Science Fiction #1

The following is fiction. Please don’t be offended, I’ve taken liberties with conventions and beliefs. This is an exercise in outrageous extrapolation.

The year: 2100

Prof Hock Ai snapped off his surgical gloves and stomped out of the operating theatre. Damn, they were getting younger and younger. That last patient was just 53 years old, still attractive and the mother of a teenager. Hock Ai was the lead surgeon for a team of specialist harvesters, and his team had just removed the patient’s liver, kidneys, heart, lungs, gut, skin, corneas, face and thigh bones for transplant into a dozen or so other patients who needed those organs and body parts.

Hock Ai put his palms up to his eyes and rubbed. To think that only yesterday, his patient had been full of vitality and perfectly healthy. Well, almost. She had been diagnosed with early onset Alzheimer’s and tests showed she had some 5 years more to go before becoming completely dependant on others for care. Most patients put it off till later, but some feared the disease so much they presented themselves to the harvesters very early.

How did it come to this? Hock Ai pondered. The fact was everybody dies, and death occurs when vital organs fail. Unfortunately, the vital organs did not deteriorate in unison. There was a mismatch – on the one hand, a sector of contributing members of society with failing organs, and another sector with healthy organs who were dependent because of failing brains. It was only a matter of time because altruism crept into the Euthanasia Act and Multi-Organ Harvesting became a new surgical subspecialty.

Hock Ai looked up at the clock – the short hand pointed at 4 and the long hand at 2.  He tried to remember… had he had breakfast?

Five facts about Organ Donation today (2012):

1. Posthumous organ donation (of kidneys, liver, heart and cornea) is mandated by law in Singapore unless you have opted out under the Human Organ Transplant Act (HOTA):

“All Singapore Citizens and Permanent Residents 21 years old and above*, and are of sound mind, are included under HOTA. Those who choose to remain under HOTA will have a chance to help others, in addition to a higher priority in receiving a deceased donor organ if they need such a transplant in the future.”

Source: Live On

2. It was long suspected that China harvested organs from executed prisoners. This fact has just been acknowledged in an announcement by health officials that the practice would be phased out.

3. A notorious Singapore prisoner, “one-eyed dragon”, sentenced to hang, is strongly believed to have made a directed posthumous donation requesting that one of his kidney’s be given to a businessman. (See the newslink here). That businessman had been under investigation for allegedly trying to purchase an Indonesian kidney.

4. Couple of movies about Organ Donation, altruistic or not:
“Never let me go” – based on Kazuo Ishiguro’s book
“Seven Pounds” – starring Will Smith.

5. There is no such thing as a brain transplant, so you cannot donate a brain to an Alzheimer’s patient.


It has been a tough couple of weeks, with changes on many fronts.

Some changes in the workplace are unexpected and unwanted. And the worse is not over yet.

Other changes in the family are necessary and for the longer term good. In the last month, through my efforts, mom met many relatives whom she had lost contact with for several years. If not for these meetings, who knows, she might have lost all memory of them sooner rather than later. As it was, she already cannot recall some of them at all. If she felt uncomfortable over those encounters, she has already forgotten her discomfort by now.

Often change brings uncertainty, doubt and fear about the future. At times like these, I turn to calming images and thoughts. Here are some of my favourite pictures from the Singapore Botanic Gardens.

“A garden is a delight to the eye and solace to the soul.”

– Sadi


"Who are you looking at?"

A Safe Place

I attended a class on building dementia facilities a few days ago. It was eye-opening and sad at the same time.

Sad because I have just realised that in Singapore, we have homes for patients with dementia, but by and large, they are for the poor and destitute. Living conditions are not ideal, some would say even awful. (Here’s a picture of a typical nursing home.) A group of dedicated advocates is trying to improve on the situation, hence the class.

Most people keep their dementia parents at home, and try to cope. Basically my home is now the assisted living facility for my mom. I have a helper who comes in daily to cook and clean. This works because at this point in time mom is still fairly independent. She can be left alone at home for a few hours, while she reads, watches TV, writes in her notebook, and generally looks after herself.

I don’t let mom cook, partly because I think she has lost the ability, and also because I don’t want her to learn how to turn on the gas stove in my house, having read about the dangers looming in the future.

The eye-opening bit in the class was this – we were given a scenario where someone new has come to work in the facility, and she has never interacted with anyone with dementia. We were asked to explain to this new employee the most important things to know in dealing with dementia patients.

As the class described what they would say, the most important point that came across was, Don’t Argue.

– don’t argue, listen and try to understand

– validate and don’t argue

– look them in the eye when talking to them, treat with respect, and don’t disagree.

– speak in simple sentences, don’t lecture, don’t argue.

The other useful thing that I learned was that if the toilet was visible from the patient’s bed, they will use it, and it greatly reduces the incontinence problem. Now I have been considering some home improvements, but having the toilet fully visible from the living space is not possible in my home. I will cross that bridge when I come to it. Maybe leaving a toilet light on at night will help.