Critically evaluate the role counseling and psychotherapy theory and Essay

Critically evaluate the role counseling and psychotherapy theory and practice in the application of adventure therapy - Essay Example It is important to note the appropriate role and use of counseling in the context of society and in relation to abnormal psychology. For example, the counselor is primarily dealing with normal, functioning children and adults that may at some point during their life develop psychological or emotional problems with which they benefit from personal and professional assistance. Generally, between 5% to 10% of the population at any time can be expected to display the signs and symptoms of major mental illness as defined in abnormal psychology, such as schizophrenia, bipolar disorders, manias, psychosis, etc., though less than 1% will require clinical hospitalization. (NIMH, 2008, See: Appendix) This leaves counseling as a profession tasked with first separating cases of abnormal psychology from problems of normal development of individuals, and secondly, assisting in the provision of effective treatment to the individuals who are seeking counseling. It is in this context that Adventure T herapy should be understood, as well as its application, for there may be human development problems that are caused by the individual’s relation to modern society that can better be solved by treatments fostering social relationships and exercise activities as opposed to pharmaceuticals or institutionalization. Nevertheless, there may also be instances where a combination of medication and Adventure Therapy can also assist in the treatment of those afflicted with psychological problems and mental illness. Creating the ability to distinguish the causes and treatments for patients is an important aspect of training that the counselor must undertake, including research in a multiplicity of methods and a willingness to experiment in finding the treatment that best suits the unique nature of every individual and effectively promotes positive mental health recoveries. The life of an individual can be viewed on a continuum of functionality related to self-realization with normality at the center, functioning at the highest levels of individual mental and physical operations at one extreme, and the psychoses and neuroses of severe mental illness or insanity at the other extreme. The counselor can expect the range of behavior for most people to stay within the realm of normal operations on usual occasions, straying into psychological crisis through challenges, problems, and obstacles in life or relationship issues that occasionally need to be addressed by the individual. Viewing the counselor’s office as a mixture between a general practitioner’s office and an emergency room highlights the manner that the counselor must prepare for all of the contingencies of not only mental illness, but also for mental health, in the population he or she is tasked with serving. Counseling in this regard can be seen as a tool to help maintain or restore normalcy to individuals based upon their own self-definition of importance and accepted societal standards of fu nctioning. In being able to distinguish between the critical and clinical symptoms of severe mental illness and the factors that are required to build a stronger sense of well-being and mental health, the counselor can begin to serve the diversity of needs that he or she will encounter within a given population, as well as to understand some of the causes that lead people to psycho-spiritual crisis and life

Political philosophy Essay Example for Free

Political philosophy Essay KNOWLEDGE IS FORMED AND ACQUIRED IN THE COURSE OF OUR LIFE THOUGH COGNITION AND IT IS NOT INBORN AND DEVELOPS FROM OUR OWN IGNORANCE. JOHN LOCKE COMPARED IT WITH TABULA RASA OR SOME SORT OF A BLANK SHEET UPON WHICH NOTHING IS WRITTEN. THESE ARE DATA OR IMAGES OF THE OBJECT WHICH STIMULATED OUR SENSE-ORGANS-SIGHT, HEARING, TOUCH, TASTE AND SMELL ARE, IN A MANNER OF SPEAKING, RAW-MATERIALS WHICH OUR BRAIN FORMS, THROUGH ABSTRACTION, INTO CONCEPTS OR IDEAS, AND WHICH WE EXPRESS IN SIGNS OR LANGUAGE. THERE ARE TWO OBSTACLES TO COGNITION THE BIASES WHICH BECLOUD THE HUMAN MIND AS â€Å"IDOLS† AND THE ERRORS IN REASONING WHICH ARE THE SO CALLED FALLACIES. REASONING IS A MEANS FOR ACQUIRING KNOWLEDGE BUT IF IT IS FALLACIOUS IT CANNOT YIELD BUT DECEPTION. MOREOVER THERE ARE THREE THEORIES OF KNOWLEDGE NAMELY; EMPIRICISM, RATIONALISM AND INTUITIONISM. IN EMPIRICISM, KNOWLEDGE COMES FROM EXPERIENCE AND EXPERIENCE IS A SENSE OF PERCEPTION WHICH MAY BE UNDERSTOOD AS DIRECT OBSERVATION BY THE SENSES OR INDIRECT BY USING INSTRUMENT OR BY EXPERIMENTATION. EMPIRICISM TEACHES THAT WHAT WE SEE, HEAR, TOUCH, OR SMELL, IS ALL THAT WE CAN KNOW. OUTSTANDING EXPONENTS OF EMPIRICISM WERE JOHN LOCKE, GEORGE BERKELEY, DAVID HUME AND THE SO-CALLED LINGUISTIC PHILOSOPHERS. RATIONALISM MAINTAINS THAT REASON IS THE SOURCE AND TEST OF KNOWLEDGE AND NOT SENSE-PERCEPTION. KNOWLEDGE CONSISTS OF CONCEPTS WHICH GENERALIZE ABOUT THE NATURE OF REALITY SO THAT IT HAS A UNIVERSAL AND PERMANENT CHARACTER. IT IS THE REASON OR THE INTELLECT WHICH â€Å"MANUFACTURES† THE DATA INTO CONCEPTS, JUDGMENTS AND LAWS, AND THAT IS HOW OUR KNOWLEDGE IS FORMED. WHAT WE KNOW IS â€Å"WHAT WE HAVE THOUGHT OUT†, OR WHAT REASON HAS â€Å"ABSTRACTED† FROM THE DATA OF SENSE PERCEPTION. THE KNOWN DEFENDERS ARE PARMENIDES, PLATO OF ANCIENT GREECE, DESCARTES AND HEGEL OF THE MODERN WORLD. THE THIRD THEORY WHICH IS INTUITIONISM CLAIMS THAT THE SENSES CAN ONLY MIRROR THE APPEARANCE OF THINGS HENCE WHAT WE CALL SENSE-DATA, CANNOT TELL US WHAT THINGS ARE IN THEMSELVES. BUT THROUGH INTUITION, WE CAN HAVE â€Å"A FEEL† OF WHAT LIES BEYOND THE PHENOMENA CAPTURED BY OUR SENSES AND TRANSFORMED BY REASON INTO CONCEPTUAL SYMBOLS. INTUITION â€Å"INTUERE† (TO LOOK INTO) IS A DIRECT APPREHENSION OF KNOWLEDGE WHICH IS NOT THE RESULT OF CONSCIOUS REASONING OR IMMEDIATE PERCEPTION. ADD THE FACTS THAT THERE ARE TWO METHODS OF INTELLECTUAL INQUIRY, FIRST IS THE INTUITION THAT GRASPS THE ESSENTIAL NATURE OF REALITY AND â€Å"TIME† AND THE SECOND IS ANALYSIS WHICH IS THE STABILITY AND PREDICTABILITY, BUT OFFERS ONLY â€Å"A PHOTOGRAPH† OR â€Å"A SNAPSHOT† OF WHAT IS ESSENTIALLY A DYNAMIC, ACTIVE WORLD THE ONLY WAY TO BRIDGE THE DISTANCE BETWEEN THE â€Å"OBJECT KNOWN† AND â€Å"THE KNOWER†, WE MUST USE â€Å"INTELLECTUAL SYMPATHY† THAT EXPERIENCES BEING AS A WHOLE, AS â€Å"A DYNAMIC CONTINUUM†. LASTLY, THERE ARE DIFFERENT NOTIONS OF TRUTH NAMELY THE CORRESPONDENCE THEORY, COHERENCE THEORY, PRAGMATIC THEORY AND THE MARXIST THEORY. EDUCATION: THE WORD EDUCATION COMES FROM THE LATIN VERB â€Å"EDUCERE† (TO LEAD) OR FROM â€Å"EDUCARE† (DRAW OUT). EDUCATION IS THE ART OF LEADING OR GUIDING A PERSON TO SOCIAL CULTURE SO THAT BY EXPOSING HIM TO ITS COMPLEXITIES AND HE MAY ACTUALIZE HIS Introduction to Philosophy POTENTIALITIES. EVERY PERSON, REGARDLESS OF RACE, GENDER OR CLASS HAS A DORMANT POWER WHICH IF DRAWN OUT