Wag na init ulo baby

A study published in Nature strengthens the suggestion that long-term climate changes can affect violence. Hsiang, Meng and Cane, the authors of this paper, are from the Columbia University in New York, contrary to my ridiculous assumption that they're based in China.

They analyzed quantitative data of the El Nino phenomenon/Southern Oscillation (ENSO) from 1950 and 2004 which extend to both tropic and subtropic regions in  almost all continents except for Antartica and Europe.

They then found a one-way correlation that 21% of all civil conflicts are strongly associated with these inter-annual climate patterns.

It is easy to imagine how several uprisings could have ignited when the unforgiving weather supports this kind of hotheadedness. Behavior aside, it's an easy recipe for disaster: Prolonged El Nino negatively affects the crop yield and level of drought, which can precipitate into famine and strife.

Efforts in the previous years to correlate civil distress and weather patterns, for example rainfall levels, have been criticized for their weak experimental designs. Now, there is a well-accepted, if controversial, proof that human behavior leading to civil strife can be aggravated by weather temperaments.

Even Amaya, a fictional babaylan on popular TV, has to beg the heavens for rain.
image credits: iGMA.tv

Ergo, it is best to please the weather spirits and rain gods just like what our ancestors did. Nothing to lose.

Hsiang, SM, Meng, KC, & Cane, MA. 2011. Civil conflicts are associated with the global climate. Nature 476, 438-441. doi:10.1038/nature10311.

Ottery, C. 2011. El Niño linked to civil conflict in tropical countries. SciDev.net. online article here.

Losing weight: fat chance

If you are overweight or obese, it is advised to cut 500 calories a day in order to lose half a kilogram off your weight. However, research evidence suggests that a flabby person will have a different metabolism compared to a muscular guy or a skinny one, and will therefore need varying strategies.

For example, a 23-year old like me who is 170 cm tall (5'7") and weighs almost 70 kg, should eat 2294 calories a day. However, a 110-kg version of me must eat 3080 calories per day to fend off his daily body needs, while a 90-kg clone would require 2729 calories.

Clearly, as a person becomes heavier, more calories must be cut from the diet, and adherence to diet should become stringent. This is not the usual case, however. Increasingly few of the overweight and obese subjects are strictly compliant with proper food intake. Fat chance.

Expectedly, those who have the willpower to resist gustatory temptations rarely become overweight and obese. More likely, those are the guys and ladies plastered on billboards with svelte, chiseled tummies.

image credits: Angel Locsin's facebook fan page

The mantra for the rest of your life therefore is to stay, rather than to become, slim.

Nonetheless, if you want to get a personalized realistic assessment of the steps needed to reduce your weight, you can visit Dr. Kevin Hall's site of the US National Institute of Diabetes and Digestive and Kidney Diseases at bwsimulator.niddk.nih.gov.

Source: The Economist. 2011. A wide spread problem. The Economist, August 27, 2011. page 71.

What a legacy

Steve Jobs's speech during the 2005 commencement exercise at Stanford resurfaced during the week that he resigned from Apple Inc. He left due to health reasons particularly pancreatic cancer.

He carried a hefty chunk of Apple's market cap when he left, but the guy still has some money left in Wall Street. He owns some Disney shares, because the guy started the era of profitability and critical acclaim for Pixar.

In this speech, he said: "I'm convinced that the only thing that kept me going was that I loved what I did. You've got to find what you love. And that is as true for your work as it is for your lovers. Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don't settle."

Column Five Media chronicles the public life of Steve Jobs in this beautiful infographic.

image credits: the guys from Column Five Media

Flight of fancy

image credits: xkcd.com

Alternate game plot

image credits: xkcd.com

Elementary derivation

image credits: xkcd.com

Transient denial stage

idea by inspired: xkcd.com 

Priorities win again

image credits: xkcd.com

Sixth TED translation

TED2008, Filmed Feb 2008; Posted Oct 2008
Translated into Filipino (Pilipino) by Schubert Malbas
Reviewed by Polimar Balatbat

Modern communication during this decade has changed dramatically. I remember MIRC, an Internet Relay Chat (IRC) client for Microsoft Windows which was popular in early 2000 and was the mainstay chat system in internet cafes in Davao. I think this utility made the typing shortcuts and smileys popular, things like LOL, BRB, and =), but I never got to use it.

