Wednesday, October 3, 2012

Bring Me The Warming

7/13/12 0710 Hilton Suites Boca Raton Fla. The Florida sky show is right up there with the great sky shows I’ve had the privilege to witness. The long low ragged lines of palms and other travel agent dreams, or the I can’t believe it blue of the water, white of the coral sand beaches, or even better the sea of grasses, undulating in waves pushed by a weather front. And overhead, super cells of almost black water filled clouds rimmed by shades of grey and piled up thousands of feet high, making mountains well intentioned ground bound attempts at such heights. And it’s all moving, evanescing, roiling, dogs and old bearded men, witches and warlocks, ducks and your mama’s apron, a whole cast of characters fit for any story you might be populating. And then the rain; marching across the tame lake, sweeping across the grass, tossing the palm trees into a dance. Roaring in like a great beast, as animate as you can imagine. And then there’s the famous calm, and the golden amazement lighting up the departing clouds. On a par with the distant perfection of clouds over the Himal on the road from Leh up the Markha Valley in Ladakh, on our way to the meadow in Niemeling, where we met the first snow of the new winter although it was still summer . Or the perfect puffs of Navajo clouds against the impossibly clear view and over the perfectly executed variously green puffs of brush on the red hills as you cross the border from Texas into New Mexico. Sky shows; who needs fireworks? On the other hand, we did stop in Pennsylvania and spent some money in a strange little house converted into a store; three rooms crammed floor to ceiling full of fireworks. With improbable names like Firedragon and Unicorn Silver. Bypassed the one’s called Enforcer and Controlled Mayhem; Fuji wouldn’t like that even if Joaquin would. Bought a bunch of sparklers, but turned out not to be the good kind, the ones with the dangerously hot wires that need to be put immediately into a bucket of water. They did have a huge versions; might as well try a box. Against all my long dormant 13 year old desires, I didn’t go for the cherry bombs or 88 salutes. Staggered back to the car with the let’s face it probably illegal haul, and so I was ready at that magical hour of dusk, when the fireflies (yes, young Californians; they really do have fireflies on the East Coast, and yes you can catch them and put them in a bottle, if you have air holes and promise to let them go before you go to bed) The sparklers were kinda disappointing; they may be safer, but they don’t look like Tinkerbell flying around that castle like I wanted them too. But the kids were forgiving. And the big sparklers were a great success. The roman candles were perfect for the side yard. And the 8 to 12 dollar Unicorn Silvers and Celestial Extravaganzas really lit up the sky and sent Fuji into the nearest sheltering arms. And so now the glorious fourth is over, and the House of Representatives has voted once again to repeal the Affordable Care Act ( Oh, I so hope they have miscalculated on this one, and that enough people have benefitted already as to give the test of reality to their Big Lie), and here I am again in beautiful Ratsmouth Florida, pursuing the dream of a new medical school. Yes, and global warming takes on a new life of its own when you are two hours late because of unprecedented storm patterns sweeping the entire East Coast. Or with news of droughts and fires here, and floods and tornadoes there. Who needs to go traveling to look for sensational weather; it’s coming to your hometown sooner than you think. Waterfront property? Just sit tight, it’s on its way. Well, the boats are in the water, and the fish are waiting. Went out with Ms Amalia and Steve and had a beautiful fishless time, but the time before that…well, another story. Aloha

Same Old Xanadu

9-30-12 Deerfield Beach Hilton, SE Florida 0710 Same old Xanadu; the 7 story hotel block rising out of palm trees, convenient to the freeway, not too far from the waterway and doors foggy with condensate this early AM. I’m back to what is hubristically called the Gold Coast in pursuit of the elusive medical school start up... Four days of meetings and planning’s, the waggle dances and antennae grooming we worker bees do as we move through the hive. The illusion of separation and of being in control is still a strong motivator for me, although I think age helps to keep a perspective. Nothing like aches and pains plus slow reflexes that occasionally send one crashing to the ground to give one perspective. But you wouldn’t know about that, you perpetually young thing, you. Luckily for me, I kind of enjoy the intensity of this roller coaster ride. For one thing, the project is actually something I believe in; a different way of approaching medical education. And the people I am trying to explain it to are certainly intelligent. Since my interest (a student centered inquiry directed process to replace the teacher centered process I encountered in medical school) isn’t perfectly aligned with their interest (making a profit), the talking is sometimes ...well, tedious isn’t too far off the lex-mark. And yet for the moment, there actually is some alignment; we all want to reduce the cost of medical education. And sometimes, those who live here in Xanadu on the Gold Coast do become interested in the project itself. But that doesn’t mean they lose sight of the important thing in life. The legacy of Willie Sutton is alive and well here. Yes, and you’re not the only one who feels young. The only problem is that I also have the memories of what it was like to REALLY be young. I dream of being able to dive forward onto the floor, tuck, and roll up into Judo Fighting Stance. That was 20. Or power out of a hole in the river even though I didn’t really belong in class 4 water. That was 40. Or sit easily in half lotus. That was 60. 70 is different, and yet in my mind, every time I have to pack up a household, I am waiting for the adult to come along and tell me what to do. The adults, of course, are our children. I had a brief wonderful meeting with David, my old friend and host when I lived here during medical school, and Youme who with husband Hai is raising little Song and pregnant with Loligo or Tunicate or whatever prenatal name her amazing imagination uses. Just walking around the block in the heat of the Coral Gables night, in the full moon, and the kind of connection that reminds me how much friendship and a shared perspective outlasts the palaces and the gold. Yes, and the sun is booming up out of the sea, the palms and the hotel blocks are silhouetted just like the brochures would have us believe. ‘There’s gotta be a palm on it” says Betty, one of our co-conspirators, as we plan a trifold to advertise the medical school should we pass the hurdles towards accreditation that lie ahead. Wish me luck. aloha

Reflections on the Appearance of a Boddhisatva

6-24-12 0925 Hilton Suites, Ratsmouth, Fla. Like many somewhat autistic people, I like labels. Like to see 'em, like to paste 'em on unlabeled events, dogs, small children and even emotional states. Yes, its a pesky habit, but generally not harmful to those small children, etc. I guess a subset of this is diagnosing everything in sight. Probably helps with the doctoring. Probably doesnt hurt other stuff. And a blessing of age has been the slow, sometimes painful, ability to re-label. To admit to myself that the stereotype isnt the reality, That, to use Suzanne Vega's metaphor, my own personal movie may not allign well with reality., Why this reflection, with only minutes to go before heading to Fort Lauderdale airport to travel back north? While the air outside is soggy with the just passed downpour, while the reflections of cloudy light on the evanescent pools that were a parking lot are just waiting to be walked through? Because during the last few days, in the many meetings connected with the business of maybe making a medical school, I've sometimes attrributed evil intent to some actions, some people even. When they could better be considered as another learnable moment, another manifestation of mind. Another bodisatva in the road. More later. Don't worry, all of this will rub off somewhere on the way north.

