.
For drinks, she had hot lemon tea and I had a hot honey lemon. It
reminded her of the honey lemon tea of our first meeting and she
laughed, displaying her lovely set of teeth and her ready, sweet
smile.
I told Sally I was enjoying her company and for a first date I was
very pleased with how it was progressing along. She expressed an
earlier anxiety that she had--given our age difference (I'm 44)--she
was worried we might have nothing in common to talk about. She was
glad we had nothing to worry on that score.
Sally asked me about my divorce. I told her I was not comfortable
discussing the reason as I was still on good terms with my ex. Talking
about the divorce was like betraying her trust and the private nature
of a relationship. She agreed when I suggested that she would not like
it if whatever happened between us was blabbered to other people.
Sally said she understood. Maybe when the time was ripe and if it was
relevant, I'd confide in her. But not just yet--I needed to know her
better.
Sally was quite clear that she wants me not to expect anything. I
guessed, correctly, that she did not want to rush into things and
would like things to take their course.
She asked me what I had been doing. I said my last job was as CEO of a
medical supply company. She expressed surprise that an obviously
"successful" person, a CEO no less--would take a romantic interest in
her. Her humility and total lack of vanity was the very essence of her
charm. I told her as such. She was bemused, expressing disbelief,
probably thinking I was telling her a line.
The lighting in the restaurant gave a warm glow to her cheeks and
before I could comment on it she said that the lighting made my face
look handsome. We laughed. I had a warm tingling sensation in my
cheeks ever since I realised I was in love with her. I certainly had a
buzz and she made me high.
Sally drove me home and asked if she'd like to take my dog for a walk.
I was greatly pleased when she said she would love to do so and
although she was a little afraid of Speedy who is huge in comparison
to her slight body, she eagerly accepted the idea of walking Speedy.
Speedy excitedly jumped on her a couple of times and I naturally took
the opportunity to hug and touch her to protect Sally from Speedy's
enthusiastic slobbering. We walked the length of my street and as I
was still not contented, we walked round the block as well. At some
point I asked her if it was too much to hold her hand and she promptly
replied in the affirmative. So its hands-off for now.
Our next meeting was at a more public occasion, but was lovely to see
her again and we did manage a few quiet moments to ourselves. Sally
wore beige slacks that slipped and bared her black panties. I made a
jocular remark about them--( Why do women wear black panties? In
memory of all those who were buried here )--to which she responded
with rowdy laughter.
At some stage she was seated on a barstool and I was behind her. I
eyed and admired her voluptuously broad butt. I told her I noticed
from the back that she had curvy hips. She said I was naughty to
notice such things and laughed.
We met next at a Christmas Tree Lighting ceremony on December 2. I
passed Sally a hand-written journal I had been keeping since we had
first met--it contained 40 pages of entries. Then, she said she had to
go away for about two weeks...
I only saw her briefly on Dec 11 at a gala charity dinner when I just
managed to pass her a " I Miss You! " card. She had returned
specifically for that dinner as she had to go on stage to receive an
momento as her company had managed the event.
Not being able to see her for weeks--she was hundreds of miles
away--was driving me crazy. I wanted to surprise her and made a fan
club website devoted to her and uploaded some photographs of
her--taken by a friend on Dec 11 when she went on stage.
Also, I had wanted to write in my journal and not elsewhere as I had
wanted it all in one location. Keeping my emotions and thoughts from
running around wild in my mind was driving me crazy. In retrospect, I
should have started another journal and not wait for the original.
On Tuesday, Dec 17 I received a very angry email from her demanding
that I delete the website. How dare I published her photos on the
Internet without her permission? I was so stunned, I did as she
commanded without a moment's hesitation. I phoned her at 1 pm (we
spoke for 5 and a half minutes) to let her know that I did as she had
demanded. She was pleased that I complied and immediately let it be
known that I was on probation--I was not permitted to call her, only
emails were allowed. While she was away, I had been permitted to call
only once a day. That night I took 50 mg of chlorpromazine at 1.30 am
as I was anxious not to lose any sleep over this incident less it
trigger a depressive episode.
