Thursday, June 14, 2018

Jurassic World: Fallen Kingdom "Spoiler-Free"Review

A couple of serendipitous things happened this weekend. First off, I happened to have the weekend off for the first time in a long while; second, I just happened to be randomly in the mood to watch a movie, and it just turned out that Jurassic World: Fallen Kingdom was showing; and, to round it all off, I was the only person in the theater for the early 10.45am showing.

This is only the second time that I've been in a theater by myself. The other time I randomly happened to watch a mid-week showing of "The Grudge II" post-breaking up with my ex, so you know I must have had a death wish. I was alone in the theater for two-thirds of that movie before another soul randomly walked in, and I don't know how I kept my wits together. Anyway, I digress; take home message: I'll definitely be taking advantage of more early showings.

Jurassic World: Fallen Kingdom is to Jurassic World exactly what "The Lost World" was to "Jurassic Park". Coming hot on the heels of a catastrophic failure of the dino park, both sequels focused on travel missions back to the heart of chaos. The preface to Jurassic World lets us know that the dinosaurs on Isla Nublar are facing yet another extinction level event in the form of an active volcano that threatens to wipe them off the map in much the same fashion as the dino-kiler asteroid. Being the politically correct world that it is, of course animal rights activists would rally to seek to conserve these genetically resurrected animals; others would rather prefer the expedient death of these animals in light of safety concerns; and, of course, since this is a Jurassic Park movie, someone's always in it for the money.

This is a wonderful way to segue into bringing back Jeff Goldblum's "Dr. Ian Malcolm"back to the mix, with an impassioned speech before the senate. It also serves as the introduction for our favourite heel-wearing heroine - Claire Dearing (Bryce Dallas Howard). A tad more sympathetic (and heely) since her previous tenure as the island resort's manager, she is brought back on a quest to effect some sort of dino-rescue; because this involves our last outing's stellar empathetic and intelligent dino character - Blue - undoubtedly, Owen Grady (Chris Pratt) is not too far behind. Along for the ride are Zia Rodriguez (Daniella Pineda) - a paleoveterinarian that has never seen a dinosaur up-close; there's also Justice Smith's Franklin Webb, an IT specialist channeling his inner Dr. Ian Malcolm with a bug-eyed nihilistic approach to the dinosaurs. (The Rodriguez-Webb pairing seems like a throwback to The Lost World's Dr. Ian Malcolm-Dr. Sarah Harding dynamic).

As far as sequels go, this one was bigger, darker, and, most importanly, BETTER. The pacing is adequate to set up the world-building for a post Jurassic World environment; things go into hyperdrive when the movie decided to embrace its disaster movie premise. Usually we've only had the dinosaurs antagonize the humans, but it's a new twist to see the dinosaurs overshadowed by a foe as massive as an active volcano. This time the humans are running and so are the dinosaurs. That massive running with the dinosaurs scene shown in the movie's trailer is epic in terms of scale and the desperation portrayed; fortunately things have come a long way since Peter Jackson's "King Kong", so it looks believable for the most part; you'll still have yourself questioning how the humans thrive through it, but it's not a jarring experience

For a dinosaur movie, this one sure does tag at the heartstrings. Seeing as Blue is a much bigger part of this movie, we get an expansion of Owen's and Blue's relationship. In the course of the franchise, we've also come to love some of these dinosaurs. Most herbivorous dinos have been portrayed as particularly benign in the franchise, and the Brachiosaurus might rank as one of the more iconic. The Brachiosaurus is poignantly used to highlight two specific scenes: the first is an introduction of the adventurers to a Jurassic World where the dinos are roaming free (I think every Jurassic Park has some variation of this scene); the second is one of the standouts of the movie, and I can't even mention it without spoiling is that good.

As much as the carnivores are usually portrayed as vicious killers, every one seems to love the iconic T-Rex, aka Rexy, the original big bad encountered in the original movie. She has come to the aid of humans on more than one occasion, and her survival is always something we look forward to (she barely made it out of her fight with the Indominus Rex in the last outing).

Seeing as this is a Jurassic Park movie, there is definitely the foolish part of humans on display, and this is the idea that they can somehow turn the dinosaur hybrids into weapons. Not to be outdone by producing the killer Indominus Rex in the prior outing, Ingen and Henry Wu manage to produce a more nimble IndoRaptor, which is capable of getting to its prey regardless of where they choose to hide. That probably deserves a Darwin Award right there.

This is a beautiful 2 hour 10 minute spectacle with everything working in its favour; the plot is crammed in to perfection, and it doesn't leave your mind anytime to wander. It's great to see Pratt and Howard channel their chemistry from the last outing, and Pineda and Smith complement the whole team's dynamic very well. I also need to highlight child-actor Isabella Sermon, who portrays Maisie Lockwood - granddaughter to Benjamin Lockwood (Jon Hammond's former partner). She is used very well to propel the plot elements of what's happening at InGen, and, if you're paying attention before the big reveal, becomes a focal plot element herself. She definitely knocked the role out of the park, and it remains to be seen what her role will be in the future sequel.

The movie ending propels this franchise into previously unrecognized ground, and the producers will have their work cut out for them in trying to build a cohesive story about the aftermath...but for now, simply sit back and enjoy a Grade A movie.

