Retrospectoscope

A good friend forwarded this article to me... I can only wonder whether that person was asking me the key question: "Would you do it again?"

So... I'll answer, "Would I do it again?"

Being a physician changes your identity.  The paths before me were ministry, law/politics or this.  While I went to a science/engineering school, philosophy and social systems were always more interesting to me.  It was ultimately my father that really made up my mind to do medicine.  What were his choice words?

"Honour your father and mother that you may live long in the land.  This is the first commandment with a promise."

Unless I felt some strong reason/leading to disagree, they felt that it would be best that I obeyed/submitted, a la Ephesians.

I raged.  Why couldn't I go to the mission field?  Or seminary?  Or... law school?  Or business school? 

They argued that they were given to me as my parents to guide and lead me.  They wanted me to hearken to their wisdom, vis a vis Proverbs 1.  Like a garland for my neck.

I obeyed. 

It wasn't easy, and it made for frightfully interesting medical school interviews.

"Why did you decide to apply to medical school?"

"My parents."

"What made you interested in medicine?"

"My parents."

"What made you think about becoming a medical doctor?"

"My dad."

---

So here I am.  It's been 14 years since that fateful discussion, in the great room of our home near DC. 

I've grown to love and hate this field in different portions.  The privilege of medicine is difficult to articulate.  I touch people from the inside to out, and the successes and mistakes change the course of peoples lives irrevocably.  I dream about my patients and wake up in the middle of the night with nightmares about complications and errors in judgments.  Some critical choices are replayed over and over again in my dreams, sometimes going well, sometimes disastrously.

At its best, medicine is about science touching humanity.  We study the body to extend life as best we can, trying to give each person the best chance at a long and productive life.  I counsel people to make the choices that will garner the most gain for the least risk.  We have to study the choices we advise to make sure the science backs those choices up.

It's an art.  Complications are a reverse lottery.  You win the complication, even if it was a .01% risk, and you get the whole kit and caboodle.  You decide to do nothing, and the worst can occur.

Life doesn't come with a warranty.  There is no return to the manufacturer.  If you come into the world with a design flaw (so to speak), you're stuck with it.  All we can do is try to mitigate the damage.

It's magical.  It's wondrous.  It's humbling.

It's also haunting.

So much money flows around medicine, it's easy to see waste -- but on the flip side, bare bones medicine is dangerous too.  You see hypocrisy and disingenuous-ness, on the part of physicians and on patients.  You see people trying to garner sympathy from their families, or their friends.

There is also no shortage of powerful egos and personality clashes.

Instinct can become dogma.  Dogma can be stifling.

You can also find people so committed to medicine that their families wither from that devotion. 

Would I do it again?
Face the financial burdens early on, the stress, the uncertainty -- the delayed gratification?  Would I prefer some other path, and never bear the mantle of "physician"?

It's hard for me to imagine any other role now.  I could have done many other things; of that I have no doubt.  But I get to help people every day.  When things are good, they are very good.  When things go bad, you feel very responsible.

Yes, I would do it again.

But I warn would be physicians how bad it can be, and how it better not be about wealth... because it's really not all that for the vast majority of physicians.  I warn them about the personal sacrifices, and the sacrifices their families might face.  I would say, be really careful before making that choice.  In some ways, there's no going back.  More than most other professions, once a physician, always a physician.  You invest so much, it's hard to pull out.

For the record, I don't resent my parents advice.  They do the best they can, lovingly.  They've never intended me harm.  Sometimes I disagree with their advice, but I always listen, and I largely obey.  Scary being a parent, eh? HUGE responsibility.

From 10/4/2005.

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From the desk of the Vagrant:  Male Trafficking.

Very troubling.  Man's covetousness knows no bounds, it would appear.

My father called yesterday to let me know that one of his friends passed away from a heart attack.  He was only a year older than my father.

