A family doctor's observations and commentary on life, family, travel, the human condition and the joys and pitfalls of running a medical practice.
Saturday, October 17, 2009
Friday, June 12, 2009
Adventures in Haiku

Egg and leaf
Blowing and rolling down
Rain forgiving
Glades beginning
Sun rays form slices
Clarity shining
Windows remind
Slender plans forming now
Begin to last
Haiku-poems consist of respectively 5, 7 and 5 syllables in three units. In Japanese, this convention is a must, but in English, which has variation in the length of syllables, this can sometimes be difficult. Toyomasu.com
Steve Martin's version of haiku does not follow any of the traditional Japanese rules. He is not generally revered in Japan for his remarkable work but here in America he is one of our most respected artists. Martin created the fictional poet, John Lillison also known as, 'England's greatest one-armed poet'. He has given us two memorable poems;
Pointy Birds
Pointy Birds, O pointy birds,O pointy pointy.
Anoint my head, Anointy-nonity.
Anoint my head, Anointy-nonity.
In Dillan's Grove.
In Dillan's Grove my love did die,
and now in ground shall ever lie.
None could ever replace her visage,
until your face brought thoughts of kissage.
and now in ground shall ever lie.
None could ever replace her visage,
until your face brought thoughts of kissage.
Sunday, June 7, 2009
Croquet Motocross
Croquet motocross is a lot more fun and it is aerobic!
To be the first to hit your ball across the field, strike the wooden stake and then get back and put your ball through your own wicket before your competitors.
Rules of the Game:
1. Place all of the wickets in a line across one side of the lawn and place one of the multi colored croquet posts at the other side of the lawn.
2. A referee is stationed at the post to be sure that all players are competing fairly.
3. All contestants place their wooden balls in their own wicket and stand behind with their mallet all pointing toward the wooden stake at the far end of the field.
4. When someone shouts "Go!" all of the players hit their own ball as hard as they can toward the stake at the far end of the field.
5. All players are allowed to hit other contestants wooden balls along the way and send them off course but ultimately the goal is to hit your own ball and make the trip back over the field, hit the post with your ball and then go back and hit your own ball through your own wicket.
Wednesday, June 3, 2009
Metier

though I knew she was sleeping,
I'm empty and aching and I don't know why.
Counting the cars on the New Jersey turnpike,
They've all gone to look for America"
Paul Simon - America
Forrest Gump's great gift was clarity of heart. He lived a transparent life without the comfort of an emotional veil or disguise. The popularity of the character was due to the fact that Forrest was the manifestation and expression of his own internal rhythms and lived life for all to see at the mercy of his reactive 'self'.
Forrest Gump's destiny was to live each day tossed by the waves of life that we all experience without a the stabilizing sail or keel that every person needs to stay afloat. This story was narrated to the audience as Forrest was about to embark on the most tragic event of his life, the death of his beautiful Jenny. As pragmatic as ever, Forrest endures this death and sees the gift of his child and the chance to be a father as a hopeful chapter in his life. Having lived a life of shocking clarity and earnest intensity, the character has no need for redemption and there is no tragedy to be found in his simple journey. It is rare in real life when we are introduced to an adult person who has been blessed (or cursed) with the gift of perfect introspection.
Clarity of heart is the natural gift that children have. Adults must protect this fragile ripple until the child experiences their own journey through life. Then, hopefully, the grown adult will carry the memory of what it was like to be hopeful and trusting and to see the broad scope of life as a series of challenges rather than an impending tsunami. Better yet, life could just simply be like a box of chocolates.
mé·tier
Variant(s): also me·tier \ˈme-ˌtyā, me-ˈ\
Function: noun
Etymology: French, from Old French mestier, from Vulgar Latin *misterium, alteration of Latin ministerium work, ministry
Date: 1792
1 : vocation or trade 2 : an area of activity in which one excels : forte
Sunday, May 31, 2009
Jean Therapy

Now, I have a tie and an ironed shirt, clean socks and shoes and a belt. The tie was the last to join the wardrobe and even now I have a difficult time putting one on. Besides, we all know now how germy ties can get.
Back in the days of jeans and t shirts, some things never really seemed to matter. I did'nt have a car so there were no car payments. There were only two keys on my keychain and since I did'nt own a car, one of the keys went to some mystery lock somewhere. We had music cassettes back then and were able to make 'mix tapes' of our favorite music. The hair was longer and I occasionally had to hitch hike to get to work.
Now that I am all grown up with a real job and all, I sometimes miss the free and easy days when I used to wear jeans to work. I have about seven keys on my key ring, two cars, a bank account, car payments, kids braces, mortgage and a 401K. Like most married guys my age we keep relics of our past around to remind us of how things used to be before we took on all of this responsibility. My wife has to put up with a drawer full of old t shirts and some shorts and a cardboard box containing some of my most precious 'stuff'.
My days of traveling the world, living on a shoestring and going without health insurance are over. Sometimes on a Sunday morning as I pull on my jeans to go wash the car or clean out the garage I kind of miss that simple life. Then when my daughters call me to pull them in their sled or help fix their bike or when my wife needs me to run an errand involving something called, 'topsoil' I am glad to have my jeans and am happy to be a husband and father.
Saturday, May 30, 2009
The God's of Call