God Bless

Monday, May 21, 2018

Avengers: Infinity War "Spoiler Free" Review

As with all things these days, I've put off this review for quite some time. It really was quite a deeply emotionally invested movie considering that it is the culmination of a lot of (mostly) well told stories. I knew once I'd watched it that I'd have to do two parts to this review: the plain spoiler free and an in-depth analysis with my insinuations for the direction in which the next movie in this franchise would be headed.

I heard one movie critic refer to this movie as Thanos 1.0 because coincidentally it seems like he's the biggest character in this movie; not literally, of course, but he does command the biggest stage presence throughout most of the movie. Throughout most of the MCU (since the first Avengers movie), he's stood in the shadows as this quintessential big bad that we were eventually going to confront, and now here he is; as menacing as ever. When he's onscreen, he's quite the menace; and even when he's off-screen, he still looms ever large as the mastermind behind something quite sinister. He's definitely one of the best movie villains that Marvel has put onscreen to-date. The "Mad Titan" is played a tad more seriously than his comic book origins; instead of being some lovesick puppy obsessed with courting the incarnation of death, this time around he's a tad obsessed (seemingly obsessive-compulsive) with randomly eliminating a fair random portion of the universe as some form of benevolence that would help restore some semblance of balance. And his methods are quite surgical and precise. The best villains have always been those that you can empathize with; you may not approve of his methods, but you can understand him, and maybe even respect him in spite of it all.

This was characterized as a heist movie from the beginning, but it is so much more than; I'd suggest that Ant-Man was the MCU's one true heist movie. This is part heist movie, and also part melding together of all the disparate stories and characters that had been set in motion; this thus brings the space-faring Guardians of the Galaxy (GoTG) and Thor together with mostly earthbound heroes like the Avengers (post-Civil War), The Black Panther and the Sorcerer Supreme, Doctor Strange. Just like the initial team-up of the Avengers, things are a little messy with egos clashing and loyalties being tested from the outset. This was important to the way things were presented because as viewers we've essentially cosied up to this whole machine that is the MCU, but forgotten that our heroes haven't all encountered each other previously. The writers also keep the story tight by reminding us that not all characters are aware of the events of Captain America: Civil War, and leaving room open to interweave the other separate characters whose stories have yet to be woven into this latest Thanos thread.

Be that as it may, the team-ups are spread far and wide apart. The teaming up of Dr. Strange and Iron Man makes for a mostly palatable arc with the exceptional weak link being GoTG's Starlord. This team has enough pride among its members to just throw things off-kilter; apparently Doctor Strange didn't fully learn the virtue of humility and Tony, being the ever arrogant billionaire, clashes with him from the start. The antics of Starlord, however, seemed a bit misplaced for this movie. His humour sometimes has that strange Marvel quality whereby it makes a joke of something serious...somewhat like the way they wrote Tony in Iron Man III.

One of the best character arcs has to be that of Thor. Thor Ragnarok certainly gave us a greater understanding of the character, and in this movie no one's story epitomizes the theme of LOSS as much as Thor's. Since his vision in Avengers: Age of Ultron, he's mostly been plagued about the underpinnings of the Infinity Stones. He and Asgard were directly involved in dealing with the Tesseract (Space) and the Reality stones; and he was responsible for helping bring Vision to life, thus making Vision the bearer of the Mind stone. This time around he probably has the largest arc, interacting with most of the separate Avengers teams, and delivers some of the best heroics.

Also fresh of his Thor Ragnarok appearance, Bruce Banner and the Green Goliath also weave an interesting web among the separate teams. Since a lot of Thor Ragnarok was based on the "Planet Hulk" storyline, it stands to reason that not much of Banner was essential to that movie's plotline. However, with an earthbound Banner this time around, we require more Banner than we actually do the Hulk (to a certain point). This movie does put a bit of emphasis on the clash between Hulk and Banner, and is probably starting us along a trail where we'll eventually encounter one of the other Hulk personas sooner rather than later. It was also a treat to see Banner interact with Shuri, the MCU's resident genius-supreme.

This movie worked well for its gnarly two-and-a-half-hour run time; the action was on point with the Russo Brothers' signature penchant for action spectaculars here for all to see. What we have here is a complete story with an ending so sad that even the greatest pessimist will surely be on hand for the sequel to see how things will ultimately be resolved in a positive fashion; but it is missing some things. Thanos' "Black Order", his impressive minions are just as menacing as he is, but they just appear out of nowhere. A part of me wants to see their beginnings and how they all ended up serving Thanos. Surely, they must have an experience akin to Gamora's and Nebula's, something that either tugs at the heartstrings or at least points out why they are so devoted to him and keen to make his vision a reality. One part of the heist is also missing, and I hope we get to see it in the sequel (to mention anything else would be too spoiler-y).

Just have to say that this is only one of 3 movies that I've watched twice during it's theatrical run - Spider-Man II & Batman: The Dark Knight being the other entries - and one of the 2 that I willingly wanted to (ended up watching The Dark Knight again because of a friend). Each time was a joy, but there were a few cinema sins committed this time around.

