Sunday, June 18, 2017

Fifty Things To Do Before I Die



My parents moved when I was seventeen years old, the summer after I graduated from High School. I moved out a few days after I turned eighteen. There was a window of about thirteen months when I could have written the above list. Most of that time I was working two full time jobs -- with my Uncle installing roofs and then at night and weekends I worked in the kitchen in the Clackamas Red Robin restaurant. I wrote this list, and, then promptly forgot about it, until my Mother found it some years later when she was cleaning out the room. Perhaps it was when the carpeting was replaced, but it must have been ten years or so after I wrote the list. She gave it to me and then, I promptly stowed it away in some shoebox where I have stashed nostalgic stuff from the past. Recently, I moved to Long Beach and going through the unpacking process, I stumbled upon this list I entitled Fifty Things to Do Before I die. 

An examination of the list shows how ridiculous some of the aspirations of me at age seventeen were, but they are not in the majority. Most of them are attainable and worthwhile -- some of them I've even accomplished, or are on the way to accomplish. Four of the entries are blocked out due to involving specific people who I don't want to identify -- nothing terrible regarding them, I simply don't want to involve them -- it is not fair to them. I thought I'd take the self-indulgent, cathartic time to evaluate just how I'm doing regarding the goals set for myself. I haven't died yet, and twenty or so years have gone by -- I should have gotten somewhere by now, you'd think!