With a pager comes a mystical aura which doctors refer to as "The God's of Call". This concept was made famous in the classic book, 'The House of God' by Samuel Shem, M.D, Ph.D. The God's of Call dictate every aspect of a doctor's on-call life. Once a doctor is issued a pager, he or she is at the mercy of an all seeing force that moves through the universe and uses physicians beepers as it's metaphysical loudspeaker to channel it's messages to patients through their doctors from the vast sea of human experiences.
The Gods of Call know when a doctor gets a chance to sleep because the pager goes off waking him up. The Gods of Call dictate whether a blood draw or EKG will be successful. The Gods of Call also have telepathic powers so that a doctor will break stride on the way to one part of the hospital because she knows that another patient needs her urgently somewhere else without even being alerted. The sooner a physician acknowledges the awsome power of the Gods of Call the easier their lives will be.
When a physician retires, the Gods of Call move on to other doctors. The healing aura that is beamed through pagers, in a doctors dreams and over the hospital PA system helps to keep patients safe and keep physicians in awe of the demands and responsibilities of their craft.
Zaftig

zaf·tig
Pronunciation: ˈzäf-tig,
Function: adjective
Etymology: Yiddish zaftik juicy, succulent, from zaft juice, sap, from Middle High German saf, saft, from Old High German saf.
Date: circa 1936
Definition: of a woman : having a full rounded figure : pleasingly plump
Source: Websters English Dictionary
Friday, May 29, 2009
The Captain Lied

Everybody knows the Captain lied."
Leonard Cohen
When managers, leaders and supervisors knowingly mislead their staff, the problem they are trying to avoid may retreat but will doubtless resurface later to cause more problems. I was recently watching the classic James Bond film, 'Goldfinger'. Oddjob is the quintissential lackey in that he does whatever he is told even if he knows he is being misled. Oddjob believes his boss so implicitly that this trust eventually leads to his death by electrocution in the bowels of Fort Knox.
Captain Kirk would never lie to Mr. Spock. President Bush would never lie to Dick Cheney. Mick Jagger would never mislead Keith Richards and Bernie Madoff would never make the mistake of lying to....everyone. You see my point.
When leaders mislead and trust is violated we need to advocate for ourselves and be our own watchdogs. We would all do well to remember poor, trusting Oddjob as we watch our 401K plans and possibly our children's future disappear like the setting sun on a bleak African plain.
NASA Splashdown

The space race is over and we won. The John Glenn experiment, (seeing how an older person will handle weightlessness) has been examined and we already know that we can grow certain plants in space so thank God for that minor miracle. We cannot inhabit our own Moon so why would we even try to explore Mars? We can't handle our own waste without turning our planet into a toxic dump so why would we bother to do the same to another planet?

Hubble Telescope Cost: 76 million went for the Shuttle servicing mission, the engineering maintenance of the Hubble mission cost about 475 million. Tile inspection and rescue mission capabilities equal 553 to 636 million. Source: NASA
President Obama should form a committee to re task those resources to develop new energy strategies, increase education spending for children to support math and science programs, take care of our elderly population and fund extensive medical research to help improve the lives of the people who need help.
If there are still NASA engineers who need to build rockets and shoot them off into space after all of these social programs are funded and if there is still money left over that no one wants then I say let them at least put some nuclear waste in the rockets so their payload bays can do some good for the rest of us. Exploding Earth's nuclear waste in deep space will look very similar to the images the Hubble telescope transmits now and will probably be even more spectacular!
Thursday, May 28, 2009
Lonely Tony, the Hub Cap King

If he were a human, Tony would probably be one of those tough hoods from movies like West Side Story or Grease who smoked cigarettes and combed gel into their hairs to make a duck tail in the back (except on him it would'nt be called a 'duck' tail). Tony was tough like The Fonze and by being fearless, ferocious and a pretty fast runner he generated respect and admiration for guinea fowl everywhere. If he were a human, Tony would love his mother, would pick on his little brother, Joey and get to second base with his girlfriend, Karen every Saturday night at the drive in movies.
Tony loved picking fights with other hub caps and when cars came down our street he would dart out of his driveway and run alongside a car staring down the hub cap of the passing car until he had chased it away. The reflection in the moving hub cap would always appear to be running away from him so Tony always successfully defended his turf and his imaginary gang of buddies back at the Subaru in his home driveway.
One day, Tony was gone. Some say he just had to go a-wanderin' that the old neighborhood just got too small for him. Some folks said he finally fell beneath the wheel of a moving car from a rival driveway. There are those who say he just up and flew away up to that big hub cap heaven in the sky.
I say Tony just got tired of doing all the work, running down car hub caps and defending his gang and went to stake out another neighborhood to take over and find a few chicks.
Get it?......Chicks!
Thursday, May 21, 2009
Filswillert Inc.: A Google of One

