A good post call day

I'll have to write about the excitement at the end of my call night some other time. Today, however, was a good blogging day. I finished my shift a little after 0800 and went first thing up to the Marshall's in Marble Hill to look for a new shoulder bag since my old one, courtesy of my old violin teacher, Ms Morrow, is more than ten years old and showing its age.

At Marshall's I found several more good buys: new dress socks, a stove-top espresso maker for $9.99, a good-quality shoulder bag made by the makers of the Swiss Army Knife, athletic pants that are actually long enough without being wide enough in the waist to fit in two of me, and a pair of Timberland casual brown slip-on shoes.

I slept for a few hours at home before venturing out in the first winter storm, or Nor'easter, of the season. The mental image I have for Nor'easter is thick swirling flakes resulting in a gleaming blanket of freshly fallen snow. This, strangely, was not concordant with my experience of a slushy wintry mix that made the sidewalks slippery and produced a slurpee-like bog at the bus stop's curb. The most pleasing image from the "storm" was seeing small trees' spidery branches covered in a thin layer of clear ice.

After a little exercise at Columbia's fitness center, I met up with Lauren and Maurcio at 116th and Broadway, where we boarded the 1 Train to take us down to SoHo where we had hot chocolate at Jacques Torres. Mauricio and I had the "wicked" hot cocoa (spiced with chili pepper) and Lauren had the incredibly dainty espresso. I mentioned to her that I might feel annoyed if I'd ordered espresso and gotten the mere tablespoon's worth her cup held. Only then did I realize that she too was slightly annoyed with her portion size!

We wandered for an hour or so around SoHo and the West Village where we made stops at a cheese shop, the Magnolia Bakery, and the Chess Shop (see picture above) where Tyler, a friend of Lauren, was working. Only in NYC can you find a shop devoted to chess...and the rival Chess Emporium was just across the street! The Chess Shop, however, had a better atmosphere and a good-sized room with people playing chess for $2 an hour. It was the sort of place where one might pull out a pipe to smoke and was slightly run down, whereas the Chess Emporium seemed newer and more commercialized. The "Starbucks" of the chess world, if you will.

Mauricio came over for a light dinner of leftover zucchini soup, toasted turkey sandwiches, chips, and a Magnolia cupcake, and I got to spend the remainder of the evening tucked in bed reading and writing this post. Ah, the only thing lacking from the post-call day was a crossword puzzle...

4 8 15 16 23 42

Some numbers follow me in life. Take 113. My address growing up--113 Horseshoe Drive. Also the URL of this blog. It's one of my numbers. I also like 259, the number of the highway that runs north/south through my hometown of Kilgore, Texas.

One number that has recurred on multiple occasions is 352, so I'm officially embracing it as another one of my numbers. Its appearances are impressive:

• The prefix of my telephone number in the city where I went to medical school and internship
• My apartment number during internship
• My violin locker during undergrad at Baylor for four years

The violin locker has one of the more interesting stories. I was visiting campus with a friend of mine who was about to start grad school at Baylor. I took Jessica by the music building to show her my old stomping grounds, and eventually we wandered over to the music lockers. I knew, of course, which row my locker was on, but its exact location, five years after graduating in 2001, was lost to me. I pointed vaguely to a locker and said, "I think my locker was around here."

At this point, Jessica started laughing. I'd pointed to locker 352, but at that point she probably didn't know of 352's recurrences in my life. What she was laughing at was that there, next to the number, was a faded label with my name penciled in! After five years with surely at least two different occupants of the locker, no one had bothered changing my name on the locker. And now, a year and a half later as I remember the incident, it seems like there was something unusual within, perhaps a little plastic Mozart figurine or something of the sort.

So thus, the sequence begins: 113, 259, 352

Fun website

Are you a nerd? Do you like geography? Think you know the 50 states pretty well? Well, look no further. This website is for you.

Another OB story

Dr S, the chief of the obstetrical anesthesia division, has been promising to tell us the story about F.C., an interesting patient of his from several years back. He didn't have the time today to tell us the story, but instead related another interesting anecdote.

The day started normally with a couple epidurals for women in labor, overseeing a cesarian section, the usual. He was called to one of the labor rooms with another epidural request. When Dr S walked in, however, he noticed the patient lying stark naked in bed, in labor. A little unusual, perhaps, but nothing too remarkable. After all, patients are very frequently naked in the operating room, though we try to keep at least part of them covered when they're awake.

The vibe here was different. Dr S soon picked up on why when he looked up and saw the patient's husband sitting in the chair beside the bed...also completely naked. They were evidently the "crunchy granola types" and preferred the "natural approach." (Why they were in a top-tier medical institution requesting an epidural rather than squatting at home on the kitchen floor with a bucket of warm water, a pair of gleaming scissors, and some fresh clean towels, I cannot say.) After taking a moment to register the situation, Dr S regained his cool and explained the process, benefits, and risks of an epidural to the patient, who wished to proceed.

As if that weren't weird enough, the story doesn't end quite there. The patient then requested that Dr S remove his clothing before he placed the epidural. This was part of the" natural approach."

This led to a series of musings:

• Hospital policy does not explicitly require that one wear clothing while placing an epidural. It does require gloves, a hat, and mask, though. Would the family object to the hat and mask?
• What, if any, extra documentation would be required? "Patient identification confirmed. Risks, benefits, and alternatives discussed. Consent for epidural obtained. After proper hand hygiene and removing my clothes, the patient was placed in the sitting position. Sterile prep and drape..."
• Was the husband sitting on a towel?
• Where would one put one's pager?

In the end, and probably in part because of the multiple quandaries raised by the circumstances, Dr S told them no, he would remain fully clothed for the epidural.

Epidural hubris

So I just finished doing a combined-spinal/epidural on a woman who has had scoliosis of her back repaired. The usual risks of neuraxial analgesia--inadvertant dural puncture, headache, difficulty placing the catheter--are all greatly increased in patients with a history of back surgery.

This patient was in the hospital last week for induction of labor, but when the obstetrical anesthesia fellow wasn't able to place the epidural, the patient was sent home.

She came in tonight in spontaneous labor, and again requested an epidural. This time I was on duty. And can I say that--*boom*--one one attempt, the spinal was given and the epidural catheter threaded easily!

On this note of success, it's now time to hand off the primary pager to Todd, my co-resident who's been sleeping peacefully for the last few hours, and it's my turn to hit the sack.

Three delightful findings

Every day, no matter how much I'd like to forget it, has its bright spots, like getting to enjoy the snow flurries through the window this morning for about 5 seconds. Here are a few more from today:

• In the September 22 edition of The Economist I ran across a review of Alan Greenspan's new book The Age of Turbulence: Adventures in a New World. Evidently, not everyone would naturally look forward to encountering this 530-page tome: ...nobody ever accused Mr Greenspan of being a lively speaker, let alone a born storyteller, and no reviewer could approach this volume with anything but a heavy heart and a sense of duty.
• From the same review, Who would have guessed that 500 pages in Mr Greenspan's company could slip by so easily?
• And finally, reading in amNewYork I ran across an article about possible subway fare hikes by the MTA. Obviously, most riders are opposed, and there were public hearings provided for them as a forum heard by the MTA board. Some, however, doubted the efficacy of their testimony in convincing the board and yet chose to testify: "I told my co-workers about it [the public hearing], and they said it was like spitting in the wind," said Sahre Davis, a receptionist and community college student from Greenpoint who also testified at a hearing. "I'd rather spit, because I know it will land somewhere."

