Monday, September 27, 2010

a long time coming

As faithful followers of this blog will note, an indecently long interval has passed since last I posted. That's life. I neither offer excuse nor beg forgiveness.

Tonight, however, I'm inspired to write (at least a short little blurb), if for no other reason, to draw your attention to the change in the above description of this blot. Where the subheading used to refer to yours truly as an "intermittently disillusioned pathology resident," or some such bunk, I've now assumed a new identity. Yes, I am a hopelessly chronic case of academic addiction.

Of course I have a fairly good idea of where to lay the blame for this intellectual dependency. Don't quote me on the (pseudo)science here, but my impression is that people who are denied a certain substance or experience throughout enough of their formative years, are more likely to develop unhealthy attachments to such vices later in life.

I was home-schooled for the first eleven years of my education, so whereas most people develop a healthy balance of respect, disdain, appreciation and general apathy for formal education by the time they get through college, once I started taking classes at the local community college at age 18, I was hooked. A hopeless junkie for life. And like any addict, I rode the crest of an initial wave of academic ecstasy (top of all of my classes, prize pupil of all of my instructors) and thought that it would last forever. Neurotransmitters become exhausted, receptors become saturated, and all junkies must ultimately crash. I managed to graduate from college with a decent GPA, but that was in no way due to my last two quarters. And by the time I'd finished my last class, I was more than ready to (as PGW would so eloquently put it) part brass rags with the whole academic mess and just settle down to work for a while.

That "while" lasted just over a year, after which I found myself studying for an MPH in International Health and Development at Tulane's School of Public Health and Tropical Medicine. The thrill of that first big hit after a respectable piece of abstinence put me over the edge and I took the big step down the path into darkness: I applied to medical schools.

Eight years later, I've finished my medical training (four years for the MD and another four of pathology residency), and what do I do? Do I call it quits for good, get a job, and contribute to this blessed capitalist abomination in which I live? Nope... the "dark passenger" was too strong (as the eponymous hero of another of my guilty vices, the Showtime series Dexter might say).

I have fallen into the epitome of academic intellectually masturbatory depravity: the PhD! This time I'll focus on Environmental and Occupational Health (after four years of diagnosing death and disease, I'd really like to get involved in the preventative end of things).

So... am I full of guilt and self-loathing? Am I writhing in an agony of ecstatic despair for my hopeless condition?

Well... classes start the day after tomorrow, and actually, I'm pretty damned happy about whole thing. (AAaaahhhh... the sweet rush of that first taste... a stronger cut... a new, exotic flavor... my next fix).

Thursday, March 25, 2010

a word about a word... and about apples

By the way... the title of the previous post refers to an example of one of the many things that I loved about the book Anathem. Stephenson has the most elegant gift for politely drawing the reader's attention to the etymologies of words that we use without a second thought. Data is one of these. Frequently throughout the story, as characters engage in philosophical or scientific discussions, they refer to the "the givens" -- that is the pieces of raw information on which further arguments may be based. At one point in the story a character refers to the discipline of Datonomy and the person with whom he is conversing recognizes this as the naming of "the givens." When I read that my mind went wild, started racing, knowing that I knew the connection but couldn't quite access it. "Data, datum, dat, date, dato, da..." and there it was: dar! The Spanish verb meaning to give.

In all of my years of education, studying sciences, statistics, even a bit of the philosophy of science, I'd been using the word data every day without even considering its root. And that insignificant little passage in Anathem was what finally brought it all home. Data (singular, datum) must be derived from the same root word as dar, hence a datum is a gift.

It puts a whole new spin on the language of basic scientific investigation. Data, which so often is seen as the raw output of an experiment -- the stuff that needs to be analyzed and refined before it assumes the far more noble and desirable status of information is, in its essence, the gift given to the investigator... and like all gifts (if they are truly given freely), it is up to the investigator to decide how best to use (or abuse) them. The gift itself is neither good nor bad. It is raw material that is waiting to be utilized. Like all gifts, data is sometimes deserved and sometimes not, and it is up to the recipient of the gift to recognize the value of the data... or not. There are many examples of seemingly serendipitous scientific discoveries. Careful examination of these tales will usually reveal that the hero had spent years (even decades) working hard, slogging away at a problem, and without that preparation, would not likely have been in the necessary frame of mind to recognize the value of the discovery. All the same... Fleming's agar plates did grow mold (an accident -- a gift), leading to the discovery of penicillin; Röntgen's cardboard barrier turned out not to be as opaque as he'd assumed (an accident -- a gift), leading to the discovery of X-rays; Jenner happened to pay attention to the wive's tale (another gift) about milk maids not getting smallpox, leading to the development of all subsequent vaccines; and maybe... just maybe... an apple fell on Newton's head.

OK... so most don't believe that a falling apple had much (if anything) to do with Newton's descriptions of this revolutionary force called gravity. All the same, it's become the symbol of serendipitous scientific discovery. Interesting that it's also the symbol of something else: sin. Or is it? Not really... the "apple" that Eve takes from the tree isn't the sin. The sin is the fact that she's taking it when told not to, and that is entirely beside the point (for now). The apple is the fruit of the Tree of the Knowledge of Good and Evil. That's right... knowledge!!! The tree is the source of the knowledge. Just like data -- the raw pieces of stuff that are turned into information -- are the source of human knowledge -- the gift. Yeah... I'm stretching a bit now and I hope you'll all pounce with criticism, but still, the symbolism is just begging to be seen. And I'm certainly not the first to see it. Check out Philip Pullman's His Dark Materials! That tree of knowledge is the ultimate gift, the datum from which comes information -- information that accumulates to become knowledge and knowledge that is necessary to build a meaningful understanding of one the world in which we live. And remind me... who was it that told Eve not to eat of the fruit of that tree? Oh yeah... him again.

A datum from Neal Stephenson

A few days ago I finished reading Neal Stephenson's Anathem. It was one of the most enjoyable and satisfying books that I've ever read. As I told a friend when I was only a quarter of the way through it, reading Anathem felt like drinking a very rich, full-bodied wine (thinkAmorone or Barolo). It's an incredibly complex book that is still delightfully accessible. It's got layers upon layers of physic, philosophy, cosmology, culture and humor all tied up in a damn fine story. The book to which I'd be most likely to compare it is Umberto Eco's The Name of the Rose. The above mentioned friend, George, who is something of an expert on many of the topics covered by the book -- a professional, in fact (he's a professor of philosophy) -- wrote a review of Anathem that I encourage you all to read (don't worry -- it won't ruin the story if you read the review first!). George's review does more justice to the book than I ever could, so I'll conclude by saying that if you don't read Anathem you're denying yourself one of the finest literary treats to be had, and although the 1000-ish-pagedness of the tome turned me off for almost a year, by the time I'd read 100 pages, I was wishing the book was at least 3000!