  1. Parents, this was rated a PG-13 movie. If you're going to bring your younger children along, get them to be quiet. Having a kid upfront shouting loudly about the blow-by-blow of a scene is downright annoying. I now understand why some shoot outs break out in cinema halls!
  2. Y'all patrons need to put your phones down. Being interrupted by you flicking your phone on-and-off is uncalled for. It's not like a whatsapp conversation is going to save your life. Get your act together.
  3. 20th Century Imax is a disaster. Don't think I've ever been able to watch a movie in peace there for a long time. This time around, the projection equipment broke down about 25 minutes into the movie. After 45 minutes of finagling, they finally restarted the movie and basically kept us there for more than an hour. God help me, apart from the IMAX screen, everything else about that theater belongs in the scrap heap.

    I did learn one good thing though: if you end up in the front seats (4th row in my case), don't consider sitting in the middle - that'll just be an exercise in cognitive-dissonance. Rather, take a seat on the edges, and enjoy a crisp movie experience.
Finally, I give this movie two thumbs up, an A+. It'll be an enduring memory for years to come. This is as much a game changer as the first Avengers movie, and a gift to the world. Looking forward to what's coming next.

God Bless. 

Monday, April 16, 2018

The Things That Medical School Won't Teach You (8): "Dealing with Drunk Patients"

After a short stint of dealing with inebriated patients within the casualty department lately, I guess this is as good a time as ever to highlight one of the mainstays (and frustrations) of the healthcare experience; and there can be no better way of showing this than to indulge you in a very sordid experience from my internship.

So there I was working in Casualty, and having an average kind of day. The calm was interrupted by a bit of a ruckus as a group from a county referral hospital that will remain unnamed (including Medical Officer interns) brings a patient into the Casualty area. The patient's dramatic story goes a little something like this:
He had been drinking at a local tavern, and once he had consumed his fill, he decided that he was not going to pay the bill. He was most clear in communicating this to the bar owner, who happened to be a woman, and on this day she was not going to settle for this level of belligerence. She therefore proceeded to take a Fanta bottle and smash it against the left side of the bloke's neck.
So he's literally been hand delivered to us - a referral - because it has been determined that he's ended up with a laceration to his jugular vein. Without even staying to answer any more questions, the whole group disappears, leaving us to mull over the fate of this unfortunate soul. This was certainly a task that might have been better handled by a Vascular Surgeon (heck, even a General Surgeon), so I relayed the message to my Medical Officer (MO) and he told me to take a "peek under the hood", and make my assessment.
So I take him into the minor theater with two assistants in tow to help me cope with any eventualities...and that's when things get interesting: the patient who appeared almost lifeless up until this point suddenly starts drunkenly flailing his limbs all over the place, you'd think he was reliving some vividly joyous moment in the pub. Not only do I face the risk of perhaps dealing with a gusher of a leaking blood vessel, I have the added pressure of dealing with an uncooperative idiot. So I do the only thing I can do: ask for more people to hold this person down, which ended up being 3 more people (his relatives).
So, with the idiot well secured, I have one of my assistants peel off the heavy layer of compression dressing from his neck, with me standing with the needle holder and suture ready to start suturing. Sure enough, there was a laceration; but, luckily, the bleeding was minimal and definitely not from the jugular vein. After placing enough sutures and getting an adequate level of hemostasis, I sent him to the ward for observation and to sober up. Lord knows I wanted to rap his head with my knuckles, but I just held back the urge and walked away.       
No matter your attitude towards alcohol usage, I guarantee that you will without a doubt be irritated about dealing with an inebriated patient. Now, technically, people can drink alcohol at any time of day on any day of the week, you are more likely to be overwhelmed by such patients at night time and the weekend; but as in the experience I quoted above, that patient showed up around 3 pm on a weekday, so if you're from a "drinking nation" you'll have to be prepared whenever.

There really is no way of telling what kind of inebriated patient you'll get; alcohol elicits many different responses from its consumers. Some people might just be happy and might even get more courageous (even awkwardly flirtatious), while others become a chaotic storm of anger and rudeness; then you also have the person who'll drink themself into such a stupor that they become like the living dead, practically comatose. Alcohol also turns some people into scholars of no particular renown. I have also encountered the emotional wreck (more often a woman, but on many occasions also a man) who becomes so overcome by emotion and just breaks down crying. It really is a wheel of fortune scenario.

Anyway, the patient is one thing, their complication is another: Good old trauma is probably number one on the list, with these discombobulated folk tripping over themselves or getting into fights, which results in them getting cuts, bruises, broken bones, head injuries, etc. Others overdo the drinking and come in with hangovers or (for those who neglect to eat) with dangerously low blood sugar levels (hypoglycemia). Again, for some, hysteria is their only real complication.

As soon as a drunk patient shows up in the casualty area, you can just see the staff roll their eyes, looking out of the side of their eyes with palpable discontent. You might not be a judgmental person under ordinary circumstances, but some questions will just pop up in your head, even for the slightest of moments; kind of like these:

  1. It is only 2 pm on a Monday. Surely there must be something more constructive you could be doing with your time?
  2. My friend, how many drinks do you have to take to lose enough of your dignity to show up here smelling like urine and poop?
  3. (for the family member whose drunk relative you've treated before) When are you intending to get him into rehab?
  4. You probably have children. Is this the best thing you could be doing with your time?
  5. What convinced you that it was a wise idea to drive anywhere in this kind of condition

But like all good professionals, we put our best foot forward and get to addressing the issues at hand. Now is not the time to be criticizing and getting disgusted; it's time to be compassionate! And we will definitely try to be compassionate, but the patient determines the extent of compassion that they get.