Day of stress

I'm not a big fan of days like today. Not only was it the first day of a new rotation for me (obstetrical anesthesia), but it was also my first day back from a two-week vacation. This is the first time I've had more than one week off at a time since I graduated from medical school. The longer break was nice, but I knew it would be tough coming back to work.

It was tough to get out of bed to hit "snooze" on my cell phone at 0450. It was tough to go back to sleep, so I just got up after lying there a few minutes. It was tough to stay warm at the outdoor 125th Street station as I waited 30 minutes for the 0539 train which never came. It was tough to change in the locker room since I'd forgotten my combination. (All I could remember was Uncle Paul and Aunt Betty's shed's combination. That'll teach me to offer to rake the yard!)

And then I showed up to the labor and delivery floor where the stars, misaligned as they were, had three--and only three--anesthesia residents showing up for their first day of OB anesthesia. My assignment was the toughest, at least from my perspective. As the resident covering labor and delivery, I received any calls from the OB residents requesting epidurals, evaluated patients for epidurals, placed epidurals, and followed up on epidural patients. (Notice a theme?) I was also the first person called for emergency c-sections, which I would then coordinate with the residents covering the OB OR's. Then there were follow-ups from the day before, and the ordinary confusion of learning new paper work systems, new places to get medications, new kinds of medications, new mazes of corridors and rooms, new nurses' names, new obstretricians' names, and different ways of documentation.

And finally, placing my first few epidurals in OB was not a small source of stress. I'd only placed 4 or 5 epidurals before, and the technique is trickier than doing a spinal since a catheter has to be threaded. In addition, there is the constant danger of pushing just a millimeter too far and puncturing the dura with a large-bore needle (a "wet-tap," colloquially), leading to a severe headache for the patient, frustration for my attending, and embarrassment for me.

While placing an epidural in one particularly obese patient on whom I had trouble locating any landmarks, I thought my needle might be against bone at one point of the procedure. "Just a little more pressure," I thought. With that, the needle leapt through the rather crunchy ligament its tip had been buried in and landed a few millimeters deeper. The tension emanating from my attending who was standing at my side was palpable. I withdrew the stylet...no gush of cerebral spinal fluid! The stars had shifted, Fortuna's wheel was spinning, the Fates smiled upon me. The needle was in the perfect place. I wasted no time in threading the catheter and getting out of there!

I was mentally exhausted by the time I walked in my apartment at 1700. Even though I'd only worked a little over nine hours, the constant multi-tasking and the newness of it all was draining. Given that most people really like their OB anesthesia experience, and given that most of the stress was learning the new system, I think things will get much better quickly. Before long, things will probably take half as long as they did today. We shall see by the end of the month how my perspective has changed on OB anesthesia.

The marathon completed!

So the marathon is over! Last weekend was a good one. I got several hours' sleep on call Friday night, and by 0900 Saturday I was heading to Midtown to catch the Chinatown bus to Washington DC. (The Chinatown bus enterprise has expanded to include departures from Midtown which is much more convenient for me.)

It's always an experience to ride these buses, which provide a $35 round trip between NYC and DC. One looks for a small crowd of people with bags (usually six or eight people if one arrives ten minutes early) waiting on a streetcorner. It's important to verify with at least two others who speak English that all are waiting for the same bus. At the appointed time, or even a few minutes early, a white, generally unmarked bus will round the corner. At this point, people come out of the woodwork to fill the bus. I'm always impressed with how a group of ten people expands to sixty when the bus pulls up!

On arriving to DC after a thankfully uneventful trip, I descended to the Chinatown Metro station and stood a few minutes baffled by the array of ticket choices. It seems one pays based on the distance traveled, rather than a flat fare as in New York. It's necessary to save the ticket to exit the Metro as well. I decided on the all-day pass for $6.50 and walked to my train.

The Metro, I must say, was eerily clean and quiet. It reminds me much more of London's Underground than of the Metro system's older domestic cousin a couple hundred miles to the north. The trains glide up to the platform as soft red lights flash along the edge, warning the absent-minded straphanger stand back for the approach. The stations feature huge barrel-vaulted ceilings reminiscent of New York's 168th Street station, only newer, cleaner, and starker. On board the carpeted train, I saw two people, at once, stand and insist that a woman with a toddler take their seats. (Have I changed so much after 16 months in the city? Have I grown so callous, so aloof? My feeling is that if there is as little as one open seat in the car, the young mother can take that one and seat the child on her lap. No reason to give up MY seat!)

Alison lives off the Cleveland Park stop on "The Red Line." I was amused hearing the locals call the lines by their respective colors on the Metro map. In New York, tourists are easy to spot as they wrestle with maps in blustery Midtown, ride pedicabs through Central Park, or career* through the streets on double-decker buses. But an even surer way of being nailed as a tourist is to call the 1 Train, "The Red Line," or refer to the 4,5,6 subway as "The Green Line." Silly Washingtonians! To be fair, I guess they have no need to differentiate between express and local lines.

Alison's neighborhood was charming. She lives in a four story renovated building just a couple blocks from the Metro stop. The walk their takes one past cafes with sidewalk seating and an old two-story firehouse. She parks her silver convertable Mini Cooper in a dilapidated brick stall off the alley, and her granite-countered, wood-floored apartment is home to two cats, one if which is probably the fattest I've seen.

I left my bag at Alison's before meeting up with Adam & Ashley, and friends Ernest and Sharon back downtown. We rode to Ernest and Sharon's house in Arlington where we rested for the afternoon. Adam, Ashley, and I watched college football and dozed in front of the TV while Ernest and Sharon attended a Halloween party. Since it got late, I crashed on the living room couch for the night rather than spend an hour trying to get back to Alison's.

The alarm clocks rang early the next morning! We parked near the Pentagon and joined the throngs of runners and well-wishers in the march around the gigantic building under the cool, pre-dawn sky. After a long wait for the porta-potty and a generous application of anti-chafing lube, Adam was ready to begin.

Adam and Ashley before the race.

Adam and his cheering section. From left, Sharon, Ernest, Ashley, Adam, and Jonathan.

The starting line. It took at least fifteen or twenty minutes for all the runners to pass through!

The first stretch!

We waited for Adam at mile 9, but somehow all four of us missed him! And that, in spite of real-time tracking available online: Adam's dad would call Ashley periodically with updates; the service also will text-message cell phones with updates on the runners' progress. Sadly, we weren't able to see Adam again until the finish line. Here's his final approach:

Wearing a medal proudly!

I didn't have too much time to hang out afterward; the others dropped me off in Chinatown for me to catch the bus back. As I waited, I ran into Becky and Carolyn, two friends from Baylor who both then went to church with me in Dallas. Becky lives in Washington now, and Carolyn was up visiting her.

It was a fun, but tiring, weekend. I arrived at my 125th Street station around 2200. It was somehow comforting to be back to the density, the noise, the dirty, screeching subways, and the cool night air of New York City.

Congratulations, Adam!

The Marine Corps Marathon

Most of my regular readers know that I've been training for the Marine Corps Marathon for several months. The big day is Sunday, October 28, in Washington DC.

I'll be there, but I won't be running. Since I've been out of the world of blogging lately, I haven't had a chance to update the blog about my knee injury sustained in late August. I went out for a 12 mile run one Saturday and felt fatigued throughout the entire run. I also noticed my hamstrings seemd a little tight.

After only 6 miles, I was feeling so fatigued that I cut the run short, and around that time I noticed a little aching in my knee. "Nothing to worry about," I thought. "A little ice and ibuprofen will take care of everything."