Sunlight and Altitude

6-11-12 0620 Wilson, WY. Sun climbing up through the trees, and down on the valley floor the fog is layering and curling. Brent says that when you take the lift up to ski, its sometimes 30 degrees warmer on top. Warm would be nice, but sunlight is enough just now, after several days of grey. Dogs barking here and there as the working people wake up and head out. Fugi is making small woofs of her own. Things have settled down; the resident giants are all male, so she occupies a pretty safe position, and is starting to take advantage of it, nipping back a bit, after spending some of the day yesterday under cars . Dinner at a Grille just off the square in Jackson last night, with another Alan, now retired from movie production, enjoying insider war stories from another profession. Like the details of how Steven got Rick hired to star in Encounters of the Third Kind, after his great work in Jaws. And it was great hanging out with Brent ; we were residents at SFGH together, when being in Family Practice meant jumping through all the hoops and hurdles that Internal Medicine set up to keep us from heading up clinical care teams. It’s easy for me to feel how the loyalties established in wartime, or in the equivalent business environment can be as strong as they are. Years after, I still feel he has my back, if needed. At 6148 feet, Wilson is high enough to evoke some DOE..dyspnea or shortness of breath with exertion. Going uphill, I turn to a kind of rapid diaphragm breathing that I ordinarily use only for more than 3 flights of stairs. Of course I could slow down. But there’s Babs, a flash of red through the aspens up along the trail, with Brent close behind and the furry flurry of large dogs..and today feels much less breathy. When we flew into Leh, Ladakh at 11,000, we just got in bed for the afternoon. But after a few days I was running comfortably. Maybe not today. Perhaps, as Sala says, we can’t go back to there. Yes, and balance is another issue. I feel that my medical practice has been like a good introduction to the chapters of the book I am only just getting to. I’ve heard about most of the aging changes years ago from patients who were a little further along the trail. So I feel philosophical, as I tumble down the slightly uneven path I might have only stumbled on a few years ago. And remind myself to treat a 40# pack as a fracture hazard, rather than merely a burden. On trails in the Markah Valley, old people walked between villages very very slowly. At night, if needed, they slept beside the trail. But the got there. Yes, and now the sun is splashed through the green of the foliage in big buttery patches, and although it will mean going down into the fog, I want to get going. After all, Old Faithful waits for no human say-so or denial. So far. Best, Alan

Home on Squirrel Hill

6-17-12 0635 Squirrel Hill, Pittsburgh, PA. They say that before the arrival of Europeans, a squirrel might have traveled from tree to tree all the way from the Coast of Massachusetts to the Mississippi. And the presence of large deciduous trees is still really impressive. They spring up along freeways, they persist in parks. You can almost feel the oxygen flowing out of them. Or maybe it’s just the humidity. In any case, here we are in Squirrel Hill, after a walk in Frick Park, about 500 acres of open space and trees, holding the Mansion of the benefactor, now serving brunch if you want good eggs benedict. Pittsburgh was already a thriving city when the railway was arriving in Cheyenne Wyoming. This is where the stuff that made Cheyenne came from. It’s right in the crotch of the Monongahela and Allegany Rivers, which flow on together as the Ohio, heading SW towards Miss River herself. More the stuff these days is virtual; Google has a growing work group here (http://www.businessinsider.com/google-pittsburgh-office-2011-2), and Carnegie-Mellon celebrated its 115th comencement this spring. Squirrel Hill has over a dozen synagogues, and families walk to worship, and walk their kids to school at Colfax (http://www.pps.k12.pa.us/colfax/site/default.asp) This is where Bimla and Haral’s kids go. Here’s the Vision Statement: At Pittsburgh Colfax K-8, we focus on full implementation of the America’s Choice reform model to raise all students’ performance levels. This is achieved under the guidance of a high-performance leadership team in tangent with involved parent community members that embrace the professional learning community and is interdependent upon effective execution of classroom rituals and routines that are aligned with the standards-based and student-centered workshop model. Harrumph! I’m not sure about the use of ‘in tangent’..since the adjectival use of the word in the dictionary means 1. Making contact at a single point or along a line; touching but not intersecting. Or 2. Irrelevant. I looked up the Vision and Mission because we talked about the challenges in a school housing students of many cultures, and I wanted to know if items like cultural competence were explicitly mentioned at this level of education. Seems not. In planning medical education these days, such items are essential. The sun descended slowly, and the heat gave way to the cool of evening. We had barbecued chicken and tofu with neighbors; other neighbors arrived a bit later. The kids played, viewed the two hooded rats that are houseguests in a large terrarium, and sat on laps. The houses are brick with stained glass in tasteful places, and mostly the original dark wood paneling, but with new kitchens, LG refrigerators, and stoves named for animals. The streets are leafy and quiet. We talked about addressing substance abuse in pregnancy, and recipes for quinoa. Sala left to have dinner with a Buddhist friend. Fuji, socialized to Lucy the local small dog, was docile after a long walk. Finally, there were fireflies on the lawns along the darkling street. Goodbye West!! Hello East!! Best

