Simple Reasonable Conclusions

Long Post...take your time!

2008-06-04T17:35:00.000-07:00

It has been a while since I posted. Much has happened, but I have not been fully inspired to write anything. Sometimes you just gotta write something.

First off...RADIOHEAD!

Most of you will not fully appreciate the above video. This was a concert that I had hoped to see for many years. I first listened to Radiohead in high school when "Creep" became popular. I bought Pablo Honey. Though it was okay. Basically ignored the next two albums until a college roommate convinced me that OK Computer was one of the best albums ever recorded. I borrowed it, and he never got it back. I listened to it sparsely as well, at first, enjoying it superficially. Somehow, though, I got hold of The Bends, and I was hooked completely. "High and Dry," I recognized somehow. But I just loved the musicality. I was in Nashville at the time I listened to it the most, and that was a time when I discovered the importance of rhythm guitar. At least, good rhythm guitar. And I contend that The Bends has some of the best rhythm guitar ever. Off of this album, "The Bends" is perhaps my favorite song. That's the song in the video above. But I could have an inner debate for quite a while about my favorite Radiohead song.

Among Radiohead fans, there are the "Bends" allegiant, and there are the "OK Computer" allegiant--each fans typically declares one of the two as their best. I'm a "Bends" guy. So is my cousin Blair (who was next to me at the concert and acquired the tickets from a guy named Franklin). More people are "OK Computer" people, I think. Certainly the following albums are great (Kid A, Amnesiac, Hail to the Thief, and In Rainbows), but a clear diversion from their previous albums to more inaccessable to the masses, but innovative, progressive, and artistic. In my world, I want the musicians to be a bit weird or unusual, especially in their approach to writing. But not so much as to alienate the fans. I understand it's all subjective. But Radiohead seem to write such tremendous "art" songs, creating transcendent moods with music, taking pop instruments and creating chords and sounds that stretch the mind and acoustic palate.

(Geez, I'm really flowing here.) All of this to say, it was a great moment for me. They have been quite influential in my playing. You can hear it when I play guitar. I bought a Fender Telecaster because Johnny Greenwood (Radiohead guitar player) played one. I bought a Small Stone Phaser (a guitar special effect) because he used one. As I mentioned earlier, their rhythm guitar style inspired me and changed my approach to playing. Just listen to "My Iron Lung" to hear what I'm talking about--I still love it and it inspires me. Listen to the special effects in the intro, then listen to the chords under the verses. Then this song also shows off Thom Yorke's voice. "Bones"--the simplicity of the guitars in the verse, then the octave jumps mixed with blues during the chorus; Thom's vocals--perhaps the most dynamic, and a very inventive melody. (Note: I'm very effusive with my compliments...must be the coffee.) I could probably over-analyze all of their songs. And most of you aren't interested. So I'll end with a summary statement: favorite band, finally saw them live, great show.

...Since my last posting, the Royals have been no-hit by Jon Lester of the Red Sox, had a 12 game losing streak, and now have won only 3 of their last 19 games, nestling them in
last place in the AL Central. Fortunately, they're in a battle for last with Detroit, whose fans must be even more disappointed. The Royals have a knack for making opposing pitchers look like Cy Young candidates, with some suggesting teams should give a slumping pitcher a start against the Royals to break a slump. I've seen Sidney Ponson look like a magician. Went to my first game when the Twins were in town, and the Royals lack of hitting made Kevin Slowey (who?) look like a stud. They've also sent their best young hitter to the minors because of a lack of production. This really is a talented young team in many ways. Except for hitting, it appears. Their pitching staff has done well, often performing at a winning or first-place level. But too often, they lose close games, especially on the nights when the pitching struggles. They're doing well against the monstrous Yankees, especially Jose Guillen even in a loss yesterday. Right now, they're down 6-3, but they still look competitive. I'll keep watching.

...What would you bury yourself in? Maybe we should ask this instead of, "What would you have written on your tombstone?"

...Chalk these up to something I thought of as a kid and am amazed to see come to fruition. I'd love to try it out.

...aaaaand the Royals have lost now, 6-3.

...really? First, Hollywood people can be so weird, and it baffles me that anyone would listen to their opinions in regards to politics or anything worthwhile besides art, fashion, music and other creative ventures. Second, when is Clay Aiken gonna tell everyone he's gay? Seems like he's treating us like sleuths, like ET with the Reese's pieces, giving us clues like little bits of candy. Just say it! Third, does the fact that she artificially inseminated indicate one or both of them just hate sex? Or heterosexual sex? What can be made of it??

...Thanks for reading. So here's an update, in case you're interested. I finish residency in December. Have been looking at jobs in OKC, the Dallas area, and in Austin. All of which are tempting for their own different reasons. I'm ready to leave KC--just needing a change of scenery.

Show Month

2008-05-15T10:01:00.000-07:00

Two down...at least one more to go.

Maybe you have one too--a checklist of things you want to do in life. Some of mine are trivial, others garden-variety, all ultimately personal. This week I've made a strikingly rapid assault on this checklist, having seen two bands I love, and one coming this weekend.

It began Tuesday with The Police...

Great show!! One that you just enjoy and soak in the pleasure of seeing this tumultous trio play the songs from childhood, remembering how I never thought I would have the chance because these guys have a history of not getting along and on-stage fights. They played every song I wanted to hear, except for Synchronicity II, but I'm not complaining. Andy Summers looks every bit of 65, but can still play. Made me think how fun it might be to be the old guy in a band with young, highly-talented players and eventually make it big. A guy can dream, right? A surprising thing was the average age of the crowd. Prior to the show, I speculated average age being thirty, but I would say most were 40 or older. Lots of grey hair there. All in all, great show. My first visit to the new Sprint Center here in KC, which I watched being built from the ground up from my nearby apartment.

And then Wednesday night, Wilco....

This is the second time I've seen them. This time was better than the last show. This one was an outdoor show in Lawrence, KS--a great college, somewhat bohemian, town. They played several songs from Being There--the CD that introduced me to them--which made me very happy. Last time at the Uptown, they essentially played the new songs from Sky Blue Sky and selections from Yankee Hotel Foxtrot and Ghost is Born. My personal favorites were "Say You Miss Me," "Misunderstood"--which is much better and easier to appreciate live, "Handshake Drugs," and they played "California Stars" from the Mermaid Avenue album with Billy Bragg--one of the great leisure songs. And, its lyrics are written by Woody Guthrie. The whole album was an interesting project, profiled in a documentary that you should rent.

Next....Radiohead...the topper!...

Picher, A-Rod, iPhone

2008-05-12T19:39:00.000-07:00

If you're a Yankee hater, here is more fuel for your fire. This guy can't catch a break. I don't think many other players actually like or respect this guy--maybe as a player, not a person. But he's not all bad. My guess is that he's one of those players/people who just doesn't connect well with people. Such a stud athlete, people always wanted to be his friend until he became an adult. Now the people who want to be his friend, he cannot trust--just people who want something for free. Anyway...

I should move to Israel. I'd be envied. Really, the iPhone is the coolest thing. I'm not a gadget guy. And this is such a smart machine. It's my first iPod, of which I have become one of the iPod drones in the world, arriving at work with the earbuds in place. Zoned out. I find it is a crutch for the introvert side of me that really doesn't like things like elevator small talk, forced hallway smiles, and talk about the weather. But I realize the bleakness of a world full of people lost in their iPods--I think of a New York train or Chicago street.

You may have heard of the tornados that hit northeastern Oklahoma a few days ago, killing 6 in the small town of Picher, Oklahoma. What you may not know is that this was perhaps the knockout blow to this old mining town. Because of lead mining, Picher was born. And now, because of lead mining, Picher is dying. The government, after acknowledging the environmental disaster in Tar Creek, is buying out residents homes in an effort to displace them from an unsafe living. This story has been profiled in many places. Notably, I happened to read this article days before the tornado hit. A picture or two says a thousand words. Here is a video featuring a resident of Picher and former miner. (Plus, those of you unfamiliar with the nuances of the modern day Oklahoma accent, you can hear it in the narrators' voices in those features) Another article from over a year ago. There's even a documentary about the small town. This is a sentimental story, not that I have ever been to Picher, but I have driven through so many of these small towns in Oklahoma and Texas. And to think the people were unknowingly exposed to so much lead, but yet the town was sustained by the industry and worked dutifully to support the American industrial machine. So now you can fully understand the story behind the story of the tornados this week--that they struck perhaps the final blow to Picher, OK.

May 6, 2008

2008-05-06T11:13:00.000-07:00

...At work I see many people with chronic pain problems. And this can be the bane of my existence at times. There are people with actual problems who, whether they recognize it or not, become drug addicted. Some will blame the doctors for their addiction, saying that the doctors are the ones that put them on such potent drugs with their accompanying rapid withdrawal effects. This is an interesting article I found detailing a study of demographics of chronic pain. Of note, I found interesting the associations with level of education and the lack of availability of certain drugs in lower socioeconomic areas.

...How about a feel-good story from right here in Kansas City? I must say, however, that the attention lavished on him from celebrities may be a bit much. But he should be applauded for his efforts. Must be interesting to open up a new world with words at age 70.

...I continue to be shocked once in a while when I meet people who seem by all appearances and behavior to be like me who snort cocaine. COCAINE!! I have come to understand an educated, rational person using weed (know plenty of those), but the cocaine users have really suprised me. Maybe I shouldn't be. Maybe I'm naive. I see lots of patients who smoke crack (some of which surprise me as well, especially their nonchalance). And I see that powder is hitting the mainstream.

...For Radiohead fans, here is a great website. And I owe thanks to the overly obsessive people out there whom I can rely upon for details I love but would never really seek out.

...Finally, congratulations to my old roommate Matt Moreland and his wife Sara on the new addition to their family. They are in China right now picking up their daughter whom they have adopted, and you can follow along.

May 2, 2008

2008-05-02T11:25:00.000-07:00

If you have a lot of time to kill, here is a compilation of the Top 50 Greatest Comedy Sketches of All Time, as collected by nerve.com. 50 is a lot. But they really seem to have gotten the ones I like.

So...what would you do? Watch and see what he did.

The Royals are back to their losing ways again. The pitching is doing well, but you can't have an offense that gets shut down by Sidney Ponson!! They lost 2 of 3 to the Rangers--my other team--who are the one team worse than the Royals in the AL.

April 29, 2008

2008-04-29T06:45:00.000-07:00

To the web!...

...The newest version of Grand Theft Auto comes out today. And no matter how much my moral core prompts me to feel otherwise, I have to admit that this is a fun game to play. At least, the old ones were fun. Forgive me. Not sure I would spend the money on something like this any more, though.

...Anyone else think that now is about time to stop this thing? If I were Billy Ray, I'd say it's time to shut it all down for a bit, or you're gonna get this, this, or this. And it actually seems as if they are trying to do the child star thing right. But is there a 'right' way anyway?

...So there are apparently people who actually wanna be the body behind the horrible new OU 'mascot'. Does anybody who is a Sooner fan like the horses?

...I'm uninformed and unmotivated, politically speaking, but something just doesn't seem right. And it seems like another industry has picked up on this, too.

...An article here on athletes and smoking from ESPN.com. (And you might notice where I've lifted my new blog style.)

...I like movies, but I don't like every movie, or even most movies, for that matter. So I like to know, if I'm going to spend the time and money on seeing one in the theater, if it is worth it. And this website is the one I've found that seems to give me good information on whether a movie is good or not. Test it and see. Look up your favorite movies on there, or the classics, and check the ratings, and you will see that it is reliable. Just saw "Juno" a couple of weeks ago, partly based on their consensus review, and thought it was great.

Welp, have a great day every one! (all three of you)

Yankees fans are ridiculous

2008-04-27T17:25:00.000-07:00

I will leave it to Joe Posnanski, columnist for the KC Star, to express the newest level of Yankee ridiculosity.

Surf on...

-Royals took two of three from the Blue Jays. Meche loses again.

-Just a quick plug for a band from Oklahoma City, Aranda--good friends of mine that I used to sit in with on occasion. It was a huge honor/privilege to sit in with them, because of their talent for singing, Dameon's guitar ability, and song writing ability. They have a new record. If you like what you hear, buy a record! Or go see a show.

-Need a new idea for a diet? Try going to prison. Seems to be working for this guy.

April 25, 2008

2008-04-25T03:39:00.000-07:00

So after I posted last week about the Royals, how they were playing well, over .500, and near the top of their division...they promptly have gone out and lost 7 straight games, including both games of a doubleheader yesterday, and are now nuzzling into last place in their division. Seems to be a comfortable spot for them. And people are talking much less about them at work and around town. The excitement is dying down. Now it's going to be more about T-shirt Tuesdays and Buck Nights...still can't wait to get out to a game.

Bouncing around the net...

Wesley Snipes is in trouble for not paying taxes. I need to renew my license plates. I hope I don't get thrown in jail too.

Where did Barry Bonds go? Bill Simmons, one of my favorite columnists on ESPN.com, gives his take.

Saw this t-shirt after searching for more info on my Myers-Briggs test (see recent blog), proving there is a t-shirt for just about everything. I might actually get the baby blue version.

Will someone please come over and bake this for me? In my late night/early morning wakeful periods that I find myself in thanks to my job, I'll catch some interesting shows on the food network. And, naturally, I'll crave some kind of junk food. I've also seen some show where a lady was in a cake baking competition who made a key lime coconut cake !...please find this as well and make it for me.

Finally, before I go to work this morning, the story of a tough and crafty 95 year old woman, from Oklahoma, no less.

Have a great day...

The Portait of the Healer

2008-04-23T15:45:00.000-07:00

Healer Idealists are abstract in thought and speech, cooperative in striving for their ends, and investigative and attentive in their interpersonal relations. Healer present a seemingly tranquil, and noticiably pleasant face to the world, and though to all appearances they might seem reserved, and even shy, on the inside they are anything but reserved, having a capacity for caring not always found in other types. They care deeply-indeed, passionately-about a few special persons or a favorite cause, and their fervent aim is to bring peace and integrity to their loved ones and the world.

Healers have a profound sense of idealism derived from a strong personal morality, and they conceive of the world as an ethical, honorable place. Indeed, to understand Healers, we must understand their idealism as almost boundless and selfless, inspiring them to make extraordinary sacrifices for someone or something they believe in. The Healer is the Prince or Princess of fairytale, the King's Champion or Defender of the Faith, like Sir Galahad or Joan of Arc. Healers are found in only 1 percent of the general population, although, at times, their idealism leaves them feeling even more isolated from the rest of humanity.