Not so. The pain got worse, and for the next few days my knee hurt with nearly every step. I took two weeks off and then ran another short 6 mile run on a soft surface, and the same thing happened.

Given that I'd had knee problems five years ago, I decided it was wisest to bail on the marathon, which was fairly disappointing given that I'd come so far. My long runs were up to 16 miles, and I was beginning to consider a brisk 8-mile run "short."

I attribute the knee injury to less than ideal training leading to inflammation. I was working in the ICU at the time, and I'd been doing long runs on the weekends without doing as many short runs during the week since I was so busy. The key to successful training, however, is a gradual buildup in both long run mileage as well as total weekly mileage. Perhaps since I wasn't giving my joints the mild stress of short runs during the week, I didn't benefit from the strengthening they would have provided and therefore became injured when I attempted my longer runs.

In any case, my medical school friend Adam is now in Washington DC from Texas to run the marathon, so his wife Ashley and I will cheer him on! Most immediately, I have to pack after a night on call and make it to the Chinatown bus pickup spot in Midtown in the next 45 minutes!

Mavis' birthday

On Saturday, October 20th, a few friends and I drove an hour upstate to Bear Mountain for a picnic and hiking trip in celebration of Mavis' 29th birthday. The weather was perfect, the sky sunny, and the leaves were just starting to change.

Here's a picture of the five of us that climbed into Mavis' little Corolla for the day: Jonathan, Gloria, Mavis, Mauricio, and Clay.


A view from close to the top. Strangely my first thought was that if this were the view from Washington Heights, about how far away would the Empire State Building be?

Looking down at the park area where we first arrived. We picnicked by the small lake in the lower left-hand side of the picture. Nearby was a German festival. The river flowing from left to right in the picture is the Hudson.

On the way down, we noticed 4 or 5 deer that seemed to let us get very close. This one was looking directly at me, but then turned her hed just as I snapped the picture. She must think she looks better in profile.

I power Blogger

So I've added a couple new elements to my blog format. You'll notice a list of labels in the right-hand margin. Starting this summer I've begun categorizing the posts, so if you're writing a biography of my life and you're writing a chapter on my exercise and reading habits, it'll be easier to find posts that pertain to those topics. Alternatively, if you're just a crazy stalker and you want to know what parts of town I can usually be found in, just click, "Around town."

As a side note, this was suprisingly easy to do. Back when I had a counter in the older days of Blogspot, I had to add it by copying html text form another website and then combing through what seemed like hundreds of pages of densely-packed html code before, by trial and error, I could find the appropriate place to paste it. The improved Blogspot is much easier. It features a schematic of the format in which I can simply click and drag to rearrange elements, and adding things is a snap.

Also, at the bottom of the page is a new logo. Rather than cliched slogans like, "Powered by Power Bar" or "Powered by Intel" or "Powered by Cold Fusion," I like the spin on this one. "I power Blogger." That's right. What would Blogspot be without people like me?

In the same vein, I smile every time I think of Stephen Colbert's new book, I Am America: And So Can You.

Two thoughts for the day

Thought 1: New Yorkers are surprisingly patient.
There are normally four large elevators that carry passengers up from the subway far below ground at the hospital's stop, though today there were only two functioning. When I came in at 0900 this morning (after being at the hospital late last night on "short call"), there were hundreds of people waiting in the narrow hallway and the underground bridge over the tracks, just waiting for an elevator. For such a fast-paced city filled with power-walkers in business suits and streets made cacophonous by blaring horns, the faces I saw in the crowd were strikingly pleasant and patient. There was no pushing, no rude comments, no rolling of the eyes. People seemed to quickly assess and accept the situation, and then patiently wait their turn for the large metal freightlike elevators.

Thought 2: I saved someone's life today.
Since I was assigned to come in late (0900) today, my task was to write post-anesthesia notes on yesterday's patients and to respond to cardiac arrests and stat intubation requests. We went all day without a single peep from the arrest pager until about 2:45. The first year anesthesia resident had just beat me to the medical ICU, and we quickly assessed the patient. 60 year old with pancreatitis and worsening respiratory distress. No significant cardiac history. High potassium. Although his blood gases, when last checked, were okay, at a glance I could tell that he was quickly heading to decompensation.

I'd been to many "stat intubations" last year, but this was my first time to be a senior resident and to direct my new anesthesia colleague! We gathered our equipment: larnygoscopes, breathing tubes, oral airways, CO2 detector, and arranged for a free-flowing IV and suction. After applying monitors (there were none when we first arrived since the patient had just been transferred from the floor!) and preoxygenating, I gave repeated doses of propofol until the patient was adequately relaxed with intermittent doses of phenylephrine. I wanted to get the patient deep enough so we could intubate without paralyzing him, since his high potassium meant we couldn't use the very short-acting drug succinylcholine.

This we were able to do. The first-year resident took a look with the laryngoscope while I applied cricoid pressure. I could feel the tube slide through the larynx, and we quickly inflated the cuff and checked for CO2 return and breath sounds as we squeezed the bag. Success!

This was followed by the anticlimactic job of some rather vague and broadly-brushed charting. "Good job!" I told Lynn as we headed back for the security, order, and comfort of the anesthesia lounge. And then I realized that not only was it exciting to be the senior and directing the emergency proceedings, we just potentially saved this man's life as part of our day's work! I'd say it was a good day.

Another post-call day

I've missed the world of blogging, and evidently some of my readers have missed my posts! I got several hours' sleep on call Sunday night, so after a satisfying nap on my new couch yesterday morning, the day was mine to enjoy. I started by doing laundry at nearby Bubbles. On the way back, however, I discovered some workmen doing some welding and installing marble slabs on the new prefabricated metal stair frames that were recently put in, so I dropped the clean laundry off at Ezer and Jan's (they live just a block or so away from me) and suggested Jan could do some ironing if she didn't have much else to do.

I did a little fun reading at the open-air Max's Cafe on Amsterdam while sipping a caffelatte and enjoying a italian tuna and garbanzo bean salad on arugula. Then it was off to Columbia for a structured library environment to do some anesthesia studying.

After a productive hour and a half or so, I walked home, made an omelette for dinner, and got ready to go to the opera with my roommate Jordan, who had complimentary tickets and had invited me earlier that afternoon. More about this on my planned "Jonathan's Month of Culture" post, but I thoroughly enjoyed the Metropolitan Opera's new production of Verdi's MacBeth. I think that after I move from New York City down the road (assuming I do), I'm going to miss being able to catch a musical or an opera on the spur of the moment.

Jonathan reenters the world of blogging

Armed with my lap-top, a guilty-pleasure Mary Higgins Clark mystery, and today's crossword puzzle, I made my way this evening to nearby Max's Cafe near the corner of 122nd and Amsterdam for use of their free WiFi internet. When my sister and brother-in-law, Shelley and Chris, came to visit recently, they told me about the internet connection. Since I've been in my new apartment for nearly a month and still don't have internet, I thought I'd take advantage of this luxury afforded by this "Central Perk"-like establishment.

As I sit near the huge open windows looking out on the sidewalk seating, I'm not sure if it's the end of summer or the cusp of autumn. The ever-so-slightly cool breeze, the night air, and my hot caffelatte make me favor the latter. Here, the young gather to read, talk, and drink. If they smoked, one might confuse it for Paris.