If its 6/16 this must be Pittsburgh


6-16-12 0605 Northwest of Columbus OH. The answer the pop-quiz is….well, not quinoa. Chenopodium quinoa is actually green and leafy, and perhaps blows in the wind, but it’s not a member of the grass family, and therefore, poor little goosefoot..not a REAL cereal. Amazing where an innocent little question about corn can getcha to. So yesterday, 4 states; starting West of Ms Miss, and transiting Illinois, Indiana, and now along into Ohio. I know, I’m ‘State’s dropping’; bad form in travel writing, but hey, when its miles and miles of that epidemic generating edible oil, fermentation base, and ubiquitous sweetener that is the single largest factor in our obesity problem, ya gotta resort to something other than jaw dropping yawns. Yesterday, raw from the attack on our little Prius (I agree, Paul, what IS it about our Priuses?) and ready for displacement activities, we followed a red with white italic script sign off I 70 and into a little residential nook with two antique stores. ‘Lets go to that one first’ says Sala, ‘its got more junk out in front’. This turned out to be Winter Wheat ( http://www.facebook.com/pages/Winter-Wheat-Antiques/126770104043086 ), which has 4 plus Yelp stars, and in my humble opinion is the best stocked single owner antique store west of Maine. Like Liberty Tool (http://www.libertytoolco.com/ ) its arranged in categories, but unlike Liberty that really is about tools (except for that upstairs…) Winter Wheat is the result of over 40 years of a couple of teachers antiquing. It’s a little hard to find counter space to stack up your finds (certainly not the front counter, where he was involved in a refinishing project), or the middle section of the first room (there are three, somewhat like Russian dolls) where she and a friend were scrubbing small things clean). I got into the baskets (BUSHEL baskets) of costume jewelry pins (have been trying to make silver pins, and thus engaged in the humbling process of actually making a catch that works) and that alone would have taken hours to really accomplish. And there were mountains beyond mountains of dolls and knives and tools and yes, green jars as well. But Fuji was baking in the Hoosier sun, and besides we gotta get to Woods Hole. We did go to the other place in the same neighborhood, which is the more conventional ‘barn’ of 30 small booths, and where the bronze plaque of Goethe was not half price (‘ those folks have some confusing signage’) but a bargain at full price of $4, but the genuine original Bear brand ‘Panda’ model compound bow intended for boy scouts was. Bye bye Amalia and Joaquin, hello Diana and Cupid! It was a longish day, but pleasant. We are all kind of settled into traveling. Fugi likes her head on the broken but usable console, lying on top of the rummage of sweaters jackets and pillows. We generally remember in time to replenish the ice chest. Picnic lunches look good enough to have passer by’s making comments about wanting to join us. Actually moving along through ‘A Farewell to Arms’, and Bergers ideas on passion. Call it dotage or call it wisdom, I am finding Sala’s always well intended comments helpful instead of nettling. Driving, for example. I asked her to back off on my driving technique, and so when she does comment on my driving 45 in a 60 mph zone, she’s right, and I am happy to accept it in the helpful intent category. And she seems able to see my suggestions about making fewer corrective movements of the wheel as reasonable rather than domineering. Yes, and the issue of choosing a motel has been finessed by the growth of the dog friendly La Quinta chain of motels. There is pretty much one in every town, and neither of us has ever much enjoyed the process of finding and choosing. If you are into that process, write and tell me how you handle the conflict side of it, I’d like to learn against a time of no La Quintas. Well, time to fire up the La Pavoni and take the hound for a run walk. Today its on to Pittsburgh and a visit with my brilliant student Bimla on Squirrel Hill. Nenda Salaama, Alan

Old Patience

6-12-12 0700 Cody, WY. An auspicious date in terms of dozens. I can't remember how that particular enumerating method developed..but like 'ounce's and the 'pud' (an old Russian weight) to say nothing of 'stones' , which is alive and well in Britain, I hope its engraved on those tablets we are including in all the soon-to-be space junk we are launching. I mean, the future of humankind had better be in the stars, because what it's looking like here ain't so pretty, However, Old Patience, which Sala feels is a better name, is definitely worth the trip. We pulled into the parking spaces in front of the store (although Yellowstone has a bodaciously few stores) in the oldest national park in the world about 10:30. This isnt the old Lodge, with its art deco sconces and beautifully appointed writing spaces NOT suitable for computers but wonderful for pen and paper after a day of walking amongst the fumaroles, this is the new space with its cash registers and bar coded plastic wrapped made (ahem, well lets just say, 'Elsewhere') gifties. Fuji could smell the western chipmunks immediately, although they keep a pretty low profile. Lots of people sitting around on the porch, so we figured we had some time. But by the time we had settled in a bit, people were trending towards the geyser site, so we joined them. As you know, the entire exclusion zone around Old Faithful is about 4 football fields in size. A crowd 2 or 3 deep had already gathered around most of the perimeter boardwalk, many sitting on the benches provided for that purpose. Afterwards I learned that dogs are not allowed on the boardwalks, but no one objected and there were actually no Smokies in sight The area itself, to bring back your memory,is kind of a blasted heath (or what I always imagined the witches skulking around in before they started in on the eye of toad culinary work), and in themiddle, in a kind of pile of mineral made by herself, is the mildly fuming opening that will, faithfully, be host to a huge outporing of superheated water and steam. The crowd is worth watching too. For one thing, its a pean to the reality of reality...of experiencing the real thing. Dammit, I will SEE Old Faithful in action, mit meine augen selbst; no the channel cannot be changed, and if I were to be in the wrong space at that time, I would be boiled, not just electronically inconvenienced. Large, small, thin, fat, speaking many languages. Polite, pushy, stuffing their faces, chatting, quiet, even reverent. From one side of the perimeter, looking back along, the peoples features fade into strategic dabs of paint. And the vapors..are they getting a little more dense? Yes, and then the first bubbling upheavals start...not to different that watching a coffee percolator start up (when was the last perked Folgers coffee with chicory I had?), but quickly getting larger and larger. And then, great clouds of steam and white water froth gushing upwards, all against absolutely clear wide blue skies.Huge bolts and rising clouds of whitest white, moving upwards, frothing over and slushing down to cascade across the minerals of previous years...centuries. What aspiration, what image of endeavor, of reaching for the sky, of exceeding expectations. Higher and higher each pulsation, as gorgeous as a water fall but going UP!!. Its exactly...A GEYSER!!! What a great word to be applied to becoming old...from now on, you may address me as 'You old geyser!' anytime you want!! Yes, and then there was the subsiding, the burbling bouncing dimunitiion. ' I'll be right back!', you could almost hear the Geyser muttering. , The absolutely still group of people began to natter and nabob again, and we walked along the boardwalk with our illegal hound looking hopefully over the edge, not for the Geyser, but for chipmunks who live under the boards. The rest of the trip, around the Grand Loop, by mudpots and paintpots and an absolutely spectacular Upper Falls in the Grand Canyon of the Yellowstone, was all amazing and beautiful and studded with bison (who also make the landscape more beautiful, thanks again A.W. ) and (imagined) elk and antelope. And now its a beautiful morning in Cody. Last night we checked into our Super 8 (average price of motels here is about $150) and then went back downtown to catch the staged gunfight bringing together an improbable group of characters (including, without explanation, Dick Chaney, the pheasant hunting law breaker, playing the part of the black hat heavy...yes, here in Cody Wy, go figure!). Maybe some more on that, and not going to a rodeo, but Old Patience is plenty for one day