Healers seek unity in their lives, unity of body and mind, emotions and intellect, perhaps because they are likely to have a sense of inner division threaded through their lives, which comes from their often unhappy childhood. Healers live a fantasy-filled childhood, which, unfortunately, is discouraged or even punished by many parents. In a practical-minded family, required by their parents to be sociable and industrious in concrete ways, and also given down-to-earth siblings who conform to these parental expectations, Healers come to see themselves as ugly ducklings. Other types usually shrug off parental expectations that do not fit them, but not the Healers. Wishing to please their parents and siblings, but not knowing quite how to do it, they try to hide their differences, believing they are bad to be so fanciful, so unlike their more solid brothers and sisters. They wonder, some of them for the rest of their lives, whether they are OK. They are quite OK, just different from the rest of their family-swans reared in a family of ducks. Even so, to realize and really believe this is not easy for them. Deeply committed to the positive and the good, yet taught to believe there is evil in them, Healers can come to develop a certain fascination with the problem of good and evil, sacred and profane. Healers are drawn toward purity, but can become engrossed with the profane, continuously on the lookout for the wickedness that lurks within them. Then, when Healers believe thay have yielded to an impure temptation, they may be given to acts of self-sacrifice in atonement. Others seldom detect this inner turmoil, however, for the struggle between good and evil is within the Healer, who does not feel compelled to make the issue public.

The above is the description of an INFP, my personality type according to the Myers-Briggs test. Another result from my dabbling in self-awareness.

Baseball

2008-04-21T07:08:00.000-07:00

So, I like baseball. Here's a blog by Rob Neyer who writes for ESPN. This is one of a few blogs I read about baseball on a regular basis. If you are also a baseball fan, I'd also recommend a couple of other ESPN columnists. His columns lean toward analysis of the game--statistics and such. The one I visit the most is a blog by Buster Olney, but you have to be an "ESPN Insider" to read it (monthly fee, which I gladly pay). His blog is more about keeping a pulse on happenings with every team, filled with links to beat writers in every market, so you get the little details which make following a local team so much fun. In all honesty, that is what makes me enjoy the Royals so much. I can get so much detailed information and analysis on a daily basis here in KC through newspapers, radio, television, internet, and water cooler talk. So, basically, Olney's column directs you to all those things in each baseball city.

I read Sports Illustrated regularly as a kid. Well, not the whole magazine. I would skip to the 2-3 page baseball section to read Peter Gammons, and I would have to say his columns were the greatest fuel to my baseball fandom. These days he writes periodically for ESPN (also an insider feature I believe). If I am correct, he is going to be a part of the Baseball Hall of Fame for writers. And how cool is that for him. All of these guys are essentially fans who focused their journalism careers and writing on the game they loved. I certainly don't envy the life on the road and having to play the political games to get the interviews and the scoop they are required to get. But, as with Gammons, you do something you love long enough, you will end up having success. Imagine that for him...writing about all of these baseball players, and then you also end up in their hall of fame.

When I moved to Kansas City, I began to read Joe Posnanski's column in the Kansas City Star. He's really pretty good. It's fun to try and get into the mind and hearts of the long-suffering Kansas City Royals fans. I say 'long-suffering,' but I am old enought to remember the Royals being a very good team in the 80's. In fact, I was on a little league team called the Royals for one year. I doubt there are many Royals teams in the little leagues around the country anymore. Lotsa Yankees, Red Sox, Dodgers, Cardinals, Braves. You can tell that Posnanski has been around for it all, and it's fun to keep up with. Each spring he writes a column about how the Royals will win it all. Which is followed later on (not much later) in the season by a column about how the Royals will never win it all. Good stuff.

I like baseball. Weather's getting warmer. Royals are back in town this week.

Today's links

2008-04-19T11:58:00.000-07:00

So, this is troubling. Plus it's an echo of an earlier event.

And, again, this is where I live.

The Royals are young and a fun team to watch. A few young stars with a lot of talent. They lost to Oakland last night. BUT...they are over .500, and they are in second place in arguably the toughest division in baseball. And...they're back in town next week...AND...the weather is warming up. KC summers are nice. The winters...not so much.

Next month, I will be going to this, this, and this. Great month!

Psalm 1

2008-04-13T09:55:00.000-07:00

Happy are those who don't listen to the wicked, who don't go where sinners go, who don't do what evil people do. They love the Lord's teachings, and they think about those teachings day and night. They are strong like a tree planted by a river. The tree produces fruit in season, and its leaves don't die. Everything they do will succeed.

But wicked people are not like that. They are like chaff that the wind blows away. So the wicked will not escape God's punishment. Sinners will not worship with God's people. This is because the Lord takes care of his people, but the wicked will be destroyed.

Matthew 15--Jesus speaking
I am the true vine, and My Father is the vinedresser. Every branch in me that does not bear fruit, He takes away; and every branch that bears fruit, He prunes it, that it may bear more fruit. You are already clean because of the word which I have spoken to you. Abide in me, and I in you. As the branch cannot bear fruit by itself, unless it abides in the vine, so neither can you, unless you abide in me. I am the vine, you are the branches; he who abides in me, and I in him...he bears much fruit; for apart from me you can do nothing.

If anyone does not abide in me, he is thrown away as a branch and dries up; and they gather them up, and cast them into the fire, and they are burned. If you abide in me and my words abide in you, ask whatever you wish, and it shall be done for you. By this, God is glorified--that you bear much fruit and become my disciples. Just as God has loved me, I have also loved you. Abide in my love. If you keep my commandments, you will abide in my love; just as I have kept God's commandments, and I abide in his love.

These things I have spoken to you, so that my joy may be in you and that your joy may be made full.

ABIDE
verb (used without object) 1. to remain; continue; stay: Abide with me.
2. to have one's abode; dwell; reside: to abide in a small Scottish village.
3. to continue in a particular condition, attitude, relationship, etc.; last.
–verb (used with object) 4. to put up with; tolerate; stand: I can't abide dishonesty!
5. to endure, sustain, or withstand without yielding or submitting: to abide a vigorous onslaught.
6. to wait for; await: to abide the coming of the Lord.
7. to accept without opposition or question: to abide the verdict of the judges.
8. to pay the price or penalty of; suffer for.

My thoughts:
-The language (as translated at least) is kinda harsh in the Psalm. "Wicked", "evil." It takes much for me to consider someone or something wicked or evil. Perhaps you or others can relate to that type of language. In particular, maybe that author. Currently, I do not see much around me as wicked. I do see bad things and bad people, and bad things that people do to each other. But it doesn't fire me up like that. I guess that speaks more to my level emotions.
-I relate more to the broken branch. What I don't like is the idea of being thrown away. Like I'm such a disappointment.
-At the end of the excerpt from Matthew, Jesus Christ says that he's telling us all these thing to give us joy. Interesting. Joy. I know there are books out there and sermons preached on joy. And certainly, if you know me well, joy has been at a minimum in my life for the last 2 1/2 years. Joy...that would be nice.

Your thoughts...?

The Cry

2007-11-19T11:09:00.000-08:00

I'm sorry, my friend, that you now have The Cry
Deep from the gut, powered through the throat
Flattened with face to the floor
Spine twisting
Abrupt and looming
Cathartic and primitive
But shameful, loathsome, and possessive
Joy-depleting, age-accelerating,
Friend-confusing, family-frustrating
Tears drain away parts of your soul

But I remember who you are is who you were
The glide of innocence is gone
The bumps warned of have come
I pray for rapid return
Of your former state of mind
Of the uninhibited and lasting smile
The one I knew before the mask went on
May your face be resistant to the digs of the frown
To the wrinkles that crack me
To the pounds that weigh me down
May time pass quickly and busily
And new love come soon to soothe and swoon
Who you are is who you were
and who you will be someday too

Uncle Andy

2007-10-20T11:44:00.001-07:00

My uncle, Andy Caire (above), died September 1st. He died in his sleep after a brief illness. Andy was the youngest of three boys, my dad's youngest brother. He was an artist, most accomplished with sculptures, I believe. He was a marksman, connoisseur of rifles and southwest history. Lived for many years in Lubbock, Texas. Most recently he moved to Williamsburg, Virginia, where he worked as a smith in the historical village. Andy was a big guy, deep voiced, wore a very long ponytail and a mustache with curved handlebars. He was a lover of dogs. In Williamsburg he often sat on his porch with his dog, Wally, as other residents passed walking their dogs and gave out dog treats to them. One of my earliest memories of visiting Uncle Andy was seeing his St. Bernard named Buck, and we were small enough to ride on Buck like a horse. As I mentioned, Andy was an unofficial historian of southwest U.S. history. He had an incredible personal library dedicated to the subject. He was a member of rifle team in college at Texas Tech, and I remember visiting his home in Lubbock and seeing his personal awards for marksmanship, such as a seven of hearts card with one heart in the corner shot out from something like 50 yards. In my apartment I have several small desktop sculptures that he has made throughout the years. Uncle Andy always remembered our birthdays, sending us a yearly check for $20, written with his distinctive small handwriting. And he always gave my mom such beautiful Christmas gifts to make her home more beautiful, even after the divorce.

I must say I feel a certain kinship with Uncle Andy, being the youngest of three boy, single, and kinda artsy at times. In fact, my dad will sometimes accidentally call me Andy while talking. I think I carry on his sarcastic and sardonic sense of humor, as well as perhaps an extended bachelorhood. Unfortunately there is much more to him than I will know. And his life ended fast and early, though relatively painless and easy given the circumstances. Please remember my grandparents, my dad, my Uncle Beau, and the rest of our family in your thoughts, as well as all of Andy's friends and coworkers in Williamsburg.

Disco-Cyborg Takeover

2007-09-17T06:32:00.000-07:00

From Rolling Stone Issue 1035
Sep 20, 2007

by Joe Levy

In the third week of August, a new Britney Spears song surfaced briefly online, a ballad so negligible it may have been a demo. It was suprisingly stripped of digital processing, leaving Britney's voice completely exposed, and it soon disappeared, only to be replaced by the first single of her comeback campaign, "Gimme More." This was business as usual, with the same mechanized Ann-Margret purr she's used from the beginning and lyrics that equate the gaze of the crowd and the cameras with sex. Is it too unkind to point out it sounds just like Justin Timberlake's "Sexyback," but without the hooks? And is it even unkinder to point out its intentional provocations weren't nearly as shocking as the ballad that had leaked a week before?

What made that ballad so can't-look-away strange was hearing a vocal free of Auto-Tune, the pitch correction software that defines pop music today. You know the sound of Auto-Tune, at least pushed to its limits, when it produces the vocoder-like robotic vocals of T-Pain's "Buy U a Drank" and other summer ubiquities such as Rihanna's "Umbrella" or Sean Kingston's "Beautiful Girls." All of them deploy the digital efect that comes when vocals are tuned too tight, a quavering disco-cyborg melisma that's become the keynote of so much of the Top Forty.

Auto-Tune is infamous for making possible careers that would never exist without it, allowing the turd polishing (as producers call it) that can turn the wee-packaged mediocre singers into stars. But used sparingly, it allows producers to seamlessly correct flat or sharp notes--literally to pull them in line with the proper pitch on a computer display--and it's likely that most of what you hear today is pitch corrected in one place or another. Not because the vocalists can't sing--because they can't sing perfectly. "Auto-Tune is like the fake tits of the music industry," says one producer. That is, it both creates and fulfills inhuman standards of beauty.

Auto-Tune is nothing new, and neither is that disco-cyborg effect, which powered Cher's "Believe" nine years ago. There's no more sense in complaining that it's fake than there was in bitching about drum machines twenty years ago. But it dominates the current moment, for better and worse. It merges the singer and the track, reducing everything to technology, which is perfect for ringtones or music on YouTube. It has its uses. But it rarely sustains more than a song. Try listening to Rihanna's entire album (which has sold sluggishly, despite a massive hit single) and you'll soon know thte truth of the philosophy limned by Justin Timberlake in the hook of 50 Cent's new single: "I'm tired of using technology/Why don't you sit down on top of me?" Sometimes, you want the human touch, even if it's a wobbly Britney vocal no one was ever supposed to hear.

This is where I live...

2007-08-21T19:52:00.000-07:00

Kansas City!!

Blame it on global warming!!

2007-07-17T08:53:00.000-07:00

What ever happened to old fashioned heat waves? Rainy seasons? These days, it seems to me like every environmental abnormality is being blamed on global warming. Perhaps the wild fires are worse now because trees are drier because of global warming. Maybe someone will find a link between autism and melting ice caps.

Here's an article that highlights some of my own thoughts about this new-found gusto for environmentalism...

Prius Preening
Is my hybrid turning my kids into eco-snobs?
By Emily Bazelon
Updated Thursday, July 12, 2007, at 4:24 PM ET

On an average Saturday morning, there are five blue Toyota Priuses in the parking lot of our synagogue. I know because my children count them, starting with ours. They could do this with any popular item they own, of course (not that they have too many chances in our late-adapting household). But their hybrid love made me cringe last week, when the New York Times ran a story about the success of the Prius (purchase required), and I saw myself in it.

Why are Prius sales surging when other hybrids are slumping, the Times asked? Because buyers "want everyone to know they are driving a hybrid." According to a marketing survey (which the Times ran in a graphic I couldn't hide from), more buyers bought the Prius this year because it "makes a statement about me" (57 percent) than because of its better gas mileage (36 percent) or lower carbon dioxide emissions (25 percent) or new technology (7 percent).

If I'm being honest, I'd answer "all of the above" in response to that survey. It also made me worry about how my kids perceive our family Prius ownership. Do they think we're doing our small bit to save the Earth, or are they imbibing a look-at-me smugness?

This is a problem that can arise in many contexts—nationalism and religion spring to mind. There's a fine line between pride in one's identity and unearned moral superiority. But environmentalism has particular pitfalls. One's salvation from sin doesn't depend on anyone else's salvation, not directly. But one's salvation from global warming does. My air conditioning is cooling off my house and heating up your planet.

Kids get this, I think. They also get that grown-ups think the matter urgent. It's a hard lesson to miss when we're surrounded by a doomsday culture spawned by fears of global warming. On Earth Day, my son's first-grade class learned about saving Dear Mother Earth by recycling and conserving water and, yes, telling other people to do those things (starting at home with their families). Don't get me wrong: I'm all for Eli turning off lights and telling his younger brother, Simon, to quit blasting the hot water. I'm also all for Al Gore sounding the alarm to adults. But the mass death threat lurking in kid-aimed lessons about climate change reminds me of the antinuclear propaganda I grew up with in the 1980s. Remember The Day After? I don't think my 7-year-old and 4-year-old really need exposure to end-of-the-world scenarios. I've read them the 1971 The Lorax lots of times, but one later Seuss title we don't own is the Cold War allegory The Butter Battle Book.