If your experience is like the one I encountered with the patient with the neck laceration, you've got to ask yourself how much you really value your life, health and relationships, and whether you're willing to sacrifice them over your job. In this day of diseases like HIV, Hepatitis B, C and Lord knows what other bloodborne pathogens are skulking about, you certainly don't want to end up with a needle-stick injury. Medical practice spends all/most of its time being associated with the Hippocratic "Do no Harm", but on the job training will teach you that you have to protect yourself first.

You should never assume that you have to do something "concrete" for a drunk patient. For some of them, all they'll need is to be observed while they sleep off their drunken stupor; if you want to get fancy, you could boost them up with an infusion of normal saline and Vitamin B complex. Some people will show up with nasty cuts and wounds, but the alcohol will make them superhuman - immune to pain - and extra combative; rather than risk sparking off a fight in the casualty, you're better off letting the patient go home and sober up. Trust me, when the alcohol wears off and the pain becomes unbearable, they'll come back for the stitching that they may have turned down a few short hours ago.

The hysterical drunks are pretty much just looking for attention from loved ones. The drunks you really have to look out for are the ones with major injuries that require urgent intervention. In line with taking care of yourself and your fellow staff, be prepared to

  1. Sedate the patient. Diazepam and Chlorpromazine will be your friends. (unless the patient has a head injury, in which case Chlorpromazine will be a better choice)
  2. Strap that patient to the bed with no mercy
After that, attend to the patient with the speed required. I'm not saying things would be trouble free by this point: you could maybe hope to be insulted or just reviled by the drunk patient, but at least you'll have some control over the situation; and control is really important, because you never really realize how small and confined your casualty area is until some pandemonium breaks out.

After all the drama is over, you can have a big laugh about it. These war stories are "comedic gold"...well perhaps only among fellow medical staff. Your other sane friends might be hard pressed to find humour in tales revolving around bondage, blood and guts, and needles. Most importantly, you'll have the kind of on the job experiences that'll make you a better clinician.

God Bless

Thursday, March 29, 2018

The Things That Medical School Won't Teach You (7): A mother is not supposed to die in childbirth

I always knew I'd wind up coming back to the Obs/Gynae Department, a treasure trove of crazy medical experiences. Suffice it to say, my drama in the department began as early as the very first day that I set foot in it. I didn't have the joy of being eased into the department in the manner I would've appreciated. Right after I finished my Surgical rotation, I moved into the Paediatrics Department along with 3 of my other colleagues; my time in Paediatrics was short-lived because an inadvertent gap had arisen in the Obs/Gynae Dept, occasioned by the early departure (read completion) of some of the interns who were in the department at that juncture. So I ended up being cherry-picked to be moved into Obs/Gynae after only 3 weeks in Paediatrics.

So the memory I'm choosing to highlight is Day One of Obs/Gynae, with all the machinations having already taken place.

We began the day with a mortality meeting to discuss the demise of a mother (the dreaded "maternal mortality"). So I sat back listening to one of my fellow interns highlight the patient's history: the patient had progressed to full-blown Eclampsia and had to be placed in the ICU; in addition, the patient's blood pressure had been very difficult to control and the patient's urine bag from her catheter was filled with frank blood where ideally there should have been urine. 
Now in my mind, I'm logically reasoning out that the eclampsia has caused major organ damage and that in addition to ICU care she would also need Dialysis if she was to have any chance of survival; surely there wasn't much that could've been done for this patient. 

This is where the story took a bit of a twist; after the intern had finished her deliberation, the Medical Officers went into attack mode and basically acted like they were pinning the patient's demise on the interns' follies. I even remember that one of the medical officers had rather scathing remarks for the intern who had used intravenous Hydralazine to try to control the patient's blood pressure. 
Interesting side note: (Intravenous) Hydralazine is one of those drugs that medical personnel are very very afraid of using. Quite a potent vasodilator - especially in its intravenous (IV) form - many a medical professional has had the misfortune of having a patient rapidly progress from high blood pressure to low blood pressure/shock or even death after administration of this drug. Some nurses are so afraid of the IV formulation of the drug that they will reconstitute it, and then give it to the doctors to personally administer it. 

Truth be told, the intern was merely following orders of that very same Medical Officer who had recommended the infusion when consulted for help via phone, but it would have been considered sacrilegious to bring it up at that Mortality meeting, especially against a superior. The blame game only ever seemed to have a downward trajectory at those meetings.
In case you aren't aware of it, working in the Obs/Gynae Dept is one of the hardest tasks ever. In most places, particularly public hospitals, the workload is immense; however, it has the added dimension of having the most medico-legal ramifications tied to it. The death of a child is definitely a bad outcome, especially if it ends up being a "fresh still birth", which can pretty much be construed as the medical professional having failed to act in time. On an ever worse scale than that is THE MATERNAL MORTALITY, which, at any time that it happens, generates a storm of controversy that will require explanations to higher-ups in governmental oversight organizations.