It was clear from the tone in his voice that he was thinking about his own mortality -- and how his days and years on earth are numbered.  It profoundly affected him -- this death.  It no doubt brings to mind the fact that neither my brother nor I have married and moved on to that "next" stage in life.  It troubles me, yet I don't really know what to do about it, other than trust the Lord to guide.

Easter represents the Christian's hope against death.  "O Death, where is thy sting?" 

Nailed to the Tree, at Cavalry, was our sin, imputed to Christ, and put to death.  Justice was meted out onto a proxy, and with that proxy died our sin and the eternal death that would have been our just desserts.

If Christ did not rise from the dead, my faith is foolishness.  As Paul writes, "we are to be pitied above all men."  Central to biblical Christianity is Easter, not Christmas.  Christ's death must be effective for the expiation of sins and his resurrection real for our spiritual and fleshly redemption.  Were we to hope in a God who never rose, and never accepted our sin, then the whole premise of our belief would fail utterly.

Good deeds, no matter the number, are never sufficient for Righteousness.  Righteousness requires the absolute absence of sin; of any wrongdoing or wrong-thinking.  That is not humanly possible.

Fortunately, in Christ, we have been imputed his righteousness; accepted through faith, by grace.

1 Corinthians 15:12-20

Now if Christ is preached, that He has been raised from the dead, how do some among you say that there is no resurrection of the dead? 13 But if there is no resurrection of the dead, not even Christ has been raised; 14 and if Christ has not been raised, then our preaching is vain, your faith also is vain. 15 Moreover we are even found to be false witnesses of God, because we testified against God that He raised Christ, whom He did not raise, if in fact the dead are not raised. 16 For if the dead are not raised, not even Christ has been raised; 17 and if Christ has not been raised, your faith is worthless; you are still in your sins. 18 Then those also who have fallen asleep in Christ have perished. 19 If we have hoped in Christ in this life only, we are of all men most to be pitied. 20 But now Christ has been raised from the dead, the first fruits of those who are asleep.

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As Good Friday approaches, I meditate again on these truths.  My hope is in the Lord.  I hope that my father on earth will live to see me married.  "Nevertheless, not my will but thine be done."

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There's a certain kind of stroke, left untreated, is associated with an 80% rate of death/major morbidity.  I treated a person with this recently.  It was really, deeply gratifying seeing that person improving.  From no movement in all for limbs and a number of brainstem dysfunctions to volitional movement again.  Happily, he won't be "locked in."

Thank you God, for preserving him.

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As an aside:
Since I've changed the name of this site, the number of hits has gone down dramatically.  I used to get about 10,000 visits per year... about 1/3rd that.  Interesting.

 

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Christian Divorce Rates - Were we always looking at false stats?

I traveled home today, enjoying the steady, wafting flow of snow, caressing the windshield with their frigid fronds of crystaline water.  April 6th, winter in Cleveland.

It was beautiful, however, thus I have no complaints.  I smiled a smile, from ear to ear.  Enjoying the crisp air.  Moments before, I had been walking in the cold, feeling the daggers of wind across my bare face.  Ducking behind a sign, sheltering me from the wind and snow, I couldn't help feeling like a kid again.  Instead of driving, I wandered down the street to meet a friend to eat.  Glorious windy, snowy, Cleveland, covered again in white.

 

I have yet to go to the actual Rock and Roll Hall of Fame, despite its presence here in Cleveland.  It's no doubt quite lovely... but I've yet to get the unction to do so.

I have, however, gone to the 2009 Rock and Roll Hall of Fame Induction, featuring: Run DMC, Wanda Jackson, DJ Fontana, Bill Black, Spooner Oldham, Bobby Womack, Little Anthony and the Imperials, Jeff Beck and Metallica.

I wouldn't have purchased tickets -- and I didn't.  A friend of mine found himself with an extra ticket, and I decided to go with him, despite the probable high decibel levels of noise.  Fortunately, I found myself with enough cash to help him cover the sunk costs of the ticket, and he found himself with an extra pair of earplugs.  We both were happier for the trade.