Scare tactics and smugness will not win the day for the planet. Thomas Friedman makes this point well with his proposed motto, "Green is the new red, white and blue." He argues that going green should be "capitalistic and patriotic," an ethos that belongs to Kansas as much as to the liberal precincts of Washington, D.C., and San Francisco. If environmentalism remains the snooty project of the Pious Prius Brigade, then my kids and your kids, or their kids or grandkids, will be moving to Greenland.

Following Friedman, I want to make sure Eli and Simon never utter the kid version of the sort of overbearing environmentalism exemplified by this New Yorker quote: "I do daily yoga with my wife. We live in an energy-efficient house with solar-panel appliances. We use organic linens and towels. We try to ride bikes to work." Don't you want to punch this guy? I do. I thought of him a couple of weekends ago when we went on a family camping trip. In the middle of a clear West Virginia stream, some of our fellow campers soaped up, shampoo and all, with nary a thought, seemingly, to the chemicals they were injecting straight into the water. Eli looked at them and then at my husband and me. "Those people shouldn't be doing that!" he said. "We should stop them, shouldn't we?" We shook our heads and told him to keep his voice down, and while I can't quite remember what we said, I hope it was some halfway coherent explanation about how sometimes you just have to let other people be.

At the same time, when kids feel the pull of a powerful family ethic—a strong belief in its own way of doing things—that's a thing to behold. We know a 14-year-old who is a strict and committed vegetarian. He believes that it's wrong to kill animals to eat them, and he converted his parents and his two brothers to eating His Way. There's real force to their collective choice to respect and live out his principles, and a kind of beauty, too. I've written before about trying to inculcate a countercultural family ethic. I'm still committed. And, in our house, some greeniness is part of it. Last winter, when we decided to buy our first new car in 13 years, I was editing the Slate Green Challenge. My husband does environmental work for a living. It seemed ridiculous not to take the biggest chance we had to reduce the family carbon count—and the tax break we got from D.C. was nice, too.

Also—and here's where the "making a statement" part comes in—neither of us really wanted to drive a minivan, our other logical option, given the many-kid carpools in our future. This feeling was tied to green values, sure, but it was also about an aesthetic: avoiding, for now, becoming a minivan mom.

I like our Prius. It's quiet and easy to park. It's averaging gas mileage of 43.4 miles per gallon, not off the charts by any means, but significantly better than the car we traded in for it. Eli and Simon enjoy watching the small video screen on the dashboard, which shows the car's relative use of electricity and gas at any given moment (at least I think that's what it's doing). We all like that hip feeling that comes with other people asking questions about a new product you've decided to make your own.

So far, I'm happy to say, the kids don't seem to have jumped from Prius pleasure to Prius preening. When Eli spotted yet another blue one on the road yesterday, he asked why the car is so popular. I couldn't resist annoyingly answering with, "Why do you think it is?"

Silence in the back seat.

"Well, why did we get one?" I prompted.

More silence, then in a small voice, "So we won't poison the air."

I launched into Gore speak: We're still driving, so we're still poisoning the air, except that actually we're not poisoning it, since carbon dioxide isn't poison, but, yes, we'd gotten the car to help at least a little bit with global warming. I took a breath so I could continue with my explanation, when Simon cut me off.

"I know why we got it," he said. "Because the old green car smelled bad."

Good answer.

Jack Laughing

2007-07-11T21:36:00.000-07:00

This is my cousin's baby Jack:

Imus

2007-04-14T01:11:00.000-07:00

This is an editorial by sports columnist Jason Whitlock of the Kansas City Star, who, if you can't tell in the article, is a black man.

Imus isn’t the real bad guy
By JASON WHITLOCK - Columnist

Thank you, Don Imus. You’ve given us (black people) an excuse to avoid our real problem.

You’ve given Al Sharpton and Jesse Jackson another opportunity to pretend that the old fight, which is now the safe and lucrative fight, is still the most important fight in our push for true economic and social equality.

You’ve given Vivian Stringer and Rutgers the chance to hold a nationally televised recruiting celebration expertly disguised as a news conference to respond to your poor attempt at humor.

Thank you, Don Imus. You extended Black History Month to April, and we can once again wallow in victimhood, protest like it’s 1965 and delude ourselves into believing that fixing your hatred is more necessary than eradicating our self-hatred.

The bigots win again.

While we’re fixated on a bad joke cracked by an irrelevant, bad shock jock, I’m sure at least one of the marvelous young women on the Rutgers basketball team is somewhere snapping her fingers to the beat of 50 Cent’s or Snoop Dogg’s or Young Jeezy’s latest ode glorifying nappy-headed pimps and hos.

I ain’t saying Jesse, Al and Vivian are gold-diggas, but they don’t have the heart to mount a legitimate campaign against the real black-folk killas.

It is us. At this time, we are our own worst enemies. We have allowed our youths to buy into a culture (hip hop) that has been perverted, corrupted and overtaken by prison culture. The music, attitude and behavior expressed in this culture is anti-black, anti-education, demeaning, self-destructive, pro-drug dealing and violent.

Rather than confront this heinous enemy from within, we sit back and wait for someone like Imus to have a slip of the tongue and make the mistake of repeating the things we say about ourselves.

It’s embarrassing. Dave Chappelle was offered $50 million to make racially insensitive jokes about black and white people on TV. He was hailed as a genius. Black comedians routinely crack jokes about white and black people, and we all laugh out loud.

I’m no Don Imus apologist. He and his tiny companion Mike Lupica blasted me after I fell out with ESPN. Imus is a hack.

But, in my view, he didn’t do anything outside the norm for shock jocks and comedians. He also offered an apology. That should’ve been the end of this whole affair. Instead, it’s only the beginning. It’s an opportunity for Stringer, Jackson and Sharpton to step on victim platforms and elevate themselves and their agenda$.

I watched the Rutgers news conference and was ashamed.

Martin Luther King Jr. spoke for eight minutes in 1963 at the March on Washington. At the time, black people could be lynched and denied fundamental rights with little thought. With the comments of a talk-show host most of her players had never heard of before last week serving as her excuse, Vivian Stringer rambled on for 30 minutes about the amazing season her team had.

Somehow, we’re supposed to believe that the comments of a man with virtually no connection to the sports world ruined Rutgers’ wonderful season. Had a broadcaster with credibility and a platform in the sports world uttered the words Imus did, I could understand a level of outrage.

But an hourlong press conference over a man who has already apologized, already been suspended and is already insignificant is just plain intellectually dishonest. This is opportunism. This is a distraction.

In the grand scheme, Don Imus is no threat to us in general and no threat to black women in particular. If his words are so powerful and so destructive and must be rebuked so forcefully, then what should we do about the idiot rappers on BET, MTV and every black-owned radio station in the country who use words much more powerful and much more destructive?

I don’t listen or watch Imus’ show regularly. Has he at any point glorified selling crack cocaine to black women? Has he celebrated black men shooting each other randomly? Has he suggested in any way that it’s cool to be a baby-daddy rather than a husband and a parent? Does he tell his listeners that they’re suckers for pursuing education and that they’re selling out their race if they do?

When Imus does any of that, call me and I’ll get upset. Until then, he is what he is — a washed-up shock jock who is very easy to ignore when you’re not looking to be made a victim.

No. We all know where the real battleground is. We know that the gangsta rappers and their followers in the athletic world have far bigger platforms to negatively define us than some old white man with a bad radio show. There’s no money and lots of danger in that battle, so Jesse and Al are going to sit it out.

Please Pray

2007-03-30T17:29:00.000-07:00

...for my good friend whose little 1yr old boy is in a hospital with a lung problem...he's been in the hospital too long during his short life...prior to this he was a sweet quiet little boy with flushed, ruddy cheeks...now his disease has made him far too quiet...please pray for his momma too, who has had to bear so much burden...pray for healing, and if not healing, then peace beyond all understanding...thank you

What my patients might be thinking sometimes...

2007-03-29T20:23:00.000-07:00

bags

2007-03-07T16:37:00.000-08:00

those sons a bitches
who made you suspicious
are holdin' for riches
your hearts best wishes

I AM SPECIAL

2007-03-01T07:53:00.000-08:00

Inspired by this article: http://www.msnbc.msn.com/id/17349066/?GT1=9145
Fueled by my own thoughts...

Among the phenomena of my generation, as well as the next one which is teens and college students, is this notion of being suuuuuper special. That everyone has a right to their dream, to their ideal, to perfection, to never settle. While I think this is okay to a degree, I find that it can plague a person's life to be perpetually unsatisfactory, that the goals they are striving for are just not fair to themselves and their failure to achieve leaves them sad and wanting.

An example I see today is these silly American Idol auditions, where the auditioner is really just not that good by almost all accounts. The judges tell her she's not going to Hollywood, and she throws a fit (loud or quiet) and says things like, "I'm never going to give up on my dream," or, "This will only make me stronger and I'm never going to stop."

Well, maybe they should stop. When do we draw the line on chasing the dream vs spinning the wheels?

I had a patient the other day who I decided to ask what she wanted to do in the future for a job. (unusual small talk) She said she wanted to get into law, then become a federal judge. I commended her on her aspirations, and asked where she was in school. This 20 year old was not in school, was beginning courses at a local junior college, and aspired to "law classes" at a local university.

Now...I'm 30, and if I got the notion that I wanted to be surgeon general or something, I know it's already too late for all that stuff. These offices and dreams are long in the making for the people who arrive there. And, better or worse, there's often a pedigree one must have that often does not include junior college and a few years languishing in your early twenties. So I found it funny that this girl thought being a federal attorney was completely achievable if you just "set your mind to it."

Maybe we need to encourage less single-mindedness. We should encourage the periphery. Just because you want to, you are HIGHLY likely not to become a superstar entertainer. And maybe you should call off the dream. Or maybe just readjust it. Even the finalists on American Idol will make a living, but they won't be superstars. And eventually most of them will retire from entertainment and pursue a different life. So what makes you think that, if you're rejected early on in the process that you should "get stronger," and pursue this even harder? Just because you want to? Because you wanna be a star?

It is not a right to become highly successful. Yes, we hear stories of the self-made millionaires and celebrities who were down on their luck and had a breakthrough. But the problem is in expectation.

The word "passion" means "suffering." When you tell me music is your passion, don't confuse yourself because it is simply what is fun for you. If it is your passion, then it brings suffering to you. You will suffer anything to do music in any shape or form. You will suffer to try to find your niche, whatever that is. And that is certainly different than expecting success to come to you just because you want it.

There are times...

2007-02-17T12:18:00.000-08:00

...I feel my face get stuck in a pursed-lip grimace
...I can catch lightning in a bottle, but there are holes in my lid
...the dealer always wins, but I never get up to leave
...I'm pessimistic about optimism
...I'm too realistic about ideals
...I feel like the sun is a long lost friend

...that I am satisfied
...that I am dutiful
...when I feel unrecognized
...that I am an underachiever and disappointing
...that I am overly criticized
...I am hopeless
...things will never change
...things have to change
...that the testimonies are true
...that God just might not intervene
...that God is silently waiting, tapping his fingers

...that I will be stuck like this for a very long time
...when I am waiting for a savior
...when I know I am a complete fraud
...I believe time heals all wounds
...when the wounds reopen
...when my imagination overtakes me
...when my anger boils
...when I look at old pictures and wonder where I went
...I long to laugh until I feel tired
...I forget when I last laughed like that

...I feel like I am really smart
...I'd rather be flipping burgers
...I wonder why I'm still single
...when I believe Emily was the worst thing that ever happened
...that the break up ruined years of my life
...memories tear me down
...I feel cheated
...I cannot sleep
...I eat too much
...I can't wait to move from here
...when I believe I'm the same kid I was when I was 22
...I am alone and I know it

...when I believe in the odds
...when I know God has a safety net
...I have great company
...memories hold me strong
...people believe in me strongly
...the guitar is an extension of my emotions
...God is near
...I smile and it feels like I'm working new muscles
...I feel great peace and try to exploit it

...I know I'm a whiner
...I know I'm ungrateful
...I know I'm oblivious
...I know I'm safe
...it could be worse
...I know it's really good

Shadow of the Super Bowl

2007-02-06T19:00:00.000-08:00

OK...so I borrowed this from another blog, who borrowed it from another blog. But I like it.
“Fax of Life” from Rubel Shelly:

That there is “life outside of football” may be a necessary reminder for some sports fans and couch potatoes now that Super Bowl XLI is over. Now that the Indianapolis Colts have the Lombardi Trophy in hand, some of them may be wondering what they will do until next season begins.

But the line is actually from Tony Dungy, the Colts’ head coach. It wasn’t spoken after last Sunday’s water-logged victory over the Chicago Bears but just after his son James committed suicide 13 months ago.

In a speech he made shortly after that tragedy, Dungy talked about all three of his sons. He spoke first of his middle son, Eric, and said his competitive nature is so focused on athletics that “it’s almost a problem.” Then he turned to his youngest son, Jordan, whose rare congenital condition makes him insensitive to pain.

“That sounds like it’s good at the beginning, but I promise you it’s not,” said Coach Dungy. “We’ve learned some hurts are really necessary for kids. Pain is necessary for kids to find out the difference between what’s good and what’s harmful.”

“Cookies are good,” the coach explained, “but – in Jordan’s mind – if they’re good out on the plate, they’re even better in the oven. He will go right in the oven when my wife’s not looking, reach in, take the rack out, take the pan out, burn his hands – then eat the cookies and burn his tongue and never feel it.”

“Pain sometimes lets us know we have a condition that needs to be healed,” Dungy said. “Pain inside sometimes lets us know that spiritually we’re not quite right, and we need to be healed. And that God will send that healing agent right to the spot. Sometimes pain is the only way that will turn us as kids back to the Father.”

Only then did Coach Dungy speak of his oldest son, James, who took his life three days before Christmas 2005. He spoke of his family’s pain. He talked about lessons they were learning from it. He and his wife have since joined an organization dedicated to preventing teen suicide.

Trends in Names

2006-10-26T10:23:00.000-07:00

Always have thought it's interesting to see how some names are trendy at certain times and then fall out of fashion. For example, my grandfather's name is Floyd. Bet you won't see many baby boys out there named Floyd. Its time has passed. Well, this website graphically displays the trends int names since 1880. Interesting. I like plugging in "mom names" and "dad names" like Carol or Janet or Susan or Tom or Roger, and seeing them trend in and out of favor.

Enjoy!... Name Website

2006-09-26T23:20:00.000-07:00

Get this video and more at MySpace.com

Lookalike??...

