Changing our lives: Whose responsibility is our health? June 2014

Changing our lives: Whose responsibility is our health?

“The treatment of a disease represents an admission of failure. Prevention is the goal of medical research and clinical practice.”

Professor Peter Elwood, Cochrane Institute, Cardiff University,

Apologies to those loyal readers, who read and comment on my occasional health related blogs. I am a couple of  months late in my self-appointed task of sharing ideas every couple of months, but last month got rather busy while I attended the 50th anniversary International meeting of the International College of Applied Kinesiology, (AK) in Washington D.C.,USA.

Capitol Hill, Washington, where lobbyists manoeuver their politicians into mostly obstructive, destructive, obfuscation, and not much changes for the better!

 

The late Dr. George Goodheart, the founder and genius behind Professional Applied Kinesiology

 

 

 

 

 

A chance for  350 clinicians from 14 countries from around the world to gather and both share their new research as well as honour and remember the genius of Dr. George Goodheart the inventor/discoverer of AK.

It is always a pleasure to learn and share amongst old friends from all over the world who share a passion with such enthusiasm.

No sooner had I returned on the red eye flight from Washingtion and done a couple of days work than, at the request of my rock musician daughter, we were off to Glastonbury. This daughter  had enjoyed many gigs playing  at Glastonbury in the past, (for heavy rock music fans check out her band, here. )

So before we were irredeemably decrepit wanted us to experience the atmosphere of this unique event down on the farm in Somerset. Discussions of our experiences of the Glastonbury Music Festival will have to remain for another time and place,  here but although I am not particularly into music,  the most fun music I stumbled across, were the lively, Melbourne band ‘The Woohoo Review’ a brilliant cross between Klesmer, Mariachi and Jazz, check them out here  here.  But enough…

Whose responsibility is our health?

On July 5th the National Health Service had its 66^th birthday.  With an ageing population, and the ever-increasing cost of medical interventions, there’s more pressure on the NHS, which is why we need changes to services to focus far more on health prevention out of hospitals, and use the range of talented clinicians more beyond the limitations of the over pressed GP’s as Goldstein and Weeks have suggested in America were they make a strong case for greater integration of

Various kites are flown by politicians, such as the idea that everyone in the UK should start paying a £10-a-month NHS “membership charge” to save it from sliding into a decline that threatens its existence. While advances in modern science and engineering have nearly doubled our lifespans in only four generations, our quality of life has not reached its full potential. We need radical change towards true preventative medicine that goes well beyond screening and public health programs.
The Emerging field of Functional Medicine, as practiced by a growing core of advanced clinicians, including here at Helix House, seeks to pinpoint and prevent the cause of illness, rather than treat its symptoms. What is Functional Medicine you may ask and surely it is no different from the prevailing medical model?

Functional Medicine, like Professional Applied Kinesiology and Osteopathy which share many of the key principles,  is an integrative, science-based healthcare approach that treats illness and promotes wellness by focusing on the bio-chemically unique aspects of each patient, and then individually tailoring interventions to restore physiological, psychological, and structural balance.

Functional Medicine focuses on understanding the fundamental physiological processes, the environmental inputs, and the genetic predispositions that influence health and disease so that interventions are focused on treating the cause of the problem, not just masking the symptoms.

There are seven basic principles underlying functional medicine which include the following:

• Science-based medicine that connects the emerging research base to clinical practice.
• Biochemical individuality based on genetic and environmental uniqueness.
• Patient-centered care rather than disease-focused treatment.
• Dynamic balance of internal and external factors that affect total functioning.
• Web-like interconnections among the body’s physiological processes also affect every aspect of functionality.
• Health as a positive vitality, not merely the absence of disease.
• Promotion of organ reserve.

Managing chronic diseases accounts for three quarters of our total healthcare costs, because too often we’re masking these illnesses with palliative pills and temporary treatments, rather than addressing their underlying causes. Worse, only treating symptoms leads us down the path of further illness. But with all the public discussion of the funding of the NHS, such issues are, almost never, publicly aired despite the frustrations of many well-meaning clinicians within and outside the NHS..

At one stage, governments tended to consider matters of health and disease were the concern of the individual.

