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.
Monday, September 10, 2007
Sunday, July 29, 2007
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.)
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.
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.
Friday, July 27, 2007
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.
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