Because I’d had the root canal, there wasn’t any pain, so I didn’t go see the dentist after six months like I was supposed to.  If I had, they’d probably have detected the failure, and they might have been able to just extract the molar and leave the premolar in place.  But I’ll never know for sure, because I was just too busy to go to the dentist and put it off until I started noticing a little tenderness around that tooth this year.  By then, both roots had collapsed and had to be cut out (not pleasant).

Getting the teeth replaced requires titanium pins to be inserted into my jaw and then crowned, at a cost of $12000 in total.  Next to that, the crown I need (to replace a 15 year old root canal filling) seems downright cheap.  In fact, I’m going to get another molar crowned as well, because it is at risk of cracking and having the same problem as the molar I had extracted.  $1200 for a crown looks pretty good compared to $500 for an extraction and $6000 for an insert.

Why are my teeth so crappy?  Well, it’s not because I don’t brush them regularly or well.  In fact, it’s a little galling to have two teeth removed and then have the dentist and the hygienist gush about how wonderfully clean my teeth are and how I have such excellent oral hygiene.  Make is seem even more unfair.  Nope, it’s probably mostly genetic.  Pretty much everyone in my family has fairly crappy and weak teeth.  Growing up on Waiheke where the water doesn’t contain fluoride probably didn’t help either.

So, if you haven’t been to the dentist in a while, make an appointment now.  Better to spend a little up front than have to spend a huge amount later on.

Pleasure procrastinators apparently put off doing things and just can just relax.  I can’t do that.  No matter what I’m doing, I feel constantly guilty about all the things I should be doing instead.  And I don’t usually relax when I’m procrastinating.  Instead, I put off important work to do things that are much less important, or often, don’t even need to be done at all (especially by me).  And I’m not a disorganised procrastinator, I don’t put things off because I wrongly estimate how long it will take.   And I always do manage to get everything done in time – I don’t miss deadlines.   In fact, I’m pretty good at knowing exactly when I have to stop procrastinating in order to get something done by the deadline. 

The self-doubt procrastination come in whenever I’m not sure exactly what to do or how to do it.   It’s easiest to just put things like that off and work on things that I do know how to do.  This is particularly true with big projects – it’s hard to know where to start.  That’s how come I end up working on trivial things instead of important things.  They’re concrete and well defined and don’t require any difficult thinking.

I tend to be a binge worker.  I’ll work with full effort for months on end, 7 days a week, 12+ hours a day until I just burn out and can’t do anything.   Usually I get sick at the end of every semester and spend an entire week at home not doing anything except lying in bed or on the couch.  I don’t have the energy to get out of my dressing gown, let alone check my email or do anything productive.   And then as soon as I am better, I have to catch up on what I missed when I was sick.  I don’t actually get to properly rest and recharge ever.  The last time I went on holiday was when I went to Texas a few years ago, and even then, I couldn’t stop feeling guilty that I wasn’t working on my thesis.

I have this feeling that I don’t deserve to take a break until I’m finished everything that I need to do.  So I can never relax properly because I’m constantly guilty about not working.  I worked 10 hours every day this week, and 14 hours one day.  I worked 8 hours yesterday (Saturday).  I went into work for half an hour this afternoon (Sunday).  And now I’m sitting here watching the boats on the harbour and typing this with a guilty feeling that I should be working right now instead.  Like I’m slacking off.   I know it’s not rational – the University does not expect me to work 7 days a week.  And there will never be a time when I’m finished all my work – there’s always more to do.   But I just can’t get rid of this constant guilt.

So far, my regular charity ‘portfolio’ looks like this:

• Unicef Global Parents
• Kiva.org
• NZ Breast Cancer Foundation
• Auckland Rescue Helicopter Trust

This year I also supported the Atheist bus campaign, although I’m unlikely to make that a regular thing.  Since my kiva lending will keep rolling over, I’ll have more money to spend next year,  so I’m still on the lookout for other charities to support:

• Charities that hand out condoms
• Something with an environmental/conservation slant
• Groups that support education, particularly science education for kids or, even better, educating parents about the importance of educating their kids

And part of my official letter from the university confirming that I’m really finished:

I have no plans to change the name of my blog just yet though.  There’s still plenty of procrastination to be done, even if it’s not specifically thesis procrastination.   Suggestions for a new title welcomed.

