Sunday, March 31, 2013

A Burden of Proof

"Ei incumbit probatio qui dicit, non qui negat."

Latin legal expression

And it says, "The burden of proof lies with who declares, not who denies."

I lead a rich, colourful second life on the internet, on public fora, social media and behind the curtains of private messages. People might accuse me (and people like me who conducts the bulk of their correspondence in zeroes and ones) as antisocial hermits. Many have lamented the fate of humanity when they see a group of friends all completely absorbed in their smartphones, ignoring one another, while they text rabidly to far away individuals outside the prison of proximity. That is a perplexing a complaint to me because in my opinion, we are communicating far more robustly than we used to. The set of "people in the same room as you are" is too small a sample size to contain many people who you would like to converse with, if there are any at all. That is a statistical fact.

There are many notable exchanges I had in the past but I must quit my full-time job if I want to document every single one of them here but occasionally, I have one which is short, concise and significant enough that is worth writing about.

On Choosing Atheism or Rather, Not Choosing Atheism.

I had one such dialogue recently, and it began when someone who fancies himself as an apologist for Christianity asked me the following question:

"I'm just curious about what made you embrace atheism as your worldview. Was it because you found no evidence for Theism? Or was it because you found atheism more plausible? Hope you don't mind me asking."

Yes, he is the sort of person who capitalises the T in theism.

My answer, to summarise and rephrase, sought to clarify that I did not actually "embrace atheism as my worldview." I just simply don't can't believe it when people claim that their favourite god or gods exist because my threshold for acceptance have not been met - it is not a choice. I cannot accept such extraordinary claims based on no evidence whatsoever. It is like posing the question, "Why don't you eat bananas?" to someone who doesn't have any bananas. Even if I want to, I can't.

With that out of the way, I want to talk about the real meaty part of the discussion.

On the Burden of Proof, and Shifting It.

After a few to-and-fros, he posted the following message to me,

"You seem to be stressing that your atheistic-agnostic worldview doesn't need to have positive arguments because by definition it is a default position. I don't think I will concede that, Dr. Kok. To me, atheism (and agnosticism) is a worldview that claims to be exclusively true while holding every other worldview to be false (kindly correct me if I'm wrong). However, as you put it, it doesn't need to make a positive argument. That is a poor philosophical assumption. Let me ask you a simple question, how do you know atheism (or agnosticism) is true? Is it because all other worldviews are false? I mentioned in my last debate that the absence of evidence is not evidence of absence. It is possible to disprove the existence of fairies from a Christian Theistic perspective. Two steps needed:
1. I need to give evidence (positive arguments) for Christian Theism.
2. I need to demonstrate why fairies are incompatible with Christian Theism.
Ergo: It would logically follow that fairies do not exist. If fairy-advocates wish to justify their position, they need to demonstrate that CT is false and then erect positive arguments for the existence of fairies. I cannot just sit back and tell people that just because fairy-proponents are unable to provide sufficient evidence that they are therefore false. It would be absolutely arrogant to do so."

What the Apologist did, in so many words, was play a game called Shifting the Burden of Proof and calling me arrogant in the process, but let us ignore the obvious hypocrisy of it for a moment. To expand on my earlier clarification that atheism is not a worldview I have chosen, atheism is a reaction to the claim that God exist. If no one in the history of mankind have conceived of the idea of God, then atheism cannot exist. Atheism is not a claim or even a counter-claim. It is the rejection of a claim.

Now, the Apologist basically wants me to prove that there is no God. To demonstrate how crazy and illogical that is, consider the following picture,

Burden of Proof Comic
Yeah, that is how theists who ask me to prove the non-existence of God sound to me.

In a court of law, one of the manifestations of the burden of proof is the presumption of innocence - or as it is popularly expressed, "innocent until proven guilty". If you want to accuse someone of committing a crime, you must furnish the proof. The defendant is assumed to be innocent until you can prove him or her otherwise beyond reasonable doubt.