When I attended university in 2004, Friendster was the national craze, and there also was Multiply. After I received my bachelors degree, the advent of Plurk, Facebook, and Twitter kicked in.

Social networks have progressed so much in such a short period of time. I always believe that they will evolve into something greater in the future.

In this TED Talk, John G. Rives tells us of a modern, if a bit confusing, love story. Rives is a poet, author, and narrator on television shows, and speaks English, American Sign Language, Latin, Ancient Greek, and conversational French.

Fifth TED translation

TEDGlobal2011, Filmed Jul 2011; Posted Jul 2011
Translated into Filipino (Pilipino) by Polimar Balatbat
Reviewed by Schubert Malbas

Pick your poison: worms, viruses, trojan horses, keyloggers, rootkits, or spyware. Malware design is getting more sophisticated by the minute.

We are at risk of losing data we deem most valuable: our school work, our office files, our photo albums. This TED Talk by Mikko Hypponen reminds us to think of contingencies if ever we lose computer data, simple things like back-up, system scans, and firewalls.

Mikko Hypponen is the chief research officer of F-Secure, an anti-malware firm based in Finland and one of the most trusted in 2010 according to AV-Comparatives.

Fourth TED translation

TED2007, Filmed Feb 2007; Posted Jun 2008
Translated into Tagalog by Jaime Florentino
Reviewed by Schubert Malbas

Admit it: modern living is difficult without having a refrigerator at your home. Fresh produce from the market gets easily spoiled, so you either have to eat everything in one go, or you just have to buy processed or cooked food everytime, which kinda sucks.

Imagine if refrigeration was not available in health centers: practically all medicines and vaccines needing cold chain logistics system would be useless.

The first known method of artificial refrigeration was demonstrated by William Cullen at the University of Glasgow in Scotland in 1756, using a pump to create a partial vacuum over a container of diethyl ether, which then boiled, absorbing heat from the surrounding air. The experiment even created a small amount of ice, but had no practical application at that time.

In 1805, American inventor Oliver Evans designed a refrigeration system based on the vapor-compression refrigeration cycle, which has been and is still the most widely used method for air-conditioning and storage chilling.

Taking this a step further is Adam Grosser, a venture capitalist who thought of making a fridge that uses no electricity, but instead utilizes any indigenous cooking fire available including bits of wood or even camel dung. While still in the prototype stage, each piece of functional refrigerator costs as little as 25-40 dollars.

Grosser and his colleagues are still working on making them commercially available soon, but the seminal idea of a portable non-electric fridge is already impressive, and should be built upon by other engineers and scientists who are interested in making refrigeration accessible to everyone on the planet, with or sans electricity.

Through the looking-glass

My take on Mideo M. Cruz's Poleteismo Exhibit is simple: you are what you see.

What I see is this: the juxtaposition of Filipino religion, politics, and capitalism is ridiculous and is most unfortunate. Pundido na ang mga bumbilya: our contemporary society needs greater enlightenment. Primarily, therefore, the exhibit served its purpose: it makes the audience think. Mr Cruz has every artistic right under human laws, and he should be therefore acquitted.

It can be argued on the other hand that Mr Cruz committed sacrilege under Catholic laws, a sin that transcends ephemeral human authority. Remember however that we on earth were not given by Christ the ultimate authority to make judgments on others. We should not condemn Mr Cruz. We can leave Mr Cruz's eternal fate in the hands of God. Poor guy.

In the end, you are what you see.

Sizing Up Pulmonology

created image at: tagxedo.com
Since I got house-arrested for having shingles awkwardly placed around my left eye, I missed a week of cardiology and another week of pulmonology lectures. I'm still coming to grips with the concepts of pulmonary pathophysiology; having attended no plenary discussions makes it doubly difficult to understand.

If I were to survive the written and practical exams this week, it will be by God's grace. He knows how much I want this. Meanwhile, I'm hitting the sack first.

OFWS in the middle east

If I had been POEA administrator or DFA secretary, I would have banned all deployment to the Middle East and North Africa since Tunisia's succesful ouster of Zine el-Abidine Ben Ali in January of 2011, when the Arab Spring has since spread from Libya to Syria. It would have effectively reduced costs of mandatory evacuations in case of war in order to bring back OFWs.

A summary of infographics chronicling the revolution in the Arab world has been collected by the Economist below. The region itself is becoming increasingly volatile, due in part to a more liberal and digitalized youth demographic.