The CT scan I was supposed to have never happened – I lucked out and they had a free surgery slot open up on the Monday and they put me in it.  Saturday and Sunday I was mostly just waiting, popping painkillers and tethered to my drip.  Fortunately, they gave me a much nicer hospital gown that didn’t risk causing everyone nearby snow blindness every time I got out of bed.  It was actually very comfortable.  I wasn’t eating anything because the pain was too unbearable, so between visitors, I mostly just marked my exams, txted people and dozed.

The surgery itself was fairly uneventful – I put on the surgical gown (no arse coverage at all), the sexy compression stockings, signed all the consents, met the surgeon, surgical nurse and anaesthetist and listened to them explain what was going to happen.  They put an oxygen mask on me, put something in my IV line and I went straight to sleep.   I came to when they were lifting me off the operating table onto my bed and wheeling me into recovery.  I was only in recovery about 15 minutes, getting morphine every time the pain went above a 3/10. 

I got back to my bed to discover my mother waiting, along with some lovely bunches of flowers.  I showed off my 9 large gallstones (3 were donated to science) and was pretty much too groggy to do much except sleep for the rest of the day.  It was actually several hours after the surgery that I realised I had a rather large tube sticking out of a hole in the middle of my stomach, there to drain any blood and liquid away from the internal site of the surgery.  Moving was extremely painful, although not because of the surface wounds.  The pain was actually deeper, in the muscle, and felt rather like I’d done the most hideous killer abdominal workout ever devised.  The surface incisions weren’t stitched and started bleeding every time I moved though, so I had to had my dressings changed often.  

The most annoying part was that I couldn’t roll over at all and had to sleep on my back, which I’ve never been very comfortable doing.  The next few days were mostly spent resting and having my dressings changed frequently.  I could eat again, without pain, although frankly, with the quality of the food I was getting, I still preferred not to.  I’m sure the regular hospital food isn’t bad, but to avoid stressing my bile ducts, they had me on a low fat diet, which was awful.  I was craving protein something awful.  I was actually relieved when they put me nil by mouth again for Thursday’s procedure.

Although the surgery went according to plan, they weren’t able to clear my bile duct so on the Thursday I had to have an endoscopy to check it and clear it if necessary.  They didn’t knock me out for it, just sedated me and gave me something to numb my throat.  I could feel the camera thingie bumping against the inside of my stomach and duodenum all the way down – a very bizarre and unpleasant experience.  Fortunately they were able to clear the duct fairly quickly and it was all over in a few minutes.  I only started gagging just as they removed it from my throat.  The sedative they gave me was awfully powerful and I ended up sleeping almost all the rest of the day.

And finally, on the Friday, a week after I was admitted, they removed all the various tubes that were sticking out of me.  I learned firsthand the value of direct pressure on a wound.  IV lines tend to bleed very heavily when removed, but you press hard on them for a minute or so and they close right up, not even needing a sticking plaster.  

Removing the drain tube from my stomach was a rather more interesting procedure.  It was stitched in place, and penetrated a few inches through the muscle, so I thought.  The nurse cut the stitch away and told me to take a deep breath and hold it, as she pulled about 20cm of tube.  Then another deep breath and another 20cm, followed by a third deep breath and another 10cm or so.  There was over half a metre of tube inside me and for the life of me I can’t figure out where the hell it was.  It sure didn’t feel like that much at the time.

Finally, after all this (and a little bit of paperwork), they cut off my hospital bracelet and set me free!

I’m pretty damn lucky to be living in NZ.  I know people in the US who have had to pay thousands of dollars to have this surgery, never mind the cost of a week in hospital.  Using the Southern Cross health insurance scheme costings, I consumed over $20k worth of healthcare, and it didn’t cost me a single cent (well, not directly).  I am a huge fan of socialized medicine.

After three days, I was almost out of tramadol and got myself the next available doctors appointment.  It was two days away so I had to beg drugs from my sister to get me through til then (fortunately her medicine cabinet was well stocked).  The doctor gave me a heap more tramadol and sent me off for some blood tests the next morning.  The day after the blood test, the doctor phoned me at home in the morning to tell me something was seriously wrong with my liver and I needed to get myself off to the hospital for some tests.