Sunday, March 14, 2010

Six Years

Six years ago today a girl came to my apartment / tango studio for breakfast and a dance lesson. Seventeen months later we were married. One might argue that I'd violated some rule of the teacher / student relationship. The lesson was free though and no grades were assigned. Besides, I think those rules might be a little fuzzy when it comes to dance lessons. In any case, although February 14, that much touted day of lovers means little to Kate and myself, March 14 will always be special. Here is a story inspired by the events of March 14, 2004. Other stories covering events leading up to the tango lesson are to be found here and here.

Monday, March 1, 2010

Brazil, East Berlin and the End of the World

I recently watched two movies back to back. The first was Das Leben der Anderen (The Lives of Others); the second was Brazil. Friend and fellow blogger Areophany of Martian Utopia Cafe was present for the first of these and wrote a short review of it, complete with links to the trailer, music and other reviews.

The second film, Brazil is not set in the country of that name. Its title refers to the song Aquarela do Brazil, known in Anglophone lands simply as Brazil. According to legend, director and co-writer Terry Gilliam was inspired to create the film when he encountered a man listening to the song on a portable radio while sitting all alone on an overcast day in the middle of a desolate coal-strewn beach somewhere in the UK. The contrast between the upbeat sunny cheer of the music and the oppressive tenor of the surroundings moved Gilliam to reflect on humanity in the face of adversity and out of these reflections was born one of the finest films of the last century.

Since watching the two films, I have found myself pondering their commonalities and the relative positions and motivations of their principle characters. There are two important characters in The Lives of Others: Gerd Wiesler, the high ranking secret police officer and Georg Dreyman, the playwright to whose life Wiesler listens with great interest (and ill intent). There is really only one central character in Brazil, the protagonist Sam Lowry. He is a nobody, a simple cog in the huge Orwellian complex of government ministries (Information Adjustment, Information Dispersal, Information Retrieval, etc.) that ostensibly protect the populace from a terrorist campaign of bombings that is well into its second decade ("beginners luck" as a high ranking official jovially pronounces).

The worlds of Brazil and The Lives of Others are both governed by oppressive authoritarian structures that thrive on media censorship, pro-state propaganda and invasive surveillance of their citizens. In both worlds the a range of responses is exhibited by the citizens to their state: complicity, cowed cooperation, sneaky little low-risk rebellions (watching old movies on work time) and premeditated covert actions that would be considered criminal by the state. There are plenty of movies and books about heroes rising from such environments -- people recognizing that the systems under which they live are intolerable and unjustifiable and then taking action (small or large) against said systems. Some of these stories are inspiring, some depressing, many both. The best ones are those that get me thinking hard about my own life, culture, government, media and the threats, real or imagined, that face me today or in the future.

My fantasies tend to spin out of control. In one possible future I see an intrusive Big Brother looking over my shoulder at every turn and me living in constant fear that any little unpatriotic turn of phrase or anomalous facial expression will provoke a bag over my head and a quick trip in an windowless panel wagon to a dank interrogation cell. Another scenario is largely inspired by a recent visit to the top floor of the National Holocaust Museum in Washington, D.C., where I gained a new appreciation for how easily a desperate, scared and adequately uneducated people can be led to tolerate and even support utter atrocity through calculated use of well designed media campaigns. I extrapolate from the currently vague and intermittent alignment of the modern media giants and the military industrial complex to a vast empire of multinational corporations that entirely supplant traditional government as such and control the flow of information to the masses so thoroughly and artfully that while everyone believes that the media is free, unfettered and honest, in fact every bit of information consumed is a carefully engineered fabrication, custom designed for each consumer, resulting in a population that can be controlled and directed to the finest degree without inspiring more than the most fleeting impressions of invasion or oppression. There are innumerable variations on the fantasy futures that play through my mind, but they all come down to the same basics: a corrupt and powerful few dictating the activities of the people by means of force, fear, deceit and manipulation.

In watching these two films back to back, rather than feeling the usual dread and nausea in the pit of my stomach, I found myself feeling impatient. Hardly a day goes by that I don't hear or read of another outrageous assault on freedom, humanity, civil rights or information and yet despite it all, my life goes on as usual. I eat the same good food, sleep in the same warm bed, receive the same monthly direct deposit paycheck and fumble, as usual, through my tax return. When is all the shit going to finally hit the fan? When is the horror going to come to my door? When do I get the chance to find out what I'm really made of? Am I a Sam Lowry, content to roll along with the tide of a depraved culture until it becomes so screwed up and insane that I'm forced to react? Am I Georg Dreyman, cognitive of the problems that surround me, fully aware of the corruption at the top and of the helplessness of those at the bottom, maybe a little bit smug in my superior understanding and occasionally trying to express myself (without risking too much) through some carefully crafted work of art? Or am I a Gerd Wiesler? Will I be a servant of the regime until some especially poignant ray of humanity illuminates my world, allows me to clearly see how vile I have become and inspires me to change, even if it means suffering the frightful consequences of spurning the powers at the top? Or maybe that ray will never shine through and I'll just keep doing as I'm told until I die, always relatively comfortable, relatively secure, relatively guilty, relatively damned.

Let's spice up the pot and add another story to the mix: V for Vendetta. The movie or the graphic novel, take your pick, they're both excellent. Here we're given a few more kinds of responses to a very 1984-esque civilization. In addition to an almost Gerd Wiesler type in policeman Dominic Stone, we've got the titular character, V, a victim of state sanctioned human experimentation who has become a masked vigilante, out to destroy the evil government. Evey Hammond is a young woman working for the government's media arm, a Sam Lowry sort of character who undergoes a thorough transformation, eventually taking up V's mantle as the righteous champion of truth and freedom. V's character raises the idea of outright and even violent rebellion that leads to massive revolution. So in any of my envisioned dystopic futures, what is the chance of such a hero emerging? What is the chance that I could be him or at least his next Evey Hammond?

But there's another future that I consider to be far more plausible than any of the above -- one that is eloquently sampled at multiple time points in David Mitchell's Cloud Atlas. This book, which reads with a sensuous fluidity of phrase that is almost poetry, is a series of nested stories, each told in a different voice and a very different style. Each story is, in one way or another, linked to the previous, and together they span a period of time beginning in the mid-19th century and ending in an undefined future -- probably around 2150, give or take. In that future civilization has crumbled in ruin. Humans still exist, but they have reverted to a primitive tribal existence in which artifacts of (our) modern technology are curiosities, day-to-day survival is a struggle and human lifespans have dwindled back to the preindustrial standards of 20-50 years. In the book this future has followed a peak in technological and industrial progress that is just a little beyond our current state and that is accompanied by a system of governments and media that seems only a little more authoritarian and propagandist, respectively, than our own. The specific sequence of events that leads humanity from their advanced state of civilization to near ruin is not described in detail, but there are plenty of hints, many of which point to the all too real effects of climate change.