I remember one time during a ward round, one of the Obs/Gynae consultants made the following observation:
Childbirth is a natural process. Mothers who come to a hospital to deliver should have a better outcome, otherwise they might as well just deliver at home.
Superficially, this would appear to be an ever-abiding truth, but anyone who has ever worked in an Obs/Gynae ward should know better; after all, "the greatest untruths are truths slightly distorted."  Childbirth is not merely the number of hours that a mother spends in labour and delivery; rather, it is the culmination of roughly 9 months of nutrition, care/neglect, wisdom/folly, health/disease and development that has already occurred prior to actual labour and delivery.

The more distant someone is from the reality that goes into a successful pregnancy and delivery, the more they embrace that aforementioned untruth; in my experience, top brass (especially those in government) are the most likely to be ensnared by this untruth. I remember that when my country (Kenya) initiated a Free Maternal, Child Health Program, they simply declared Maternal Child Health services free at government hospitals, and made sure the public knew as much. So you had mothers rushing in en masse to have their deliveries at hospital, which should have been ideal, right? Actually, because the referral system isn't at its best, mothers overloaded certain hospitals of their choosing (Kenyatta National Hospital - bearer of most suffering - being one of them). Imagine the pandemonium when the medical professionals encountered massive patient loads against no capacity building efforts whatsoever, and handcuffed to the mantra that "a mother is not supposed to die in childbirth".

In my opinion, that mantra needs a little bit of tweaking; a better way of stating it would be that "it is undesirable for a mother to die in childbirth". This reflects the truly complicated dynamic that exists between pregnancy & delivery, and antenatal & post-natal care. When you deal with the common mwananchi, and even people who seem to be of an upper echelon, you get the vivid impression that people "freestyle" this whole pregnancy business. Many were the times that we were discovering a mother's medical problems as we had her up on the table prepping to perform a Caesarean Section (C/S); or better yet, we learnt it as the mother was wheeled screaming into the maternity ward. Here's a taste of that litany:

  1. The patient who has managed to go all 9 months without any sort of medical checkup whatsoever. 
  2. The mother who has been pushing with each and every one of her contractions, before she was even adequately dilated; her whole vulva and cervix are so oedematous that any chance of normal delivery is gone.
  3. The dear soul who chose to augment her contractions (using herbs et al) so that she could speed up the whole process of delivery...which actually only ended up causing foetal distress.
  4. The lady with multiple previous C/S scars who chose to stay at home till labour was dangerously upon her, convinced that she could perhaps deliver naturally this time around; unwittingly, she instead puts herself at risk of suffering uterine rupture.
  5. Slicing through a placenta during surgery because the mother had an anterior placenta; something that we might've been prepared for if she'd had a recent ultrasound done.
  6. The mother who has been suffering from Gestational (aka Pregnancy-induced) Diabetes and hence she's carrying around a massive (macrosomic) baby.
  7. The woman who has been blissfully walking around with blood pressure readings that are so off the charts (for example 200/130) that you wouldn't be surprised if she had a stroke right there on the table as you're trying to operate on her.
  8. That perfectly healthy young lass so overwhelmed by the whole mystique surrounding childbirth that she insists from the very beginning that she wants a C/S. Worse still if she's gotten reinforcement from friends or unwitting clinicians. Without the proper psyche, good luck getting her to cooperate with the midwives. As an added bonus, this is also the type of patient who the anaesthetist will have an especially hard time administering spinal anaesthesia to. 
  9. The mother who has been manhandled or neglected at a peripheral facility, and usually ends up spirited to your facility a bit late in the game. Congratulations, all her problems now become your problems
  10. The patient who, despite being an adult of sound mind, is unable to commit to being taken to theater for a C/S without her husband first showing up in person to give consent; this despite the medical professionals being pretty sure that they have a Non-reassuring foetal status (NRFS) on their hands, and that urgent surgery is the best course of action.
  11. And with any pregnancy, you face the twin threat of massive bleeding events before or after delivery (aka Antepartum and Postpartum Haemorrhage).
    The causes are many, but by the time they are upon you you'd better act quick or risk losing your patient.
I'm pretty sure that there's more that could be added to the list, but it should at least be an eye-opener. My point in all this is that if you want to have the kind of health outcomes for Maternal Health that are the pride of developed countries, then you have to realize that your outcomes can only be good as the quality of your patients; you also have to be prepared to put in a lot of work.
  1. Education of the common people about the importance of Antenatal and even Postnatal care; 
  2. Massive investments have to be made into capacity building, because hospitals, and all classes of medical professionals (especially nurses and doctors) won't just appear out of thin air. 
  3. Outreach must be emphasized; it''s time to embrace preventive medical aspects wholeheartedly.