OR DEVELOPED COULD EQUIP THE INDIVIDUAL TO FILL A VARIETY OF ROLES IN SOCIETY. EDUCATION AND TRAINING IS OF DIFFERENT MEANING. EDUCATION HAS TO DO WITH THE DEVELOPMENT OF THE WHOLE PERSONALITY WHILE TRAINING DEALS WITH THE GAINING AND ACHIEVING OF SKILLS. THERE ARE AIMS OF EDUCATION; FIRST IS TO PREPARE. THE YOUNG FOR â€Å"CITIZENSHIP†-THE SUBTLE MEANS OF PROVIDING THE STATE IN ALONG RUN WITH FUTURE LEADERS AND FOLLOWERS WHO WOULD PUT INTEREST OF THE STATE AND NATION ABOVE SELF. SECOND AIM IS TO DEVELOP THE INDIVIDUAL â€Å"AS A MAN†- ENABLE THE INDIVIDUAL TO REALIZE HIS POTENTIAL POWERS AS A HUMAN BEING SO HE COULD BE FREE IN OUTLINING HIS OWN DESTINY. THIRD, IT SHOULD AIM TO PRESERVE THE PREVAILING SOCIAL SYSTEM BY WAY OF TRANSMITTING THE IDEAS, THE BELIEFS, THE VALUES AND THE PRACTICES OF SOCIETY. FOURTH, IT AIMS TO CONTRIBUTE TO SOCIAL TRANSFORMATION AND IT MUST FOSTER  A NEW CONSCIOUSNESS THAT IS SUPPORTIVE OF THE PEOPLES DREAM AND STRUGGLE FOR A MORE JUST, HUMAINE AND DEMOCRATIC SOCIETY. FIFTH, IT SHOULD PREPARE US FOR ETERNAL LIFE IN A PARADISE TO COME AND LASTLY IT SHOULD AIM TO COMPREHENSIVELY PREPARE US TO BE A â€Å"WORKER† OR TO BE â€Å"A CITIZEN AND TO BE â€Å"A PERSON. †EDUCATION HAS AN IDEOLOGICAL CHARACTER. TO LITTLE, INDEED, DOES THE SCHOOL GOING TO PUBLIC SUSPECT THAT EDUCATION AS A SOCIAL INSTITUTION CAN BE MANIPULATED BY VESTED GROUPS FOR THEIR OWN POLITICAL INTERESTS. TO SOME PEOPLE WHOSE ECONOMIC AND POLITICAL FORTUNES ARE ENTRENCHED THAT EDUCATION IS USED TO PROMOTE SOCIAL CONFORMITY AND AGREEMENT. TO OTHERS WHO HAVE NOTHING BUT THEIR STATE OF DEPRIVATION AND UNCERTAINTIES, EDUCATION CAN EMPOWER THEM TO STRUGGLE FOR SOCIAL CHARGE. POLITICS: POLITICS IS A STRATEGY TO MAINTAIN ORDER AND COOPERATION AMONG PEOPLE OR INDIVIDUALS WITH DIFFERING NEEDS AND IDEALS IN LIFE, OR FOR REVOLVING CONFLICT WITHIN THE GROUP WHETHER THIS BE A FAMILY, A TRIBE, A VILLAGE OR A NATION-STATE. IT MAY BE UNDERSTOOD AS A CONTROL OVER THE SITUATION SO THAT DIFFERENCES ARE RESOLVED AND PREVENTED. THERE ARE TWO MAIN APPROACHES TO POLITICS NAMELY; POLITICAL PHILOSOPHY AND POLITICAL SCIENCE. POLITICAL PHILOSOPHY HAS A SPECULATIVE AND NORMATIVE CHARACTER BECAUSE IT DEALS WITH THE QUESTION OF WHAT IS POLITICS â€Å"OUGHT TO BE† OR WHAT IT SHOULD BE WHILE POLITICAL SCIENCE IS EMPIRICAL AND DESCRIPTIVE IN NATURE BECAUSE ITS MAIN CONCERN IS THE ANALYSIS AND DEFINITION OF THE STATE AND ITS INSTRUMENTALITIES AND DESCRIPTIONS OF THEIR FUNCTIONS. POLITICS IS THE SCIENCE AND ART OF GOVERNING SOCIETY IN THE PURSUIT OF COMMON GOOD THEN ITS CONCRETIZATION IS THE GOVERNMENT WHOSE AIM IS THE PEOPLE AND THE SECURITY AND WELFARE OF THE PEOPLE. FORTHETHREEGREATPHILOSOPHERSNAMELY;CONFUCIUS,PLATOANDNICCOLO. MACHIAVELLI TO BE GOOD RESPONSIBLE POLITICAL LEADERS OF STATE THERE ARE VERY ESSENTIAL QUALITIES TO BE CONSIDERED. FOR CONFUCIUS, POLITICAL LEADERSHIP IS NOT FOR THE COMFORT AND ENJOYMENT OF THE RULERS, NOR ARE THEY SIMPLY FOR THE MAINTENANCE OF LAW AND ORDER, BUT FOR â€Å"THE HAPPINESS AND ENLIGHTENMENT OF THE PEOPLE†. HE ALSO PRESCRIBED THAT THOSE WHO ASPIRE TO LEAD THE PEOPLE MUST POSSESS THE VIRTUES OF HUMAN-HEARTEDNESS, RRIGHTEOUSNESS, PPROPRIETY AND Introduction to Philosophy WISDOM. FOR PLATO, A PERSON’S LIFE IS ORDERLY OR â€Å"JUST† WHEN HIS REASON CONTROLS THE EMOTION AND TEMPERS THE APPETITES. THE THREE KINDS OF PEOPLE SHOULD POSSESS THREE ELEMENTS IN MAN. A RULER SHOULD EMBRACE REASON, THE SOLDIERS OR WARRIORS SHOULD DEAL WITH THEIR EMOTION AND THE ARTISANS OR ORDINARY PEOPLE SHOULD CONTROL THEIR APPETITES. ALL CITIZENS MUST UNDERGO RIGID PHYSICAL, INTELLECTUAL AND MORAL TRAINING. PLATO’S PHILOSOPHY ON EDUCATION WAS ONE OF SO CALLED SELECTION ELIMINATION. NICCOLO MACHIAVELLI WROTE A BOOK ENTITLED, â€Å"THE PRINCE â€Å"POLITICS, AS AN EXERCISE OF POWER, SHOULD BE DIVORCED FROM MORALITY AND RELIGION. POLITICS HAS NO MORALITY; IT IS A NAKED POWER OF â€Å"EXPEDIENCY†. OR HIM AN EFFECTIVE LEADER IS BOTH. A FOX AND A LION, BOTH A MAN AND A BEAST AND BOTH GREAT PRETENDER OR GREAT DISSEMBLER. B. Analysis (Critique) KNOWLEDGE: THESEARCHFORKNOWLEDGEISANEVER-ENDINGADVENTURE LIKEWE’VESEENIN MOVIES AND PLAYS. THE WHOLE OF REALITY IS TOO VAST THAT WE CAN KNOW ONLY TOO LITTLE OF IT IN OUR SHORT LIFE-TIME; HENCE, IT WOULD BE THE HEIGHT OF INNOCENCE TO NARROW OUR PRESENT KNOWLEDGE, UNLESS WE CHOOSE TO CLOSE OUR MIND TO OTHER POSSIBILITIES. OUR KNOWLEDGE IS A PRODUCT OF ALL OUR ABILITIES, SENSATION, REASON AND INTUITION. AND O AGREE WITH THE SAYING THAT â€Å"KNOWLEDGE IS POWER†, A POWER TO RECREATE THE WORLD, A POWER TO CONSTRUCT A BETTER SOCIETY WHERE ALL MEN AND WOMEN COULD LIVE WITH DIGNITY, FREEDOM AND PEACE. I DO BELIEVE THAT THERE ARE ALWAYS MORE TO KNOW SINCE IT IS DYNAMIC AND TOO ENORMOUS. WE SHOULD ALWAYS HAVE THE GUTS, THE PASSION AND THE LOVE TO LEARN AND TO CONTINUE SEARCHING AND BUILDING ON THE BODY OF KNOWLEDGE. NO DOUBT, KNOWLEDGE ADDS COLOR AND RELATIVE CHARACTER TO MAKE OUR LIFE WORTH LIVING AND SPENDING. OUR KNOWLEDGE SHOULD NOT BE AFFECTED NOR DISTORTED BY OUR OWN COGNITION. WE SHOULD KEEP IN MIND TO ALWAYS USE REASONING SINCE IT IS ACQUIRING KNOWLEDGE NOT JUST BASING IT TO WHAT WE PERCEIVE. YES, WE CAN CONSTRUCT KNOWLEDGE BY OUR SENSES TO EVERY SITUATION WE’RE EXPERIENCING YET WE SHOULD ALWAYS BE RATIONAL. KNOW THE REASON TO EVERY DETAIL NOT TO JUSTIFY THINGS BUT RATHER TO BE REASONABLE IN JUDGING AND JUMPING TO CONCLUSIONS. KNOWLEDGE IS A STUFF OF REALITY; IT IS A WAY OF TRUTH AND NOT A WAY OF SEEMING OR GIVING OPINION. ALSO THE ONLY THING WE SHOULD NOT DOUBT IS THAT WE ALWAYS IN PARTICULAR SITUATION DOUBT. DON’T BE AFRAID TO DOUBT OR TO QUESTION THINGS BECAUSE IT IS A WAY OF ACQUIRING AND GAINING ALL WE NEED TO KNOW. ON THE OTHER HAND WE COULD STILL OBTAIN KNOWLEDGE THAT IT IS NOT THE SENSES, NOR REASON CAN PROVIDE ADEQUATE UNDERSTANDING OF REALITY BUT THE SO CALLED INTUITION. KNOWLEDGE IS AN INTERCONNECTED CHAIN WHEREIN THERE IS AN AGREEMENT WITH ONE SET OF KNOWLEDGE WITH ANOTHER SET OF IT. IT IS A CYCLE WITH NO BEGINNING AND ENDING. THE MORE WE BECOME CURIOUS THE MORE WE QUESTION AND THE MORE WE SEEK FOR THE ANSWER. WE ALWAYS HAVE THE PRIVILEGED TO OPEN OUR CLOSE UNDERSTANDING OF THE WORLD AND WE ARE FREE TO EXPLORE ITS LIMITATION AND BOUNDARY. WE ALWAYS HAVE THE KEY TO KNOW THE SECRETS OF THE REAL MEANING AND Introduction to Philosophy VALUE OF LIFE. WE SHOULD NOT STOP TRAVELLING THE BEAUTIFUL AND COLOURFUL JOURNEY OF OUR EXISTENCE AND DON’T STOP TO STRIVE AND TO GAIN THE PERFECT AND UNDYING KNOWLEDGE. EDUCATION: SINCE WE ARE SEARCHING FOR KNOWLEDGE, HAVING AN EDUCATION IS OF GREAT HELP. IT IS A VITAL INSTRUMENT TO EXPLORE OUR LIMITATION AND TO GO BEYOND THE HORIZON. HAVING AN EDUCATION IS LIKE SEEING A RAINBOW AFTER A RAIN SHOWER; IT ADDS COLOR AND MEANING AFTER THE SUDDEN DARKNESS. WE SHOULD NOT JUST BE TRAINED, WE MUST BE EDUCATED. BEING EDUCATION FOR ME IS OPENING THE WINDOWS OF OUR MIND AND SOUL. WE SHOULD PUT EFFORT TO UNDERSTAND, TO COMPREHEND, AND TO BE SENSITIVE TO IDEAS, ASPIRATIONS AND INTEREST TO WHICH