The hospital admission was pretty quick and painless – less than 5 minute wait in the emergency department, less than 10 minutes in the waiting room at the admission and planning unit (APU) and then I was handed a hospital gown and told to put my clothes in a brown paper bag.  The hospital gown was the stereotypical one that doesn’t cover your arse, but once I was in bed, it didn’t really matter.   There was lots of waiting around as various nurses and doctors came and spoke to me, and several people came with needles to suck my blood.  Eventually they put a drip in my arm and left me alone for a little bit.  When I say alone, I mean in a very noisy ward with 6 other patients and their visitors, nurses and doctors.  Fortunately, I had a book and my cellphone to keep me amused until they came and wheeled me off (bed and all) to radiology for an ultrasound.

If I’d had the ability to twitter from my cellphone, I would’ve had a constant array of things to complain about.  The guy next to me had his condition and medication regime explained to him three times (by the doctor, nurse and pharmacist) and claimed to understand what was going on.  When his family showed up and asked him what was wrong he suddenly seemed to forget, insisting that he didn’t know what was wrong, that he hadn’t seen a doctor, and that nobody had told him anything except that he was going home and had some new pills. 

They guy opposite me gave a very loud and detailed narration of his rectal bleeding, another woman had to have her blood sugar monitored every half hour, and the nurses came and took my pulse, blood pressure and temperature every hour.  I felt great pity for the orderlies who had to wheel me around as my hospital bed had a mind of it’s own and wanted to go sideways rather than forwards. One orderly told me it was probably older than him and I combined.   It was like being in a dodgem with the steering stuck – we basically just bounced of walls and doors and trolleys all the way to radiology and back.

It was about 4pm before a parade of specialists came with the news that they wanted to do a CT scan the next morning so I’d have to say overnight.  On the plus side, they were finding me a bed upstairs so I didn’t have to stay downstairs with all the swine flu sufferers.  Unfortunately, they didn’t move me until nearly midnight so I had the opportunity to try and go to the bathroom in a hospital gown and to experience the Loudest Snorer in the History of the World. 

Rectal bleeding guy was bitching and moaning about the noise made by the nurses taking a history from the newly admitted woman next to him and went and sulked in the TV room for a bit, complaining it was too loud to sleep.  He didn’t come back til about 10pm, so I managed to snooze a bit beforehand, but when he came back, we all found out what too loud to sleep really meant.  I have never in my entire life heard anyone snore as loud as this guy.  I swear everything in the room was moving towards him as he sucked in each breath with the noise of a jet engine.  I tried covering my ears with the pillow but it didn’t do the slightest bit of good. 

It was at this point that I’d better go to the toilet.  Unfortunately, the toilet was out in the corridor.  Not only did I have a gown that required me to hold it closed at the back so as not to reveal my arse to the world, I had a drip stand to manoeuvre with my other hand.  I managed to negotiate my way to the loo without mooning anyone, but then I had to open the toilet door.   It swung outwards, meaning I had to grab it and step back.  Stepping back meant I had to hold onto the drip stand, and so my only option was to flash my arse to everyone in the vicinity.  Fortunately APU isn’t particularly crowded at that time of night, but still, not one of my most dignified moments.

Because I was concentrating so much on not flashing my arse to strangers, I hadn’t noticed that my drip had actually stop dripping and was now actually running in reverse – the entire drip tube up to the bottom of the drip itself was now full of my blood.  Fortunately on the way back to my bed, I ran into the nurse who told me it was normal and nothing to worry about, despite how scary it looked.   Even more fortunately, the nurse had  ear plugs for everyone – the industrial ones my brother uses when guiding helicopters and planes at Whenuapai.  And even with those on I could still hear the Loudest Snorer in the History of the World(although it was muted enough that I could sleep).

Still, I was extremely happy when and orderly came and took me upstairs to the lovely quiet and peaceful gynaecology ward, where I got a new super-comfortable, non-squeaking, automatically adjustable bed.  Yay!

To be continued.

Kiva is a web-based US microfinance organization.  They partner with institutions in a variety of countries in developing countries to offer loans to people who need them to support their businesses.  Most of the loans go to sole traders or family businesses.  The people to whom I have loaned grow vegetables, raise cattle, run general stores, sell soft drinks, beer, hats and a variety of other goods.

The local partner microfinance institutions provide information about the loan repayments, and Kiva has a system of fellows who do volunteer work uploading profiles of all the borrowers and making regular updates about the progress of their business.   The interest rates are not too bad by the standards of our country, at around 20% or more (although this is comparable to the unsecured rates we are charged, for instance on credit cards).  However the lenders generally don’t qualify for bank loans in their countries and would normally have to borrow through loan sharks at extremely high interest rates (varies by country but the average is over 85%).    The field partner also usually provides a program of business mentoring and support along with the loan.