My evening was a mellow one. After arriving home around five o'clock, I made some split pea soup with plenty of grated carrot, onion, pepper, and garlic and enjoyed it with a glass of smooth merlot and a leftover skirt steak. This was followed by a quick call to my attending for tomorrow to discuss the planned thymectomy and mediastinoscopy, as well as thirty minutes of leisurely violin playing.

As for my blogging, never before have I gone a full calendar month without a single post. As has been my habit of late, I will probably post a few retrospective posts in the next week or two to highlight some of the more memorable happenings of the month of August and early September. I will mark these titles with an asterisk on behalf of the diligent and thorough reader.

And thank you, readers, for the comments of encouragement. Thanks for staying with me, DO, MG, EK, et al. Hope you enjoy the read, and good night.

Calm before the storm

As my regular readers can probably tell from my flurry of posting this week, working nights covering the Pain Service has afforded me both some sleep at night and free time during the days. It's almost like a vacation where I stay in the city and can catch up on things (house cleaning, grocery shopping, laundry, packing, signing the new lease) that can be difficult to do during a normal week. I appreciate this, especially since I have eight busy weeks ahead of me working in the ICU and doing cardiac anesthesia, two subspecialties I am particularly interested in.

I worked Monday through Friday nights (1900 to 0800), and then was off for 24 hours until Sunday morning. Today I'm working a 24 hour shift before reporting for duty in the ICU at 0700. The day has been filled doing little things like adjusting patient-controlled analgesia orders, pulling out epidurals, checking on a patient whose epidural accidentally came out while her blood was anticoagulated (we wanted to make sure she didn't have the potentially devastating complication of an epidural hematoma), and adjusting an overly confused and somnolent patient's medications. (Oxycodone is worth a shot to minimize unwanted side effects.)

Yesterday was a good day. After coming home, I quickly changed and went for my long run in Central Park. Two loops around made as 12 mile run. The first loop was done in 52 minutes (what I felt was a gentle pace), and the second loop, though I felt I pushed harder, took 55 minutes, bringing my total time to 107 minutes including water breaks. I'm not unhappy with this time, though I would like to work toward eight-and-a-half minute miles. And given the warm, humid weather, this was a good chance to practice disciplined hydration. I noticed that chugging six or seven gulps of water every couple of miles makes a big difference.

Because I've worked up a little more gradually to this long run (compared to the half-marathon I did in April), I believe it was a little easier on my body. Sure I was sore afterward, but I didn't feel as much of an old man as I did after increasing my distances very quickly. I'm beginning to appreciate the wisdom of training carefully to avoid injury.

And lastly, a quick update about my black runner's toe. I will spare those with a more delicate constitution a picture. Evidently it is common for runners to develop bruising both under the toenail and at the very tip of the digit. Most often, it is caused by shoes that fit too snugly, though increasing distances too quickly may also contribute. Both of these factors may apply in my case, since I tend to buy shoes that fit well. At one point, I was worried I would lose the toenail on my right second toe since it lifted as easily (and painlessly) as one might lift the hood of a Chevy. However, the brusing seems to have healed a bit over the last few days, and the toenail is reaffirming its grasp on the little fleshy nubbin.

The rest of the day was spent packing, going through paperwork, and in the evening Mauricio brought a movie over: Wes Anderson's Rushmore. I fed him one of my Trader Joe's BBQ Chicken pizzas, leftover salad, broccoli, and pineapple juice. (Mauricio really likes juice, I have discovered.)

My welfare check doesn't cover the iPhone plan

Soapbox alert: This post has a deceivingly fair and balanced beginning.

Sorry for yet another post of socio-political musings, but at least I came up with a somewhat interesting title. The thought has crossed, and continues to cross my mind that the richer America has become, the more its citizens expect as a fundamental standard of living.

Perceptions about a "basic" standard of living (is this term redundant?) are affected both by time and space. Air-conditioners, weekly (or daily) fast food, cable television, cellular phones...these are all things that fifty years ago would have been considered amazingly luxurious (if they were even around), but are all things that now, I suspect, can easily be had with a typical welfare check. Even moving from Texas to New York City where the cost of living is much higher, I notice people doing without (no car, no air conditioner, no spacious apartment, no dishwasher, no in-apartment washer and dryer) and not complaining about it. Granted, unless you happen to live on Central Park West, these concessions are out of necessity. But the point remains that just as in this time period, geography factors into basic standard of living, so too within a set geographical domain (the United States), the time period affect the expectations of standard of living.

As a side note, looking historically just a generation or two will show our grandparents doing with less sugar and fewer pairs of pantyhose during World War II in order to focus our nation's resources and attention to where they were needed most. The idea of going without, however, is entirely unknown to Generation X'ers like me. Like it or not, we've been fighting a war for the last four years in Iraq, but our standard of living has changed not one bit. True, this probably reflects a richer country, but it also means that societal economic sacrifice is about as foreign to me as sacrificing a goat at city hall.

But should time and geography affect our perception of whether we are barely getting by or whether we have an abundance? The poor in Africa are just as poor today as they were in 1950. The rich here are far richer. So should the poverty level be an absolute (food, clothing, shelter) or a relative index? I think I could argue effecively either way, but perhaps it should be both. Or one tempered by the other, if that makes sense.

In other words, the thought that a family can afford an SUV, cable television, a couple cellular phones on a family plan, year-round home temperature regulation, monthly movie tickets, and weekly (daily?) restaurant visits, but cannot afford basic health insurance is absurd, especially when viewed from the historical and geographical perspectives I mentioned above. Anyone who can afford all of the above is incredibly wealthy both historically and compared to all people living today. Hence, this situation is not one of wealth versus poverty, but one of wise versus misplaced priorities.

I want you to remember this the next time the discussion of universial health insurance comes up, or the next time you're tempted to complain about the $20 co-pay for your visit to the doctor.

Thank you, Ganden Thurman

Not too long ago, I was read with interest this letter to the editor of the free daily amNew York:

U.S. deserves better health care
Our health care system and the health of the general population of our country are a disgrace--plain and simple. It's high time the government lived up to its constitutional duty to tend to "the welfare of the people" they are supposed to represent. Please grow up and tend to the issues at hand directly rather than blithering about such gross pseudo concepts such as globalization, privatization and capitalism. None of these abstractions has anything to do with our jobs, our country and its potential to become a more perfect union.

Ganden Thurman, Manhattan

Goodness, where to begin?