WE MIGHT OTHERWISE BE INDIFFERENT TO EACH OTHER. WE SHOULD NOT JUST BE CONTENTED JUST TO BE TRAINED BECAUSE IT SIMPLY MEANS WE JUST WANT TO IMPROVE OUR ABILITY TO DO SOMETHING WITHOUT DEEPENED UNDERSTANDING, WIDENED SYMPATHY OR HEIGHTENED ASPIRATIONS FOR IT. THERE SHOULD BE A COMMON AGREEMENT ON WHAT IS EDUCATION SHOULD AIM AND DEFINE THE PURPOSE OF EDUCATION WITH NO BIAS AND FAIR CHANCES TO PEOPLE OF DIFFERENT SOCIAL POSITIONS AND SHOULD NOT BE IN HARMONY WITH THEIR FUNDAMENTAL INTERESTS. IT WOULD BE AN ILLUSION TO EXPECT THE PREVAILING EDUCATION TO BE TRULY TRANSFORMATIVE AND LIBERATING BECAUSE OF TODAY’S INEQUALITY ESPECIALLY IN SOCIAL STATUS ASPECTS THUS THERE IS A NEED TO RE-INVENT EDUCATION SO THAT IT WILL FOSTER A NEW AWARENESS AND PERSPECTIVE THAT IS SUPPORTIVE AND REFLECTIVE TO OUR ASPIRATIONS AND STRUGGLE FOR SOCIAL TRANSFORMATION. POLITICS: EDUCATION HERE IN THE PHILIPPINES IS AFFECTED BY MANY FACTORS SUCH AS THE KIND OF POLITICS WE HAVE. I DO BELIEVE THAT POLITICS SHOULD FUNCTION AND AIMS TO GO AFTER THE WELFARE OF THE PEOPLE AND NOTHING ELSE BUT THE SECURITY AND NEEDS OF PEOPLE. POLITICS IS BOTH A FREEDOM AND RESPONSIBILITY. IT IS POWER YET WHEN USED IN A WRONG WAY OR BECOME A PURSUIT AND CHASE OF PERSONAL INTERESTS COULD BE ABUSED. POLITICS IS NOT JUST A SYSTEM ITSELF BUT A SYSTEM OF IDEAS WITH MISSION AND FUNCTIONS. IN SPITE OF THE CURRENT SITUATION IN OUR COUNTRY WE COULD STILL PURSUE A FAIR, JUST, HONEST AND RESPONSIBLE POLITICAL SYSTEM. WE COULD STILL MAKE A CHANGE. ASIDE FROM BEING A GOOD AND RELIABLE FOLLOWER WE COULD CHOOSE AND ELECT GOOD AND RIGHT POLITICAL LEADERS ESPECIALLY WITH OUR DEMOCRATIC TYPE OF SYSTEM. WE NEED TO BE RESPONSIBLE ENOUGH TO DESIGNATE THE FIT AND APPROPRIATE RULER WITH THEIR BEST QUALITY AND CHARACTER. WE SHOULD CAREFULLY ANALYSE AND EVALUATE A POLITICAL RULER WHO HAS THE INTEREST IN SERVING THE PEOPLE WITH SINCERITY AND SHOULD NOT JUST MAINTAIN HIMSELF OR HERSELF IN POWER. C. Contextualization KNOWLEDGE: Introduction to Philosophy FILIPINO IS A KNOWLEDGE SEEKER AND SO EXPLORATIVE WHEN IT COMES TO NOURISH AND DEVELOP THEIR LEARNING AND ABILITIES. WE HAVE SO MANY PROUD KABABAYAN WHO ARE SO PASSIONATE AND DETERMINE IN ACQUIRING SUCH KNOWLEDGE THEY ARE LOOKING FOR. SOME OF US EVEN TRY TO GO TO OTHER COUNTRY FOR THEIR SEARCH FOR KNOWLEDGE. WE ARE NOT CONTENTED WITH JUST HAVING A KNOWLEDGE THAT IS ALREADY IN FRONT OF US. WE USUALLY GET OUT OF THE BOX AND GO BEYOND THE HORIZON. AND BECAUSE OF THIS PERSEVERANCE, MANY FILIPINOS FROM DIFFERENT FIELD BECOME SUCCESSFUL AND FAMOUS. MANY JOBS AND OPPORTUNITIES BECOME OPEN TO FILIPINOS BECAUSE OF THEIR ABILITY AND PASSION TO LEARN. EDUCATION: PUBERTY BECOMES A BARRIER TO ATTAIN THE GOAL OF HAVING A BETTER EDUCATION. NOWADAYS, AS YOU LOOK WITH THE STATUS OF OUR COUNTRY, PHILIPPINES I MUST SAY THAT WE OUR STRUGGLING ESPECIALLY THE UNFORTUNATE INDIVIDUAL TO GET SUCH APPROPRIATE AND GOOD QUALITY OF EDUCATION. IN OUR COUNTRY; LIVING STATUS AFFECTS A LOT IN MAINTAINING A GOOD QUALITY OF EDUCATION. THERE ARE SO MANY FAMILIES WHO BATTLE FOR FINANCING THE OTHER EXPENSES OF THEIR CHILD LIKE PROJECT AND DAILY TRANSPORTATION AND FOOD ALLOWANCE. FOR AN UNDERPRIVILEGED FAMILY WITH INCOME THAT IS NOT ENOUGH WITH THEIR DAILY CONSUMPTION, HAVING A BUDGET FOR EDUCATION COULD BE A LEAST PRIORITY. MANY OF THE YOUTH TODAY EVEN THEY WANT TO CONTINUE THEIR COLLEGE JUST COULD NOT BECAUSE THEY HAVE NO CHOICE BUT TO WORK TO SUPPORT AND PROVIDE FINANCIALLY FOR THEIR FAMILY. ALSO IT IS COMMON, IN SOME FAR BARRIOS MANY FILIPINO CHILDREN BEFORE THEY COULD REACH THE NEAREST SCHOOL FROM THEIR HOUSE THEY NEED TO STRUGGLE AND WALK ON RIVERS AND EVEN SOME SLOPPY MOUNTAIN BEFORE THEY CAN GET THERE. IN SPITE THEIR DEDICATION TO BE EDUCATED, SCHOOL BUILDINGS AND GOOD LEARNING FACILITIES AND MATERIALS IS NOT ENOUGH TP ACCOMMODATES LARGE POPULATION IN OUR COUNTRY. ALSO CORRUPTION IS ONE OF THE MAJOR REASONS WHY NUMBER OF FILIPINO IS UNABLE TO AVAIL THEIR RIGHTS TO BE EDUCATED. INSTEAD OF FINANCING THE EDUCATION SECTOR, THE MONEY OF FILIPINOS GOES TO THE POCKET OF THOSE WHO ARE GREED AND SELFISH OFFICIALS. NO DOUBT, PHILIPPINES IS A RICH COUNTRY WITH ITS SPLENDID NATURAL RESOURCES YET OUR MONEY COULD NOT EVEN FINANCIALLY PROVIDE AND GIVE STABLE WORKS AND OPPORTUNITIES TO THOSE WHO NEED JOBS. POLITICS: IT BEEN AN ORDINARY SCENARIO DURING ELECTION THAT THERE ARE SO MANY UNNECESSARY ACTIONS TOOK PLACE LIKE VOTE BUYING, BALLOT RESULT CHEATING, KILLING OF POLITICAL RIVALRY, AND THE LIKES JUST FOR THOSE SELF-CENTRED ASPIRANT OFFICIALS TO WIN THE SAID ELECTION. AND EVEN AFTER THE ELECTION, DURING THEIR SERVING YEARS SO MANY VOID PRACTICE IS BEEN HAPPENING. CORRUPTION IS ONE OF THE MAJOR PROBLEMS HERE IN THE PHILIPPINES. MANY ELECTED POLITICAL OFFICIALS ABUSE THE POWER GIVEN TO THEM FOR THEIR OWN INTERESTS. TODAY’S ISSUE IS WHAT THEY CALLED PORK BARREL SCANDAL WHEREIN THE BUDGET ALLOTTED AND GIVEN TO POLITICAL OFFICIAL FOR THEIR PROJECTS AND PROGRAMS THAT SHOULD AND MUST HELP FILIPINO GOES TO POCKET OF JUST SOME PEOPLE. FINGER POINTING AND HAND WASHING THAT THEY DON’T USE ANY OF THE PUBLIC MONEY FOR THEIR OWN WELFARE IS STILL ON INVESTIGATION AND NOT YET ANSWERED. Introduction to Philosophy INSTITUTIONALIZING IS ALSO HAPPENING IN OUR COUNTRY AND THE MOST AFFECTED ARE THE PUBLIC ESPECIALLY THE POOR. IT IS ALSO COMMON IN OUR POLITICAL SYSTEM HAVING A FAMILY DYNASTY WHEREIN THE POWER IN MANY PLACES IS JUST IN THE HAND OF ONE FAMILY. EVEN WE ALREADY HAVE AUTOMATED KIND OF ELECTION SYSTEM, WE STILL STRUGGLE TO HAVE THE FAIR AND JUST POLITICAL SYSTEM WE ARE LOOKING AND HOPING TO ACHIEVE. LASTLY, WE FILIPINOS STILL ELECTING WRONG PUBLIC SERVANT. WE ARE STILL BLIND WITH THEIR LOOKS, WHETHER THEY ARE CELEBRITIES OR IF EVEN THEY TEND TO FINISH THEIR EDUCATION AND WITH THEIR FLOWERING PROMISES AND WORDS. WE NEVER REALLY PRACTICE A CRITICAL JUDGEMENT TO CHOOSE THE RIGHT AND THE GOOD STATE RULER. D. Evaluation 1. SUBJECT THE SUBJECT PHILOSOPHY REALLY HELPED ME TO BE OPEN-MINDED AND CRITICALLY INCLINED WITH EVERYTHING AROUND ME. WE HAVE SO MANY THINGS WE STILL NEED TO KNOW AND ACQUIRE YET PHILOSOPHY SERVES AS AN ASSISTING TOOL TO REALLY KNOW THE MEANING OF OUR OWN EXISTENCE AND THE REAL MEANING OF OUR LIFE AND ITS PURPOSE. MY CLOSED WORLD BECOMES EXPOSED WITH WHAT IS REALLY HAPPENING. 2. PROF SIR RODERICK CENTENO IS A VERY KNOWLEDGEABLE, RESPECTED AND FULL OF SENSE KIND OF PROFESSOR IN PHILOSOPHY. WE REALLY ENJOYED LISTENING TO HIS LECTURES ABOUT PHILOSOPHY. IT SO REFRESHING THAT WHILE LEARNING WE’VE ABLE TO HAVE FUN AND ENJOY EVERY LEARNING AND DISCUSSION. THE REPORTING IS A GOOD WAY FOR US STUDENT TO EXPRESS OUR PERSPECTIVES AND OPINIONS ON THINGS. IT HELPS TO BOOST OUR INTEREST AND AWARENESS ON THE THINGS THAT BEFORE WE REALLY DON’T HAVE CARE AND IS NONE OF OUR BUSINESS. THE REFLECTION WRITING ACTIVITIES IS A USEFUL FOR US TO HAVE SECOND THOUGHTS TO EVERY ISSUE AND DECISIONS. AND I OBSERVED THAT SIR GIVES IMPORTANCE IN MANAGING HIS AND OUR TIME. Introduction to Philosophy.

