Nostalgia...

This old wall sign in Portland reminds me of the sign over the drug store in Burrton in the 70s. :-)

One of my favorite passages from all the novels I've read

From The Hours by Michael Cunningham:

How often since then has she wondered what might have happened if she'd tried to remain with him; if she'd returned Richard's kiss on the corner of Bleecker and MacDougal, gone off somewhere (where?) with him.... Couldn't they have discovered something ... larger and stranger than what they've got?

Or then again maybe not, Clarissa tells herself. That's who I was. That's who I am--a decent woman with a good apartment, with a stable and affectionate marriage, giving a party. Venture too far for love, she tells herself, and you renounce citizenship in the country you've made for yourself. You end up just sailing from port to port.

Still, there is this sense of missed opportunity. Maybe there is nothing, ever, that can equal the recollection of having been young together. Maybe's it as simple as that. Richard was the person Clarissa loved at her most optimistic moment. Richard had stood beside her at a pond's edge at dusk.... It had seemed like the beginning of happiness, and Clarissa is still sometimes shocked, more than thirty years later, to realize that it was happiness; that the entire experience lay in a kiss and a walk, the anticipation of dinner and a book.... What lives undimmed in Clarissa's mind more than three decades later is a kiss at dusk on a patch of dead grass, and a walk around a pond as mosquitoes droned in the darkening air. There is still that singular perfection, and it's perfect in part because it seemed, at the time, so clearly to promise more. Now she knows: That was the moment, right then. There has been no other.

AIDS/LifeCycle meets California Gurls

This video gives a great picture of how much fun this year's AIDS/LifeCycle was (and hides quite a bit of the challenge of cycling from San Francisco to Los Angeles :-). Here's ALC's version of Katy Perry & Snoop Dogg's "California Gurls." Enjoy!

(Video link)

Atul Gawande on the challenges facing medical practitioners

Dr. Atul Gawande gave the commencement speech to the Stanford Medical School class of 2010. It's worth a read:

When we talk about the uncontrollable explosion in the costs of health care in America, for instance—about the reality that we in medicine are gradually bankrupting the country—we’re not talking about a problem rooted in economics. We’re talking about a problem rooted in scientific complexity.

Half a century ago, medicine was neither costly nor effective. Since then, however, science has combatted our ignorance. It has enumerated and identified, according to the international disease-classification system, more than 13,600 diagnoses—13,600 different ways our bodies can fail. And for each one we’ve discovered beneficial remedies—remedies that can reduce suffering, extend lives, and sometimes stop a disease altogether. But those remedies now include more than six thousand drugs and four thousand medical and surgical procedures. Our job in medicine is to make sure that all of this capability is deployed, town by town, in the right way at the right time, without harm or waste of resources, for every person alive. And we’re struggling. There is no industry in the world with 13,600 different service lines to deliver.

It should be no wonder that you have not mastered the understanding of them all. No one ever will. That’s why we as doctors and scientists have become ever more finely specialized. If I can’t handle 13,600 diagnoses, well, maybe there are fifty that I can handle—or just one that I might focus on in my research. The result, however, is that we find ourselves to be specialists, worried almost exclusively about our particular niche, and not the larger question of whether we as a group are making the whole system of care better for people.

Quote of the day

On the subject of Pfizer's Boehringer's "female Viagra" and the human sex drive:

It seems simple enough to me in a free society. If it works, whoever wants to use it should be able to. You want more sex drive? Have at it. Personally, I'm somewhat relieved by the abatement of mine with age. The time I spent!

-- Andrew Sullivan

I hear ya, man.

Gail Collins on Obama's Oval Office speech

A nice column from Gail Collins at the New York Times:

I was hoping for a call to arms, a national mission as great as the environmental disaster that inspired it. After the terrorist attack, George W. Bush could have called the country to a grand, important new undertaking in which everyone sacrificed personal or regional advantage for the common good. The fact that he only told us to go shopping was the one unforgivable sin of his administration....

We are frustrated... and it’s possible that Obama may never be able to give the speech that will make us feel better. He may never really lace into the oil companies or issue the kind of call to arms on energy that the environmentalists are yearning for.

That’s because it won’t get him anywhere. Unlike Bush, he has no national consensus to build upon. He’d barely finished his muted remarks on Tuesday before the House minority leader, John Boehner, accused him of exploiting the crisis “to impose a job-killing national energy tax on struggling families and small business.” Michael Steele, the Republican Party chairman, claimed that the president was “manipulating this tragic national crisis for selfish political gain.” And the ever-popular Representative Michele Bachmann denounced the BP restitution fund as “redistribution of wealth” and “one more gateway for government control.”

As a political leader, Barack Obama seems to know what he’s doing. His unsatisfying call for a new energy policy sounded very much like the rhetoric on health care reform that used to drive Democrats nuts: open to all ideas, can’t afford inaction, if we can put a man on the moon. ... But at the end of that health care slog, he wound up with the groundbreaking law that had eluded his predecessors for decades. The process of wringing it out of Congress was so slow and oblique that even when it was over it was hard to appreciate what he’d won. But win he did.

Ironic. The man we elected because we hoped his feel-good campaign speeches might translate into achievement is actually a guy who is going to achieve, even if his presidential speeches leave us feeling blah.