Malgré les échecs de 1848 Beale a d'autres ambitions pour Berlioz: par l'intermédiaire de son fils Willert, qui lui sert souvent d'agent (cf. CG nos. ...www.hberlioz.com/London/BLfriendsf.htm - 203k - Source: Google
So I am here to proudly announce my newest invention/company; 'Filswillert Inc.'. I have yet to register the company with the State and pay the fees, there is no Board formed and the business plan may pop into my head over coffee while I'm driving to work next Thursday. The factory has not been built yet but I do have my personal parking space set up in my mind where my new BMW will go. This idea will revolutionize something. I don't know what but it will revolutionize something...or somebody...or someones pet. Something! Really.
So stay tuned to your local news channel for updates and when you go to bed at night and say your prayers for the children in Africa, the President and the Economy don't forget to meditate for at least 10 seconds on Filswillert. By keeping Filswillert in your thoughts your name will automatically be added to the list of involved stockholders that will help run the company and change the universe. Your good vibes will assure you a dividend check from the Filswillert Fund once we get it on the stock exchange. The Filswillert Diversification Equity Management Fundiplication Solidarity Group (FDEMFSG) will eventually include every carbon based life form on the planet so you might as well get used to the idea and sign up early so you can get in on some of the valuable coupons and get an early start on the Christmas Club. If you have enough miles with your Filswillert Credit Card (from the Filswillert Global First Bank and Trust) then you can rent one of the corporate jets and...charge it.
Filswillert Inc. is absolutely going to change the way everyone thinks about everything so just as soon as I clean out the garage on Saturday and help the kids with their homework I'm going to really get busy and plan to make some phone calls. After all, being the CEO of a global conglomerate is a big responsibility.
Remember our global slogan, 'Filswillert: By the Future, For the Future and With the Future!'.
Filswillert is the registered trademark of The Filswillert Corporation and Filswillert Inc. and may not be reproduced in any form without express written permission from the Filswillert World Headquarters.
The Trojan Donut

I often wonder what the perfect attention-getting strategy would be for a doctors office. For a medication that will only be prescribed by a practitioner then the old stand by's seem to be the best. For products that the whole office might get excited about then lunch and free pens will not really work.
If I was trying to sell something and wanted to spark the imagination of the whole office staff I would choose to drop off a package that looked....different. Offices have a buzz and a culture and this culture is dictated by the employees. If a package came to the office that was filled with measley donuts but had a balloon attached, a couple of scratch tickets at the bottom of the box and a well done ad campaign with a web address and call back information on it then that would get some attention and respect.
A donut is just a donut but launching a box of donuts at a well entrenched target like a medical office that is very used to being bombarded by donuts and bagels all day and deflecting these from the doctor is difficult. Sales people need a nuclear option and in my opinion, balloons, scratch tickets and a good pitch will engage the office staff and allow the message to penetrate deep into the heart of the office to have a chance at becoming part of the daily buzz.
So to all you sales people out there dress those donuts up and give 'em a chance to get your message out there!
Monday, May 11, 2009
Third World Gatorade

Toby has discovered a new recipe to help cure hunger and dehydration; Fanta orange soda and Pringles potato chips. These ingredients contain calories, salt, sugar, water and....thats it. All you need are vitamins, nutrients, anti oxidants, fruits, vegetables, protein, amino acids and a few minerals and you have the perfect food/beverage combination.
'Third World Gatorade' is going to hit someday soon so buy stock in Pringles potato chips and start stocking up on Fanta. Kids will love it. The village elders will talk about it as they soak their chips in Fanta to smooth out the edges and pre digest the salty goodness. Teenagers can trade the cans of Pringles and swap soda bottles to get some root beer or cola flavors instead of (hungrily) buying RPG's on eBay and listening to state sponsored radio propaganda while riding (thirstily) through the Third World streets late at night in their Buick's.
Contemplating Irony

American Idol, The Olympics, The PGA Tour and even Jeopardy and Wheel of Fortune all make success seem emminently do-able. These are ordinary people! They put their pants on one leg at a time just like the rest of us. If Bill Gates can be a bazillionaire so can I. If Picabo Street can win a gold medal after crashing into a fence at 80mph then so can my sister. If Bill Murray can become a famous comedic actor just be being himself then why not my brother (who is much funnier than Bill)?
When the fortunate few wake up every day and make a fantastic living by making the rest of us look bad to each other and to ourselves then we regular Joe's gravitate toward the anti hero, the underdog and the trusty the one-hit-wonder. We identify with the man who stopped the subway train from jumping the tracks, got the little girl out of the drain pipe and pushed the old lady out of the way of the drunk driver. How about the woman who grabbed the wheel of the school bus just before it crashed, helped the kid in the wheelchair to navigate the ramp and went out of her way to call a sick neighbor. We love these heroes!
The kids I really can't stand are the show off skateboarders, snowboarders and freestyle motocross riders. These people risk serious injury to do aerial stunts disguised as daring acts of bravery. If they really want to show people what great heroes they are they should get off their skateboards, pull up their pants and turn their hats to the front for a change, spend less time getting lip piercings and tattoos of their ex girlfriends name on their necks and stop trying so hard to get on MTV Cribs!
Hey Dude, be a real hero, at least look like you are trying to get a job!
Wednesday, May 6, 2009
The Lucky Monkey God

