Bamboo River

Recipes and Patterns

2011-04-15T23:58:00.016-06:00

Oddly enough for someone who uses a food recipe so rarely, I love knitting from patterns. There’s something very satisfying to knowing fairly specifically the end result of a knitting project, selecting the yarn, enjoying the clever construction and beautiful yarn, and getting the predicted product at the end. Patterns are definitely not for everyone, though. Today at my LYS, some spoke disdainfully of following patterns, as if they jailed the intellect. “I never follow a pattern.” “I just treat a pattern as a suggestion.” Are pattern-lovers mental sheep, or automata executing the steps of someone else’s intellectual property? Now there’s a fun idea for an amigurumi.

As someone embarking on her second year of knitting, I look back on last year and see the specific lesson that each pattern taught me: the baby hat taught me knitting in the round, the Girasole (Ravelry) taught me lace and how to read my knitting, Dryad (Ravelry) taught me cables, and I continue to learn from each pattern. I’ve also observed what pattern formats I like and dislike. Additionally, I’ve found that designing knitwear is a great small business, and discovered different venues of advertising patterns. I’ve even learned the value of swatching!

Looking ahead, I find that I’m starting to want to enter the world of designing. While I would love to be one of those designers whose every pattern is worth sighing over, my goals are more utilitarian. Firstly, now that I have a supportive LYS, I would like to be able to sell some knits. Being acutely aware of intellectual property law and custom, I’ve been looking at the fine print at the end of my favorite patterns and finding that selling products made from the patterns are generally frowned upon, even from patterns that I paid for. Therefore, I’m planning on writing my own patterns so that I have completely guilt-free baby sweaters, toys, shawls, and mitts to sell for more yarn money. Secondly, I love to teach, and have always loved to teach, and a lot of patterns have nixed that too. Finally, as any other crafter does, I love to create, and I would love to see how other crafters take a pattern of mine and treat it the way I do a recipe: take it as a suggestion and creatively re-interpret it in unexpected and beautiful ways.

Cookie Melt-Down

2008-12-11T15:44:00.003-07:00

You win some, you lose some, they say. I've continued to attempt to bake despite the fact that my thermometer and my food scale hasn't come yet, this being a hindrance because measuring flour by volume makes for wildly inaccurate proportions.

This week, the blueberry muffins and the pizza have been successes, though I'm still working on the pizza. It's coming out as a thin-crust pizza, and I like slightly more bread-like crust. What failed were the pomegranate and chocolate chunk cookies. The idea is fabulous, and in the oven the pomegranate's seeds turn nut-like in consistency while continuing to add a tartness to the buttery, sweet cookie. The recipe doesn't specify the type of flour, and being the geek I am, I now have bleached and unbleached all-purpose flour, bread flour, and pastry flour, these all having different proportions of starch and protein and having different characteristics. Now scientist and baker Shirley Corrhier has a book called Cookwise, which applies food science to recipes. So I looked over her chart of how to adjust cookie recipes to get the kind of cookie you want: tender, chewy, puffed, flat, etc. There was a lot of ways to do this, but I decided to used pastry flour to get puffy cookies.

Of course, life intervenes, and the baby cried for food just as I was getting the pizza out of the oven to add toppings. I gave Sunny some quick instructions for finishing the pizza, and told him to turn down the oven before making drop cookies from the cookie dough I'd finished. The recipe is a whole stick of butter and a whole cup of sugar, and just enough flour to keep it from becoming candy. I don't know what happened next, but when I came out, the cookies were a series of melted disks on the baking sheet. They'd flattened out and spread out until the whole sheet was one very thin cookie.

Well, Sunny scraped the cookie off of the wax paper and we've been eating the very yummy chunks of chocolate and pomegranate butter cookie. I'm debating whether I should try all-purpose flour next or bread flour, but at this point I'm feeling the urge to try my hand at Japanese cuisine again, so I've shelved my baking supplies until the thermometer and the scale get here.

From Cooking to Baking

2008-12-05T21:56:00.004-07:00

I view cooking as a process that provides delight both gustatory and creative while additionally nurturing and sustaining my self and my family. In very little time, I can whip up a meal borrowing Italian, Vietnamese, Japanese, and Californian elements. I don't even have to pre-plan much; I just keep a running list of what staples I need at each of my favorite food stores and stock up when the baby allows me to go there. Then, I just create at whim. However, this week I've embarked upon a journey into that unknown and reportedly fussy land called baking, where doing things ad hoc can result in disaster.

As a chemistry major, I was one of those people who knew what to meticulously measure and what I could just slop into the reagent and save some time. While the journey to the end product was fascinating, I didn't worry too much about getting every detail perfect. As you can imagine, I considered myself a "qualitative" person as opposed to a "quantitative" person. I did really terribly in analytical chemistry, the flavor of chemistry where one tries to perfectly measure things.

Now that I'm trying to teach myself how to bake, I find myself reaching back for some of those quantitative lab skills. I haven't yet broken out a lab notebook to diagram out a bread-making experiment, but I'm tempted to, given that I've forgotten about steps that take an hour or more, delaying dinner (pizza) by an unacceptable amount of time. It's a strange mental shift away from my slap-dash cooking, but it's refresh ing. I'm buying a scale and a thermometer, and with increased accuracy of measurement and execution, I'll be able to make breads that are consistent; once that is achieved, I can then move on to refining the bread to suit my personal taste and circumstances.

Yesterday, I tried to replicate the amazing muffins at The Standard Diner, actually a swank joint here in Albuquerque. Now, I despise blueberry muffins for their heavy texture and cake-mix taste with sour berry remnants. These were amazing and converted me with their small size, actual muffin texture with holes larger than a cake's, a crunchy and sweet top, and fresh blueberry taste. I used the recipe from The Bread Bible by Rose Levy Beranbaum, which took about twenty minutes to assemble.

This week I learned why the "room temperature butter" is supposed to be at room temperature: if you pull it out of the fridge, it's too hard and resists the incorporation of other elements. Elementary? Yes, but I had to experience it before I could believe it could resist the wiles of a stand mixer. Yesterday, I pondered the instruction "fold". Why not just mix? So I did. The muffins were yummy, but they rose oddly, and the texture was uneven. Alton Brow's baking book suggests that an uneven crumb is due to overmixing causing more gluten formation, making the walls of the air pockets too strong. But why are the air pockets uneven? I'll have to try the muffins again, and I'll fold this time.

Today I started a pizza dough and a baguette dough. For more flavor and longer shelf life, I'll let them rise overnight. Both are further recipes from The Bread Bible. Pictures of rising dough to come!

Pediatric Book Review: Raising Baby Green

2008-09-01T11:20:00.005-06:00

Raising Baby Green: The Earth-Friendly Guide to Pregnancy, Childbirth, and Baby Care by Alan Greene (Author), Jeanette Pavini (Contributor), Theresa Foy DiGeronimo (Contributor)
ISBN 10: 078799622X

I'm reviewing this book first because I very much didn't like the book. Now, Sunny and I try to live as eco-friendly as possible, with new adaptations when we think of them. We're planning on breastfeeding, using cloth diapers, and plenty of hand-me-downs with the baby. So I considered this book as a possible repository of new ideas.

What I found was that a) this book did not give good, thoroughly researched information on the topics I expected like breastfeeding and cloth diapers and b) the author generically just states over and over to use "organic" products. Regarding the first, in order to be persuasive, the book should have a plethora of facts and some well-chosen hard data. Many of the sites advocating cloth diapers have clearly outlined how much cloth diapers cost, including estimates for power, water, detergent, and labor vs 3 years of disposable diapers. It is very persuasive to tell a new mom that she will save at least $1000 on cloth diapers, and more if she choses to wash the diapers at home instead of using a diaper service, and detail out why instead of magically presenting the final numbers. But such accounting was not in evidence in this book.

