Tuesday, November 25, 2014

On obesity

Just a photo of a nice croc I saw
I read an article recently about how to best manage obesity as a society. It wasn't a medical journal, though, it was an economics/finance/management report published by the McKinsey Global Institute. It was written by business analysts and economists; which was interesting to me as usually I see these articles about obesity in the context of public health and medicine. And it got me thinking about just how did obesity become a problem. The report is very interesting and I certainly don’t intend to repeat it all; in fact what I’m writing here are merely my own insights and opinions that took this article as a starting point. But if you get the chance, read at least the executive summary of the McKinsey report here.

Food has always been a necessity for us humans, and obesity is not a new thing. The problem is the high prevalence of obesity and the subsequent high rate of health problems for which obesity is a major contributing factor. You then recall times from history like the great depression and wonder how did we overshoot so much that now obesity – an excess – is the problem. The thing is that perhaps the exact same things that brought us out of the great depression brought us to high rates of obesity.

Towards the end of the great depression, a lot of interesting things began to happen. Yes, there was the onset of World War II, which brought about destruction – and subsequently, at it's conclusion, a great need to re-create, produce, manufacture, and re-build the world! Industries soared. Governments and commercial enterprises became really good at economics and business. Extremely good.  And with the end of the great depression, of course, food became more than a rationed commodity, more than a human need, it became a highly lucrative commercialised industry more than it had ever been in our society. The success story of business and industry tracks that of obesity rates. Every strategy that led industry to thrive, also drove obesity rates to rise.

Think about all the strategies that make businesses successful, and then you finally may get closer to finding an answer to the question of how did we as a society let obesity rates rise to the levels they are today. Well, firstly, a great business needs a product that is desirable. What is a more desirable consumable than food? And more than being a desire, it is an actual human need! Food is one of those things that would sell even if it wasn't advertised anywhere.

But food is advertised – and very well; a great marketing strategy is one of the fundamentals of a successful business. The interesting thing is that the food that receives the most advertising is the least nutritious and yet most energy-dense. Unfortunately as a society we developed technologies and became really good at modifying our environment so as to minimize the amount of energy our own bodies expend. Our progress as a society, our advancement, is because we built efficient machines that use external energy to do the hard labour we previously took on. We walked greater distances, lifted more, did more physical work just in our everyday than we do now. And hence the large disparity between the energy content of what we consume (that energy-dense food advertised so heavily) and the energy we expend – with excess energy being stored in our bodies as fat.

Marketing isn't just about direct advertising, though. It even involves exploiting existing societal norms and evolving new ones. What do I mean by this? Actually this concept is the most wide-ranging aspect of how business, and food as an industry, has grown. But let’s take, for example, just two interesting quirks of us human beings: 1) we perceive more as better, and 2) we perceive bigger as better. Have you ever tried to buy just a Big Mac at McDonald’s? Well, let me tell you it costs nearly as much as a Big Mac meal, with the fizzy drink and the fried potato chips included. We all prefer to get more for our money, so we do end up buying a much higher energy intake for just a few cents more. But it’s not just about the big bad fast food giants, even our supermarkets do it.  They sell us even staple foods, but at a cheaper rate if we buy more of it. Why? Not because they think “poor, poor, undernourished people; let them have more food”. No, they do it because we are consumers, and only consumers to them. They sell us more so we pay more (we think we’re making a saving, but the reality is companies never underprice their items even in the “deals” they give us). The concept of portion size is similarly related. And portion size isn't just about how big our meals are, but the fact that because our foods are so energy-dense and our lifestyles for the majority of us are so sedentary, the physical-size of our meals isn't even what we’re really talking about here. And who does know what we are talking about when we say things like “portion-size”, “recommended daily intake”, “calories”, “kilojoules”, etc? Not that many of us! Education about nutrition and its relation to health and lifestyle are severely lacking in our society…