  1. Publish A Novel I'm closer to this goal now, than I've ever been in my life. Between when I wrote this list and now, writing as an endeavor has only existed in the second half. Roughly ten years ago I started my undergraduate studies, which included a degree in creative writing. At this time I'm nearing completion of my first draft of a novel I hope to have published in the near future. 
  2. Publish A Collection of Poems Hmm. During my recent unpacking I did come across a binder full of poems I wrote during my teenage and early twenty years. Most of them are cringe-worthy, angsty things that may as well  be the lyrics to some shitty Nine-Inch Nails song, or some emo, eyeliner-wearing whiner who prides himself on being "deep." If I ever publish a collection of poems, it will either be an easy money-grab because I am famous for something else, or a posthumous money grab by my estate, because I was famous for something else. Either way, it will be worth the embarrassment.  
  3. Learn to Play The Piano I still want to learn. This one is getting kicked down the road, unfortunately. 
  4. Earn a Phd In Quantum Physics I'm a doctor, and that is as close as I'll ever get to this. Well, one time I did see the Schrodinger equation written on a chalkboard in the science building on campus, that's probably as close to as I'll ever get. 
  5. Not Watch TV For One Month Straight While this hasn't happened recently, I've gone large chunks of my life with having no television involved. Granted, I did just buy a new sixty five inch television (great deal at Costco) so I'm not sure this will happen in the near future. Residency doesn't exactly lend itself to laying around all day and watching TV so, I'm not too worried. 
  6. Run Five Miles A Day Again, for a period in my life I was an avid runner. I love running, but arthritis makes it a tough go, especially when carrying around a couple (few) extra pounds. I wish to save the remaining cartilage in my knees for things more enjoyable. 
  7. Live In Canada For One Year Well, considering the politics in this country...
  8. Do 360 Kickflips Consistently There was a time where I could be seen throwing some threes around Creston, or the Waterfront, but I never did have them on lock. In the grand scheme of things, I always thought my switch threes looked much better, not that I ever had those on lock, either. 
  9. Travel Europe A couple of years ago I had the pleasure of wandering around Europe for nearly a month. London. Amsterdam. Paris. Barcelona. Can't wait to go back. 
  10. Visit East Coast Relatives I never have done this. As time has gone, and my connection with the ACC has dimmed, it seems less and less likely. Perhaps, in the future, I can make it happen, I would like to see where my grandparents came from. 
  11. Learn To Pray Daily This one is still a struggle. 
  12. Walk For One Month When embroiled in the struggle that is practicing medicine, this becomes more of a desirable experience than I might have imagined. I've always held a romantic notion of 'wandering' and I while taking off on foot may never happen, I desire more wandering to be in my life. 
  13. Learn To Watch My Mouth In general, this hasn't been a huuuuuuge problem in my life. There have been times where I shoulda just shut up, no doubt. I grew up hearing 'sticks and stones can break my bones but words can never hurt me' but it isn't true, no matter how convenient it would be, if it were. 
  14. Become Proficient In German I don't foresee any major undertakings to learn how to speak German in the near future. I mean, I would like to do so, but realistically, this one is dead.  
  15. Become Proficient In Spanish My medical Spanish needs a boost, that is for sure. 
  16. Become Proficient In Latin Just not gonna happen. 
  17. Call The Art Bell Talk Show Coast to Coast AM, the name of the Art Bell show, which Art Bell hasn't been a part of for years, as far as I know, seems to have turned into an alt-right mouthpiece. I remember hearing Alex Jones as a guest many years ago and I think that says it all. No thank you. 
  18. Address Congress And Give Them A Piece Of My Mind I mean, I would have many different things to say now than I did 20ish years ago, but my point still stands. Disgusting. 
  19. See BB King Live BB King died May 14, 2015. I never did get a chance to see him perform. 
  20. Bench Press 400 Lbs That is a lot of weight! I believe the most I've ever bench pressed is 250lbs, and that was not a one time max effort, but during a time where I was doing sets. Maybe, at my peak, I would have been able to push up 275 lbs, maybe? Besides, I doubt I need to add the extra mass needed to get to that state. I'm fine with my 225 BP at highest set now. 
  21. Learn To Speak My Mind (Selectively) Another item where growing older takes care of things automatically, or, at least a mix of effort and time. 
  22. Spend One Month In Solitude In The Wilderness There things like this on the list. I'm not sure I'm in a place where I'm as excited to spend a whole month by myself in the woods, maybe I'd do one of those television shows where we spend a few weeks in the wilderness. I wouldn't be afraid to do it naked. 
  23. Publish A Research Paper On The Philadelphia Project This could easily be the most ridiculous thing on the list, and the thing that betrays my age at the time of writing. So silly. 
  24. Travel To Israel Between my preclinical and clinical years of medical school I took on an acute care internship at a small hospital in Netanya, Israel. Initially it was going to be five or six of us going, but they all fell out and I decided to go by myself. I rented an apartment for myself, on my own dime and walked to the hospital everyday for a whole month, well, on the weekends I walked to the beach and swam in the accommodating waters of the Eastern Mediterranean. I learned a lot, I fell in love with the land and the people and cannot wait to go back. Tel Aviv is one of the most enjoyable, dynamic, vibrant and friendly large cities I've ever been to. 
  25. Thank Grandma Pamer And Tell Her I Love Her Grandpa Pamer died only three-ish years before this and Grandma was, I think, still living on her own. It must have been either my senior or sophomore year and I was required to do a project for my German class. I roped my Grandma Pamer into showing me how to make some German meals. She was a good sport and she walked me through how to make cabbage rolls, and I don't remember what else. She included some stories from her childhood and how she learned to cook for a large family on a short budget. I wish I still had that VHS tape -- who knows where it went. In the following years she was overtaken with Alzheimer's Disease. It was tough watching the descent into dementia but I'm thankful for the time we had. 