Secondly, I have a big problem with the indiscriminate use of the word "organic". The author is apparently fine with the use of organic formula as an alternative to breastfeeding. The primary problem with formula is not how it's grown, it's that it is artificial and inadequate nutritionally and immunologically. In other areas he recommends organic baby wipes, organic this and that. The problem with the word "organic" is that it doesn't always mean what a consumer might think it means. Organic farms don't necessarily use zero pesticides, they just have to use approved ones from a list. Nor are organically produced disposable products the best for the environment. I'm planning on using cloth baby wipes and water for my baby's rear end. What do "organic" disposable baby wipes contain?

So, I rate this book a 2/5 for "nice try. Good idea and poor execution". There's better information out on the internet, don't just take this book's word for it.

Pediatric Book Reviews

2008-08-30T20:16:00.002-06:00

What can I say...I'm big. At 37 weeks pregnant, I'm nearly full term (38-42 weeks), and I'm big. As far as I can tell, it's all baby and breasts, though, so I'm hoping that walking will become much easier once that baby drops into the world.

In preparation for the baby, many moms will start reading "baby books", a category of nonfiction whose discussions range from how to shop for the baby on a budget to how to parent to how to breastfeed. With one of my fellow residents, who's due the same time I am, I'm developing a curriculum for new parent-residents to complete at home, which means I get to read the books and get credit towards completion of residency at the same time. To track my current forays into the wilds of baby books, I'll be posting brief notes on each book.

A Week in Arlington and Alexandria, Virginia 4

2008-06-25T23:36:00.003-06:00

Found in Old Town Alexandria's Bistrot Lafayette , the seafood was all fresh, not frozen, and excellently handled in a Chardonay and garlic sauce that left every bit well seasoned and tender. I ate the accompanying creme brulees, one lemon and one espresso, too quickly to take a snapshot of them.

A Week in Arlington and Alexandria, Virginia 3

2008-06-25T23:33:00.002-06:00

Happily, I got a chance to meet up with a medical school friend, Wayne, who is also a drummer. He's many kinds of geek, and while we may share some of them, like computer geek, here he demonstrates one I can't claim: band geek.

A Week in Arlington and Alexandria, Virginia 2

2008-06-25T23:30:00.002-06:00

My second, and equally satisfying, experience with Ethiopian food. The entrees ordered come on injera, a pancake-like sourdough flatbread, with more injera for one to pick up food and eat with. Here I have five vegetarian dishes around beef that was exquisitely caramelized without being too sweet. Too bad that I can't have coffee anymore; Ethiopian coffee appeared to be just as exquisite.

Wikipedia on Ethiopian Cuisine

A Week in Arlington and Alexandria, Virginia 1

2008-06-25T20:41:00.006-06:00

Sunny's been away from Albuquerque for work quite a bit this summer, and I've had a hard time keeping the blues away. Since he's working in Arlington for a bit, I decided to come out and visit him and my extended family in Fairfax, VA, despite the fact that my vacation got moved to a week in which he was gone to Missouri for a conference for a few days. Arg. Thus far, we've been to Fairfax, Arlington, and I'm discovering old town Alexandria after having done my obligatory visit to the National Mall. Unfortunately, being six months pregnant has really cut into my stamina, and I've been getting lightheaded if I walk too far, and I haven't been able to see as much as I wanted. Still, I had a most amazing seafood pasta today, and I've been able to see an old friend from medical school, as well as spend a lot of time with my favorite Monets.

Experimental Treat: Basa Fillets and Sticky Rice

2008-04-30T15:57:00.006-06:00

A few weekends ago, as I recovered from switching between nights and days, I felt up to cooking and decided to try something new to me but very old to Viet Nam: sticky rice and steamed fish.

I love "glutinous" rice and have loved it since childhood. It's stickier than jasmine rice due to a higher amount of amylopectin, not gluten, and it's prepared in any number of ways, both savory and sweet. I've had it dyed red (wedding colors) with plums, white topped with peanuts and sugar, the famous "mango and sticky rice" way of Thai restaurants, and as a portable pocket stuffed with mushrooms, green onions, and select meat. However, it has always failed me when I've tried to make it. Traditionally, it's soaked for hours and then steamed. I've tried shortcuts with rice cookers and saucepans, to no avail. It always comes out burned at the bottom, soggy at the middle, and too hard and uncooked on top. EW. Perfect sticky rice, in my mind, should be firm but not hard, clear, and well hydrated. The solution was to finally use the wok that Sunny'd gotten me last fall, along with accompanying bamboo steamer, line them with banana leaves, and steam. Perfecto! Sticky rice for a side to the main course, and then mango and sticky rice for dessert.

To top it off, I ran across a fish I hadn't heard of at the organic market I shop at. "Basa from Vietnam" was the title. A quick wikipedia search showed that it's a catfish analogue that Mississippi Delta farmers are offended by because it's taken up quite a percentage of the domestic catfish market, so the lobbied to have it labeled as "basa" instead. They've got a point. I'm not really convinced that there are significant numbers of aquafarms in Vietnam that would hold up to US inspections. However, I slapped the fillet on a banana leaf, drizzled it with sesame oil and some ginger, and steamed it, and it came out perfectly. Yum.

References:

1. On Food and Cooking, the ultimate food science reference
2. Wikipedia on Basa

First Prenatal Visit

2008-02-04T22:08:00.000-07:00

Our first prenatal visit today went as expected for me. Sunny's never been to one, so I made sure that he got to see my cervix. I think that both of us are reassured that our doctor will listen to us and communicate well; the great news is that since she is a family practice doctor, our relationship doesn't have to end once the baby's born.

Now, I thought that we were about a month pregnant since we started coming up positive the first week of January. Normally pregnancy dating goes by the date on which you started your last period, but since I stopped birth control just a few days before that, I figured that it would take a while before I would ovulate. However, my uterus apparently feels about two months' pregnant, so we'll see what next week's ultrasound shows!

The Mommy Diet

2008-01-27T13:52:00.001-07:00

After discussing it for quite a while, Sunny and I stopped birth control on December 1st. A month later we're pregnant, which alleviated quite a few worries. Now we're trying to figure out how to optimize my health while the prototype human being develops inside of me. Now I've always been short on exercise, and I love food, so making healthy choices in terms of that is high on our priority list. The babies in the Newborn ICU whose mothers had raging, uncontrolled diabetes haunt me. An infant of such a mother can have just about ANY defect, and that's not going to be my baby.

Research on nutrition and diet has always been unsatisfying because it is impossible to completely control someone's diet. You can't really make two hundred people eat exactly the same diet for years in order to truly study the effects of a diet. Add the insurance liability of studying pregnant women, and the end result is that I view a lot of the dietary advice for expectant mothers with skepticism. For instance, the March of Dimes website suggests that 12 ounces a week of fish that may have mercury is safe. How do they know that! I love salmon both as sushi and as gravlax, and now I'm avoiding both. I have blatantly ignored any advice about soft cheese containing a dangerous amount of bacteria. I figure that as long as it is made from pasteurized milk, and it's made from a reputable dairy, I can handle it. I am unhappily avoiding raw oysters, but cooked clams are still on my radar!

The food restriction that really breaks my heart is the restriction against coffee. I love coffee. I associate it with good moments from my childhood and great moments from college. Have you ever had Vietnamese-style coffee? It's drip brewed slowly to extract all of the essence of the ground beans, and an inch of sweetened, condensed milk adds creamy lipids and wonderful sweetness. It's better than a daydream and sweeter than cutting class. Now to hear that caffeine can make for smaller babies and have possible, subtle psychological and neurological effects on the baby is scary. But it's a possible, and I love coffee. An occupational concern is also that I use coffee deliberately to perk me up at the end of a long night on call. Otherwise I run the risk of making bad decisions or one of those desperate let-me-sleep-damnit decisions. My current solution is to switch to hot chocolate, which is a bit too sweet, and avoid caffeine except for those situations where I really need it. Not a satisfying solution, but I don't have enough evidence to give it up entirely, or to keep drinking it blithely.