Moving out of law and into science, there is a concept known as the null hypothesis - something I picked up in from my statistics, research and journal-writing lectures in med school. So what is it? Let's pretend we are running a scientific experiment to investigate if being Christian affects a person's susceptibility to catch HIV. So, we will get a bunch of people, divide them into non-Christians and Christians, and then test them for HIV. There can be two possible inferences or outcomes,
  • There is a relationship between being Christian and the susceptibility of catching HIV.
  • There is NO relationship between being Christian and the susceptibility of catching HIV.
The first one is what we call the alternative hypothesis, or the claim we are really testing for. The second one is our null hypothesis, which is the default or negative statement. Experimenters with try to disprove the null hypothesis and an experiment can only reject the null hypothesis, or fail to reject it. So, drawing from the example above, if we cannot find evidence that being Christian is correlated with HIV infection, then we would have failed to reject the null hypothesis. To bring it to a real world example, in a drug trial which fails to reject the null hypothesis, we would consider that the drug is useless for what it was tested for.

Anyone with half a brain can immediately see the parallel between this and the god question, which can be formulated as the following hypotheses,
  • God exists.
  • God does not exist.
If we cannot prove God's existence, then we would have failed to reject the null hypothesis of "God does not exist." And therefore, we should assume the agnostic atheistic position until proven otherwise. After all, we aren't going to take a drug that failed to show any evidence that it works.

In all aspects of life, we expect the burden of proof to fall upon the claimant. In court, a person is innocent until proven guilty. In science, we assume the null hypothesis until the alternative hypothesis is proven true. If someone tells you that he had seen Batman, you wouldn't believe him until he proves to you that he did, right?

Only when it comes to God do theists like the Apologist ask for special treatment for their personal beliefs. They want you to prove that there is no God. You know why? It is because they have utterly failed to prove that God exists, and all they can do is muddy the issue and try to shift the burden of proof when it is really their burden to bear.

On Realising When the Burden of Proof is Being Shifted.

"I am not arrogant. It is just that you are crazy for asking me to prove that you don't have a baseball God doesn't exist," I told the Apologist, which elicited the following response from him,

"You are right about one thing - that namely we are innocent until positive proof of guilt can be found. Atheism claims that all worldviews are guilty of falsehood and yet promptly denies the responsibility of providing positive arguments in its favor. I guess that's supposed to be a logical proposition to you. Anyhow I want to suspend this conversation with you because I think when intelligent arguments fails and name-calling emerges there can be no decent outcome. Thank you though for engaging in dialogue."

Bitch please, I was right about everything.

See what I mean about apologists trying to muddy the issue and stealthily attempting to pass off baloney as logic? To repeat myself, atheism is the denial of a claim, the DIRECT OPPOSITE a claim. He disingenously re-characterised the atheistic position as one that claims that all other theistic worldviews are false, essentially turning rewording atheism to make it sound like a positive claim, a worldview comparable to Christianity, Hinduism, Zoroastrianism and other such fairytales. Forgive me if I remain unimpressed at this cheap syntactic trick that essentially tries to say that blue is really red. That is theistic logic for you.

Remember, I never said "There is no God." I am always asking, "Where is the proof of God."

Incidentally, this is also what we call building a strawman, and if you can picture a man made out of straw, you'd see it as something that superficially resembles a man (but isn't one) which is flimsy and could easily be knocked down. Likewise, the Apologist's description of atheism is one that only superficially resembles atheism (but isn't), so he gives the appearance of having refuted my argument, while slyly avoiding the substance of my argument. However, I am too experienced in spotting logical fallacies to let this one slip by me.

I see what you did there bird
You have to wake up way earlier than that to sneak one past me.

Besides, characterising atheism as a worldview comparable to any number of theistic beliefs smells of that tired "atheism is a religion" canard oft-repeated by theists. Saying atheism is a religion is like saying not-collecting stamp is a hobby, that baldness is a hair colour, or that unemployment is a job - further demonstrating the Apologist's poor grasp of informal logic.

He also tries to sit in the admittedly very cushy chair of being "innocent until proven guilty" in his reversal of the courtroom analogy. To read between the lines, he is basically saying God exists until you prove he doesn't. He had come full circle and assumed the role of the stickman in the comic above who claim he has a baseball, and when asked to produce said baseball, announced indignantly that no one can prove he doesn't have a baseball. Even if we search every crag and crevice in the entire universe to look for this elusive baseball of his, he could still claim that his baseball is invisible and lies outside of time and space. Sound familiar? Using this strategy, anyone can claim that anything exists on the virtue that it has not been disproven. Like Delos Banning McKown said, "The invisible and the non-existent look very much alike." My money is on non-existent.