While the safety of OFWs must be a paramount priority, at the back of my head, I'm starting to think that this is their own undoing. Six months ago they could have sold their land ownership in the provinces so that they can secure a job overseas. Funnily, they are now asking the Philippine government to redeem them from the violent demonstrations and fierce fighting in the Middle East and the promise of livelihood back home. In this situation, I think nobody won.


image credits: xkcd.com

Statistical bias

image credits: xkcd.com

West philippine sea

adapted: xkcd.com

Creepy discount code

image credits: xkcd.com

Smarter bedtime stories

image credits: xkcd.com

Next tourism secretary

With the current tourism department secretary resigning this August, the public clamor is palpable.

Several names have been floated as possible replacements: former Senator Richard Gordon, former Tourism Secretary Ace Durano, former Defense Secretary Gilbert Teodoro, former MMDA Chairman Bayani Fernando, and Camarines Sur Governor Villafuerte. A lot of them have earnest track records in efficiency in management. However, history suggests that many of them will have difficulty switching alliances to the current Philippine president in office. Alternately, any incumbent undersecretary or assistant secretary can be promoted to the Cabinet position as long as he or she has a winning vision for Philippine tourism.

We need a leader at the helm, more than ever. Consider the numbers first:

Number of foreign tourist arrivals, 2008-2010
from United Nations World Tourism Organization 2011 Report
Asia and the Pacific184,057180,936203,838
Hong Kong (China)17,32016,92620,085
Macao (China)10,61010,40211,926
Korea. Republic of6,8917,8188,798
Taiwan (pr. of China)3,8454,3955,567

The Philippines should not compare itself with others, since that is crab mentality. However, when other neighboring countries have seen increasing statistics over the last 3 years while ours has become stagnant, shouldn’t this sound off the alarm?

Rather than to wade in the frustration of failures past, one way to exploit this numbers gap is to make visa applications more friendly! I don’t know how the immigration system works and if extortion is still rampant, but I’ve been through a horrible experience of extortion harassment from a male immigration officer in NAIA3 two or three years ago. There goes Filipino hospitality under the bus.

Well, how about discussing with other Southeast Asian countries the possibility of easing up cross-border controls for foreign arrivals? Europe, which attracts millions of tourist arrivals thanks to well-preserved historic sites, has a similar policy under the Schengen Agreement in 1985. The Schengen Area currently enlists 25 member-states, encompasses much of mainland Europe comprising 4.3 million square kilometers of land, and covers 400 million people. It’s like securing a single visa for inter-country travel into the entire Schengen area. Citizens from member states therefore do not need to bother with cross-border controls.

Schengen Area. image credits: Wikimedia

The Philippines has a lot of tourist spots and tourist festivals, yes, but they are physically far from each other, provided we are a fragmented archipelago. Sadly, even some of our functioning airports are dilapidated. It’s more difficult for an expatriate to experience the entire Philippines, when he or she can choose to stay in mainland Malaysia, Thailand, or Singapore where all famous destinations are reached by a single train ride.

Needless to say, in order to improve arrivals, any foreigner should first feel compelled to visit the Philippines, through quality ads seen on BBC, CNN, National Geographic, Discovery, or CNBC. For me, South Korea and Malaysia are doing a fantastic job. Many Filipinos watching these advertorials on TV are left scratching their heads: shouldn’t we at least spend our marketing money like they do?

Last time I checked, in chronological order, the most successful overseas themes we've had were Wow Philippines and Philippines: It’s More Than the Usual.

Second, it is pretty mandatory that tourists must feel safe. Therefore, pressing issues with kidnappers and terrorists must be properly addressed by concerned agencies aside from the DOT.

Lastly, we need a visionary leader ASAP. It’s not much to ask, since competent names are already put on the table. It is only then proper to ask you, dear Mr. President, to choose the successor wisely. Thank you very much.

The itch begins

Chief Complaint
Itch (medical jargon: pruritus [Latin]), Grade 10/10

So, basically I'm on my way to recovery from herpes zoster, but something horrific is brewing: the itch. Now's well into the ninth day since the onset of the shingles rash, and I started to feel like scratching the entire thing.

Imagine the agony! It's really easy to give in to the urge when you're unaware, so I have to remind myself always not to, since it will leave the viral infection fresh and contagious.

image credits: Wikimedia
Skin itch is referred to the same somatic receptors like dermal pain; however, itch brings about the growing desire to scratch, while pain makes you want to withdraw from the sensation.