Quoted from: Subhamoy Das
When President Barak Obama was running for election he was sent lucky charms from people all over the country to bring luck to his bid for office. People sent in precious items from their families, gambling chips and small religeous tokens. Time magazine ran a story of the various items sent to Obama and among them was a charm depicting the image of Hanuman. To me, this particular gift is significant because it illustrates just how far his influence and message of unity and prosperity has reached people from even the most diverse cultural and religeous origins. President Obama has a message and a vision that crosses many boundaries and speaks to the hopes of our international community of citizens in the United States.
I am not exactly sure, but it seems doubtful that President Bush ever recieved a lucky Hindu monkey god charm prior to his run off election with Senator Al Gore.
Thursday, April 23, 2009
The Gospel According to Lloyd
Sunday, April 19, 2009
The Cupcake Solution

Cupcakes can be made from almost any food like substance. Cupcakes are easily transported and can be stored indefinetly. Cupcakes have an internationally recognizable size and shape and even if they are made of spinach and spam kids will eat 'em up. If a person is socially isolated and lonely all they have to do is go pick up a cupcake at the supermarket and people will approach them curiously asking them about their snack. If a person needs to find a way to use leftovers to feed the family then cupcakes offer the perfect way to disguise the remains of last night's meatloaf. Cupcakes can be dropped from an airplane to the starving children of the world making relief efforts easier because the planes do not have to land to deliver their cargo. Best of all, when addressing the problems facing our global economy and Third World debt, let's not forget that bake sales can be our very own grass roots solution to the problem and cupcakes can lead the charge (ahead of brownies and cookies) on fold out tables on church lawns all over the country.
Save the whales! Fight bigotry and ignorance! Help kids learn to read! Build homes for the homeless! End strip mining, slash and burn deforestation, nuclear arms proliferation and global warming!
Get those girl scouts mobilized and put the mighty cupcake to work for world peace and global harmony! We can do it!
Oh Julia, (we never knew ya)

In World War II, she helped the U.S. Navy solve their problem with sharks by developing shark repellent. Sharks had a habit of setting off underwater explosive devices, foiling U.S. plans to blow up German U boats . She met diplomat Paul Child when she was working for the OSS, and they married. When Paul was posted to Paris, Julia trained at the famous Cordon Bleu cooking school and began her second life as a chef.'
Quoted from 'The Daring Book for Girls'
by Buchanan and Peskowitz, Harper Collins, 2007
The next time you are on the subway or waiting in line at the bank or in line at the local coffee shop and see an elderly person quietly drinking their tea, having a meal or waiting to be served you might speculate on what kind of life they led before they grew old. Chances are, that elderly person has seen and done things in life that would seem unbelievable to you.
After all, that man sitting in the corner with his teacup was not born elderly.
Thursday, April 16, 2009
Peter's Chicanery

Peter has lost weight. A lot of weight.
A year ago, you would have thought he was a set up for a coronary and a life as a cardiac cripple. He works as a chef, was overweight with a full belly and skinny legs. Peter had jowls and chins. Then something happened. Peter got the 'religion' of good health. He joined the 'Cult of the Well'. Quietly, without fanfare, in the early morning or late at night, alone without an iPod or a dog to keep him company, Peter began to walk.
It took awhile for his efforts to show but he kept at it like the steadfast Tin Soldier in the children's stories. The gut went down and the legs got strong. His pants size went down from a 46 to a 34 and he became the pride of the neighborhood.
Now Peter will probably live a long healthy life without medications. His heart will be strong, his bones and back will last longer and he will enjoy a lower risk of depression. He will sleep soundly at night and worry less.
Peter walks five miles a day. He walks fast and with purpose, not talking or strolling. It takes him an hour to walk all that way but that hour a day has given him an entirely new life, almost a brand new body and his guardian angel has dealt him a completely new hand from the one he was forced to live with when he was overweight and out of shape.
We are all proud of our neighbor and when we see him on the road we always wave and point him out to our kids. Peter looks up and waves quickly but then lowers his head and focuses on his walking. He has a job to do and he does it as though his life depended on it.
Every day.
chicanery def.
1 : deception by artful subterfuge or sophistry
1 : deception by artful subterfuge or sophistry
2 : a piece of sharp practice (as at law)
Tuesday, April 14, 2009
Quisp Requiem