‘The Great Stink’ might be seen as one landmark in our slow progress towards communal care of our health and the realization that serious public investment in infrastructure was equal or more important, than the medical treatment of disease. It was the summer of 1858 during which the smell of untreated human waste was so strong in London that the huge task of building the London sewers was taken on for the benefit of all. Gradually over the next ninety years more and more efforts were made to invest publicly in fighting disease culminating in the founding of the National Health Service on July 5^th 1948.

The modern health challenges we now face as a society are both societal and individual, as a recent study by the Institute of Primary Care and Public Health show. Lead by Professor Peter Elwood, of the Cochrane Institute, Cardiff University, Healthy Living: Healthy Ageing, known as, The 30-year Caerphilly Cohort Study, was a long-term study of a large representative sample of men.

A number of ‘healthy’ behaviors were defined: non-smoking; a low BMI; regular exercise; a plant-based diet and alcohol consumption within the guidelines. Combinations of these behaviors were referred to as ‘healthy lifestyles’. In this paper the health benefits of a healthy lifestyle were examined and some interesting findings were discovered. As they say in the report;

“It is my decision whether or not I smoke, what body weight I maintain, whether or not I exercise regularly, what diet I take and how much I drink”.

All perfectly true and yet since these five healthy life style choices were chosen for the study thirty years ago, we know a lot more about, for example, the influence of social relations and social inequality on survival. Good, supportive social relations alone are at least as important as that of smoking, and much more important than heavy drinking, physical activity or obesity. So do get out there and talk to your friends and make some more!

Higher levels of income inequality damage the social fabric that contributes so much to healthy societies and can, sometimes, militate against good social relations. Now, a major new review of the evidence from almost 150 studies confirms the important influence of social relationships on health. People with stronger social relationships were half as likely to die during a study’s period of follow-up as those with weaker social ties.

As the work of epidemiologists Richard Wilkinson and Kate Pickett have shown, in their brilliant book, The Spirit Level, first published in 2009; 

“The weight of the evidence, and its continued rapid accumulation, make the important link between income inequality and social dysfunction inescapable”.

When discussing some of the more disingenuous criticisms of their work on equality, Wilkinson and Pickett point out in a recent article New Statesman | Yes, we are all in this together;

“In their book Merchants of Doubt, the American academics Naomi Oreskes and Erik Conway suggest that the defense of a kind of free-market fundamentalism is the most plausible explanation of why the same individuals and institutions are often involved in attacks on research in areas as diverse as tobacco control and the evidence on climate change”.

You could add to this, without any criticism of good drugs and surgery medicine, the tedious attacks on all kinds of non-drug based medicine, whether they are osteopathic, acupuncture or functional medicine. The same coterie of dodgy, obtuse scientists and mendacious journalists can usually be found to have links back to the vast corruption and multi-layered conflict of interest between the practices of medicine, medical science and the $1.3 trillion drug industry.

The Caerphilly Cohort Study showed how extraordinary changes in disease rates and life expectancy can occur if individuals can just follow five, basic, healthy life choices, they found;

“Few men in our cohort followed all five behaviors, but in those who consistently followed a lifestyle which included four or five healthy behaviors experienced reductions, on average, of about 73% in new cases of Type 2 diabetes, similar reductions in heart disease and stroke, and, most remarkable of all, about 64% less dementia! Non-smoking was associated with a reduction in cancer of 39%”.

However, sadly, in the study it was also found that despite the expenditure of £280M/year on Public Health and Health Promotion in Wales in recent years, there has been virtually no change in healthy living over 30 years! As Wilkinson and Pickett show, across whole populations, rates of mental illness are five times higher in the most unequal compared to the least unequal societies. Similarly, in more unequal societies people are five times as likely to be imprisoned, six times as likely to be clinically obese, and murder rates may be many times higher.

“In a recent survey of 15,000 adult subjects in Wales, 19% of adults reported that they were following three healthy behaviors, 7% were following four and only 0.5% were following a lifestyle based on all five behaviors. Thirty years previously, when the Caerphilly Cohort Study was set up, the proportions had been almost identical (19%; 5% and 0.1%). Similar findings have been reported from studies of workers in healthcare (!) in the USA, and though better, the proportion following all five behaviors was reported to be only about 3%”.