• I would argue that it is not axiomatic that the United States' health care system is a disgrace. By many measures we have a very effective and cutting edge medical system. (Anyone care to get an elective gallbladder done in Canada or Britain? That's right...you'll have to wait. A long time. That is, unless you have money to go the private route, I'd assume.) Yes, one might argue that the richest nation in the world should provide health insurance or coverage to every citizen. This is not, however, an inalienable right granted by our constitution, and I think its time we stop treating it as such. In other words, discussions about universal health coverage should begin, "Since we've progressed to where we are as a nation, let us consider as a society the advantages and disadvantages of providing universal health insurance to all citizens," not, "Our health care system is a disgrace."
• I might agree with you that the health of the general population is a disgrace. The difference, however, is to whom to assign blame. You clearly blame the government. I, from my humble 6 years in the field of medicine, blame the population. People who make bad choices and then expect the government to fix the problem are dead weight on society. If every American ate appropriately, exercised 30 minutes a day 4 to 5 days per week, stopped smoking, did not abuse drugs, drank alcohol in moderation, and followed his doctor's recommendations, I suspect that the Medicare coffers would burst at the seams. So perhaps that righteous indignation, sir, should be focused not on the government but on our societal sloth and excesses.
• "Welfare of the people." Constitutionally, this includes life, liberty, the pursuit of happiness, universal health insurance, cable television, and fewer dropped calls.
• "It's high time the government [took care of the people] they are supposed to represent." If you're going to write a letter to the editor, please proofread it, or at least ask a friend to edit it. A sixth grader should know that the proper pronoun for "government" is "it," not "they." (Sorry, I'm getting tacky here.)
• This is where it gets fun. The government is instructed to "grow up." Fair enough.
• "...[stop] blithering about such pseudo concepts such as globalization, privatization and capitalism. None of these abstractions has anything to do with our jobs, our country..." This makes me smile every time I read it. There's a story about an economist who visits China during Chairman Mao's regime. There he sees one hundred men digging a pit, while a backhoe sits unused. On asking why they don't simply use the backhoe to dig the pit much more quickly, the Chairman explains that then the men would be out of work. The economist replies, "Oh, well then if its work you're looking for, why not have the men dig with spoons?" The anecdote illustrates the difference between work and productivity, abstractions that have everything to do with our jobs and why our country is even at the place where we can talk about universal health insurance. People that don't grasp the difference between work and productivity, or between income and wealth, are the same people who think raising minimum wage helps poor people, that outsourcing hurts our economy, and that Wal-Mart has made people poorer, not wealthier. These are mindsets that, sadly, I cannot deconstruct in one post. But yes, Ganden Thurman, globalization and capitalism have everything to do with our jobs and our country.

Lone Star vacation

When I moved to New York City, the possibilities for little excursions seemed endless: a hiking trip upstate to see the leaves change; a train ride to Washington; taking the Fung Wah (Chinatown bus) to Boston; perhaps even a little getaway to Montreal.

Although I have gone to Philadelphia to see relatives a number of times, and I had a great time going on my own to London, most of my time off has been spent in Texas. This includes a trip in October where it seems every meal I spent with a different friend or family member, a week at Christmas, a conference in May, and most recently the final week fo my second year of residency.

Former-fellow-small-group-leader Bonnie & Scott's wedding. They chose flattering earth tones for the run to the getaway car.

Mauricio came to Texas for a few days. The last time he had been in Texas, he was in a terrible car accident, so this trip was better. I took him to the Mesquite Rodeo.

My second-favorite event at the rodeo: calf-roping. My favorite event was when the little five-year-old girls were released from the chute riding a bucking lamb.

A cute girl who was sitting in front of us.

I took Mauricio to the Sixth Floor Museum which is all about the Kennedy assasination. Afterward we had a drink up in Reunion Tower. Here's a view of Dealy Plaza from the tower. The School Book Depository (which now houses the museum) is the 7-story orange brick building.

I went down to Waco for a day with DO to visit our old roommate Clint, his wife Kristin, and 8-month old Luke. Reese, Jennifer, and daughter Madeline came over for dinner. Here's a picture of Luke and Uncle Jonathan.

And an older picture of Luke. (This is the paradox of photography: the picture is older, but in it Luke is younger.) His hair is very soft and fluffy.

You don't see this every day

I was impressed with this. The two-story carparks are common. Four is unusual. I suspect you'd need to call ahead, unless you want to wait an hour for them to get your car down!

Blank inside

A little cropping, a little black & white magic...and voila!

Morningside pics

I began taking pictures on my way to Morningside Heights. Somebody got the crazy idea to paint the fire hydrant. Spectacles like this reaffirm my respect for tradition and conformity. I don't care if it's "fun." We're all going to get sick of looking at it. Still makes for a good picture, though.

I'm proud of this shot. I intend to crop it a bit. It looks cool in black and white, the way the light plays off the many surfaces of the ironwork. Maybe I could make it into a greeting card. Probably one that starts off Blank Inside. Or perhaps a Late Birthday, since the iron curly-Q's fading into the distance could signify dejection.

Noooo, this isn't something from Transformers. It's the 125th Street subway station, nestled high up under the tracks. I think I won't love it in the winter as I stand on the open air platform waiting for trains.

Max SoHa's. (That's SOuth of HArlem) Very reasonably priced Italian food in a rustic setting.

Max SoHa's outdoor seating area. Utilized whenever the temperature is between 40 degrees and 95 degrees.

And now, here it is! My new apartment building is the one on the left. My windows are the ones on the third floor at the corner of the building. The tree in the foreground is across the street, but I included it in the shot to make it look more picturesque. On the ground floor is--I love it--Praise the Lord Dental.

This is the view out back. There were some kids playing baseball in this alley when I took the picture.

The view out front. This is Dustin's building. On the ground floor, obscured by the foliage, is another Italian restaurant with outdoor seating.

And lastly, a computer mass grave I stumbled across on Columbia's campus on my way to work out this afternoon. A little creepy.

Moving to Morningside

Today I signed a lease for a new apartment in Morningside Heights. I'm very excited about the move from Washington Heights. Although the new apartment is 50% more expensive and about 2/3 the size (making the price per square foot about 2.25 times as much), a true New Yorker will not forget the importance of location. We can deal with heaters that don't work, omnipresent roaches, noisy neighbors, and dilapidated fire escapes, but we need to be where the action is. Goodness, we live in Manhattan! If I wanted cheap rent, I would live in Queens. Queens, people! (n.b.: Here's a short interesting read on the term bridge and tunnel.)

So allow me, please, to sing the praises of Morningside Heights:

• Subway-accessible to work (10 minute ride on the 1 train)
• Park-accessible: The neighborhood is nestled between Riverside Park, Central Park, and Morningside Park.
• Food: Abundant places to buy groceries, from the common Met and corner delis, to the expansive and very reasonable Fairway, to the new and glitzy Westside Market.
• Eating out: Many great choices in this college neighborhood. I'd have to start by mentioning Toast. But there's also the Italian flavored Max SoHa's and Sezz Midi, casual dining as well as fast Asian cuisine, a nearby Cuban restaurant, Dinosaur Barbecue, Greek food, "Central Perk"-style Max's Cafe, even an Ethiopian restaurant and a couple Starbucks to boot. For coffee, however, I'm partial to the Hungarian Coffee Shop iover by the cathedral. (Don't drink the Hungarian coffee; it's terrible. Go with the Viennese coffee.)
• Exercising: The new apartment is only a ten-minute walk from Columbia's campus where I work out.
• Friends: Many of my good friends in the city live nearby, including Ezer & Jan and soon-to-be-born Simone, Justin & Wen, Mauricio, Mavis, Dustin. And Clay is moving with me. William and Katherine used to live a short walk down 122nd.
• Cultural institutions: Morningside Heights has perhaps more than any other plot its size in Manhattan. (That's right, I just made that statistic up.) But within just a square mile or so are Columbia University, Teachers' College, Barnard College, Manhattan School of Music, Union Theological Seminary, Jewish Theological Seminary, Riverside Church, and the Cathedral of St. John the Divine. This is no lightweight neighborhood. Lincoln Center is just another 10-minute subway ride away.
• Bookstores galore. You can find anything from Barnes & Noble to a corner used book shop. One of my favorite is Labyrinth Books which combines the best of all.
• Airport: Many people have a love-hate relationship with many things. However, nearly all New Yorkers simplify the relationship to just hate when it comes to airports. There's the wretched LaGuardia where it's surprising if the security line is shorter than 30 minutes and a shock if your flight leaves on time. There's Newark which costs an arm and a leg to get to. And then there's JFK. I think JFK is somewhere near the Hamptons. I can get to Philadelphia faster than I can get to JFK. But those are the airports we're stuck with, so as long as I have to go to LaGuardia, at least I'll be living near the M60 bus which takes me directly there.
• Church: My church meets at Union Theological Seminary, less than five minutes away. This will make it easier to have people over for lunch afterward.