Psychological Interventions in Patients with Cancer

Psychological Interventions in Patients with Cancer Introduction Patients with cancer may experience comorbid conditions such as anxiety and depression, and symptoms including fatigue, nausea and vomiting. Anxiety and depression are both very common and it has been estimated that 16–25% of newly diagnosed cancer patients experience either depression or depressed mood (DSM-IV criteria) (Sellick 1999). Studies in women with breast cancer have shown that up to 30% develop psychological morbidity (either anxiety or depressive disorder) within one year of diagnosis (Bleiker 2000; Maguire 2000). Cancer-related symptoms are also very common. As many as 70–80% of all cancer patients receiving chemotherapy experience nausea and vomiting (Lindley et al. 1989; Morrow 1992) and 78% of patients are estimated to be affected by fatigue (Ashbury et al. 1998), in particular those with advanced cancer and those receiving radiotherapy and chemotherapy treatment (Ahlberg et al. 2003; Jacobsen et al. 2007), where symptoms may persist even after treatment has finished (Servaes et al. 2002). The use of psychological interventions can be beneficial in the management of cancer-related conditions and symptoms and may result in improved quality of life and better long-term outcomes (Devine and Westlakes 1995). Psychological interventions may be classified into four groups (which also include broader psychosocial interventions) as described below (Fawzy et al.1995; Greer 2002; Edwards et al. 2004): Cognitive behavioural interventions involve the identification and correction of those thoughts, feelings and behaviours that may be involved in the development and/or maintenance of cancer-related symptoms or conditions (Jacobsen 1998). Individual psychotherapy interventions involve one-to-one interaction between patient and therapist, aimed at reducing feelings of distress and increasing the patient’s morale, self-esteem and ability to cope (Fawzy et al. 1995) Educational interventions provide patients with information about cancer, ways of coping with the disease and what resources are available to help them, with the aim of reducing commonly experienced feelings such as inadequacy, confusion, helplessness and loss of control (Fawzy et al. 1995). Group interventions may be either patient led or led by healthcare professionals and serve to provide social support for cancer patients (Leszcz and Goodwin 1998). One intervention within this category, supportive-expressive group therapy, involves building bonds, expressing emotions, improving the relationship between patient and healthcare professional and improving coping skills (Edwards et al. 2004). It is also important to consider the effectiveness of other interventions, such as the use of complementary therapies, which may be used alongside psychological interventions to achieve a greater improvement in cancer-related conditions and symptoms than those obtained using psychological interventions alone. This paper reports the process and findings of a literature review performed to identify and evaluate published literature on psychological interventions in patients with cancer, and other interventions that may also be effective in achieving improved psychological outcomes, together with a discussion of how the evidence gathered may guide informed decision-making on best clinical practice. Data sources and search strategy Electronic searches were performed on the Medline, CINAHL and PsychINFO databases for English language articles published between 1998 and 2008. Search terms included cancer AND intervention OR cancer AND therapy plus education OR patient education OR educational OR cognitive behavioural OR cognitive OR psychotherapy OR psychological OR supportive-expressive OR supportive OR group psychotherapy. For each trial, the quality of both the trial itself and the report in the published literature were assessed. Literature review Main results Well-designed, single or multicentre, randomised controlled trials involving large study samples were selected for inclusion, together with systematic reviews and meta-analyses. Only UK published literature was originally planned for inclusion; however, due to the limited number of high quality, well-designed studies identified, searches were performed again to identify suitable non-UK articles. Summary of studies selected Cognitive behavioural interventions One randomised controlled trial and one systematic review were identified from the UK-published articles found during the electronic searches. The randomised controlled study by Moynihan et al. investigated the use of adjuvant psychological therapy in 73 men with newly diagnosed, non-suicidal men with testicular cancer (Moynihan et al. 1998). This is a cognitive behavioural treatment programme designed specifically for patients with cancer. The therapist was a mental health nurse with experience of caring for testicular patients and who was trained in adjuvant psychological therapy techniques. Outcome measures included validated self-completed questionnaires such as the Hospital Anxiety and Depression Scale, the mental adjustment to cancer scale and the psychosocial adjustment to illness scale. The treatment group showed a minimal reduction in anxiety after 2 months and when adjustment for histology, stage of disease and type of treatment was made, the observed effect was not signifi cant. No between group differences in depression scores were observed after 2 months. After 1 year, control patients actually achieved better anxiety and depression scores than those in the treatment group. This study therefore concluded that there was no benefit from the use of adjuvant psychological therapy in men with testicular cancer. The systematic review performed by Richardson et al. evaluated the use of hypnosis for nausea and vomiting in patients with various types of cancer (Richardson et al. 2006). Study participants were children in 5 of the 6 randomised controlled studies selected. Meta-analyses demonstrated a large effect size of hypnosis compared with standard treatment, and this effect was at least as large as that achieved with cognitive-behavioural therapy. Limitations of this review were that the sample sizes of the studies included were small, and some of the studies were poorly described in the published literature. As the majority of the studies were conducted in children, further research is needed in adults to confirm these findings. A number of non-UK published studies evaluating the use of cognitive-behavioural training in patients with cancer were also identified. A randomised controlled study conducted by Korstjens et al. investigated the effects of physical plus cognitive-behavioural training compared with physical training alone on quality of life in 147 patients with various cancers who had completed treatment (Korstjens et al. 2008). Quality of life was measured using the RAND-36. After 12 weeks, there were no differences between groups in quality of life. It can therefore be concluded that adding cognitive-behavioural training had no added benefit on cancer survivors’ quality of life compared with physical training alone. Individual psychotherapeutic interventions Fenlon et al. conducted a randomised controlled trial to investigate the effect of relaxation training in reducing the incidence of hot flushes 150 women with primary breast cancer (Fenlon et al. 2008). Study participants in the treatment group received a single relaxation training session in conjunction with the use of practice tapes. Outcome measures included a patient diary and validated measures of anxiety and quality of life. After 1 month, the incidence and severity of hot flushes were significantly reduced (p Educational interventions A randomised controlled trial by Ream et al. evaluated an educational support intervention (i.e. investigator-designed information pack) for fatigue in 103 chemotherapy-naà ¯ve cancer patients. Additional psychological support was also provided by nurses. After 3 months, the intervention group reported significantly less fatigue, lower levels of anxiety, depression and distress, and better adaptive coping (all p Jones et al. carried out a randomised trial to investigate whether different types of educational information could increase interaction between the patient and others, thereby improving emotional support and psychological well-being (Jones et al. 2006). A total of 325 patients with breast or prostate cancer who were about to begin radiotherapy participated in the study. Patients were given either a general information booklet on cancer or else a booklet containing personalised information. Outcome measures included the use of Likert scales to score answers to questions on anxiety and depression (non-validated) and Helgeson’s social support questionnaire. Results showed no differences between groups in anxiety or depression scores but patients who received personalised information reported that they were more likely to show their booklet to others and believe it helped in discussions. These findings suggest that this type of intervention may have the potential to improve emoti onal well-being by increasing the levels of support patients receive from others. A systematic review conducted by Smith et al. evaluated the effectiveness of mindfulness-based stress reduction as supportive therapy (Smith et al. 2005). This is a highly-structured psycho-educational, skill-based therapy that combines mindfulness meditation with hatha yoga. Two randomised controlled and four uncontrolled trials were selected which used self-reported outcome measures for mood, stress, anxiety and quality of life. Study findings showed improvements in mood and sleep quality and reductions in stress in patients following the use of this intervention. However, the studies included in this review largely involved small sample sizes and may therefore be underpowered. Furthermore, the quality of the written study manuscripts was variable; for example, some contained limited descriptions of the randomisation process and a lack of methods on sampling and participant recruitment. While these results are encouraging and suggest that mindfulness-based stress reduction may be e ffective as a self-administered intervention for cancer patients, further research conducted through well-designed, randomised controlled trials is needed to confirm these preliminary findings. Group psychological interventions A non-UK published study was conducted to investigate the effectiveness of hospital psychosocial support groups on emotional distress and quality of life in 108 women with breast cancer (Schou et al. 2007). Outcome measures involved the use of the validated Hospital Anxiety and Depression Scale and the EORTC quality of life questionnaire. After 12 months, the prevalence of anxiety was significantly lower among group participants than in non-participants (19% vs 34%; p=0.04). These findings suggest that psychosocial support appears to have a long-term benefit on anxiety although the effects of this intervention on depression and quality of life were inconclusive in this study. Another non-UK published randomised controlled trial has been conducted to investigate the effect of supportive-expressive group therapy compared with educational materials on distress in 125 women with metastatic breast cancer (Classen et al. 2001). Participants were offered either one year of weekly group therapy plus educational materials or educational materials only. Outcome measures included the Profile of Mood States (POMS) to assess mood disturbance and Impact of Event Scale (IES) to assess change over time in trauma symptoms. Patients who received weekly therapy showed a significantly greater decline in traumatic stress symptoms than those in the control group but no between group differences in mood disturbance were observed. It can be concluded that supportive-expressive group therapy may offer some benefit in reducing distress in women with metastatic breast cancer. Complementary/alternative interventions Wilkinson et al. conducted a multicentre randomised controlled trial to investigate the effectiveness of aromatherapy massage in the management of anxiety and depression in 288 patients with cancer diagnosed with clinical anxiety and/or depression (Wilkinson et al. 2007). Patients were randomised to receive either a course of aromatherapy massage plus usual supportive care or supportive care only. Outcome measures included the validated State Subscale of the State Anxiety Inventory (SAI) and the Center for Epidemiological Studies Depression (CES-D) Scale. At 