What Rachel Maddow would have said if she were President

Awesome, check out Rachel Maddow's "fake president" Oval Office address on the Gulf oil spill.

Alarmingly incoherent

Mommy, mommy, she scares me! LOL

I love Sarah Palin's suggestion that "the Dutch" would be helpful in plugging the Deepwater Horizon leak because they "are known for dikes." ????

(Video link)

AIDS/LifeCycle 9 - an amazing experience

Wow! Last week I was on the medical team for the AIDS/LifeCycle. What an amazing experience! I was a rider on ALC6 in 2007 (recap here), but being a roadie was a completely different challenge.

The medical team was made up of doctors, PAs, RNs, and EMTs who had volunteered a week of their time to support the 1900 cyclists and nearly 550 roadies who made the 545 mile journey from San Francisco to Los Angeles. Over $10 million was raised to provide services to those living with HIV/AIDS and to prevent new infections.

Like most of the roadie teams, the medical team worked its collective butt off. The base camp medical tent opened at 6am every morning and shut down at 9pm, closing midday only to relocate to the next town on the route. We also staffed lunch and four rest stops along the way and were open overnight for emergencies. On my night shift I didn't get to bed until after 3am and then rose at 5:30am when the team started to show up for the morning rush.

We handled all of the normal things you'd expect on a ride of this kind--dehydration, road rash, saddle sores--along with all of the medical issues that the 2500 participants showed up with on day one. We also had a nasty stomach virus that made the rounds; a large number of folks needing IV fluids during the course of the week as a consequence.

I'm a new EMT, and I learned so much on the LifeCycle. I can't say enough about the providers, nurses, and other EMTs who never hesitated to help me out. Many of them commented during the week: it's amazing what a group of people can accomplish when they're all working together. For me, the most remarkable thing about us was how quickly we coalesced into an effective team. For that I have to credit our medical director, the medical captains, and the charge nurses and pharmacist who led us.

In addition to all the new friends I made, the best part of the week for me was getting to help so many different people. Given the sometimes difficult conditions we were working under, people were so grateful to have us on the ride. It was nice to feel so needed.

Finally, I have to say a big "thank you" to my bff Tommy. It was his idea for us to join the medical team, and working with him for the first time was awesome, even with our little kitty fight on day 6. :-)

Goodbye to the Merc

When I was a kid my parents had a 1941 Mercury two door sedan painted to somewhat resemble a watermelon. It was loud, occasionally backfired on Main Street, and was known to be temperamental about starting when parked out in the middle of nowhere.

But the backseat was so big that we once used it as a camper. :-)

Ford is shutting down the Mercury line which was introduced in 1939. Sigh.

R.I.P. Blanche Devereaux

Rue McClanahan died today, the third of the Golden Girls to do so. Her passing suddenly forced me to think what it will be like when members of my own inner circle begin to... struggling for the right word here, but I guess it's just "die." Heavy sigh.

First 500 days

First Read takes notes of what's happened in Obama's first 500 days of office:

Day 500: With hyperpartisan stories like the Romanoff job offer (dredged back into the news), the kickoff of the Blagojevich trial, and, of course, the continued oil spill, it might go unnoticed by some that today is Barack Obama's 500th day in office (though, some might argue TOMORROW is 500; We’ll let Judge Mark Knoller decide, but we digress). There's always a lot of hype surrounding a president's first 100 days, but Obama has now been in office five times longer than that marker and what a stretch it's been. On a day -- in a presidency -- when small-picture brushfire stories (like Romanoff) are dominating, here's a step back at the big picture and all that's gone on. It could almost read like Billy Joel’s “We Didn’t Start the Fire”… Oil spill, Health care, Tea Parties, Financial reform, bailouts for cars and banks, the stimulus, Cash for Clunkers, Toyota, Haiti, L’Aquila, Iran's elections, David Cameron, Gordon Brown, Israel flotilla, North Korea sinks South Korean ship, Afghanistan troop increase, underwear bomber, Ft. Hood, Times Square, Predator drones, Nobel Peace Prize, State of the Union/Bobby Jindal, Ted Kennedy. Scott Brown, Michael Steele, Sarah Palin resigns, Bob McDonnell, Chris Christie, special elections, Sonia Sotomayor, Elena Kagan, incumbent fever (Bennett, Specter, et al), Charlie Crist's party switch, Evan Bayh, Sex Scandals: The Appalachian Trail, John Ensign, Eric Massa, Mark Souder, Jim Traficant out of jail, announces independent bid, The Salahis, Carrie Prejean, It’s John Edwards’ baby, Rangel loses his gavel, The Replacements: (Blago/Burris, Gillibrand/Caroline Kennedy, Beau Biden/Iraq/hospitalization, Al Franken sworn in as a senator MONTHS after Election Day, The Gores separate. And, by the way, for a little more context, remember this: JFK, at Day 500, had not yet faced the Cuban Missile Crisis and his attorney general, RFK, had yet to order the integration of Ole Miss. or the University of Alabama.

Quote for the week

Sooner or later everyone sits down to a banquet of consequences.

Tarde o temprano todo el mundo se sienta a un banquete de consecuencias.

-- Robert Louis Stevenson