 

 

 

 

 

 

So to conclude, we have to see changes both in individual behavior and find ways of organizing society towards greater equality. Reigning in the destructive food, alcohol, drug and tobacco industries as well as building better and more houses and encouraging good jobs.

We find ourselves with our own 21^st century Big Stink!

As Wilkinson and Pickett show, see diagram, Social problems are closely linked with inequality amongst rich countries, and this is not just bad for the poor but bad for everyone.  Our own malodorous predicament consists in wealthy, advanced societies with growing, destructive inequalities within, and equally huge and dangerous inequalities without.

 

 

These pernicious  global inequalities suck young, desperate, individuals to risk all on treks across the Sahara or dangerous boat trips to reach the shores of richer, freer countries. While many in those advanced countries squeal at the incomes, they often fail to identify or act on the vast and growing underlying internal and external inequalities driving such epic migrations and the social anxiety and conflict such, too rapid and dramatic, upheavals, naturally tend to generate.

The challenge remains. Poverty, culture and inequality strongly militate against building the kind of society that can protect us from our own poor choices in matters of health. The world has recently tipped over to one where there are more people living in cities than on the land and more suffering from the effects of obesity than starvation. Babies born today can expect to live in a global world of three or four billion more people.

What was once the skewed, lifestyle-driven, sickness of the rich world is now rapidly plaguing the developing world. There are still enough medical mysteries out there without the majority of us killing ourselves, voluntarily, long before out time, with our own destructive personal and political choices.

Let us end this month by giving the final words to Wilkinson & Pickett;

“The health of our democracies, our societies and their people, is truly dependent on greater equality”.

 

February Bonus 2013

Asian Travels January 2013

Normally these blogs have a distinct health and wellbeing theme. This month, because, as some of you may know, during January I was away in Asia working and playing, this is an un-ashamed travelogue month, when I share with you where and what I was up to. So if you could not get an appointment with me, now at least you will know what  I was doing just when you wanted me on hand! The privilege of age is getting to do things you fancy. So here goes.

Seoul, South Korea.

It all started a few years ago, on a cliff top in Cornwall. My friend Lee, suggested that he and I might enjoy exploring Vietnam together one day, being of that age that the very name Vietnam, takes us back to our stormy ’60’s youth. This suggestion was then consigned to the “one day” file and the years went by.

When I was a young man, hungry for direct experience rather than just book learning, after many years as a student, I had travelled extensively over Asia, ending up in Japan for a year, where, thanks to bit parts in films and teaching English, I was able to earn enough to take me onwards as well as touch something of the old and new life of Japan.

Did we really think those sideburns were cool in 1971?

So, when the call went out to members of the International Board of Examiners, of the International College of Applied Kinesiology, for volunteers to go to South Korea as part of an examination team in January 2013, I wasted no time in putting my hat in the ring. Here was my chance to return to my old East Asian stomping ground, forty years on, and, maybe, even fit in the Vietnam trip in as well, and, with a bit of luck, get paid for  my efforts too.

So the long months of planning rolled on and, before I knew it, the end of the year was approaching and I had arranged not only a week of examining in Seoul but a trip around Vietnam, (due to timing difficulties only crossing Lee, and his daughter’s path for a brief night in Hanoi), then back to lecture at the ICAK-Korea AGM and  on to Osaka to meet up with one of my daughters, Hanna, who was going to be working the week before organising a conference in Bangkok. From Osaka we would continue via an old friend, Katsue, in Kyoto,  and then on to Tokyo, my old home all those years ago ending with a weekend seminar for the AK community in Japan. A seven flight, three-country, five week intensive…goodie, just up my street!

January the 1st 2013 saw me flying the long flight to Seoul to join my two colleagues, Kathy from the USA and François from Quebec to start examining the eight impressive Korean Doctors for the advanced Diplomate exam. Nine hours time difference needs a little getting used to so on our first day Kathy and I, first to arrive, ventured out on a sightseeing jaunt into the -15C bright, clear, cold, sunny Seoul air to explore and enjoy the absorbing sights  of the palace of Gyeongbokgung,

Gyeongbokgung is the most popular tourist site of the city, with good reason. A key focal point of the whole country a lot of South Korea’s heritage can be gleaned from this fine palace and some of the impressive museums around about.