Dont Cry over Broken Glass

6-14-12 0900 Omaha NE Metro Glass. Well, the good news is that my genuine Stetson “25” hat, new to me at the antique mall in beautiful downtown Cody was, after we went through the rubble, not stolen. The bad news is that some actually valuable and important stuff was. Apparently if you just break the drivers side rear window of a Prius it doesn’t set off the alarm system. Otherwise, since we were sleeping within 25 feet of the car with an open motel window, we would have heard something. Its easy to see how vulnerable we all are when something REALLY happens. I went stumbling out to the car to get my running shorts…bleeped the car open as I approached from the rear,opened the hatch, and thought ‘hmm, my LL Bean brown duffle bag isn’t where it should be. OMG, did I put it on top of the car and it fell off?’ I think I actually walked around to the drivers side and peered through where the window used to be without realizing it wasn’t there..because I was looking for a mid sized brown duffle bag, not a pile of tempered glass. Didn’t see it, but the inside was messier than I remembered, and so I went back to the open hatch and maybe then realized that something was wrong..then finally realized that the middle console was ripped entirely off and the window was lying in that sad little pile that is what happens when you break tempered glass. During that 'getting up to speed' time, I was pretty disfunctional, but luckily, it was just me, the birds tweeting, the sun shining, and the little pile of glass in the beauty of a Nebraska morning. Well, the good news is that they didn’t take the box of shoes, or for that matter the camera, or much of anything else. The green glass mason jars that sala just bought, and the buffalo horn that I got back in Cody also survived. The bag they did take unfortunately had my backup hard drives, and my passport. But hey, whats a backup hard drive compared to a sacred buffalo? Another bit of good news is Metro Glass, where a skilled young fella is at this moment replacing the window. And so, with any luck, we’ll be rolling on. The reception person is named Fallon, yes, he mom was very into a certain TV show, and she's from Tustin, has been here 5 years, and is kind of enjoying being a bit of an exotic in a small pond. So we will more on. The book tape, borrowed from Brent, is ‘A Farewell to Arms’ which I have never been able to finish on my own time. And Sala is reading John Berger, so we will be speaking of passion and similar philosophical topics. I can hardly wait. Aloha

Sunday, May 13, 2012

I wish I lived in a kind of a zoo...

5-3-12  0612  Train #66 Amtrak DC to Boston, Davisville RI.

After a night of slow progress, we've turned into a commute train and are flying along like a TGV through a rainy dawn. This is the catboat and saltmarsh section of the trip, Lots of boats still in winter shrink wrap in the little marinas, And the rain makes me a little anxious about my plan to spend a week in Woods Hole working on catboat 'Susie P' and fishing skiff 'George B'.  My mind is lurching around the aisles of my diazepam and ibuprofen treated travelbrain, so buckle up,this may be a bumpy ride.
Yesterday I left Silver Spring after a night in the hospitality of Liz and Ray and their aging Shiba-Inu Sessi and joined the team for our meeting at the AAMC offices to consult regrding the Florida medical school project. I love walking around DC, because sooner or later you will pass the offices of anyone who is anyone. Who would have thunk that the World Wildlife Fund would have a whole building? And so close to Tanzania House. The meeting was over by about 2 PM, and I asked to be dropped off at the National Zoo.

We are just pulling into Providence. As you probably know, the automotive experiencer of Providence RI is now a little like a sedate roller coaster as I 95 flies over on its way, like a great river,all the way south to Miami. The train gives you a Bladerunner's eye view of the concrete and steel that holds all this up, and the various small camps underneath the prosperity. Turns out we will sit here for 15 minutes. Just to be sure I don't make the 8 oclock bus to Woods Hole,I guess.

Yeshi taught me a a verse of a song some time ago

"I wish I lived in a kind of a zoo
All of the animals would be you
And when it came to feeding time
I'd....feed....you, pretty baby!"

Back in 1954, all 6 of us Steinbach's moved en famile to DC accompanying my father who had a one year appointment as Assistant Director of the National Science Foundation. Burr was one of the generation of biopoliticians that came roaring out of WW II intent on creating a new face for scientific research. He and George Wald had been the first National Research Council Fellows at U Chicago, and the one year appointments in the 50's were one of the ways that NSF was integrating itself into the very fabric of scientific support. Out in Bethesda, the National Institutes of Health was going one step further, and actually DOING the research on site. In any case, I went to Alice Deal Junior High School, just off Connecticuit Avenue. Each morning we arriving juniors were met by a gauntlet of student from the High School across the street who shook us down for any lunch money we might have. As a boy, I was assigned to Print Shop ('teach them a useful trade skill'), just as allthe girls were assigned to Home Economics. We all took Latin, and every once in a while some phrase like 'Parva puella pulchra est' will shoulder itself past all the english/german/spanish gemisch and appear on the battlements of my aging mind.

Because I was a very young 8th grader and chubby (the gym instructor remarked 'you jump pretty good for a fat kid', confirming my worst fears about why Peggy,the girl next door, was not immediately falling in love with me) with barely peach fuzz to be seen on any cheek, my social life wasn't m the richest. So I took solace in dodging out the back to avoid the after school shake down, and tkaing the bus down Connecticuit Ave to the Zoo.

At the time, the National Zoo was probably a solid Level II with elements of level III. Meaning it was well past the hideous cat house smells and mangy small mammal house of the Zoo we visited in Cairo, but had only a few educational displays, an no real pretense of support for scientific research. Like all large level II comparables (San Francisco, San Diego, Regents Park, Jardin des Plantes) it had lots of species but minimal labeling. The level III components were mostly engraved bakelite cage tags with maps of the world, and sometimes a stern 'ENDANGERED' placard.

