Lou the Subaru

Here is a short video of off roading with the new Subaru.  Lou was pretty bad ass.  You almost need a seat belt to watch the video... but that is a combination of factors, ha.

Farmer's time

I was thinking the other day about how my studies in grad school have been a little bit all over.  The central theme is generally tied back to religion, but I have done work on Bible reading, something akin to cognitive schemes, some criminology, some family stuff, and now I have moved on to sociology of medicine stuff.

This gave me a good excuse to read a classic in medical thought that is more 'humanistic' in flavor - Mountains Beyond Mountains.  The book is about Paul Farmer who seems to be one of those interesting people who is very shallow in terms of not hiding what is going on in his head but also massively deep and guarded so you never really know what is going on.  He is also a fierce advocate for those who are struggling in life and are stuck in a life of poverty.  I have been thinking about a section towards the end of the book when he is explaining to the author why he does not think it is a waste to spend tons on money on a patient who is likely going to die anyways.  He is trying to point out to the author the irony of saying that is a lot of money and possibly a waste but the same people never think about what it means to have more than that same amount of money in excess, sitting in a bank not healing poor people.

Then he has a great line.  I have had the same feeling before, although clearly not to the same degree as Farmer.  Mostly because it is fairly autobiographical for me, I imagine.  He says, "It's just, you know, I never have been able to figure it out. I mean, I've figured it out, but I realize no it takes so much time to get to that point, to explain it, without offending someone."

Sometimes it seems as if we look to easier arguments like political or fiscal expediency to cover the brute response of, "But Lord, who is my neighbor?"

look out below

Well, it has been a bit since the last post.  Lots has happened and I was going to just do a photo dump with short captions and call it good.  I may still do that, but it still takes longer than just writing something quick and short, although not so much a re-cap.  But lets face it... who really likes really long blogs anyways?  The sugar to help the medicine of a blog go down is brevity.

A week ago I finished up SCUBA diving training and got the first certification.  The open water dive was a TX experience for sure.  It was at a SCUBA park that was out in the country:


View Larger Map

Driving out, the view is of rolling Texas nothing with cows grazing.  Stroll through the small town of Terrell, which I think may be best described by the picture below, which is an actual picture I found that someone else took.

The water was super murky, so we could only see like 5 or 10 feet down there.  They did have two boats sunk, but with few fish and no plants and, surprisingly, no coral, the boats are not so much fun.  Apparently the have an airplane under there somewhere, too.  Didn't see that.  Probably touched it at some point though.

Other new experience was fire ants.  They are terrible.  Pain - not so bad.  Itch - thought of having my feet amputated, but had second thoughts that this may be extreme.  Cheers.

brandied cherries

ever bought cherries and then not be able to finish them all?  well fret no more... i bring you brandied cherries.  you can do this with either rainier cherries or the normal ones.  equal parts water and sugar to boil (basically just making simple syrup).  add some cinnamon and the cherries.  simmer a few.  add equal parts brandy.  remover from heat, put in jar, cool, then refrigerate.  you are welcome.

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layout

So as you can tell I changed the layout today.  Not sure if it will stay.  It is kind of a fun/different way to display more in a smaller space.  Just click on a post to see the whole thing.  If you want to comment,  scroll to the bottom (after you clicked on a post) and click on either 'view comments' or 'add a comment.'  we'll see... strong preferences?  let us know.

Doctors, culture and patient compliance

My first year at Baylor I wrote a theory paper about what happens within a patient/physician interaction when there is a larger and smaller spread between the two people's cultural background.  So if the patient is very poor and is struggling in life, the world that they know and how it works has a very different feel and nature to it that the physician, whom we would assume is not struggling - at least in the same sense.  I got to thinking about these issues again today at the eye doctor.