Other Mommy diet resources:

Food Standards Agency in the UK

American College of Obstetrics and Gynecology patient handout

Kid's Health patient handout

Being Whole: Certifications I Aim to Acquire

2008-01-07T01:19:00.000-07:00

Ones I Have Achieved:
Bachelor of Art
Bachelor of Science
Medical Doctor
Kukkikwon certified 4th Degree Black Belt
Wife

Ones to Achieve:
Registered Massage Therapist
Ph.D.
Professor
Associate degree in Culinary Arts
Registered Yoga Teacher
Author
Mother

Being Whole: Teapots

2007-12-19T02:10:00.000-07:00

I have just purchased an item that I've been eying for years: an iron teapot! I love Asian tea, and all the accoutrements that come with it, from fancy porcelain teapots to whimsical, handmade ceramics to intricate trays designed for Chinese-style tea consumption to the fabulous, hand-tied teas I adore.

Iron teapots are lovely and functional, which is more than I can say for the ceramic teapots I love as well. Artisan ceramic teapots are often handmade, and they are very thin. In order to use them, I boil a whole pot of water, with the teapot and teacups submerged in the water to ensure that the whole piece is warmed evenly. Any bit of uneven temperature means that part of the ceramic expands and part doesn't. You have no idea how many teapots I broke in my youth doing that, but with my iron teapot, I can just dump in hot water and enjoy tea. Still, the iron conducts heat well, so I purchased an iron trivet anticipating just that.

Pediatric Check-Up: NICU or Neonatal/Newborn ICU

2007-10-16T02:29:00.000-06:00

I'm currently doing night shifts in our baby intensive care unit, and though I hate being separated from Sunny at night, I am enjoying the experience. What do I like about this sub-specialty that Sunny's nicknamed "xeno-medicine"?

Firstly, I really enjoy doing procedures. In English, a procedure is a course of action or series of steps. In medicine, a procedure is usually a series of steps involving some kind of invasion into the body, whether that be a spinal tap, a knee joint aspiration, or in my case, umbilical catheter placement. I'm getting super-good at placing tiny tubes into babies' belly buttons, and I like it because a) no pain for the baby is involved, and I'm saving them from needlesticks b) it provides a good, reliable way to give nutrition and to get lab data. One of the things I really like about our residency program is that there are few fellows here. Fellows are doctors in training for a sub-specialty, and they often need experience with procedures. Even though our NICU has fellows, though, residents often get first dibs on procedures, with fellows supervising. I'm getting pretty good at this one, and soon I hope to become an expert at another common procedure here: intubation, or inserting a flexible, plastic tube to assure a good airway for breathing.

Other reasons to come!

About Albuquerque Life

2007-10-14T22:40:00.001-06:00

I often get asked about Albuquerque: "Why did you move to Albuquerque? Do you like living there? What's in New Mexico anyway?". Considering that my relatives thought that I was moving to Mexico, it's not unexpected that most people are curious about Albuquerque itself.

I truly enjoy living in New Mexico. I contrast it to Nevada, where I lived most of my life. Northern Nevada is similar to New Mexico in that it has a great, high-altitude desert climate with most days sunny and bright. There is an amazing amount of outdoors hiking, climbing, skiing, fishing, and more to do, though personally I think that New Mexico's outdoor attractions are more interesting. In a prior post I mentioned that Sunny and I had gone sledding at White Sands, and we are planning on going to Carlsbad Caverns soon. Both states are predominantly rural states with a few population centers. Both of them look like endless stretches of sagebrush and highway as one drives through them. Yet they are very different to live in.

What I think is fascinating about New Mexico is that it has its own distinct culture as a state, and Nevada definitely lacks that. It starts with food. New Mexico has its own cuisine based on local products, especially chile, blue corn, and cheese. Next, art abounds; people here have a much more natural philosophy about art, that art can be produced by anyone, and many people create some form of art without hesitation or worry that they are pretentiously claiming to be "an artist". I am the proud owner of several pieces from a local part-time potter and hope to own more. The Native reservations are still very much alive and producing new techniques based on their traditional pottery, stonework, metal smithing, and weaving. Architecturally, many buildings, including my house, are built to appear similar to ancient Pueblo dwellings; I can actually look around in a suburb and know that I'm in Albuquerque and not, say, some random place in California or Connecticut. Finally, as a modern touch, New Mexico has a great density of scientific work and atomic history, such that Sunny is very excited to be working on his Ph. D. here and is in no way compromised by our location.

More specifically, I really love our part of Albuquerque. Sunny and I are all about living in a "live-walk" community where human-powered traffic predominates and neighbors actually socialize with each other. We live in University Heights AKA Nob Hill, and we can easily commute to school and work and grocery shopping by bike. A cluster of small businesses and great restaurants featuring Greek, Italian, sushi, other Japanese, Korean, Irish pub, and Vietnamese food lives on Central Avenue, three blocks north of our home. Plus, I have little problem finding most of my cooking ingredients as there are multiple Asian markets near by. Furthermore, There are a lot of young families as well as established families here. Greenspace abounds, with four parks and public tennis courts within walking distance. Finally, a library and a well reviewed elementary is 3 blocks south of us. We've been to several house parties on our block, and will probably host one next summer. If you're interested in moving here, leave a note with any questions!

Blog Moving...Possibly

2007-10-07T23:30:00.000-06:00

Since deciding to blog more often, I've been posting the last 10 months of blogs on my website. For my latest exploits, visit me there!

Addendum: However, the software that enables my blog on my website has been becoming buggier (it broke just after I wrote the above), and I don't want to spend time doing the upkeep, so the blog may migrate back here depending on my level of laziness.

Addendum #2: Blog has migrated!

White Sands National Monument and Trinity Test Site

2007-10-07T18:37:00.000-06:00

This weekend, Sunny and I took a day trip around southern New Mexico. We started by heading to the Trinity Test Site, the site of the first nuclear device explosion in the world. It was pretty anticlimactic. The whole of the original crater has since been filled in by dirt, so none of the fused sand is visible except for some pieces in a display case. There are also some historic photographs, including an aerial view of the site that includes a view of the site of the 108-ton TNT explosion they used as a calibration so that they could measure to force of the atomic detonation. These pictures were interesting, though only a brief nod was given to how devastating the force of an atomic explosion is on life and non-living structures. The picture of the sign is at the gate to ground zero. I thought the distances were interesting given that the flash was seen from Albuquerque, and windows were broken in Alamogordo during the explosion.

Then, we went to the White Sands National Monument and sledded on the gypsum sand dunes until we were tired, and hiked a bit. Sledding in October! Hiking in bare feet (not us, though I was tempted)! On our way back we looped through Las Cruces and drove by the future home of the nation's first spaceport. Since I'm starting a food section to my blogging efforts, I'll have to mention that La Cocina, a restaurant in the town of Truth or Consequences and one that was well reviewed in a Frommer's travel guide, was awful. Billed as New Mexican, their enchiladas and chile rellenos were awful, my prime rib was unevenly done, the Blue Moon (on tap!) lacked an orange slice, and their “authentic” New Mexican chile wasn't even hot.

Trinity Site web page: http://www.wsmr.army.mil/pao/TrinitySite/trinst.htm
Trinity test on Wikipedia: http://en.wikipedia.org/wiki/Trinity_site
White Sands National Monument: http://www.nps.gov/whsa/
Don't eat the food: http://www.roadfood.com/Reviews/Overview.aspx?RefID=3912

Brief Check-In: Food Blog

2007-09-30T21:00:00.000-06:00

So my newest project is to tour Albuquerque in the pursuit of food. Good food, that is. In brainstorming with Sunny, I've come up with a list of various food tours I could work on, including oysters on the half shell, flan, sushi, pho, microbrews, mead, and more to come. Yesterday we went to a local Red Lobster and tried shrimp, lobster, crab, and oysters. It was a decent baseline for what uninformed persons might consider good seafood, but I'll never go there for seafood again unless someone twists my arm. More on that later. Email me with any suggestions for a topic!

