Sep 29, 2012

Timely fat!
Timed high-fat diet resets circadian metabolism and prevents obesity
  1. Oren Froy2
+Author Affiliations
Institute of Biochemistry, Food Science, and Nutrition, Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
  1. 2Correspondence: Institute of Biochemistry, Food Science, and Nutrition, Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel. E-mail:
1 These authors contributed equally to this work.
Disruption of circadian rhythms leads to obesity and metabolic disorders. Timed restricted feeding (RF) provides a time cue and resets the circadian clock, leading to better health. In contrast, a high-fat (HF) diet leads to disrupted circadian expression of metabolic factors and obesity. We tested whether long-term (18 wk) clock resetting by RF can attenuate the disruptive effects of diet-induced obesity. Analyses included liver clock gene expression, locomotor activity, blood glucose, metabolic markers, lipids, and hormones around the circadian cycle for a more accurate assessment. Compared with mice fed the HF diet ad libitum, the timed HF diet restored the expression phase of the clock genesClock and Cry1 and phase-advanced Per1Per2Cry2Bmal1Rorα, and Rev-erbα. Although timed HF-diet-fed mice consumed the same amount of calories as ad libitumlow-fat diet-fed mice, they showed 12% reduced body weight, 21% reduced cholesterol levels, and 1.4-fold increased insulin sensitivity. Compared with the HF diet ad libitum, the timed HF diet led to 18% lower body weight, 30% decreased cholesterol levels, 10% reduced TNF-α levels, and 3.7-fold improved insulin sensitivity. Timed HF-diet-fed mice exhibited a better satiated and less stressed phenotype of 25% lower ghrelin and 53% lower corticosterone levels compared with mice fed the timed low-fat diet. Taken together, our findings suggest that timing can prevent obesity and rectify the harmful effects of a HF diet.—Sherman, H., Genzer, Y., Cohen, R., Chapnik, N., Madar, Z., Froy, O. Timed high-fat diet resets circadian metabolism and prevents obesity.
all Greek to you? 

Timely high fat diet better than untimely low fat diet = 12% thinner, 21% less cholesterol
Timely high fat diet better than untimely high fat diet = 18% thinner, 30% less cholesterol

Conclusion, if you eat on time, you can eat as much as you like... If you're a mouse?

Sep 28, 2012

Jumping the gun again, mate?

Some people believes that I am an authoritorian bordering on sadistic whenever I asked them to write explanation letter about certain irregular activities in the ward.

And often people mistaken explanation letter as apology letter. Explaination letter is to truthfully explain what had happened and to decide whether somethings are out of hands and out of basic human capabilities. My mind hungers for the pathogenecity of things.

I am not a perfect being and at times, I did jump to conclusion, but I tried my best not to jump the gun. Thus, an explanation letter helps a lot, unless your confession is indeed a misdeed, then it would be polite for an apology to follow.

Again, there it was, out of the blue, some people insidiously attaching me with something that I was totally not guilty of.

For starter, I did not ask someone to passover on my behalf and I passover to another person myself. The proof of my communication is registered in my phone and the proof of another acceptance of my communication is also evidently kept.

I just asked that someone to call up when the patient had reached that place therefore reducing time wastage if another person is being called in prematurely.

Would have got all this truth if one would be wise enough to ask me and maybe the other junior personnel, the 3 staff nurses and the other medical officer from another department who is in the scenario.

If the issue is about another matter, relating to vital omission of certain intraoperative procedure. Then, it is another ball game altogether, because its failure is a failure of a whole system and a whole unfortunate chain of events.

Antenatally did the person in-charge of proposing and finalizing such procedure make the adequate arrangement to ascertain the fulfillment of procedure?

Did the person who posted up the operation conveyed the 'extra-ordinary' to the person who supposed to do the operation?

Did the surgeon read and understand about the patient before the operation?

How can that person who had taken part in the antenatal hospital admission review and finally end up being the surgeon do not know the need for the procedure?