    I have a personal gripe with how this was done in Kenya because part of it ended up as the "Beyond Zero Campaign" under the First Lady, which in my opinion is misplaced despite the well-meaning sentiment behind it. This decision would be on par with the president deciding to outsource the leadership of the Ministry of Energy's fledgling Nuclear Energy Department to someone without any experience in the field. This is not a pet project, and needs to be recognized as a pillar of healthcare in this country.              
  4. Funding needs to be increased, and has to be targeted especially at mothers with High Risk Pregnancies.
    In line with this, ultrasonography has to be considered an essential service for mothers to have access to, and should be covered under Free Maternal Health.

There really are no quick fixes to any of these issues, but I think there is hope for useful course correction if we can all have a clearer appreciation of the bigger picture. I have hope that this would benefit everyone, especially the mothers (actual, potential and otherwise) who are such an important part of our lives. I also hope that I won't be scaring any students away from this Department; even if you won't be specializing in Obs/Gynae, it is still a delightful rite of passage that you shouldn't do without.

God Bless.

Wednesday, March 28, 2018

Pacific Rim: Uprising - Spoiler Free Review

Pacific Rim 1 this is not!

(It might get a little annoying, but I've got to reference the original movie in some respect.)

From the opening narration, which finds us introduced to the world of Jake Pentecost (Jon Boyega), estranged son of Stacker Pentecost, he assures us that he is not his father (it won't be the last time he reminds us either). Since his father's demise, and the cancellation of the apocalypse, Jake lives a carefree life of debauchery, and is something of a squatter; he funds his life by dabbling in some unsavoury barter trading, which eventually ends up getting him in trouble and forces him to choose the lesser-of-two-evils in order to earn back his freedom. (A nod to his father who was a strong believer in second chances)

The world of Pacific Rim has undergone a massive face-lift since the breach was sealed from the prior installment: humans have had an unprecedented period of peace during which they have been able to rebuild their cities; the Pan Pacific Defense Corps. (PPDC) is also undergoing a remodelling of sorts, with new technology being looked at as a way of leap-frogging the problems of training pilots and the weakness of Neural Bridge Compatibility (which allows 2 pilots to drift, forming the seamless bond that allows them to operate the massive Jaegers).

This movie plays out like a slow burn because a lot of the initial plot is just building up towards the story. It does not have the immediacy that the first movie had because by the time the opening exposition was done, we already had alarm bells ringing, and a quick introduction to the actual devastating power of the Kaiju. Here we witness a new world, get introduced to a new PPDC, and only by the end of the 1st third of the movie are we immersed into the beginning of a convoluted plot mystery which seems a tad more corporate espionage than straight out Kaiju invasion.

It was saddening to hear that Charlie Hunnam's Raleigh Beckett wouldn't be back this time around; however, the movie did manage to bring back Mako (Rinko Kikuchi), and the wacky pairing of Drs. Newt (Charlie Day) and Gottlieb (Burn Gorman). Guillermo del Toro, prior to this sequel, had initially hinted that the drift that Newt and Gottlieb shared with the Kaiju brain as well as possibly having dumped Gypsy Danger into the alternate universe, would be the spark for this movie; the writers honour that in some way, but it seems that most of that played out kinda like misdirection because they take the story down some paths that people haven't necessarily gelled with.

The original Pacific Rim was a beautiful movie which paid homage to Kaiju and Mecha lore; critics threw around references like Godzilla and Gundam, and in my case specifically, I would name "Saber Rider and the Star Sherrifs". This movie felt like it pays homage to yet another book/movie: "Ender's Game." I just haven't the faintest idea why the kids (teens) in this movie were considered so intricate to the plot. Looking back on things, I'm not certain if training the pilots very young was emphasized in the original movie (as much as it was in this one), but there certainly weren't any kid pilots in the original.

Some of the plot points from the original exist in this movie: again they find themselves tracking down the maverick ranger to help with their Jaeger program. In the original, we knew it was because Stacker Pentecost was facing limited funding and was leading an unpopular cause to help end the Kaiju threat. This time around, the situation is a little relaxed, but humanity still holds out some inkling of suspicion that the Kaiju will attempt to make a comeback; thus, rather than defund the Jaeger program, they're pumping in a technological upgrade (much to the chagrin of some of the pilots), but this does not excuse the dearth of adult pilots that we witness within the movie itself.

The only welcome addition to this movie would have to be John Boyega. He is charismatic and carries the movie, delivering the correct amount of sass when it's required. His Jake Pentecost doesn't seem to take most things seriously, probably opting to steer clear of a legacy well curved out by his father, which in all truth is quite eclipsing and engulfing. His character arc, which is the most fleshed out, centres on him coming to terms with this and learning to be his own kind of hero.

His foil for his misdeeds is his partner, Ranger Nate Lambert (Scott Eastwood). Played as a by-the-book "army man", he gives a face to the strict Jaeger program's ethic, which was initially typified by Stacker Pentecost, but doesn't have as strong an archetype in top brass this time around (Ip Man III's Zhang Jin isn't given any real depth in his portrayal of Marshall Quan); He and Jake irritate each other to no end, and compete in more than a couple of ways.
The only other significant character worth mentioning is Jing Tian's Shao; the brilliant head of the Shao Corporation, she's portrayed as ruthless and demanding. The question about where her loyalties lie is what makes her the primary antagonist for the first part of this movie.