There are several things that struck me at the induction. 

First, there were a lot of people thanking God.  I'm fairly certain most of them meant the God that I talk to every day.  At the same time, it made me think about what people are thanking God for.  For fame, prosperity ... for what?  The Metallica lead singer thanked the "higher power" that gave him inspiration to create music.  I'm not sure, but I think that his version of God differs from what the Bible teaches.

God is God.  Whoever calls upon God calls upon God.  Whether those prayers are spoken with an understanding of who he is a wholly different question.  I base this assertion on what we read in Romans 1.  Creation testifies of God.  We experience amazing talents and abilities, better so if we use them and hone them.  Our experience of creation turns our hearts in a sense of wonder, our spirits to a sense of amazement as we consider how insignificant we are before the Universe and its origin.  That's what Paul writes about.  The general revelation teaches a great deal about the nature of God; but the Gospel is not so easy to infer from creation.  In fact, it cannot be inferred.  Romans 10 shows us how it must be transmitted.  This knowledge is gained by hearing, enacted by believing, brought to fruition in obedience -- and all through Grace made manifest by the Spirit working in us.

Hearing most of the artists thank God (and I mean God as understood by those of a Judeo-Christian background) was uplifting.  I would daresay their sense of humility was most touching.  For those at the end of their career, they no longer seem so great in their own eyes.  This perspective is telling.  Youth is often so self-absorbed.  When all seems to be within one's own grasp, it is easy to be one's own "God."  I'm curious what the reminiscences of Metallica's singers be like in 3 decades.

Their was a sequence commemorating artists that recently passed away.  One segment contained a track from Pink Floyd's Dark side of the Moon.  I teared.

I remember listening to that album so many many times in the latter years of high school.  I'd turn on my father's stereo system (Actually, quadrophonic -- Quadrophonic before 5.1 and subwoofers were really available!) and close my eyes, listening to the feast of sound wash across my body and my soul.  The piquant tones of their music contained such melancholy, recalling hope amidst futility.  Pink Floyd, so quintessentially British.  In some ways, art is best found in the ashes of dominion.  Much of the great art of English language music is found in the shadow of its Empire.  Coping with the reality of a post Imperial place in the world, it's art blossomed as the people searched their souls for meaning.

That sort of music is far more soul searching than insipid sounds built for masses content to find an escape from daily tedium or music that celebrates mindless positivity.  The discord that marks those conflicting thoughts in tension shows maturity to me.

Time, the third track on the Dark Side of the Moon, is the epitome of DSOTM.  The ringing clocks, so precisely recorded were a pleasure to listen to.  With care, one could almost point to where each sound originated from on a virtual wall of sound.

Ticking away the moments that make up a dull day
You fritter and waste the hours in an off-hand way
Kicking around on a piece of ground in your home town
Waiting for someone or something to show you the way
Tired of lying in the sunshine staying home to watch the rain
You are young and life is long and there is time to kill today
And then the one day you find ten years have got behind you
No one told you when to run, you missed the starting gun
And you run and you run to catch up with the sun, but it's sinking
And racing around to come up behind you again
The sun is the same in the relative way, but you're older
And shorter of breath and one day closer to death
Every year is getting shorter, never seem to find the time
Plans that either come to naught or half a page of scribbled lines
Hanging on in quiet desparation is the English way
The time is gone the song is over, thought I'd something more to say

Home, home again
I like to be here when I can
When I come home cold and tired
It's good to warm my bones beside the fire
Far away, across the field, tolling on the iron bell
Calls the faithful to their knees
And hear the softly spoken magic spell

---

"And you run and you run to catch up with the sun, but it's sinking
And racing around to come up behind you again
The sun is the same in the relative way, but you're older
And shorter of breath and one day closer to death"

It recalls the perspective of the Teacher in Ecclesiastes, recognizing the "vanity" of everything under the sun.

In Breathe, track 1...