It so happened we met again Wednesday night at a business dinner with
a mutual client. Again, we did manage to have a few quiet words
together. She forgave me for my audacity but made it clear that I was
still on probation--I was so pleased --I told her that I had felt
awful the past 48 hours--like I had been walking on egg-shells and my
tummy was turning, churning. On her part, she agreed to return my
journal which I had lent her to read at the beginning of the month.
She, however, informed me that she didn't now need the settee she had
earlier requested from me. This was in response to my asking whether
she received the SMS giving the width of it--153 cm. She had wanted to
know its dimensions because she needed a relatively small settee to
fit in her apartment. I was crest-fallen, but perked-up when the
conversation eventually turned to less serious matters.
I left at 10.40 pm with a load taken off my shoulders.
What I need to know is what should I do next? I posted (snail-mail)
cards apologising for my error. In mitigation, I said I was driven by
my enthusiasm and the intensity of my affection for and devotion to
her and I had wanted to surprise her. I told her I had no intention of
hurting her--that was the last thing on my mind. I had learnt my
lesson and would not pull a stunt like that again.
Would flowers help? I need a woman's perspective on this. Should I
back off until Sally contacts me? If she doesn't, does it mean I blew
it? How much space does Sally need? How will I ever know when I can
get in touch again? Help!
On the night of Monday, January 6 2003, I had a meeting with Sally and
her now boyfriend, Gary. It was a business meeting with two other
colleagues of mine, but I did manage a few private words with her as
usual.
On Dec 31, when Sally SMSed me that she was already taken, she didn't
tell me who her boyfriend was, only that he was someone I knew. I
suspected it was Gary but this puzzled and confused me. On our first
date, Sally had told me that she had told Gary repeatedly--
berkali-kali --that she was not in the least romantically interested
in him. So what gives? By Monday, I had realised that Sally, like any
other woman, has the right to change her mind.
Also, on Monday night, Gary spoke of his religious convictions. He
unabashedly claimed that he had none and that he worshiped money. How
Sally could go out with him is beyond me and in that manner, she has
gone down in my estimation of her.
She looked sad and tired; and definitely a far cry from the Sally I
had met and fell in love with in November. Then, she used to smoke 3
cigarettes a day. Now she smokes much more.
Earlier that day, a mutual friend of ours, Don, had surreptitiously
witnessed a shouting match between Gary and a young lady Don did not
know. Gary was yelling and saying that he had already cancelled the
supplementary credit card he had given to his wife. It was an ugly
scene. So, Gary was married and Sally was his extra-marital affair!
One thing I know for a fact, Gary is Sally's first boyfriend and we
all know from experience that first relationships almost always don't
work out. It turned out that Gary had formed a business--a partnership
with Sally and her sister, who backed the venture financially--and is
using Sally's flat address as the business address. This was
convenient because they were living together there. Sally had resigned
her job with the event management company to work with Gary full-time.
I suppose she was impressed with the money he had thrown at her--the
"working holidays" over Christmas and New Year, gallivanting at
various resort towns (Penang, Kuantan, Malacca and Kuching) and
travelling first-class.
Of one thing I am certain--patience has its rewards--in time, God will
deliver someone better into my arms. It could be Amanda, a new
acquaintance, or even someone I haven't even met yet, but if I am true
to myself, in time I shall reap the rewards of my patience.
I hadn't expected closure over Sally to be so unperturbing. Maybe it's
the carbamazepine, a mood stabilizer I was on, but whatever it is, its
her loss, not mine.
Three months later, Don received an SMS from Gary. It read that Sally
had left him and Gary was about to commit suicide. Don immediately
called Gary. It transpired that Sally's conservative parents had
learnt of their affair and were aghast that she had lost her virginity
before marriage to a married man who was co-habiting wth her in her
apartment. Gary had spent all the money Sally's sister has invested in
the business, taking Sally on those "business trips" all over the
country with nothing to show for it. It was a scandal!
Needless to say, Sally didn't attend Gary's funeral. Neither did I,
for that matter.
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