Did the surgeon fail to listen to what the staff nurses who noticed the peculiarity and reminded the surgeon?

Finally, did I really took some time off to shake my bollocks or contributing to the department by organizing and chairing the whole event with involvement of several departments including the attendance of the big shot from State Health Department even though I was sharing half of the on call burden of my other colleague the night before?

Lots of questions unanswered and perhaps presumedly being answered based on assumptions.

About passing over does bring back very vivid livid memories of how I was being screwed, mentally stomped to the ground and diminuted to less than a tagging medical officer when I was being accused of failure to  pass over a pending emergency procedure to the on call superior. I did inform the office hour's superior and offered to pass over to the on call's superior but was being told it will be done superior to superior.

Nobody came to my defense, no apology for the false accusation.

Nothing beats the stench of superiority and the holier-than-thou attitude.

Double standards will eat in, one fine day.

Buddhism has a name for it - it is called kamma.

I am just doing my part to send out a gentle reminder.

During my school days, I was being taught a useful two-liners.
Never assume because ASS/U/ME, because when you assumed you are making an ass out of you and me. 

Sep 27, 2012

Pilo's 5 ideas for Healthcare Budget

below are excerpts from Page 45-47 of PR's Shadow Budget for 2013.

Improving healthcare services
Pakatan Rakyat affirms that healthcare is a basic fundamental human right. It is the condition for our pursuit of happiness. And yet the Barisan Nasional government spends little in healthcare, at the same rate as authoritarian Laos and China.

In terms of delivery, public healthcare personnel are stretched. Although the public sector provides for up to 85% of the population, it is served by only 25-30% of specialists and 45-60% of all registered doctors.

Pakatan Rakyat will strengthen the shape of Malaysian healthcare in the future. Improvements will include:
- The scope of public healthcare and the means of financing this public good;
- Pay and job conditions for medical personnel;
- Ways to improve health indicators for the Orang Asli and Bumiputras living in Sabah and Sarawak and increased allocations to reflect the costs involved in providing services to these communities in hard to reach rural areas. Amounts allocated per household to Sabah and Sarawak are presently smaller than in Perlis and Terengganu despite their much larger geographic areas5;
- Better meeting the needs of senior citizens and patients requiring long-term care. Increase the number of health care professionals specially trained to look after the needs of senior citizens and of those requiring long-term out-patient care and monitoring and hospitals with facilities and infrastructure for geriatric services and long term out-patient health care will also be considered6; and
- Adopting new models of community and home-based care for patients not needing hospitalisation but who have difficulties getting to a clinic or hospital for health care due to age, injury or illness. Such measures would promote injury and illness prevention and reduce unnecessary admissions into hospitals, which would provide significant savings to Malaysian health system.

The availability of public healthcare services that provide good and wide ranging treatments allows for greater number of economically disadvantaged groups to seek treatment at government hospitals. This reduces the tendencies (stemming from resignation or fear of waiting list, unavailability of services etc.) of patients from the poorer segments of the society to go to private clinics to seek treatment.
At the point of this entry, the Balisan's Budget for Healthcare have yet to be unveiled and tightly kept in the black briefcase of Najip.

One thing for sure to be anticipated from Balisan's Budget is drop out of the much anticipated 1Care. The conception of this idea from the start is a shameless ploy to nick the rakyat's money by masquerading as the national health insurance scheme. Their main selling point of this idea was it is the way forward as it is adopted by developed countries such as Japan, Taiwan and UK. They managed to fool less educated people, but not people who better understood how many cans of worms those systems had opened by adopting such system. Plus, the many ways monetary funds may be easily be siphoned off with 1Care is way too obvious, even for any half-wit Malaysians.

Nope, this entry is not for bashing the almost toned-down 1Care.
Possibly the biggest disappointment with PR's Budget and the Balisan's Budget (to be unveiled tomorrow) is that all their Strategy or Budget are simply hot-air Promises.