And that brings us to the next segment of this sprawling ramble of a blog post. With increasingly hostile weather on the coasts and droughts inland, the habitable and arable regions of the globe will soon have shrunk to such an extent that there will be widespread famine, which will, in turn, lead to conflict. The vectors that carry infectious diseases will converge on these same geographic areas and with increased temperature and humidity, they will thrive and fueling monstrous epidemics of death and suffering. As material and energy resources fail and looting of all types of productive facilities becomes rampant antibiotics and other simple medications will become unavailable. Those with guns and the will to use them will maintain their way of life for a little longer than others, but in doing so will have already sacrificed some part of their humanity. A few isolated groups may succeed in eking out a decent existence, at least for as long as they can remain undiscovered by the ever increasing numbers of desperately looting hoards. Science, art, music, literature -- much of what we love and enjoy in life will disappear as the struggle for survival comes to dominate all motivations.

It's a bleak future. I don't like it, but I think it's quite probable. I probably won't survive to see it achieve such extremes, but unless I die young, I'm sure that I'll see the beginnings of the fall. I expect to see costs of food, land, housing, health care and transportation rise to the point that those of us now living comfortable middle class lives will be making due in small apartments on very simple diets, farming every scrap of yard we can find and celebrating once or twice a year with a bottle of wine. I expect that after a relative peak in intrusive policing and surveillance and mind-directing media campaigns, a resource strained government will discover that its population is so focused on the basics of survival that such high-tech control measures are no longer necessary and that a few token food handouts along with occasional shows of force are more than adequate to maintain a semblance of order (think Soylent Green)... until everything falls apart completely and anarchy (so long idealized in the setting of adequate resources) shows its ugly side.

Over the course of a few centuries things might recover to some extent. Once industry has ground to a halt and the planet has had a few hundred years to recover from at least a little of the damage we've done, civilization may have a chance to grow again (assuming the human race has not gone extinct). And what would that recovery look like? The best depiction that I've encountered is in the fourth (and final) book of Ken MacLeod's Fall Revolution series, The Sky Road. In MacLeod's version of the future civilization hasn't fallen quite so low as I expect it to, so the world of Sky Road may be a little brighter than reality, but it gives a good feel for the struggle to somehow regain a hint of humanity's glory days.

So now I've rambled far from my initial topics and have touched on many more works of film and literature than I'd initially intended. Humor me though, as I introduce another -- one that has aided me in my search for a meaningful response to the horrors and desperation to come. Author Stephen Baxter wrote a story called Last Contact (included in the 2008 collection of The Year's Best Science Fiction. It is an end-of-the-world story. The projected End has nothing to do with climate change, but is due, rather, to a massive cosmological event far beyond any human influence. Destruction of the planet is assured and unavoidable. Reactions vary, but one of the central characters in the story is a member of a team of scientists expending every last ounce of its energies to study the phenomenon that is soon to be its destruction. They do this knowing that it will do them no good, but hoping that just maybe, should another intelligence come afterward and attempt to make sense of what has happened, a faint impression of their work, a shadow of a signature of their research might remain and be of benefit.

The scale of the destruction portrayed in Baxter's story is far in excess of that which I foresee; the emotions evoked are similar though. I see monumental and inevitable doom and gloom ahead. I have spent much of the past year intermittently depressed, wishing that the world would come to its senses in time, change its ways and rescue itself. This wish will not be fulfilled. The end is nigh, as Watchmen's Rorschach's sign reads. There's nothing that I or anyone can do now. The damage is beyond humans' capacity for repair. So now that it's settled, now that I am convinced that the destruction of civilization as we know it is assured, what do I do?

When King David's first son by Bathsheba was sick, David fasted and prayed for a week, pleading for the child's life and making himself generally miserable in his anguish. When the child died, however, "David rose from the ground, washed and anointed himself, and changed his clothes. He went into the house of the LORD and worshiped; he then went to his own house; and when he asked, they set food before him and he ate. Then his servants said to him, 'What is this thing that you have done? You fasted and wept for the child while it was alive; but when the child died, you rose and ate food.' He said, 'While the child was still alive, I fasted and wept; for I said, Who knows? The LORD may be gracious to me, and the child may live. But now he is dead; why should I fast? Can I bring him back again?'" (NRSV)

The horse has left the barn. King David's child is dead. I can stop mourning and wishing and hoping. From here on out I understand that destruction is a foregone conclusion. As horrible and regrettable as this is in the global sense, on a personal level it is a strange relief. Instead of wallowing grief and anguish I can now focus on what can be done. I cannot stop climate change and the four horsemen that will accompany it, but maybe in studying it, studying the human health effects associated with climate change I will be able to contribute some tiny grain of useful information that may survive the dark ages ahead and assist a future human race as it seeks to pull itself from the rubble and slowly rebuild. This is optimistic and ultimately just another fantasy, but it is something and it gives me a reason to go on... some meaning.

It also allows me to focus on how much I love of the life that I currently live. I don't know when the shit will hit the fan, and maybe I'll be lucky enough not to see it, but I know it's coming and this knowledge makes every moment of comfort, beauty and pleasure that I enjoy now all the more valuable. Since coming to terms with the end of the world as I know it, relationships have grown more valuable to me, natural beauty more moving, music sweeter, food tastier, sex more intensely pleasurable, wine more satisfying, books more engaging. Everything I touch and experience today may be taken from me as the world descends into chaos, but the memories that I make now will not desert me and if I am in one of the last generations to enjoy everything good that this civilization has to offer, I'm going to savor every second of it, soak up all of it and be ready to contribute to the oral traditions that may keep a glimmer of humanity alive through the long winter. I'm not likely to have the opportunity to be Sam Lowry, Evey Hammond, Gerd Wiesler, Georg Dreyman or V, as those characters are all products of civilizations, which flawed though they might be, are relatively stable. No, I am more likely to be Sol Roth, the old geezer sharing space in a tiny apartment, pouring over the occasional book and telling the next generation about real food from the good old days.

Then again, the best way to ensure that a particular version of the future never happens exactly as predicted is to foretell it as certainty -- G. K. Chesterton's game of Cheat the Prophet. So maybe even now, as I commit my ideas to this electronic page, I am doing my part to avert one of a thousand possible dismal future. Now for the other nine hundred ninety-nine.

Tuesday, February 2, 2010

Someone's Thoughts on Avatar

I have not written a post about Avatar myself. I had considered doing so. I've seen the movie twice and I enjoyed it very much both times. I felt that to write about it, however, would require an investment of time that I did not have available. Fortunately, plenty of others have written about it, and I have read many reviews and critiques. Today I discovered what, in my opinion, is the finest review of the film out there, by Andries du Toit, author of the blog, A Subtle Knife. It hits everything that I would have tried to address, plus a whole lot more... and it even refers to two of my favorite works of literature along the way: The Lord of the Rings and His Dark Materials. Give it a read... it'll be well worth your time spent.