I want to conclude this topic of discussion with a direct passage of recommendation from the McKinsey report I mentioned earlier:
“Education and personal responsibility are critical elements of any program aiming to reduce obesity, but they are not sufficient on their own. Other required interventions rely less on conscious choices by individuals and more on changes to the environment and societal norms. They include reducing default portion sizes, changing marketing practices, and restructuring urban and education environments to facilitate physical activities.”
What do you notice about these recommendations? If you’re like me, then you will have noticed how most of the things suggested that we need to try to do as a society to combat obesity are the complete opposite of everything you need to do to have as great and successful a business as the food industry in industrialized countries is. We became obese not merely because we ate too much, but we ate more than we needed to because the food industry needed to grow its profits. I think in health care we particularly need to take note of this. Sometimes we think we must help individuals (or blame them, as we sometimes do), but the truth is individuals were helped in their demise by large industries and corporations who focused on our consumption/profit value rather than the effect of their products on our health.

Sunday, November 9, 2014

On sex and illness

Back in the day, the general thought about romantic partnerships was that the woman had to be dutiful, and part of her duty was to make sure her man was getting sufficient sex to keep him happy. This was prior to the 1960s (though in many cultures and countries this is still a very prominent idea). Back then, men made up the greatest proportion of the salaried workforce, and men’s ideals dominated the media. A by-product of this era that I find particularly interesting is the notion that men (and women) need sex to be happy, and that sex is a necessity to keep relationships strong and lasting.

A question us health professionals often overlook when consulting our patients is the importance of sex to them – they are, of course, human beings just like us and therefore have the same interest in it that we do. There was a time when we were all being urged to tell our cardiac patients to abstain from sex for a certain period of time after a cardiac event or surgery – and the message got through to us and them. We became good at dishing out advice to patients that sex after heart problems is a big no. Patients, motivated to obey as they didn't want to suffer complications from what is a very serious health issue, listened and took this very seriously too. A lot of us, however, forgot to frame anything but the negative to our patients and advise them that sex is OK too, and bar a few restrictions, it was OK to resume it. It was like as if as health professionals we thought that patients are sex-crazy insatiable beasts that cannot resist the urge to have sex straight after having (often) extremely painful chest surgery and/or losing a large amount of physical endurance. The reality we were forgetting is that very often after cardiac events, people (yes, patients are people too) become depressed, and with depression often comes an actual loss in libido. Suddenly after a major health scare we are faced with the realisation that our life isn't infinite, that our risk of dying is a lot higher than we once thought, and that we now have a chronic illness that you just can’t shake off and pretend like nothing ever happened. Our patients’ whole lives change, priorities change, relationships are tested and adjusted – and there we are as health professionals thinking that our patients actually want to have sex after considering all this! Yes, some do, but the majority probably also would benefit from being reminded that once they’re ready, sex is OK.

Another interesting scenario is sex in the context of cancer. I mean specifically cancers that affect tissues that we traditionally would associate with sex: breasts, prostate, testes, etc. As an example, let me consider women who have the most common type of breast cancer, those which are hormone-related/responsive. Treatment of their cancers often involves surgery, scars, and sometimes very marked deformity. All this in areas of their body often thought of as very intimate, sensitive, and defining of one’s sexual identity. Radiation treatment does similar, and sometimes making an area that was once so sensitive in a positive way, extremely tender.  Medically, to achieve remission of their cancers, these women often have to be put in a state of sudden menopause. And then come all the effects that go with menopause: vaginal atrophy, loss of libido, low mood, hot flushes, etc. You put all of this together and can you imagine how hard it is not only to think of sex, but to actually enjoy it in the way these women once did. Now think of the effect this has on a relationship if we aren't being open and honest on what people with these types of cancers are going through.