  26. Learn To SCUBA Dive Oh yeah. It is a shame that I haven't gotten around to this. Maybe I make this a goal while I'm in Southern California for the (at least) next few years. 
  27. Go Skydiving Sure. I think the thing that I least look forward to concerning jumping out of a perfectly good airplane is having to do it tandem. 
  28. Have Children We'll see. We were close last year. 
  29. Read War And Peace This one perplexes me. Maybe I should just read it? If I knew this was a goal of mine, I would have just read it already. I guess now I know, or know again, more specifically. 
  30. Spend A Night In Jail Haha! Of all the things I'm glad haven't come to fruition, this one could really screw up my life. Stupid responsibilities and professional considerations. Sheesh. 
  31. Snowboard In Alaska Haven't done this, but I did get a few great years of riding in Colorado that I never put on this list. Maybe I'll get some big mountain riding in before I'm pushing up daisies. 
  32. Meet Jeremy Wray And Eric Koston I stood next to Jeremy Wray at a Tampa Pro contest in, it must have been, 2002. He is tall for a skateboarder. Much respect for tall skateboarders -- we have further to fall! Now fat and tall skateboarders, woowee! 
  33. Meet The Woman I Love And Marry Her Nearly 11 years to the day. 
  34. ***
  35. Travel To Papua New Guinea The desire to do this has diminished greatly as I've grown older. When I was very young my Mother traveled to see her sister and her family, who were in PNG, and I've known many others who worked there. I used to spend many hours imagining what it was like to live there, among the native people, in their villages. I don't spend many hours these days thinking about that. 
  36. Listen To Others More It has become abundantly clear that my greatest strength in the capacity of being a physician is my ability to connect, relate to and build rapport and relationships with patients. And for that matter, other health care workers too. Around the country a new and young generation of physicians have taken the the valid criticisms of the previous' generations of doctors and their bedside manner and just, general way they conducted themselves to heart. Perhaps it is partially due to the physician not being the end-all-be-all in clinical decisions (in general this is not good for patient care, but I will not digress at this time...) as we were in the past that has led to the greater harmony concerning team-based patient care, perhaps its just the natural evolution of people recognizing shortcomings of the past (if only this was applicable to more areas of society) and the movement to remake us doc's in the likeness of humanity. 
  37. Be Willing To Help Others More As discussed directly above, I think my journey towards and in medicine has functioned to more than accomplish this goal. I don't think that I ever was severely lacking in this area, but admittedly, all of us should aspire to this goal on daily basis. Unless you're driving slow in the left lane of the freeway, I'll be there for you! 
  38. Hitch Hike Across The Nation This one seems very similar to the one below, that has me walking for a whole month. Forrest Gump was fresh in everybody's mind back in these days -- and I really did love that part of the movie. 
  39. Bungee Jump As I get older, I feel less inclined to do these kind of things. I would probably still do it, but I don't actively seek out these types of adventures. 
  40. Kickflip/Shuvit The PSU Gap I never did either of these and the parking lot is gone. Off of 4th street, on the SW side of the Portland State University campus was a parking lot. This parking lot had a smooth run up to what amounted to a little lip (think very small jump ramp) and then maybe five or six feet of dirt and then the sidewalk. The run-up was perfect, as was the landing. Although, before the parking lot was gotten rid of, MAX tracks (or StreetCar tracks, I don't remember) were put in, making the roll away after the sidewalk more difficult. Zak Danielson 360 flipped this gap in 411VM issue #4, which can be seen below. I ollied and frontside 180'd it and I'd like to think that kickflipping, heelflipping or a shuvit over it could have been accomplished given the opportunity. 411VM #3 Zak Danielson at the PSU parking lot  
  41. Own A House I've had a few now. Will have more. 
  42. Get An Enjoyable Job I think becoming a doctor fits this bill. It certainly isn't always enjoyable but I think it is more fulfilling than I could have imagined. It is worthwhile to note that none of these items on the list have anything to do with medicine, much less becoming a doctor. 
  43. Get Tattoos Don't have one yet. For a few years, I actively avoided getting tattoos as I saw them as more conformist than not having one. I love good, tasteful ink. Terrible, tattoos just look so trashy. I guess you could say I was trying to out hipster the hipsters by not having ink. I have some things in mind. Maybe I'll get one this week. 
  44. Own My Own Company This one may be the one item I completed closer to the time of creation of the list, in relation to all the others. At the ripe ol' age of twenty two I started a small construction contracting business. I didn't engage in that business for very long, nearly two years but it gave me a taste and even now I have an LLC (not actively conducting business right now) and foresee myself as a small business owner (active) in the near future. This time, I won't be installing cheap carpet in section 8 housing, thankfully. 
  45. Study Philosophy I took a community college class in introduction to philosophy at Mt Hood Community College once. I didn't finish the class. 
  46. ***
  47. ***
  48. Always Go For It Thinking back to my self, and what was going on in those days, this pertains, most likely, to two different and specific endeavors: skateboarding and girls. I like to think that, in general, in the grand scheme of life, that I have, indeed, 'gone for it.'
  49. ***
  50. Always Be Honest, No Matter What Still striving, and always will be striving for this. 