Soon To Be Read

My previous post was about the last book that I finished reading. This is about the next one that I plan to start (not likely to be the next book that I finish, as I've got several others in progress already): Anathem by Neal Stephenson. The massive hard-bound book was given to me by one of my colleagues over a year ago and it has been sitting on a shelf taunting me ever since.

My attention was recently redirected to Anathem by a friend (and frequent blog commenter), George Berger, who has just had his highly eloquent, expertly informed and intelligently critical review of Anathem published on The Zone, a prominent magazine-style website devoted to Science Fiction. Congratulations George!

I know, based on George's review and the recommendations of other friends, that I will thoroughly enjoy the book. The two reasons that I've taken so long to start it are 1) that I'm pretty sure that I will be entirely absorbed by it and will have difficulty doing anything productive until it's finished and 2) it's so damned big that it'll be a royal pain in the ass to haul around with me. The second obstacle was recently eliminated when I received a Kindle for my birthday and promptly downloaded Anathem. As for the first problem... well, I guess I'll just have to deal with it.

Recently Read

Yesterday I finished reading China Mieville's Perdido Street Station. I'm not sure how to even begin to describe it: there are so many overlapping genres and themes represented that to start by calling it science fiction or fantasy or social commentary and then adding appropriate modifiers and descriptors seems inadequate. It was certainly an enjoyable read -- one of those books that consumed my waking (and often sleeping) consciousness and that kept me happily distracted from many other activities, obligations and other stressors (as you may have noticed, my blogging has fallen off of late) -- and even as mere entertainment for its own sake, this book is well worth reading.

My own ambivalence about whether to call it fantasy or science fiction is reflected in the variety of awards and honors that the book has received (or for which it has been nominated). When talking to people about the book over the past few weeks I have most often described it as a science fiction novel set in a fantasy world. Yes, there are all manner of strange fantastical creatures coinhabiting the city of New Crobuzon in the world of Bas-Lag, and yes, there is magic (referred to as thaumaturgy) scattered fairly heavily throughout, but the protagonist, Isaac Grimnebulin, is a freelance scientist who seems to approach these magical aspects of his world (as any scientist should) as though they are merely phenomena that have yet to be adequately investigated. He is only really interested in thaumaturgy, however, to the extent that it can help him further his real work: demonstration and utilization of a theoretical virtually limitless source of energy.

Early in the novel Grimnebulin is contracted to help a formerly winged creature (whose wings were taken as punishment for an unspeakable crime) regain the power of flight. As he explores the various approaches to the problem, Grimnebulin collects a vast array of winged animals for study, some of which are far more dangerous than he initially realizes. In his frenzy for knowledge and successful completion of his project, he unwittingly unleashes a creature that threatens the existence of all sentient being in New Crobuzon. Most of the book follows Grimnebulin and his various companions and acquaintances as they seek to control this unholy terror, and the slimily disgusting and horrifically painful ordeals that they endure along the way are described so skillfully that as a reader I found myself cringing, crying and cowering along with them.

I could go on describing the story, but ultimately it wasn't the story itself that kept me reading -- it was the characters. They are drawn with incredible depth and their conflicts (both internal and external) are explored with elegant finesse. Grimnebulin, for example, is an overweight scientist who has abandoned the mainstream academic world in order to have more freedom to pursue his somewhat unorthodox ideas. He has been careful not to burn bridges however, and maintains frequent (if somewhat strained) relations with his former mentor and the University. As might be expected of a freelance scientist, he's constantly struggling for funding and New Crobuzon doesn't seem to offer much in the way of grants for independent investigators. So when a lucrative offer comes along he is forced to balance the practical demands of life against his driving intellectual passions. He also has another passion: his Khepri girlfriend, Lin. The Khepri are a species whose females have humanoid bodies with giant scarab bodies for for their heads (yes, I had a hard time with this at first too -- there's no hint of how such a race might have evolved -- but eventually Mieville's writing helped me overcome my doubts and just accept it) and interspecies relationships between humans and Khepri are taboo at best. Lin is an artist, however, and among her avant-garde circle of friends she is allowed to be a little more open about Grimnebulin than Grimnebulin can be about her with his academic crowd. This asymetry in the relationship leads, predictably, to tensions that are just a small sample of the interspecies (and inter-class) tensions that abound throughout the city.

So where are we now... we've got a science fiction story set in a fantasy world that is replete with magic, monsters and complex relationships... What else can we add to the mix? How about AI? Yes, artificial intelligence plays a big role in the story too, as some of the steampunk robots (or constructs, as they are called) develop viruses that usually result in system failure, but very rarely lead to self-awareness. The difference between artificial intelligence and the consciousness of living organisms becomes very important as the two classes of intelligent beings alternately collaborate with and antagonize one another in their efforts to control the devastation being visited upon New Crobuzon.

Tying the story together and serving as periodic interludes are the first-person, present-tense reflections of Grimnebulin's un-winged flight-hungry client who comes from a very different part of Bas-Lag and whose values and perspectives differ greatly from those of the rest of the characters. His story is both inspiring and tragic, and is only fully revealed at the conclusion of the book... a conclusion, I might add, that feels far more like that of a modern literary novel than that of an action filled SF or fantasy thriller. It's a conclusion which does not bring resolution of many many of the story strings and which will probably leave many readers feeling unsatisfied. I found it pleasantly credible, however, as in (at least my own experience of) real life, the endpoints of the various processes, projects and problems rarely coincide.

So give it a read... and let me know what you think. It's one of the stranger more unexpected books I've read in quite some time.

Sunday, January 17, 2010


One of my favorite quotes about power is from Frank Herbert's Chapterhouse: Dune:

"It is not that power corrupts but that it is magnetic to the corruptible."

This is part of longer passage about the failings of governments:

"All governments suffer a recurring problem: power attracts pathological personalities. It is not that power corrupts but that it is magnetic to the corruptible. Such people have a tendency to become drunk on violence, a condition to which they are quickly addicted."

The theme is repeated elsewhere throughout the book:

"Power attracts the corruptible. Suspect all who seek it."


"We should grant power over affairs only to those who are reluctant to hold it and then only under conditions that increase the reluctance."

I recently read Iain M. Banks new book, Transition, and discovered this particularly eloquent statement of the same basic idea:

"Only people already riddled with the internalised special pleading and self-importance that too much power brings could even start to imagine that this might be in any way sustainable."

It the conclusion of this longer reflection on the problem of life extension and/or immortality for the "wise" and the powerful:

"The old and powerful never want to let go. They always think they're both profoundly indispensable and uniquely right. They are always wrong. Part of the function of ageing and dying is to let the next generation have its say, its time in the sun, to sweep away the mistakes of the previous age while, if they're lucky, retaining the advances made and the benefits accrued. It is an insane conceit. Power always drives to perpetuate itself, but this is a phenomenal extra distillation of idiocy. Only people already riddled with the internalised special pleading and self-importance that too much power brings could even start to imagine that this might be in any way sustainable."