Malaysians do not need another Election Budget.

PR's Healthcare budget focussed more on the Orang Asli Health Services, Geriatric Services and Community Health Services. Possibly, a good way to go, as they are harping good votes from elderly citizen as the young voters are already in their 'fixed deposit'.

As simplified as it is, budget is simply a calculation on how much we want to spend (or allocation of spending) and making sure what we spent on is worthy of its value or more.

I had thoughts about how our healthcare budget should be.

Perhaps it may be too ideal or downright infantile as I am afterall a health-management idiot, but I just want to share what I think our Healthcare Budget should be.

1. Focus on the primary care and prevention

Healthcare has always been grossly misunderstood as the provision of secondary care, where posh doctors, specialists or Consultants in Clinics or Hospital providing the medication or surgery. The real burden in healthcare is indeed for this tier of care.

Nevertheless, the burden of disease actually comes from the failure of our Primary Care. Primary Care leaders of the country may be cursing me right now, because of my disrespectful comment. Yet, many Primary Care doctors on the ground would agree with me that many activities - all the speeches, all the courses, programmes, thematic works and etc were actually being carried out, but possibly only a minority shown real results. Real results.

The biggest threat to our national security is not terrorism, but the burden of non-communicable disease. We need to sit down and focus on reducing Obesity and Smokers, because those 2 conditions by themselves can spawn a whole shebang of diseases - Diabetes, Hypertension, Renal diseases, Cardiac diseases, Cancers, Eye diseases, Skin diseases, Depression and the list goes on.

Obesity should be tackled in two ways. Encourage healthy diet and increase opportunity for exercise.

Policy-makers should take bold move to introduce Perfect Weight Incentive, a small portion of extra bonus or monthly incentive for those with normal BMI, starting with the public sectors. Hospitals and clinics should start charging more if the patients is of higher BMI.

All working offices should also provides simple gym room, sport or recreational area for all employees and make allowance for 30mins of exercises from their working hour (430-5pm). All housing areas should have properly maintained Parks for home makers.

Guidelines on fighting obesity already been started but has it been properly followed through. Malaysia | UK.

Main blame for weight gain among ladies are pregnancies, therefore a proper diet guidance during pregnancy is important.

It is every human rights to have the freedom to smoke. However, it is costly, if the secondhand smokes affect the greater proportion of the people. Thus, banning of smoking in public area should be implemented nationwide and strict law-enforcing is essential. What's the point of putting up a big notice board of 'Fine on Smoking' in the hospital ground and the members of hospital puffing away below that notice. Proper smoking area should be allocated for smokers, to allow the auto-destruction of these sub-population. Smokers who attend public health services should be confirmed of their status by blood or urine nicotine tests and be charged more.

2. Family building

Family planning is family building. Pregnancies should be planned and properly executed. Our country's pick up on contraception is very appalling. This had lead to many teenage pregnancies and various problems associated with pregnancies due to unplanned pregnancy. Unplanned pregnancies at extreme of ages have relatively poorer outcome in the conception leading to less healthy babies with various health implications in their adulthood. Furthermore, various medical illnesses worsen during pregnancy and some to irreversible stage.

The cost of using effective contraception is small compared to the massive cost of handling various medical problems in the mother during pregnancy and future diseases associated with the children.

Having the proper number of children can build a happy, strong family with strong family ties. Family support in time of need can ease a lot of health burdens especially for the people of geriatric age group.

3. Competency-based and provide job satisfaction

All medical personnel should be strictly monitor of their duties and competencies by their own superiors and be counter-checked by another independent body. This is to promote fairness and justice as much as possible.

There are few medical assistants in operation theatre who gets to sit idle in their resting lounge while the doctors pushed the patient in themselves. There are medical assistants in the health clinics that come to work only once a week, yet pushed the medical officers around. There are medical officers in the Health Clinics who do not conform to the working clinic rotation requirements because of certain connection to certain Datuk.