19/46. Some of the softer goals are subjective in nature. I'm giving them to myself. Please, if you dispute, feel free to call me out. 


Thursday, March 16, 2017

Righting the Writing

I'm still trying to write a novel. The outline and overall plot has evolved into a simplified version of what I have previously described on this blog. I still have more than one timeline involved, but I have taken my first scenario, involving the earthquake and subsequent landslide in the Columbia River Gorge and the Native American family caught in it and added a modern day timeline. Gone are the two subsequent sections -- the 'shanghai'd sailor' and the Netanya bombing character. I'm roughly 25% done, concerning word count alone, but feel like I'm missing some key elements that will propel me to the next phase of the story.

In the modern day timeline, I have a 29 year old male who is built from elements stemming from my experiences and a few key friends of mine. For the past three weeks I've been working in a hospital in Wisconsin, consulting physicians and some support staff with a new computer set up. I've had plenty of downtime, and I've tried to write but have found it hard, and have struggled to produce anything I want to keep. However, I've been able to comb through my hard copy of what I already have written and copy edit and identify sections that require re-writing. In general, such intense scrutiny before the overall work is completed, is something I try to avoid. That said, I've never attempted a writing project of this magnitude before. My gut tells me that I should back off of the hard copy scrutiny, as it has served to discourage me. I believe in the story, but through intense inspection I've been focused on a small grove of trees and lost sight of the forest.

In fact, even writing about writing and the inherent struggles should serve to weaken whatever block I've been working through. Working in a hospital for fourteen hours a day, in a three week straight blitz has not served to allow abundant inspiration to flow -- I recognize this, but time is growing short and I must manufacture a breakthrough.

As much as I think my intense editing and rewriting has been detrimental for my ability to continue writing this novel, I do think I learned something about my intentions concerning the core elements of the story -- of what I want to say and what I want the reader to understand. I've gotten lost, as I have subconsciously brought themes into the story, which serve to confuse and distract the reader -- hell, they distracted me! These disorganized, tangential elements are self-indulgent. My biggest obstacle lies in finding a compromise between telling the story I want to and avoiding overwhelming hedonistic digressions.

What kind of things have seeped into the story that I need to address before moving on? Let's see. In no particular order:


  • Stubbornness and harboring of bitterness and anger and what it means for family dynamics
  • Generational differences in worldview, especially concerning economics in the U.S. 
  • Hypocrisy that can occur with blind adherence to religious dogma -- especially the dichotomy that modern American Christians have allowed to prosper
  • Anti-science proclivities and the ridiculous, insidious nature from which it springs
  • Human-ness and its transcendence through time and cultures, no matter how disparate  

All but the last one I identified after re-reading and editing my initial work. The last one, concerning human nature and how very much alike we all are, in fundamental ways, is exactly what I am hoping comes off the paper when the reader goes back and forth from the two timelines. I include it in this list only because I do see it bubbling up in ways I had not specifically intended -- this pleases me, and is indicative of being on the right track, at least as this is concerned. 

Do I continue to build on the other elements I've built into the story? I think I need to, in some fashion with, perhaps, varying intensities. Thankfully, public reception of a novel, written by yours truly, will have little bearing on my career or ability to feed my family. And, moreover, I'm simply writing this for myself -- and in that lies the need to seek balance. I do want people to enjoy it, but that is not the supreme, guiding goal of this project. I have to be comfortable that the only person I really want to love it, is me -- and that is much harder to come to terms with than I would have thought. 

Thursday, March 9, 2017

What we've got here is a failure to communicate -- About Failure

Failure is painful. Pain, in general, we avoid. However, like all things we can override our primal drive to avoid pain if we recognize its utility in a cost-benefit ratio analysis. In other words, no pain -- no gain.

Recently I was reading about a high-school teacher's experience concerning the differences between students in 1997, 2007 and now, in 2017. She had numerous things to say, but what stuck with me and, what was the primary driving force of her analysis, was that students today are overwhelmingly lacking self-confidence. She tied this to a fear of failure. They are unwilling to try anything challenging or new without a significant amount of one-on-one guidance and encouragement. Of course, in a classroom of more than thirty students it is impossible to give this type of attention.

While pondering this perspective I became overwhelmed with situations and dynamics that I have experienced and witnessed. Education, ideally, in my mind is a time where failure is a path to learning and growing in ways that initial success -- whether it be by accident or competence, disallows. I started my undergraduate pre-medical studies in my late twenties and because I had that goal of becoming a physician, I felt the pressure to not fail. There were individual tests I failed (not too many, thankfully) but the prerequisite classes for medical school matriculation were very important and a failure would be painful (and while it would be a growing experience I'm glad I didn't have to "grow" in that fashion.) Because of these classes and the rigors involved I came to appreciate my English, literature and writing classes very much. I had one writing instructor for many of my writing classes and after I got to know him I had a discussion concerning my paranoia about my GPA and what it was going to take to get into medical school, and despite my enjoying his classes very much I needed to know what criteria he would use for grading his students. I remember telling him I was concerned that if I tried to branch out, to take risks and write in styles, fashions and themes that I was not already comfortable with, that it would affect my grade. How sad is this? I love writing. I loved his classes and I became a better writer because of them. He was a Ph.D teaching at a University -- he knows how things work and what grades mean for advancement. Obviously, I don't know what he was thinking but I'd like to think that he would recognize the fallacy I'm trying to get into here: that failure is beneficial, provided lessons are learned. I did achieve high marks in all of his classes -- and I think I deserved them, if only because I put forth tremendous effort, which was easy -- after all, it was like a respite from all the chemistry and biology classes -- a chance to exercise the other, starving part of my mind.