These quotes bring to mind a number of current situations. There are myriad obvious examples of corruption among the powerful, but I'm especially struck by the applicability of these quotes to the appalling lack of term limits for elected officials AND the level of compensation enjoyed by such officials.

In my perfect world higher education would be freely available to all and would be a requirement for eligibility to vote. Those who chose to pursue higher education would also be required to repay their years of education in service work, for which they would receive a decent living wage. Those who serve well would be promoted to higher levels of authority -- some of them to governing positions, as representatives of their peers -- but not to never levels of pay (pay grade during service years would depend on number of dependents in the household). Once their terms of service were complete, they would be returned to the working population and would not be allowed to hold official positions again. If they were particularly passionate or motivated, they would be free to communicate their opinions to their representatives in government; they would have no official say (beyond their vote as an ordinary educated citizen, of course) in matters of state though.

OK. Now, dear readers, please start shooting holes in my utopian scheme so that I can begin work on plugging and repairing them.



Today at 10:00 in the morning I am sitting at my computer putting together this week's laboratory medicine quiz for the pathology residents. Which of the following fluids may be transfused simultaneously through an infusion line with red blood cells? I don't actually know the answer off the top of my head, but that doesn't really matter. I just pick questions from a question bank, copy them to the body of an email and send them out to the residents. They have a week in which to send me the answers. At the end of the year the person with highest percentage correct answers will get a cash prize. Usually about $150, but it depends on how generous the attending pathologists feel when I make the rounds, asking for contributions. It's a bit of a pain having to go from office to office, knocking on the doors, asking for contributions for this year's laboratory medicine quiz contest, but in the end all of the pathologists are great about it. They like to see us engaged in friendly intellectual competition and they understand that this is a fun way for us to get ourselves to study some rather dry topics. We're all intelligent, motivated, successful young doctors, after all. Of course they don't mind putting $10 or $20 dollars in the pot for our collective educational motivation.


I go to the front door, dreading the possibilities. A pair of young, bright-eyed Jehovah's Witness missionaries for me to deflate with my superior biblical knowledge? A real-estate agent asking permission to post signs in our yard, directing people to his open house? A 2o-year-old single mother of three selling the latest, greatest cleaning supplies that are both environmentally friendly and sure to remove grease, rust, blood, and fruit juice stains from even the stubbornest of surfaces?


It's Ronnie.

Ronnie is a young man who lives in the neighborhood with his diabetic father. Ronnie works two part-time minimum wage jobs and does yard work and other odd jobs when he can find them. Ronnie's father is severely disabled, cannot perform any sort of manual labor, and has never been trained for any other type of work. Between Ronnie's meager earnings and his father's social security benefits, the two of them are usually able to pay for rent and utilities, with just a little left for groceries. Ronnie's father is on Medicaid and most of his medications are covered, but there is a $34 copay each month for the insulin to control his blood sugar.

It is winter here and it gets fairly cold at night. The bill for heating gas in the winter months can easily reach four or five times that of the summer months. When forced to choose between paying the gas bill and the copay for his insulin last week, Ronnie's father decided to keep himself and his son warm. He did not tell Ronnie that there had not been enough money for insulin. Ronnie only found out when he found his father on the floor, unconscious and barely breathing. Diabetic ketoacidosis. An ambulance trip. A day and a half of treatment and observation in the emergency room. A day of work lost for Ronnie. Ronnie and his father return home this morning to a house with heat and a little bit of food, but with no $34 for the insulin copay. They will not have $34 dollars again until Ronnie's next paycheck, five days from now.

Knock. knock. knock.

Ronnie hates doing this. He hates having to walk around the neighborhood asking for yard work. He hates knowing that all of us in our warm homes, happy and content with our own lives, will be made to feel uncomfortable by his neediness, by his very existence. He hates knowing that many of us will look through our peep-hole, see a slightly bedraggled young man, and automatically assume that he needs money for his next fix. Ronnie hates to ask for help. He also hates to see his father dying.

Knock. knock. knock.

Ronnie tells me about his last two days in the emergency room with his father. I already know why he is here at my door and I'm desperately trying to think of some odd jobs that I can have him do around the place. $34. On my resident's salary, that's about two hours worth of work. Can I find two hours worth of work for Ronnie to do? Two hours that he'll save me so that I can feel justified giving him the money to keep his father alive? Should I have him pick up the dog shit in our back yard? Should I have him pull weeds from the front yard that is going to be re-landscaped in a couple months anyway? Should I just give him the money and send him away so that I can get on with my day?

Ronnie and his father are a small but fairly representative sample of a huge and rapidly growing segment of our population: the underserved, underemployed, underpaid, and largely unheard poor. The poor. The poor without adequate access to healthcare. The poor without adequate government assistance for food and utilities. The poor who are reminded of how much it sucks to be poor in this country every time they have to ask for help. The poor who were born to the similarly poor. The poor who are marginalized when it comes to educational and employment opportunities. The poor who grow up undernourished because they're eating the shitty processed food that is less expensive per calorie than the healthy balanced diet that their developing bodies and minds really need. The poor who make the rest of us uncomfortable with their very existence. The poor who are desperate and sometimes steal to make ends meet. The poor who suffer at least as much mental illness as the rest of us, but who have virtually no access to treatment for such disease and must therefore self medicate with alcohol and illicit drugs. The poor who commit suicide far more frequently than the rest of us. The poor who are a nuisance to the rest of us, a problem about which we'd rather not have to think. The poor who turn to drugs to temporarily escape their poverty, only to find themselves enslaved to substances and dealers. The poor who cross an arbitrary line in the desert looking for employment, only to be arrested and deported... or to die of thirst under the hot sun when they've lost their way and are afraid to stay close to a road for fear of being arrested. The poor who have seen their mothers and older siblings beaten and raped and therefore figure that it's part of life and don't seek help or refuge when their turn comes. The poor who are far more likely to be murdered. The poor who join gangs and commit horrible acts of violence in an attempt to gain some sense of control and empowerment. The poor who rot in prisons for the rest of their productive lives while their families grow up, grow apart, grow old. The poor who bother us, interrupting our productive, healthy, happy lives by asking for help.

$34. A minuscule grain transferred across the fulcrum of economic disparity. A sick sad reminder of that day in the near future when the the situation will recur, when that $34 won't be available and the ambulance may or may not arrive in time. A reminder that the status quo just isn't enough when it comes to health care in this country.

Knock. knock.knock.

Monday, January 11, 2010

Frankl, Avatar, and most of all, Star Trek

Sorry folks, but I'm not literate, eloquent or creative enough to have drawn all of the above listed themes together. Fortunately someone else is. Areophany of Martian Utopia Cafe has written (yet another) truly excellent post. So good that I think I'll have to go back and read it again very soon. It is, in part, a reflection on finding meaning in an all too often cruel and ridiculous world, and in part an homage to the Star Trek novels, in the form of a series of well crafted mini-reviews. I've never read any of the Star Trek novels, but now that I know where to start, I think I might just have to.