Cheers, Truc-Ha

Being Whole: New Things

2007-06-16T23:33:00.001-06:00

I started medical school in Connecticut not knowing a soul for about 300 miles. The jumble of studying, New England snow, Eurocentric culture, and complete lack of friends made medical school a rough stretch of years for me, and I didn't adjust well. As I tried to grow as a person and as a clinician, I also clung to the few stable things I established in my life: calls to Sunny, my bedroom, my favorite books, and a few teachers I had longitudinal contact with through the three years. One of those teachers, Dr. Hom, is an experienced internist in Northwest Connecticut. I'm not sure if he guessed the extent of my disorientation, but we did speak often of how to balance a clinical career with a well-rounded set of interests. One of his strategies was to subscribe to a magazine on a new hobby every few years. When I started working at his practice, I think he was reading about chess.

This past year, there has been more new things than I can count. I'm now a homeowner and a cat keeper. I'm an MD with a paying job. I'm finally living with Sunny, and I have a partner I can share day-to-day work with as well as all the other lovely parts of a beautifully growing relationship. I have a new set of friends, though no new confidants yet. Still, as winter crashed the hospital with more patients than I could count, I found that sensation of disorientation becoming frighteningly familiar again. I will always remember my first winter with a pediatric service as a bleak, exhausting, and depressing time. Trying to avoid my usual habits of depressive episodes, I decided to try something new.

First, I started with yoga. Yoga is an interesting flip side to being depressed. A yogini still concentrates on herself, but on her musculature, balance, and posture instead of the roiling, confused mass of negative emotions that characterize me in a slump. I'd lost almost all of my Tae Kwon Do muscles and some of my flexibility by the time I came to Albuquerque, so it's been nice to work out while working on something. "Going to the gym" has always been a self-inflicted punishment of boredom for me. Yoga is fun, and as I'm naturally very flexible and non-violent, it fits well with me.

Next, I've started with more craft-type arts. I'm sculpting a tree out of copper and various other metals right now; the leaves will be out of origami paper. It was originally supposed to have origami hanging from it, but this one's too small. The next one, maybe.

I'm also gardening. I don't water consistently, so right now my tomatoes and squash are doing well, but I've managed to kill various bushes that should have been more drought resistant than the tomatoes and squash. My indoor plants are doing better. My kumquat tree has just flowered, and the whole house smells like its fragrant little flowers. I don't know how many fruit I'll let it grow yet, but since the tree looks pretty hardy, I might let it make a few.

Lastly, today I colored my hair purple! Not really an unusual thing to do, but my father has some old-fashioned ideas about that (something about changing your appearance means you reject your family; to see what I think of that, see this link ), and I am also generally conservative in my appearance. I now have purple highlights. I was originally going for anime-colored purple, but I decided on a very dark, almost black, purple so that I still look professional. Can you tell from the picture? It's hard to see; some day I will have hair like Aeon Flux.

No, we are not pregnant yet, but we're planning to start trying next year.

Pediatric Check-Up: Out Of Intern-ment

2007-06-03T13:28:00.000-06:00

Part 1:
Back in World War II, the US government rounded up a good portion of Japanese Americans and sent them to detention camps simply because the Japanese had bombed Pearl Harbor. They were considered "security risks" based on their ancestry. During the scary days after 9/11, a good many of us worried a similar fate would befall the South and Middle Eastern Asians.

Now, during this year of internships, I have not been locked up or had my civil rights violated by my program, but all the same, there is a sense of imminent release. I look back on a long, scary year of tremendous forced growth, and try to assimilate it into myself in the most useful way possible. I feel that I've grown, but am still figuring out where and where I have more growing to do.

References

http://en.wikipedia.org/wiki/Japanese_internment_in_the_United_States

Iron Chef: May 2007 = Strawberries

2007-06-01T22:01:00.000-06:00

What is "Iron Chef"? Iron Chef has been described as a "game show", though I tend to disagree based on the fact that creativity and inspiration are what win the day, not just blind chance and regurgitation of facts. Iron Chef is a Japanese television show with the whimsical premise of an eccentric gourmand who has Iron chefs and guests chefs face off against each other. In each episode an ingredient is chosen as the theme for a meal of multiple courses. Crazy dishes as well as hilariously voiced commentary make this show entertaining, though unfortunately no DVD's of the show were available the last time I looked. If I could just subscribe to the Food Network, I'd actually watch TV.

At medical school, 5 of us started having themed cooking nights about four times a semester. While none of us ever went as crazy as squid ice cream, it was a fun way to get together and enjoy each other's company in a homey fashion. We never got around to having a competition since most of our houses didn't have enough kitchen space, but good times and good conversation were abundant. Since experience and good conversation are especially valued by Sunny and I, I'm hoping to continue the tradition in New Mexico. An added twist is to try and make the theme ingredient something seasonal. At some point in time we might add something like a conversation topic, and this last meeting we did a bit of origami. Hopefully Iron Chef will expand beyond the demesnes of Truc-Ha and continue even after I move on and out of Albuquerque, but I'll have three or more years to establish it, so we'll see.

Cooking, I've observed, is an artform that can be 1) avoided 2) dreaded 3) practiced daily 4) mangled. I personally do a lot of survival cooking that I use shortcuts to make tasteful and somewhat healthful. I have a lot of excuses. Part of my problem is that I don't really enjoy grocery shopping; going to farmers' markets twice a month is a fun and community-conscious alternative, but it doesn't provide for the rest of the month. I could go on, but sometimes I think about the philosophy of the endeavor. A cornerstone of daily life, I've often used the preparation of a nice meal as meditation practice. I don't chop well or evenly, but if I concentrate, it gets better, and I relax. I have to concentrate on planning everything out so that the scallops won't be in the pan long enough to get tough, and so that the salad won't wilt. I don't tend to have side conversations, and the house is usually quiet, waiting for the meal. The results are very concrete as well as mental. At the end of the two hours of standing meditation, I have a yummy reward for my endeavors. Either that, or my attention wandered, and I'm scraping the burned part off the chicken. As any meditation student, I also try to educate myself. This is a great justification for trying the cuisines of many ethnicities, as well as spending time at gourmet joints like Graze (thumbs down) or Ambrosia (thumbs up). Thus, I think that anyone can develop themselves as a capable cook (and should), and I'm have a lot of fun doing it for myself and with friends.

References

Iron Chef article on Wikipedia

First part of an Iron Chef episode

A Cat's Life: Weight Management

2007-05-18T22:41:00.001-06:00

Today Ulysses has gone to the vet for some dental work. Trust me he hated it, but I was also a little worried about it because he has gained quite a bit of weight over the last year. When I got him, he was 14 pounds and looked well. Now he is almost 19 pounds and is a fat, slow-moving cat.

Psychologically, many people tend to see the obese as people who lack brain power. The train of thought goes like this: if they were smarter, they'd make better food choices or at least do something so that they wouldn't neglect themselves and look like that. For doctors, we tend to cringe even more as these patients have more medical problems, come to see us more, hear us talk about weight loss, and often have a hard time getting anywhere with the root of their medical problems. As a pediatrician, at least I can often talk about weight maintenance, since your average overweight Caucasian 10-year-old really should weigh more than 140 pounds in a decade, and they just have to hold the fat until they grow into muscular adults. I hope.

Anyway, with Ulysses, he's not smart enough to understand that he needs to diet, and he's obviously failed to self-regulate his own intake. He loves food, and I can certainly empathize with that. I've tried a few different regimens involving a mix of canned food, AKA “wet” food, and kibble, or “dry” food. I used to give him a lump of wet food (1/4 of the can) in the morning and let him snack on as much dry food as he wanted through the day. Then, after a significant weight gain, I tried limiting the dry food. Then I tried halving the dry food and increasing the wet food. Last week he was on wet food only and ate about 1.75 cans a day, begging for more.