Wow--I knew I liked the neighborhood, but compiling this list makes me even more excited about living there! The only thing it lacks is a Trader Joe's. I'll follow this post with some pictures I took of the neighborhood.

The blur that is ethics

This was a rather interesting article from CNN.com today. Although more likely to run across poems, anecdotes, and grammatical philosophizing as one strolls down Mulberry Street, sometimes the reader might encounter something a bit more complicated. In these cases, one should tread carefully, remembering that there are two sides of the street.

Take that to mean whatever you want. I found this article interesting since I remember hearing a different spin on the story a year or two ago after the hurricane. "Euthanasia" and "homicide" were terms more apt than "abandoned by his government." I don't mean to imply that all ethical issues are gray, but reading the doctor's perspective provided me with another occasion to imagine the sights and sounds of Memorial Medical Center in the aftermath of the post-Katrina flooding. (It was the fact that the city is built below sea level and that the levees could not hold the surge, more so than the actual hurricane, that did so much damage, if I recall correctly.)

In this sweltering hospital with no electricity and no operational pharmacy, patients languish and the staff is stretched thin in terms of both numbers and emotions. At the time, no one knows if help will come in a day, a week, or weeks. (Pre-Katrina, a week would have been inconceivable. However, now's not the time to discuss the politics of it.) Doctors and nurses are doing their best to take care of patients, night and day, that they may know little about. If the staff's suffering is difficult to imagine, how much more so that of the ailing patients.

The facts are that morphine and midazolam hydrochloride were given to some patients. This sounds like a very reasonable regimen for ICU sedation. The doses given, curiously, are absent from the article. In any case, I suppose the question comes down to one of intent: did the physician intend to kill the patients, or to relieve their suffering? The ethical dilemma stems from the paradox that actions based on divergent intentions may appear very similar.

In other words, a dose of morphine and midazolam that is necessary to treat a patient who is hyperventilating, anxious, in pain, or otherwise decompensating may lead to a fatal respiratory depression. Goodness knows that if the congestive heart failure exacerbation patients weren't getting their diurectics and ACE inhibitors (because, as I understand, the pharmacies were shut down), or if the septic patients were not getting their antibiotics, then there is no fine line between easing suffering and hastening death in these patients already on the brink. Rather, they overlap to the degree that there may be no difference, other than that of intent.

As I recall, the Hippocratic Oath does state that the physician shall not "prescribe a deadly drug..." To take this literally would mean that nearly no drug could be prescribed. After all, Tylenol is deadly in large doses. So is water. Coumadin (a common blood thinner) was developed first as rat poison. So what the oath is getting at, I believe, is the intention behind the prescription. Medicines don't treat patients; physicians do.

In this case I cannot make a clear judgement, other than simply to say that from the facts presented, I cannot disprove that the doctor intended only to relieve suffering. And I can also say that I noticed the author used the everyday term "morphine" but included the very technical "midazolam hydrochloride", the latter word being thoroughly unnecessary to all but the pharmacosynthetic chemists out there.

Subway singing

Can I just say how beautiful it is to walk home from the hospital at 0800 in the glorious 65-degree sunshine as the city wakes up? The puttering of the taxis and cars snaking downtown and the nearly palpable cheer of people basking in the brightness on their way to work stand in sharp contrast to yesterday's drizzly urban gloom. I, on the other hand, have a full day ahead after me after my night's work which consisted of a few calls up until midnight and then one lone call at 0545 this morning.

In the course of my blogging, I have referred more than once, I think, to Billy Collins' poem "This Much I Do Remember," a charming, short mediation on memories and their preservation. In the poem, he carries in his pocket "the small coin of that moment, minted in the kingdom that we pace through every day." A "perfect grape" of a memory would be appropriate, had he not already applied the metaphor to a haiku.

For the last few weeks, a little paper boat has been drifting through the current of my mind. It passes and is nearly forgotten, until, a few days later, the corner of my mind's eye catches a glint of white paper floating around the bend. This is one I don't want to forget; a paper boat I want to carry in my pocket, so to speak. Please allow me to share it...

The canvas was set as I rode the subway home late one evening. The nearly deserted car swayed gently on the tracks as the clatter of the wheels drifted to my ears. Corners were folded over and edges gently creased as I noticed a middle-aged couple sitting across from me: a white man and a black woman. I returned to my reading, as is my habit on the subway.

And then, gradually, over the hum of the clicking steel, I began to hear singing...faint at first, and then louder bit by bit. The woman was turned facing the man, singing something that can best be described as a jazz standard. Her eyes were closed, her face transfixed with an expression of pleasure as she tenderly held his hand in hers.

And he, lost also in the little world she created with her music, tapped a beat with his foot, the corners of his lips upturned in a peaceful smile. That was it: a slow, intimate melody with a simple rhythm. Her voice was sweet; quiet but intense. As a stranger, and especially as a New Yorker, I felt mildly embarrassed but happy to witness this personal moment late that night as we neared the 190th Street station. We all exited the car together, and they walked, hand in hand, into the darkness.

And now, kneeling beside the water, I will let this little paper boat sail away, knowing that one day, if I find myself again reading these words, I will smile as it passes me by once more.

Angel of the night

That's how I think of myself tonight. Floating eerily through the darkened quiet halls of the hospital. Nothing more, perhaps, than a faint shimmer of light in the mirror; a nebulous presence; the flutter of patient-controlled-analgesia forms that flip through the lonely chart at the abandoned work-station; the ominous chill up the nurses' spines as they sit in the curry-scented break room. For tonight, this very night, I begin my week of nights managing the Acute and Chronic Pain Services. I am here to relieve pain, to ease suffering, yea, to walk with dying souls to the very brink of death.

Well, okay, not that last part, but the rest is true. I show up at 1900 and take over the pagers from the day folks. My job is to see any new (and urgent) consults, to help with any issues that come up on the existing patients, to be a backup anesthesia resident for the regular OR call team, and to hope the pagers stay quiet. With any luck, I'll be able to keep my sleep schedule at nights and catch up on some things during the days.

The evening has already been interesting. I met Dustin at Soundz to celebrate his last day of his old job in the scheduling department of the Manhattan School of Music. (Just because I met him at a bar, I should note, does not mean I drank beer.) Tomorrow he starts in the recording/sound engineering department.

Prior to Soundz, I had picked up some bread pudding from Sarabeth's on 80th and Amsterdam to make good on a bet I'd lost to Dustin. (Sure enough, the still unfinished towers of the Cathedral of St John the Divine are not both shorter than the gabled roof. Why do I make this kind of bet? Why have I not learned? I still owe him a six-pack for a more recent wagered assertion that Baton Rouge is of course fewer than seventy miles from New Orleans. The actual figure is 81 miles, if mapqust.com can be trusted.)

The cathedral in an artist's rendition. I've seen a few variations on the web.

The cathedral more or less how it looks today.

Things haven't been too bad at the hospital. I wrote some patient-controlled analgesia orders for a patient. I also helped a fellow resident set up for and begin a cardiac case--a patient with a recent heart transplant and an aortic balloon pump was being brought back for a ruptured aorta. (I don't see why these things can't wait for morning.) This was pretty cool. He came from the ICU with a spaghetti bowl of IV fluid channels and about ten stopcocks in a row with various pressors and medications flowing in, and his beating heart was covered only by a thin layer of sterile dressing.