Saturday, January 9, 2010


Selah is the transliteration of a Hebrew word that occurs frequently in the Psalms of David. There seems to be some debate about the correct interpretation, but the one that I was told most frequently as a child was, "stop and consider what you've just heard." Another translation is, "Let those who have eyes see and those who have ears hear." It is also used in some passages as a verb meaning to weigh or to measure against.

All of these are appropriate responses to a recent post by Areophany at Martian Utopia Cafe about the atrocious Isreali policies toward Palestinians.

So read his post; read the references; weigh his words; stop and consider. Selah!

Friday, January 8, 2010

Follow-Up: Part 3

I've grown weary of this self-indulgent ramble through the past year, so I'll finish up briefly before seeking worthier blog fodder.


I grew up trying to catch fish with a rod and reel. I lived on a little creek in Oregon that almost certainly had fish. I really knew nothing about catching them though, and would use whatever mad combination of worms, lures, insect parts or other bait to try. I was vaguely aware of flyfishing, but never tried it. Never until this past August. My wife, Kate, grew up flyfishing and her parents both flyfish -- especially her father. In August, Kate and I spent a week with her parents at a little cabin on the St. Joe river in Idaho. Kate's father taught me the basics and I spent many a pleasant hour up to my knees (or waist) whipping the green line into sinuous S-curves over the river, before dropping the fly of the day on my target water. Of course I also spent many hours retrieving said fly from rocks, tree branches and snags, or tying replacement for said fly onto my ever shrinking leader. In all honesty, I had not expected to enjoy flyfishing nearly as much as I did. I figured that it would be another generally pleasant way to enjoy the outdoors, but with no great advantage over just sitting beside the stream with a book and a bear. I was wrong. It is great fun, technically demanding, often frustrating and frequently rewarding. After having carefully planned my strategy and finally landed the fly just where I want it, the thrill of having a fish strike is somewhere between landing a point in a fierce epée bout and having an improvise recipe turn out exactly as hoped. I am already looking forward to the next fishing trip... when I'll get to use the beautiful new custom-built fly rod that Kate's father gave me for xmas/birthday.

...or V-F-Fs as they're called by those in the know, are making a runner of me. I've always kind of liked the idea of running, and have, at times, actually enjoyed a run if all the conditions were right and I was in just the perfect frame of mind. Overall I've associated running with misery, asthma exacerbations, and knee injuries, and have avoided doing much of it. Now I'm pretty sure that my bad experiences with running are because I was trying to run in the popular manner -- a very unnatural manner. In his book Born to Run author Christopher McDougall explores the running style and the life style of the Tarahumara people of northern Mexico. He also discusses modern running culture and technique at length and argues (quite effectively) that the heel-strike style of running that is currently in vogue (and has been for a few decades now) is an artificial and potentially VERY harmful invention of Nike that has survived only by duping most of the western world through aggressive marketing campaigns. Humans were meant to run and our feet have evolved perfectly to do so... if we use our feet correctly. We should run as we do when we're barefoot (any surprise that some of the greatest runners of all time have been barefoot runners?). Vibram Five Fingers shoes are essentially a thin rubber sole glued to a foot-glove. They provide a little protection from gravel, thorns and broken glass while allowing your feet to move naturally and interact with the ground almost as though they were bare. Using these shoes has forced me to change much about my running posture and stride and consequently I'm already finding that I can run longer, at colder temperatures (temperatures that would previously have triggered an asthma attack), and without ANY knee pain afterward. I'm thrilled... and have even been vaguely scheming with Kate on the possibility of training for a marathon.


Elion is my nephew. He is going on three years old and is a really terrific kid. Lately he has gotten into "cooking," so for xmas this year he was given a toy kitchen of his own, complete with toy food, knives, electric mixers, and chef apparel. I am really hoping that this culinary passion will persist. We've got plenty of good cooks in the family, but no real professional chefs. We've got doctors, dentists, artists, musicians, actors, producers, and plenty of engineers... but no chefs. Elion, it's up to you!

...fed me the most amazing meal I've ever had. At the conclusion of the meal I was ready to die. A sensual experience so intense that I couldn't think straight for two days. No more details. Go eat there yourself.


...will be Elion's sister in about four months. I'm very much looking forward to meeting her... and finding out her middle name.

There are, of course, many other events and encounters from the past year about which I could write in excess, but if I do, it will be by accident, or as they relate to other topics.

What is food to one man is twitter poison to others

Today the U.S. State department, as part of its increasing interest in social networking, will launch a contest to "tweet what you think democracy is in 140 characters or less." The winner is the person whose 140 (or less)-character tweet is re-tweeted the greatest number of times in the next two weeks receives an HD digital video camera.

In his
recent article in Foreign Policy about the State Department's interest social networking, Indiana Senator Richard Lugar writes:

"The adroit use of social networking sites, such as Twitter, Facebook, and others, coupled with text messages and increasingly widespread mobile-phone technology, can help lend support to existing grassroots movements for freedom and civil rights, connect people to information, and help those in closed societies communicate with the outside world. It also promises to give a strong economic boost to small entrepreneurs and the rural poor. The World Bank estimates that for every 10 percent increase in the number of mobile-phone users in a developing country, there is nearly a 1 percent increase in its economic output."

This emphasizes the positive applications of social networking for international (and domestic) development. Just over a week ago, however, Will Heaven of the
Telegraph painted a rather darker picture:

"In Iran, for instance, the government controls the internet with a nationalised communications company. Using a state-of-the-art method called "Deep Packet Inspection", data packages sent between protesters are now automatically broken down, checked for keywords, and reconstructed within milliseconds. Every Tweet and Facebook message, in other words, is firmly on the regime's radar." did Scott Peterson in
his article in the Christian Science Monitor:

"Iran already has powerful Internet eavesdropping and hacking capabilities, thanks to systems sold to by Nokia and Siemens. 'We didn’t know they could do this much,' a network engineer in Tehran told the Wall Street Journal last June. 'Now we know they have powerful things that allow them to do very complex tracking on the network.'

Iran was 'drilling into what the population is trying to say,' a California Internet security specialist was quoted as saying in the Journal. 'This looks like a step beyond what any other country is doing, including China.'"

I wonder why Senator Lugar didn't mention this... or why there isn't any sort of disclaimer on the State Department's
contest announcement site.

I use Facebook frequently and Twitter occasionally. I use my cell phone pretty much non-stop, especially for texting and email. Generally I'm a big fan of social networking systems and a proponent of the exploding accessibility to and use of mobile technology worldwide. I'm especially intrigued by some of the
disease surveillance and other public health efforts. But I don't fool myself for one minute into believing that just because such systems have been used for good, they aren't also being exploited for more sinister purposes, both abroad and at home.