Clive and Kathy explore the cold city

When I was last in Korea in March 1972, I notice, re-reading my diary of that journey from Japan to Korea,  I referred to the country then as,

” sad, confused, half adapted, screwed up but open…” How things have changed! Then it was Japan, which was the shiny, new, East Asian tiger, pushing all before it.  Now its light was dimmed by crazy bank debts of trillions of Yen, while the South Korean economy, as seen by Samsung’s, fourth quarter profits going up by 76%, is racing ahead and Seoul is transformed, utterly. Nothing of the old, low-rise city, is recognisable. Down in Gangnam all is style and high-rise neon-soaked modernity. Gone is the Seoul of yesteryear. Now it is a spectacular city of wealth and vibrant energy, as fiery as the food. Only the remains of an anarchic driving style remind you how recent has been the transformation from war-ravaged dictatorship to hyper-modern, affluent democracy. Let us hope despite the adoptions of some Japanese banking styles, they will not fall down the same enormous rabbit hole that the inflexible Japanese economy has been stuck in for so long now. But it is not as if we have the wisest bankers in the world either I remind myself.

When I was first in the city, Park Chung-hee was the dominant General-turned-President-strong man, using his power and secret police to control and enrich the country. Still revered by many for his long reign and drive to turn South Korea into a modern, industrial export-driven state, Park Chung-hee is also remembered for his brutal and growing illegitimate reign, a heritage that his daughter Park Geun-hye who was elected as South Korea’s 11th and first female President and took office in February 2013, has to live with as best she can.  This transition from Japanese occupation, war torn destruction and post war instability to affluent modern democratic state is a remarkable one. And it was a pleasure to see the country, whatever its on-going difficulties and its tragic division into Stalinist, Gulag state in the north and successful democracy in the south, at least finding a better life for so many in the south.

The tragic blot on our landscape that is the DMZ between North & South Korea, still a highly armed and contested flashpoint.

After the work…comes the Karaoke. We all look surprisingly well behaved. You are not seeing the other photos of the singing in action!

If I ever wonder why I choose to travel around the world and put in such exhausting hours I am reminded of the great sense of affection and warmth that can grow up, so quickly, between those who share a passion for helping others through such medical ideas as applied kinesiology, osteopathy, chiropractic, NLP & functional medicine. We had not been in Seoul for more than a week before we felt a strong bond of shared passion and enthusiasm. So much so that, sometimes, during our translated practical exams, hearing chunks of technical, imported English, mixed in amongst the Korean, one could, in a fatigue-filled reverie, almost imagine one had mastered the complexity of Korean! Of course an illusion, and yet metaphorically we did ‘speak the same language‘ and, when this happens across the barriers of culture and language, a great affection is rapidly engendered. If this is strengthened, after all the hard work, with food, alcohol and even Karaoke (Hey Jude, is always a good one to end a long work spell with) then international friendships are made and cemented surely a good outcome. As I left our kind host and organiser the impressive Dr. Seung Lee, I was glad that I was coming back to share more with his stellar group.

Vietnam 

The still ubiquitous, Uncle Ho, father of the nation.

The flight from Seoul to Hanoi is only a few hours across China, and yet it is a long journey culturally. From a country

Not Uncle Ho

once divided and which had suffered a murderous war that laid waste to it  and killed millions, leaving it still bitterly divided to another which, with a different history, had suffered a similar meat-grinding fate, was a few decades behind in its journey to recovery and democracy, and yet which has managed, with much bloodshed, to finally throw off colonial oppression and, at unbelievable cost, has at least united its people, all be it under the increasingly corrupt waxworks of the Politburo in Hanoi.

Communist social realism still holds sway as the preferred art form in public spaces, and yet the predominantly young population, seem to accept it as mainly a quaint, out-dated foible of granddad’s generation.