I've done some reading. First, there's the problem that cat food packaging, which unlike people packaging, does not necessarily list the absolute calories it contains, and how much of those come from fat, protein, and carbohydrates. Instead it lists percentages, without stating how those percentages were calculated. Because of this, you cannot compare the percent protein on a kibble package (33%) to the protein on a can (10%) and conclude that kibble has more protein, which it doesn't. Secondly, cats' metabolisms are geared to protein and a mostly meat diet, though Ulysses likes some grass now and then. Thus, a high carbohydrate diet gives them a metabolic state similar to adult diabetics. To give you an example of the health risks of that, an adult human diabetic has the same risk of getting a heart attack as the risk of a second heart attack in someone who's already had one. Not good.

To complicate it further, I can't bear the thought of him starving, so I can sympathize with those moms of obese kids who don't have the heart to make their kid diet. That won't stop me from doing it, but I really hate it. It also drives me up the wall when he begs too.

So the solution? The ideal solution would be to feed him only wet food a few times a day. It is not ideal for us because I work so much and there's often no one around to feed him more than once a day. I really hate to give him dry food again, but we may have to go back to it. The vet is going to give me the number of calories he needs (I tried to estimate using the formula we use for premature babies…obviously wrong), and I've written our current pet food supplier to ask them just how many calories are in their products. Based on that, I'll be able to calculate how much food he really needs. It still won't be the correct percentage of protein, fat, and carbohydrates, but at least I'll stop overfeeding him for a time. Ulysses gets grumpy when he's hungry. I'm afraid I'll have to wear thick socks this summer or risk getting attack kitty marks on my calves.

Pediatric Check-Up: Mom's Quote 1

2007-05-18T13:14:00.001-06:00

Doctors, especially doctors in training, like to bemoan that "no one understands" just what we go through other than our allied medical professionals. Now I don't agree with that completely, but I do agree that a large percentage of people do not understand the training pathway or just what our training consists of. So here's a funny quote from my mom this week while I was visiting Reno (translated): "So now that you're out of school, you're less tired, right?"

Er, that didn't sound as funny, but please reference my previous blog post from this January:

Current total hours worked: 101.5!
Current days working on this part of the job: 7 days

Here's a picture of a fellow intern that same month. Can you tell that we were delirious?

Philosofiend: Wealth (And Gifts)

2007-05-17T16:34:00.000-06:00

Everyone knows a person it would be hard to shop for: a colleague with everything, in-laws with odd tastes. I've got a mother who doesn't make decisions on her own. How do you find a Mother's Day gift for someone without an opinion, especially if you detest insincere holidays such as Mother's Day? Luckily, my mother in-law is very "girly" and into various scented sundries as well as cosmetics, so I picked up a spa kit from my favorite, moderately Earth friendly boutique chain. Of course, most perfumes and colognes make me want to puke, so I chose something with very neutral scents and not puke-o-genic. Additionally we went to a spa for massages together once we arrived in her city, and made her a mixtape of music she likes and may like.

Now this course of action may seem very simple, but it is still philosophically driven. In giving a gift, we are not limiting ourselves to find something material that the person may like. For instance, there's a lot of souvenir kitsch that my mother enjoys and that I refuse to buy for her. Instead, we've expanded our idea of gifts to giving something that will enhance the person's enjoyment for the moment but also broadens the giftee's perspective or introduces them to a whole new skill set or set of experiences. We've given mixtapes, how-to gift books, de-virginized sushi eaters, and taught origami. It's a lot of fun for both parties in the exchange, and it suits our value system while also allowing us to spread something that we enjoy.

Of course sometimes it's still a case of "you can bring a horse to water, but you can't make him drink." I've bought a few different "how to use your Mac effectively" books for my dad, and also spent some time introducing my mom to computers, but there's still a beautiful G5 water-cooled Mac desktop idling in my parent's dining room using maybe 5% of its computing potential. But I digress.

I was thinking about the concept of wealth in our country. Currently, many (though not most) people enjoy a relatively decent quality of life. On home visits in the more disadvantaged neighborhoods in Albuquerque, people have heat, clean water, shelter, clothing, enough food calories, and preventative health care. In better neighborhoods people enjoy more consistent heat, greenspace and parks, safe neighborhoods, and better food. In my neighborhood, it's quiet, mostly safe, there's lots of young families nearby, and there's a good elementary school three blocks down the road.

So what does wealth mean in the context of Albuquerque, NM in 2007? For myself, what works is similar to an idea my father learned in wartime Vietnam: "they can't take what's in your head." In my context, where personal safety is less of an issue, I'd revise that to say "what's in your head makes you wealthy." In this context, the wealth I enjoy encompasses multiple skill sets, many wonderful experiences, and the ability to acquire more. Sunny and I have gone to Amsterdam, Saigon, New York, San Francisco, Hong Kong, and a really nice spa. I garden, and he codes. I troubleshoot medical instances, and he's made all of our house's doors fit in their jams. We're healthy and safe enough to continue all of that and more in a context of love, respect, and mutual values subject to discussion and tinkering. I think that even in less prosperous circumstances, this method of conceptualizing wealth would serve us well.

Being Whole: Training And Development

2007-05-07T00:24:00.000-06:00

Recently, one of the testier attending physicians in the department was speaking with another intern who appeared to be at least five years older than me. In reference to this intern's increased life experience points and presumably more focused and ambitious career plans, this attending linked them together and rather casually derided “the folks who go to medical school and don't know what they want and halfway through decide that they don't want all this [waving at the hospital].”

Now I resemble this remark because I do not intend to find a job as a usual pediatrician or go into subspecialist training when I finish. I intend to chart my way off the beaten path that leads from medical student to practicing physician. I love the work some days, and it's a valuable body of knowledge that I can master. Yet I am looking for work that will allow me to use many of the skill sets I have, and also to continue to be a generalist, learning new skills as I go. Incidentally, I will also be looking for work that is more conducive to family life and to pursuing my wide range of non-career interests. Therefore, I disagree with the implication that I've wasted the seven years I'll have put into the medical career at the end of my residency.

In the gaming world a player's character gathers experience points in each battle, whether the beast is slain or not. I can stretch a simile and suggest that each endeavor, each moment in life, garners myself experience. Though I do occasionally regret a choice, usually I get over the unnecessary emotion and view the moment as a learning experience. Similarly, while I could have chosen to take more of a risk and just moved to San Diego with Sunny to look for a job instead of going to medical school, and perhaps been happier finishing a Ph.D. program in English, I made the best decision I could at each step of my path between entering medical school and finishing my intern year in a pediatric residency. Thus, I am now endowed with one of the rarer professional degrees one'll see in academic research, and I also have a large body of knowledge on how children might be raised, though not the experience of course.

I have always pictured myself as a person who constantly evolves and develops herself. Though this stage in my growth may seem very masochistic to others, it still serves as a stage of dramatic growth. It is very narrow-minded to consider it a waste of time despite the fact that the outcome is not the expected one.

Pediatric Check-Up: Friends' Babies

2007-04-17T20:29:00.000-06:00

I have very prolific and fertile relatives, and many of my aunts are young and still contemplating further babies. Also, my friends are starting to drop babies, though thankfully not many. The first pregnancy in my cousins has been announced, and in any pediatric setting, you'll find lots of colleagues with fetuses or babies. The fertility boom makes it an awkward time to be a pediatric resident interested in sleeping at night.

Now, I am fond of babies, especially that class of babies that I can return to their mothers when they start crying or pooping. Still, the climb in pregnancies is making me slightly alarmed. I have your typical close, big, extended family that gossips constantly amongst itself. One misinterpretation of my grudging advice by someone, and then everyone will leave me alone...which is an attractive thought.

Homesteading: Xeriscaping, Zeroscaping

2007-04-08T18:12:00.001-06:00

Landscaping a home doesn't necessarily result in monetary returns once the house is sold, so our home was perfunctorily landscaped in the front and not at all in the back. The front yard is definitely dated; it's two mature trees and a flat grass lawn with a few smaller trees. It brings to mind the white picket fence era, circa 1950, when the home was first built and municipal water didn't cost so much. It looks cute...when it's green. And at a mile high in the desert, it doesn't look green often.