Thursday, January 7, 2010

Follow-Up: Part 2

OK... now for the 2nd half:

environmental health

Having thoroughly turned my career trajectory on its head (or knocked it appropriately to its ass) by withdrawing hematopathology fellowship applications, I was left, about a year ago now, looking for a new direction. As described previously, I entertained the idea of pursuing additional training in biomedical informatics. I wasn't entirely convinced though and figured that if I was considering a major shift, I really ought to explore other possibilities too. Art, journalism, law and public policy all made the list of ideas at one time or another. I wasn't ready to write off my medical training altogether though. Way back before I even started medical school, I studied public health for a year. One of the most enjoyable courses I took was on environmental health problems in developing countries. Environmental health (EH) is that segment of public health that deals with identification, quantification and elimination (or at least mediation) of the environmental determinants of disease and death. The classic subfields of EH are toxicology, water, sanitation, disease vectors, air quality and food safety. More recently, the health impacts of climate change has become a major focus as well. So the more I considered all of the various facets of a potential career in EH, the more it seemed to fit my needs. It stands at a strategic intersection of medicine, public health and the environmental sciences. It would provide me with the skills, knowledge and credentials to join the fight against climate change by helping to demonstrate its potentially devastating effects for humanity.

red mars

An old friend of mine, who is known to this blog as Munjaros, loaned me a trilogy of books by Kim Stanley Robinson: the Mars trilogy. So far I have only read the first one, Red Mars, but it was one of the best books I've read. Like many great science fiction books, it is both inspiring and depressing. Inspiring because it presents a very plausible picture of how we humans might proceed to expand our domain beyond this earthly gravity well; depressing because it reminds me of just how much time, energy and resources we've wasted, and consequently, how far behind we are. Behind who? Our potential. I am looking forward to reading Green Mars and Blue Mars. Thanks Munjaros.


George is a fellow science fiction fan, and in particular a great fan of the works (and person) of Ken MacLeod. I first became acquainted with George through comment streams on Ken's posts. At some point, I think either he made reference to problems in health care or I mentioned that I was connected with medicine. He then shared with me a shocking tale from his own life of a hideous health care failure in a country that has long had a reputation for providing some of the best care in the world: the Netherlands. I was honored to be of assistance to him in getting the story posted on a population health forum in the US, and have since been delighted to see it posted elsewhere as well. George is passionate about health care, human rights, workers' rights, and exposure of injustice anywhere. He is constantly sending me links to important articles -- the kind that are usually ignored by mainstream media, but that need to be read. Several of my blog posts have been inspired by links from George. There is much more I could say about George (and if you keep reading my blog, you'll see plenty of comments from him), but for now, I'll just say thanks. Thanks for the continual flow of information and analysis and thanks for your friendship.

climate change likely the greatest threat that the human race has yet encountered. The data to support this statement abounds and is readily available for "him who has ears to hear." I'm frequently overwhelmed by the enormity of the problem and constantly overwhelmed by the enormity of the stupidity of those who deny it. I have learned much about climate change and the near hopelessness of the human plight from Areophany, one of the co-writers of the blog, Martian Utopia Cafe. I hope that he's wrong in his assessments of the situation (he's frequently said that he hopes he's wrong too), but overall, I think he's right, which leaves me with two options: give up or fight (possibly) in vain.

forged steel

My love of steel goes back to long before I ever worked with it at all. It goes back to my childhood fascination with swords and knives. As a teen I used the money that I made working in my father's wood shop to purchase a welder and some other metal working tools. Along with friends Munjaros and his brother Zech I had all sorts of fun playing around, making stuff out of steel. The most technique for working steel is forging: heating it in a furnace (forge) and beating it to your will with a hammer on an anvil. I've only done a VERY little bit of this. I built a miniature forge out of firebricks, a barbecue and an electric billows when I was 16. I had plenty of hammers, but my anvil was a chunk of railroad track and I had to resort to charcoal briquettes for fuel. I never made anything useful or even remotely functional, but I can still feel the thrill of pulling a piece of red-hot steel from the forge and watching the sparks fly as I reformed it with energy transferred from my arm to the hammer. I haven't forged anything since. Zech, however has. One of his pieces stands elegantly in my living room. Many more of them, including some truly beautiful hand-forged knives can be seen on his blog site.

Violent as this sounds, no blood is shed in its use... at least not directly. I believe that if taken excessively, it could result in a skull splitting headache the next morning, but in moderation, it is a nearly perfect substance (even more nearly perfect than chocolate chip cookies). I discovered skull splitter at D.B.A., a bar in the Marigny, New Orleans. It's the best replacement I've found yet for my beloved (but sadly no longer imported to the USA) McEwan's.


...isn't all its cracked up to be. In fact, when it comes to being a chief resident in the pathology department at the University of New Mexico, it can be quite a crock. It does have its perks though. In addition to the additional pay, it means a little more control over my schedule, as I'm the one in charge of making the schedule. It also means a whole lot of meetings with a whole lot of people, where I have to discuss a whole lot potential changes to the residency program or sort out a whole lot of dumb interpersonal failure-to-communicate type issues. Looks good on a resume though, and for better or for worse, it seems that I'm pretty good at it (some sort of natural talent for diplomacy and negotations). I sure haven't gotten bored since becoming chief... and I sure am looking forward to surrendering the mantle of authority at 12:01 a.m. on April 1, 2010 (not that I'm counting down or anything).

Another book that I read in the past year. A book that haunts my dreams at night and my thoughts throughout the day. Part period novel, part science fiction, in The Cloud Atlas David Mitchell performs one of the deepest and most affecting explorations of the human experience that I've encountered. It's up there with Haruki Murakami's Wind-up Bird Chronicle and Julian Barnes' History of the World in 10 1/2 Chapters.


The most unexpected xmas/birthday present that I received this year was an Amazon Kindle. I suppose I shouldn't have been surprised, given my love of books and gadgets, but given that I hadn't ever mentioned the Kindle to my wife or her parents, it was quite a treat to receive it from them on xmas morning. You can read all of the reviews of it elsewhere, as well as the head-to-head comparisons with the Sony Reader and the Barnes and Noble Nook. Suffice it to say, that they all have the pros and cons, but I'm very pleased with the Kindle and find reading from it to be quite enjoyable. It's also an incredibly dangerous device, in that it is WAY too easy to buy books for it. Oh... and here's the shocker: I've actually managed to turn it to some academic purposes as well. Amazon will convert documents in .doc or .pdf formats to their proprietary Kindle format for me and send them to the device, so now I'm reading all sorts of toxicology papers and textbook chapters on the Kindle. The vast majority of my Kindle's content is currently science fiction though.