I should say, at the outset, I liked Hanoi.  Therei is of course, the sad Leninist mausoleum, where Ho’s mummified corps, is still used, against his wishes, as a prop to sustain the national myths and so bolster the questionable right of a single party to hold all power to itself but even accounting for the twitchy, self-important, military scene around the large ministries of state, I have to aknowledge that we have our own, after all. The more you study the tragic history of Vietnam the more you feel inclined to cut the regime some slack, in a way that would have been unthinkable in, say, unreformed Eastern Europe, let alone the city built on lies and concentration camps, Pyongyang in North Korea. Of course this is in not inconsiderate part because the use of, old style, communist lies & coercion is much tempered and the likeable, industrious people of Vietnam seem to be able to get on with their lives and generate wealth, largely unbothered by fear of the secret police, as long, as they don’t rock the boat or want political power. I suspect eventually in some decades time a new less corrupt more democratic system will prevail. And to have achieved what they have, you can see perhaps why they needed such a ruthless political system to take on and overcome the challenges they faced in Ho’s day. This is a country that will go far and I cannot help developing an abiding affection for. The people are generally warm, approachable, the misogyny of central and southern Asia is muted, somehow out of the ashes healing seems to be occurring and all with fewer scars than anyone dared hope for.

Street food.

Many people have better things to concern themselves with, especially in their formative years, than international conflicts on the other side of the world. And then there are the International News Nerds, of which I must have been one.  I was mesmerised with admiration for the photography, and horrified by the content, of Larry Burrows brilliant war reportage from Vietnam in Life magazine throughout my teen years. Graduating to a slow burn radicalisation brought about by the quagmire of the Vietnam war (or The American war, as it is known in Vietnam) in my student years and beyond in the late 60’s and early 70’s. Marching in London and San Francisco is almost a life time away, and yet Vietnam was at the centre of a whole caldron of key issues that came to the fore at that time and have persisted to change the world since those turbulent days.

Prime Minister Harold Wilson may have been a brilliant man, but he was an uninspiring leader to young people getting the vote for the first time. And yet, decades later I hold a soft spot for Wilson in one area at least, and that is his refusal to bow to pressure from Johnson to send troops to Vietnam. My generation were right in the bulge of troop numbers of the mid to late 60’s and so, now, visiting the country that might have been my early grave, held particular resonance.

Two wheels? The whole family still has to ride together!

The first thing that strikes you about the streets of Hanoi or Saigon, (HCMC) are the sheer numbers of motor scooters that flow like beeping liquid through every street in the city. The highway code is in its infancy, and yet, after the first shock has died away one soon adapts to the nerve-wracking task of crossing the road; stepping out slowly but firmly into the stream of belching bikes, watching them flow around one in an aqueous ballet, invariable one reaches the farther shore of the opposite pavement, somehow intact.  The roaring and purpose has magically accommodated one within its big mind and one lives to explore another street. Although, of course, if you thought you were going to be safe walking down the pavement, think again, after all, where do you think those 3 million bikes are parked and where can one set up a banana fritter stall, play badminton or run a hairdressing business?

Woman cyclist in Mekong Delta village

There is something wonderful to me about reading up on a country, its people, culture and history, and then travelling there, however briefly and trying to get a feel for its life and loves. It must be the wanabe anthropologist in me, that likes to dip my toe in like this, but equally I would not make a true anthropologist, who must be able and willing to immerse oneself in a culture, its food, customs and language for years, away from loved ones. I have had a minor taste of that when young and was not that good at it. But these little amateur adventures are fun.

I was able to spend several days on my own exploring Hanoi then go on and see many of the familiar well known sights of Vietnam, including Halong Bay, and travel on the Reunification Express, (perhaps that last word is a bit of a misnomer) down to the ancient capital of Hue, on the perfumed River and on via the Hai Van Pass, via Da Nang, to Hoi An and beyond to the deep south in Saigon and the watery world of the Mekong delta. There is still something rewarding about rocking along in an old train through the night, however grim the loos, waking as the train cranks along through unfamiliar rice paddies and deposits you in the heart of a new fascinating city, in this case, the old capital Hue.

The Perfume River. In the autumn, flowers from orchards upriver from Huế fall into the water, giving the river a perfume-like aroma, hence the soubriquet.