Diphenhydramine (an H1-receptor antagonist) usually does the trick, but the only meds I have right now is ranitidine (an H2-receptor antagonist which is used for peptic ulcers and itchy hives) and chlorphenamine (an H1-receptor antagonist useful for urticaria, but has low bioavailibility). Let's see if chlorphenamine works!

Overthinking V1

HZO (herpes zoster ophthalmicus) is a recrudescence of VZV (varicella zoster virus) from the trigeminal nerve (cranial nerve V) ganglion, particularly an inflammation of the ophthalmic (V1) branch of the trigeminal nerve.

image credits:  Gray's Anatomy
The trigeminal nerve is mostly a sensory nerve, but is also a motor nerve. The maxillary (V2) and mandibular (V3) branches are also useful for biting, chewing and swallowing aside from sensory functions. The ophthalmic (v1) branch is a purely sensory branch.

After the inflammation has subsided and serious ocular complications have aborted, one may test neurologically the extent of nerve damage on V1. V1 supplies sensory innervation to the skin of the eyelids, eyebrow, forehead, nose, cornea, ciliary body, iris, lacrimal gland, conjunctiva, and part of the nasal mucous membranes.
  • Test the corneal reflex
  • Test for pain (light touch and pinprick)
  • Test for temperature 
  • Compare the left side with the right
  • If sensory deficit is found, determine the edges affected

A normal person should blink when a wisp of cotton is brushed against the lateral aspect of the sclera. V1 receives sensory input from the surface of the eye. Blinking also requires an intact facial nerve (CN7) efferent function, since it provides eye lid closure.

If both sides of the face fail to contract, a V1 nerve lesion is suspected. If unilateral facial palsy is observed, a CN7 lesion is suspected. A reduced corneal sensation may be noted by the examiner, comparing both left and right sides, which may point to partial V1. An absent corneal reflex is an early sign of sensory trigeminal lesion.

To make the neurologic examination of the trigeminal nerve more thorough, examine the muscles of mastication, which is efferently innervated by the V3 nerve. Inspect for signs of temporal wasting and lateral deviation of jaw to the side of the lesion. Test for teeth clenching, mouth opening, and jaw diversion.

Just like any other disease, know that if you feel anything wrong, do not hesitate to ask your primary care doctor about it. Prevention beats any measure of cure.

Derma wins

I think my dermatologist, who graduated from UST, is great. Amongst all consultations I had for the management of shingles, I agree most with the medications she prescribed. There are a lot of literature online to back her up, and the meds are working for me so far. It really shows how quality medical education, if placed in competent hands, can work well for your patients. I'm pretty inspired to become as competent as her.

Dr. Sherill Ann D. Mendoza is a MD graduate from the University of Santo Tomas and a United States-trained dermatologist. She has a private dermatologic clinic in Tagum City and receives a lot of satisfied patients daily.

Herpes boy

Date of Admission: August 10, 2011, 2:00 AM
Location: Manila Doctors' Hospital Emergency Service Section

General Data
SM is a 23 year old male from Pasay, a second year medical student, and a Roman Catholic. Patient presents with watery and crusty blisters on the forehead and palpebral area, with intense head pain and vomiting.

Chief Complaint
Intense, continuous debilitating head pain, with grade 10/10, which developed about 4 hours prior to consult. Patient feels slight relief with cool air, but no relief with paracetamol, ibuprofen, naproxen, or diclofenac. Headache radiates from the nape region towards the left fronto-temporal area and left eyelids.

History of Present Illness
9 days prior to consult, patient started experiencing episodes of severe headache.

6 days prior to consult, patient visited local clinic for headaches and heaviness around the eyelids even after 6 hours of sleep. Patient was prescribed with naproxen and diclonefac after claiming that paracetamol and ibuprofen did not work.

5 days prior to consult, patient revisited local clinic because the medications were not effective. He was later referred to a headache specialist. After history-taking and physical examination, specialist prescribed sumatriptan.

4 days prior to consult, patient took a single oral dose of sumatriptan but it did not work.

3 days prior to consult, small maculo-papular lesions of less than 0.5 cm in diameter were observed from patient's left forehead.