6 weeks post-randomisation, patients who received aromatherapy massage showed a significant improvement in clinical anxiety and/or depression compared with those receiving standard care only (p=0.001) but this effect was not sustained at 10 weeks post-randomisation (p=0.10) Patients receiving the aromatherapy intervention also recorded a greater improvement in self-reported anxiety at both 6 and 10 weeks than those in the control group (p=0.04). These results suggest that although aromatherapy massage may not confer long-term benefits to patients with cancer, short-term benefitsmmay be seen. Strengths and weaknesses of this literature review As previously stated, one of the major limitations of this review was that the original searches only included UK-published articles. As a lack of good quality published research was identified, further searches were conducted to identify suitable non-UK articles to include in the review. Although a number of studies were selected that recruited participants with various types of cancer, several studies involved patients with only breast cancer and only one study was conducted in men only. It may therefore be argued that the scope of this review was too narrow. One of the systematic reviews which were included (Richardson et al. 2007) involved small studies which were sometimes poorly designed or poorly written up. The findings of this systematic review should therefore be treated with caution until supported with data from randomised controlled trials. The strengths of this review are that well-designed randomised controlled trials were included, with sample sizes large enough for adequate power. The reports of these trials were generally good quality and comprehensively written with a logical flow. The aims and/or objectives were clearly stated, and descriptions of study design, participant recruitment and selection, and the randomisation process were included. Many of the outcome measures used were validated instruments, a description of all measures was included and appropriate statistical analyses were used to analyse the data. Implications for clinical practice Previous research and systematic reviews have reported conflicting findings on whether psychological interventions for patients with cancer are beneficial or not (Greer 2002; Edwards et al. 2004). The current review also presents conflicting data on the benefits of psychological interventions in cancer patients. Two of the studies selected presented evidence that cognitive behavioural interventions provide no added benefit to cancer patients. Interestingly, a systematic review concluded that hypnosis may be beneficial but many of the studies were conducted in children so whether these findings are also observed in adults requires further investigation. Individual psychotherapeutic interventions such as relaxation training may be beneficial for breast cancer patients in reducing distress although no improvement in anxiety or quality of life was observed. The effectiveness of these types of interventions in men and in patients with other types of cancer requires further research. Educational interventions and group psychological interventions produced the best outcomes of all the psychological interventions evaluated. In particular, the use of educational booklets and information packs, either used alone or in conjunction with psychological support, may result in improvements in psychological and emotional well-being in patients with cancer. Again, further research is needed to determine whether these types of interventions are beneficial in patients with all types of cancer. Psychosocial support groups and supportive-expressive group therapy have both been shown to be beneficial in women with breast cancer, particularly in reducing anxiety and distress. Further evidence is needed to demonstrate the effectiveness of these interventions in men. Complementary and/or alternative treatments such as aromatherapy may play a role as adjuvant therapies and can be beneficial in the short-term management of anxiety and depression in cancer patients. Conclusions This review has provided evidence that certain psychological interventions such as educational and group interventions may provide some benefit to cancer patients in the management of cancer-related conditions and symptoms including anxiety, depression, fatigue, nausea and vomiting. Both short- and long-term improvements in quality of life and emotional well-being may be achievable using these interventions but further research is needed to provide the evidence to guide best practice. Psychological and psychiatric support services are currently unable to meet demand from oncology services and the oncology nurse is ideally placed to play a key role in the provision of psychological care and support for cancer patients, either directly or as part of a multidisciplinary team. For example, educational interventions such as information leaflets can be developed and provided to patients by the oncology nurse, who would also able to lead group therapy sessions. It is essential that the nurse has sufficient knowledge of the most appropriate psychological intervention to use for patients and the skill and expertise to implement this effectively to ensure a successful outcome. Bibliography Ahlberg, K., Ekman, T., Gaston-Johannson, F., Mock, V. 2003, ’Assessment and management of cancer-related fatigue in adults’, Lancet, vol. 362, pp. 640–50. Ashbury, F.D., Findlay, H., Reynolds, B., McKerracher, K. A., ‘A Canadian survey of cancer patients’ experiences: are their needs being met? Journal of Pain and Symptom Management, vol. 16, no. 5, pp. 298–306. Bleiker, E. M., Pouwer, F., van der Ploeg, H. M., Leer, J. W., Ader, H. J. 2000, ‘Psychological distress 2 years after diagnosis of breast cancer: frequency and prediction’, Patient Education and Counselling, vol. 40, pp. 209–17. Classen, C., Butler, L. D., Koopman, C., Miller, E., DiMiceli, Giese-Davis, J., Fobair, P., Carlson, R. W., Kraemer, H. C., Spiegel, D. 2001, ‘Supportive-expressive group therapy and distress in patients with metastatic breast cancer’, Archives of General Psychiatry, vol. 58, pp. 494–501. Devine, E. C. Westlakes, S. K. 1995, ‘The effects of psychoeducational care provided to adults with cancer: met-analysis of 116 studies’, Oncology Nursing Forum, vol. 22, vol. 9, pp. 1369–81. Edwards, A. G. K., Hulbert-Williams, N., Neal, R. D. 2008, ‘Psychological interventions for women with metastatic breast cancer’, The Cochrane Library, issue 2, CD004253. Fawzy, F., Fawzy, N., Arndt, L., Pasnau, R. 1995, ‘Critical review of psychosocial interventions in cancer care’, Archives of General Psychiatry, vol. 52, pp. 691–9. Fenlon, D. R., Corner, J. L., Haviland, J. S. 2008, ‘A randomized controlled trial of relaxation training to reduce hot flashes in women with primary breast cancer’, Journal of Pain and Symptom Management, vol. 35, no. 4, pp. 397–405. Greer, S. 2002, ‘Psychological intervention. The gap between research and practice’, Acta Oncol, vol. 41, no. 3, pp. 238–43. Jacobsen, P. Hann, D. 1998, Cognitive-behaviour interventions. In: Psycho-oncology, Holland, J. (ed), Oxford University Press, New York, pp. 717–29. Jacobsen, P. B., Donovan, K. A., Vadaparampil, S. T., Small, B. J. 2007, ‘Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue’, Health Psychology, vol. 26, no. 6, pp. 660–7. Jones, R. B., Pearson, J., Cawsey, A. J., Bental, D., Barrett, A., White, J., White, C. A., Gilmour, W. H. 2006, ‘Effect of different forms of information produced for cancer patients on their use of the information, social support, and anxiety: randomised trial’, British Medical Journal, vol. 342, pp. 942–8. Korstjens, I., May, A. M., van Weert, E., Mesters, I., Tan, F., Ros, W. J., Hockstra-Weebers, J. E., van der Schrans, C. P., van den Borne, B, ‘Quality of life after self-management cancer rehabilitation: a randomized controlled trial comparing physical and cognitive-behavioural training versus physical training’, Psychosomatic Medicine, vol. 70, no. 4, pp. 422–9. Leszcz, M. Goodwin, P. 1998, ‘The rationale and foundations of group psychotherapy for women with metastatic breast cancer’, International Journal of Group Psychotherapy, vol. 48, no. 2, pp. 245–69. Maguire, P. 2000, ‘Psychological aspects. In: ABC of Breast Diseases, Dixon, M. (eds), BMJ Books, London, pp. 85–9. Moynihan, C., Bliss, J. M., Davidson, J., Burchell, L., Horwich, A. 1998, ‘Evaluation of adjuvant psychological therapy in patients with testicular cancer’, British Medical Journal, vol. 316, pp. 429–35. Ream, E., Richardson, A., Alexander-Dann, C. 2006, ‘Supportive intervention for fatigue in patients undergoing chemotherapy: a randomised controlled trial’, Journal of Pain Symptom Management, vol. 31, no. 2, pp. 148–61. Richardson, J., Smith, J. E., McCall, G., Richardson, A., Pilkington, K., Kirsch, I. 2007, ‘Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence’, European Journal of Cancer Care, vol. 16, no. 5, pp. 402–12. Schou, I., Ekeberg, O., Karesen, R., Sorensen, E. 2007, ‘Psychosocial intervention as a component of routine breast cancer care – who participates and does it help?’, Psycho-oncology, E-pub ahead of print. Sellick, S. Crooks, D. 1999, ‘Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development’, Psycho-oncology, vol, 8, pp. 315–33. Servaes, P., Verhagen, C., Bleijenberg, G. 2002, ‘Fatigue in cancer patients during and after treatment: prevalence, correlates and interventions’, European Journal of Cancer, vol. 38, pp. 27–43. Smith, J. F., Richardson, J., Hoffman, C., Pilkington, K. 2005, ‘Mindfulness-based stress reduction as supportive therapy in cancer care: systematic review’, Journal of Advanced Nursing, vol. 52, no. 3, pp. 315–27. Wilkinson, S. M., Love, S. B., Westcombe, A. M., Gambles, M. A., Burgess, C. C., Cargill, A., Young, T., Maher, E. J., Ramirez, A. J. 2007, ‘Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter, randomized controlled trial’, Journal of Clinical Oncology, vol. 25, no. 5, pp. 532–9. Table 1. Summary of main UK published studies selected

Pollution and Plunging Male Fertility :: Pollution Environment Environmental

Pollution and Plunging Male Fertility Several reliable studies have confirmed that fertility among men has decreased as a result of pollution. The average male ejaculation is about three milliliters. This amount of semen can contain between 20 million to 300 million sperm per milliliter semen. To determine the approximate number of sperm per milliliter of semen, technicians must place a drop of semen on a slide and, while looking through a microscope, they count the sperm within a certain sector. Men that have sperm counts below 20 million per milliliter are said to have reduced fertility and those whose counts fall below 5 million are considered sterile. In 1974, C. M. Kinloch-Nelson and Raymond G. Bunge at the University of Iowa, studied the semen quality of men who had fathered two or more children and were about to undergo vasectomies. Of the 386 fertile men studied, 7% of them had sperm concentrations above 100 million per millimeter and the average concentration was 48 million. When they compared their findings to similar studies done in the thirties, they found that sperm counts had been decreasing for 50 years. "They discovered that among healthy adult males who were not being treated for infertility, the average sperm count had declined by about 40 percent, from 120 million sperm cells per milliliter of semen to about 70 million" (Big Drop 36). In 1979, a professor at Florida State University, upon analyzing student semen samples discovered surprisingly low sperm counts and alarmingly high levels of toxic chemicals (including DDT and PLB's). "He suggested that environmental pollution might be causing the sperm decline" (Big Drop 36). The results of his findings triggered studies all over the world, showing counts in the range from 55 to 75 million and others showing numbers well above 100 million. Men exposed to high levels of toxic chemicals on the job were found to have semen containing pollutants. "Most scientists held to the view that changes in counting techniques were responsible for the reported dip" and . . . "after a few headlines, the sperm crisis became yesterday's news" (Big Drop 36). In 1996, Niels E. Skakkebk, a Danish pediatric endocrinologist, began studying male infertility and growth disorders among children . He had been noticing numerous boys with testicles that had not descended and malformed genitals. A study done in 1984 examining 2,000 Danish school boys showed that 7% of them had one or both testicles still inside their bodies.