The standard contribution each person makes to a loan is US$25.  Most loans are in the vicinity of US$500 – US$1000 so many Kiva lenders share in each loan.   The two main risks are that the borrower doesn’t repay the loan to the field partner, and that the field partner pockets the money rather than pass it on to the borrower or back to Kiva.  Both have happened in the past, but Kiva has a system of volunteers to check up on the field partners to try and reduce the latter risk.

The borrowers usually repay the loans a little bit each month over terms ranging from 6 months to 2 years, and the field partners settle up with Kiva the following month.  As soon as $25 is repaid, the lender can re-lend it again to another person.  As this is charity, Kiva lenders don’t receive any interest.  Kiva tries to fund itself through donations, and the interest charged to the borrowers goes to fund the work of the field partners.

I started a month or two ago with 8 loans, which are now between 8% and 33% repaid. I was able to make another loan this month, and should be able to make another in a couple of months time.  I like the idea that this is like a donation that can be reused again and again to help people.

The problems faced in developing countries are quite different from most of the western world.   More than half of the people born in the poorest countries will die before the age of 5.  The root cause of most of these deaths is poverty.  Most people do not even have clean water to drink or adequate shelter, never mind things like vaccinations, antibiotics and medical care.   Malnutrition is  a huge problem, with the WHO pinpointing it as the single gravest threat to public health.  Malnutrition is the biggest contributing factor to child mortality.

There are many charities working on various health problems faced in developing countries: providing measles vaccinations, malaria nets, cheap antibiotics and anti-retrovirals.  Other groups try to provide clean water and sewerage systems to try and reduce water-borne infectious diseases, or to provide medical clinics with trained doctors and nurses to try to improve public heath.  Other charities take an education approach, particularly health education.  With low literacy rates impeding the transmission of information, many segments of the population in developing countries don’t know basic useful information like mosquitoes cause malaria, or washing hands before handling food cuts down on food-borne illnesses, or that HIV is sexually transmitted.

But what if these groups succeed?  What if we vaccinate against all the infectious diseases, eliminate malaria, get HIV under control and reduce the incidence of water-borne diseases?  What if most of those children who currently die before the age of 5 survive until adulthood?   If malnutrition is currently such a big problem, how much worse will it get if we find solutions to all the other causes of death?  How will we feed everyone?

There is an oft-repeated statistic about how the world’s annual food production is sufficient to feed the entire world.  However, the world has not solved the systemic logistical problem of distributing that food so that everyone gets it.  If we solve (or even partially solve) the other health issues without making enough progress on the hunger front, things are just going to get worse rather than better.

Solving the hunger problem helps the other health issues as well, since malnutrition makes people more susceptible to diseases.  But there are two ways to solve the hunger problem. One is to improve the quantity/distribution of food.  The other is to reduce the number of people.

Now, I’m not talking about killing people, or even letting people die.  But what about preventing so many people being born in the first place.  For instance, in the Democratic Republic of the Congo, the average woman has more than 6 children, and 3 of them die before the age of five.   There is a 10% HIV rate in the Congo, with HIV now being one of the leading causes of death of people who reach adulthood.   I’m sure that at least some of the women, if they had the knowledge and access to them, would choose to use condoms both to prevent HIV infections and to prevent pregnancy.  If you can’t even feed the children you currently have, wouldn’t you choose to not get pregnant again, given that the chances are high that the result of the pregnancy will be that you have to watch your child die?

To follow this line of thought to its conclusion, the two best forms of charity we can give to developing countries are:

1. Supporting the distribution of condoms and education people about their use
2. Supporting the systematic improvement in food production and distribution (rather than one-off transfers of food aid)

Some charities operate locally, some nationally and some internationally.  The adage ‘charity begins at home’ would suggest starting with local charities.  But even the worst-off people in New Zealand have a standard of living that is astronomically higher than millions of people in third world countries.  The same amount of money could potentially make a much larger difference overseas.   