2 days prior to consult, most of the lesions on the forehead have developed into watery vesicles, while the eyelids have become edematous, with which patient complains of reduced area of vision. During a practical examination in the wards, his professors noticed the lesions and identified them as herpes zoster ophthalmicus (HZO), which prompted the patient and his classmates to bring him to the hospital's ophthalmology clinic. The ophthalmology residents and consultant have positively confirmed the diagnosis, and prescribed tobramycin + dexamethasone ointment and moxifloxacin + dexamethasone eyedrops for the next 7 days. Patient also visited a private internal medicine clinic, and received prescriptions of loratidine, meloxicam, and azithromycin.

1 day prior to consult, patient was advised by his dermatologist to take acyclovir and prednisone. Later that day, patient was unable to sleep because of severe head pain, felt nausea and experienced two episodes of vomiting.

Review of Systems
(+) eye fatigability, lacrimation
(+) nausea, vomiting
(+) palpable lymph mass (left neck)
(-) fever, weakness, anorexia, weight loss/gain
(-) blurring of vision, visual aura, hearing loss, tinnitus
(-) dysphagia, nuchal rigidity
(-) cough, dyspnea, tachypnea
(-) chest pain, orthopnea, PND, palpitations
(-) abdominal pain, diarrhea, constipation, masses, jaundice, pruritus, stool change
(-) dysuria, hematuria, frothy urine, erectile dysfunction
(-) joint pain, muscle pain
(-) polyuria, polyphagia, polydipsia, nocturia, slow-healing wounds

Past Medical History
(+) Acute upper respiratory tract infections
(+) Acute typhoid fever
(-) hypertension, cancer, DM, tuberculosis, allergies

Family History
(+) Cancer - grandmother, uncle (mother's side)
(+) Cerebrovascular Disease - grandfather, uncle (mother's side)
(+) Hypertension - aunt, uncle (mother's side)
(+) Diabetes - uncle (mother's side)
(+) Dyslipidemia - aunt (mother's side)
(+) Arthritis - father

Personal Social History
(-) smoking, alcohol use, drug use
He is the eldest of 3 children, and currently lives in a boarding house in Pasay. His family is in Davao.

Previous Medications
Tobradex ointment (tobramycin + dexamethasone), 2xday, applied at the root of eyelids
Vigadexa eyedrops (moxifloxacin + dexamethasone phosphate), 1 drop 4xday
Virest (aciclovir), 800mg (2 tabs) 4xday
Pred10 (prednisone), 10mg x recommended dose, aug10-11: 4 tabs, aug12-14: 3 tabs, aug15-17: 2 tabs, aug18-20: 1 tab
Zithromax (azithromycin), 500mg 1 tab 1xday
Allor10 (loratidine), 10mg 1xday
Loxicam (meloxicam), 15mg 1xday

Physical Examination
Patient was awake, alert, and ambulatory. The patient was coherent in addressing questions, and aware of his medical situation. Patient's blood pressure is 110/70 with the patient sitting, LA, pulse rate is 72 bpm, and respiratory rate is 22 per minute. Patient is afebrile.

Upon gross HENT examination, patient has watery vesicles in the left fronto-temporal and palpebral areas as well as along the ridge of the nose. The area of the skin underlying the watery lesions is erythematous. The patient presents with ptosis due to edematous eyelids. There is a 0.5cm immovable palpable nontender lymph mass in the left carotid triangle of the neck. The left mandible area is also swollen.

Patient has a visual acuity of 50/20 O.D., and 60/20 O.S., but claims to wear eyeglasses for correcting refraction error. Upon ocular examination, the patient has pink conjunctiva and anicteric sclera. There was no dye uptake and no inflamed cells were observed. There were no signs of keratitis or uveitis.

General Working Impression
Acute herpetic neuralgia secondary to herpes zoster ophthalmicus (HZO)

Course in the Wards
At the ER section, the patient underwent ophthalmologic workup and was given ranitidine and pregabalin. Upon admission, most of the previous medications were put on hold, with tobramycin, moxifloxacin, and acyclovir maintained.
8/10/11: Patient seen by Ophthalmology, given gancyclovir eye gel 1drop 5xday. Patient seen by Infectious Disease, acyclovir dosing rate was stepped up to 5xday, 800mg/dose. Patient underwent CBC and blood chemistry workup. Results showed normal Ht, Hgb, RBC, platelet and creatinine levels. However, CBC showed slightly reduced WBC count and slightly elevated neutrophil count. Patient complained once of severe headache, gabapentin was given as needed.
8/11/11: Patient does not complain of headache anymore. Patient's eyelids were less edematous and of improving quality. Patient was discharged by Ophthalmology and Infectious Disease, for follow-up.