I finished highschool in the 1990's. In many ways, in those days, I had a solid, if not misguided, sense self confidence. And while I didn't aspire to further my education at that time, in a rudimentary, incubatory fashion I learned how I wanted to live my life and who I wanted to be through many trial and error type experiences. Many of those experiences, at the time, felt like less like searching for truth than just having fun. And that, precisely is the elixir of youth.

I can easily point to many aspects of modern life that can work to subdue a young person (or, if we're honest with ourselves, all of us regardless of age -- us old fogies simply have the benefit of growing up in a social-media-less environment, among all the other things I'll point out.) However, taking a step back and examining what I think is an important aspect of the human experience will allow a proper framing of what these larger societal shifts and their impact on our emotional life.

Satisfaction and happiness are both dependent functions of an individual's expectations, in any given situation.

I buy a bottle of wine for $10 and I really enjoy it. My expectations were low. The situation was pleasurable. I am satisfied and happy with the purchase and libations.

I buy a $100 bottle of wine. It's okay -- I didn't spit it out. My expectations were high. The situation, while acceptable, lacked in pleasure, relatively. I am less satisfied and happy with the expensive bottle of wine.

And here is the key -- in a vacuum, with mitigating factors such as price, which lead to varying expectations, my enjoyment of the expensive bottle of wine, compared to the $10 bottle, may actually be superior. But it is the function of expectation which dictates which scenario I will prefer.

A child who views the lives of their peers through the filtered lense of social media is comparing their "low-lights" against other's "highlights." Growing from child, to teenager and into adulthood is difficult. It is an emotionally charged out of control train which can leave the tracks.

Pathways to successful careers less plentiful now compared to twenty years ago. Many students are paralyzed by what they see as impossible standards for success. Beauty. Brains. Money. Innate coolness. We see these projections of partial reality and our expectations function to decrease the satisfaction and happiness in our own lives.

We also have a President who refuses to acknowledge any deficiency regardless of how obvious. That man is not the only guilty party -- many people in positions of leadership, at all levels see their grip on power depending on their perceived infallibility. Allowing humanness to shine through, to acknowledge the struggle we all share is tantamount to failure. And, with this perspective, people beholden to such beliefs see failure as a finality of defeat. Temporary setbacks and learning experiences are indicative of incompetence. I see this larger trend in society only serving to exacerbate the spiritual flogging of our society.

The Scientific Method.

To explore our world and search for answers of mechanics and etiology, and of course, the ever juicy -- what if?

Experiments that do not work as expected, even failing to prove a hypothesis are valuable. A student who fails a test can take it as a sign he or she is just not good enough to earn a good grade. Or, they can learn, adapt and grow.

Just as science has been demonized and vilified due to its insistence to recognize facts, our young people have had their psyche and sense of self-worth beaten down with weaponized untruths.

People who do not believe in themselves don't believe they need to be treated well. They will not fight for themselves. Politically, they will prefer finger-pointing and blame-shifting rather than objective determinations, leading to leadership which uses these prods to stay in power. A tried and true technique.

But back to the high school students of 2017. Trite admonishments such as 'it is not how many times you fall down, it is how many times you get back up,' while containing wisdom are lost in the flood of inspirational posters and other catchphrases. And these students are not putting themselves in a place to fall down in the first place -- and this is the key dynamic that I believe the teacher was referring to. And I get it. I remember when I was a pre-teenager who wanted to get into skateboarding, being around the older kids and being scared to try things such as drop-in on a ramp for fear of failing. So I found places where no one else could witness my failings and I kept at it until I felt comfortable in my abilities around others.

Social anxiety has become the new 'nerd' in that it is acceptable to blame, or indulge in what is an honest feeling that I would guess (eschewing my solipsism belief tendencies) all of us have, to some degree or another. And like many other things, pushing through and, even when failing multiple times, persisting leads to self-confidence. This is important, as it is a genuine self-confidence, a manner of existing that doesn't necessarily require the bravado of arrogance or rotting pridefulness. Perhaps my upbringing, where I was endowed with a sense of self-worth, leading to a base foundation of self-confidence as a human being, independent of performance, allowed me to grow in a healthier (subjective analysis, to be sure) fashion than some others. Is that what younger people are missing -- is this what happens when life becomes so measured, metered, quantified, judged and evaluated that we come to feel that our self-worth is based on performance alone?