Common Man Tragedy in Arthur Millers Death of a Salesman Essay

The idea of dramatic tragedy is a classical one, discussed in Aristotle's Poetics. Before it can be established as to whether Miller really has written a tragedy or not, the very concept of tragedy must be investigated. Aristotle asserted, 'Tragedy is a representation, an imitation, of an action.1? He went on to outline the common features tragic drama must have. Tragedy has six elements, which, in order of importance, are: plot, character, thought, music, language, and spectacle. The plot requires peripeteia, anagnorisis, and cathartic effect. It must take place in one day, in one setting, with a unity of plot (i.e. all tragic, no comic subplot). The character must be ?good? (there is some debate as to the vague nature of this word), be 'true to type', be consistent in behaviour, be a great man (that is, to be representative of a whole society), and have one single tragic flaw. Thought is exactly that; the ideas that the speakers express in language. Music is also self-explanat ory. As for language and spectacle, the development of these is the perpetual instinct of drama to struggle closer and closer to real life. Willy Loman's character does adhere to the tragic hero guidelines to a certain extent. Rather than being a man who is a representative of a society, he represents society. His allegorical name of 'Loman' or 'Low-man' allowed Miller to twist the formula somewhat. He is true to type in that he dreams the American Dream, and subscribes to the desire for money and material possessions in capitalist society. Whether Willy is a 'good' man is debatable; his affair would indicate that he is not, his wife dotes on him, and Biff is crushed by the discovery of the mistress, so much so that he loses all faith in his fa... ...illy is a victim of the society in which he lives, or a victim of his own poor judgement. ?Willy is not simply a victim of that success-mongering culture. Miller wishes us to see that Willy accepts the success value all too easily and completely. The play suggests that, along with our pity for Willy, we take a critical attitude.8? Bibliography: BROWN, J. R. and HARRIS, B. (1974) American Theatre ARNOLD DOWNER, A. S. (1975) American Drama and Its Critics CHICAGO KERNAN, A. B. (1967) The Modern American Theater SPECTRUM KRUTCH, J. W. (1967) American Drama since 1918 BRAZILLER LUCAS, F. L. (1972) Tragedy ? Serious drama in relation to Aristotle?s Poetics CHATTO & WINDUS PORTER, T. E. (1969) Myth and Modern American Drama WAYNE SCANLAN, T. (1978) Family, Drama, and American Dreams GREENWOOD WILLIAMS, R. (1969) Modern Tragedy CHATTO & WINDUS

The Henry Wiggen Novels of Mark Harris Essay -- Southpaw Drum Seamstit

The Henry Wiggen Novels of Mark Harris  Ã‚  Ã‚     Ã‚   There can be no question that sport and athletes seem to be considered less than worthy subjects for writers of serious fiction, an odd fact considering how deeply ingrained in North American culture sport is, and how obviously and passionately North Americans care about it as participants and spectators. In this society of diverse peoples of greatly varying interests, tastes, and beliefs, no experience is as universal as playing or watching sports, and so it is simply perplexing how little adult fiction is written on the subject, not to mention how lightly regarded that little which is written seems to be. It should all be quite to the contrary; that our fascination and familiarity with sport makes it a most advantageous subject for the skilled writer of fiction is amply demonstrated by Mark Harris. In his novels The Southpaw (1953), Bang The Drum Slowly (1956), A Ticket For A Seamstitch (1957), and It Looked Like For Ever (1979), Harris chronicles the life of Henry "Author" Wiggen, a great major-league baseball star. Featuring memorable characters and deft storytelling, these books explore the experience of aging, learning, and living in time, with baseball as their backdrop. Henry's first-person narrative is the most important element of these stories. Through it he recounts the events of his life, his experiences with others, his accomplishments and troubles. The great achievement of this narrative voice is how effortlessly it reveals Henry's limited education while simultaneously demonstrating his quick intelligence, all in an entertaining and convincing fashion. Henry introduces himself by introducing his home-town of Perkinsville, New York, whereupon his woeful g... ...ause they are so well written. The expertly devised narrative voice, easy humour, compelling characterization, and thoughtful, even philosophical storytelling combine to create a series of books which compare favourably to many included on the Modern Library's recent list of the 100 Best Novels of the 20th Century, which seems not to contain a single novel set in the world of sport. It is a curious prejudice, this apparent lack of respect for literature concerned with sport, to which these novels represent a pointed and hearty rebuke. Works Cited Harris, Mark. A Ticket For A Seamstitch. Lincoln: University of Nebraska Press, 1984. ---. Bang The Drum Slowly. Lincoln: University of Nebraska Press, 1984. ---. It Looked Like Forever. Lincoln: University of Nebraska Press, 1989. ---. The Southpaw. Lincoln: University of Nebraska Press, 1984.   

Island of the Sequined Love Nun Chapter 42~43

PART THREE Coconut Angel 42 Bedfellows Just before dawn, Tuck crawled through the bottom of the shower like a homesick cockroach, scuttled out of the bathroom under the mosquito netting and into bed. There were things to do, big things, important things, maybe even dangerous things, but he had no idea what they were and he was too tired and too drunk to figure them out now. He had tried, he had really tried to convince the Shark men that the doctor and his wife were doing horrible things to them, but the islanders always came back with the same answer: â€Å"It is what Vincent wants. Vincent will take care of us.† To hell with them, Tuck thought. Dumb bastards deserve what happens to them. He rolled over and pushed the coconut-headed dummy aside. The dummy pushed back. Tuck leaped out of bed, tripped in the mosquito netting, and scooted on his butt like a man backing away from a snake. And the dummy sat up. Tuck couldn't see the face in the predawn light filtering into the bungalow, just a silhouette behind the mosquito netting, a shadow. And the shadow wore a captain's hat. â€Å"Don't think I don't know what you're thinking because I'll give you six to five I do.† The accent was somewhere out of a Bowery Boys movie, and Tuck recognized the voice. He'd heard it in his head, he'd heard it in the voice of a talking bat, and he'd heard it twice from a young flyer. â€Å"You do?† â€Å"Yeah, you're thinking, ‘Hey, I never wanted to find a guy in my bed, but if you got to find a guy in your bed, this is the guy I'd want it to be,' right?† â€Å"That's not what I was thinking.† â€Å"Then you shoulda taken odds, ya mook.† â€Å"Who are you?† The flyer threw back the mosquito netting and tossed something across the room. Tuck flinched as it landed with a thump on the floor next to him. â€Å"Pick it up.† Tuck could just see an object shining by his knee. He picked up what felt like a cigarette lighter. â€Å"Read what it says,† the shadow said. â€Å"I can't. It's dark.† Tuck could see the flyer shaking his head dolefully. â€Å"You know, I saw a guy in the war that got his head shot off about the hat line. Docs did some hammering on some stainless steel and riveted it on his noggin and saved his life, but the guy didn't do nothing from that day forward but walk around in a circle yanking his hamster and singing just the ‘row' part of ‘Row, Row, Row Your Boat.' They had to tape oven mitts on him to keep him from rubbing himself raw. Now, I'm not saying that the guy didn't know how to have a good time, but he wasn't much for conversation, if you know what I mean.† â€Å"That was a beautiful story,† Tuck said. â€Å"Why?† â€Å"Because the steelhead hamster-pulling ‘row' guy was a genius compared to you. Light the fuckin' lighter, ya mook.† â€Å"Oh,† Tuck said and he flipped open the lighter and sparked it. By the firelight he could read the engraving: VINCENT BENNIDETTI, CAPTAIN U.S.A.F. Tuck looked back at the flyer, who was still caged in shadow, even though the rest of the room had started to lighten. â€Å"You're Vincent?† The shadow gave a slight bow. â€Å"Not exactly in the flesh, but at your fuckin' service.† â€Å"You're Malink's Vincent?† â€Å"The same. I gave the chief the original of that lighter.† â€Å"You could have just said so. You didn't have to be so dramatic.† Tuck was glad he was a little drunk. He didn't feel frightened. As strange as it all was, he felt safe. This guy – this thing, this spirit – had more or less saved his life at least twice, maybe three times. â€Å"I got responsibilities, kid, and so do you.† â€Å"Responsibilities?† Now Tuck was frightened. It was a conditioned response. â€Å"Yeah, so when you get up later today, don't go storming into the doc's office demanding the facts. Just go swimming. Cool off.† â€Å"Go swimming?† â€Å"Yeah, go to the far side of the reef and swim away from the direction of the village about five hundred yards. Keep an eye out for sharks outside of the reef.† â€Å"Why?† â€Å"A guy appears out of nowhere in the middle of the night saying all kinds of mystical shit and you ask why?† â€Å"Yeah. Why?† â€Å"Because I said so,† Vincent said. â€Å"My dad always said that. Are you the ghost of my dad?† The shade slapped his forehead. â€Å"Repeat after me – and don't be getting any on you, now – one and two and three and ‘Row, row, row, row, row†¦'† He started to fade away with the chant. â€Å"Wait,† Tuck said. â€Å"I need to know more than that.† â€Å"Stay on the sly, kid. You don't know as much as you think you do.† â€Å"But†¦Ã¢â‚¬  â€Å"You owe me.