Ok, so another update. My brother, James, went into hospital yesterday with Meningitis. We found out late yesterday, after he'd had a lumbar puncture and the works that it (very thankfully) isn't Bacterial and is most likely Viral. It could be Tic-bite Fever related Meningitis because he was bitten by a tick while on a walk in the Tsitsikamma forest last week. If you know James and want to contact him, then mail me and I'll send you his phone number – he has it with him and can receive messages. I went to visit him this morning.

So back to me hating hospitals. Foucault wrote on hospitals, schools and prisons, how the spaces are similar and how we treat the institutions themselves. In each of the above the architecture is similar, the spaces and the hierarchies work similarly, as people entering into these spaces we don uniforms to differentiate between those 'of' the space and those 'not of' the space. In the hospital, James is not James, he is Mr Harris supervised by Dr Frost in room 5 bed B. He wears a light blue standard-issue hospital overall. An indication that it is him is that he wears his checked boxers.

I get the feeling that as a way of dealing with patients in general it is easier for doctors if the patients are no longer individuals, but rather some abstraction of the individual. It makes it easier to deal with their possible death. Doesn't require genius level-intellect to think that I know. What reinforces this for me is that someone I know who has completed the full six years of medicine and is doing their year of work is thinking about leaving medicine, apart from the trauma of AIDS scares from random pin-prick issues, the ridiculously long hours (sometimes 35 hours of being 'ready'), there is the issue of the distance issue with patients. I have not discussed this that much with this person, but in a space where you both need to relate to the patient, but immediately be distant from them the psychological strain must be massive.

So, not only are patients not who they are in hospitals, but it is quite possible that for doctors to remain in hospitals they have to distance themselves from themselves. This space of 'the hospital' is filled with abstractions of people. Where do the real people go? I don't know.

What made it even stranger for me in the last few minutes of my visit this morning was seeing James trying to pull the duvet off of himself. He gets really hot, and with his fever he has been even hotter. He couldn't pull the duvet off of himself because of the drip in his arm, his eyes were uncharacteristically blood-shot and red-rimmed. James wasn't James. He asked me to help him. I took the duvet off of the corners of the bed and laid it at his feet while he inserted himself under the sheet. I told him I loved him. Visiting hours were over and I had to leave.

Visiting hours are an important part of the hospital structure. For us as the visitors it is even more important that we do actually visit our friends and relatives in the hospital. Part of me believes that we need to go and see them to remind them who they are, that they are not Patient X, Room Y, Bed Z, that they are themselves. I do not mean to say that everything we are is caught up in our names, but the gaps to the outside world, the visitations from others these serve as an additional way to access something which may have become distant to us – that which makes us who we are both in construct and in make-up.

All of the above thoughts had me crying in my car on my way home. I hate hospitals. I don't like seeing people I love being distant from themselves. I am sad because my brother is in pain, has been in pain, and there was not much I could physically do about it. Hence, while listening to Interpol blaring discords, I cried.

This inevitably brings me back to thinking what I can do, what are my skills, what can I or can't I do? There isn't that much research on health economics in South Africa, not enough to make a solid difference. Like many other areas there are skills deficits and massive gaps open in research. For someone like me it is possible to apply my skills to this area. One of the things for which I am thankful is that my parents have the resources to pay for James to be in hospital, to pay for him to get good care, to be in a room by himself (or at most sharing with one other if it becomes necessary). This leads to the consideration that most people in South Africa don't have health care other than that provided by government, they can't afford it, it's expensive. Moreover, the differentials between public and private supplies of health care are massive and they are distortionary. How do we solve it? Get more doctors? As we know the UCT MBChB curriculum changed towards that very purpose. I am supportive of that. How else can we support it? More research into the area? I don't know. I am continually reminded of the difficult job Thabo Mbeki and his cabinet ministers are faced with – HIV/AIDS problems, poverty, unemployment, record death rates amongst policeman because of the prevalence of crime (you don't want to live in Gauteng by the way). I am not envious of all of their position. However, I am good at research and I will do that till the cows come home. I will write, I will read, I will analyse and assess because even though I hate all of these phenomena for some irrational reason I love South Africa and my family, friends and other citizens more. I want South Africa to succeed.

This reminds me of something else I was considering recently. When I play a game of Magic, I get frustrated more when I play badly/misplay than when I have 'bad luck' so to speak. I do get frustrated when I notice that the 'luck' was also a consequence of an earlier misplay, etc. Subsequent to the hijacking I am continually cognizant of the choice that I am making in remaining in South Africa, of being in a specific space (back to philosophy of spaces). So me being in this context where I can be hijacked is both a consequence of an earlier decision and bad luck, so to speak. Relate this to Meningitis and that is almost purely luck (Ok, again decision to go on walk and not protect against Tick bites if that's the case, but hey?). Anyway, it's just something to think about. Again, I reiterate, I love you all my friends (assuming you're a friend if you are reading this). We'll chat soon.