Mai Ziang and Tien Tien are expecting a cub any day now, so there is a 24/7 video watch . I too watched over the shoulder of the volunteer observers in the control room on site. I regret to say that I havent been able to get the PandaCam on line,,or for that matter the Naked Mole RatCam either..but perhaps its a Amtrak bandwidth problem; you might want to try,  http://nationalzoo.si.edu/Animals/WebCams/default.cfm. Mai Ziang was acting like some other pregnant mammals I have known, so the happy news should be coming soon.

The Pandamonium exhibit, with extensive very attractive if artificial rock grottos and lotsof home grown bamboo is definitely Level IV..and in general so is the rest of the National Zoo these days. I can just hear Amalia and Joaquin saying brightly 'Not our Grandfather's Zoo!!'. Fewer species, but each 'house' has not only lots of explanations of everything including poop, but also a transparent research facility (as opposed to the secretive hidden offices where the keepers I knew as a 8th grader lurked to smoke). By the way, as poop goes, Panda poop is apparently a vibrant although limited quantity source of biofuel.

At the other end of the charismatic megafauna spectrum, there is a Komodo Dragon exhibit...it was closed but that didnt stop one of the residents from parading around in site of us dragonmavens. The open uplands of Komodo island is probably the only place where an incautious tourist could actuallyfind themselves in a real life Jurassic Park situation..you know,where the Velociraptors start picking off the ecotourists?  Thats because Komodo's do actually kill and eat people...on Komodo and a few other contiguous islands, they are the top predator. Blue forked tongue flicking out to taste the environment a good two feet long!!

There is a fantastic Amazonian reptile exhibit with those incredibly beautiful and amazingly toxic little frogs that are high up on the list of casualties from global climate change. The elephant compound is getting redone, and will be roomy and attractive to even the most discriminating pachyderm. 

And its free!!

OK, we are heading into BackBay, time to pack up and send this before I have a chance to censor it,  Let this be a lesson to you about brain function after a night on Amtrack in the company of mind bending drugs like Ibuprofen.

Aloha

Saturday, February 25, 2012

River of Cars, River of Grass

02-25-2012 0525 Sea Breeze Cabins, Sanibel Island(it’s not Kansas, Christine!), Fla.
OK, Atul, lets run the damn check list. Mild breeze off the Gulf of Mexico. Check. Whispering palms.Check. Ceiling fan with those built in light bulb sockets gently rotating over the king sized bed. Check. Cozy little cabin with the occasional palmetto bug on the front porch next to the plastic dishpan you wash the sand off your feet after crossing the shell driveway from the beach. Check. Hmm…well; must be Paradise after all, I guess we can get on with the operation.
Only my companion on this trip isn’t Dr Gawande or Dr Vergese, it’s Ms. Sala!! And guess what: she loves Florida and Sanibel in particular. I guess these checklists actually work after all!!
I mean, what’s not to love in this season? Oh sure, a few extra sentient beings who must be kept away from the voting booth at any cost, but it’s too early for the mosquitos, there were actually 14 inches of rain somewhere in the not too distant past, and Steve, our airboat driver, was avuncular and full of information (some of it less than totally well researched) about everything from apple snails to the origins of the Seminole.
“Yes I have been in an airboat” said Sala when I proposed this monstrously un-PC activity. “ In New Zealand!”. Well, no honey, that was a JETboat…but the two have a lot in common. In both cases you get into something that has the innocent look of a child’s plaything scaled up. Yesterday, at Osceola Panthers small airboat ride, gift shop and snack bar (proudly located 15 miles west of Krome Avenue on the Tamiami Trail US 41 and open daily 9 AM to 5 pm) we wandered around said gift shop as we waited for ‘the driver to gas up the boat’ (that’s the non- PC part; no further environmental horrors). Way too many little tanned and dried alligator heads (well, if we sold veal heads in stores there would be a general stampede to vegan eating), but the price on those at $5 seems below parity from the 1970’s when I first came down here for medical school. In contrast, the price of the Miccosukee patchwork little girl skirts that I bought on a starving student diet for $12.50 or so have escalated to $250 (the adult versions are $750). But then, it’s been several generations of tourists telling the next gen ‘when you’re out in the Everglades pick up a couple of those darling patchwork skirts that uncle Al brought back for the kids’.
Anyway, walked down the dock and on to the airboat. Steve’s neck was definitely tanned way beyond being red, his belly showed the evidence of hoisting an occasional one with the boys, and his manner of speech confirmed his answer to Sala’s question as to how he knew the difference between a hammock and the river of grass that we embarked on. ‘ I grew up here’, he said. ‘You know your backyard; I know mine’.
So, the commonality of AIRboats and JETboats is noise and speed. Part of the speed is because it is unexpected. 30 mph on the well-marked highway; no big deal. Through a mixed landscape of grass and small bushes, without windscreens and accompanied by a noise that literally makes it impossible to hear yourself talk, it’s pretty stimulating. But the airboat , at least with expert drivers, may be the only remaining fossil fuel powered vehicle that does not have a seatbelt. It really turns softly, like an airplane caught in a two dimensional dream; an eerie feeling as the driver slews us from side to side to follow trails through the grass, or to depart and slide over a whole clump of grass.
We stopped several times, once at a chickee (living platform) whose thatched huts had to be rebuilt after Katrina leveled everything, that had a thermometer out in the open. It was just topping 100 F on a windy day; Steve assured us 120 was not unusual in the summer. And he remarked that when he was doing rescues, if he could not reach the stranded parties before dark, he would advise them (by cell phone I guess) to get in the water and cover their faces with a shirt, to survive the mosquito swarms.
So, it was the right time, and even though everyone assured us it wasn’t a good time for birds, there were plenty. Egrets of several sizes, anhinga’s diving in the clear water of the canals (called ‘borrow’ canals, because the limestone that is the rock bottom of the river of grass was ‘borrowed’ to make the road you are driving on), and at the Big Cedar Park visitor center, a flock of ibis flying over. 15 foot alligators too. Lazing around on the banks and swimming with a casual grace that you never get to see in those concrete washbasins they give them at the zoo.
And several days ago, Sala got to touch a wild manatee.
So we arrived at our overnight paradise here in time to walk through the spartina and onto the beach, which is just like any beach that happens to be part of 18 miles of white sand and mounds of shells. Yeah, the mounds may be smaller than described in ‘The Lions Paw’( a children’s book which features run away orphans, a search for a shell, and Sanibel-Captiva prominently) but they are still here, enough little bivalves and other mollusk shells to withstand the army of tourists that are visiting just as we are.
There were way more parchment tube worm burrows (Chaetopterus probably) on the beach that I’ve ever seen..perhaps the only indication of oily trouble under the water. But certainly no oil on the beach. The water…well, it’s like SF bay, only pleasantly warm. For that clear blue-green you got go to the Keys.
We’d spent the week in Miami, with Alan making meetings in Boca to talk about medical schools, and Sala playing with Youme and Song (who is maybe 16 months now, with that age’s reserved affect until you pass whatever test she is administering and she cracks the first big smile, instantly bonding you to her). To be fair, we stayed in SOUTH Miami, not downtown, near where David and Edith and Youme and Hai and Song live, and where I lived during my medical school days. So running there in the already warm mornings, sunlight through palms, nut husks and palmetto fronds underfoot, is a romantic return to feeling young and fit and having only the set tasks of school to comfort the brain.
I also got sick on this trip; the same GI thing the whole nation is dealing with, only this was a repeat of a 5 day episode two weeks ago, and lasted only 24 hours. Leaving me so very grateful for feeling good most of the time. And so much more empathic to the difficulty of those who are in a prolonged period of not feeling good.
It’s been a good trip from the relationship point of view. Another persons point of view, particularly when it comes from Sala, who has been part of most of my memories, makes the passage that much more interesting. And as a couple, you have entirely different conversations with new people. Much more detail about babies and clothing, perhaps less caution because our obvious difference makes some kind of statement, gives some kind of reassurance, particularly when traveling in the South. And as Sala says, having that nice young couple in the White House means that people know who she is.
So, a run on the beach when the sun comes up in an hour (very likely), some more searching those piles of shells for the Lions Paw (very unlikely), breakfast on mango and papaya (the black sapote and other exotics became ripe yesterday, and a ripe sapote must be eaten right away, since it passes into corruption far more rapidly than those fruits we encounter in supermarkets) , and then head out into the river of cars to cross the river of grass back to the pad of cement and our flight back to San Francisco, to find Aminta and the little dog.
Aloha
Alan

