Let us assume that you are invited to a special dinner where each person is charged RM 1,800 for it. Try to imagine what it is going to be like. I would think it must be a very nice place, the service is excellent, the plates and spoons are made of high class silver and the restroom perhaps has gold plated taps. Then, let’s come to the real thing – the food – must be imported exotic stuff. What do you think each dish would cost? Make a calculated guess and form a mental picture in your mind.

Now, what if I tell you that your RM 1,800-per-person dinner consists of only three dishes? The first dish costs RM48.00, the second RM47.00 and third RM 188.00. That brings the total cost of food to RM283.00. Would you scream your head off and say – What a let down? What kind of expensive dinner is that? What makes the food that cost only RM 283 to become RM 1,800? Don’t be upset, such a thing may happen most of the time right under your nose, only that you are not aware of it.

Sometime in April 2008, I made a discovery. A lady came to our centre. She had breast cancer and had undergone chemotherapy. It cost RM 1,800 per cycle. She gave me her itemised Outpatient Bill. The drugs used were: 5-FU, doxorubicin (or Adriamycin) and Cyclophosphamide. This is the popular combination used for breast cancer. You may know it as FAC. Think of that special dinner again and look at the cost.

1.        Cost of chemo-drugs

a)      5-FU …………………........ RM 48.00

b)      Cyclophosphamide……RM 47.00

c)       Doxorubicin  8 mg …...RM 90.00

d)      Doxorubicin 50 mg……RM 98.00     

 Subtotal  RM 283.00

2.        Other medications. Since chemo-drugs are essential poison, you need other drugs to help you endure that treatment. So you are given ;

a)      Ciprobay  500 mg, a drug again bacterial infection …………...........………RM 158.00

b)      Dexamethasone 8 mg, anti-inflammatory, immunosuppresent steroid  RM 11.70

c)       Fomotidine 20 mg, drug for ulcer …………………………………......................…..RM  7.20

d)      Kytril 1 mg TAB, anti-nausea and anti-vomiting drug …………..........…...…RM 120.00

e)      Kytil 3 mg Injection, - as above - ……………………………………....................…RM 145.00

f)        Motilium 10 mg, for bloated stomach, burping and stomachache   .…..…RM 28.00

g)      Sodium choloride 0.9% 500 ml, 100 ml and 100 ml – as saline drip ….…RM 61.90

  Subtotal RM  531.80

3.        Charges of doctor, hospital and etc.

a)      Hospital accommodation………………………..RM 52.50

b)      Ensure Vanilla …………………......………………RM  88.00

c)       Laboratory tests ……………………………...…..RM156.00 

d)      Prescription charges …………………………..…RM   8.00

e)      Chemo – no exiting line ……………………….RM 100.00

f)        Procedural fee ……………………………...…….RM   30.00

g)      Others (missing item)…………………..………..RM ??

 Subtotal RM 434.50

  Subtotal 1 = RM 283.00

  Subtotal 2 = RM 531.80

  Subtotal 3 = RM 434.50

  Grand total = RM 1,249.30           

If patient had paid a total of RM 1,800 – what do you

think the missing item of RM 550.70 represents?

            After I studied the above, what come to mind is my days in Serdang College (in the 1960s!). Lecturers and students then often get together for dinner party. After dinner some of our lecturers would tell us jokes. Since this one is a dirty joke, let me just say it in a cleaner way. There is this Son who wrote his father about going hunting – he likes shooting birds. Every month he sends home his bill of expenses. Father studied the bill and one day wrote back: Son, your outing is getting expensive. Why not find cheaper birds to shoot. The son accepted the suggestion. Some months later the son send his bill as usual but this time with a new item – Gun Repair (which turns out to cost many times more than the birds shot so far!).

           This lady went to the hospital to treat her cancer. The total cost of the drugs for the cancer is only    RM283.00. But the patient had to pay RM 1,800. The rest of the expenses (RM1,517) are for Gun Repair? Workshop rental? Mechanic fees? (No disrespect to the hospitals and doctors – regard this as figurative).

·          Since the chemo-drugs are poisons, we need other drugs to prevent and mitigate all the possible side effects. All these cost RM 531.80 which is 188% of the total cost of the chemo-drugs. This is the Gun Repair component of the treatment.

·          Since we need a special Workshop, backed by special facilities, to administer the poison, the cost comes to   RM434.50. This represents about 150% of the cost of the chemo-drugs.

·          The mysterious item of RM550.70, is the most expensive of the support-items. It is 195% or two times the cost of the chemo-drugs.  Could this be consultation fee?

Some of you may suggest that there must be a mistake in what I have written. Yes, I was hoping it was a mistake too! But no, I have double checked, it is NOT a mistake.

A 21-year-old lady with ovarian cancer (that had spread to her colon) gave me her Itemised Bill. She had undergone many cycles of chemotherapy and the one on 8 April 2008 cost RM 2,298.50.

The following are the chemo-drugs used for her cancer:

1) Bleocin, 15 mg, a potent antitumour antibiotic  ………....…....   RM 400.00

2) Kemoplat 50 mg (from India), this is cisplatin chemo-drug ..  RM  96.00

3) Fytosid 100 mg (from India), this is etopside chemo-drug…...RM 135.00

                  Total cost of chemo-drugs is RM 631.00 or 27% of the total cost of her treatment.