Hue’s ancient citadel one time seat of the old Emperor and his vast retinue of mandarins, eunuchs and concubines, was much damaged during the famous Tet offensive of 1968. This attempt by the NLF and the North Vietnamese to trigger a mass uprising was a catastrophic failure in that no mass uprising was triggered and over 5000 local people in Hue alone, were murdered by the north simply because they were educated. More NLF (VC) troops were lost than the Americans lost in their whole involvement in Vietnam, during this offensive and yet, through its impact on public awareness in the USA, it became a turning point in the whole American war.

Gradually some of the old treasures of the heritage of Hue are being restored and again it is becoming something of the cultural centre in the way perhaps, Kyoto or Oxford are in their countries. Along the Perfumed river, is the famous Thien Mu Pagoda, at one time the training place of both Thich Quang Duc, famous for his anti-government protest in 1963 when sitting motionless in full lotus, he burnt himself to death as a protest against the president. Also from this Pagoda came the famous Vietnamese Zen teacher Thich Nhat Hanh who has had to live in exile in, Plum village, France for over 40 years.

Students prepare for their graduation with a photo call at the Temple of Literature, Hanoi.

It is interesting to note that while Buddhism in its quiescent, simple family temple form, is tolerated by the communist government, they are far more twitchy about anyone teaching young people to actually practice Zen, as Thich Nhat Hanh has so profoundly done over many decades. He was allowed to return a few years ago, but only under close observation from the secret police. I was most happy, through a friend of a friend in Plum village, to spend an afternoon with a young English-speaking Vietnamese, I better not put her name, and hear how it was to aspire to practice what she called, ‘real Buddhism’ in a communist country. It must be a strange assignment for an undercover cop to have to go and meditate to ensure no disloyalty to the motherland is brewing in the youth of your country!

Travelling up over the Hai Van Pass a climatic watershed between north and south, takes one to Da Nang,  and on to the attractive old trading port of Hoi An. There like many others before me I had a nice suit made to measure for me in not much more than a day, something I was glad of back lecturing in Seoul and Tokyo.

Fisherman on the beach near Hoi An

The further south we went the warmer it got. Today the tailoring business is almost out of control in Hoi An so many are there vying for your business. This is a city that hundreds of years ago was a major trading centre linking, China, Japan Vietnam and even as far away as India. Today unscathed by the destructions of the wars, it is an island of the old and small scale in a country that, especially the closer one gets to Saigon, is going the way of all, into the concrete box culture that is despoiling the world. But here in Hoi An some remnants of the old wooden buildings are still to be seen.

It is a truth universally acknowledged that, at a certain point in a nation’s evolution, a big, phallic skyscraper, preferably with semi- useless attached helipad, is required to announce ones “arrival”!

Saigon, always the wild, mercantile, south to Hanoi’s more political, poetic north, comes with a blast of hot air and motorbike fumes. Vibrant, bustling, still, for some of us old romantics, with the faint whiff of the ghosts of Graham Greene, murky CIA secrets and, for those of a certain age,  there still lurk in the back of our memories those hard to  forget, iconic images of the end of the American war. Tragic shots of helicopters on roofs, as below harassed Marines fought off growing throngs of desperate, fearful, abandoned Vietnamese, trying to escape, before, after Pol Pot not long before in Cambodia who knew what horrors might come with the arrival of the feared Northern Army.

But today there is a largely young population, all born long after those chaotic times. Inward investment along with Vietnamese energy and entrepreneurial zest, is making Saigon, if not loveable, certainly a vibrant, bustling city. The new boys on the block are selling obscenely expensive handbags from glitzy Gucci shops down town, below new high rise blocks with helipads half way up, on the fiftieth floor. These sit, slightly strangely, with the straight-laced old-style, puritanism of the communist propaganda posters in the parks.

Beyond the city lies the great Mekong Delta. Rice basket of Vietnam, capable of taking three crops a year, and making Vietnam, which could not feed its own people, now the number one rice exporter in the world.

The Mekong Delta wakes up to the morning sun.