Well... I've now addressed all of the topics on my original list. In doing so, however, I've discovered that there are some very important ones that I neglected, so there will have to be at least one more installment, in which I'll cover the following (and possibly other topics as well):

vibram five fingers

Tuesday, January 5, 2010

2 new blogs to watch

I am working on the follow-up post to my end-of-year/birthday ramble. But first I want to draw your attention to two new blogs on the net.

The first is Enigmatic Variant (think Elgar) and belongs to my wife, who is a runner, a reader, a writer, a violinist, an anesthesiologist, and the kindest, smartest and most beautiful person I know. I'm really looking forward to reading her posts!

The second is Zech Moore Artwork and Custom Blacksmithing. Zech is one of my best friends and when we were teenagers together in Oregon we started messing around with metal work. He kept with it and is turning out some fantastic hand-forged artwork and blades. I have one of his pieces (the wine stand on the second page of posts) and am thoroughly impressed with it.

Sunday, January 3, 2010

Follow-Up: Part 1

OK, this is where I tackle the first half of the items on that list in my previous post.


Hematopathology is the subfield of pathology that deals with diseases of the blood, bone marrow, lymph nodes, and spleen. About 27 months ago I decided to pursue a career in hematopathology. It's a fairly lucrative field, always in high demand, and offers just the right amount of variety without so much that one becomes entirely overwhelmed. It's also at the cutting edge of medicine. It employs wonderful technologies like flow cytometry, FISH analysis, and various molecular assays, as well as plenty of time behind the scope and even the option of some patient contact (should a pathologist ever actually desire such a thing). Until just over a year ago I thought I had everything settled. I knew I'd have great recommendations from the hematopathologists in my residency program and had little doubt about my ability to get a spot in one of the better fellowship training programs in the country. A little less than a year ago, after having gone through an exhausting application process and interviewed at several top-notch programs, I decided not to pursue subspecialty fellowship training in hematopathology.

Yet another amazing book by one of my favorite authors, living or dead, Ken MacLeod. It's an all too timely tale of an all too possible future (several aspects of which I'd love to see realized!). It includes plenty of enticing themes (super-intelligent robots, space elevators, etc.), but what I particularly enjoyed was the setting: a world in which religion held little sway.


My wife, Kate, is an anesthesiology resident. In march of 2009 she was offered (and accepted) a subspecialty training fellowship in pediatric anesthesiology at Seattle Childrens, giving us a specific reason and date for our long anticipated return to our beloved Emerald City. Also, after not having ever observed an anesthesiologist's role in the OR from the beginning to the end of a case, I recently accompanied Kate to work for a day and watched her perform local nerve blocks and run cases. Very interesting and very technical. In a spirit of reciprocity she accompanied me to work and watched her first-ever autopsy.


After reading one of Ken MacLeod's other books, The Star Fraction I was convinced that my nearly complete state of computer illiteracy would be a tremendous handicap in any possible version of the future, so I finagled my way into an undergraduate introductory course on Unix. It was great fun, and though I don't use Unix or Linux on a daily basis, much of what I learned about computer systems/structures has served me since. I enjoyed the course so much, in fact, that for most of the past year I was thinking I'd pursue a career in biomedical informatics. I spent a month at the Mecca of pathology informatics, University of Pittsburgh, attended three national meetings on biomedical informatics (presented a poster at one of them), and dove head first into every informatics-related project that came my way. Ultimately, however, I decided that even though I do believe that innovations in informatics and the technology to support them are the future of medicine, I was more concerned about the future of a habitable planet, so I chose a different path.


As mentioned above, reading one of Ken MacLeod's books inspired me to take a Unix class. That's not the only manner in which it inspired me though. I read The Star Fraction while I was still planning on a career in hematopathology. It had been several years, however, since I'd discovered that I derived no great joy or satisfaction from medicine, and even as I was making plans for the next stage in my training and career, I was hoping to find something else -- and yet afraid to really look for it. Ken's book introduced me to a vast array of social, scientific, political and (as far as I can tell) completely original ideas that served to shake me into a realization that if I wasn't pursuing a career in which I truly believed and about which I could work up a decent passion, then I might just be wasting the most important (the only truly important?) opportunity of my life. Reading Ken's book also lit a fire under my lazy ass in regard to politics and world events. I've always been vaguely aware of the goings on in the world, but have tended to depend on one (relatively decent) source of information (NPR) and then done little with said information. I still don't pursue the truth as rabidly as I'd like, but I'm far more aware and far more skeptical of any one source... and I'm rapidly shedding my fear of using my voice on behalf of people and causes that are ignored or misrepresented. Thank you, Ken.

health care

What blogger worth his salt hasn't touched on health care in the past year? As 1) an MD working in a university hospital that serves most of the uninsured of the community, 2) an observant individual who has now lived in two of the three poorest states in the USA, and 3) someone with many friends in other countries throughout the world, I have no doubt that the US health care system is a disaster. The worst and foremost failing is that it is a health care system instead of a health system. Until the emphasis is correctly placed on promotion of health through education, healthy living environments, healthy workplaces (and work practices), and real, meaningful reduction of the economic disparity that is running rampant, any health care system is going to be nothing more than an expensive band-aid that rapidly becomes entirely unaffordable. Enough ranting though... especially as I'll return to health care related topics later in this post. Suffice it to say that none of the US health care proposals of the past year have gone nearly far enough, and they've all been "shaved, sterilized, and destroyed" to the point that the end result will only be slightly better than the current state of affairs. It will be better... but there'll still be a LONG way to go before health in the USA is even close to being adequately reformed.


Until seeing trailers for the movie of Watchmen I was entirely unaware of the story. Fortunately I have three cousins who more than made up for my childhood lack of comic books. While conversing with one of them about the film trailer, he told me, "if you only ever read one comic book or graphic novel, it should be Watchmen." So I picked up a copy and read it. It was truly great. The movie was excellent too... and I like it better and better each time I see it. If you haven't seen it, read the book first. If you have seen it, be sure to watch the Director's Cut. If you've seen the Director's Cut, watch the Ultimate Cut, which includes all of the Black Freighter sequences that were left out of the theatrical version. Oh... and Watchmen is not the only comic book or graphic novel I'll ever read. I've already read V for Vendetta and I'm looking forward to starting the Sandman series.


Scotch whisky at it's finest. I do love Laphroaig, Caol Ila, and even Ardbeg, but when push comes to shove, if I had to settle on just one, it would be the Signatory 18-year-old Bruichladdich. Enough said. Slainte Mhath! Slainte Mhor!


For this I'll refer to my previous post on the topic. In summary, I'll paraphrase and respond to a line from the movie Gladiator:
There was once a dream that was Obama. You could only whisper it. Anything more than a whisper and it would vanish... it was so fragile. And I fear that it will not survive the winter.
The man has survived a winter, but the dream has not.

On that rather somber note, I will close this post. I will be back to cover the other half of the topics though, so stay tuned.