It’s no big leap of the imagination to conclude that a lot of relationships often become sexless after cancer affecting what we predominantly think of the sexually-defining features of our body. For those who are not in a relationship at the time of diagnosis, entering or re-entering a relationship is equally as daunting and is often delayed by many many years. Now, as an example (because I have seen this scenario a few times in my own practice), consider a heterosexual couple where the woman becomes diagnosed with breast cancer. Initially, both partners become concerned about the physical well-being of the partner affected by the cancer. The couple shares common goals: for the woman to survive the cancer, and for her to tolerate the treatment as best as possible. Of course, despite our best personal support networks and the best-meaning friends, family, and health professionals, cancer diagnoses and treatments are very isolating. Everyone may know what you’re going through, they may care about you and want the best for you, but only you are going through it in mind and body. It’s a sad fact of life, that at times no matter who’s around you, you feel very alone. The cancer treatment begins and ends for the woman, but the emotional adjustment takes a lot longer. Sometimes it takes a very long time, and though couples never forget the cancer, they sometimes forget to speak of the less “heavy” things of life, things like sex. And more than simply not speaking of it, sex during and after cancer becomes taboo. I mean, such greater things are in question when the cancer diagnosis came up: mortality, strength, survival, endurance, support – who can think of the mundane things of life like sex? But time passes and life and relationships continue once the acute cancer story is done with.

And, yes, we do think of sex. Not just the partner who hasn't been sick, either! We know that the person who has survived cancer has all that physical and emotional stuff to deal with, scarring, pain, deformity, loss of libido, low mood, etc. How can you possibly have sex again? Unfortunately, this same information is often locked up inside with shame, fear, and the desire that if we just ignore the issue it will all just go away. If we return to the example of the woman with breast cancer, the partners of these women often do not know her struggle beyond the acute cancer story. No one talks about it. And so they wonder what they’d done wrong, what did they do during the woman’s struggle to turn them off them sexually still so many years down the track? Can they ever undo this and how? Is this it; is this just how it is after cancer? Does a sexless marriage mean a loveless one? Is it wrong to still be sexually attracted to the woman she is despite her body changing? Has this got nothing to do with the cancer? Has it really got nothing to do with it at all, and the only reason the woman isn't leaving is because she’s grateful for his support during her cancer battle? Is gratitude enough to continue a seemingly loveless marriage? These thoughts are very emotionally painful – and I think very important to talk about. Similarly, I've known of men who won’t approach their partners sexually after cancer treatment for fear that she won’t want it, can’t have it, and just not knowing (and unable to ask?) how it will be different for her. Women may react to this in the way that, ‘hell, not only did I just go through cancer, now my partner doesn't even want to touch me or know me sexually’. And so the cycle of sexual abstinence continues…

And what do I conclude? That we talk about sex. That it becomes neither an expectation in relationships nor a forgotten burden. That health professionals to their patients about it, but more importantly, that couples talk to each other about it. And that we be allowed to form our own conclusions as to the importance of sex in relationships.

Monday, October 27, 2014

On the purpose of life

What if the purpose of life isn't to be kind and experience happiness and all that stuff? What if the whole purpose is to try to live as long as possible, be gratified at all costs, and try to outlive others so that either us or our offspring (mine, and not that of others) have a chance of becoming God? Because if you outlive every other human being, then by default you are supreme, right? And I say human being because I imagine that other creatures don’t worry themselves with questions like “what is the purpose of life?”

I am, of course, not the first to think of this evolutionary/survivalist theory of life. There’s a theory that even altruism, that warm, fuzzy, “nice” stuff we seemingly do without self-interest, does actually pose a survival advantage. As an example, let’s say I become a humanitarian and go out of my way to help other people in whatever disadvantageous situation they find themselves with (ill health, poverty, etc.). You may think that it’s selfless, right? I mean, how does helping others help me, when if anything I am giving up of my time, efforts, money, etc to help another human being? Well, indirectly it does boost my potential to survive and still come out on top because it buys me allies. Other people see my “selfless” acts and get a positive impression of me – and that makes them want to help me! People more powerful than me may want to protect me, associate with me, give me opportunities I would never had had access to on my own. Numbers of people want to protect you, embrace you as an ally, and defend you from bigger enemies than you could handle on my own. Selflessness pays off! And it pays off probably more than pure instinct-based, survival strategies ever could.