2006-09-15T15:30:00.000-07:00

| View | Add Favorite

Sixteen Days From Now...

2006-08-09T11:45:00.000-07:00

...is my 30th birthday.

In celebration, I am going to be in Texas for a week starting the weekend of the 25-27th.

That weekend, namely Saturday, Aug 26th, I am hosting any friends who might be in the area (by area I mean Texas) at a lake house at Cedar Creek Lake south of Dallas, for food, lake fun, hanging out.

Since i don't have many of your updated email lists, consider this as your friendly personal invitation. And I know it may be late notice for all you planners out there. But if you can make it out, I think it would be fun to have a reunion of sorts as best we can.

I am inviting any friends, especially those in Texas or Oklahoma who I haven't seen in quite some time. So all you ACU folks, bring your spouses and kids if you please.

But please let me know if you're interested in making the trek. It is about one hour south of Dallas near Trinidad, TX. I'll provide food and drink....

...but please email me or comment here if you are interested. I would love to see my old friends, and by old, i mean those of us who are 30 or near thirty.

I'll send you details when you respond.....

If none of you want to do this....that's fine....i'll be there anyway enjoying myself...but it would be cool to have you there too. If the 26th is not good, I'll be there all weekend anyway if you are looking for a getaway and wanna hang out.

Let me know. I'd love to see you.

Sincerely,
Sam

Bad Video

2006-06-26T19:45:00.000-07:00

One Year

2006-06-17T05:31:00.000-07:00

I uprooted my life one year ago today.

...choreography by Blair

2006-06-07T10:13:00.000-07:00

Evolution of Dance

2006-05-18T23:31:00.000-07:00

Sweet Sweet and Sugar Free

2006-05-07T11:53:00.000-07:00

I drink lotsa diet drinks. In fact, I would say that I can count on one hand the number of regular, sugar sodas I have drunk in the last year. But my consumption of sugar substitutes, through diet drinks and sweetener for my coffee, is generous and, for me, guilt-free. Guiltless because I can trust the FDA in this case, approving these foods to be consumed. While there will probably be some surprise down the road when I am aged and stiff in the joints that something once though innocuous, like the type of fabric softener I use, will cause me to die of cancer, I am choosing to believe that most protective agencies like the FDA are striving for the greater good--and not overly influenced by economics or power.

All that to say...I've included a link below that should assuage any of your fears about Diet Coke, Diet Pepsi, or any of the other sweeteners, being linked to cancer. I'll continue to guiltlessly chug my daily aspartame flavored drinks...

aspartame

Easter is for pictures!...and Jesus...(sorry)

2006-04-26T10:50:00.000-07:00

David Caire and Peter Caire in their Easter sport coats:

A dashing Caden Caire:

The dear eyes of Emery Anne Caire:

Bubba and Thithter:

and the newest, beautiful Anna Elizabeth Caire:

My Vacation to Arizona

2006-04-12T19:29:00.000-07:00

So I went on vacation to Arizona last week, where the skies are cloudless and the roads very flat. Spent time with my friend Brian who lives there. Then friends Jerry and Ali joined us for the weekend.

Me, Brian, Jerry

Jerry, Brian, me, and Ali

For the ladies...

Attempting to tweeze the largest hangnail witnessed by humans:

My evil left eye can see right to your heart...be convicted!

Had a great time...the first vacation time where I actually went on a vacation in a long while. Thanks to B, J, and A for being tremendous, supportive friends and for being fun travel companions.

And...one to grow on:

...and the next day

2006-04-04T12:27:00.000-07:00

Went to the game...PERFECT weather for a day game...sat in the sunny section by the right field line...the sun was to our left the whole time...

...so today I have a slight sunburn on the left half of my face.

also, fans, I'll be headed to Phoenix tonight for a vacation. Visiting Bruss, an old pal from OKC and LifeChurch...I'll also be playing guitar for the new LifeChurch campus there in Phoenix on Wed and on the weekend...so welcome back to the fold to me.

...more later...here's to spring!!

Opening day 2006

2006-04-03T09:23:00.000-07:00

Today is opening day of baseball...one of my favorite, nostalgic days of the year. I have been a baseball fan since I was a kid, and this day was always so much fun for me. Especially when we first got cable television when I was in 8th grade, and I could watch WGN and TBS and ESPN. So much baseball on TV!

Now I live in a city with a major league team for the first time, and I'm going to opening day at the ballpark for the first time.

...AND THEN...the national championship game of the NCAA tournament!!...What a day!!...I think I'm gonna pick Florida this year.

This guy was just let out of his glass case of emotion...

Women and Brad Pitt

2006-03-31T14:57:00.000-08:00

I have a link at the sidebar on my blog to Bill Simmons of ESPN.com Page 2. He is a sports writer, but also mixes in a lot of pop culture. Very funny writer. If you are a big sports fan like me, you'll love his column. And, ladies, if your husband is a sports lover, then he will appreciate this man's column.

Here is the excerpt...

"I was enjoying a lovely Sunday afternoon at the gym when I realized March Madness was on the television screen in the fitness area. I thought this would be a perfect opportunity to impress my boyfriend (a diehard Tar Heel fan) and return home with some knowledge about one of the games. However, as I watched the Bradley (BRAD)/Pittsburgh (PITT) game and checked out the score (in the bottom corner), I couldn't get past the fact that the score read "BRAD PITT." I actually laughed out loud. It was even spelled correctly! Needless to say, I couldn't tell my boyfriend a single fact about the game and wound up looking even more like your stereotypical girl. Any suggestions?"

Don't worry, Vicki -- you weren't alone. At least 50 male readers e-mailed me just to say that their wives or girlfriends noticed the exact same thing. A quick sampling:

While watching the Pittsburgh-Bradley game for 2 hours, my wife sits down on the couch and within 3 minutes asked why it says "Brad Pitt" on the screen. I guess the tourney really has something for everyone.
-- Ted Reed, Minneapolis

Wife walked in while I was watching Bradley-Pitt in the second round, looked at the score in the bottom right of the corner, and said, "Wow ... the screen says Brad Pitt!" Yet another reason to ban all women during tournament time.
-- Kevin, Albany, N.Y.

In the spirit of your Sports Gal/Sports Mom NCAA Tournament brackets, my wife had the following comment during the Bradley/Pitt game. She says in the most excited voice I have heard from her during televised sports and tells me that the box score says "Brad Pitt." Only a woman would notice that.
-- Ryan, Phoenix

And so on. My favorite e-mail came from David Rushall in Denver, who noticed the graphic before his wife and reported afterward, "I kept telling my wife 'Look, there's Brad Pitt!' She could not believe I could pick him out of the crowd during live play, so she continued to scan the crowd. After a while I let her know it was just the score in the upper left corner: BRAD 74, PITT 66. I giggled and continued to point him out every 10 minutes until the games ended."

Was this some sort of sociological experiment by CBS? Were they trying to increase the number of domestic violence incidents during that first weekend? Nobody knows. But the BRAD PITT saga led to an intriguing question from Dan in Villanova:

"This made me wonder if there were any other match-ups in any sport where the abbreviation would be a celebrity's name. I bet each of my buddies $5 that I could think of another one besides BRAD PITT. Can you come up with any? I don't feel like losing $30."

Well, I racked my brain trying to come up with one match-up so Dan didn't have to lose the 30 bucks. Couldn't think of one. So I went to ESPN.com's page that lists every college hoops team and wrote down every possible name that could fit into one of those spots for a graphic: TEX (Texas), RICH (Richmond), PITT (Pittsburgh), BRAD (Bradley), PENN (Penn), BROWN (Brown), BALL (Ball State), CAL (California), JACK (Jacksonville), SAM (Samford), BUCK (Bucknell), KEN (Kentucky), KENT (Kent State), RIDER (Rider) and BROWN (Brown).

Playing the mix-and-match game, there are two possibilities: Either a Jacksonville-Bucknell game (JACK BUCK) or a Troy-Brown game (TROY BROWN) ... and those two names aren't even remotely in Brad Pitt's class, nor would they have gotten your average female viewer to scream excitedly at the screen. I don't know about you, but I'm starting to realize that this BRAD PITT graphic was a once-in-a-lifetime event, not just because of the odds but because of the male-female ramifications in every household.

(By the way, I spent more than an hour figuring this out. And you wonder what I do all day.)

Dance

2006-03-28T14:30:00.000-08:00

Elizabeth Newberry Wooldridge

2006-03-21T04:27:00.000-08:00

My dear, sweet grandmother, Peggy Wooldridge died this morning at 5am surrounded by her family at home in Dallas,TX. She was 92 years old.

She was a cute little lady, with timely funny quips, a good laugher, and honestly opinionated like an old lady should be. She was an American girl raised in Chihuahua, Mexico, who went to college, married a giant, short man who was the quarterback at Texas Tech in 1924. She raised three girls, including my beautiful mother, her youngest daughter. "Gabby" survived to meet 17 of her great grandchildren. She still could speak fluent spanish if needed. She was our matriarch for the last 20 years since my grandfather died. Grandmommy will be missed.

Marching

2006-03-20T01:03:00.000-08:00

...Is it too early to begin counting down the days until I finish residency and can move? Two years, 3 months to go.

...My body is so confused. I have switched back over to regular daytime hours after spending two weeks on night shift. Today, I slept from 4pm until 1030pm in my bed, extending what was supposed to be a nap. Now I find myself wide awake at 3am. I thought I was past it, but the body refuses.

...Now I am in working in the neonatal ICU, with all the preterm babies. All so small...I'm kinda scared to move them around too much.

...The basketball tournament has been awesome, as it is every year. My bracket predictions were miserably poor, as they are every year. Sucked to see Oklahoma go out early, but I should have predicted it. Too bad Kansas went out 1st round again, meaning that's all we're gonna hear about in KC on the sports radio. Glad to see Air Force lose...

...Going to a concert on Tuesday. Wilco is playing. Should be a good time. Just need to find someone to use the second ticket I bought.

...Finished reading a book that I started in November. Just finished it tonight. A book about Lewis & Clark (mostly Lewis) and their exploration of the Missouri River. The inner nerd in me is fascinated by exploration and discovery, by imagining what the city I lived in looked like when it was small, how the land laid out before construction changed it all, how the streets got their names, why some streets became four-lane, what used to be where the interstates are now. Anyway, it was a long book and I've completed it. Good stuff. Makes me want to vacation in Montana & Idaho and see some of the sites they saw that are reportedly much like they were 200 years ago.

...One year ago I found out I matched for residency in Kansas City. It was one of the best days I've had in years, achieving something I had hoped for so much. My mom was so happy for me. My brother was happy to hear it. My dad was with me when I found out. My ex-girlfriend was excited for me. I was in love. On the weekends, I was playing guitar at a great church with great friends, living a smaller version of my musical dreams on a weekly basis. I miss the guys in the band. Afternoons at the driving range were regular. I was winding down my medical education, enjoying the friendships I made in medical school. Kansas City, here I come! Seemed so exciting...

...Today, so much has changed. Much can change in one year...it has proven to be true, and I hope that bears out again in the next year, just in a different way.

L & D

2006-03-12T03:15:00.000-08:00

This week, my sleep schedule has been reversed, as I have been on rotation in labor and delivery, bringing humans into the world at all odd hours of the night. Weekends, I have off. Unfortunately, I am up all night. As a matter of fact, the sky is beginning to change colors as the sun rises. Beautiful...and this sure beats waking up to watch the sun rise.

So last week I delivered five babies. In other words, I was there to catch the babes as they vaulted from their mothers' bodies. I was just there to make sure no cords were stuck around necks, good suction was provided, cords were cut, etc.

During the scuffle of shuffling instruments in my hands and clamping cords, I miss out on the mother's moment. Not to be overly soft, but there is truly nothing like the gaze from a mother to her baby.

It's also funny to think about what's going through baby's mind...like "What the hell just happened??...Why am I choking?...and why am I needing to breathe all of a sudden??...Man, it's freezing in h...wherever I am...All I can do is SCREAM! SOMEONE just HOLD ME or something." You watch them blink and move for the first time...it's all kinda fun.

And then it's back to bitter doctor land, where there's always other stuff hittin' the fan. Where patients don't do what's best for them. Where you have the mandate to just not screw up. To document everything correctly. To interview patients quickly and with compassion when they are far too verbal or tangential.

Please, God, give me more patients....Ooops...patience. I need to learn.

And while you're at it...give me a few more friends so I can go see lots of Royals games. And some friends who can teach me new tricks...I'm gettin' older by the day.

Serenity please...and some somnolence...it's 5am, dude...sorry...Dude

______________________________________________________________________

BTW...for those who were curious...turns out the girl from that prior post actually has a boyfriend--a detail I somehow did not pick up on during our brief conversation. Explains the discretion with which she handed me the note.

So...if you know any short women in the KC area...who are, using the female lexicon "gorgeous," (not 'cute') then let me know.

Your life's theme song

2006-02-09T15:30:00.000-08:00

Wondering what the theme song to your life is??
Go to this website and enter the date that you turned eighteen years old. Leave a comment with the result.

I'll go first...

"I'll Make Love To You" Boyz II Men...HMMMMM...really?

one day stories honest thinking feeling

2006-02-02T15:15:00.000-08:00

February 1, 2006--

5:15am Woke up...actually...no...

4:00am Woke up first at about 4:00 without the alarm. Fought waking for the next hour and a half, losing every 20 minutes or so. Snooze two times. Finally give in, shower, clothe myself, eat Raisin Bran--Kellogg's because it has more raisin. I realize that raisins are a gas producing food, rivaling beans. But I eat them anyway. Drinking Pibb Zero--need caffeine. Listen to the OKC sports radio station on the internet because KC sports radio sucks, and I miss "The Morning Animals."...but I hate the reminders.

~6:45am Get to work. Mild winter KC morning, unseasonably so.

7:00am Check-out from overnight ER docs at 7am until 7:15. Exit room, "MEDICAL CODE...TRAUMA 2" heard from the over head paging system. Walk over to trauma 2, patient wheeled in, already been "down," or without breathing or pulse for a long time. The team ran resuscitation, told me to try to put in a central IV, which was unsuccessful. Patient shows poor signs of survival. Death called, 0721. Some walk in to work today to meet deadlines. I walk in to work today to meet death.

7:35am But it didn't affect me much, since I had never seen the man alive. It's different when you care for the person for a month or a week and they die. Unfortunately it's by far much different for the family and friends. Must remember. Always.

8:15am Working in the ED. See a girl come through, with the a large team of doctors and medical students, who I've noticed for the last couple of months and who I think is pretty and has always been very nice to me for the 30 seconds of interaction we have had about 4 times before. Talk to her briefly, in passing, while looking over a chart. Double check her name on her nametag. Off to see patient...