If certain people do not work competently or their contribution is unnecessary, perhaps we can really cut cost by reducing those positions. I have heard of Consultants in Australia pushing in their own patients for Ultrasound.

And, please, do not speak of medical doctors or medical personnel as money-faced people. Although we appreciate a big paycheck but we appreciate more a good working condition where we do not get fxxked by people of same rank or below, just because they are senior or with big cable.

The recent overhaul of HRMIS for the public servants, medical personnel included, is a clearly amusing. As a medical officers, my Sasaran Kerja Tahunan (SKT) or Annual Work Target is similar to the house officers in the department. As I read the 'Template' for the SKT, it was a very ideal SKT, but I doubt all those targets had been achieved completely.

Spending a small amount of money on monitoring competency and good working environment beats wastage of money due to incompetency and outflow of medical personnel to the private healthcare.

4. Medical registry and data

One of the weaknesses in our country is our pending success to create and maintain a good registry.

Currently, various of registries had been initiated and the registry that I had known since I started service as a houseman is COTDS, which supposed to record all operations done in Public Hospitals.

COTDS is Computerised Operating Theatre Documentation System. Sadly, few months back, COTDS was being replaced by COTDS2 but COTDS2 was plaqued with various problems. And now, I was told the Ministry had pulled the plug on COTDS and COTDS2 because of payment problem.

Frankly-speaking, with the registry and data, various analysis and population-based study can be undertaken. With proper supervision and guidance, I guess it is no harm in propelling our massive number of young budding house officers to do simple analysis and study of the data.

At some point of time, recognition of treatment or management to conditions or diseases specific to our region can help better usage of our healthcare allocation for treatment.

5. Private participation in health care

Give out tax rebate for private healthcare centres or private companies who organize health-related events and campaigns that shown impact in reducing health problems. Get them to build more parks, gyms or recreation areas.

Private healthcare practitioners/specialists/consultants should be made compulsory or be enticed with personal tax rebates to serve in public hospital in rotation for small amount of time, perhaps once a month or once in two months. And perhaps if they are willing to serve in public healthcare centers in the Borneo side, they can be given bonus holiday package of 'Cuti-Cuti Malaysia' there.

It is a win-win situation. The public healthcare can get expertise from private healthcare practitioners. And in return, they can rekindle their interest by seeing different spectrum of diseases in public healthcare, plus a relaxing get-away from the routine.

Sep 22, 2012

It's tough till...

You think it's tough studying, wait till you started working.
You think it's tough working, wait till you started studying while working.
You think it's tough studying while working, wait till you started teaching while working.
You think it's tough teaching while working, just look at people who have no opportunity to study, work or teach.

~ Piloism

Sep 21, 2012

Made in Eritrea

Before admitting myself to med school, there I was, working through 12 hours a day of standing in Sales. I was a watch seller in a local mall, still standing strongly today, though not as bright as it was in those days.

I found selling or successful sales very addictive, but at the end of the day, it just does not feel right, mainly because of the truth that we trying to hide from the customers.

For instance,

"This watch company is established by a Swiss,

The creator is a Swiss,

This watch is fully designed by Swiss,

It is well known among the Swiss,

Swiss Bla Bla Bla,

Bla Bla Swiss Bla Bla..."

Well, the watch is made and assembled by Eritrean.

Some people believes it is purely about bending the truth.

But, how far can you bend before it becomes a truth?

Maybe I was able to sell these watches to the whole big crowd

Neverthelss,one day, the truth you come back and haunt you.

Painting a bright convincing picture can never trumps the beauty of the truth.

You can say all you want to say, the truth speaks for itself.

Sep 20, 2012

Perception of impossibility

Alice: This is impossible.
Mad Hatter: Only if you believe it is.

I rushed to General Operation theatre for 2 pending procedure.

A call from the nursing counter for me.

It was a referral from one of the primary care department of my hospy.

She had to start her conversation by sighing and tell me this:

"Dr Pilo, hi, I need to refer a case to you. It is impossible to reach you."