I don't know.

It seems possible. My ramblings and spontaneous musings while trying to write this are insufficient to fully explore this sweeping generalization encompassing a whole generation. In fact, sometimes when I take a step back, I truly think that us humans, through time are surprisingly steady. A small percentage of us fight for and achieve power. Most of us just want to have fulfilling lives, enjoying our family and a modicum of freedom which money can provide. Often I think that indeed, 'the kids are alright.' But, in order to not completely invalidate my musings I will assert that the innate and supreme fundamental human craving to communicate and ultimately feel understood is being fucked with through our means of mass, personalized communication. Loneliness and forced apathy abounds. I feel it too.

Thursday, January 19, 2017

Still Searching For That Clinical 'Banger' For The Ending

In no way can I blame my parents for not forcing me to learn to play a musical instrument as a child. However, there are many times where I wish I did know how to play an instrument or at least read music. Many of my friends do indeed pursue music as a passion and even a career. I've often found myself wondering, in awe, how the fingers of a piano player or a guitar strummer can so effortlessly find their place with such precision movement. The closest thing I have experienced involves skateboarding; repetitive movements -- muscle memory that becomes subconscious in that a conscious decision to execute a larger "trick," or in the case of music, a "tune" or "song," is comprised of a symphony of learned behavior. It becomes automatic.

Skateboarding has also been responsible for much of the music I've loved. I grew up in an era which had 411 Video Magazine's monthly VHS offering was eagerly consumed. Each video started with this iconic tune:


The alarm on my phone plays this song. Something subtle in the meaning of the song, buried deep inside my mind, irrevocably lodged in there when I was a teenager gets me amped up -- the perfect alarm song. 

Of course, the songs during video parts are even more influential for me than the 411 theme. One of the first skate videos I remember watching was The New Deal's "Children of the Sun." Besides the 411 videos, it was the first video which I watched, and rewatched hundreds of times over. Dave Duren's part had a song from the Smashing Pumpkin's album "Gish" from 1991. Of note, this is before "Siamese Dream" took the alternative music scene by storm in the mid-nineties. 


The very nature of skateboarding, in sharp contrast to institutional team sports, has a propensity for it's participants to pursue artistic endeavors. Painting, music, graffiti, writing -- some of my favorites have roots in skateboarding. Shooting a basketball is an individual endeavor, but winning a basketball game is a group effort. Skateboarding has no team, it has no winners or losers! One may point to the many skateboarding competitions in contrarian efforts -- well, sure, a "winner" is crowned but these are judged on a subjective style interpretation. I would even argue that the staunchest competition skaters only do it for the money. And in this lies the most beautiful aspect of skateboarding -- it is an artistic expression of the skater. This is not expressly unique -- gymnasts, skiers, divers, and many others conduct themselves, at the base maneuver level, the same way. However, I propose that the culture and the manner in which skateboarding has evolved -- using urban architecture and utilitarian infrastructure in novel ways, sets it apart. The rallying cry for the past forty years of, "Skateboarding is not a crime" arose from the pushback (and in many cases, understandably so) of using the urban landscape in a manner that is a delight to my eyes. Inspiration is fertilized by tribulation. 

Bad Religion, Black Flag, Minor Threat, Tribe Called Quest, Wu Tang Clan, Buffalo Tom, Motorhead, Souls of Mischief, Nitzer Ebb, Sebadoh, EPMD, Bad Brains, Del Tha Funkee Homosapien, Pennywise, Ned's Atomic Dustbin, Stereolab, Fugazi, Superchunk, Seaweed, Tortoise, Slayer and my love of so many more are all rooted in skateboard videos. 

I used to always ponder what song I would want for my own video part. When I think about it now, I imagine myself with a highlight reel of clinical moments -- diagnosing that rare condition, calming the anxiety ridden patient and not mistaking the PE for pneumonia. And if I had to now have a song, I would still want to use that age-old trick where I get to choose two songs (think "Yeah Right" by Girl, who had most of their riders get a "B-side" with a different song) and they would be:



and 


The goal is to have more than one video part, of course. Too much good music out there. 



Monday, December 5, 2016

Paths to Pathological Apathy

I got the news that another physician had committed suicide a few days ago. Sadly, this is not surprising, but this time it was a person I knew. There has been a lot written recently about physician and medical student suicide and I will leave the numbers and such for other people. What I do want to address is what I perceive to be the underlying reason -- and again, many other smarter and more experienced people than myself have written about this, too. I feel like the suicide epidemic in our society, including physicians, but also other groups seeing huge increases (veterans and children) shares a common cause.