Wednesday, February 1, 2012

Running, jumping, and standing still at the Exploratorium

1-28-12 San Francisco
Sala, Alan, and Fuji cranked up the mighty Prius and on Saturday last drove over to Berkeley to pick up Amalia (now 9) and Joaquin (almost 7) to go check out the San Francisco Exploratorium. Perhaps because it’s primarily aimed at Children who appreciate long words, more than 40 years after its founding in 1969 The Exploratorium is still called by its full name..no cute contractions based on geography or Manhatten wannabees. And it’s still housed in the Northern end of the Palace of Fine Arts ( Maybeck, 1915, built for the Panama-Pacific Exposition (sometimes called the ‘Innocent Exposition’), and designed as an open rotunda and colonnades to evoke a Roman ruin…and to create additionally an exposition space in the semicircular building that now houses a theatre as well as the Exploratorium). The collection of watery reflecting pools and fountains accommodate satisfying numbers of well fed waterfowl. The russet colored massive stones soar over the walkways, positively shouting ‘ You think one lousy 1906 earthquake and devastating fire can stop US??’. Nowadays, the Palace colonnades are generally occupied with brides and grooms being photographed. But we didn’t see any as we arrived; perhaps too cold.
We left Fuji in the car, after a brief walk around the meadow across the street near the St Francis Yacht Club, but about half way through the visit, Sala noticed a dog, without any Service Dog paraphernalia, and after confounding several of the ‘explainers’ (young people who roam around doing what docents do in less lively places) , I finally got the answer from the Head Explorer for that moment, a dowager type seated behind the office desk; ‘dogs are allowed as long as you are fully responsible for them’. Without pausing to consider all the hypotheticals ( …suppose an elephant, escaped from the circus, sneaks quietly into the building, is frightened by the dog and tramples a small child? Suppose….) I extracted the little dog from her prison and marched her back inside, both of us quite delighted.
By that time, A , J (and us grandparents) had eaten pizza and sodas at the little cafĂ© (no upscale Latte’s or white china cups and plates here, thank you; think Zoo and you have the right level of amenities) and raced off to see the ‘Light’ exhibit. First on the list; you put your chin on a special chin plate, look at the target, and the camera takes a picture and then displays two versions of your face, one constructed of the right side and its flipped dup, and the other constructed from the left side. There’s a switch that lets you elide to adjust the nose width. Yes, we are all quite different right to left. Second; a puddle of light on the floor, made up of overlaps of the three primaries, so that the center is a tetroid of white light. Ho hum. But look what happens when you move more red than blue. The ‘shadow’ turns yellow, based on which lights are left unblocked. Then there’s a large screen classic Pac-man game, but with the controls separated, so it takes a team of 4 to operate the little cookie munching ghost threatened Pac person. And the monochrome room, where all the vivid colors of the vivid children are reduced to a dun colored hue, which you can resurrect with a white light source.
The kid’s favorite is the bubble tray. Like most of the favorites, it’s simple, just much more durable and bigger than what you can have at home. The aluminum rings are 2 feet and more in diameter, so with a little practice Amalia and then Joaquin are pulling up soap film tubes and bringing them down over their heads. An Explainer has worked out how to cut loose a big bubble, which then hangs overhead for a long time. When I try it, just before closing time, about 3 out of 4 times there is no film, and I am somewhat foolishly bringing an empty hoop up over my head. Then the soap molecules pack parallel, the surface becomes tense, the atmosphere is trapped, the bubble expands and an opalescent hood, like the break of a wave in many colors hangs all around me for just an instant before breaking into a few drops of soapy water.
I kept a casual eye on the bubble chamber; one other nerd headed right for it, towing a group of friends. He was probably saying the same stuff I said to Sala ( J and A glazed over very fast); we are seeing the traces of ions left by muons; cosmic rays. This is how most high energy particle work was done until 40 years ago. We are looking at the passage of muons and electrons that were released by supernova millions, billions of years ago and finally arrive here, San Francisco. Well, the kids are right; this is dated stuff. No chance of seeing the Higgs boson here.
Upstairs, accompanied now by an enthusiastic if somewhat confused little dog (who has transformed our family from viewers to exhibitors..with each dog-child encounter the words ‘fully responsible” come ringing in my ears) we are in the ‘Sound’ section. I think the most fun was the walk softly room..a 12 foot tray of gravel with microphones that record a ‘sound score’ of the scrunching you make walking across the tray. I tramp in at a 75 with normal gait. I can get it down to 17 by great care. Sala, walking mindfully one supposes, scores just over 5…Amalia, light as a feather in her holiday Uggs, gets a 4.2, and after a number of leaping scrunchy 40’s, Joaquin somehow manages an incredible 1.7. But there’s also a room of 4 different marimbas (where Sala and I rediscover we have nothing special going in that department, but have a great time), and a place where you can play drums along with a selection of recording stars. And, amazingly, there’s a nice little booth made for two with headphones where you can listen to 5 different conversations between couples, then press the red button for the answer of which is more effective..or another set of numbered buttons that explain why that particular conversation is effective or offensive. From this, I find that expressing anger is not all bad…good to know. Exactly how this exhibit got here is hard to say, but it’s definitely from Berkeley (says so on the attribution).
There is a special case that is devoted to the parts of exhibits that wear out after a million duty cycles, but generally the exhibits are amazingly safe, durable, and self-explanatory. I guess those that aren’t break and are removed. Some date back to before Frank Oppenheimer (younger brother of Oppie) put up the original collection of exhibits…demonstrations of wave action made of steel and brass rods. Model steam engines that work from compressed air. A model of a 4 cylinder internal combustion engine that can be cranked to demonstrate how it works. The air cannon, the mist bowl, the collections of plants and animals. The classroom, for groups and particularly for teachers is not in operation..its Saturday after all.
All in all, we probably saw only a scant hundred of the over 475 participatory exhibits. Wikipedia says 560,000 people visit annually, and the Exploratorium ( a non profit) had an annual budget of $44.7 million. Made the price of so-so pizza less painful. Joaquin’s hands were full of bubbles as we left, meaning he was not able to take a last turn at the sand design turntables ( Alan intervened as he was contemplating mixing the bubbles and the sand). Later, Joaquin did some translational research work on the beach, attacking the larger palette offered there. Fuji, released from her leash, dug right along beside him. Amalia constructed small rocky islands that were then inundated by the advancing surf. Alan watched the wonders of the pacific and of the children.
If you want to see the Exploratorium in its original glory, ya gotta visit soon; sometime in 2013 it’s scheduled to move to the fleshpots of Pier 17 on the Embarcadero, leaving the Palace to the newlyweds and the swans.