Not wanting to get too caught up in all that, I left at a convenient time and made my way back to the tranquility and unfettered internet access of the anesthesia library, my home base for the night.

Out of sequence posts

So for the last few months, I've been alerting my vigilant readers that I might post out of sequence as I attempt to catch up after a month of lackadaisical writing. I suppose there might be one or two souls out there who cling to every conjured image from my life; every play on words; every musing on puctuation; every mediation from The Economist;

• every
• bulleted
• list;

every lumbering sentence; every

~~~~~~last
~~~~~~~~~~~~ carefully
~~~~~~~~~~~~~~~~~~~~~~penned
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~letter.

For those souls (exist, as they may, only in my imagination) I've devised a new system. I will title my out-of-sequence post beginning with an asterisk*. With this system, the studious and compulsive reader may glance at the titles in the right-hand column and go back and read any with asterisks that he finds of interest. An advantage to this system is that I will not have to periodically write posts such as this one to indicate that I'll be doing some catch-up writing. Enjoy.

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* Because I fear that there may never again be a time again to mention it, I should remark that for the last fourteen years I have been unable to forget my eighth grade English teacher's (Ms Hanshaw's) pithy misquote of Nathan Hale: "My only regret is that I have but one asterisk for my country."

Potter-mania

It's striking how many people (nearly all adults) I see on the subway reading the final installment of the Harry Potter series. This is no ordinary book. At 750-odd pages and a distinctive yellow hard-back cover, it definitely earns the title of "Tome".

Perhaps even more interesting are some quotations I read this morning on CNN.com:

When I closed the book I was overjoyed and devastated -- overjoyed at the story, and the way it had played out, but devastated that the tale was complete," she said. "It did feel like a bereavement, like it was saying farewell to a long-trusted friend."

"J.K. Rowling does not disappoint; I thought she did brilliantly. It was terrifying; sometimes I was scared to keep reading on. I cried buckets," said Todd, 20, who lamented that "never again will I stay up all night reading a new Harry Potter book, or go to its midnight release party, or invent wild theories about Harry being the Heir of Gryffindor."

"That's it," she said. "It's all over. I feel like I just said goodbye forever to my oldest, dearest friend. All I can do is re-read, and in the future when I have children, I'll get to share these books with them. I look forward to that day."

~

The part that intrigues me is the literary-character-as-friend phenomenon. Perhaps it's not a defining mark of great literature (not all character-friends find themselves in great works, and not all great works have a character-friend), but I think it says something about the way people approach literature. For instance, my quick-reading/guilty-pleasure Mary Higgins Clark suspense novels end with my feeling little invested into the characters, but satisfied with numerous loose ends tied up in a clever way. As I mentioned in last year's post on Pride & Prejudice, however, Elizabeth became one of my early friends in New York City.

~

To my readers: any character-friends come to mind, other than the ones already mentioned in this post?

Running update

The week that just ended Sunday* was one of my best running weeks yet. I ran a total of 26.9 miles in three hours and forty-nine minutes. The sum comprises

• a 4.9 mile "tempo" run in Central Park (8:07-minute miles),
• a five-mile treadmill "hill" run (3-4% grade at 8:34-minute miles),
• a ten-mile "long" run along Riverside Park on Saturday (8:54-minute miles),
• and a six-mile "easy" run on Sunday (8:14 minute miles).

My easy run didn't turn out to be so easy. I found myself trying to keep a good pace and really pushed myself up Cat Hill just pass the Boathouse. Only a handful of runners passed me on the six-mile course which tells me my pace is decent. (One was bare-chested and wearing a heart-rate monitor, so I'm not going to worry about him.)

Runners' World magazine's online training log helps me keep track of my progress. One of the best features is an integrated google-maps feature that lets me plot my route, and the computer tells me the distance I ran. I suspect the ten-mile run was actually farther, given that the running path's multiple twists and turns are not well reflected on the route I traced along the Hudson River. In that case, my time per mile should be even less.

It might be a stretch, but I think a goal coming into focus would be to do the marathon in 3:30 hours, which would be eight-minute miles. I definitely have a lot of work to do between now and October 28. My friend Adam, who also happens to be running the Marine Corps Marathon, has made that his goal. It would be great to be able to run with him.

-------------------------------

* I usually think of Saturday as the last day of the week. I find myself disliking corporate calendars that start the week on Monday since it seems very work-oriented. My online training log, however, places Sunday as day 7. (Seems theologically appropriate for a day of rest, but I'm not sure that's what they had in mind.) Hence, my running week ends on Sunday.

Rainy Monday

Since I'm working nights this week, I don't have to go in until 1900. Unfortunately I'm not very good at sleeping in, so after tossing and turning for thirty minutes, I got up at 0700. The first order of business, in my slightly manic manner which is usual for a caffeinated weekday off, was to make an overly ambitious to-do list in my green spiral notebook in which I've been compiling to-do lists for nearly two years. (This spiral notebook is made even more interesting by my hand-drawn maps for various errands I attempt to consolidate on one outing. I find a map made beforehand helps drastically in planning an efficient route.) Realistically it will probably take a week to tackle all the projects on it.

After a few minutes of web research and a reasonable ten minutes of hunting, I located my well worn little blue social security card and my passport and took the A train down to 34th Street to the Express DMV. I filled out the appropriate form to exchange an out-of-state driver's license for a New York State one and inquired at the information desk which line I should get in for the license exchange. From the response I got, one would think I had just told the woman that her $500 doctor's visit would not be covered by her health insurance, and she got a parking ticket to boot. Is it unreasonable to expect vaguely pleasant service? Ah yes, but this is New York City. Experiences like this were all too familiar when I used to visit the city. I suppose now that I rarely have to ask for help, I don't have as many such encounters.

The short of it is that Texas is one of the few states that does not print the date of issue on its drivers' licenses, and so I must request a paper copy of my Abstract of Driving from the Texas DMV before obtaining a NYC license.

Outside on the rainy Midtown streets, throngs of people hurried to work in the deep urban canyons, dodging taxis splashing through puddles and huddling under their ubiquitous black umbrellas. Penn Station bustled with passengers arriving from the commuter rails. I enjoyed the energy of the city, even on a gloomy day.

The best way to salvage this trip to Midtown, I decided, was to make a run to Trader Joe's. There I was greeted by a great selection, good prices, and refreshingly friendly employees. Along the way, for my good deed of the day, I stopped and helped an elderly Spanish-speaking woman fix her wind-inverted dilapidated umbrella, even though it meant getting a bit wet. A surge of kindness nearly led me to give her my very nice automatic-up-and-down/easy-to-revert umbrella which I splurged on and keep in pristine condition. Nearly.

Typical Trader Joe's fare: BBQ-Chicken pizza, biscotti and baked brie in French brioche (for the "Good-bye Washington Heights" party), extra virgin olive oil, "Goddess" salad dressing, spicy soy & flaxseed chips (4g fiber, 6g protein), and cinnamon Puffins cereal (6 g fiber, 2 g protein, only 6g sugar per serving)

It's difficult to go to Trader Joe's without stopping by their nearby wine shop. There I stocked up on four bottles of $3 very drinkable TJ-label wine, a nicer Chianti for my planned "Good-bye Washington Heights" party, and a bottle of Argentinian Malbec, which I'm growing to appreciate.

