Monthly Archives: August 2005

This bothers me

As I’ve mentioned before, one of my favorite parts of the Sunday paper is thumbing through the Parade magazine and reading the column “Ask Marilyn.” I was mildly irrated to be stumped by a geometrical puzzle submitted by a reader. Of course Marilyn found an elegant–and correct–solution.

Toward the back of the magazine, I noticed a full page add for a “Faberge-inspired Tribute to a Departed Loved One.” This is, in essence, a decorated egg on a pedestal which opens to reveal a winding staircase leading up to a cross. The egg “Plays the touching melody of Amazing Grace” and features “More than 175 sparkling faux jewels.” All this is yours for “two convenient monthly installments of just $19.99.”

What disturbed me was the inscription on the base of the pedestal.

If tears could build a stairway,
And memories a lane,
I’d walk right up to Heaven
And bring you home again.

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Calatrava

This new skyscraper is evidently the tallest building on the Scandinavian penninsula. Designed by the famous architect Calatrava, it boasts a view of Denmark from its upper floors. I like the twisting effect. (More info here.)

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More things I’ll miss about this city…

  1. Vespers, the quiet, meditative mid-week communion service at my church. I’ve always appreciated how compact this service is–short, yet full of great liturgy. It’s an often much-needed pause in the midst of a busy week. And I love it when autumn turns into winter and the evenings get darker and the air becomes crisp…still, week after week, there’s Vespers.
  2. Watching the meteor shower my first year of med school, with friends, in the back of a truck. Sure, we should have been studying for our anatomy finals…
  3. The opportunities to spend time with the homeless at the downtown shelter and the one where my church visits. It was in these places that I came to realize how approachable these people are, and that despite the differences in our education or what we wore, we really had a lot in common.
  4. Ethnic shopping. This ranged from the Vietnamese grocery “V-T Mart” down on Maple, to the local Carnival with more choice of tortillas than bread, to Chinatown with its dim sum and milk pearl tea.
  5. The toll road. First off, it feels luxurious to take it as a fast route between points A & B. And secondly, it provides a change of perspective on buildlings and places I frequent from the streets.
  6. The fact that it’s close enough to my parents’ house in the country to caravan out to G-town with friends. We’ve done this several times, and people seem to enjoy everything from the dog Shacor to the ducks and the pond, to visiting the festival on the brick-lined streets by the railroad tracks in historic downtown.
  7. Smoking a cigar with friends on the balcony. This works well with a short tumbler of Scotch.
  8. The county hospital. Dirty, inefficient, difficult nurses, lots of babies. On the medicine wards, we were bound to have interesting cases. And we could count on nearly 3/4 of our patients’ medical histories including diabetes and hypertension.
  9. The ice storm during our second year. An extra credit question was given to the medical students who braved the roads. Clay stayed over at our place since it was closer to school. In the morning I made my famous “Flour-n-water” biscuits.
  10. Our Family Practice rotation. Flora, Clint, Amber. Working out, cooking, Smallville, turning the A/C down as low as it would go, running around the college campus, studying at the law school. Those were the days!

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Lake Atitlan


A friend of mine recently returned from Guatemala. One of her favorite parts of the trip was seeing the beautiful and famous Lake Atitlan. Coincidentally, this lake is where my dad spent a a good part of his youth. Their home was on the shore, and he has memories playing with his brother beside the waters, which would get choppy every afternoon when the wind picked up.

I’ve always taken delight in teasing Dad about his reminiscing about Lake Atitlan–the most beautiful place in the world, he would say. A quick Google search revealed, however, that the place is amazing… Hope you enjoy these pictures.

These appear to be Guatemalan children. For some reason they came up when I searched for Lake Atitlan. I don’t know if guys are allowed to use the word “precious,” but if so, I’m certain that it would apply to them.

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Dancing nun


I’d wondered what went on at World Youth Day. (Please see the following CNN.com article: Nun rapped for wild dancing.) I’d sure hate to have Mother Superior waiting for me every time I came home!

* disclaimer: The above picture represents a different dancing nun and is provided only for illustrative purposes.

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Jonathan, victim of circumstance…

So there I was at the hospital today, minding my own business, trying to get my work done. I realized that with one patient, we were getting nowhere with our workup of his baffling neurological symptoms, and it was time to consult neurology. (I’d already discussed this possible plan of action with the attending yesterday.)

I called the answering service of the neurologist on call, and within fifteen minutes the neurologist paged me. I was in the ICU, so I promptly picked up a phone and dialed. I’m in a habit of deleting pages as soon as possible so that my pager nearly always displays the wonderful message, “No new messages,” and today was no exception. As the phone rang, I deleted the call-back number, thinking it would be a quick conversation.

“Hello? …Hello?” the neurologist said. I answered back, but he continued, “Hello? Is anyone there?” Obviously he couldn’t hear me and soon hung up. Having no way to redial him, I went through the answering service again, which took a few minutes. “Sorry, I had deleted your number before I realized you could hear me. Could you please page me again?” Within five minutes, I’d received a second page with his number.

When I dialed the number, however, I got an error message, “This is not a working number.” He’d typed in his number wrong. So I called the answering service back, taking a couple minutes to navigate through the computerized options, and left a message saying the number left on my pager was not a working. A few minutes later, I was paged yet again, but this time with a partial phone number.

As I sat there, trying to figure out what to do next, I received a fourth page, this time with a full ten-digit number. I dialed it…at last, it rang! And even though I used a different phone in the ICU, still the neurogist couldn’t hear me on his cell phone. “Hello? Hello?” he said. Exasperated, his angry voice exclaimed, “Don’t you know how to use a phone?!?”

I decided to go to a different nurse station and try to call back yet again. Finally, he answered AND he could hear me! But by this time, the conversation was off to a bad start, and I felt like he took every opportunity to point out how inadequate and insufficient our work-up had been of this patient. “Get an MRI-head, and if it’s negative, then do a lumbar puncture, and THEN if you can’t figure things out, give me a call and I’ll come see the patient.”

*sigh* Days like this make me tire of internal medicine. At least in a mere ten months I’ll be doing anesthesiology!

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Vioxx

$253 million??? I thought this seemed a bit absurd. (see link)

I’m in no way defending Merck or excusing them for the possibility of obfuscating risks. But it seems to me that although the studies show a nearly doubled risk of cardiovascular events (heart attacks & strokes) in patients taking the drug for 18 months or longer, it would be difficult to prove that any particular patient suffering an MI or a stroke would be in the statistical group over and above the basline group at risk for these events in the placebo arm of the study.

In other words if 1/1000 of the placebo group had a heart attack and 2/1000 in the Vioxx group had a heart attack, would Merck be responsible for both patients suffering heart attacks in the Vioxx arm? Or would it be resposible for 2-1=1? And if so, which one?

I acknowledge too that having seen billboards advertising for class-action Vioxx lawsuits and knowing the sometimes greedy, litiginous, and dishonest nature of the American public may sway me unduly toward the drug manufacturer’s side. Then again, 90% of the settlement is punitive–for dishonesty in advertising, I presume–and it seems just a little out of the realm of 12 small-town jurors to set such a precedent for the inevitable and numerous cases to come.

It sure is nice to have a personal forum! Comments are welcome.

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