Therefore, I'm looking at redoing the front in two years to be a multi-level xeriscaped succulent garden with a path going through it. Points of interest will be rocks, colorful shrubs, or groups of bulbs or colored grasses. I'm trying to use Google SketchUp for planning, though I'm currently figuring out the controls.

Succulents interest me with their variety of shapes, not all prickly, and range of colors. Additionally, like orchids, they tolerate my irregular watering habits well, which is why I've switched from orchid acquisition to accumulating small, brightly colored pots of varying varieties, including jade. Watch for pictures to come!

Xeriscape Council of New Mexico, Inc

http://www.highcountrygardens.com/

New Mexico Water Conservation Program

Citizen Of The World: First Tax

2007-04-07T21:19:00.000-06:00

Ick, income tax filing. After four years of medical school, when I racked up debt and didn't have to file, it's an unpleasant experience to wade through the 1040 instruction manual again. Why does it have to be so convoluted, confusing, and difficult? Some would argue for a VAT (value-added tax) on all goods and no income tax, but among other things I'd be very concerned for the poor, having been from a previously low-income family. And why does the government tax two people differently if they are single as opposed to married to each other? Why should the tax code be so difficult that it takes up hundreds of thousands of dollars just to be codified and written each year? Flat tax can also hurt the poor, but it makes a lot of sense in cutting down bureaucracy.

Currently my solution is to provide Sunny with all of my documentation, and cook and clean while he does the taxes. Not the best one, but until I know enough to have an educated opinion.

Federal tax forms for individuals

2006 New Mexico tax forms for individuals New Mexico's state tax forms "piggy-back" on the federal form, like most states'.

Being Whole: Movement

2007-03-11T21:01:00.000-06:00

Three days ago I took a yoga class at a local school chosen from the surprisingly high number in the area. It was wonderful to take the time to sit correctly and breathe fully. Under stress, many people tend to take quick, shallow breaths, and during this hour and a half hiatus I suspended stress and breathed.

I have a curious relationship with exercise. I've been a mid-level athlete before, but I rarely have enjoyed competing. Though I have been a regular at the gym before, I don't enjoy repetitive movements, nor exercise for the sake of exercising. I don't like any sport that brings me near cars or near to where non-participants can watch me. What I enjoy, I often think of as studied movement. I enjoy those sports that allow me to study my relationship between my will, the execution of that will into my body, and various forces of physics including inertia, force vectors, and momentum. Thus I usually find myself dancing, rock climbing, practicing yoga or doing martial arts forms.

It feels good to be sore again, and to be correctly aligned. I'm sleeping better, and am slowly recuperating from a month of overwork followed by a month of one virus after another inhabiting my respiratory tract. For those in the area, let me know if you'd like to go the the next class!

Pediatric Check-Up:Passing Disease

2007-02-13T15:02:00.000-07:00

One big issues with having a centralized institution for the care of the sick is that there are naturally a lot of sick people there. Furthermore, they're sick with different things. In pediatrics, this translates to clinics and floors full of infectious diseases that can be passed from patient to patient, from patient to staff, and vice versa.

On a systems level, that means that everyone is generally treated with "standard precautions", which include hand-washing before and after every patient contact, and not eating in areas where we care for patients. That second part is generally why I am usually dehydrated. For unlucky hospitalized patients, there are also "contact" and "droplet" precautions. The first is for those patients who have an infectious but not respiratory illness, in general. The second is for everyone who has a cold. There's even further levels of precautions for people who might have tuberculosis or pertussis, but fortunately we don't see more than a few cases of possible pertussis patients in a month. Precautions are for everyone's safety, however they do have an emotional impact on our "chronic" patients: those children with chronic diseases who are hospitalized often, and for long periods of time. These patients are often left in the hospital by their families. The staff of the inpatient unit is often like a second family to them, but when they are placed on any protocol above standard precautions, they are usually isolated in their rooms alone other than the two to five hours that their nurse or the Child Life workers can spend with them. Spend some time listening to a three-year-old sobbing "mommy daddy gone" when you haven't the time to spend comforting her, and you'll know why hospital staff hate taking certain precautions even though we know why we have to.

On a personal level, this being my first winter in pediatrics also means that on top of my resolving lack of sleep, I've also been flat on my back with rather violent viruses, one of which has recently migrated to my eyes, giving me the all-to-gruesome "pink-eye". It's really hard to drive when your eyes are full of gunk, I've noticed. However, I am making a come-back, and next week is the three-day Intern Retreat in Taos, New Mexico. It's a rural town famous for artists (and some art), an aggressively organic lifestyle, a world-class ski resort, and yes, there really is art there. I'm looking forward to it, and my second vacation of the year starts after it!

Pediatric Check-Up: Hours

2007-01-16T20:33:00.000-07:00

Current total hours worked: 101.5!
Current days working on this part of the job: 7 days

Pediatric Check-Up: A Time of Advocacy

2007-01-13T16:09:00.000-07:00

From Merriam Webster Online

Support: (1) : to promote the interests or cause of (2) : to uphold or defend as valid or right : ADVOCATE (3) : to argue or vote for

So one of my ideas for my advocacy project was to build a website for the local GLBTQ (gay, lesbian, bi, trans, queer) community. This website would function much like an information and triage desk. It would list available resources, as well as providing enough information to give people an idea of where they should look next to find real people to do things with, such as volunteer, advocate, or just plain drink with.

In speaking with some community members who are active in various organizations providing services in the area, this website is needed, but not only as a website, but as a comprehensive online community. This is interesting to me as this is a variant of what Sunny and I are trying to do with http://poeticpublishing.com and http://davinciconcept.org. While with those sites we've built a site and are trying to recruit members, in this case a group already exists but needs a virtual home. For the online communities we've already built, Sunny and I already have capacity for email, forums, and serving content. To build this one, I would probably use a wiki as well, though maybe I'd use DokuWiki instead of MediaWiki as the collaboration on content would not be the focus of this group. For emailGmail, I would also use and then for listserve management, I would try Google Groups. For community calendaring, Google Calendar, of course.

Why all the Google use? It's free, it works, it's meant for multiple users, and I don't have to host or manage it. Furthermore, the text ads are very unobtrusive, and it's a small price to pay for all the work that I don't have to do myself. Same thing with the wiki use. I'm familiar with DokuWiki and MediaWiki, and though I don't currently understand the nuts-and-bolts of installation and of upgrading these two, I have watched Sunny upgrade this site, the content of which is managed and displayed by DokuWiki.

Now, of course, this online community would not be the same as the real-life community it serves. There are plenty of people without access to the internet and computers. However, I think that the majority of the population have access to either libraries or their own computers, and that reaching out to the less technologically privileged would be a project that can be fulfilled by one of the current organizations.

In terms of this working as my advocacy project, my residency director thinks that it's a great project, and I'm looking over the CATCH grant paperwork to see if they might fund the learning curve that I'll need to undergo in order to do this properly. Let's hope that it does!

A Cat's Life: Toilet Training

2007-01-09T20:12:00.000-07:00

Cat feces carry a risk to both pregnant women and immunosupressed people. They can transmit the pathogen Toxoplasma, of which cats are not the only carrier. Besides being infectious, cat feces and urine are just gross to deal with, so Sunny and I have been planning to train Ulysses to use the toilet for a long time.

Firstly, I looked around on amazon.com to see what was available, and then read some reviews. I found that I needed a training device, though some people have used plastic wrap, like Saran, for a trainer. Then I needed flushable litter. Though I had a device picked out on amazon, I ended up buying Doogie's Litter Kwitter at the local retail pet store so that I could return it if it didn't work. So far Ulysses is making a mess, since the training seat isn't deep enough to hold a lot of litter, and Ulysses is a big cat. Litter gets all over the bathroom floor, and sometimes there's poop too. Eew. But hopefully the mess will be offset by future freedom from sifting through kitty litter for cat poo. And no toxoplasmosis when I'm pregnant.