 "Run, rabbit run
Dig that hole, forget the sun
And when at last the work is done
Don't sit down
It's time to dig another one

For long you live and high you fly
But only if you ride the tide
And balanced on the biggest wave
You race towards an early grave "

There is an extra irony to this set of lines, as they recall a popular song during WWII which was sang in defiance to the Luftwaffe bombing runs.  Wiki article.

In all though, it's really telling that these men, still in their early adulthood, saw futility so clearly.

Pink Floyd was an amazing band that showed so much insight into life -- not content to simply "Run" or "Try to fly as high as you can."  Daedalus and Icarus.  I am much more like Daedalus I fear.

So I shed a tear, for the band is gone... and it reminds me that so many live and die in a defiant sprint, eager to live and die in a flash.  Life is so fragile, it ought to be well spent.

---

Metallica -
  I began to listen to Metallica in high school, much to the chagrin of my parents.  Flea of RHCP, had some very glowing praise for Metallica, though punctuated with more curse words than needed, I wot.  I agree.  Their musicality is deep, though (then) unconventional.  Their musical structure is both complex and nuanced.  They are not needlessly complex, understanding that technical genius does not necessarily confer emotional connection.  They do both brilliantly.  Although I prefer their thrash metal earlier work, full of brash, boundless energy.

  Another thing about Metallica (and many speed metal bands for that matter) is that they are socially conscious, writing about issues that matter.  I started my experience of Metallica with Ride the Lightning, which deals with execution, Fight fire with Fire, which deals with the cold war paradigm of "Mutually Assured Destruction," and Master of Puppets, which deals with drug abuse.  It didn't hurt that they read HP Lovecraft. 

  They deserve to be in the R and R Hall of Fame.  Kudos.

---

Another thing that really struck me is the near worship that many in the audience held for the bands.  It was eerie. Wrong.  "Thou shalt have no other gods before me."  Concerts make "gods" out of men... Rock concerts, anyway.  It's a strange phenomenon -- that there is such a spiritual connection in the music.  We experience this in Praise and Worship, but this sort of concert directs the emotion towards humans.  Not so great.  (Pet peeve:  Don't worship praise leaders...  If I need to explain that, then... well...)

Last thought:

Listening to Tommy Page and Jeff Beck play classic Led Zeppelin riffs was absolutely amazing.  I had to stand for that one.  Amazing...

---

I love music so.
That's why I wear earplugs. 

The noise pollution we experience regularly erodes our high frequency hearing.  If we were aborogines on the outback, we might have a chance.  Earlier researchers showed that their populations did not demonstrate geriatric hearing loss.  It's not inevitible, at least at ages we're used to attaining.

While my earplugs earn me odd glances, I'd rather live to enjoy another concert than lose my hearing in one go or two.

These days, when I go home, I turn on my stereo (yes, only stereo) system in my room and listen, just listen.  Beryllium tweeters casting forth high frequency tones that are crisp and so very far from harsh.  I hope the Lord has a provisioned much music in Eternity.  It might be my chiefmost pleasure in life.

Consumer Mentalities - From the Economist

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As the economic news continues to trickle in regarding how much more economic pain we'll have to endure as a world population, one encouraging note is that we might actually start remembering that stuff does not equal happiness.

So much of what we purchased in the heady days of rocketing stocks and easy credit was unnecessary.  Most people overleveraged themselves for lifestyles that they could not sustain.  Systemically, we encouraged this behaviour...

If it really is true that we, as a people, are recalling that many material goods are unneccessary, that's a good thing.  In the end, he with the most toys doesn't win.  It's not a bad thing for conveniences to proliferate; but not at the cost of the environment, nor our humanity.

That populations of extravagance can live alongside that of starvation; that is a travesty.

Hmm... How extravagant have I become?

I'd give it a B+

Cinematography is good, but I think my issue is with the plot flow.  There are some abrupt transitions in personality style that the time-jumps don't prepare you for...  the flow isn't quite right to my eye -- but looking beyond that, I think this is a great sketch of the American family in the 1940s.