The rest of the cast was way too young, and again what makes me feel like they were trying to emulate "Ender's Game". This is that uneasy melding of characters into a plot in previous movies like Transformers, X-men: The Last Stand, etc. where you feel like they can't possibly be of any use to the world if it was required of them. It's the kind of thing that just exceeds a movie's "suspension of disbelief" quota and makes you feel shortchanged; it even detracts from the massive fight spectacles.

Speaking of the action, it is sprinkled in bits throughout the movie; while Guillermo del Toro took his time to emphasize scale of the Jaegers over their maneuverability, Steven S. DeKnight downplays this in some respect to highlight just how very human-like the movement of Jaegers can be. This is particularly true of the fighting style of Saber Athena, which is as sleek as that of a Kung Fu practitioner. DeKnight and the Vfx team still do a good job of establishing the great scale of the action and its set pieces.

All in all, this movie feels like a massive step-down from the previous installment. Some critics argued that the previous movie had a dearth of characterization, but this time around, the movie feels bogged by the convoluted story and non-relatable characters (somehow remembering that one cadet's Dad was a cosmetic surgeon specializing in "breast work" ensures me that nothing useful has been added to the mythos). It saddens me to say that you'd rather wait for this movie to come out on DVD instead of watching it at the cinema/theater. (C+)

God Bless

P.S: Since they seem so set on making this a trilogy (if not a never-ending franchise), at least let them get Guillermo del Toro back in the driver's seat to course correct the next movie.

Wednesday, February 28, 2018

Black Panther "Spoiler-Free" Review

It's actually been more than a week since I watched this movie, but procrastination got the better of me, and I just didn't feel like penning anything too soon. The first day after watching it I felt a little positive about the world, and might've gotten sucked into the feel-good vibes of Wakanda. Anyway, it's had some time to marinate, so I can get into it a little now.

The movie starts off with a nondescript flashback that hearkens back to King T'chaka's time as the titular hero; from there the movie places us right in the thick of things some time shortly after Captain America: Civil War, which was, of course, our first introduction to the Black Panther character in the MCU. So T'challa now has to embrace his role as leader of Wakanda, in addition to his duties as the Black Panther. Aiding him in his administration of his duties are the very nimble and skilled all-female bodyguard force - the Dora Milaje - headed by the fearless Okoye (Danai Gurira). Also fitted in as a spy (and love interest) is Nakai (Lupita Nyong'o). Rounding out the entourage of strong female leads is the Queen Mother, Ramonda (Angela Bassett) and the tech-savvy little sister, Shuri (Letitia Wright).

The female dynamic in this movie was wonderful; the women were strong and intricate to the mythos of Wakanda; unlike a movie like "Wonder woman" where the Amazons stand out as strong warriors in opposition to a male dominated world that is mostly oblivious, the world of Black Panther lets us imagine that the strong woman is embraced, accepted and indeed needed for Wakanda to function properly.

It is essential to explore the concept of "World" as this movie lays it out. The world-building that went into this movie is mind-boggling. Unlike another MCU movie franchise - Thor - which also consists of an otherworldly setting, Wakanda has the feel of a "lived-in"city. No offense to Thor, but, personally, Asgard always felt like a beautiful pearl that wasn't really habitable; it felt like that dinner scene in the first Batman movie when Bruce Wayne sits uncomfortably in the dining room with his dinner date, but can't remember if he's ever had the occasion to sit in that room before. Wakanda seems mysterious as it fades into view away from the illusion of backwardness cast about it, and every one of its settings (with the exception of some poorly rendered "green screen" dreamscapes) come alive. Kudos to the director, the vfx team, and the costume and set designer for scouring African locales for ideas aplenty; the film brims with rich colours and the complexity of Wakandan culture is teased gloriously.

Some people might complain about the pacing of the first act, but in my books it is perfect; enough time to immerse yourself into the many layers of the make-believe world of Wakanda, and to invest yourself in the stakes so that your heart skips a beat once all the moving parts start to complicate matters.   

Wakanda is a technological behemoth that hides itself out of sight to prevent the rest of the world from disturbing its peace. In this way, they are able to keep the benefits and stores of unimaginably powerful Vibranium to themselves, but at the cost of allowing the world to perpetrate atrocities to their black brothers and sisters in the diaspora. This is the underlying thread that dogs T'challa's nascent kingship with his need to be as great a leader as his father, but also to steer clear of traditions that might be less beneficial to the monarchy than initially thought; it is the same thread that also brings Eric Killmonger into the fray with all his irreverence, iconoclasm and vengefully militant stance.  

Does the movie live up to the hype? I would say no. Don't get me wrong, it's a wonderful movie, well-acted and a pretty solid effort.The hype machine went all out for this movie: black director, predominantly (Pan-African) black cast, black writers...blackity black black! There's been no way to escape any of this. 

Is this the first Black "Marvel" hero committed to screen? Certainly not. Honours for that achievement go to Blade which was an eclectic piece of work, and probably the first seriously successful superhero outing predating the MCU and DCEU. Hats off to Blade for also giving us serious vampire baddies in a day and age when "Twilight" has scarred our minds; and lastly, Blade was probably the first R-rated comic book put to screen. 