And then there is the question of what type of charity to give to.  Charities usually work in a small niche:

• Health:  breast cancer, child cancer, cancer, heart disease, asthma, haemophilia, MS, deafness, blindness, diabetes, AIDS,  Alzheimer’s, arthritis as well as various hospitals and hospices
• Victims of crime: Sexual Abuse Help, Rape Crisis, Victim Support
• Children: Kids First, Starship, Barnados, Make A Wish, Books in Homes, Plunket, La Leche League
• Old people: Grey Power, Age Concern, Meals on Wheels
• Animals: Anti-vivisection, SPCA, Project Jonah, and various specific charities devoted to helping particular endangered species
• Human rights: Amnesty International, Doctors without Borders, Human Rights Watch
• Social stuff: Rescue helicopter, St John Ambulance, Surf Lifesaving, Coastguard, Search & Rescue, Citizens Advice Bureau, Habitat for Humanity, Safer Streets, Youth Suicide prevention
• Poverty: World Vision, Unicef, Make Poverty History, TearFund, Christian Children’s Fund, Oxfam, Red Cross
• Environmental: Greenpeace, Sea Shepherd, WWF, Royal Forest & Bird Protection Society

While obviously all of these charities do good work and are important to the people they affect, there is clearly a big difference in the type of impact they can make.  $2000 given to the Make A Wish foundation can help a terminally ill child (who has had the best medical care available) go to Disneyland before they die.   It could provide a tenth of the cost of training a guide dog so a blind person can have independence and a higher quality of life.   But that same amount of money spent on vaccines, antibiotics, malaria nets or even food, could probably save the lives of multiple people.

The effectiveness of the charity should be a consideration.  Some charities spend most of the money they raise on administration and fundraising costs, with very little of the money actually being put to a useful purpose.  These costs are necessary to enable the charity to do anything, but ideally, I’d want most of the money to actually be used to do good.

My final consideration are the ‘side effects’ of the charity.  For instance, PETA funds the Animal Liberation Front, which is committed to using violence to advance the cause of animal liberation.  Greenpeace sometimes goes over the line with dangerous and violent tactics to stop whaling and logging operations.  And many charities provide services with religious overtones.  The help they give people comes with the attached string of having to convert to a different religion.  And even where that isn’t required, many are doing immense harm by spreading misinformation about HIV and condom use and by preventing access to any form of birth control.

How do you balance all these tensions?  Which charities do you support?

Tonight’s class seems a huge step up from the previous level.  The tutor spoke in Spanish almost the entire time, and there were lots of things that other students seemed to know that I’d never come across before (like words for animals and fabrics).  However, I’m not too badly off – there were a few others there who seemed to know even less than I do.

Tonight was mostly about reviewing the basics – greetings, numbers and letters, introductions and basic personal information, the verb ‘to be’ and conjugations for a few of the most common regular and irregular verbs.  At one point, we were going around the class describing our personalities and one guy says ‘Soy caliente’.  Caliente means hot in Spanish.  He was trying to say he’s hot-headed and impulsive but we laughed a bit because we thought he was saying that he’s hot (as in attractive).  Turns out that if you use caliente in that context, it actually means ‘I’m horny’.  The tutor was too embarrassed to translate it out loud but he wrote some of the letters on the board until we got the idea.

Then he was talking about how someone would refer to themselves as being hot, as in attractive, and made me rate the guy as to how attractive he was, asking if he was a 60 or an 85 and saying he wouldn’t move on with the class until I’d given him a rating.   I said cien (100) and everyone laughed and the guy made a great show of thanking me.  When it came my turn, I described myself as optimistic, and everyone laughed when the tutor said that my rating the guy 100 was an example of that.

We have to do a regular writing exercise to practice our sentence composition skills.  Currently we only know how to speak in present tense, so we have to keep a diary describing our daily activities in present tense only.  Here’s my first week’s exercise (I have no guarantee that this is in any way correct):

Yo vivo en un apartamento en el centro.  Me levanto a las siete y media todos los días.  Mi trabajo es muy cerca de mi apartamento.  Por la mañana enseño en la universidad.  Hay ochenta y ocho estudiantes in mi clase.  Por la tarde trabajo en mi computadora.  Por la noche, mis amigos y yo bebemos tequila.

My intended translation is this:

I live in an apartment in the city centre.  I get up at 7:30 every day. My work is very close to my apartment.  In the morning I teach in the university.  There are 88 students in my class.  In the afternoon, I work at my computer.  In the evening, my friends and I drink tequila.

My love of tequila is a running joke in the Spanish class, and the tutor makes frequent reference to it.  Another student is travelling to South America to meet girls, and so the tutor often makes reference to him being sad because he’s single and mentioning him finding a girlfriend.