Wednesday, January 11, 2012

Sacramento or Bust

01-09-12 Odarkhundred hours. Muir Beach. Fuji pops right out from under the comforter when I call, looking interested and a big groggy. She performs her usual perfect downward dog asana, then leaps from the bed and trots out through the door I’ve opened, accelerates, and bounds stiff legged into the dark, up the steep driveway towards the Ecchium, her favorite hunting ground... There’s a full moon blinging the Western sky, but in her jungle its dark, evoking several sharp barks and a growl or two. As usual I worry about the slavering coyote just waiting for a breakfast morsel of ginger colored barking 12.5 pound Chihuahua Mixdog.

But, as always, Fuji’s back in a few moments, huffing a little over the insulting behavior of whatever escaped her this morning. Last summer she did catch one insanely adventurous young squirrel, and out zigged several zagging chipmunks. This natural behavior evokes a variety of emotions in her human friends, as did the entire nest of baby rabbits that she brought home, very dead, one by one. Fuji has a strong ‘shake ‘em, break ‘em’ behavioral response to anything she can hold firmly in her jaws, but the follow-up eating behavior probably requires more hunger to initiate, so she hesitates, which gives the human intervention, removal, and interment response time to intervene.

I thought about that later, marching with a contingent of Active Elders down Capitol Mall in Sacramento. We had boarded our leased busses to support the annual Medical Student Lobby Day for Single Payer Health Care. I’ve been coming to Lobby Day, when circumstances permit, since it was started 5 years ago. This was the first time I’ve come by bus, and my first social action ever as a senior.

What I thought about on the bus ride and beyond, was natural behaviors and compassion. I have to admit that a part of the thought derived from a different source. A practice of compassion had been the apparent subject of Tenshin Reb Anderson’s Dharma Talk at Green Gulch Zen Monastery on Sunday. On the bus trip up, sitting by myself in the midst of a group of like-aged and older activists and background listening to their talk, I worked on a couple of necklace projects and did not read further in my copy of The Archeology of Knowledge. I have to admit that carrying a copy of Foucault tends to promote my accomplishing almost anything else.

Does Fuji experience Empathy? Or Compassion? Or is that simply not something that her brain concerns itself with? And how does one go about promoting these brain directed behaviors (are they behaviors?) in medical students? Or is it more a matter of not extinguishing the tendencies towards compassion that they already have in their pockets when they arrive at our Professional Reformatories?

These large busses where you sit up high (remember those low slung crouching Greyhounds with the squeaky air brakes and the panting diesels?) are damn fast, and we zoom across the Carquinez Bridge, leaving the old C&H sugar factory squatting beside on the left bank of the Sacramento River. The fleet of decaying Liberty Ships is on the right bank, but out of sight up river beyond Benicia, rusting yet ready for the next call to battle. We pull off at Solano to pick up three elder males and one female.

Now that we are all assembled, our leader (a youthful 40 something and organizer for this senior group whose name I can’t remember) distributes little oranges, granola bars and various flavored potato chips. This is a lot better than SDS on the March on Washington! She also has a printed sheet of our schedule in Sacramento, and takes one necklace worth of time to explain options, depending on mobility. You can get off and march 6 blocks with the students, or be let off at the rally on the Capitol Steps, and even choose to march on once the students are launched on their lobbying missions to ‘A Large Insurance Giant’ for some ‘Occupy Style Protest’, then a free lunch in the park provided by the California Nurses. I begin to think the instructions are excessive, but no; my fellow seniors have questions, and then want to begin a political discussion of the likelihood of SB 810 passing out of committee. SB 810 is this year’s version of Single Payer Health Care for California. In previous years, secure that The Gubernator would veto, it was easy to get democrats to vote the bill out of committee and even pass it on the floor of the Assembly. Now, the suspicion is that Governor Jerry Brown (who could be on the bus, he’s 70 something) doesn’t want it to get to his desk, because he has previously pledged to sign a Single Payer bill.