8:20am ...who is a very drunk lady, who cannot even attend to my interview, but is complaining about her pancreas. Suffer through an attempt at an examination, doing my best. Get her some fluids. Make notes.

9:45 See the girl again. Sit at a computer to do minor things. The computer closest to where she's standing. Got her attention. Made small talk. Found out she likes to go to the art museum about once a week. I tell her I want to go sometime. I convince her to give me her phone number right there, handing her a prescription pad. Then I realize I'm at the nurses station, hitting on a woman. This isn't a bar! This is work. So in mid-action, I began to feel the need to be discrete--and I can tell she does too. So she sheepishly writes down her number. I tell her to fold it and just drop it in front of me. She turns her head, slides the paper off the counter. I pick it up without looking and put it in my pocket. Begin to say how I've been wanting to go to the art museum for a long time. Sheesh...smooth. But it's done.

10:00am See a lady in room A, who has one leg amputated from the past, and has come in because the other leg has a sore that looks like the sore that began the whole amputation process on the other one. She breathes heavily. Poor dentition. Drinks SEVEN beers a day. But only smokes 2-3 cigs a day (right). Both bad for circulation. I tell her she needs to just quit, explaining how it contributes to her poor circulation and that it could lead to further amputations in the worst cases. "Oh, okay," she agrees, almost as if I was the first doctor to explain that to her. "Can I get some breakfast?"

10:40am Drunk lady is sleeping it off. Nurse tells me that, when she wakes up, she complains of pain, then drifts back to sleep.

10:55am Thoughts return of the ex-girlfriend, shudder in the midst of work, our ending, my loneliness, her face, being replaced, disappointment, loss. For seconds, warm runs my blood, electric my nerves. When does it end?

12:15pm Sneak off to break room. Steal some of the free graham crackers and peanut butter intended for the patients because I forgot my lunch. Dipping the graham crackers into the peanut butter, so flavorful, tastes amazing when you're hungry and shaking. And I love peanut butter.

1:15pm Visit a patient who has belly pain, with bad swelling in his right groin, trouble urinating. Schizophrenic, too. I go to examine the area just right of his genitals. He is avoidant of this. As I press there, he nearly jumps from the bed in pain. I have to palpate his testicles as well, which elicits the same painful response. Sorry, dude. I leave him be for a while. I think he's got prostatitis or an infected testicle. My upper level resident, Natalie, tells me to go back in and do a rectal exam to feel his prostate. When I do that, he again nearly jumps through the roof, like I had a cattle prod on the end of my finger. Prostatitis.

1:30pm Two rooms down--separated only by curtains--a man is wrestling with security and nurses, exhibiting the herculean empowerment PCP provides. I'm asked to get Natalie so she can order chemical restraints. I admire my upper level. She is handling about three times as many patients as I am and exhibiting cucumber coolness. Meanwhile I'm trudging through exams, diagnosis, documentation. One day...I'll be there.

1:50pm Shudder, suddenly thinking again about the old girlfriend as I'm doing paperwork. How did I get here? Why did I have to move? Why didn't it work? How could she? So quickly? That guy. Her face. Love. It's been five months now. My OKC friends. Hours pass idle. My empty apartment. STOP IT!! God, take it away. Please... how many times must I ask you? Get the thoughts from my head. Fix me.

2:40pm See patient who is a lady with a swollen red ankle, telling me her story, how she's unable to support her large frame with this maligned left ankle, while calmly eating McDonalds french fries that her nephew bought her on the ground floor of the hospital. She can't remember hurting it. Just woke up like that. Okay.

3:00pm Afternoon check out. The end of my shift. We run down the list of patients in the ER. I zone out as I finally sit down for a bit, as the upper levels discuss the cases, think again about the ex, her happiness, my uphill. Glad to be back in the ER. Good to be back. I chose an interesting career. Tough, but fun sometimes. Action, anger, humor, people watching, major frustration, poverty, compassion, healing, relief, confrontation, apologies, manipulation, resignation, learning.

4:00pm Finish up with the day's patients. Thoughts return. Nerves fire again. Heading home...To what? Next event scheduled--work tomorrow. But I have lots of reading to do for resident conference and grand rounds tomorrow. Reading. Alone.

4:15pm Return to apartment building. Walk into my loft, which is really cool. Hardwood floors, cool design. Door shuts behind me. Sigh. Put down bag. Take off white coat. Sigh. Throw junk mail against the wall in exasperation.

4:25pm To computer. Begin to check email, which will be repeated, "Send/Recieve" every 3 minutes or so. Check and recheck websites. Shudder, as above, several times. Read blogs. Empathize with Dr. Gilbert. Realize that pain comes in so many different shapes. Cower in shame over self-pity reading Brooklyn blog. Wonder, at one time, where the Living God lives, so I ask him for directions. Check email throught the next several hours, catch a little TV. Surf. Avoid the reading. Scroll through the cell phone again and again, wondering who I can call. Call one of them...no answer. Text a friend. Call my brother to visit, but decide against the drive. Need to read anyway. Call for Thai takeout at the noodle place around the corner from my downtown apartment. Back to computer. Check email. Waiting for bed time to come around. Call mom, talk about Grandmommy's health, and other small stuff, her upcoming visit.

10:15pm TV watching...to sleep. Wait!...forgot to read for tomorrow. Read for five minutes. Shudder again a time or two. To sleep soon after.

2006, the thirtieth year of my existence

2006-01-24T08:28:00.000-08:00

...Just got a free Gilette Fusion razor in the mail. It has FIVE blades on it. This is an upgrade from my current Mach 3 razor, which battles my beard with only three blades. Can't wait for the day when they invent a way to make a razor with six blades. What advances in technology! I believe in high school, the most razors you could get on a blade was two. I'm happy to be alive.

...And have you noticed the ads for men's razors are like 30 second shorts for Tron? Or BladeRunner? Like razors are futuristic? How progressive is scraping your face with tiny knives? Get me a razor that fires lasers out of it to remove my facial hair for weeks at a time if you're gonna advertise like that.

...To the Texas fans out there: National championships are fun, aren't they? We Sooners hope the best for you in your moment in the sun. Enjoy it. Pat ol' Vincent on the back, wish him well, and we'll see you in the Cotton Bowl.

...Current listening: Death Cab for Cutie, Citizen Cope, Andrew Bird
...suggestions from the audiophiles?

...Thanks to the OKC crew for a great New Year's Eve. I had a group of about 10 friends from OKC come to KC for NYE--I have great friends. We had a good time. You should come visit, too! We'll walk over to the BBQ restaurant next to my apt and enjoy some tasty ribs.

...I have a possible steady gig playing guitar at a local church. They've have offered me a position as the back-up guitar player for a once a month service. Is there any more back-up back-up role than one that at best/worst would commit me to twelve times per year?

...In actuality, I am playing tonight at a local church called Heartland Community Church, which is a fairly large church. I can't tell you how nice it is to plug in the electric again. Can't rock out in the apartment.

...For those of you who like stories, I'll be rotating through the emergency department again next month. For now, I'll share a good one...

...A lady was visiting some friends from out of town. They decided to hit an after hours party at a local bar. As they were in the parking lot, the lady reported being assaulted by unkown individuals, suffering a small 1-2 inch cut just underneath her eyebrow. Not thinking it too big of a deal, she made it home and went to bed. As she awoke in the morning, she noted having some difficulty with her vision in the affected eye, so she went to the hospital. Noting the change in vision with the cut and blow to the head, the doctors decided to get a CT scan of the head to look for anything more severe. What they discovered was that the cut wasn't simply a cut. What they found was a brightly illuminated 3-inch serrated blade inside the woman's eye socket, at the location of the cut. This explained the loss in vision. Apparently she had not simply been hit in the face, but stabbed with a knife, the blade of which broke off the handle and was lodged inside her head. To think that she went home, went to sleep, and then woke up to report to the hospital must be substantive proof of alcohol as a pain killer.

That is all...

No Passage but for the Perfect

2006-01-11T13:50:00.000-08:00

Mother teaches baby daughter grown-up defenses
Hopes she avenges not giving in to her senses

Keep safe by keeping distant
Give love with great resistance
Carefully tend your fences
Cut ties when pain commences
Build up the walls around
And if one broken down
Step back and build another
Closer to stand your ground

Bruising blows to suitors from a ten foot pole
The body touch but do not touch the soul
Thus explains the feelings of wasted years
Why love if love is cloaked in fear

Soft Shoe

2005-12-27T13:14:00.000-08:00

I'd like to think I have a gift
I'd like to think me rare
Humor talent moxie charm
Presence savoire faire
You should see me sing and dance
On my own private stage
There's never been a show like this
To me I'm all the rage

The critic in my mind could fill
The whole newspaper page
And rejection makes me wonder
Just how the judges gauge
To outside eyes is obvious
my mediocrity?
Self-talk self-assurance create
this dichotomy?
The voices of the Positives
Say don't indulge the dark
Believe the mirror write the pages
of private stage remarks

The follies I've performed
for loved ones and for friends
Shining spotlights on myself
Alighting my descent
My need for loud ovations
A stranger's rave review
Crumbling me because I find
Auditions far and few

I'm using all the charity
I've earned throughout the years
For one more chance at that big break
To cap off my career.
Thanks to all who've done before
Who choose to fill my ears
Who conjure up my distant soul
Once so cavalier
Tick-tock, time will do the trick
Rest assured I know
My stage fright temporary
My soul made for the show

Hamiltons

2005-12-19T09:02:00.000-08:00

VIDEO

Thanks, Blair

Impending

2005-12-12T18:47:00.000-08:00

It was Thursday afternoon, about one o'clock when I returned to the ICU after lunch. Maybe 1:30, actually. I took a little longer at lunch than I should have, probably.

In the corner room to my left, I saw a nurse motioning for me to come over.

Mr. H was in the bed breathing quickly and deeply. Just that morning, our team had decided that he was ready to leave the ICU and go to the wards, as he was showing improvement after his heart valve replacement surgery. Now he was lying in the same position in bed, but strapped with a mask on his face.

I went to visit with him. Though he was breathing heavily, he was still quite aware of himself and his surroundings.

I went through my motions, examining him, checking his lines, the drainage tube from his chest. Ordered a chest x-ray. Got another physician to look at him and discuss what to do. Developed a plan, executed it.

As things progressed, I continued an interrupted dialogue with Mr. H, noting his awareness and condition. He never really worsened, neurologically speaking. But his breathing problems persisted.

He was quite raspy as well, as previous surgery in his past had left a scarred vocal cord.

"How are you doing," I asked. He nodded his head, and then shook it--probably not necessary to say any words.

"Are you getting tired?" He nodded again. Then he mouthed something. Through the high flow of oxygen through his facemask, it was even harder to hear and understand him.

I leaned in.

"Where's Dr. p? Is Dr. p coming?"

"Yes," I acknowledge, his surgeon would be on his way, though I didn't really know that for sure.

I straightened up and he motioned be back to his face again.

"I don't think I'm gonna make it this time," he said.

"We'll get you taken care of," I shallowly replied.

Mr. H died two days later, his distress and death a result of an infection.

Because he was so short of breath and was soon intubated, I believe those words were some of the last he spoke. So calmly, assuredly.

To me. Or to anyone else.

Solomon

2005-12-11T20:15:00.000-08:00

Sorrow is better than laughter, for sadness has a refining influence on us.

A wise person thinks much about death, while the fool thinks only about having a good time now.

Enjoy prosperity while you can. But when hard times strike, realize that both come from God. That way you will realize that nothing is certain in this life.

Snow

2005-12-09T16:44:00.000-08:00

There was a snow storm the night before last.

TEN INCHES of snow on my car in the morning.

Of course, being a doctor, I could not play hookey. Had to trudge through the sludge to get to work.

This morning, it was colder here in KC than it was in Anchorage, Alaska.

Amazing.

Thought Biopsy

2005-11-26T09:07:00.000-08:00

What's coming to mind at this moment:

...wondering what Ethiopian food is like? I had a visit from my friend Dr. David Gilbert, classmate of mine at OU med school. He was up here interviewing for a residency position. We went to eat last Monday night, had Ethiopian food. Kinda felt guilty, eating Ethiopian food. Like I should have boxed it up and sent it to Ethiopia so the kids there could eat it. No utensils with Ethiopian food. You are given a large, thin piece of bread that is actually more like a pancake all folded up. You tear off a piece of the pancake and pick up the food with the pancake. On my plate was ground beef, collared greens, spicy lentils and some yellow bean paste type thing. Not too bad. Kinda messy, but the warm towel was handy. And, no follow-up bowel problems.

...This month has been easier for me, compared to October--for all of you who may have sniffed out some kind of despair or lamentation in my last post. I think I may have come across a bit more despondent than I intended. Wasn't terrible, but the hardest working 21 days I've had. I was working on some kind of task every day from the moment I arrived at work at 5am until I left at ~6pm. Toss in the occasional call night where the clock doesn't stop and I don't go home until noon the next day. This leads me to another thought...

...I suppose everyone has choices in how busy they are at work. If you want to advance in your company/work, you will likely have to put in many long days with constant working through the day. If you don't impose pressure on yourself to advance, you can have the slow workday, peppered with personal phone calls, errand running, long lunches, background music, etc. There's certainly nothing wrong with that kind of workday. I'm just jealous. Must be nice.

...I feel like I should have an I-Pod. That's called effective marketing. I'm learning that I am supposed to have a need to have music at my disposal at any given moment, all contained in a conspicuous white package and white appendage from the ear. But when am I supposed to listen to music? When I'm at home, I use the stereo or computer. Work?...funny. The drive?...got the car stereo. So why should I want an I-Pod? Answer/theory: I'm almost 30. If I don't catch on to this gadget and learn it, then I'm on the downhill slide to technical oblivion. The road that leads intelligent men and women to be rendered helpless by a VCR.

...Music lately--Damien Rice

...Dealing with student loan lenders sucks. It's hard not to approach them with suspicion like used car salesmen. Especially since 3% on my loans totals into the thousands.

...It's very hard to let your light shine when a nurse pages you up at 4am, no matter the reason. Jesus never dealt with that. Dr. Gilbert, I have broken our resolution too many times.