Our eye doctor (or mine - Sara doesn't need to go... yet) clearly has a different cultural background that I do.  It is in a very nice neighborhood, in a building whose rent cannot be cheap, and I am betting serves a certain kind of client that is from the upper end of the socio-economic ladder.  Much of this makes me feel uneasy being there - not because I am intimidated by them or something like that, but I feel as though I am merely a dollar sign and has a feel to it like I would imagine a used car lot would.  The conversation they have with me, the words they use, the seemingly memorized lines that are 'answers' to my questions and the assumption that I am more than willing to pay out of pocket for additional and seemingly unnecessary stuff.  The highly visible diplomas of the doc on the wall, despite the fact that she has an office.  The clothing they all wear - stilettos (yes, literally designers super high heels) and matching everything that I guarantee is not at Old Navy.  All of it are symbols that communicate a cultural background foreign to me.

As such, I am on high alert for things that it seems that they are trying to 'get' me on (it happened no less than 4 times today).  Because I am on high alert, I am halfway listening to what they have to say about my eye care (which is only a notch above nothing) and halfway defending my wallet.  This naturally makes the conversation borderline adversarial most of the time, which spurs them to try and reassert their position as the expert in the room.  I am sitting there trying to not elevate their defensiveness because I am aware of the fact that this will not help either of us, but can't shake the feeling of a disconnect between myself and them.

All of this leads me back to the patient/doctor interaction and patient compliance.  We know that rapport with a patient increases the information the patient will supply to help the physician solve and problems or figure out a diagnosis, but past interactions also play in.  If they know the patient from past interactions, it only helps - unless the interaction is breaking down.  This is why continuity is such a big deal when it comes to medical care, but also why attempts to reduce the cultural gulf between patient and physician is crucial.  All of this leads up to the point at which the patient leaves the office or the hospital.  Are they going to follow the advice?  Will they do it willingly or begrudgingly - both of which will impact outcomes for either the better or the worse.  Are they able to follow the advice?  Did they understand the advice given, and relatedly, did the physician know whether or not they communicated successfully?  Medicine is a pretty hard job - because it really is almost never just medicine.

end of an era

yesterday was sara's last day of residency.  pretty crazy to think about.  7 years and surely thousands of hours of studying and even more actual work on top of that.  just the start of amazing things - just watch.  in lieu of deep thoughts, this time, i bring you pictures and videos.

Here is Sara opening the bottle of champagne I got to celebrate the end.  It was her first time opening a bottle and was a bit scared.  Maybe because I made her shake it a bit, too.  Sadly only a little sprayed out.  This was even filmed with her new iPhone.

Here we are with our glasses of champagne.

I made some Velvet Cadillacs with the left over champagne... half Guinness, half champagne.  They are actually really good.

Music

Last night I went to see a concert put on at our church and it was probably one of the best I have ever been to.  I got to thinking about how different music seems now with the advent of the internet and all.  I think that a majority of the music that I listen to as of late is not stuff that is played on the radio or anything like that and I have just stumbled upon in various different ways.  This is really good for many small bands that I am not sure would have been able to exist in the past very much.  This is why Noisetrade.com is interesting.  For the most part, besides bands that get radio time, most others spread through network connections and these connections are more valuable to them than record sales in a certain way.  So, they give their music away for free in exchange for a network connection to me as the consumer.  When that connection is made, they can sell stuff like t-shirts or CDs at a price that allows them a greater return, they keep people updated on shows they play, and very often, these same connections will fund their next record production in return for a free song or two.  Interesting.

The venue is great for awesome shows because it is huge but intimate at the same time and has great acoustics.  I was going to write something about how and why shows like that succeed at producing connections with the audience and producing positive collective feelings and how that relates to/is similar to the feeling of writing an interesting/creative paper or something, but I doubt most anyone who reads this is interested in that.

 The first band was Fox and the Bird. Check it:



The second was Gregory Alan Isakov, which was really great.  Violin (or fiddle, maybe?), cello and an acoustic guitar = win.  Check it:



Anyways, grades are in and summer studying has started.