As I reflected on the latest bad news, a question that was asked of me in an interview came to my mind.

"What is the largest problem facing our society today?"

Of course, this can be taken in many different directions, and I've never been asked that before in an interview (although I love these open ended questions -- my main problem is staying focused -- which is hard when you have so many (good?) things to say!) and as such, I hadn't really thought about this. After a moment's reflection I said: "apathy."

At that moment I was not looking at 'apathy' as a component of the suicide epidemic, but just something that has been on my mind concerning the larger American public in general. But they are tied at a level that I hadn't been able to put together at that moment.

Now, most of my days are filled with people who are filled with passion -- and for this I am thankful. However, I'm not seeing patients these days and I get to select who I spend time with. But even with these people (those lucky enough to see me regularly) and myself feel powerless -- which is the spark for apathy. Many of us feel it in our jobs where the joy and satisfaction that comes from a job well done is often futile, and at worst brings repercussions.

Many veterans have written and spoken about the terrible disillusionment that came from the noble desire to serve their country and protect their fellow citizens only to feel like they were nothing more than a political pawn in a grand money making scheme. A dreadful sense of powerlessness descends and, especially in a rigid power structure like the military, apathy is the safest and most natural reaction.

Humans do not thrive when they are powerless, when they have no hope, when nobleness is usurped by corruption.

Physicians today, in America, especially young, aspiring or in-training physicians are choosing a path which has disparate material rewards per unit-of-effort put forth -- this is why many of our brightest young people choose finance, or even computer engineering. The time, debt and liability that comes with being a physician is unparalleled and unless we can find satisfaction in what we set out to do in the first place, apathy will set in.

I place no claim on understanding why everyone who commits suicide does so -- but one aspect of the act itself that is noteworthy is the inherent self-empowerment (in what could be called a perverted form, to be sure) that comes with such a decision. To what degree this element plays has to be varied and individualized.

Perhaps in future posts a more detailed exploration of what makes physicians feel powerless is warranted. Undoubtedly as the years go by I will have a better understanding, too.

It doesn't mean anything to the suffering loved ones to repeat the mantra that 'suicide is a permanent solution to a temporary problem,' in the face of suffering -- I acknowledge that. But when a young life so full of promise and already acting as a conduit for good into this world is snuffed out, I don't have a lot else to say to the rest of us who are approaching this same threshold.

Friday, November 11, 2016

OMLH

I've avoided writing or posting about it. I've, mostly unsuccessfully, tried to avoid reading all of your writings or postings about it.

Like most people I had strong feelings throughout the election cycle.

For a long time I thought the Republican-come-lately's campaign was in cahoots with the DNC and HRC in order to ensure her victory.

Which says such negative things about the whole process, or at least, about my outlook on the whole process.

And in that incredible thought of mine -- that the election of our very President of these United States of America could be that corrupt -- is why I think our Reality Star just had his pilot reviewed and a new season approved.

I've spent a lot of these past six months travelling around the country. I've been up and down the West Coast, in the bible belt, Florida, the Carolinas and around the Northeast. I've met a lot of nice people -- many of whom were going to vote for Trump precisely because of his political exogenous nature. Most were highly disapproving of the essence of his character. Some went on and on about the supposed corrupt nature of Hillary, but most recognized her as a symbol of the establishment -- and this is key -- it is this element, not her gender which people voted against. This is my optimistic side speaking, to be sure.

The relative large numbers of third party voters speaks for this. And truly, I believe plain misogynists, willingly-ignorant fascists and racists, in whatever proportion they truly are in this country -- and in my first hand experience through face to face interactions is a minority, all but sealed the deal last night. It doesn't seem like many have lost when betting on the lowest common denominator of a fragile and fearful human psyche.

I do believe this nation is worse for the wear under the leadership of the 45th President.

We've seen disrespectful discourse of all kinds, striking at the tender and inflamed nerves of our society, once again highlighting the worst of us as a whole. As I've stated above, I do think that the most significant element of this outcome is the symbolic vote of non-confidence in the status-quo. But what a very painful and terrible price. This is a more dangerous place for women, minorities and vulnerable people of all kinds not because those who bought into the Tower Of Power are rapists and bigots but because it empowers those among us who are prone to the baser violence of human desire.