My reply: "I'm in OT. No line"

What I was thinking of replying her was

"How can I make it possible for you?

Well, you see, there is 3 problems with your statement.
Firstly, if you're already talking to me, how would you consider it to be impossible.

Secondly, unless I purchase the telecommunication company, I do not foresee any connectivity through my handphone in the future whenever I am in OT or A&E department. Pager system never had worked for the department ever. Even a Red Alert looks like Pink Alert.

Thirdly, if you're thinking that I am avoiding you or I am sitting idle at Starbucks Cafe far far far away from hospy, I think you're thinking way ahead of yourself. I don't even avoid my ex.

Get a hold of yourself.

Today is not my first day receiving referrals from your department.

Everyone knew, if you had called the ward, you would have known EXACTLY where I am, which is not Timbuktu."

Case noted.

Sep 19, 2012


Learnt about this song from this ultra-talented botak fella:

This is the original singer in her great MV:

[ Lyrics from: ]


我的梦里 我的心里 我的歌声里

我的梦里 我的心里 我的歌声里

我的梦里 我的心里 我的歌声里
我的梦里 我的心里 我的歌声里


我的梦里 我的心里 我的歌声里
我的梦里 我的心里 我的歌声里
我的梦里 我的心里 我的歌声里

Sep 18, 2012


Yesterday, little 2-years old Genevieve went into a shape-naming frenzy in the car.

She saw the forward and reverse buttons in the car radio and she went: Triangle, that also triangle.

Then he saw the other round buttons and she mumbled: Circle, circle, circle, circle, circle, circle, circle (Woman's nagging skill: intact)

I stopped my car at a T-Junction. Suddenly, she pointed at the sky and shouted: Hexagon

WTF! I did not learn about such a shape until I was in the primary.
(Just thinking, not saying out loud, of course)

Sep 16, 2012

Almost Van Dyke!

Having facial hair, even for man, can get a lot of various response as well, as opposed to women having facial hair.

The pharmaceutical drug rep was wondering whether I am post call.

The nurses thought I was trying to change my image. I told them it is because of high androgen.

My deareast couldn't stand having a porcupine in bed every night. She should try to embrace it.

My daughter like the ticklish feeling whenever I brushed my chin on hers.
My son, don't. (Failed the Gay Test. Good)

And one of my ex-house officer (a guy) sms me: u looked so man with your moustache!!Hehehe.
My reply to him: Walao, so previously I looked like a woman?

The real reason behind my 'almost Van Dyke' look is that I just want more sensation and feel whenever I rub my chin in deep thoughts.

Sorry for keeping everyone guessing.

Here's a PHD in Facial Hair.

A PhD in Facial Hair

Created by: Online PhD

Sep 14, 2012

Article for Men Only

The End Of Men
We talked to Hanna Rosin about her controversial claims that men are being edged out of society.

The End Of Men
By Elysha Krupp,
"Chivalry is dead. And women killed it."
-Dave Chapelle

A man and woman went on a first date. The woman -- let's call her Caitlin -- seemed in every way an ambitious young woman. As they looked over the menu and wine list, the man -- let's call him Bill -- asked her, "What kind of wine do you like?" She put down her menu, looked at him and said, "I make decisions all day. It's your turn." Bill was shocked. He had expected, given her somewhat aggressive exterior, that she would want to be the one holding the reins. But what Caitlin actually wanted was some straightforward, macho decision-making from Bill. She didn't want a lot of conversation or discussion. She just wanted to sit back, relax and have him take over.

This is author Hanna Rosin's story, as she told it to me (somewhat altered). About a year ago, her article "The End Of Men" was published in The Atlantic and went viral. Today her book, The End Of Men And The Rise Of Women -- which was born from that article -- hits stores.

Rosin suggests that college hookup culture (in which  women want casual sex and not much more) and the new economy (colored by the decline of manufacturing and the rise of fields that favor skills traditionally considered feminine, like healthcare and communications) confuse -- and even ruin – men and favor women.