As you can tell, I am a fan of the Blade Duology, but back to Black Panther. The movie makes good use of most of its characters, practically all of whom are introduced to us for the first time. Every one out here is massively talented and well put to use. Heck, even the extras are immaculate. The only return characters are Martin Freeman's Everett Ross (Civil War), and Andy Serkis' Ulysses Klaue (Age of Ultron). As with all films MCU, there is a dash of humor here and there, but it never gets to be overwhelming. Even the gallant Okoye gets to get in a few jabs at T'challa for his missteps on the battlefield after the casual "I never freeze" boast; and Shuri naughtily discards the decorum of royalty for the trappings of a mad scientist any day.

Michael B. Johnson is given a good villainous role to dig his teeth into. He seems as irreverent in this role as he did in Creed. The movie shows us the things that have marked his upbringing, and at times it manages to get us to sympathize with him; his militancy is off-putting, but even then, one is left to wonder whether a person can surpass all the bad events that colour their initial upbringing. Better yet, one is also left to theorize whether we as a people are capable of rising above the despicable methods that our past tormentors and colonizers have used to subdue us if reality shows that they actually work. Would we be able to carve out new paths, or to merely perfect these dubious acts and use them to fight back "tooth for tooth". Reminded me of "Malcolm vs. Martin" to some extent (and don't blast me for calling people heroes or villains....there are inklings of the differing mindsets at play here).

The only sad thing about the movie is how little they use Ulysses Klaue. We only got a smidgen of him in Age of Ultron, and the same pretty much happens here. He was basically "Von-Struckered" (I don't care if that's not yet a term, I'm claiming it and I'm using it)! Marvel has got to get better about dealing with multiple villains in the same movie; they can't just pile on the villains, and then leave some in a floating mess down the creek...that is unacceptable.

This movie leaves us with many loose threads that could be great fodder for the next Black Panther; it is basically impossible to give any details away without "spoiling" the movie, but rest assured that the Wakanda we started with certainly isn't the same Wakanda at the movie's end; add to this the fact that the events of "Infinity War", whose final battle seems poised to take place in Wakanda, things are bound to get plenty complicated very soon. And I for one am looking forward to everything new this movie will bring to the MCU. These are indeed great time. Wakanda Forever!

God Bless.


Wednesday, January 17, 2018

Walking through Karura Forest

Like all things easily in my grasp, going to Karura Forest is something that I've simply procrastinated about because it was something I assumed I would eventually get down to. For the longest time, I imagined it was somewhere far off (navigation instructions from Google Maps didn't help either); but then in the course of checking on some plants for landscaping, I realized that the entrance to the forest was something I had passed on many an occasion (the Limuru Road entrance); it was, in fact, directly opposite my favourite plant joint.

Anyway, since rediscovering it, I just needed the opportune moment to walk through the forest. Thanks to my new schedule as a casualty worker (2 day shifts, 2 night shifts and 4 days off), I now have ample time to get a lot of things done. Thus, on a Friday not too long ago, I finally decided to check out Karura Forest for myself.

I got to the venue around 10am, and the first thing that struck me as odd was having my backpack searched; mind you, it's not the fact that they were searching me that was was what they were searching for. Karura has gone on a full scale crackdown on (non-reusable) plastic bottles and bags. Would've made for one hell of a bad day if I'd actually shown up with soda (my vice of choice) and had it confiscated at the gate.

The sweltering heat on that day made me wish that I had started my journey earlier. The pictures don't seem to convey the heat, but it was blistering. At the start of the day, it also seemed quite humid under the canopy; at least more humidity than I've encountered in Nairobi since forever. However, once I got used to things, I was able to enjoy the scenery. There were lots of butterflies along the trail, especially by the waterfall; I was also surprised to run into some duiker along the trail (6 or so), though some of the dung heaps I encountered made me feel like bigger game might have been out and about (or maybe there might have been someone riding a horse on the trail). The beauty of the tall Newtonia trees and Fig trees along the watercourse was really quite fascinating.

Though, I must admit, it would be a better idea to purchase a map before setting out on the trail. I spent a total of 5.5 hours walking around, and probably 1.5 hours of that was from being lost. Some of that comes down to my failure to ask for directions; but then again, when I did ask for directions, I was sent in the opposite in I was sent to the Kiambu Road Exit instead of the Limuru Road Exit; and lastly, even with a map, those markers can sometimes get downright tricky. I'm referring to a specific Marker 12 which spat me out in the middle of "no man's land", a spot where they were clear-cutting the exotic trees so that they could repopulate it with indigenous trees. For the latter part of my trek, I downloaded a map of the area and was skirting a thin line between checking out the map and trying to save the dwindling battery life of my phone. In my mind, the Marker numbers should have been descending nicely to get me to the main gate; imagine my shock when Marker 12 sent me on a wild goose chase to Marker 33!

By around 3.30pm when I was ready to leave, I was thoroughly tired; but it was a great experience. Was a bit torture-some driving a manual car with leg cramps, but my lesson is learned. Don't feel like I hit everything on the itinerary, but it should be a breeze second time around. Maybe next time I might even take someone else with me. Karura Forest is definitely a great trip whether you're alone, with friends, significant others or even with the young ones. Make a point of visiting when you've got some free time.

God Bless.