To my mind, there are several major axes of tension in this film;
Dreams/Ideology vs. Pragmatism/Realism
Languages of Love
Freedom and responsibility

All set in the context of a home where neither of the two people feel appreciated anymore --

The opening starts with two younglings, the diCaprio plays a young man who works to get by, but has seen the world.  He imagines himself to be a dreamer, but he's really a pragmatist; working as a teller and as a longshoreman...  Opposite him is the dulcet future Mrs. Wheeler, who is a dreamer, desiring to be a star -- desiring to be someone special.

There's nothing explicit in the film, but I think the time jump and the following altercation shows that, in some ways, di Caprio's character goes along with her dreams at first, but quietly builds a steady job, retiring his fancies, dismissing them practically, but not consciously.

The marriage cools due to the increasing number of unfulfilled dreams... dreams that aren't communicated to each other any more.  Di Caprio, I think, is cast as a man with little insight into what he wants, but is able to fluently pursue his "image" of a stable home... kids and wife and all.  I think one of the tragedies is that he only thinks that he wants a glamourous life flying abroad -- but the definition of a successful adman ultimately is more appealing to him than wandering Paris.

She, on the other hand has decided that her dream of being an actress cannot be fulfilled -- and wants to allow him to find his dream and achieve it.  But given that he doesn't even really know what that dream is, it's hard for him to seek it.

She wants to express her love by "freeing him" from mundane responsibilities -- in some ways, this is classic psychological projection...  We realise that he doesn't appreciate being freed -- and would rather be "great"... and that legacy calls to him in kind.  (Pollack's appeal to think of his father).  He, on the other hand, thinks that a woman ought to enjoy the children and the family -- that that's normal... he believes that his material provision is an adequate display of love and affection.

Neither are receiving love in this interaction -- they both miss the other's overtures of affection.

The affairs, in this context, are merely symptoms of the sickness at the heart of their marriage -- a lack of understanding set in a skein of self-deception.

The schizophrenic's insights are curious...  for while he is presented as the unalloyed voice of truth, I think he is rather the voice of a true subset of the ideas that inhabit the couple's mind.  The reality for di Caprio's character is that he desires both -- and in the end, when forced to choose, he would rather have a conventional success (which is now in reach) rather than explore an uncoventional life.  To the schizophrenic's character this may be a flaw -- it may also be a flaw to the writer... but I believe that the final images show that the director/writer is not so harsh to the husband.  It communicates that he does/did love his family and wife... that he could not "fly away" from the mold that the world has created for him.

The final scenes prior to the abortion were also telling; I can't be certain whether the wife's gracious breakfast conversation was a farewell, or ammends -- or what have you.  The reality though is that we oft say and act due to a multitude of reasons -- which may at times be in conflict.  I like to think that she is being gracious because she realises that she does love him -- and yet that she does not want to have this child -- this child that has been cursed by the schizophrenic and father.  Whatever her reasons for going through with the abortion, I'd like to think that she is trying to be kind sincerely.  Realizing that perhaps the man before him can be adventurous within the context of his life with her and with his job as an adman.

The writer, I feel, indemnifies neither, but allows their choices and misapprehensions to earn a bitter repast in unintended dual deaths, and a single father family that will forever be scarred.

Thought provoking to be sure...

Thema:

Dreams/Ideology vs. Pragmatism/Realism
  Manifest in the wife's belief that pursuing the most fulfilling "job" is worth sacrificing stability for.  She wants at least one of them to do something that makes them feel "alive."  If not her, than him.  He looks now at the family, and the costs that transplanting would incur... he looks at the opportunities before him, and would rather stay, not completely happy, for a happy-medium.  He cannot perceive that she feels stifled and trapped.

  Both look outside to find affirmation.

Languages of Love
  He likes to talk, and give materially.  She likes time together and sharing ideas.   He is fine in confrontation.  She wants space when they fight.