I used to preoccupy myself with the question of what is the purpose of life, and more specifically, my life. Is it to love? Contribute positively to another’s life? To prove myself in this biophysical form on this planet until the biological matter I’m made off becomes unsustainable and I start decomposing into my component atoms, subparticles, and energy – so then after this, some “essence” of me (the thing I and many other “believers” call the spirit) can carry on to another alternate life? Then the question becomes, yes, but what is this “proof” we need to make of our lives? Again, is it to show that I am the best at this survival game, to boost my happiness to the maximum level imaginable, to boost the happiness of others, to feel connected to another human being in the way love connects people? What is love? Is it more than the stimulation of the right combination of neurochemicals in my brain that make me “feel” the emotion of pleasure and calmness we call love? If it’s more than the chemicals, the reactions, the synapses, does that again place it in that inexplicable spirit world? Is anything real? What is real? … and you see now where my preoccupation led me to: suddenly I’m wondering not only why do I exist, but do I exist?

At times I wonder if all this thinking isn't just all part of some secret system, that the human ability for introspection is just some sort of distraction technique. Let me explain it like this: imagine that you have an eye looking out. Now, behind it there’s a brain attached to it like a movie screen set up to capture the image in front of the eye. So whatever is in front of the eye is what is transmitted to the brain; that is the movie being watched. But now put a mirror in front of the eye, so then suddenly the only thing the eye sees is the eye itself. So then then brain becomes preoccupied with the eye (as that’s the only thing visible in the universe). But you will never know what is beyond the mirror, and pretty soon you’ll stop even wondering about what there is beyond the mirror. Hell, you may even become convinced that that eye is what it is all about. You’ll start asking yourself questions like what is the purpose of eye? Is it to keep it healthy and free from pain, to experience happiness and all that stuff…

Monday, October 6, 2014

On neighbours

From when I was very young, one of the things I remember being taught was that the best neighbour is the one you don’t even know you have. You don’t see them, you don’t hear them, and you certainly don’t interact in any other way. Is my family strange for having taught me that? My family (like everyone’s family) is strange for many reasons, but I didn't figure out the true wisdom of the neighbour theory until I moved out of home myself.

I've always tried to be the kind of neighbour I have wished to have: courteous of others’ tolerance to noise, and allowing people the right to be left alone in the place where you have every right to be alone. Now I know some people are different to me, some people want interaction with the people around them, and they think it’s courteous to interact with the people who share their street or their neighbourhood. I once even had a friend my age who when she left the house, would go knock on her neighbours’ door and tell them that she was going out. Maybe it was purely because she had some health problems  and took comfort in knowing that in times of need her neighbours would likely (or be expected to) come to her aid. Maybe that was the reason, I don’t know, but I found this very very strange. Or maybe I’m strange.

I once lived in an apartment where I had the misfortune of renting the unit above where the owner lived. I made agreements with the real estate agency and moved in, and that was my expectation of all I would have to do in order to live in this place. That was all our written contract said: I would not destroy the property, inspections would be scheduled ahead of time, and I would just do the “living” inside the unit as per my choices in life and the standard human rights afforded to anyone. But the owner downstairs would count the number of showers I had a day and approach me if I had more than two in a 24 hour period (which can happen if you work shift work like I was doing at the time). She would question me persistently if I had visitors and ask if they were moving in. If I went out onto the little veranda where I kept some pot plants, that was somehow an invitation for a conversation with her. She wanted to know what I was doing, who if anyone was living with me (no one was), what times I was expecting to be working in the following week, why I was having a shower at a particular time, why the extraction fan was running (i.e. when I was cooking), why did I let my mum park in my parking spot and leave my car in the street when she visited, etc., etc. It wasn't just friendly banter or genuine interest, it was always in the style of an interrogation, and it was so exhausting. Why couldn't this woman get through her head that living near each other did not make her my friend, comrade, ally, family member, or anything other than a stranger? As soon as my lease ended, I moved out. That was the craziest neighbour I've ever had, but certainly not the craziest I've heard of!