Pediatric Check-Up: Sleep, Rounding, and Sign Outs

2007-01-08T20:49:00.000-07:00

I've often been asked how much sleep I get as an intern; it's an understandable question because on certain rotations I work 30 hour shifts. What really bothers me, though, is not necessarily how much sleep I get, but when I have to get up. Generally, when I was on the inpatient service in August, I hit the floors around 7AM. However, now that it's the wintertime, I'm really facing a wake-up time of around 5:30AM and an arrival of around 6AM to get the work done in time to present patients to the team for the morning's planning session, generally known as "rounds". It sounds very, very painful to me. I used to be a night owl and still relish staying up as long as I want when I can. Furthermore, Sunny's a night owl too and likes to go to bed around 1AM. I can't do that with a 5:30 alarm bell.

What makes tonight even more interesting is that each team is switching personnel. All of the interns are coming from other rotations to pick up the current team load. Furthermore, the team I am switching to is admitting patients tonight, resulting in uncertainty of how many patients I'll need to see by 8AM tomorrow morning, which is when rounds start. I don't like it, but there's nothing I can do but try to make it in by 6AM, a feat I've never accomplished unless I was already in the hospital.

Pre-rounding, that is getting the data for rounds, is always an adrenalin-laced experience for me, and I don't really like it. For pre-rounds, I record a summary of all my patients' vitals, lab values, and general events from the 24 hours since we rounded last. This includes a bedside visit and exam. For new patients I am generally slow, hopefully due to me being thorough vs. some kind of intrinsic inefficiency.

Generally, though I know my patients and know exactly what to look for to see if they are getting worse or better. On a switch day, though, the quality of the information from the departing intern tries to fill in for that familiarity. The passage of information is called sign out, and it's a process that desperately needs some troubleshooting.

In an effort to decrease medical errors, residents across the nation have had their work hours limited to an average of 80hr/wk each month. This is similar to work hour limits in fields such as aviation (pilots) and other crucial errors. However, preliminary data suggests that the increased mental rest residents are getting is being offset by errors made by cross-cover teams due to sketchy sign out. I'm still in the process of reading up on this, and I hope that further studies continue not only to track the numbers, but to also test ways of making sign out more efficient and information-laden.

Occasionally, I am irked, as today, with the quality and thoroughness of sign out. One person just left and didn't bother to sign out to me. Another describes a 3 week hospital stay that included an ICU stay as "simple". Such things suggest to me that there is a systems issue that needs to be addressed by a policy statement to clarify things. My current personal policy is that whenever I leave a hospitalized patient for another rotation, I tend to leave a summary of their stay under my care, so that the next person doesn't have to flip through a whole book of notes to try to figure out what happened. I also intend that when I am team leader to clearly verbalize criteria I expect for this kind of major sign out, and make sure all of the team members understand what I am expecting. It might just be easier and less bossy to get the whole caboodle in writing, or find out where it is written, and just email it out.

References:

Editorial: Is 80 the cost of saving lives? Reduced duty hours, errors, and cost.

Residency work-hours reform. A cost analysis including preventable adverse events.

Disclaimer: I'm still reading the literature on this.

Writers' Cafe: A Diamond Age

2007-01-08T00:18:00.000-07:00

This Sunday to Monday night marks the transition to the last day wherein I can work on my entry for the 2006 writing marathon I started on Poetic Publishing, the online art development and publishing site that Sunny and I are developing. For my entry, currently titled "The Grotesque", I'm trying to write fiction, a new thing for me, and the piece sits nicely in the genre labeled science-fiction.

My problem, other than my inability to come up with a plot, is that though I have emplaced my story in a sci-fi world that Sunny and I have been developing on and off for over a year, the world's not done yet. Most irksome for myself as a primarily poetry writer is the fact that we haven't named most of the technology we're talking about.

In contrast, Neal Stephenson, author of Snow Crash, a book well-known in techie and hacker culture, builds worlds that are not only colorful extrapolations of now but are also well populated with contraptions that are superbly and uniquely named.

Today I read another book by this author The Diamond Age: Or, A Young Lady's Illustrated Primer. Though off to a slow start for the first hundred pages as Stephenson describes a world saturated with nanotechnology, the plot thickened eventually, and explorations into basic programing, cultural warfare, and parenting provided enough human significance to give the book a rating of 3.5 out of 5 overall.

Now, though, I feel totally screwed. My main character is a designer whose creations are given life by nanotechnology. It's going to take a while to wash the lingo and made-up tech of A Diamond Age out of my system enough to make me feel that I'm not obviously crimping someone else's style. Then again, the whole point of the marathon was to let go of the editor and just let the words flow. Furthermore, the development side of Poetic Publishing, also known as Poetic Authoring, is private and secure. So, if imitation ends up being the sincerest sort of flattery in this case, no one not of the community will have to see and laugh at it.

So here's my concise review of A Diamond Age: it's the pleasure of reading a solid writer break new ground in an interesting nanotech world mixed with the pain of being a nanotech writer trying to break into a new area without copying anyone.

Pediatric Check-Up: Crazy Saturday

2007-01-06T19:10:00.000-07:00

I get asked what my life is like fairly often, as I'm undergoing a type of training whose rigor is renowned. In J. Ruth Gendler's book, The Book of Qualities, I like how she describes how some people seek out suffering and are proud of having suffered. Some people avoid it. I sit somewhere in the continuum, but towards the avoidant side. I don't buy the idea that suffering automatically makes the sufferer noble. In my totally unresearched opinion, that's a religious tale they sold to some peasants to make them feel better about themselves. Yet, if an education or an experience is valuable enough to me, I'm willing to work to get it.

Currently, I'm an intern at the Pediatric Residency Training Program at the University of New Mexico Health Sciences Center, which is a lot of capitalized words. What it means is that I am in my first of three years of training to be a general pediatrician. The curriculum varies somewhat from program to program, though all programs must meet criteria to be accredited, so core facets remain similar across the country. Our year is divided into 13 four-week blocks called rotations. Each block we operate within a different part of the pediatric medical world, going from inpatient (hospital) service to outpatient to emergency to critical care to different types of specialty care.

This block I'm doing is called PARC: Pediatric Advocacy, Rural and Community. It's a relatively light block in terms of hours required. Scheduled activities are half-days at the most, with the rest of the time for self-study. The goal of the block is to educate pediatric residents in the process of advocating for our patients. This is a fluid target. "Our patients" could involve a specific patient, a family group, a certain ethnic or minority group in the area, or even creating change on a national level. "Advocating" can involve helping find resources to pay for a patient's chemotherapy, or making seat belt laws physiologically make sense for children, or writing a column, or teaching children how to safely approach a dog. Pediatricians as a group tend to be active advocates, though the issues and the populations we speak for may be very diverse. This month rests us (interns) from our labors, broadens our education, grounds us back in who we are, and gives us quality time with whatever we choose.

During this month, we also cross-cover (meaning serve where we are not working full time) the hospital urgent care clinic. Whomever covers the clinic also takes phone calls from worried mothers at night. Normally Saturdays are pretty light in clinic as we are only open from 9 AM to 2 PM, and I think that most patients don't know that we're open and don't want to go to the doctor on a weekend anyway. So what's a Saturday in the life of a resident like? Today, there was a rush of patients from opening to closing, and I was taking phone calls during clinic hours as well. I bought a coffee and biscuit for breakfast at 9 AM, ate the first bite while standing up at 11:30 AM, at the last bite while standing up at 3 PM, and left at 4:30 PM while starving for some linguine. The unpredictability of patient care is why I never commit to anything during work days when the time I leave is scheduled as "when the last patient is done". Not even food, my first and foremost romantic partner on some days, is exempt from this. I estimate that the last patient left around 5PM. I'm still taking phone calls. Crazy.

Skin and Bones: Car Seats

2007-01-05T21:57:00.000-07:00

Today, Consumer Reports released a paper saying that the car seats they tested failed side-impact testing. These were rear-facing, snap in car seats. For those of you with children, you may be really mad at me because I've been having the following conversation with my patients' parents all year long:

"Do you have a car seat for your baby?"
"Yes."
"Which way does it face: the trunk or the engine?"
"The trunk."
"Perfect! Is it in the front seats or the back seats?"
"The back."