Quisp and Quake were space aliens that blasted away at each other to vie for the attention of small hungry flying, parent-less children. Capt'n Crunch was always on the move finding treasure and trying to keep his sleepy eyes open. The Lucky Charms leprechaun danced across the screen as tiny marshmallow 'hearts, moons and stars' sprinkled electrons of joy into our collective psyche while slightly dazed children snatched at the empty air. Boo-berry, Count Chocula and Franken-berry pretended to scare unsuspecting toddlers into grabbing their spoons. Pebbles and Bam Bam, Sugar Smacks and Frosted Flakes all injected sugary rocket fuel into our young developing frontal lobes and left many a tearful supermarket aisle calamity in their wake.
Today, only a few of the mighty ceraels remain a serious fixture in children's television culture. Trix are still for kids, Lucky the leprechaun is still hopping around to confuse and annoy our children as we were once annoyed when we were children. Cocoa-Puffs remain one of the mighty heavy hitters in children's programming to this day. That brown bird has been "Cuckoo for Cocoa Puffs" almost as long as I've been alive. With that many sugar balls in him, he should be zinging off the walls every five minutes. He should also have been dead long ago of a brain aneurysm but cartoons don't really die do they?
Cocoa Puffs must be what Keith Richards from the Rolling Stones eats for breakfast!
"Quisp sprang from a noble cereal lineage. He was related to Bullwinkle the Moose, Rocket J. Squirrel, and Captain Crunch. All of these characters were created by Jay Ward and Bill Scott. Scott and Ward teamed up in 1959 to make cartoons in Los Angeles."
Quoted from Wikepedia
Tuesday, April 7, 2009
The World's Oldest Pilot

I am not a squeamish flyer. In fact, I love to fly more than almost anything. Even rough weather and landings in squalls, icy, wintery 'go arounds' and other near disasters are merely interesting curiosities to me as I watch outside the window of a jet or small twin prop in New England or the Caribbean, Florida or California. But the sight of this aging pilot getting on my plane and looking as though he were going to take the controls himself caused me to have a tiny moment of panic. He looked like somebody's grandfather who escaped from a nursing home during a Halloween party in which he was dressed up as an airline pilot!
As I boarded the plane, I stole a glance in the cockpit and was relieved to see the two duty pilots going through their pre flight check list. The stewardess welcomed me aboard and I turned and looked down to see the imposter fast asleep in one of the first class seats. His gold braided hat was tilted down over his head and his gold striped sleeves tucked underneath his crossed arms.
This elderly man was probably not a pilot anymore but was still plying his craft probably as a navigator or coordinator. The flight was a safe one and he was gone when I exited the plane.
The Devil's Breakfast

I paused, oversized spoon in hand, poised above the fried potatoes with bits of bacon scattered through the oversized chafing dish. Then I felt the Devil tap me on the shoulder and felt my coronary arteries holding on for dear life. A thin smile came to my face as my competitive spirit took up the challenge. The Devil whispered to me, "Hey, you're a doctor, you're a triathlete, you are in pretty good shape so....lets show this guy what a really serious breakfast is all about!"
I narrowed my eyes, grabbed a second plate, pushed a little kid aside and loaded up with all the deep fried animal products I could find and smothered them with eggs and cream cheese then I peered around and set my sights on....the waffle buffet. Four blueberry waffles with whipped cream and a pot of coffee later I was headed out convinced that I had set some kind of record for surviving the most toxic breakfast known to man. The Devil had moved on down the buffet line to whisper to another breakfast guest and claim another victim. I didn't care! I felt great!
It's not every morning you get to cheat death and have waffles to boot.
Wednesday, April 1, 2009
The Keith Conundrum

Keith Richards
There is simply no accounting for protoplasm.
We used to have a catch phrase in medical residency when we were signing over patients to each other at the end of each shift; we would refer to our sicker patients as possessing either good or bad 'protoplasm'. To a resident on call that phrase means that the doctor taking care of him or her for the last shift had a gut feeling about how the patient would fare for the upcoming shift. A typical summary might sound like this, "Mr. Brown should do okay for you tonight. His kidneys are in bad shape and he has just come off dialysis but he is good protoplasm so you should not get any calls."
We would all agree that the undisputed King of Protoplasm in the history of the world would have to be Keith Richards, guitarist for the Rolling Stones. Keith wakes up every morning of his life trying to think of a new way to introduce as many toxins as he can into his body. He has done this his entire life and still gets around the stage and navigates (although somewhat warily) his way through halls and rooms, his creaking lungs breathing in and out with complete disregard for his bodily functions and systems. There ought to be a medical journal dedicated just to the marvels of Keith Richards. He is a one man cohort.
Lesser men and women have crumbled after sustaining only a fraction of the abuse that Keith has subjected his body to. Kurt Cobain (drugs) Jimmy Hendricks (drugs), Janice Joplin (drugs and alcohol) all must bow from their heavenly (not-so protoplasmic) thrones to the Mighty Keith, their toxic cachectic god. Elvis came close to Keith but ultimately died (multiple drugs). Mama Cass avoided drugs altogether except for some pot and wine and still did not make it to 50 (ham sandwich). If we doctors were to develop a Protoplasm Scale we would put Keith at the top and Mama Cass at the bottom.
Medical Resident, "Mr. Brown is a 7 on the ProtoScale but look out for Mrs. Smith! She is a 2 so you better go right up and check on her."
There's no accounting for protoplasm.
Sunday, March 29, 2009
60 Minutes