So what exactly is it with some people thinking that just because you share a similar street address that you somehow share something deeper? I don’t understand this. Yes, the people we live near probably share a similar income demographic, similar priorities in choosing a house to live in, but that really is about all we share in common – and this common ground does not give us greater privilege unto each other. Yet I see it all the time, neighbours believing it is their right somehow to integrate themselves into your life. Why? Is it loneliness? Is it that because of the high rate of mental illness in our society that you’re more likely to encounter “interesting” people as neighbours? I don’t know the answer to that. I just wish that people would understand that it isn't your right to impose or seek from your neighbours any sort of validation, positive or negative. I wish that more people understood that people do have a right to privacy and to have their home be their retreat. And why do I think of these things right now? Not because of me; I couldn't tell you the names of my neighbours or recognise them if I saw them anywhere other than our street, so I consider myself lucky in this sense. But I am currently witnessing a close friend’s joy in life being sucked away by her over-involved and intrusive neighbour – and that’s not fair. She now has no retreat to come home to after work. We’re not talking here of some sort of Hollywood celebrity who has signed away their privacy for the industry they work in. I’m talking about everyday people being robbed of their basic right to be free from interference. And even if what I've believed since early on about interacting with our neighbours is wrong (and it may be), why can’t we at least try to be good neighbours to others?

AFTERWORD: Yes, I believe there is too much solitude in this world and we should be more caring and “neighbourly” towards other fellow human beings.  But the neighbourly we speak of here is more like in the biblical sense of considering every other human being as our “neighbour” and thus doing good to all other human beings. That is a concept I support fully. What I've spoken of here is of not respecting our literal neighbours right to privacy and peace.

Saturday, August 16, 2014

On my life

It’s August 2014 and it’s been too long since I've written anything here. A lot has been happening in my life. I’m happy, but a lot has happened.

Woodworking. I’m still woodworking. Still loving it. The last thing I've made is to replicate a plastic step-stool I have (because I’m short) so I can have one in my workshop and one inside the house. I've slowed down from buying tools too, but I can’t guarantee how long that will last.

Lego. I’m moving the Lego from the spare bedroom to a large display cabinet I got for my living room. I was hesitant at first to put them in a “fixed” position such a display cabinet or shelf, but now I much prefer to have them within easy view from the couch.

Work. Work is fine, but sometimes things frustrate me. On slow days I get frustrated with the fact that if I don’t see patients then I don’t get paid. On busy days I get frustrated with scheduling issues. Often I get frustrated with certain patients’ expectations of special treatment. More often I get frustrated at myself for allowing these patients’ behaviour, things other doctors or professionals from any other industry would not allow. Most days though something or someone will remind me why I do my job in the first place, and then I am satisfied.

Family. Well, not so much family as religion. I am still very dissatisfied with the way the religious group I belong to operates. My mother has to remain distant from me in order for me to protect her. And yet the threat isn't me; I am the one that loves her! The threat is posed by the religious group we belong too. I will admit that after my last blog, somebody confused a post I made on my facebook with the post I made about the things I love in life and told my mother some very vicious and hurtful lies about what I post online (she, of course, does not even use the internet to check things out herself). This resulted in my mother telling me she has never felt more ashamed of me in her life, and she is embarrassed of me because of the things I post online. Ashamed of me, of her daughter! Regretful of the fact I was born and the way I am. Yes, of me, and it’s not the first time she’s ever said that to me. And yet I love her and I know that in reality she loves me, but those words are the result of the religious group we belong too. That is sad. And there is nothing I can do to change anything. I can only love my mother, accept that she hasn't yet realised what I have (that we belong to a cult), and keep going about my life.