The bus roars and sways along through Yolo County, where your tomato sauce comes from. I came up here once or twice a week when I was doing ER work, going for an early morning pre-work run along the farm roads that are part of UC Davis Ag campus.

Well, Fuji certainly has a rich emotional life. You can almost feel the quivering passion evoked by a certain roadside smell, or the fierce joy of pursuit as she leaps into a flat out ears back low to the ground run to rout a crowd of ravens from the compost pile. And I think that’s what makes her bounce and bark to be picked up and included in any hugging. I am sure she would be there, licking my face, as she does with Joaquin when he’s hurt or sad. So, perhaps it’s empathy. But is that enough in a medical student? What’s compassion and how to we get it? Or looking at the other side of the reality dog door; what behaviors do we NOT want, and how do they take root?

Sacramento’s sole purpose these days is government, and so it’s a hop skip and jump from freeway to the Capitol Mall, and the bus pulls over next to a gaggle of students, many wearing the short white coats that allow easy identification in the hospitals where they train. And where they learn habits, behaviors, both good and bad. Compassionate or …well, uncaring..arrogant…callous; all those things we would rather our doctor were not.

About half of us seniors stay on the bus; we learn that the fierce independence that got us to this age must be replaced by an inter dependence. Six blocks is six blocks; better save energy for the trek to the ‘Insurance Giant’ and the ill-defined but tempting promise of ‘An Occupy like activity’. And here I take out my long white coat, emblem of my status as a Clinical Professor Emeritus (I actually bought this one at Goodwill for the sole purpose of taking to these demonstrations), and after slapping on my green sticky Senior for Single Payer label, I get off the bus (forgetting my sun glasses of course) and mill around with the laughing, talking, chanting group of the 1%. No, not THAT 1%...this is the 1% that has made it this far up the educational ladder. It takes a family to make a medical student. Sometimes the student has to invent and cathect a family of support when their own cannot function, sometimes the student herself is the reticent beneficiary of a mothers iron will. But one way or another, these young people are a very, very select crew. Lots of smiles, lots of black and brown faces; Asian, African, Native, Northern, Southern heritages evident in the physiognomic details. At least half are women. ARE women more likely to develop a compassionate medical practice? Irreverently, my mind fires back a typical response, a question to the question; ‘Does a dog have Buddha natures?’

“Single Payer, that’s our Right. We are here and we will fight”

“Insurance Greed makes People Bleed”

Each year a new set of well-dressed young women with megaphones leading chants. This year, three painted black Styrofoam full sized coffins, with the grim facts of death due to system failure printed on the sides. Wandering around, I acquire a sign (Single Payer Yes, Insurance Profits NO) and then see two third year students that I taught last year in the Berkeley medical program. Their short coats are gleaming white in the sun; I’m overdressed for the beautiful blue sky balmy day this is turning into (Last year was dark and cold). We chat about Board study (ours are all are in March) and their lives (not so much right now). And now we are marching, shouting, taking action, and the time for consideration of compassion is past for the moment.

The rally is noisy and energetic. The students in their short white coats (most all medical schools have a ‘white coat ceremony’ memorializing the students beginning of their clinical education), the elders with their green sticky badges, and a few of us longer white coats. The three Styrofoam coffins block my view of the speakers, but the PA system, for once, is excellent. And the speakers, including two legislators and various advocates, all give short effective sound bite speeches that I can’t help to think are a credit to our movement. Better than I could do. Writing that, I sense another salutary nudge of my own path towards interdependence. They can do it better. We did some good, they will do better.

Some genius arranged for the funeral procession theme to be led by a New Orleans style jazz band, and as the students head inside through the metal detectors that are part of our lives now (remember when…?) the band forms up and tootles off through Capitol Park. It turns out we are going to the California Organization of Health Plans, a medical insurance provider lobby group. We arrive, no stealth approach, and the lobby doors are immediately locked. The PA system and loudhailers stayed with the students, but a young woman gets up on a wall and with a rolled sign as a megaphone, shouts out “Mic Check”. There is an immediate response from about half the crowd, which is now mainly seniors. Have all of us attended an occupy, or is it learned from video? In either case, we all begin the short phrase group chorus communication methodology used by Occupy movements for their general assemblies. Some younger Occupiers have come along, and one overweight young man with a buzz cut skirmishes with the employees who are trying to let people with routine business in while keeping Occupiers out. Some seniors encourage him; most of us hope no one gets hurt.

The lunch is a big sandwich, and I share the lawn/wrap/spilled water process with an elder EMT from Modesto. His daughter doesn’t have any health insurance. He does; he discovered on his own that as a Vietnam vet he qualified for insurance. He’s been able to get his blood pressure and high cholesterol medication at a cost he can afford. Still, he thinks our current health situation lacks compassion. But before I can get started, a more urgent discussion surfaces. His daughter thinks single payer might drive doctors out of business because they would be paid less. We talk through that scenario, and after a few minutes he says that he’ll talk to her again and explain more about how it might work. She is currently paying off an ER visit where she was billed for $5200. She had a stomach pain. It turned out to be nothing.

A loudhailer announces there are extra lunch bags for those who want them. My lunch mate does. As I get up to leave a few moments later, I notice a set of car keys in the grass. I find him stowing two lunch bags in his backpack. “Dinner” he explains. I hold up the keys to explain I am not checking on him. “Oh, thanks”, he says. “Guess this is gonna happen more “

Yes, he and I will be forgetting more, leaving keys in the grass for younger eyes to find. And I hope that low level mass actions like this for Single Payer are going to be more frequent, as well. Thinking about recognizing and nurturing compassion in medical students, in the face of the system I will be leaving them with, sometimes seems almost futile. 'Maybe', the anarchomaniacal side of me mutters,' it just has to really collapse to get any change'. And then I am back on the elder bus, and we are roaring back down the highway, 10 miles to the gallon, back to Berkeley.

aloha

Alan