Beyond the Chu Chi tunnels and Halong Bay marvels of man and nature, perhaps the greatest marvel in Vietnam is the resilience of its people. Enslaved by the French for almost a century, then decimated by the Americans plus their own civil war armies of right and left, then almost starved to death and ground down under Marxist-Leninist Thought, the country has come back from unimaginable suffering and destruction of it people, its soil and its gene pool (through the wide scale use of Dioxins by the Americans), and somehow now in 2013, here is a country of optimistic, friendly, often English, French, or German speaking outward looking people, who, even as they try and sell you something you may not want, have a twinkle in their eye and share the whole joke with you.

Korea Again

Some of the Korean ICAK-K at their AGM, as I am introduced.

After the soft 30C warmth of my homestay in the Mekong, suddenly it is time to earn my living again and back in Seoul it has warmed up to a barmy -9C for a flying 36 hours, with my friends in Seoul for their AGM. This time there is only me to keep a hundred of these enthusiastic, intelligent and enormously over-qualified medics happy for a Sunday away from their families. Luckily the work ethic in Korea is fearsome and one can see why they have transformed their country in a few short decades.

I do my shtick. Always rewarding to share stuff you love and know well.

No one seems to take holidays, and advanced degrees seem two a penny. But again whatever divides people, when you get into your area of passionate interest and others share the same interest, you reach across all sorts of limitations and a strong bond links you with affection. I was honoured and touched to join them and share some of the things I have learnt over the years. It is always amusing to find oneself, for however brief a moment, being asked to be photographed with so many people and this seems to be the form at the end of such events in Korea and Japan.

What a great team behind me doing my Shtick!

On to Japan: The last leg of my Journey.

After eating out for weeks it was especially delightful to be at home with Katsue’s sister and her lovely family

From Seoul I moved on to Osaka to meet up with Hanna, my daughter. This was fun both to meet up on her birthday, and for me to return, with Hanna, to Japan after over 40 years. First we much enjoyed

Hanna and the owner of our lovely Ryokan in Kyoto

meeting up with Katsue an old friend who used to baby- sit for us when she was living in Oxford decades ago when  Hanna and her sisters were children. Katsue kindly took us around and spoiled us rotten as we enjoyed seeing something of Kyoto in our brief visit.

Kyoto, O Kyoto, what has happened to you? Sitting at the apex of Japanese culture, recognisedby the state department in 1945 as more than just another target city to be bombed, it was seen as a

Some special Kyoto bling!

treasure of the world and taken off the bombing target list. Surviving into the post-war world more or less intact, it was the city fathers who destroyed it and despoiled the old city with its intense charms, great temples and rich depository of ancient wooden buildings and cultural treasures. Today around the outer reaches of the city there are still many great temple complexes such as the outrageous bling of Ginkaku-ji  and many other more subtle treasures such as the 16th century monochrome, Daisen-in abstract garden inside the great Rinzai  temple complex of Daitoku-ji in north

I make a little pilgrimage to Daitoku-ji Temple complex

west Kyoto. So much of the city has suffered the fate of brutal modernisation epitomised by the outsized Kyoto tower and Station complex, obscuring the views of some of the great nearby temples.

As Alex Kerr notes in his Book, Dogs & Demons: The Fall of Modern Japan;”

“The tearing down of the old city of Kyoto was by no means limited to the 1950’s and 1960’s, when every city in the world made similar mistakes. The city’s destruction really gathered speed in the 1990’s, by which time Japan was a mature economy, with a per-capita income exceeding that of the United States. According to the International Society to Save Kyoto more than forty thousand old wooden homes disappeared from the inner city of Kyoto in that decade alone”.

For me, it was a happy pilgrimage to visit Daitoku-ji temple where my own first Zen teacher, Irmgard Schloegl came to study Zen from 1960-72. Her path in negotiating that fearsomely tough monastery life, especially as a foreign woman may have been eased by studying with Ruth Fuller Sasaki, an American woman who was already accepted as a Zen priest and ran a training temple for foreigners- the First Zen Institute of America, within a corner of the great Daitoko-ji temple complex.

Despite the endless urban sprawl between Kyoto and Tokyo, Mt. Fuji was clearly visible for once, beyond the smokestacks and concrete boxes.

So much of not only Kyoto but also the little I saw of Japan, was hard to recognise. Returning to my old street in Tokyo was interesting. Once full of old wooden houses and a local bathhouse round

Return to my old streets in Tokyo, 40 years on!