The last month. Gosh, I don’t feel I own this story wholly so I will try to remain respectful of other’s privacy and intimacies. In this last month I have at times felt so alone, at other times it was the closest I've ever felt to any other human being, so intrinsically-linked, so unbelievably happy, and then so terribly disappointed and angry. And yet, somehow, and definitely helped along because I know I am not alone, I remain hopeful. I feel I have this undercurrent of general positivity. I am strong because I am not alone. I feel strong because I choose to remain positive and optimistic despite some hell of an emotional roller-coaster. I feel like a soldier, but not a soldier on their own, but one that is part of an army. My army, our army, and though we may not win every battle, we are not beaten. I am so not done.

Wednesday, May 28, 2014

On my obsessions

A dam koala... A koala I saw on a visit to a dam.
If you haven’t noticed, I haven’t been writing a lot recently – and I love writing! But turns out there are a lot of things I love also. Recently someone described it perhaps more correctly as obsessions; I get obsessed with certain things. Rewind back to a year ago and I was completely absorbed with guitars. I was obsessed with learning about them, taking them apart and modifying several, and even trying to learn to play. Well, I didn't quite get to the playing part due to having a mismatch in attitudes with my teacher who discouraged me to the point I now get panicked to even hold the guitars in my house, but that’s a story for another day. The list of other things I’m told I also obsess about are my Lego collection/village, rabbits (in all shapes and form), buying bed linen, and the one thing that has been consuming me day and night for the last month or two: woodworking.

My obsession with woodworking started from when I was a teenager, or perhaps even younger. See, I was always a nerdy kid, the kid who preferred going to the library at lunch time, and absolutely dreaded phys ed class. I wasn't good any activity that was physical, and I didn't enjoy it at all. I did, however, really enjoy visual and literary arts, and once I was introduced to it, I fell in love with manual arts too. Suddenly I enjoyed something that wasn't purely intellectual – and it didn't matter how good or bad you were, most things could be fixed somehow. I did manual arts for 3 years in high school, dropping it for the senior years to focus on the academic stuff. I remember I told my mum and siblings that one day I would become a doctor and I’d buy a house and in my house I’d have a workshop and then I would take up woodworking again.

Well, here I am. Coincidentally the house I bought happened to have this room at the back of the garage that, well, someone could turn into my workshop. And that’s what I've been doing. That’s what I do when I get home from work and on my days off. I recently took a 2 week holiday in which I think I spent 80% of my waking hours in that room. A large proportion of the remaining time was spent buying tools. And you know what? I had a great few weeks. It gave me a new focus and clarity to return to work and the rest of my life.

I read a woodworking blog once where someone asked, ‘what have you learnt from woodworking that also applies in general life?’ I made a light-hearted note recently when my router stopped working suddenly just as I was preparing to fix it to a table, that some things would rather die than lose their freedom. That was a joke, of course (for people like me), but a more memorable quote I once read said that a master woodworker isn't one who doesn't makes mistakes, but one who can cover up their mistakes well. And that’s more like my style of philosophy:  Everyone stuffs up; what matters is what you do next.

But, yes, the obsession part of this, as was pointed out to me, is I spend a lot of time buying tools, doing random odd jobs in my workshop, and watching, reading, and attending woodworking shows/magazines/videos. A LOT of time! My plants are going unwatered. I get itchy at work to go home and work on some unfinished project when I have gaps between seeing patients. I've had to re-calculate my budget to try to stop myself from overspending on tools and things for woodworking. I've been neglecting my own blog and reading so many woodworking blogs. It’s ironic, yet at the same time I think I’m finally learning about the importance of balance.  When my life isn't just work, it is so much more enjoyable.

Wednesday, April 9, 2014

On Lance Armstrong

It was only when I watched this report on "smart drugs" that I finally understood how skewed our perception of Lance Armstrong is. See, in the report this scientist speaks of how taking these types of drugs can make people be able to read quicker, maybe retain some of that knowledge, maybe be able to retrieve it quicker and more consistently than if you didn't take the drug. The theory goes that if you do these things with greater ease, then you’ll be able to perform better on tests that measure how "smart" you are, and maybe even other types of academic tests. That's why some college students find using these drugs of advantage for their studies. But I asked myself, can I take some of these drugs and then go and pass a test on astrophysics or mathematics or computer programming? Could I? Not unless I've at last read the subject matter before! And that's just it; I can't be "smart" unless I put in at least some effort myself. All the best drugs in the world can't make me pass a test on theoretical physics if I don't even know what theoretical physics is.