...So now I'm in the ICU, where death is somewhat a part of the routine. (Of course, not everyone dies.) The team I'm on this month is consulted when patient are placed on mechanical ventilation. Several patients have had medical care withdrawn due to the poor prognosis of their condition. Others just have so many medical problems that families let nature take its course, with no intervention with resuscitation drugs or procedures. Other patients camp out for a very long time in the ICU, with no instructions on end of life issues, perhaps due to a lack of planning or, in one case, no family is able to be located to dictate plans. I believe now that God has given us some jurisdiction over life and death. I'm not going to touch the abortion issue. But we have become comfortable with the idea of "playing God" when in reference to creating life--birth control, in-vitro fertilization, fertility drugs. However, it is more uncomfortable regarding death. God has given us, as humans, the ability to end life. Murder is a sinful way to end life. Withdrawing medical treatment in light of a statistically proven poor prognosis is not seen as sinful. As medical advancement continues, we are capable of keeping a person "alive" seemingly forever with mechanical ventilation, a feeding tube, and a pace maker. Give antibiotics when infection sets in. Dialysis if the kidneys stop working. Miracles happen, but death is more common. And nobody gets out of this world alive. I think that God's forgiveness covers ending life in these situations. Perhaps the commandment, "Thou shall not kill" should be viewed as a heart issue, meaning that the difference between murder and withdrawal of care is malice vs. wisdom/sympathy/compassion. How many other sins or perceived/implied sins can be viewed as such?

...I need a haircut.

...To the Texas fans out there: Enjoy it while you can. Vince Young will leave one day. Heisman-less (Reggie Bush) and championship-less (USC will make them one-dimensional) to boot.

October

2005-10-30T20:15:00.000-08:00

Another month has come and gone in my residency. This past month, I have been in survival mode, just trying to keep up on things at work.

In October, I was rotating on trauma surgery. This meant 4am wake up. Work from 5:30 am to usually 6pm daily. I had a day off two weeks ago, I believe. Of course, I did have a vacation for a week at the beginning of the month. But, all work, no play makes Sam a dull boy. This past month has stunk too. I think I find solace in griping, however. I also find myself cussing a lot more. They're just words to me, but clearly they do have a vigor to them for which other words cannot suffice.

Of note from the past month...

...At one time, I was taking care of two alleged murderers at the same time. Both were continuously monitored by county police, to be arrested upon my discharging them from the hospital. It's hard to treat a person who killed someone who is complaining of pain. Sympathy is in short supply. On the other hand, far be it from me to not acquiesce to every wish of someone who isn't afraid to kill. Had another patient who took on some prison guards. Not gonna cross him either, although he's probably wishing he was in the hospital right now rather than under the careful watch of some pissed off prison guards.

...I haven't been outside much. Probably a total of 2 hours over the last 21 days.

...I worked overnight the night of the time change. As much fun as those of you who are recreational sleepers had on Saturday night, it sucks when you're up and working, and you watch the clocks turn back.

...My PlayStation 2 stopped playing discs yesterday, eliminating two forms of entertainment for me--games and DVDs. This comes just after signing up for Netflix. All I've got now is network television (no cable).

...which means I get far too many celebrity news shows and infomercials.

...Law & Order, any version, is fantastic.

...Is my last name really that tricky? I get phone calls at work from many different nurses during the day, meaning that I must answer to many versions of my name. "Carr" has been the most common. There's always the hesitant attempts, too--"Ca...Car...Carr-y??"

...This is also complicated by the fact that one of my supervising physicians is named Khare (pronounced Car-ee), but looks like "care," which is how my last name is pronounced.

...Great to hear from old friends. Drop a line if you can.

The Party

2005-10-18T21:15:00.000-07:00

Well, this has turned out to be quite the reunion. Welcome to old friends who are stumbling into my little cyber world. Thanks for making contact.

Had a week off for vacation. Went to Dallas to visit my family. Also celebrated the 1st birthday of little Sam Thomas, my namesake. It's very sad, really. You can tell how much pressure he feels to live up to the name because of how much he craps his pants when I'm around. He's a tender little guy. Still wets the bed.

Actually, he's one of the sweetest kids you'll ever meet, without a doubt. Here he is/we are:

Got to see my nephews, David and Peter, who are Will and Allison's children. They also have one on the way. Three kids within 3 years...they're not Catholic. Pete's walking now. David's using sentences and is fascinated with fans.

And, here in KC, are Caden and Emery, Jake and Amy's children, who I get to see nearly every week. Sweet kids.
Here's Emery:

And...here is me at Halloween last year:

Dr. Caire's TV prescription

2005-10-09T18:55:00.000-07:00

I watched one of the first episode's of Grey's Anatomy, chuckled at it, not with it, and have not watched much of it since. Since I don't have cable, I am reliant upon network television for entertainment, and have thus gazed at a few clips of GA again--repeat chuckling and huffing and puffing.

I'm not so cynical to think that TV medical dramas should be strictly adherent to reality. Rather it shouldn't since a great deal of it, from my experience, is mundane and not relative to the general public. But there's a limit to what I can take.

And here's an article from MSN discussing it.

I have started watching ER, and it has some stuff I can really relate to. But the amount of crazy cases you see in the hour is more like the amount you might see in a month.

My life in medicine is some combo of the pain the residents feel on ER, and the dumb butt feelings of the residents on Scrubs (as well as some of the humor).

So those I can sidle up to the remote and watch. The others are stretching it.

Only in America...

2005-09-28T15:08:00.000-07:00

Is there any other country where the poor people are fat?

Day off, or just another day

2005-09-18T08:14:00.000-07:00

I get few days off these days. I was off yesterday and today--two in a row--which is a rarity, but often actually a consequence.

Two days off...after working eleven straight.

All I wanted to do this morning was go and hit golf balls on my day off.

It's raining.

Back to work tomorrow for another week, sunrise to sunset...weather is supposed to be great.

Get to work a 6:30...copy down morning labs in the hospital. Thumb through the chart trying to make heads or tails of illegible notes from other doctors. Write a note about the patient, not totally knowing what my supervising doc really wants to do today with the patient. Repeat this for each of the 8 patients i am responsible for in the hospital. Be interrupted in this process by questions from nurses ranging from the banal to the insurmountable, usually covering any and every patient care topic not expressly covered in medical school. Talking to patients who talk amazingly slow, who smell bad, who are tragically unaware/ignorant of taking care of their own health.

It has becomed terribly difficult to connect to the "I just want to help people" aspect of medicine that we all had going into medical school. Whatever I personally had to offer with my charm is far outweighed and imbalanced by the difficulty of the science and procedure of health care. While I may be an intelligent and talented person, I often feel I am a burden to my supervisors, getting a few to many glances with smirks or furrrowed brows asking me, "Now where did you go to medical school?" These intellectual blows along with the frustrating patients who all too often reside in the margins of tolerability are making it a tired and sad era in my life right now.

Patients far too often hold a tragic flaw. Or perhaps a half dozen of them. Personal disregard (ie, smoking, fat), denial (fat, smoking), poor education, distrust of doctors, complete reliance upon doctors, addiction (fat, smoking, pain killers)...just to name a few. I would venture to say that maybe 1 of 8 patients is a reasonable, socially and hygenically aware, of moderate habits, negotiable, trusting...all at the same time. Even so, there is the idea of "What are you gonna do to fix up what I have screwed up?...And if you can't...or if you're wrong.........."

Of course not everyone is like that. But you would be surprised. And it has been very difficult for me to have much sympathy with these folks.

For the Christians out there, these are the beggars on the streets we see in the New Testament. These are the helpless and the exhausting people who were passed by. And now I can see why. Though some were certainly calloused and perhaps far from merciful, I imagine many of Jesus' entourage were incapable of helping the beggars and the sick.

They had no idea where to start with them, thinking, here we go again with the father bringing his kid to us again with the demon spells. Every day, begging for help, and what are we supposed to do.

And there's the local floozy, sleeps with any man who provides any semblance of a relationship even if the man's married, then comes to us when her heart has been broken or she's dumped on the street or she's sick and out of money or shelter.

Or...great, now we've got about a few hundred people following us around, somehow knowing exactly where we're going to be, knowing exactly where to sit outside the city to beg, expecting us to feed them. And they're only going to get pissed of when I tell them I can't help the way that I really want to help.

(Aside: Does anyone else see how amazing Jesus' feeding of the 5000 was in light of what's happening in New Orleans?)

All of this to say that, with the "all work, no play", the paralyzing weight of medical knowledge and expectation, the difficult patients...it's just been quite difficult lately.

And it's raining on my day off.

And I just found out that my vacation in two weeks has been denied...no vacation until February.

It knows...

2005-09-03T12:24:00.000-07:00

...the pager knows, Dave.

...the pager knows when you've just caught up...when you've just put your face on the flat, industrial grade pillow...

...it knows when the nurses are bored and paranoid...

...it knows when to start a run of V-tach...

...it knows when to make patients start pulling at IV lines...when to make them breathe "funny"...

...it knows when you've capped on your admissions and you are wanting to sleep the night away

My Longest Workday

2005-08-21T20:39:00.000-07:00

You may or may not know that medical residents work long hours. As a resident you are routinely "on call" at the hospital, meaning you stay at the hospital all night, taking care of any overnight admissions, addressing patient issues, or fielding questions from nursing staff about patient care, putting out fires big and small. These call nights for me are about every 4-5 nights right now.

You also may or may not know that there has recently been enacted new legislation amongst residency programs set to limit the amount of hours a medical resident works in a week.

The new limit is a maximum of 80 hours per week. There must also be at least one 24 hour period in which the resident is not at the hospital or on call per week. One must also not be on duty for more than 30 continuous hours.

These regulations are averaged out over a month's work for the most part. For example you may work 90 hours one week and 70 another, which averages out to 80 hours.

Last week, I had my longest day of work to date. I arrived at the hospital early on Thursday morning--4:45 am--to see my 7 patients in time to see them and have enough time to travel to downtown to another hospital for Resident Conference at 7 am. Conference ended at noon, and I made it back to the first hospital, where I was on call that night. So I was at the hospital all night long, and got maybe 3 hrs of sleep. Got up and started seeing my patients at about 6 am. Our team rounded on all of our patients at 9am, and we finished around noon. Lunch was provided for us by a pharm sales rep, which I had to agree to attend, which extended my day to 1:00.

Add it up...32 hours on the job that day(s).

Long day...not unusual...better than it used to be just 4 years ago for medical residents. Praise the Lord!

Disturbing...

2005-07-26T17:14:00.000-07:00

I wish we could take all of the money from PETA,

the money people spend on pet CPR,

and any of the excessive amounts of money we spend on pets

and use it to fix this crap,

to rehabilitate these kids,

and to punish those responsible...

...this is a bit graphic

http://newsok.com/article/1561355/?template=home/main

...just sick.......saddening..........maddening

There have been a couple of news segments where I have seen CPR courses for pets, and pet ambulances. I am bothered by this. While I think pets are great, this is getting ridiculous. It should be a policy that anyone who wishes to be certified or trained in pet CPR should first be required to learn and be certified in human CPR.

PETA...People for the Ethical Treatment of Animals...I really wish they would concern themselves more with the ethical treatment of humans. It may actually help their cause, since one of the signs of an abuser could be the way that they treat animals.

Back on the Blog

2005-07-25T19:50:00.000-07:00

...I'm tired, not that I'm overworked. Just not sleeping soundly lately. And the stomach's kinda upset.

...Let's see--what has been going on lately?...Been working in the ER more. Had a few night shifts in a row.

...Had another incident where a patient was brought in all shot up, died, and I went home to learn more about it on the news.

...I did a lumbar puncture (spinal tap) for the first time. This involves placing a long needle into the lower back between two vertebrae and drawing out spinal fluid into tubes to check for infection. Actually did it pretty well. This kind of thing makes me think, what right do I have to be doing this to someone? What right do I have to do a rectal exam? Why do I get to/have to do a pelvic exam to look for koochie critters? What have I done to earn this right?...I went to med school, got an MD...paid out the wazoo for it too. And the people need me to do this to them in order that they get better. That's what you get in return for an education. It's just funny to me. Getting in is the hard part. Once you're in med school, it's just a matter of passing a crap load of tests. Then you get to do some crazy stuff to strangers.

...There was, however, one crazy guy on Saturday who refused the rectal exam. No bother.

...S...A...T-U-R...D-A-Y........NIGHT!!: A man came who was shot in the testicles. Worked overnight on Sat...kinda crazy. People are out and about on Saturdays, gettin' drunk, gettin' sad and close to suicide, passin' out on sidewalks, playin' with knives, shooting each other in the nuts.

...For some reason, we have grown too accustomed to violence in this world. I swear, someone is murdered here every day. People are scared for their lives in some neighborhoods. That must explain the need to carry a gun or a knife at all times. Where I came from, people got in fights, some nastier than others. But they would eventually be broken up, and the two boilers would simmer down, battered and bloody as they may be. But too often, someone ends up in this situation, and a gun is drawn or a knife is wielded, and people get killed. It's crazy. It's not in my mind to even think about carrying a gun around to protect myself. I'm not keen right now on the idea of having one in the house to protect the family (I'd rather spend tons o' cash on a super-duper alarm system). What has happened? How do these people afford the gun, the bullets? Priorities are out of whack. It makes me think that, in some places, having a gun is equally as important as having, say, cable television or a microwave oven. Sad.

...Also attending my service on Saturday was a guy who kept throwing up blood. You know, it sucks to throw up, but it must REALLY suck to throw up blood. I think I have a friend (is it Jerry?) who claims to have a ridiculously long streak of years of not throwing up. On Friday, I treated another someone whose body was ridding itself of all contents through the in door and the out door, out of both chutes. The ultimate act of defiance from your body. The body's saying, "WHAT THE HELL?!?!?...WHAT THE HELL DID YOU JUST PUT IN ME???" It's a wonder I haven't caught it...or have I?...I say that because my belly has been bothering me lately. Paranoia?

...Female doctors can be interesting studies. Not all, just some. From what I gather, nowadays close to 40-50% of doctors are female, quite a change in the last half century. Yet in the face of this, there are still some overly sensitive female doctors out there. Countless stories are told of female med students who round on a patient in the hospital only to be asked how long they have been in nursing school. (Two completely different things, if you didn't know.) Oh, how this gets under their skin! "Are you a nurse?" OH!...how insulting!........For some reason, some female docs get quite upset when a person makes this incorrect assumption, as if it's an insult. I say, take it easy. Probably 90% or more nurses are women. It's just a mistake of generalization, not a commentary on the proper place of women in society or an opinion on the ability of women to obtain professional status. Most certainly, it's not a personal attack on that person. It's just silly.