"Men are caught between two poles where they’re not supposed to be super-aggressive macho guys, but they’re not supposed to be super-effeminate, either," Hanna told me. "We vaguely understand, more so than our fathers did, that it’s OK for men to show up at school and love their children and read to their children. We expect that of fathers. But is it then OK for a father to work part-time? We’re not sure about that one. So it’s these things are not exactly worked out."

Like Bill -- and most of my guy friends -- I'm sure you've gone on a date with a woman and been unsure of her expectations: whether you should pay the bill or walk her home or sit back and let her choose the Merlot over the Pinot Grigio. The new economy, combined with the uncertainty of what it means to be manly, is confusing. Men are not sure what women want from them in dating, and they're not sure of their place in the today's workforce.

It’s true, as Rosin points out, that men lost three-quarters of all jobs during the recession. And that's impacted many men who thought they would work at the same factory their fathers did. She also cites a study of online dating that shows all these guys wanting to marry -- more than their female counterparts. So how are they supposed to navigate this new economy and this new dating scene that’s supposedly so confusing and new?

I don't buy that men are on the decline, even if manufacturing has died down, and I'm not sure I agree that the college hookup scene is so detrimental to dudes, either. The guy friends I had in college were, for the most part, pretty damn happy to have a selection of "aggressive" college girls who didn't want anything but a drunken night of fooling around. So I called up Rosin to talk about whether guys really are frustrated by hookup-friendly women and what they can do to improve their odds given the grimness of her forecast.

Here are some excerpts from our conversation.

What do guys stand to lose, if anything, in the hookup culture?
People have this sense that’s it’s really great for guys. But there’s an idea that guys are being ruined by the sort of inability to form intimate relationships. There’s sort of, like, fear of the ambitious or aggressive woman. To start out thinking you’re not really supposed to commit isn’t a great place to be for guys who are already having a hard time graduating from college and figuring out what they want out of life. So we’re just making it more confusing for guys.

So what should guys who actually want relationships do in order not to come on too strong but also not to undervalue a woman?
Hooking up with no romantic commitment -- nobody loves that for very long. What girls are trying to avoid is the guy who wants to get married and tie them down. Most women want a boyfriend but just not a permanent life arrangement.

Men In The New Economy

I know when I was in college, I was probably more settled down and focused when I had a boyfriend than when I was in the hookup scene.
That’s a good point. Maybe what women want, it’s not necessarily the hookup culture; it’s the option to not be permanently tied down. So if you could create a world in which you could have a serial monogamist boyfriend who you were sure would not derail you and force you to move to a city you didn’t want to but you could have each one for a year at a time, that would be ideal. People are feeling their freedom and their raunch, but it doesn’t feel like it’s the place we want to end up.

Is this really what women want, though? You say that in hookup culture, women are able to focus on their studies and careers. But one of the women you interviewed says she wishes some guy would just take her out for a frozen yogurt.
Girls complain about it, but they wouldn't have it any other way. Women need for it to be this way so they can establish their careers. But... that’s why the need for human connection is stronger than any other thing and where they are now is not where they’ll end up.

What can men do to feel empowered if their career is failing or on hold? What did you see some of the men you interviewed doing to not only help themselves but help their relationships?
At first it was forced upon them, where they were home, let’s say with the kids, or had to go to school or do things that were really against their nature. And then, over time, it took on a kind of dignity, dealing with the children.

For the younger guys, there’s sort of solidarity in the fact that a lot of people have a hard time when they leave school now and are living with their parents or are not in a steady job that’s going to immediately lead to a career. I think the fact that that’s a fairly common situation for young men might make it a little easier to bear.

Insofar as you can think of that [unemployment] as not a stain on your manhood but just kind of like a universal condition of young people today who have a hard time establishing themselves in their career, then it becomes less of a source of deep shame. You’re a guy out of work, trying to figure yourself out -- just like lots of other people. If you remove -- or allow yourself to remove -- that breadwinner urgency, then it becomes a lot easier.