As you can see, the Apologist also chose to end the discourse because he thought I was insulting him by calling him crazy. What a hypocrite, I thought to myself. He had the cheek to call me arrogant first and then got his panties all in a bunch when I responded in kind. Why, his absent God's book has something to say about that in Romans 2:3,

"And thinkest thou this, O man, that judgest them which do such things, and doest the same, that thou shalt escape the judgment of God?"

Judging from this one specimen I interacted with, I am starting to see why they have chosen to call themselves apologists. They seem like a sorry bunch to me.

Burden police,
k0k s3n w4i

Tuesday, March 26, 2013

The 25th March 2013 Fire at the Sarawak General Hospital

"Seems to me the basic conflict between men and women, sexually, is that men are like firemen. To men, sex is an emergency, and no matter what we're doing we can be ready in two minutes. Women, on the other hand, are like fire. They're very exciting, but the conditions have to be exactly right for it to occur."

Jerry Seinfeld

At 8:27 PM yesterday, one of my colleagues working the night shift in the Paediatric Intensive Care Unit (PICU) texted in our departmental Whatsapp group for house officers,

"Kebakaran!!!" wrote Olivia.

Unlike the cry of "fire" in the English language, the Malay word "kebakaran" specifically carries the meaning of a destructive fire-related event separate from the actual Malay word for fire, which is "api". That is besides the point, I know. I thought it was a joke but she confirmed it,

"Yes, in the hospital. Evacuating patients. LOL."
I didn't add that. She really did say LOL.

Another house officer working yesterday night posted the following blurry camera-phone picture,

SGH Fire
At the main entrance of the SGH.

And it wasn't a drill. Sarawak General Hospital made like Nero's Rome and burned. It was only successfully doused at about 9:30 PM and from real-time updates provided by my colleagues-on-duty, I assumed that it wasn't too bad because the evacuated patients were later carted back to their respective wards where they can continue dying at their own leisurely pace. Speculations were abound. As the smoke rose from the corner of the main building where the linen department's located, many assumed that someone must have dropped a cigarette butt into a basket of scrubs or something.

I am working tonight but this morning, I had to go to the hospital to give a presentation on vesicoureteric reflux. After that was dealt with, I hotfooted to the linen department and found that business was proceeding as usual there. After exploring the perimeter of the hospital for a couple of minutes, I found the site of interest right outside the west wing of the main hospital block. There were yellow tapes to keep the riffraff out but introducing myself as a doctor working in the PICU, I simply waltzed in and mingled amongst the fire investigators, journalists, and maintenance company reps.

SGH Fire 01
It was the utility shaft.

I spoke to a firefighter on site and he told me that they were currently investigating how the conflagration conflagrated, and were questioning witnesses, taking pictures, looking at schematics, interviewing reps from the company responsible for maintaining the utility hardware and scribbling down notes and schematics - y'know, serious fire-investigating business.

As you can see in the picture above, the two biggest blackened pipes (which seemed to have grown some bumpy warts on them) are part of the air-conditioning system of the hospital and the extreme heat had warped the foam insulation around them. The smaller pipes carry all the other stuff that a hospital needs like water, nitrous oxide, medical air and oxygen. We were very lucky that the medical air and oxygen conduits didn't go kaboom and take half the hospital with it (the PICU, where I am currently posted in, is right above the spot). Those pipes were lined with asbestos. And considering that it happened right outside the Radiology Department, we could have lost our very, very, very expensive scanning equipments - even without the stopping power of a cinematic explosion.

I spoke to an electrician and he told me that the inferno probably started from the high voltage wires that also run in the utility shaft and one of them is a humongous, python-thick cable that supplies our MRI machine. I have no idea how much power is required to keep an MRI machine running but the cost of the maintenance of just one can go into obscene seven digit figures in just one year. He thinks that one of these cables must have overheated and cooked the shaft until it is crispy.

SGH Fire 03
A photographer taking pictures of the exposed MRI power cable.

SGH Fire 05
Here is a closeup.

I am no engineering expert, but having incredibly high voltage cables in the same utility shaft where a large pipeline filled with compressed oxygen also runs sounds stupidly dangerous to me.

And just in case you are interested, the utility shaft runs from here,

SGH Fire 06
The powerhouse of that keeps the hospital running.