For her treatment this lady paid 73% of the total cost for Gun Repair and other expenses. Three items that stood out are:

1)      Emend Tri-pack, prevent acute and delay vomiting and nausea ... RM 313.00

2)      Kytil 3mg, Inj, anti-nausea, anti-vomit………. …………...............……… RM  345.00

3)      Neupogen 30 mg, Inj. To stimulate blood production …......………....RM 325.00

In the website it says: You don't have to suffer from nausea and vomiting (also called emesis) as a result of chemotherapy and radiation therapy. Yes, in this second hospital you have to spend RM 313.00 + RM 345.00 to prevent from suffering such side effects. That makes a total of RM 658 to for Gun Repair! The expenses are more than the actual cost of the three chemo-drugs used. Yes, make no mistake, the Gun Repair cost more that the bullet itself.

            Chemo-drugs destroy much of the blood cells. So you need Neupogen injection to counter that and this costs RM 325.00. This expenditure represents 51% of the total cost of the chemo-drugs.

             One point that attracts my attention is the cost of Kytil, 3 mg. In this hospital it is RM 345.00. In another (higher rating, if you like) hospital it costs only RM 145.00. Patients can be asked to pay any price for the same kind of drug? It is indeed a hard and sad world.

Comments: I would like to wonder aloud --- if chemo-drugs are just like the herbs, then there is no need to pay for the Gun Repair, there is no need for a Special Workshop and no need for Special Skill to administer it. What that means the cost of treating cancer can be reduced greatly, like RM283.00 as opposed to RM1,800; or RM 631.00 instead of RM 2298.50. What a wonderful world that would be!

This insight sounds great but that is only a wishful thinking. It will not happen! The reality of this world does not work that way. For things to work successfully and to be pushed hard by All Interested Parties --- everyone should stand to benefit from such an action. And, if possible handsomely. In this case the hospital will have to benefit, the doctors will have to benefit, the drug makers involved in Gun Repair will have to benefit (besides the Bullet Factory) and the list goes on. And lastly (yes, LASTLY) the patient will have to benefit too.

There is an African proverb: If you want to go fast, go alone; if you want to go far, go together.

Einstein once said that we can’t solve the problems of the present by repeating the mistakes of the past. In the same way, if we have to improve on the present way of treating cancer, we have to set out to find a new framework or paradigm. Let me end by quoting Dr. Devra Davis, Professor and Director of Environmental Oncology, University of Pittsburgh (in The secret history of the war on cancer, pg. 435): We have learned that much evil in modern history is not natural but man-made, the results not of divine but of human will.

            To underscore what Professor Davis said, let me invite you to view the following video clips sent to me …. 

http://www.youtube.com/watch?v=0VX0JvpW5q0   or

http://www.youtube.com/watch?v=MnRPZOUVhJ4&feature=related   or   

http://www.youtube.com/watch?v=ecLwVgvvTvU&feature=related

(Note to all readers: I have written this appeal before and I am doing it again. If it is not too much of a problem for you, I appreciate receiving your Itemised Bill that you have paid for your chemo-treatment. With your help and co-operation I would be able to make comparisons of the various treatment cost. It is no use writing me saying that my chemo cost RM 5,000 or RM3,000! I need the details).

Gandhi’s Top 10 Fundamentals for Changing the World

Quoted from: http://www.positivityblog.com/index.php/2008/05/09/gandhis-top-10-fundamentals-for-changing-the-world/

1. Change yourself : You must be the change you want to see in the world.

If you change yourself you will change your world. If you change how you think, then you will change how you feel and what actions you take. And so the world around you will change.

2. You are in control: Nobody can hurt me without my permission.

What you feel and how you react to something is always up to you. You can choose your own thoughts, reactions and emotions.

3.  Forgive and let it go:  An eye for eye only ends up making the whole world blind.

Fighting evil with evil won’t help anyone. Forgiving and letting go of the past will do you and the people in your world a great service.

4. Without action you aren’t going anywhere: An ounce of practice is worth more than tons of preaching.

Without taking action very little will be done. However, taking action can be hard. You may resort to preaching, or reading and studying endlessly, but you have to take action and translate that knowledge into results and understanding.

5. Take care of this moment:  I do not want to foresee the future. I am concerned with taking care of the present. God has given me no control over the moment following.

Stay in the present as much as possible, and be accepting. When you are in the present moment you don’t worry about the next moment. And the resistance to action comes from imagining negative future consequences or reflecting on past failures.

6. Everyone is human:  It is unwise to be too sure of one’s own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err.

When you start to make myths out of people, you run the risk of becoming disconnected from them. Keep in mind that everyone is just a human being no matter who they are.

7. Persist:  First they ignore you, then they laugh at you, then they fight you, then you win.

Be persistent. In time the opposition around you will fade and fall away.

8. See the good in people and help them:  I look only to the good qualities of men. Not being faultless myself, I won’t presume to probe into the faults of others.

If you want improvement then focusing on the good in people is a useful choice. It also makes life easier for you as your world and relationships become more pleasant and positive.

9. Be congruent, be authentic, be your true self: Always aim at complete harmony of thought and word and deed. Always aim at purifying your thoughts and everything will be well.

When words and thoughts are aligned then that shows through in your communication. People tend to really listen to what you’re saying. You are communicating without incongruence, mixed messages or phoniness.

10. Continue to grow and evolve:  Constant development is the law of life, and a man who always tries to maintain his dogmas in order to appear consistent drives himself into a false position.

You can pretty much always improve your skills and habits, or re-evaluate your evaluations. You can gain deeper understanding of yourself and the world.