We do kind of think it’s more acceptable for women to drift a little bit than we do for men, so there’s a lot more anxiety for men who are drifting. They feel like they’re somehow betraying their manhood, but just stop yourself short at, "This sucks that I can’t get a job," and not at, "I am betraying my manhood and this is a source of great shame."

It shouldn’t be a source of great shame. Don’t make it bigger than it is -- you’re having a hard time finding a job like a lot of people today, and it’s not some great tragedy.

So what can a man who has lost his job actually do to help himself?
They need to re-accustom themselves to going to school or retraining to be different than they’ve always been. However, I also think that we will destroy men and make them angry if we don’t leave some room for brawn and traditionally manly virtues to be important. So, for example, when people talk about remaking the manufacturing economy, they don’t just talk about making all those guys become nurses. They also talk about artisan manufacturing, specialized manufacturing. Both of these things add an element of intellect and creativity into old manufacturing. The other thing they talk about is high-tech manufacturing. It’s still manufacturing jobs that feel like a fraternity and manly, but it requires you to get some engineering training or go to a sophisticated community college and learn about the new ways and machines used in factories. So it’s like you’re meeting the new economy halfway. It’s still manufacturing -- it’s still working with your hands, and it still feels manly -- but it’s halfway toward the new world.

Career Options In The New Workforce

Do you think it's crucial, now that manufacturing has died, that men go to school in big cities, where they will inherently have more options career-wise?
If men want to do these new jobs, then moving to cities is probably the way to go. But if you want to stay home, there’s options… to get into this new manufacturing sector that’s emerging. If you’re not a guy who wants to go to school for four years, you can go to a three-year community college or do an automotive engineering program that they use in high-tech auto manufacturing these days.

What skills do men need to develop if they want to survive in the new economy?
They can be more flexible to the changes in the economy. When I ask economists, I always talk about new jobs, like the healthcare industry is expanding or the service industry. Economists will tell me, "Don’t focus so much on specific jobs because they can change all the time." But what is really important is to be flexible enough to change when the economy changes. That’s the important quality that men seem to be missing and women seem to have. It’s the flexibility rather than any particular skill.

The other traits are more complicated. It has to do with slowly shifting ideas about what makes good leaders. Whereas we used to think it was good to be top-down, take a lot of risks, be really aggressive and make decisions quickly -- that’s how we used to define leaders and those are fairly male-centered traits. Particularly after the Wall Street crash, we’re very suspicious of that kind of testosterone-driven decision making. So we think being cautious, taking some time, taking the long view, being more collaborative -- those are things that we think are good for every leader now.

Can flexibility be learned?
There’s no reason why men can’t be more flexible and adaptable now that they are more of the underdogs and the economy is demanding of them something different. They are forced to be flexible, in the way that men who, by economic necessity, are forced to stay home and take care of the kids for some time. Eventually it becomes OK.

How do we dissipate the perception that your identity is so tied to your career? Why is manhood threatened just because the manufacturing sector is disappearing? How does a career become less about “identity”?
The crappy economy is going to force this [a rethinking of the workforce] on people. Already people ask young men what their expectations and desires are for their workplace of the future, and the line of all these workplace think tanks is a 25-year-old man imagines his workplace almost in the same way as a 42-year-old woman with three children -- it’s like they don’t think of workplaces as places you’re tied to forever, as determining your identity. That does seem like a thing of the past. Like the manufacturing guys that I describe -- those guys don’t really exist anymore. Those guys’ entire identity was formulated by this one place, almost like it was their fraternity and their lifeblood. That’s a thing really of the past, so even if you want to be that as a guy, you don’t really get to be that anymore in general.