To here,

SGH Fire 07
A hospital that is barely running.

While the Radiology Department is still semi-operational, all the MRI scan appointments were diverted to the MRI suite over to our sister hospital, the Heart Centre (PJHUS) and we have no idea when we can start firing up our machine again. Also, only emergency CT scans would be entertained for the day due to a risk of overheating. I heard that they were going to tear up the concrete-entombed part of the utility shaft to investigate further and repair the damage - so it is definitely going to take awhile.

The PICU smelled like people had been barbecuing char siew in there all night long and that made me hungry so I went to have char siew rice for lunch. The air-conditioning seemed to have gone kaput so I am seriously dreading tonight when I have to report for duty. Does it make me evil that a small part of me wish that the PICU was blown to smithereens just so I don't need to go to work? After the very sick children and babies were evacuated, of course. I am not a total monster.

Patients lodging at the billing counters. Photograph courtesy of Nadim Bokhari.

No one died.

Insider source,

k0k s3n w4i

Sunday, March 17, 2013

The Fates of Babes

"It is easier to build strong children than to repair broken men."

Frederick Douglass

I feel that the very centre of my being beats the heart of a storyteller. It is the reason why I write. I consider everything that happens around me to be unformed and untold stories, and it is my responsibility to drag them out of the chaotic neverending narrative that is reality, and define them. Every story that gets washed away in the currents, distorted by time and diluted to oblivion by amnesia is as good as if it never happened at all. When I write a story down, it lives on in words.

I have been in the Department of Paediatrics for about a month now and while there are many stories I wish to tell, none is quite worth the telling as much as the one I am about to tell you. This is a true story, and rumour has it that there is nothing quite as strange as the truth.

There is an infant about a year old who was recently admitted to my ward with the startling diagnosis of kwashiokor - startling in the sense that it is the sort of thing one would encounter in the hungry depths of most wretched Africa, not in bounteous Malaysia. Kwashiokor is a form of malnutrition where a child is disproportionately starved of protein in his or her diet, while receiving a relatively high amount of carbs. Protein is Very Important, as you can imagine and it is needed in a lot of essential bodily processes. It is needed to make antibodies, so a kwashiokor child is often susceptible to serious infections. It is needed for growth, so that child will fail to grow and thrive. A kwashiokor child is often identified by his grossly bloated belly and general swelling of his entire body - because one of the things protein does is keep water in your blood vessels. When you are deficient of protein, it allows plasma (the watery bit of your blood) to leak out into all your other tissues. This is a simplified explanation of what kwashiokor is because I am telling a story, not teaching a class. Anyhow, I am sure that all of you have an image of that stereotypical starving Somali kid with an upsettingly large belly in your minds.

Upsetting right?

The kwashiokor baby in my ward was bloated and weak. His teeth were all rotten and brown. He was developmentally retarded. He lies on his back like an upturned French bulldog puppy all day long unable to turn himself, being irritable and miserable, when infants his age are taking their first steps. Have you seen babies taking their first steps? They have that huge goofy ecstatically surprised grin on their face that seems to say, "I IS WALKING! OMG OMG OMG!" Jesus walking on water is a cool story. This is a real everyday miracle.

The mother is young, uneducated and impoverished, and the baby probably ended up this way due to her deficient understanding of nutrition or the need for a balanced diet. It made me angry. It made me think that there should a competency test for anyone who wants to be a parent because as she had proven beyond reasonable doubt, it is in fact possible for a person to be too stupid to mother. Then, I felt angry for the conditions that nurtured her ignorance, her lack of access to sound education (even though she is younger than I am).

But this is not the story I want to tell.

A couple of days ago, the police brought an Iban child in and put him under our care. He seems to be about four years old but there was really no way to be sure short of cleaving him apart and counting his rings. This very young child was found loitering at the Bormill Estate outside a coffee shop with nothing more than a cheap backpack on his back. The passerby who brought him to the police station said he was left there by his parents. Having no identification on him, there was no way of finding out who his parents are. He was dirty. There were scabs on his scalp. Coincidentally, he was then placed in a cot beside the one occupied by the kwashiokor baby and his mother - possibly because the universe remembers how misery loves company.