I've written in the past about various ways current event information is disseminated and the sea-changes therewithin. Mark Zuckerberg denies that Facebook's fake news and algorithm enforced "echo chambers" had any affect on the election. I assert that it did. I also put forth the idea that one who views Fox News as a legitimate news source is much more likely to find themselves gleefully mashing that "share" button. But is this my echo chamber speaking?

Verily, I say unto you: it is better you lose both scrolling fingers than spend one more moment in Facebook related despair.

I'm seeing and hearing much hypocrisy from a lot of people -- and one thing comes to mind and is worth remembering: the non-partisan nature of this type of behavior. It is simply human nature. And while, in general I agreed with the First Lady and HRC that when "they go low we go high" I see the fiasco during the primaries with Bernie Sanders as going very low and the leadership of the DNC had no intention of the primary process having any meaning other than the pre-ordained one. The people who were (are) itching for a major party to eschew big money and power were disenfranchised from the process before the real election even started.

Before, when I said that I thought that Clinton was using her old family friend to ensure her victory, is precisely why I now, with the benefit of hindsight, am not surprised with this outcome.

One last thought on the current state of FaceBook.



Thursday, September 29, 2016

Ender vs Roland; The Final Battle

Between work and residency interviews I have been travelling a lot in the past few months. Recently, during another drive up and down I-5 I tried to listen to the audio book The Dark Tower: The Gunslinger, the first in a series of novels by Stephen King. In my teenage years I devoured Stephen King novels. I don't think I've touched one since. What I remember makes me think that most of his work should stay in the teenage years. However, I had a conversation with a friend who was excited about the series being turned into a movie and emphatically encouraged me to read the The Dark Tower series again. I was unsure whether or not I had started this series before, but after getting into the audiobook, I was reminded that I indeed had. I was also reminded why I didn't continue the series.

Wikipedia states that the King's work is inspired by a poem by Robert Browning, published in 1855. And, it is clear that his inspiration is reflected in the flowery, prose-like text. It is so full of adjectives and abstract descriptions of everything and everyone that I found myself having to refocus my attention every few minutes and try and see if I remembered where the story had gone. Similar to driving up and down I-5, where the miles blend together and the mountains between Redding and Ashland seem like just a passing moment. Was it just this way because I was listening to, instead of reading the novel? I was curious and it made me wonder whether I would, now, think differently of the style of writing if read versus heard.

I spent more time pondering how I write, and what styles I subconsciously adhere to (ending a sentence with a proposition is a style that I actually think is okay, seeing as how that "rule" stems from Latin grammar and the Oxford Dictionary people are on wax stating that this rule is not appropriate for modern English written communica.) I also recently listened to Ender's Game, by Orson Scott Card, another novel I read as a teenager, but also one that has stood the test of time in fantastic fashion. In some ways, it translated to an audiobook perfectly. It also represents that type of writing that I would like to emulate (not the quasi-anti-semitism part) especially the action scenes that he penned. How does one go about writing an action scene that is engrossing to the reader? It is a difficult task. And one that I am struggling with currently. In a way, I'm hoping that writing about it will allow the words to flow and the action to become naturally apparent on the page.

In a world that loves hyperbole and is quick to label current events as "the greatest or worst of all time" how does one try to write an event that is awe inspiring? My personality, which is inseparable from my writing, defaults to a fact based narrative that allows the reader to assemble the story and magnitude in their own mind. When I describe a tremendous earthquake that causes half of a mountain to slide into a wide river gorge, pushing the river high onto the opposing canyon wall it seems impossible to understate the awesomeness of this scene. But writing it how it deserves to be described pushes me into using words that are commonly used in any sports article or (boo! hiss!) political news story. If Orson Scott Card was writing it he would simply describe what was going on, providing the facts that lead the reader to realize what a momentous event they were "witnessing."

I am a scientist now -- a scientist of the human condition, more commonly known as a physician. That is a limited description of a physician however -- the art of medicine is a thing for a reason. Being a physician allows for the marriage of science and humanities unlike any other state of being that I know of. I embrace this marriage and I like to think that this dynamic plays into my writing. When one side becomes more dominant I become uneasy, and I think that the The Dark Tower is, for me, too full of conclusions in the form of adjective overdose. When each character, landscape and interaction is given a paragraph of lengthy description I am unable to build a scene for myself. I want the building blocks, not a finished product for my mind's eye while reading fiction. And this is why I want to exchange my audiobook for another one -- good thing Audible had a bunch of free credits with my Amazon account.