I know, that's not a real comparison though, right? I mean if I want to pass a test on a subject matter it's probably because I at least have some interest in this matter, have heard of it, and for some reason have decided that this is important to me. If I had had access to them in medical school, would I have taken "smart drugs"? Well, I could argue that I obviously didn't need to to graduate. But what would have happened if I did? I could have taken less time to study as I may have being able to read quicker, learn quicker, and recall more consistently. I could have, in turn, dedicated more time to leisure activities. Or, I could have studied some more and got even better grades (for what benefit I don't know, but that's a possibility). The real question is would it be unfair to other students if some take ‘performance-enhancing’ drugs and others didn't? Would this whole conversation be unnecessary if every student in the class had access to these drugs? Well, this is exactly what Lance Armstrong's logic was even when he did confess to using (banned) performance enhancing drugs and techniques in international professional cycling competitions. What he told himself was that if everyone does it, it's not cheating and it’s not wrong and it's not even worthy of discussion.

But let me go back to my original scenario about "smart drugs" in academia. No, they don't work on just nothing, and if you have never heard about thermodynamics, taking all the best performance-enhancing drugs in the world will not magically make you know about it. You still won't pass tests that other students who have studied know about. You have actually no advantage over them despite the drugs - unless the drugs are not the only thing at play.

Lance Armstrong. Everyone feels entitled to call him a cheat and a liar. He's a bad person, right? Well, firstly let me state my opinion – and yes, this is just opinion. Certainly (as he admits) he has done and said some things to cover up his use of performance-enhancing drugs and techniques that hurt other people. He broke international cycling competition rules also. He denied other competitors a right to an equal playing field. And he tarnished the reputation of a sport and competitions a lot of people had a high regard for. But more than that, I think what people (and I mean people outside of the cycling world especially) feel most upset by is the selling of a false story. I mean, he was thought of a hero and an example of overcoming great adversity for equally great success in life (overcoming metastatic testicular cancer) and what is a very difficult sport. His story gave many people hope, inspiration, and motivation. This is why Lance Armstrong was so widely respected and admired. But that story (perhaps) only occurred because he gave himself unfair advantages. He molded and manipulated the circumstances so that the story would unfold the way it did: with him as the winner. That part of it I feel we have a right to be upset about, but I think for the majority of us, that is where our opinion of him should end.

Lance Armstrong  is a very flawed character, and yet I think we all somehow forget that the majority of us weren't there on the race track on bikes competing next to him.  A lot of us act as if he personally cheated against one of us. A lot of us believe he had no right to the admiration and success he had because of his use of performance-enhancing techniques. But the truth is how many of us have cycled 3,400km in 21 days? I haven’t and I don’t know personally many people who do. Yet a lot more people that don’t do this either, behave with criticism towards Lance Armstrong as if they had been his immediate competitors in the Tour de France. We didn't compete because we weren't motivated to, we lacked the physical and mental stamina to undertake such a marathon task, we simply were not up to the standard required for it at all. And that’s the thing I realised when I watched the report on “smart drugs”, that no matter what anyone says, drugs do not work on nothing. Something of the whole Lance Armstrong story was the individual himself (was it the motivation, the will, the mental determination, the hours of physical training and preparation, etc - who knows?). and not purely the performance-enhancing techniques he utilised.

So I think, yes, admit that we are angry towards Lance Armstrong for selling us a false story, for giving us hope based on false premises, for acting erroneously towards a lot of individual and sporting groups – but remember, we were not his competitors and are not and should not judge him as being any more or any less than we are: an imperfect human being.