The first day he was in the ward, he wouldn't talk to anyone and was going through cycles of crying, sleeping and then crying again. During our clinical rounds, after failing to console the boy, the mother of the kwashiokor baby looked over to his cot and started chastising him in his native tongue, to our surprise. She seemed to know this child so I asked.

"This boy is my brother," she answered.

She went on to explain that her father had left her mother and went on to start another family with another woman - and this presumably abandoned child is really her half-brother. Whoa, I really didn't see this coming!

What is the chance that this kid would be abandoned by his parents at about the same time as the kwashiokor baby was brought in? What then is the chance that they would be admitted in the same ward and placed in cots beside one another? I am not a mathematician so I don't know the answer to those questions but I am sure "damn hell improbable" is only knocking on the door of describing how unlikely this is. Anyhow, that made tracking down the kid's parents a cinch rather than the citywide needle-hunt it would have demanded. Suddenly it made a little more sense why the kwashiokor baby's mother was so neglectful - she learned parenting from the bloke who misplaced this other child.

Being ditched by your parents when you are just a teeny tiny kid must have sucked, so I bought the kid a lollipop to cheer him up. He greedily took it and started gnawing on it with a ferocity that made me flinch. I tried to mime how one would typically consume a lollipop but to no avail. I quickly stopped because I realised that it also looked like an overly obscene gesture to do to a young child.

And a cup of Nini peanut butter dipsticks. I loved that shit as a kid.

One of the custodial staff members, a middle aged woman, sort of took a special interest in the kid and brought him more snack, as did other parents in the ward. I guess they took pity on the boy because he was always in his cot alone, while all the other children in the ward were accompanied by their mothers or fathers around the clock.

Now, at the time of writing this, the child is waiting for a representative of the child protective services to review his case and presumably, ensure that the kid gets taken care of one way or another. Anyway, I wanted to tell this story because of two reasons. The first is because it's an amazing coincidence, and that is always worth telling. The second is because I need to remember what having a child means. It means being responsible for the life, happiness and ultimate destiny of a helpless little individual that needs you to always do the right thing. And I want to.

Lollipop dispenser,

k0k s3n w4i

Friday, March 08, 2013

This is Where I Am

"It's a question of discipline," the little prince told me later on. "When you've finished washing and dressing each morning, you must tend your planet."

The Little Prince (1943) by Antoine de Saint-Exupéry

I am not dead yet.

To bring everyone up to the breakneck speed by which I am moving, I am now married, expecting my firstborn's arrival and looking to relocate to Penang (where my wife had bought our first home) before the end of 2013. If you tell me in the beginning of 2012 that this is what my life would be like after just one year, I would sooner believe in the existence of God than believe you. I thought I would never be married. I was sure I wouldn't have a kid. Now, I did both those things earlier than any of my you-will-eat-your-words friends have.

I apologise for being away for so very long but I doubt there is any of you left to apologise to.

Marriage, as I have always suspected, is a very complicated and difficult thing. I have been humbled and no longer thinks that it is merely just a romantic relationship plus certification - it is not "just a piece of paper" as I have often called it dismissively. It is, to some degree, the extinction of the self. Never before in all my previous relationships do I feel the urgent need to think in terms of "us" instead of "me me me" as per my normal, pre-matrimonial self. Every decision I make now affects two - no, three lives (or twenty one, if you count our two cats). I can no longer just live in the moment but instead, somewhere south of at least twenty years into the future. Being the egocentric selfish jerk that I am accustomed to being all my life, this is not at all an easy transformation.

Being married also made me realise that I am in no way an adult just because I graduated, started practicing as a doctor and became financially independent. I am still learning to wrestle with adult responsibilities like car insurance, taxes, investments and housing loans; stuff which my wife is way more capable at dealing than I am. It is sobering to realise that no matter how intelligent or smart I am, I would probably not do very well without her help in handling all these earthier but ultimately more essential concerns. Being married to an adolescent so out of touch with reality must be terrifying for her. She likes to call it my "bubble" of idealism and ignorance - I have an idea of how the world should work and that idea somehow repels reality. I like to think of it as a forcefield of denial. For her sake (and our kid's and cats' sakes), I must deny it no further.

She is the first woman I have met who makes me want to be a better man.

This is why I was gone for so long. I had a lot of growing up to do. After all, I got to be adult enough in time to be a father.

Manning up,
k0k s3n w4i