† Two armed ninjas followed Tuck to the water. He watched them, looking for signs of microwave poisoning from the radar blasts, but he wasn't sure exactly what the signs would be. Would they plump noticeably, perhaps explode without fork holes to release the inner pressure? That would be cool. Maybe they'd fall asleep on the beach and wake up a hundred times larger, yearning to do battle with Godzilla while tiny people whose words didn't match their mouth movements scrambled in the flaming rubble be-low? (It happened all the time in Japanese movies, didn't it?) Too good for them. He pulled on his fins and bowed to them as he backed into the water. â€Å"May your nads shrivel like raisins,† he said with a smile. They bowed back, more out of reflex than respect. The far side of the reef and five hundred yards down: The ninjas were going to have a fit. He'd never gone to the ocean side of the reef. Inside was a warm clear aquamarine where you could always see the bottom and the fish seemed, if not friendly, at least not dan gerous. But the ocean side, past the surf, was a dark cobalt blue, as deep and liquid as a clear night sky. The colorful reef fish must look like M to the hunters of the deep blue, Tuck thought. The outer edge of the reef is the candy dish of monsters. He kicked slowly out to the reef, letting the light surge lift and drop him as he watched the multicolored links in the food chain dart around the bottom. A trigger fish, painted in tans and blues that seemed more at home in the desert, was crunching the legs off of a crab while smaller fish darted in to steal the floating crumbs. He pulled up and looked at the only visible break in the reef, a deep blue channel, and headed toward it. He'd have to go out to the ocean side and swim the five hundred yards there, otherwise the breaking surf would dash him against the coral when he tried to swim over the reef. He put his face in the water and kicked out of the channel until the bottom disappeared, then, once past the surf line, turned and swam parallel to the reef. It was like swimming in space at the edge of a canyon. He could see the reef sloping down a hundred and fifty feet to disappear into a blue blur. He tried to keep his bearing on the reef, let his eye bounce from coral fan to anemone to nudibranch to eel, like visual stepping-stones, because to his left there was no reference, nothing but empty blue, and when he looked there he felt like a child watching for a strange face at the window, so convinced and terrified it would come that any shape, any movement, any play of light becomes a horror. He saw a flash out the side of his mask and whipped around in time to see a harmless green parrot fish munching coral. He sucked a mouthful of water into his submerged snorkel and choked. He hovered in a dead man's float for a full minute before he could breathe normally and start kicking his way up the reef again, this time resolved to faith. Whatever, whoever Vincent was, he had saved Tuck's life, and he knew things. He wouldn't have gone to the trouble to have Tuck eaten by barracudas. Tuck ticked off his stepping-stones, trying to gauge how far he had come. He would have to go out farther to see past the rising surf and use the shore as a reference, and besides, what was above the water's surface was irrelevant. This was a foreign world, and he was an uninvited guest. Then another flash, but this time he fought the panic. Sunlight on something metal about thirty feet down the slope of the reef. Something waving in the surge near the flash. He rested a second, gathered his breath, and dove, swooping down to grab the object just as he recognized what it was: a set of military dog tags on a beaded metal chain. He shot to the surface and hovered as he caught his breath and read: SOMMERS, JAMES W. James Sommers was a Presbyterian, according to the dog tag. Somehow Tuck didn't think that a thousand-yard swim was worth finding a pair of dog tags. But there was the swath of fabric still down there. Tuck hadn't gotten a good look at it. He tucked the tags into the inside pocket of his trunks and dove again. He kicked down to the swath of cloth, holding his nose and blowing to equalize the pressure on his ears, even as the air in his lungs tried to pull him to the surface, away from his prize. It was some kind of printed cotton. He grasped at it and a piece came away in his hand. He pulled again, but the cloth was wedged into a crevice in the reef. He yanked and the cloth came away, revealing something white. Out of breath, he shot to the surface and examined the cloth. Flying piggies. Oh, good. He'd risked his life for Presbyterian dog tags and a flying piggies print. One more dive and he saw what it was that had wedged into the crevice: a human pelvic bone. Whatever else had been here had been carried away, but this bone had wedged and been picked clean. Someone wearing flying piggies boxers had become part of the food chain. The swim back to the channel seemed longer and slower, but this time Tuck forgot his fear of what might lurk behind the vasty blue. The real danger lay back on shore. And how does one, over dinner, proffer the opinion that one's employers are murdering organ thieves? â€Å"Stay on the sly,† Vincent had said. And so far he seemed to know what he was talking about. 43 Boiling the Puppets â€Å"Oh, come in, Mr. Case. Sebastian is out on the lanai.† She wore a white raw silk pant suit, cut loose in the legs and low at the neck, a rope of pearls with matching earrings. Her hair was tied back with a white satin bow and she moved before him like the ghost of good housekeeping. â€Å"How do you feel about Pacific lobster?† â€Å"I like it,† Tuck said, looking for some sign from her that she knew that he knew. There was no acknowledgment of her appearance in his room last night or that she had any suspicion of him at all. Tuck said, â€Å"I feel like I'm taking advantage coming to dinner empty-handed. I ought to have you and the doc over to my place some evening.† â€Å"Oh, do you cook too, Mr. Case?† â€Å"A few things. My specialty is blackened Pez.† â€Å"A Cajun dish?† â€Å"I learned to make it in Texas, actually.† â€Å"A Tex-Mex specialty, then.† â€Å"Well, a fifth of tequila does make it taste a little better.† She laughed, a polite hostess laugh, and said, â€Å"Can I get you something to drink?† â€Å"You mean a drink or some liquid?† â€Å"I'm sorry. It does seem constraining, I'm sure, but you understand, you might have to fly.† She had a large glass of white wine on the counter where she had been working. Tuck looked at it and said, â€Å"But performing major surgery under the influence is no problem, right?† That was subtle, Tuck thought. Very smooth. I am a dead man. Her eyes narrowed, but the polite smile never left her lips. â€Å"Sebastian,† she called, â€Å"you'd better come in, dear. I think Mr. Case has something he wants to discuss with us.† Sebastian Curtis came through the french doors looking tall and dignified, his gray hair brushed back, his tan face striking against the gray. To Tuck he looked like any number of executives one might see at a yacht club, a retired male model perhaps, a Shakespearean actor finally finished with the young prince and lover roles, seasoned and ready to play Caesar, Lear, or more appropriately, Prospero, the banished wizard of The Tempest. Tuck, still in his borrowed clothes, baggy and rolled at the cuffs, felt like a beggar. He fought to hold on to his righteous indignation, which was an unfamiliar emotion to him anyway. Sebastian Curtis said, â€Å"Mr. Case. Nice to see you. Beth and I were just talking about how pleased we are with your work. I'm sure these impromptu flights are difficult.† â€Å"Mr. Case was just suggesting that we keep an eye on our alcohol consumption,† Beth Curtis said. â€Å"Just in case we might have to perform an emergency surgery.† The jovial manner dropped from the doctor like a veil. â€Å"And just what kind of surgery might you be referring to?† Tuck looked at the floor. He should have thought this through a little more. He fingered the dog tags in his pocket. The plan was to throw them on the table and demand an explanation. What had happened to the skel-eton, the owner of the tags? And for that matter, what would happen to Tucker Case if he threw this in their faces? Mary Jean used to say, â€Å"In ne-gotiations, always leave yourself a way out. You can always come back later.† Go slow, Tuck told himself. He said, â€Å"Doc, I'm concerned about the flights. I should know what we're carrying in case we're detained by the authorities. What's in the cooler?† â€Å"But I told you, you're carrying research samples.† â€Å"What kind of samples?† It was time to play a card. â€Å"I'm not flying again until I know.† Sebastian Curtis shot a glance at his wife, then looked back to Tucker. â€Å"Perhaps we should sit down and have a talk.† He pulled a chair out for Tucker. â€Å"Please.† Tuck sat. The doctor repeated the gesture for his wife and then sat down next to her, across the table from Tuck. â€Å"I've been on Alualu for twenty-eight years, Mr. Case.† â€Å"What does that have to do†¦?† Curtis held up a hand. â€Å"Hear me out. If you want answers, you have to take them in the context that I give them.† â€Å"Okay.† â€Å"My family didn't have the money for medical school, so I took a scholarship from the Methodist Missions, on the condition that I work for them when I graduated and go where they sent me. They sent me here. I was full of myself and full of the Spirit of the Lord. I was going to bring God and healing to the heathens of the Pacific. There hadn't been a Christian missionary on the island since World War II, and I was warned that there might be a residual Catholic influence, but the Methodists have liberal ideas about spreading the Word of God. A Methodist missionary works with the culture he finds. But I didn't find a Catholic population here. What I found was a population that worshipped the memory of an American pilot and his bomber.† â€Å"A cargo cult,† Tuck said, hoping to move things along. â€Å"Then you know about them. Yes, a cargo cult. The strongest I'd ever heard of. Fortunately for me, it wasn't based on the hatred of whites like the cargo cults in New Guinea. They loved Americans and everything that came from America. They took my medicine, the tools I brought, food, reading material, everything I offered them, except, of course, the Word of God. And I was good to them. The natives on this island are the health-iest in the Pacific. Partly because they are so isolated that communicable diseases don't reach them, but I take some credit for it as well.† â€Å"So that's why you don't let them have any contact with the ship when it arrives?† â€Å"No, well, that is one of the reasons, but mainly I wanted to keep them away from the ship's store.† â€Å"Why?† â€Å"Because the store offered them things that I couldn't or wouldn't give them, and the store only accepted money. Money was becoming an icon in their religion. I heard drums in the village one night and went into the village to find all the women crouched around a fire holding wooden bowls with a few coins in the bottom. They were oiled and waving their heads as if in a trance, and as the drummers played, the men, wearing masks fashioned to look like the faces on American currency, moved around be-hind the women, copulating with them and chanting. It was a fertility ce-remony to make the money in the bowls multiply so they could buy things from the ship's store.