...Along those same lines, female med students (now doctors) who I went to school with would often bemoan their lacking dating life. No guys are asking them out. What's up with that? Well, the girls would often theorize that the guys they were meeting were intimidated by the fact that they were in medical school. That once they spilled the beans on their chosen occupation, the guys would become disinterested, as if the girl had just told them that their herpes is flaring up or something. I find all of that erroneous. I really can't see that many guys that I know being put off by a girl being in medical school, especially if he's interested enough to talk with her or approach her. Perhaps--I'm sorry--he's just not interested in asking you out. It has nothing to do with your being in medicine. It's actually more to do with chemistry or something. Okay, let's say it is true in some cases, that perhaps some men are shy of the female doctor due to some cause, be it earning potential, intelligence, etc. Even so, if he is put off by it, you don't want him around anyhow. He's probably a meat head, and that's not what a smart, gifted, driven, and entitled woman wants.

...Why does my Vornado spew air that smells like overused, hot electrical equipment? Has smelled like that from day one.

...Finally getting some of my wall hangings on the walls. Maybe I'll actually move in fully to this apartment, unlike my last one.

...Came home before lunch today. I was stopped by a news reporter and camera man as I was walking in to my apartment building. News reporter asks if I would like to speak on camera about the building next door that was torn down and how the contaminants were taken care of. I said I didn't know anything about it. Camera guy says that's the problem--no one does. I declined. Maybe that's why my stomach hurts.

...Good to hear from the OKC folks in the last two days. I've gotten two phone calls and an e-mail.

...My nephew knows my name. Well, my nickname--Tio, which is Spanish for "uncle." That's what he calls me. When I go to visit and I walk in the door, he starts running around saying, "Tio. Tio. Tio. Tio." Sometimes he'll run to the window, see my car and say, "Tio's truck." The other night, my brother Jake and I were playing with him. Caden says, "Ride Dada," and he climbs on Jake's back before being bucked onto the couch. Then he says, "Ride Tio," and I do the same, except instead of bucking, my limbs give out. He's lovin' it. "Ride Dada." "Ride Tio." It's nice to be known by this little guy. That evening was topped off by a beautiful smile from my 1-month old neice, Emery.

...Almost done with my first month. August brings new responsibilities. I begin work in the ICU at another hospital for one month. And I turn 29 next month...hmmph. I'm getting to be a grown-ass man.

Music, lately

2005-07-19T14:47:00.000-07:00

Soul Coughing...They've been broken up for a little while now. The lyrics are often nonsense/artsy/beat poet kind of stuff. But they're smooth. I love the way they were recorded. The drums sound great at times. And the bass is most often an upright bass. The keyboard sounds are unconvential, to my liking.

Morcheeba, Portishead, Tricky, Massive Attack...With Napster, I can create a 4 hour playlist of music that is related to artists that I like. So what I'll do is select those four and see what comes up. These are my favorite slow-beat, trip-hop artists. Slower than the music blaring from Banana Republic. But just as urban hipster.

Elbow, Elliott Smith, Shins, Doves...just another plug for these folks.

BTW...uncovered an old song by a group called Talk Talk called "It's My Life." It started playing, and I swore I recognized it. Turns out that No Doubt did this song--it's actually a remake. I liked the No Doubt version. The original by Talk Talk is done by a British dude. A well done remake by No Doubt.

Changing Vision

2005-07-08T17:07:00.000-07:00

As I was driving from work yesterday, I passed a car driving in the opposite direction. The driver, I noticed, was stopped at an intersection with a passenger next to her. The driver’s left eye was covered with a bandage. The passenger had nothing obstructing her eyes.

*****

I stopped later at the grocery store to pick up a few things. Walking from my car to the store, I saw a tall, high-waisted man, suspenders traveling over his plump belly supporting his forest green pants, with a navy blue based plaid shirt and a black, mesh cap on his head. He walked out of the store, turned to his right to enter the parking lot. I saw, in the corner of my eye as I passed him, his arm suddenly flail in a ballistic way as he nearly lost his balance after knicking his toe on a bit of sidewalk jutting only an inch from the rest. Arms extended, he was reaching for anything to catch himself. Fortunately, he caught himself.

*****

In the grocery store, I retrieved a shopping cart and headed inside. Obstructing my path in the entry aisle was a man wearing a white sweatshirt, white baseball cap with long brown hair flowing from the back…and knitted, white cotton gloves, gently searching with his hands through the greeting cards.

*****

Everyday things begin to take on new significance when you’re in medicine. What immediately entered my mind as I saw the man trying to prevent his fall was the beginning of the recitation of his medical history.

“…66 year old man is here today with a complaint of ‘hip pain.’ He was brought to the ER after he fell in the parking lot of a grocery store. He reports that he fell on his left side and felt immediate hip pain. He denies any light headedness or dizziness, stating that he tripped on the sidewalk. Denies loss of consciousness. Has history of diabetes, high blood pressure, and arthritis. Smokes 1-2 pack/day of cigarettes…”

He was, in my mind, a potential patient. A bit unkempt. Typical dazed look on his face. Odd shaped body. Does not really know what medications he is taking, but takes them all every morning.

The lady driving, in my mind, was the patient who just left the clinic, who has been satiated for her eye trouble, but does not let anything change what she does. She listens to discharge instructions, but doesn’t follow them. She gets only 2 of the 4 medications filled that she was prescribed. She’s gonna continue smoking, even if her eye problems are a direct result of it. When you give her all these instructions and have reasonably soothed her pain, she seems to be gracious and willing to abide. But she doesn’t…and she’ll bitch to her friends and family that the doctor tried to fix it but it didn’t work.

The guy with the gloves brings home the fact that the patients from the psych ward are all around us. The ones who stopped taking their psych meds, leading to relapse of psychosis, leading to exposing himself to a school bus full of children as instructed by “Paul,” leading to his one month hospital stay, which leads to his stabilization, leading to his release from the hospital, back to his home, where he eventually stops taking his medications again, and the first sign is that he’s wearing lots of white and knitted white cotton gloves to cope with his obsessive-compulsive disorder in my grocery store. They’re all around.

Don’t get me wrong…I believe in the validity of mental health illnesses as just that—something that can be treated.

But…they’re all around.

Emily's Word World #4

2005-07-07T10:25:00.000-07:00

Naming this string of posts in honor of the beautiful Emily, though earnest in intent, does not do her justice as a monument to what I think of her. If i was a early pioneer or explorer, I would name a hill or a mountain or a river, or an extensive expanse of scenic landscape after her. Alas, she gets the Word World--a tribute to the inner nerd in all of us, and the inner nerd in her that I love dearly.

mnemonic

mne·mon·ic (n-mnk)adj.
Relating to, assisting,
or intended to assist
the memory.n.
A device, such as a formula or
rhyme, used as an aid in
remembering.

This word was mispronounced this morning by my boss during her lecture (a very helpful lecture, mind you). She pronounced it "noomonic."

This I can understand in light of her being a medical professional, as our lexicon includes many words beginning with the prefix "pneumo-," referring to "air," or "lungs." But I think I've heard it elsewhere, whether that was in medical arenas or not--I don't recall.

(FYI: "pneuma" is the biblical greek word for "spirit," as well. So all of our references to air and breathing are rooted in the idea of a spirit. Think also of breathing in as "inspiration," breathing out as "expire." Death, in medicine, is recorded as "time of expiration." The idea of "spirit" as "air," related to each other by having to do with breathing. For all you Christians, this is an interesting way to listen to the song that begins with, "This is the air I breathe...Your holy spirit/living in me.")

Of course there are certain procedures of pronunciation to remember with silent first letters, as we have here with the leading "mn-"...which reminds me of yet another medically related mispronunciation...or actually, incorrect assumption of pronunciation.

"Dyspnea," is a medical word used to described difficulty with breathing. Note the "pnea," portion which is related to the above "pneumo-/air" discussion. When you speak greek, a word like "pneuma," is pronounced by forming the "p" with your lips, and then saying "neuma." You don't say, "pa-nooma." It should sound more like "nooma," but by simply forming the "p" with your lips, you achieve the subtlety of its pronunciation. The greek equivalents of "p" and "n" in greek are "pi" and "nu"--two separate letters, unlike "psi," the first greek letter, like in "psychology."

Anyway...So, this supervising doctor of mine in med school who was a pulmonologist (lung doctor) corrected one of the residents pronunciation of "dyspnea" while on rounds one day. The resident had said it as, "disp-nee-a." She told him that it should be pronounced, "diss-nee-a," because it should be just like "pneumonia" (when spoken fast, sounds like "noo-moan-ya").

But the resident was right, according to what I learned about greek in college. It's not so much a silent "p" as much as it is a subtle "p" sound. Certainly, it shouldn't be left out, in my opinion.

I will allow for exceptions. I will not go around using the subtle "p" before "psychiatry," or "pneumonia." I'd get laughed at...and I'm a tender little guy.

Back to "mnemonic"...the error was saying "noomonic," and not "nemonic." Using the subtle "m" in this case would be correct, but I will not insist upon it.

That is all, class...

Signed,

Sam's Inner Nerd

Li'l bits...

2005-07-06T15:31:00.000-07:00

...Today I attended a class about neonatal resuscitation held a room called the "Youngblood Conference Room."...terrible.

...Latest music on the PC via Napster: lots of Elliott Smith; the Shins; Son Volt.

...Watching local news the other night & found out my apartment building was burglarized 3 days after I moved in. Two individuals broke in through the front door, went to the club room, and stole 2 computers. Of course, I didn't hear a word about this except from the news.

...Speaking of news, Kansas City seems to be a high crime city. Or the news here is too sensationalized. They love car wrecks. There have now been 60 murders this year.

...Speaking of car wrecks, saw on the news today a blip about an unsolved hit & run on Sunday night that left a man with critical wounds. Guess who was in the ER where he was taken?

...Why am I watching so much local news? I have forsaken cable TV in lieu of cash savings. Network television sucks. Especially when you're watching in bed trying to get sleepy. Channel surfing is more like boogey-boarding.

...Happy to be in a baseball town. Went to a Royals game on the 4th--by myself (see "Introversion"). Had a nice time. Nice park here. Looking forward to Buck Night, where hot dogs, peanuts, and small Pepsi are each $1. Too bad the team is reheally bad.

Emily's Word World #3

2005-07-05T12:29:00.000-07:00

I must now archive an instance when I was corrected by the lovely and intelligent Emily.

Liberal v. Conservative

This is a post from another website written by a college friend of mine by the name of W. Clayton Nunnally:

One thing that bothers me is when people apply either of these two labels inappropriately or when they mean something else but for some reasons use one of the two labels.

I bring this up today because the supreme court ruling re: immenent domain provides a great example of the actual meaning and the difference between the two. And because Tom Friedman, a fantastic author, uses the term Liberal interchangebly with 'progressive' (and that bothers or confuses me).

I have the impresssion, valid or not, that conservative or liberal applies to one's opinion on how much government (generally federal) should be applied. I can only see this meaning in reference to something else, i.e. "economically liberal/conservative". My understanding would be that a conservative thinking person would believe the government would be better with less "knobs" on the nations economy, a liberal thinking: more knobs.

Then people throw these terms around and automatically attach 'conservative' to the adjective 'Christian' when there is no need for it.Friedman calls Islamic fundamentalist in Iran "conservative" when they actually have knobs on every goddamn aspect of a society. And he speaks of 'liberals' in the same place when he actually means 'progressive'.

Even more generally, people who think they are liberals use the word 'conservative' when they want to say 'bad'. And vice versa with 'conservatives'. Conclusion: The learning of definitions of words "second hand" or by inapropriate context leads to an avalanche of inappropriate usage. This also leave many people misrepresenting thier political ideology because they attribute false meaning to these two terms.

And yes, this is along the same lines as my problem with the usage of "Literally". I hope you notice both cases of misusage from now on.

Well said. Oddly enough, this misuse was the basis of the first communication problem I ever had with the beautiful Emily. She was trying to correct my usage of the terms, along the lines of the above writing. I became frustrated 1) because I was wrong and felt foolish for being inaccurate for all my adult life, and 2) she was right and very sure of it.

Emily's Word World #2

2005-07-02T22:04:00.000-07:00

peripheral

She's seething now as she reads this posting, because, for all of the glorious orthodoxy with which my lovely Emily speaks the English language, she regresses to the masses with this one. I have been coaching her on it, too. However, she's not to blame, since this may be one of the most used misspoken words I hear.

per IFF er all

NOT: per IFF ee all

When spelled, the second version should be "periphial." However, note that "peripheral" is not spelled, "periphial."

per IFF er all

Things lie out in the "periphery," not the "peripheeeey."

That's all. And you know I still love ya, babe.

First Day

2005-07-02T21:57:00.000-07:00

Okay…so today was my first day as Dr. Caire, officially. I worked from 10am to 6pm in the emergency department, where I will be working this first month.

My day began with a workout downstairs in the gym, followed by a “working” breakfast, where I was eating and getting all of my stuff ready for the day at the same time—kinda like how all those people act in commercials about products that are “time-saving.” I got all my pens in my pockets. My new Zire handheld device. My cell phone in new clip. Strapped on my new scrubs and took my new long white lab coat off the hanger. Got my lunch together. Grabbed a few pocket references, my new courier bag (man bag), my keys, and I was on my way.

What’s your big fear on the first day?...being late. Well, I got to the campus at 9:38 and promptly found the parking garage. I wound my way over to the hospital though the walkovers and mazes of hallways and realized I didn’t really know where I was in the hospital. So now I’m sweating, because I really wanted to be there a little early, but that wasn’t going to happen. Fortunately I bumped into a security man, and he directed me to the ED. I set my stuff down, and put my coat on, and entered the ED to begin my career…with sweat on my brow, at 9:53am.

It was a bit weird, my entry into the ED. I’m one of the doctors, the head honchos. I’ll be making things happen here. Yet none of the nurses, staff, or even my fellow residents or attendings know who I am as I stroll through. They don’t recognize me yet. But I’m about to be working side by side wih all of them to start some healing.

Dr. "B" was my upper level today. He appears to be at home in this job. He has learned multi-tasking, as he was able to write patient notes, look at chest x-rays, and explain to me how to find past calcium levels and ECG readings on the computer all at the same time. I’m guessing I’ll learn that, too. After he had oriented me to how things would operate, I had my first patient.

I haven’t interviewed or examined a patient since March—over 3 months ago. I introduced myself for the first time as “Dr. Caire,” which so tremendously self-assuring I cannot explain. I stumbled through the history and physical, ended up ordering some x-rays, wrote prescriptions, all of which required my signature and approval—once again, as “ORDERING PHYSICIAN: SCaire.” Hmph…kinda neat…I have arrived…somewhere, at least.

Today was a good day. They have lightened our patient load while we acquaint ourselves with the system and the way things work. I felt pretty confident near the end of the day, but that’s somewhat false, because one of these days I’m gonna get nailed by a case that stumps me. That’s expected. But today felt good. My attendings were helpful, and I think I’m gonna be all right.