Current Medications
Tobradex ointment (tobramycin + dexamethasone), 2xday, applied at the root of eyelids
Vigadexa eyedrops (moxifloxacin + dexamethasone phosphate), 1 drop 4xday
Virgan eye gel (gancyclovir), 1 drop 5xday
Virest/Zovirax (aciclovir), 800mg (2 tabs) 4xday
Pred10 (prednisone), 10mg x recommended dose, aug12-14: 3 tabs, aug15-17: 2 tabs, aug18-20: 1 tab
Neuropontin (gabapentin), 500mg as needed

Review of Literature
  • Stankus, S.J., Dlugopolski, M., & Packer, D. 2000. Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia. American Family Physician, 61: 2437-44, 2447-8.
  • Johnson, R.W., & Dworkin, R.H.. 2003. Treatment of herpes zoster and postherpetic neuralgia. BMJ, 326:748, doi:10.1136/bmj.326.7392.748.

When meds won't work

Apparently I have a mild to moderate sulfa allergy to sumatriptan. It should have relieved my migraine headaches, but it didn't. Such an expensive drug put to waste in my system. I have some kind of hives or probably angioedema around my left eye and left forehead.

I think I would like to reconsider another diagnosis aside from migraine. This case is far too long to continue for 7 days or more, and there's no relief to be found with acetaminophen, ibuprofen, naproxen, diclofenac, and sumatriptan. I read somewhere that this could be cluster headache, but I could be wrong.

More importantly however, I would like this pain to stop. I have three exams this week, and I don't know if I'll survive them.  

A Case for Sumatriptan

image credits: Arty Smokes

S.M., 23 y.o., male from Manila. On consult at a neurologic clinic, patient presents with generalized headache with a pain score of 7/10.

Onset of pain was 4 days prior to consult, probably provoked by stress-induced ward works and plenary lectures.

Pain progressed from mild to moderate 2-3 days prior to consult, which the patient decided to take self-medication of paracetamol and ibuprofen, but was not alleviated.

A day prior to neurologic consult, patient visited a family medicine clinic, where the consultant gave a medical impression of probable migraine, and advised to take naproxen and diclofenac under observation. Upon follow-up, patient reports that the NSAIDs did not palliate the pain significantly. He was then referred to a headache / neurologic clinic.

On day of neurologic consult, patient describes the pain as throbbing and generalized.

Patient was able to locate the pain post-sleeping on the left side of the head radiating from the nape towards the left forehead and temporalis area. The patient also describes fatigue and pain that is almost compressed on both periorbitals.

Patient reports nausea, but no vomiting, fever, flu, colds, cough or pain in the sinus area.

Based on this short pertinent history and brief physical examination, the neurologist diagnosed the case as migraine, prescribed the continued use of naproxen to see if it would work, and provided a written prescription for sumatriptan in case it did not.

Because of that, the patient felt a lot better, knowing that someone has finally agreed with the diagnosis he was anxious about, and that he has a doctor's prescription of sumatriptan in his hands, which works in 75% of all cases of migraine attacks according to literature.

Author's note: Thank you, Dr. Paul Matthew Pasco of the Philippine General Hospital. Dr. Pasco is a young, talented neurologist and is well recommended by his patients.

Disclaimer: The headache case is only a retelling by the patient and may not necessarily indicate the exact neurologic finding.

Unwavering support

image credits: xkcd.com 

Switching sides: it usually happens during elections in the Philippines. When push comes to shove, ideologies are dumped. I bet it's easier that way.

Dose of positivity

image credits: xkcd.com

Sometimes the disease is not the problem. People get better just by letting them confront their feelings of fright and doubt. It usually works in many cases.

Born clueless

image credits: xkcd.com

This is statistically significant because not all adopted sons and daughters have been told the truth.

Priorities win

image credits: xkcd.com

Thomas Hobbes once wrote, in the book Leviathan, that man is inherently selfish, predatory, and exploitive. Perhaps, as we grow older, we are expected to mature into selfless beings. It might take a lifetime to develop, but it's worth a try.