How can we, as a society, start rethinking the workforce today? Does that mean rethinking masculinity?
I do think we need to get over this idea that men can’t be more domesticated and do domestic work. If you see a guy at the park at 3 p.m., you shouldn’t be having the thought "What’s wrong with him?" I do think we need to get over the idea that men shouldn’t do jobs that are traditionally feminine, like nursing, teaching, whatever. But what about man as protector? The whole idea that the man will protect me in a firefight. It’s OK for men to still be the protectors. In the South what I was finding was that men weren’t necessarily the breadwinners anymore, but they still get to be head of the household. With the Southern families, it just takes a long time before they worked out a new language and a new way of relating to each other that allows the guy to preserve his dignity but also allows the bills to get paid.

Sep 13, 2012

A dying father's message from Paul

‘He lived and died by his own rules, and I know he had found his own fulfilment.’


  •  Be courteous, be punctual, always say please and thank you, and be sure to hold your knife and fork properly. Others take their cue on how to treat you from your manners.
  • Be kind, considerate and compassionate when others are in trouble, even if you have problems of your own. Others will admire your selflessness and will help you in due course.
  • Show moral courage. Do what is right, even if that makes you unpopular. I always thought it important to be able to look at myself in the shaving mirror every morning and not feel guilt or remorse. I depart this world with a pretty clear conscience.
  • Show humility. Stand your ground but pause to reflect on what the other side are saying, and back off when you know you are wrong. Never worry about losing face. That only happens when you are pig-headed.
  • Learn from your mistakes. You will make plenty so use them as a learning tool. If you keep making the same mistake or run into a problem, you’re doing something wrong.
  • Avoid disparaging someone to a third party; it is only you who will look bad. If you have a problem with someone, tell them face to face.
  • Hold fire! If someone crosses you, don’t react immediately. Once you say something it can never be taken back, and most people deserve a second chance.
  • Have fun. If this involves taking risks, so be it. If you get caught, hold your hands up.
  • Give to charity and help those who are less fortunate than yourselves: it’s easy and so rewarding.
  • Always look on the upside! The glass is half full, never half empty. Every adversity has a silver lining if you seek it out.
  • Make it your instinct always to say ‘yes’. Look for reasons to do something, not reasons to say no. Your friends will cherish you for that.
  • Be canny: you will get more of what you want if you can give someone more of what they desire. Compromise can be king.
  • Always accept a party invitation. You may not want to go, but they want you there. Show them courtesy and respect.
  • Never ever let a friend down. I would bury bodies for my friends, if they asked me to . . . which is why I have chosen them carefully.
  • Always tip for good service. It shows respect. But never reward poor service. Poor service is insulting.
  • Always treat those you meet as your social equal, whether they are above or below your station in life. For those above you, show due deference, but don’t be a sycophant.
  • Always respect age, as age equals wisdom.
  • Be prepared to put the interests of your sibling first.
  • Be proud of who you are and where you come from, but open your mind to other cultures and languages. When you begin to travel (as I hope you will), you’ll learn that your place in the world is both vital and insignificant. Don’t get too big for your breeches.
  • Be ambitious, but not nakedly so. Be prepared to back your assertions with craftsmanship and hard work.
  • Live every day to its full: do something that makes you smile or laugh, and avoid procrastination.
  • Give of your best at school. Some teachers forget that pupils need incentives. So if your teacher doesn’t give you one, devise your own.
  • Always pay the most you can afford. Never skimp on hotels, clothing, shoes, make-up or jewellery. But always look for a deal. You get what you pay for.
  • Never give up! My two little soldiers have no dad, but you are brave, big-hearted, fit and strong. You are also loved by an immensely kind and supportive team of family and friends. You make your own good fortune, my children, so battle on.
  • Never feel sorry for yourself, or at least don’t do it for long. Crying doesn’t make things better.
  • Look after your body and it will look after you.
  • Learn a language, or at least try. Never engage a person abroad in conversation without first greeting them in their own language; by all means ask if they speak English!
  • And finally, cherish your mother, and take very good care of her.
I love you both with all my heart.
Daddy x

Sep 7, 2012