Before Trader Joe's was a stop by PC Richards, a local electronics store with fairly good prices. I began pricing flat-screen TVs. My justification for buying a new one--rather than buying the old clunky CRT from Brad--is that a wall-mounted TV requires far less space in the new apartment's smaller living room. In addition, as much as I enjoy having people over, it helps to have a good TV for movie-watching. And finally, if we sub-let the "study", the amount I save will quickly pay for a television.

Ordinary 26-inch LCD's were around $800, generous-sized 32-inch ones were approximately $1,000, and the luxurious 37-inch sets were more like $1,200. There was a 42-inch plasma-screen on sale for about $1,300, which is far bigger than I need, but not significantly more than the 37-inch TV's. I plan to do a lot more research to make sure I'm getting a good deal.



A new Trader Joe's shopping bag and an overflowing wine rack are two of the best parts of the morning.

The last highlight of the morning was purchasing a couple more $1 reusable grocery bags from Trader Joe's. About the size and shape of paper bags, these are much sturdier and water-resistant. I'm already in the habit of bringing a fabric grocery bag with me when I go to the grocery store, so I'm sure I'll use these as well. Besides reaffirming and recentering my moral compass, the occasion led to a little introspection on my part on behalf of society. It seems to me that although the population collectively seems moderately to very concerned about the environment, it's striking how little individuals are willing to make sacrifices. Carpooling with one person uses only half the gasoline...but it's inconvenient. And from my memories of the South, it would be absurd to ask people to take a bus. Oh well, at least re-using grocery bags is a start. And for goodness' sake, buy fluorescent light bulbs!

* Running & Gypsy

A near perfect Saturday:

• Waking up to sunshine streaming in the window; no alarm
• Ten mile run along the Hudson River
• Nap (one hour)
• Lunch. An episode of The Office with audio commentary.
• Nap 2 (thirty minutes)
• Doing this and that around the apartment
• Picking up last-minute tickets for Gypsy with Patty LuPone, a must-see according to roommate Clay. I talked Mauricio into coming. (This was easy: "Hey Mauricio, do you want to go to a musical?" "Sure.")
• Lounging around Midtown waiting for the show.
• Light dinner of feta-cheese-on-puff-pastry pie and hot tea
• Gypsy. The show was okay, but Patty LuPone as the lead role, Rose, was outstanding. She carried the show, and the audience knew it as it gave her an immediate standing ovation and round after round of applause which filled the historic City Center theater.
• Sitting two rows behind Rebecca Romijn. (I didn't recognize her at the time without her blue Mystique costume.)

• Quizzing Mauricio on the nuances of the English language. Of the non-native speakers I've encountered, Mauricio has by far the best vocabulary; indeed his command of the language is better than most native speakers I know. I wasn't even able to stump him with the the word recidivism.

• 

* Let the weekend begin

Harkening back to my college days, I remember the distinct feeling that the weekend begins on Thursday night. Not that I was much of a partier on Thursday nights. Okay, I wasn't anything of a partier, but still Thursday evening brought a bit of excitement that the weekend was just around the corner. That excitement was reason to, against better judgment, stay up too late. But that excitement also was also enough to tide me over to early Friday afternoon when I found myself finished with class for the week and ready to join friends for lunch and face a full afternoon which stretched into the distant horizon of a long, beautiful weekend.

Once again, I found myself beginning the weekend a bit early. Tonight it involved seeing the new animated feature, Ratatouille, with friends at the 84th Street theater. (Do I even need to clarify that this was in the Upper West Side? Regular readers of my blog should know that the UWS extends from 59th Street to 110th, and that only under dire circumstances would I venture east of Fifth Avenue. *shudder* East Side.)

The film was a pleasant surprise. Clever, well designed, great animation, and cute. Not life-changing, perhaps, but if I walk away from a theater not regretting I paid $12 for a movie, then I'm satisfied. The image above is a gigantic ad I spotted in Dallas recently. A few more pictures follow.

Mavis, Dustin, and me. Dustin bought us ice cream beforehand.

This picture is funnier knowing that Dustin thought his tongue was blue.

Me and the rat.

June revisited

The last couple of months, as suggested by the paucity of posts on Mulberry Street, have been busy. Please note that I plan again, in the next week or so, to flesh in a few more memories from May and June, with the posts dated when the events they describe occurred, not when I write about them.

~

I will take a moment first, however, to praise Stephen Sondheim and the revival of his musical, Company, which recently closed on Broadway. I got to see it for a second time the night before flying to Texas for a week of vacation. Carrie--also a Sondheim fan--and I got rush tickets and ducked into a Starbucks on Eighth Avenue to avoid the late afternoon shower as we awaited showtime.

~

The show was even better than I remembered. Need I comment on Sondheim's creativity, originality, and wit? Not that it's an "easy" musical: The scenes are nonlinear, the show has almost no action, and the work is at times confusing. The set is sparse. Everyone wears black (never seen that in New York City before!). And yet, I love this musical about a single 35-year-old and his married friends.

~

Raul Esparza played the mammoth lead role when I saw the musical in May...his nuanced expressions, inflections, and gestures were the highlight of the show. Although initially disappointed to hear that understudy Bradley Dean would perform that Thursday night in June, Carrie and I were both pleasantly surprised by his deep, rich voice. He brought a vocal ease and a slightly different personality to Bobby which made the show that much more interesting.

~

(Sorry, there apparently is a glitch in the software, and the only way I can separate paragraphs is to place a character between them.)

Coming and going

June 26th marked one year of my living in New York City. Although I was in Texas on that date, I realized on coming back to New York how much my perception of the city has changed. Of course my "permanent" home with family and many friends is in Texas, but this city feels much more comfortable and familiar than I would have expected one year ago. (Expect an anniversary post soon!)

As Dad dropped me off at the airport Sunday afternoon, ominous charcoal clouds filled the expansive Texas sky, and the afternoon took on an eerie greenish hue. Soon I watched Jovian bolts electrifying the flat terrain for miles across the tarmac before fierce torrents rolled against the terminal windows. Instead of appreciating the rich blogging fodder, however, I was merely frustrated that the thunderstorms in Dallas diverted planes and delayed my direct flight--first by 30 minutes, then an hour, then two, and finally four hours. Rather than arrive at LaGuardia at 2030 Sunday evening as planned, I deplaned shortly after midnight and then waited another hour for a ponderous ground crew to unload the bags. The M60 bus doesn't run after 0100, and at that time at night, $30 for a cab to get home quickly seemed like a small price to pay.

Even more than missing sleep, however, I was disappointed because Sunday night was when I'd planned to go and tell William & Katherine bye. I'd missed the going away party, and they were moving out on Monday. At least I'd gotten the going away gift to them in advance, but it still seemed anticlimactic not to bid farewell in person to two of my best friends in the city.

As providence would have it, however, W&K's movers were also ponderously slow in packing up the apartment. I was able to drop by for a few minutes after work and see their place for the last time with its bare hardwood floors, echoing rooms, vacant windows peering out over Amsterdam, and empty kitchen in which so many meals I'd shared had been prepared. We gathered their luggage and the food they'd packed for the short road trip to Canada. And I was reminded that there's something very significant about a final, intentional pause before closing the door of one's home for the very last time. (I'm not sure William paused as long as I would have; he was more concerned about beating the rush hour traffic out of Manhattan.)

The whole experience of helping them carry their bags downstairs, loading the trunk of the rental car parked on the sunny avenue, and giving them a quick hug perhaps didn't have the same eloquence as the last episode of Fraiser (scene 15 in link), but at least it gave me some sense of completion of seeing these two friends off. Waco will be a better city for having them. And this crowded city will be just a little bit emptier.