The testing did not compare rear-facing car seats versus seats facing any other direction. So I'll continue my little quiz and recommend car seats over flying babies.

Dictionary Day: Baraka

2007-01-04T10:54:00.000-07:00

From the Merriam-Webster Open Dictionary Project:
baraka (noun): [ba'ra-ka] [arabic] - a state of heightened consciousness or grace achieved through religious fervor involving prayer and dancing; a blessing that can be carried and transferred from one person to another or from an object to a person (usually one who has made the hajj); the blessedness possessed by a person of character, courage, and selflessness
Muslims who have completed the fifth of the five pillars of Islam are often endowed by Allah with baraka that may transmit to those around them. —christopher j moore, book In Other Words: A Language Lover's..., 2005.

Dance! Dance is one of my favorite art forms, and one I don't hesitate to participate in. Give me tango, waltz, cha-cha; jive with me during some happy hardcore, if you can, or let's jump around to some dark progressive house music. Give me some vocals; add a little electronica, spice it up with some South Indian beats and a good soprano, and we are set!

While I am not someone with decades of experience in Modern dance or ballet, I do have a background in studying movement that comes from decades of experience in the martial arts on top of my amateur ballroom dance studies. In the realm of my own experience, dance can endow the participants with a state of exhilaration and even ecstasy, without recourse to drugs, legal or otherwise. My current theory is that the effect of fervent movement and the joy of expression is akin to the phenomenon known as "runners' high". Add strobe lights, and it's a potent experience.

Where does that leave those who join religion and dance? Religion is a private matter, and I don't engage in such activities, since I prefer to spend my energies dealing with reality and real people. Dance is a beautiful set of activities on its own, with meaning assigned by choreographers, ravers, and your own personal self. Religion and faith don't have to be part of the equation for it to be a transcendent experience full of the vigor and ecstasy of enjoying life. So, love, live, and dance!

Links:

http://en.wikipedia.org/wiki/List_of_electronic_music_genres

http://www.m-w.com/dictionary/transcendent+ I meant definition "a" or "b". Kant likes to make his own mental Möbius strips, and I don't participate in that.

Dictionary Day: Agoraphobia

2007-01-03T10:04:00.000-07:00

From Merrimam-Webster Online:

Agoraphobia: abnormal fear of being helpless in an embarrassing or inescapable situation that is characterized especially by the avoidance of open or public places

In psychiatry, one can have panic attacks with and without agoraphobia on top. People stop going out into public places because they fear that they might have a panic attack in public.

Personally, when I'm at a place where I can spend an extensive amount of time at home reading, studying, and writing, I notice that I also start avoiding the public. This is especially odd for me to experience as I work in an industry known for public exposure: medicine. However, I am more on the introverted side of the Myers-Briggs scale, and at times, public exposure tires me out. I thought that this would qualify me as an agoraphobe, however, as I'm not actually afraid of being helpless, it doesn't count.

Blog: Drivel vs News

2006-12-28T16:25:00.000-07:00

There's plenty of media devoted to how bad blogs are. Cries of "therapy writing" and "cheesy adolescent angst" or worse labels tend to make the genre less than respected. On the converse, there are those blogs which are read by hundreds of people. I personally enjoy reading design blogs, or to my favorite magazines, local or otherwise. So where does that leave this poor blog, which hasn't been posted to in literally a year?

I've decided to go for broke in an effort to keep writing. Sunny writes for posterity, but that freezes me up. It takes a lot of time and revision for me to produce something to be truly proud of. I'll put it as a secondary goal; the primary one being to natter on pleasantly with my expected audience: a) no one but myself b)friends and family that accidentally find this.

Status Report: Filling in the Past Eight Months and Next Year

2005-01-22T18:57:00.000-07:00

Since my last post, I finished 2nd year's exams, took the boards in San Diego, and began third year. I am working on writing a piece on the specifics of my completed third year rotations. In general, though, I am doing well. I feel as if I have hit my stride and found my own style of how I want to practice medicine. I just need to develop my skills and knowledge further.

At this point in my third year of medical student, regarding the curriculum, I am finished with all of my core outpatient rotations, save surgery, and will be starting inpatient in about a month. My third year project on a problem seen in ambulatory care is coming due; for it, I've chosen to look into pediatric head injuries in sports with an eye towards doing a seminar for the Tae Kwon Do judges at home as my 4th year selective project. After I finish this, all I have to do regarding third year is survive the inpatient rotations.

Fourth year is a year of electives and choices. I am fully in charge of my schedule as 4th years get their pick of rotations and sites; I simply need to fulfill requirements. In order to graduate, there are three one-month rotations that a student has to do in Connecticut. In addition there are four months available for elective rotations. One also has to take the second part of the written licensing exam and then the clinical part before Jan 1. Finally, there are two months of a senior project called a selective. I graduate May 14, 2006.

The complication for fourth year is that residency (post-graduate training) programs in California can be very competitive to get into. If I do "audition" rotations in California, it will increase my chances of getting interviews at the programs I rotate at. However, interview season is Dec-Jan. Therefore, I would ideally audition during Oct-Nov. Thus far, my schedule is July-Sept for the three required rotations in CT so that I don't have to come back from California and Sunny. I wanted to take October to study for the boards, finish applying for residency, and take both Step 2 and Step 2 CS, the clinical skills portion of the boards series. The exam is required only for graduation, not for applying to residency. This leaves only Nov to do an audition rotation before interview season heats up. I could do one in January, but it seems rather late. Also, visiting students get last priority for slots in other schools' programs. I might not even get a chance to do a rotation in San Diego before the new year. In case you are wondering, I am very worried about next year!

Part of the stress is from the fact that I need to choose what kind of doctor I want to be before I apply to programs. I also want a humane yet educational program. Then, I want to be in a nice area of California. Most importantly, I want to be with Sunny. I am hoping that this wishlist will not be too hard to fill.

A Picture of A 1000++++ Words

2004-05-22T17:41:00.000-06:00

For your viewing pleasure, these are the 2/3 of the books that I will probably be selling once I finish taking the boards and don't need them anymore (I'd forgotten about the ones in the attic). In case you were wondering what the basic science years of medicine involve, take this stack and a Harrison's Principles of Internal Medicine and you'll be set!

Stress Level: High

2004-05-20T17:56:00.000-06:00

Hello.

Currently I've been spending my days and nights at the local Borders bookstore with my eyes not glued enough to my laptop screen. I'm people watching, but when I'm not, I am studying for my last exam of the second year, aka "MOD 4", which is short for Mechanisms of Disease test # 4. Imagine taking a 5 hr final that covers ~3 semesters of physical chemistry material. The catch is that all that material was presented over 2 months, and I only started studying for this exam a few days ago.

I'm taking it early, next Friday the 28th instead of Wednesday the 2nd, not out of hubris, but because I am also studying for "the boards" which is the USMLE Step 1. I'm taking that Wednesday June 16th. It's a comprehensive exam that covers all of the material of the first two years of medical school. Now if only I could get a master's degree for finishing it.

After that I will be partying/sleeping/packing for a night, and then I will jaunt through San Diego to Reno on the 15th, stay about a week, stay a week in SD, and then start 3rd year July 6th with the receipt of a shiny little pager that will no doubt be the bane of my existence. I am expecting to visit some friends, hopefully if you all could visit me in Carson as I won't have a car ?

How am I?

My most immediate sensation is itching. Yes I itch, and in more than one place, and it is probably mediated by Th1 and Th2 helper T-cells, heh. I made the mistake of leaving my combo lotion/bug repellent/sunblock in my car, and over the course of the last two days have garnered ~3 insect bites per limb, one on my face, and one on my collarbone, right where it makes that graceful curve. What a shame; of all of my bones, it is easiest to show off my collarbone without calling attention to rounder parts of me.

Other than that, I am as usual all of the following: book-hungry, food-hungry, movie-hungry, sex-hungry, and generally dehydrated. So please send me email care packages and let me know how you are doing!