I had just discharged my sixth patient of the day when my shift ended. No patients left over for the next shift from me. And then I left. No attachments. Time to go home and relax for a little while. Kick back and enjoy the fact that it was a good day. Now, I’ll have to improve on my pace some more. But it was a good first day…and I have very much to learn.

Introversion

2005-07-01T17:46:00.000-07:00

So I’ve got the day off. This is one of those days that I’m gonna have to get used to now that I’m here in KC. I haven’t directly interacted with more than maybe 3 people. I have talked on the telephone with a few, but person to person contact has been limited to less than three. On recollection—a girl at the coffee shop…........maybe that’s it. I worked out this morning…nobody else was in the gym downstairs. I worked on the computer for most of this morning, nobody else in the apartment. (howling dog next door noted) I went to the coffee shop around 2pm to do some studying. I left there, came home, and have been here since. Planning on staying here, too—more studying to do. What’s funny is that I’m not miserable at all. Perhaps a touch—I do miss my Emmy. I am lonesome enough to notice my nearly complete isolation, but not sad about it. It’s Friday night, and I note that only because, since I’m below 30 years old, I should probably be out and about tonight. But I don’t have any friends tempting me to get out there to go to a bar or anything else. Doesn’t really bother me. I know some people who could not stand a day like I’ve had today. Likewise, I have a low tolerance for a day when I’m around people from sunrise to sunset. Tomorrow is highlighted by work, where I will reacquaint myself with the human race.

The Work Begins

2005-06-30T18:02:00.000-07:00

For the last three days, residency has been terribly boring, with orientations that are far too long. Monday and Tuesday were very long—conferences from 7:30 am until 6 pm at the Embassy Suites hotel. Stuck in one room all day, talking about benefits, insurance, policies, privacy, and some other topics of questionable relevance at this time. Though I would prefer it to being thrown immediately into work, these orientations were too long. Not many highlights to speak of.

We got our schedules today, the day before the month begins. We just got our ID’s and parking permits today as well. I had to go and buy a set of scrubs and a lab coat—had to buy my own uniform. Seems like these things should have been taken care of for us. July 1 is our first day of work, and I have the day off. Don’t do any ED work until the 2nd. They are starting us off gently, only working us 10 shifts in the ED, with several more training courses schedule for us during the month to occupy our time, including ATLS, PALS, ACLS Instructor, and probably a few others.

In the ED, we’ll be concentrating mainly on Fast Track cases, which are more “bread and butter” types of emergencies—not life threatening. Even so, I am scared when I left myself dwell on it. Part of it is the fact that I’m the doctor and I’m signing off on the treatment of these individuals starting Saturday. I’m culpable. I am in charge of the assessment, diagnosis, treatment and discharge of these sick people. If someone has a cut finger, I’m gonna have to clean it and sew it up, which I’ve only done once or twice. If they have a broken finger, I’ll have to splint it, which I’ve never done. I think I could spot a bladder infection, but I’m not sure what antibiotic to give. If a baby comes in with a rash, I might as well walk right out of the room. And let’s hope the kid doesn’t have a mild temperature.

Add to this lack of knowledge my own desires and expectations of capability. I want to make a good impression and show my new bosses and co-workers that I am going to be a strong doctor. But I’m clueless and my skills are rusty if not deficient. I don’t know how I’m going to make a good impression on these people. As a student I could try to feign confidence, knowing that it was expected for the doctors to have to correct me and that what I said or did had little bearing on what really happened to the patient. Not anymore.

I’m nervous right now, thinking that I have no idea what to do if someone’s having a heart attack.

Then there’s also the paperwork. Just like any other job, the beginning is rough as you grow accustomed to the routines and logistics and how things are run. I anticipate lots of screw ups with paperwork, aside from knowing how to sign my own name…which carries its own burdens...(sigh)...(see above)...ahh, funny that sometimes worry and stress is so cyclical and yet so inert.

Emily's Word World, #1

2005-06-24T10:05:00.000-07:00

My beautiful girlfriend, Emily, loves words and language and correct grammar...thus, I am beginning a line of thoughts classified under "Emily's Word World," which will be dedicated to words, their misuse, mispronunciation, misinterpretation, etc. Here is the first

comfortable

Studying it reveals a 4-syllable word...com-fort-a-bull

Yet everyone says...comf-ter-bull

Three syllables, AND the "er" and "t" are switched.

If we need to drop a syllable, we should more appropriately say...comf-ta-bull

I've done this in front of Emily before, and she immediately stops my train of thought, saying, Wait!...say that again."

I know what she's getting at...

..."I said, 'I'm not comftabull with your picking up on all my idiosyncracies.'"

ACK...AAHack hack...

2005-06-24T09:59:00.000-07:00

Just dustin' off the keyboard to post briefly on this blog.

I'm now in KC--CPR certified, and, this afternoon, will be certified to restart someone's heart if I have to. Not as thrilling as you'd think. Actually, my imagination makes it terribly frightening--the responsibility and all.

Livin' in a cool downtown loft with nice hardwood floors, with a schmancy black table displaying some of the handiwork of JBergin. No wall hangings are up yet. I'm scared to disturb the neighbors. Of course, I could just go knock on their door and introduce myself, but that's too much right now. Will wait for the wknd.

Here's my current contact e-mail: samcaire@hotmail.com

If you e-mail, I'll send my phone # to you if I know you.

Back to the studying/training...I'll post more later if I get inspired.

Sam

Vin Diesel

2005-04-29T12:18:00.000-07:00

Go to this website for facts about Vin Diesel...click refresh to view another...

http://www.4q.cc/vin/

Wearing Shorts Today

2005-03-18T12:45:00.000-08:00

Thank you, God, for a day with beautiful weather.

Kansas City here I come!!!

2005-03-17T13:55:00.000-08:00

...Found out today that I have been hired as a resident at Truman Medical Center in Kansas City beginning in July.

Thanks to those who read this for the encouragement, thoughts, and prayers.

days

2005-02-09T09:49:00.000-08:00

everyday
i fail
everyday
is a new challenge
everyday
people can be fooled
everyday
yesterday is done
everyday
increases my age
everyday
is a deadline
everyday
is a new to-do list
everyday
i hurt a little
everyday
i forget something
everyday
do you expect something
everyday
i let you down
everyday
my soul is self-defiant
everyday
empty verbage
everyday
i get up again

i don't talk to you
everyday
you probably miss me
everyday
i need help
everyday
you wait for me to turn
everyday
there is an opportunity
everyday
i am myself
everyday
you love myself
everyday
my errors are witnessed
everyday
i can learn
everyday
intervention can happen
everyday
clean slates created
everyday

be with me
everyday
even if i ignore you
everyday
i need you
everyday
meet me halfway
everyday
meet me most of the way
everyday
i'm closer to peace
everyday
even if i don't feel it
everyday
you miss me
everyday
beside me
every day
can i have a feeling
everyday
can you direct me
everyday
you can overcome me
everyday

Mockery

2005-02-07T15:07:00.000-08:00

You become that which you mock...

...So, then, I am destined, by reviewing my last post, that I will be fat.

If it weren't already so apparent that I am destined for weight problems, I may have more to say.

Perhaps I should try to soften up my heart and not get as annoyed at folks.

Maybe I should smile more at them...give them a hand...pat 'em on the back.

WWJD?...sheesh...not what I usually do.

Know Thyself

2005-01-28T16:04:00.000-08:00

If I could wish one thing upon all people in this world, it would be greater self-awareness. After I introduce this and give some examples, you will see that this is a multi-layered issue that is in an abundant need of improvement in our world.

Self awareness...It is knowing your physical, emotional, and social self. It is knowing you are a part of a bigger picture, that your actions affect other people.

Examples of people with a lack of self-awareness:

...Loud cell phone talkers.
...People who cuss on those public cell phone coversations.
...Too many carry-on items on the plane (see previous post)
...Body odor.
...Grandma perfume.
...Fat people on airplanes.
...People who, for some reason, cannot whisper, but just talk in normal voice more "quietly."
...Loud talkers.
...Close talkers.
...Soft talkers.
...Slow walkers (often multiple and fat) in malls who take up the entire width of the "lane."
...People who leave their blinker on.
...People who are looking around at anything but the stoplight when it changes to green.
...People in front at the stoplight in the far right lane who aren't going to turn right, while people behind them want to turn right.
...Babies who cry at bad times. (that's not fair, is it?)
...Cell phones in movie theaters that ring--and then answered by those people.
...People who haven't figured out that you can quickly press a button to stop the ringing cell phone without hanging up on a person.
...People who give with expectation.
...Unemployed, fat smokers who are sick.
...People who write ads for car dealerships.
...People with huge, untended boils/wounds/abscesses/toenails/feet.

There are many...many...more.

Future Survey

2005-01-22T12:22:00.000-08:00

I am moving in June. I have interviewed at several locations. How 'bout some assistance with where I should live.

Rank these from 1 to 10:

Lexington, KY
Little Rock, AR
Kansas City, MO
Baton Rouge, LA
New Orleans, LA
Temple, TX
Richmond, VA
Columbia, SC
Omaha, NE
Columbus, OH

...just curious.

Music Recommendations

2005-01-18T15:10:00.000-08:00

Band: Elbow
Album: Asleep in the Back
Recent addition to the collection (much thanks to my friend, David Gilbert). Love the 1st track. They are melodic, slower tempo, good for the gray days. If you need comparison, combine Coldplay and Peter Gabriel.

Band: Radiohead
Album: The Bends
Radiohead fans are in one of two camps: those who allege to "The Bends," and those who allege to "OK Computer." My S.R.C. is that people are devoted to which of those two was the first they bought/heard. "Bends" was that for me. If you are a guitar player, this is the best example of excellent rhythm guitar in a modern rock setting. The guitars are adding to the music, not simply backing the singer. Masterful.

Band: Spoon
Album: Girls Can Tell
Great title for an album. I guess it's supposed to make you feel insecure. This is an accessible alternative to the pop song-writing out there. This stuff should grow on you. I began to like this album after letting it spin in my car CD player for many days.

That's all for now.

Listen to these tunes, and let yourself be hippened.

[Strength] + [Weakness] = 0

2005-01-14T14:56:00.000-08:00

I once was told that everything is math.

Biology is really chemistry. Chemistry is really physics. And physics is really just math.

My good friend has posted on her blog her acknowledgment of weakness in two areas: diets and baking cookies.

To me, that equation works out to be a benefit. Can't eat tasty cookies you cannot bake, right? The result is positive.

Here's my deal:

Strength: Self-starter
Weakness: Bad-finisher

Result: Lots of unfinished business, self-loathing from poor perseverance. Negative result.

Life really is about math.

9 Degrees

2005-01-14T14:54:00.000-08:00

I'm visiting Omaha, Nebraska, next week for a job interview. Forecasters are predicting highs in the single digits.

That's very cold.

I have only seldomly existed in a sub-zero environment, so much so that I cannot remember the last time.

The last 24 hours...

2005-01-11T13:10:00.000-08:00

I've had a tough day today.

Last night was tough, too. Cried hard...and I'm not afraid to admit it.

You can ask why, but I may not answer in depth.

It's good for me to cry, but only occasionally. If I'm going to cry, that means I'm digging into some deep, surprisingly sensitive areas.

If I'm gonna cry, it had better mean something.

Funny how it sneaks up on me, though. Most often it does sneak up on me. It happens when I talk about my mom. And I don't say that to make the ladies swoon. We've been through some stuff together, and she hasn't deserved one bit of it. Mind you, it hasn't been from me, either.

But the surprise cry is cathartic, in a way.

The father and son playing catch.
The lost, panicked dog in the busy street.
The woman putting her best face on as her marriage crumbles.
Seeing a picture of yourself as a baby in the arms of your now distant father.
Remembering when you and your siblings spent every day together.

Today and last night were different cries. Painful cries, almost mourning. That, I do not do often at all. I was in a sad state. I cannot remember the last time I've done that. Kinda weirded myself out.

Airline Annoyance

2005-01-11T11:17:00.000-08:00

It was recently announced that cell phone service on airplanes will soon be achieved--much to my dismay. Actually, I'm less dismayed than fearful and pissed off.

I have had a major upswing in my airline travel recently and have been introduced to the pet peeves of this lifestyle. Cell phones are one. The two main culprits are business people and women. Both have been guilty of being on that stupid phone like it's an oxygen tank. You see them at the gate before boarding and you realize they've included you in their conference call as well. They're a little loud, too--do they think we aren't forced to peep in on their conversation? They continue their phone call on the airplane right up to the second that the attendant forces them to hang up. And wouldn't you know, the minute the plane lands and slows down, those fools are right back on the phone, and, again, I'm in on the business meeting/idle woman chit-chat. (btw...I love women dearly...everything about 'em.) Can't it wait a little bit? Don't you want some privacy??

Then there's the carry-on baggage. Remember the rules--maximum of two, one up above, one under the seat below you. There are people out there who don't know these things. Some people cram both large items up above, leaving little room for the late-coming flyer who has to search the plane up and down for some space in the overhead bin. One above, one below.

A similar beast is the coat monger who crams their bags up above and then adds a huge coat or two up above. And usually the coat is poofy, goose-down coat or something, that expands in the bin. This is how it happens. Stuff it in there, then a sleeve flops out. Stuff again, sleeve flops out. Stuff sleeve really hard in bin, sleeve flops out more slowly. Remove poofy coat and re-fold, stuff in bin, everything flops out quickly. Stuff in with olympian might, and the coat magically stays long enough until person hurriedly slams the overhead bin over the coat. Sheesh...then they settle into their seat.

...and get on the cell phone to tell whoever in their right mind cares that they just boarded the plane. Try the text message.

Funny video...

2004-12-21T13:53:00.000-08:00

www.ebaumsworld.com

go to "latest media" at the right and click on the picture underneath with the guy with the fist over his mouth. Watch this video...

Medical Primer

2004-11-29T20:44:00.000-08:00

Currently I am on a rotation with the Infectious Diseases team at a local unnamed hospital. There are a few phrases that spell doom or evoke other responses when encountered in one of your patients' records.

One is "groin abscess."

Another is "foul smelling discharge."

...In my world right now, those are translated "Good morning," and "Welcome to work."

Primary Posting

2004-11-17T10:49:00.000-08:00

I have both friends and family with blogs. Thought I'd throw myself into the mix because people think I'm brilliant and thrive upon each word I say or write. This should satiate those masses.

Actually, I don't write much--at least not creatively. But I thought I might use this for my own occasional ramblings as well as posting anything I find interesting.

We will see. Stay tuned for more.