In the famous college football game between Stanford and Berkeley on November 20th 1982, 'The Play' ranks among the most controversial and compelling football stories of all time. With four seconds on the play clock and poised to lose a key game to the Stanford Cardinals, the Bears recieved a squib kick and, won the game by completing five lateral passes and eventually scoring the winning goal. While the film footage has been viewed and reviewed thousands of times I am most impressed by what the Berkeley Bears coach said to his winning team after the game was over.
Coach Joe Kapp gathered his team in the locker room after the game and reportedly said to his elated players, "A football game lasts for 60 minutes, not 59 minutes and 56 seconds. The game lasts for 60 minutes." This statement is significant and I often think of it as a metaphore for the hardships that often occur in life. While it is too simplistic and naive to hope that patients suffering losses and struggling with disease could hope to draw strength from this phrase, there are moments when doctors need to help their patients rally and fight. Sports metaphores are often helpful in this regard because cheering for our favorite athletes and teams offers us a vehicle for self introspection and our heroes are often a source of personal pride.
The game of life does not end at 59 minutes and 56 seconds.
The game of life lasts for 60 minutes.
Click here to see 'The Play': http://www.youtube.com/watch?v=0fZCCAqoSwY
Saturday, March 28, 2009
Caravanserai

Recently, one of these organizations has decided to give something back to the volunteers and relief workers. This organization has decided to set aside a plot of land and build a retreat for their own aid workers and have offered this service to workers from other organizations. I hear that in the woods of New Hampshire a small farm or community will be developed solely to create a place of respite and a place to heal for the men and women who have given so much to others. Post traumatic stress disorder, nightmares, depression and family discord are often the reward these workers recieve for months and years of living among the poorest and most desparate people in the world. These workers often surrender any hope of living a normal life after some of their experiences and need a place to meet and regroup before heading out to live and work among the poor again.
A 'caravanserai' is a designated place where generations of Asian and African nomadic traders and travellers would stop and restock their stores, trade goods and share news of the road ahead. While we all need some type of place to go when the stress gets to be too much, those tens of thousands of invisible samaritans who live and work to bring hope, food and medicine to the refugees, victims of war, political instability and the economic hardship need a place of their own more than any of us. These workers see things and experience a level of human tragedy that we in America can only imagine. I for one am glad to hear about this type of resource to help support aid workers and I hope that this effort on their behalf leads to more support for their important work abroad.
Photo: S. Butler: Beersheva, Israel 1980
Friday, March 27, 2009
The Daddy School

The New Dad's daily schedule and curriculum of classes will look something like this:
8:00am: Speed Diaper Changing 101
8:30am: Coffee Break (and call home to see how your wife is doing).
8:45am: "Goo Goo, Ga Ga" -Basic Communication Skills
9:00am: How to Power Nap
9:15am: Power Nap Practice Session
10:00am: Coffee Break (and call home again).
11:00am: Exercising with Your Baby (former title; Basic Rough Housing)
11:30am: Sports, Fighting and Aggressive Posturing
12:00: Lunch (and call home again).
12:30pm: Daddy Fundamentals -
Compassion and Respect for the In Laws
Goofy Faces and Other Stress Relievers
1:30pm: How to say, "Yes Dear" (like you mean it) with practice time.
2:30pm: Baby Culture Sessions:
Stroller Etiquette - Tricks for Going Uphill and Downhill
Pacifier Sharing - Learning How to Spot the Sucker.
Ketchup for All Seasons - The Perfect Food Group
Vegetables are Our Friends - Mr. Broccoli and 'Here Comes the Airplane!"
Professor the Messer - a symposium on baby food flinging techniques
3:00pm: 'Drool, Pee and Poop' - Bodily Fluids and Their Hidden Dangers
3:30pm: How to Shop for Groceries
A Guide to Searching the Entire Store for One Lousy Item
4:00pm: Homework Assignment, Evening Prayer and Dismissal...then call home...again.
5:00pm: Drive home to begin the evening shift but bring a coffee for the road to stay awake.
Saturday, March 21, 2009
Rasta La Vista, Baby!