Freedom and responsibility
  This is more of the first point -- but cast in this way, she views societal expectations as largely invalid... him... well... he views them as acceptable if not unconditionally valid.

Most sad to me is that the outsiders don't really understand the family.  Very sad.  And very true. 

"Happy people are much alike.  The sad are all uniquely miserable."

This is a movie I could never have appreciated when I was 19...  I understand both of their impulses so much more now...

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There is no redemption in this family -- they try, but fail.  The final breakfast is such a cruel moment in that the final beauty that they enjoy is to break so irrevocably shortly thereafter.  I'd like to imagine that a family loved by God would be able to surmount some of these issues...  I'd like to imagine that His grace could overcome...

The banking crisis explained:

Young Chuck moved to Texas and bought a donkey from a farmer for $100..00. The farmer agreed to deliver the donkey the next day.
The next day he drove up and said, 'Sorry son, but I have some bad news, the donkey died.'
Chuck replied, 'Well, then just give me my money back.'
The farmer said, 'Can't do that. I went and spent it already.'
Chuck said, 'OK, then, just bring me the dead donkey.'
The farmer asked, 'What ya gonna do with him?
Chuck said, 'I'm going to raffle him off.'
The farmer said 'You can't raffle off a dead donkey!'
Chuck said, 'Sure I can Watch me. I just won't tell anybody he's dead..'
A month later, the farmer met up with Chuck and asked, 'What happened with that dead donkey?'
Chuck said, 'I raffled him off. I sold 500 tickets at two dollars apiece and made a profit of $ 998.00.'
The farmer said, 'Didn't anyone complain?'
Chuck said, 'Just the guy who won. So I gave him back his two dollars.'
Chuck now works for one of the major banks

If it were only so simple...

Money problems really hit you where it hurts, eh?

The Vagrant's comments earlier are telling; the present "crisis" really ought to remind us to store up treasures where thieves, moth, rusts, falling stocks, robber-barons, hedge funds, do not destroy, eh?

In other news:

http://xkcd.com/556/

This is a great strip.
Moreover, I love Don Quixote.  I am an incorrigible dreamer. 

 

Thank you, Lord, for taking care of my patients this last week.
Many were very complicated; and yet you took care of them.  You know how many things could have gone wrong, and yet you allowed things to go smoothly.  Thank you for having mercy on them, and thereby, also on me.

Please heal them as your hand would.

Yours, by your blood,

The world isn't fair.

The oppressed don't always find their cause engaged, the thief isn't always caught.  Over the past several decades, the finance industry has been in a boom with eras of truly impressive incomes.  Few begrudged their incomes when the world economy was chugging along merrily, doling out wage improvements to many.  It is not hard to understand, however, why many might find the current bonus situation so appalling.  With substantial losses all around, why do financiers find themselves relatively protected?

Few find that just.

The outrage (on the internet, in the press, and on the television) is striking and deafening.  Finance will never be quite the same -- at least while this generation is still investing.  The bad taste of being taken for a collective "ride" is on the tongues of the masses. 

Heard a sermon recently about the call for justice.

I'm not going to belabour this point, because others have done it so much better than I can.  The bottom line is that God's word speaks about his anger towards injustice in chapter after chapter, book after book.  That we do not preach this more stridently at the pulpit is a travesty.  The due conclusion of Christ-like love is Christ-like indignation over injustice.

If one were to be a lover, and one's beloved were passionately concerned with the state of his/her puppy, one would have to be emotionally stunted not to sympathize/empathize.  Is it any wonder why we don't find our walks emotionally charging when we refuse to engage in mirroring God's thoughts?

Truncating our experience of God's word to mere internal reflections results in a truncated spiritual life and experience.  It is like following a recipe to bake a beautiful cake, and stopping with getting out the flower.  The fullness of life in Christ is predicated on a multifaceted obedience.  To be a man after God's own heart, one must take God's point of view;  At that point, I think it would be impossible not to be engaged in such affairs.