40 years on, it was hard to recognise much of Tokyo, so it was good to find my old street still intact.

the corner for all of us who did not have such facilities at home, now it was, despite the still small plots of land along the tiny streets that had remained intact, new fancy houses were abundant, often with outsized cars trying to negotiate the miniature streets.

My old station

In some ways it was good to see that the neighbourhood had gone up in the world. But there was a certain unease to witness, in Tokyo, as in Kyoto, the wholesale transformation that had occurred, leaving almost nothing of the old recognisable.

Shibuya was its intense self still, and it was fun to stop by at the world’s most profitable Starbucks coffee shop overlooking the busy street crossings of Subuya, where once I had to endure the crowds each day to and from work at Tokyo English Centre. How happy I was when I could leave the frenetic bustle of Tokyo and swap that life for a summer in the mountains near Kyoto growing vegetables and doing yoga and trying to work out where my young life was going.

While Hanna explored greater Tokyo I was due to be giving a weekend seminar. Sadly the day before I went down with a fever. But, after six months in the planning, the show must go on, so somewhat feeble and feeling distinctly not on form, I managed to call on ‘Dr. Seminar’ to boost my adrenaline, stay upright for the weekend and deliver the seminar to a charming group of Japanese enthusiasts for this work.

A great team to translate for me and keep my upright for the weekend.

They were, like their Korean colleagues, a pleasure to teach and get to know. I was only sorry that my health gave out at this crucial juncture so that, although I was able to do my stuff, I was not quite my usual effusive self! However it was with some gratitude and relief that, my job done, I was able to fly home the next day and get on with getting well.

It had been a great trip, new friends made, old familiar places revisited and updated to their current status in my mind and new cultures explored. What a great privilege to travel the world and share ones enthusiasms, teaching and learning.  It doesn’t come much better than that!

Always a good time when, work done, we can enjoy getting together for a photo!

Book of the Month:

Saigon 

by Anthony Grey published by Pan in 1982.

Of the dozen or so books I consumed, about the area, leading up to, and during, my East Asian travels in January, perhaps the one that stands out as having most impact is the now, rather forgotten, but brilliant historical novel Saigon by Anthony Grey, the one-time Reuters correspondent in Beijing, who became famous during the Cultural revolution when the Red Guards took him hostage in his flat in Beijing for two years.

Perhaps as a result of this long period alone, ~I do not know, some years after this he came out and wrote one or two, if not great works of literature, certainly engrossing and reasonably historically accurate, novels about both the Long March in China and the long battle for Vietnam.

Saigon follows the fortune of an American, Vietnamese, French and British family as their lives are intimately affected by and affect the turbulent years between 1925 when the French colonialists were still firmly in power in Indochina, up to those, above mentioned, days of collapse, when the Americans had to ignominiously leave Saigon by helicopter in the dying days of the South Vietnamese regime in 1975.

Admittedly the intertwining of these families fortunes over this fifty year period at times, stretch our credulity and yet the reader forgives any narrative licence taken with the plot because this does allows us to be at just about every key moment, from the last days of the Emperor in Hue, to the rise of Ho Chi Minh in the north in 1945, on to Dien Bien Phu in 1954 through the struggles of the American War and the denouement of the fall of Saigon in 1975. We gain a ringside seat with these characters and live and breathe the heroic and often bloody story of those crucial Vietnamese years of gaining their freedom, at least from outsiders. Today there is still some freedom to be gained from a one-party state, but that is another story.

It is clear that Grey put in a considerable amount of scholarship over a three year period in both Paris, Washington and London, when Vietnam was still closed off limits for such research, reading extensively in the archives consulting experts in the history of Vietnam in order to both paint such a vivid and exciting picture of the times, as well as maintaining the readers trust and confidence in his historical verisimilitude.

Over 750 pages the reader, as in any really good historical novel, both learns an immense amount about the country and period in question and, at the same time, gets drawn personally and emotionally into the account in a way that is more difficult in all but the best pure history.

If you have any interest in this area of the world and have time for only one book, this might be it. Even if you don’t it is a good read!