Stepping off the plane on one of my visits, I would be absolutely enchanted by my nut brown little girls scampering towards me with their little sandals and platinum blond hair hugging me tightly and squealing, "Daddee! We miss yoooo!" Those days are thankfully over and we have been all together again for several years back home.
If Bob Marley were alive today he would probably have smiled and nodded in appreciation at how his music and culture still impact visitors and island experiences. Rastafari are a small group and are marginalized in many Caribbean cultures but to my little family for those months these men and women were always kind and thoughtful towards us during our long, hot, sleepy visit to a beautiful leeward island.
A Job Well Done
Bill Belichik - Head Coach of the New England Patriots
"We could be heroes, just for one day."
Heroes - David Bowie
As a husband, father, brother, son and doctor I have had to come up with a way to compartmentalize my life so that my day can run smoothly and all of the tasks and projects can be completed efficiently.
Job: My 'job' can best be described as the way I choose to conduct my life. My job in life is to be; healthy, be a good husband and father, to be productive, creative and to basically look out and protect my physical and emotional health for the longest time possible. This is the most important category because if I do not conduct the fundamental aspects of my life in a healthy way then the other two parts of my life will not work. My 'job' includes; exercising, eating correctly, sleeping soundly, taking time to laugh, spend time with my family and cultivate meaningful relationships.
Business: My 'business' is running my medical practice every day. This is what I do to generate income for my family, and it is where I work closely with other people. My business is what I do every day in the community that require people skills, management skills and conflict resolution skills. The business is the venue where I practice my profession and spend capital I have built in the life that I have created by doing my 'job'.
Profession: My 'profession' is to be a medical doctor. This required years of study, sacrifice and comittment to achieve. Now my 'profession' requires daily practice and dedication to constant learning and development within this complex and demanding line of work.
Thursday, March 19, 2009
Shut Up and Eat Your Snowshoes!

Madeline Kahn
Many films and television shows are created to be funny and I often think that visual media is how many of us experience humor. When you are tired of watching TV and are ready for a good fun read, I have a book for you. 'Shut Up and Eat Your Snowshoes!' by Jack Douglas is long out of print but this guy was a comedic genius. Douglas was a sought after writer in his day for the Jack Paar Show. He had traditional Japanese wife named Reiko and together, they bought a home in the snowy wilds of Canada. If you are familiar with the television, radio and film celebrities of the 1950s you will recognize the cast of characters that parade through the home in search of cocktails, broads and a swingin' swell time away from the stress of Hollywood and New York. The next time you are tired of watching 'Family Guy' and 'The Simpsons' on TV see if you can get a copy of this book and sit down for a good old fashioned belly laugh.
Tuesday, March 17, 2009
Be Brillig!

Jabberwocky, Lewis Carroll
This famous poem has been studied, dissected and analyzed for years in high school english and college english literature courses. The poem is loaded with nonsensical words and phrases that nontheless paint a picture of the legendary mythical monster and describe the fear and terror of the beast in vivid (if abstract) detail.
Fear of the unknown is one of the most powerful and crippling forms of terror. Fear, anxiety and panic are thought to be neurochemically driven responses that are encoded in our DNA as a survival mechanism. It has been said that the body retains no memory of pain. We can recall pleasant times when we felt relaxed, calm or secure but to call up an accurate memory of physical pain is difficult. Ask a mother if it is easier to relive the pain of her baby's delivery or remember the feeling she had watching the sun set from the deck of a cruise liner she was on many years ago and she will recall the pleasant memory much faster. Fear, has an achilles heel.
To me being 'brillig' is to be on guard, to draw a deadly weapon, wait calmly for an attack and to be the first to strike when the monster lunges. I don't know if it is an adjective or a noun. I don't really care (and neither did anyone else in my high school english class). The poem is still a classic.
Never mind the mome raths!
BE BRILLIG!!
T'ween and Teen Media

Years ago, Walt Disney approached his stories about tweens by featuring orphans as the lead characters. Films like, 'Pollyanna', 'Toby Tyler', 'Tom Sawyer' and even, 'Cinderella' placed the orphan in a unique position in society and allowed spectacular and even unbelievable adventures to occur because there were no invested adults to interfere and no family structure to foil the plot. The orphans could get away with things that kids with parents could only dream about but Walt was always careful to show the lonliness and self doubt that his characters felt.

My kids watch two television shows in particular that feature tweens who have very busy, uninvolved parents and who have virtually no supervision in school or at home. Shows like 'Zack and Cody' and 'iCarly' casts boring adults only as fumbling, babbling idiots who have no insight or experience and offer nothing (even a coherent conversation) to the child actors. The plots of these shows feature the kids solving their own problems in spite of the interference of the adults around them. The kids feed themselves, get themselves to school, call each other on their cell phones and put themselves to bed often for days on end without an adult in evidence.