† â€Å"Well, it does sound better than getting a job,† Tuck said. Curtis didn't see the humor. â€Å"By forbidding them to have contact with the ship, I thought I could kill the cargo cult, but it didn't work. I would talk of Jesus, and the miracles that he performed, and how he would save them, and they would ask me if I had seen him. Because they had seen their savior. Their pilot had saved them from the Japanese. Jesus had just told them that they had to give up their customs and taboos. Christianity couldn't compete. But I still tried. I gave them the best care I could. But after five years, the Methodist Missions sent a group of officials to check on my progress. They cut my funding and wanted to send me home, but I decided to stay and try to do the best I could without their support.† â€Å"He was afraid to leave,† Beth Curtis said. Sebastian Curtis looked as if he was going to strike his wife. â€Å"That's not true, Beth.† â€Å"Sure it is. You hadn't been off this island in years. You forgot how to live with real people.† â€Å"They are real people.† As amusing as it was to watch the perfect couple illusion go up in flames before his eyes, Tuck put out the fire. â€Å"A Learjet and millions in electronics. Looks like you did pretty good with no funding, Doc.† â€Å"I'm sorry.† And he looked as if he was. â€Å"I tried to make it on what the islanders could raise by selling copra, but it wasn't enough. I lost one of my patients, a little boy, because I didn't have the funds to fly him to a hospital that could give him the care he needed. I tried harder to convert the natives, thinking I might get another mission to sponsor us, but how can you compete with a Messiah people have actually spoken to?† Tuck didn't answer. Having spoken to the â€Å"Messiah† himself, he was convinced already. Sebastian Curtis drained his glass of wine and continued. â€Å"I sent letters to churches, foundations, and corporations all over the world. Then one day a plane landed out on the airstrip and some Japanese businessmen got out. They wouldn't fund the clinic out of charity, but if I could get every able-bodied islander to give blood every two weeks, then they would help. And every two weeks the plane came and picked up three hundred pints of blood. I got twenty-five American dollars for every pint.† â€Å"How'd you talk the natives into it? I've given blood. It's not that pleasant.† â€Å"They were coming on a plane, remember? Airplanes are a big part of these people's religion.† â€Å"If you can't beat 'em, join 'em, huh?† â€Å"They always brought something on the plane for the natives. Rice, machetes, cooking pots. I got all the medicines I needed and I was able to get the materials to build most of this compound.† Beth Curtis stood up. â€Å"Oh, as much as I love hearing this story, I think we should eat. Excuse me.† She went to the kitchen area, where a large pot was boiling on the stove, reached into a wooden crate on the floor, and came up with a large live lobster in each hand. The giant sea bugs waved their legs and antennae around looking for purchase. Beth Curtis held them over the pot, puppeting them. â€Å"Oh, Steve, you got us a room with a hot tub. How wonderful,† she made the left lobster say. â€Å"Yes, I'm very romantic,† she said in a deeper voice, bouncing the bug with the words. â€Å"Let's go in now. I'm a little tense.† â€Å"Oh, you're wonderful.† Then she dropped the lobsters into the boiling water. A high-pitched squeal came from the pot and Beth Curtis went to the crate for another victim. â€Å"Beth, please,† the doctor said. â€Å"I'm just trying to lighten things up a little, ‘Bastian. Be still.† She held the second lobster over the pot, then looked at Tucker as she began her narration. â€Å"This is the crazed doctor talking. There's always a crazed megalomaniacal doctor. It's traditional.† Sebastian Curtis stood up. â€Å"Stop it, Beth!† She affected a German accent. â€Å"You see, Mr. Bond, a man spends too much time on an island alone, he changes. He loses his faith. He begins to think of ways to improve his lot. My associates in Japan came to me with a proposal. They would send me to a seminar in San Francisco to brush up on organ transplant surgery. I would no longer be selling blood for pocket change. They would send me specific orders for kidneys, and I could deliver them within hours for a cool half-million apiece. A dying man will pay a lot for a healthy kidney. In San Francisco I met a woman, a beautiful wo-man.† Beth came out of character for a moment, grinned, and bowed quickly, then went back to terrorizing the lobster. â€Å"I brought her here, and it was she who devised the plan to get the natives to comply with having their organs removed. Not only beautiful, but a genius as well, and she had a degree as a surgical nurse. She used her abundant charms on the natives† – she held the lobster where it could have a good view of her cleavage – â€Å"and the savages were more than happy to donate a kidney. Meanwhile, I have become rich beyond my wildest dreams, and as for you, Mr. Bond, now it's time for you to die.† She dropped the lobster into the pot and began to shake with a diabolical laugh. She stopped laughing abruptly and said, â€Å"They should be ready in about ten minutes. Salad, Mr. Case?† Tuck couldn't think. Somewhere in that little puppet show of the damned was a confession to cutting out people's organs and selling them like so much meat, and the doctor's wife not only didn't seem to have any regrets about it, she was absolutely gleeful. Sebastian Curtis, on the other hand, had his head down on the table, and when he did look up, he couldn't make eye contact with Tuck. A minute passed in uncomfortable silence. Beth Curtis seemed to be waiting for someone to shout â€Å"Encore!† while the good doctor gathered his wits. â€Å"What I'd like you to understand, Mr. Case, is that I – we – couldn't have taken care of these people without the funds we've received for what we do. They would have no modern medical care at all.† Tuck was thinking again, trying to measure what he could say and what he wasn't willing to reveal. He couldn't let them know that he knew any-thing at all about the Shark People, and, as Vincent had implied, he'd better find out more before he threw down the dog tags and Pardee's notebook. The doc was obviously stretched pretty tight by the situation, and Mrs. Curtis – well, Mrs. Curtis was just fucking scary. Play it chilly. They'd brought him here because they thought he was as twisted as they were. No sense in ruining his image. â€Å"I understand.† Tuck said. â€Å"I wish you'd been a little more up front about it, but I think I get all the secrecy now. But what I want to know is: Why can't I drink if you guys do? I mean, if you guys can perform major surgery when you're half in the bag, then I can fly a plane.† Beth said, â€Å"We wanted to help you with your substance abuse problem. We thought that if you weren't exposed to other drinkers that you'd relapse when you went back home.† â€Å"Very thoughtful of you,† Tuck said. â€Å"But when exactly am I supposed to go home?† â€Å"When we're finished,† she said. The doctor nodded. â€Å"Yes, we were going to tell you, but we wanted you to become used to the routine. We wanted to see if you could handle the job first. We're going to do the operations until we have a hundred million, then we will invest it on behalf of the islanders. The proceeds will assure we can continue our work and that the Shark People will be taken care of as long as they are here.† Tuck laughed. â€Å"Right. You're not taking anything for yourself. This is all a mercy mission.† â€Å"No, we may leave, but there'll be enough to keep someone running this clinic and shipping in food and supplies forever. And then there's your bonus.† â€Å"Go,† Tuck said. â€Å"Go ahead.† â€Å"The plane.† Tuck raised an eyebrow. â€Å"The plane?† â€Å"If you stay until we finish our work, we will sign the plane over to you, plus your salary and any other bonuses you've accumulated. You can go anywhere in the world you want, start a charter business if you want, or just sell it and live comfortably for the rest of your life.† Tuck shook his head. Of all the weirdness that had gone on so far, this seemed like the weirdest, if only because the doctor seemed so earnest. It might have had something to do with the fact that it was one of those things that a guy hopes all his life he is going to hear, but convinces himself that it's never going to happen. These people were going to give him his own Learjet. He didn't want to do it, he fought not to do it, he strained, but nevertheless, Tuck couldn't stop himself from asking. â€Å"Why?† â€Å"Because we can't do it without you, and this is something that you can't get any other way. And because we'd rather keep you than have to find another pilot and lose the time.† â€Å"What if I say no?† â€Å"Then, you understand, we'd have to ask you to leave and you would keep the money that you've already earned.† â€Å"And I can just go?† â€Å"Of course. As you know, you are not our first pilot. He decided to move on. But then again, we didn't make him this offer.† â€Å"What was your first pilot's name?† The doctor shot a look at his wife. She said, â€Å"Giordano, he was Italian. Why?† â€Å"The aviation community is pretty small. I thought I might know him.† â€Å"Do you?† she said and there was too much sincerity in the question for Tuck to believe that she didn't know the answer. â€Å"No.† Sebastian Curtis cleared his throat and forced a smile. â€Å"So what do you think? How would you like to own your own Learjet, Mr. Case?† Tuck sat staring at the open wine bottle, measuring what he could say, what answer they not only wanted to hear, but had to hear if he was going to leave the island alive. He extended his hand for the doctor to shake. â€Å"I think you've got yourself a pilot. Let's drink to the deal.† An electronic bell trilled from the bedroom and the doctor and his wife exchanged glances. â€Å"I'll take care of it,† Beth Curtis said. She stood and put her napkin on the table. â€Å"Excuse me, Mr. Case, but we have a patient in the clinic who requires my attention.† Then the whiplash mood swing from officious to acid. â€Å"She presses that buzzer so much you'd think it was attached to her clit.† Sebastian Curtis looked at Tuck and shrugged apologetically.