The distillation process of thought (with a nod to the topic of palliation)

A trivial glimpse into my heritage: my maternal family used to distill their own starch-based spirits to sell at farmers' markets in Hong Kong. That occurred before my time, before their semi-rural life inevitably succumbed to the roaring waves of urban sprawl.

The process of producing a spirit, as with any alcohol, is a labour of love that requires time and patience. Firstly, the harvested rice is processed and fermented for a month. When it is ready, the distillation process begins. The goal of distillation is to separate the ethanol from water to concentrate the alcohol. Therefore, the boiling point that is desirable is above that of ethanol (78.2 degrees celcius in a water mixture), but below that of water (100 degrees celcius) so the ethanol rises, cools, and condenses, leaving the excess water behind. Without thermometers and with the utilisation of crude firewood in the distillery, I do not entirely know how my mother's family determined the ideal temperature range for distillation, and that's a fascinating mystery to me. Anyhow, following several cycles of distilling and cooling, the spirit is sealed in an airtight container and left to age for 2-3 years to mature before being ready for consumption.

I perceive that sometimes the human thought journey draws metaphorical parallels with the process of rice spirit manufacturing. The weather, seasons, and climate have to be optimal for the growth and harvest of the rice crop, like with the ability and conditions necessary to develop certain trains of thought. At harvest time, you can choose to turn the rice into spirits, or cook a quick, delicious meal of steamed rice. Those are the two journeys to follow - one of great labour that yields great reward and the satisfaction of creating a complex product with many flavour nuances, and the other of instant gratification that yields clear, practical results of feeding the masses. There are pros and cons to both pathways of thought and there exists a place in life for both.

[Stop here if you don't want to read rambles]

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In my professional life, there is a question that I have chosen to pursue down the long route, "If we will inevitably spend more time at work than at rest, what type of job/s do I want to work during the week?" 

The original seed of thought was "palliation". Palliative care involves relieving the symptoms of suffering so that people can live their best lives independent of circumstance, be it a curable or non-curable disease/experience. That was what I learnt at a paediatrics palliative care event in April 2018.

The problem with jobs that involve providing palliation is that there are too many options out there. The most obvious pathway is in nursing, a job where one seeks to deliver holistic, patient-centred biopsychosocial care to clients across all health contexts. Nurses pop you panadol for your physical pain, provide you with mental health first aid, write you social work referrals because of challenging home circumstances, and help the terminally ill fulfill their dying wishes. Another option is full-time Christian ministry which has clear eternal value - by God's grace, providing spiritual palliation via spiritual cure because you point people to the riches of the gospel of Jesus's life, death, and resurrection. A third is to become a physician or surgeon who works with people with chronic and often incurable diseases - for example, glaucoma is presently incurable, and the doctor forms a decades-long therapeutic relationship with recurring patients to provide interventions that help them retain as much of their remaining sight as possible, as well as listening to their unique stories and providing referrals tailored to patients' personal needs e.g. some may need low vision services whereas others may need counseling. The fourth is less obvious and personal - but to enter into laboratory research, legal services, fine arts, or engineering - where you create better environments to meet human needs or chase answers into what systems, policies, services or products can alleviate an aspect of human suffering. To sum it up, the jobs that involve palliative care delivery can manifest so broadly. It is a raw, massively wriggly can of live worms with too many possibilities.

Thus far in the distillation process, I have narrowed down my personal criteria to four for further consideration:
1. The job must have some direct contact with clients of the intended services (to see clear results).
2. The job shouldn't negatively impact the quality of my family life if I were to start one.
3. The job would have opportunities for intellectual thought, critical thinking, auditing, and improvement.
4. The job can provide me with basic life necessities like paying the bills and putting food on the table.

That chops out fine arts, purely laboratory work, and engineering for me. I'm bad at cooking so definitely shouldn't be a chef - leave that to my cousin. Presently I will keep labouring towards my nursing registration, and enjoy my existing work in both clinical research assisting and ophthalmic 'nursing' - a delightful concoction of solving questions regarding optimal medical interventions, and being part of an auxiliary team that provides a kind, practical help to glaucomatous patients - be it reassurance pre-op, wound care and patient education post-op, or the odd emergency who is so afraid of the uncertainty of whether their sudden vision loss is permanent. I'm glad for my nursing studies though, because it has also shown me that our elderly and those with dementia face many barriers to receiving quality palliative care, which has tugged at my heartstrings. It has also shown me that few people can stomach the role of providing paediatric palliative care, which I feel I have the strength to provide, much like how I am clear headed and unfazed when placed in the emergency department. There is still a ticking time bomb for me to make decisions soon - to hand in grad apps in July for nursing jobs (and sort out the headache of finding appropriate referees in barriers filled health system), and also to prepare for further examinations and applications if I want to move into another field. However, it may be best to enjoy the moment and work as a registered nurse for now. That is as good as any other palliative care work that fits my criteria.





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