Even Mr. Rogers is trying to channel the Children's Television Workshop (and his focus was on very young children).
In the book, 'Strong Fathers, Strong Daughters' by pediatrician, Meg Meeker, MD, we are advised to have a very involved role in the lives of our children right up through the teen years because teenagers "have not fully developed the ability to think reasonably and abstractly." When television marginalizes and downgrades the parent to further the plot, effectively causing the children to behave as though they really are orphans, a curious dynamic unfolds and the tween viewer envisions in the story the empowerment of self worth without paying the price of self doubt. In 21 minutes on a television screen chock full of ads aimed at blowing out their developing frontal lobes, kids rule and adults play the fool.
Mr. Rogers and Walt Disney are hopefully up in heaven right now negotiating a reincarnation.
Sunday, March 15, 2009
Medical Diet Review
"Among the 80% of participants who completed the trial, the average weight loss was 4kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. The diets improved lipid-related risk factors and fasting insulin levels. At 2 years, 31 to 37% of the participants had lost at least 5% of their initial body weight, 14-15% of the participants in each diet group had lost at least 10% of their initial weight and 2-4% had lost 20kg or more." The average calorie allowance for the subjects was between 1900-2500 calories per day throughout the two year study.
The results of this study indicate that we should all pay closer attention to our portion sizes and have an accurate count of the number of calories we take in each day to achieve meaningful weight loss.
Reference: New England Journal of Medicine, February 26, 2009. 360;9 pp. 859-873
Photo Credit: http://www.MyPhotoDiet.com
Saturday, March 14, 2009
Bungee Maestro

David Kirke
David Kirke is credited for creating the idea of bungee jumping. He and his friends came up with the idea to jump from a suspension bridge in North Somerset, England. One of the founding members of the Dangerous Sports Club while at a student at Oxford, he and his friends decided to try the idea out using elastic cords over a 245 foot drop. In April, 1979, while spectators looked on, Kirke, dressed in a top hat and tails and clutching a bottle of champagne did a back flip from the bridge and excecuted the first successful bungee jump in history.
Now 63 years old Kirke is proud of his idea and legacy for thrill seekers everywhere. On April 1st, the sport of bungee jumping will be 30 years old. If you are a regular bungee jumper your knees and back will feel 50 years old.
Reference: The Week. March 20, 2009
Political Muscle(s)

Obama is smart, professional, savvy and fit. Leading by example is the best kind of leadership.
Arnold Schwarzenegger look out. There's a new Terminator in town...and she wears a dress!
Friday, March 13, 2009
The Children's Time Zone

Let me give you an example. When children are babies, they spend all day in one spot and all of the care and attention are delivered to them day and night in one slow, drawn out sequence of events. Feeding, burping, changing, tickling, sleeping, laughing and crying occupy the baby's time completely. The parent is used to a different pace of life altogether. An adults life inherently has more stimulus and complexity. Adults need creative input, conversation, future plans, happiness, sorrow, sleep and so on. Adults in America are used to having more of everything and having it faster. Babies grow into children and their world broadens to puzzels, games, books and school. They are catching up but still occupy a relatively small space and are entertained by activities that often seem dull to an adult. After all, how many times can an adult do the same horsie or duckie puzzle without being bored even if we are sharing the wonder and amazement of our children?
We would all agree that life on a remote farm in the midwest has a different rhythm than life in Manhattan. The adult is sort of like the person from New York and when they have a baby it is like one long visit to the farm. Sure there are cows and corn and fences to fix but the adult misses the bright lights, the noise and the excitement of living in the city. Now that my girls are older, we can do more together as a family. Their lives have speeded up and become more complex. This may be why experienced parents with older children will often cringe at the thought of having a newborn child once theirs are older.
Even though raising babies and children is the greatest joy I can imagine, now that my kids are a bit older I am glad to be able to at least visit the city and leave the farm behind.
The Rand Corporation

“From each according to his ability, to each according to his need,” a scheme that resulted in enslaving the able to the unable. The first man to quit was a young engineer, who walked out of a mass meeting saying that he would put an end to this once and for all by “stopping the motor of the world.”
Quoted from 'Atlas Shrugged'
We are all in this together and if our elected and appointed leaders can't get us back on track then we all need to work harder and invest our time, vision and money in wiser ventures in the future.
Ayn Rand was born in St. Petersburg, Russia, on February 2, 1905. At age six she taught herself to read and two years later discovered her first fictional hero in a French magazine for children, thus capturing the heroic vision which sustained her throughout her life. During her high school years, she was eyewitness to both the Kerensky Revolution, which she supported, and—in 1917—the Bolshevik Revolution, which she denounced from the outset. In order to escape the fighting, her family went to the Crimea, where she finished high school. When introduced to American history in her last year of high school, she immediately took America as her model of what a nation of free men could be. Long an admirer of cinema, she entered the State Institute for Cinema Arts in 1924 to study screenwriting. In late 1925 she obtained permission to leave Soviet Russia for a visit to relatives in the United States. She spent the next six months with her relatives in Chicago, obtained an extension to her visa, and then left for Hollywood to pursue a career as a screenwriter. On Ayn Rand’s second day in Hollywood, Cecil B. DeMille saw her standing at the gate of his studio, offered her a ride to the set of his movie The King of Kings, and gave her a job, first as an extra, then as a script reader. During the next week at the studio, she met an actor, Frank O’Connor, whom she married in 1929; they were married until his death fifty years later. Ayn Rand lived from 1905-1982
Quoted from AynRand.org
Cartoon Credit: Lawrence Gilson