Why I am leaving Medicine

May 17th, 2017

Why I am Leaving Medicine

Kenneth A. Feucht, M.D., Ph.D.

I formally decided to quasi-retire in October of 2016. This meant for me, getting out of the surgical oncology profession. My intention is to continue working until 31MAR2018 in an outpatient wound care clinic associated with the hospital in Puyallup where I live. Remember that training in my profession consisted of 15 years past the 12 years through high school, so that I have completely identified myself as a surgeon, making my profession not easy to give up. I would have liked to have continued practice until I was 65 or more, but frustration with medicine and the changes which have occurred since becoming a physician have led to my desire to leave medicine. This is not an easy decision. I have a deep love for my patients, and found the profession to be quite rewarding. It was particularly satisfying dealing with patients not only for the relief of their physical ailment, but also to help them psychologically through a major crisis in their life, which is usually the situation when somebody is given a diagnosis of cancer. With my decision to retire a bit earlier than I had wished, I felt that chronicling the root causes for my decision would be appropriate. The list of my grievances with the health care profession is in no way intended to be comprehensive, but to cover the major areas of frustration for me as a surgeon. This is NOT an in-depth, heavily researched paper with references and documentation, but an off-the-cuff rendering of my feelings regarding the status of health care. Perhaps someday I will take the time to render a more academic version of this treatise.

Health Care Orientation

Hospitals began in the fourth century in central Turkey in a region called Cappadocia. At that time, the poor and destitute who were ill were abandoned by the community and sent away into the woods, where they were often eaten by wolves or other forest beasts. This allowed for containment of communicable diseases, but did not reflect well on the care of the ill patient. It was St Basil who took these poor people and reincorporated them into a caring community environment. Thus, we get our word “hospice” or “hospital” from the latin word which would be translated as “hospitable”. Hospitals became defined as an agency that attended to and offered the patient an ability to return to the community of the faithful while under care.

Germans have two names for hospitals. The most common is “das Krankenhaus”, though they also use the term “das Hospital”. Translated literally, “Krankenhaus” simply means “sick house”. It is a vastly more fitting word for what we have today, and the term “hospital” should go out of existence. Hospitals are no longer places of caring, and they do not offer the patient a gracious return to the community, or hospitality. They are places where patients are treated with sterile rigor, where children dump aging parents once they have become a nuisance, where occupants are considered to be more work for already overworked nurses, where physicians rapidly fly by patients, knowing that they dare not say either too much or to little, but where everything needs to be documented in a complex electronic database, and where nurses spend most of their time making sure that those databases are replete with boilerplate (and thus useless) data to fulfill various government mandates over what needs to be documented. The entire orientation of healthcare is narcissistic reflection on themselves looking past and ignoring the raison d’être for their existence, the patient!

Defining “Healthcare”

What is healthcare? What is involved? What is health? What is wellness? How do you define something nebulous? The dictionary defines it as “the maintenance or improvement of health via the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings.” This definition can be strewn out to as broad of meaning as life itself. Is my mental stress over an upcoming test in school a part of healthcare? Is my desire to become and identified as a female when I started out genetically and physically a male a part of healthcare? Is my carelessness in attending to my mental state when I accidentally kill somebody else while driving a motor vehicle under the influence of alcohol actually a healthcare problem?

But, why do we even waste the time to precisely define the full nature of healthcare? Is it really important that we have a narrow versus broad definition of healthcare? From a personal point of view, the manner of defining healthcare is unimportant, but from a health care policy perspective, it is vital. The government promises that healthcare will be paid for, but exactly what that means is quite nebulous. In Germany, going to the spa for a week or two rest is covered. In the USA, the breadth of coverage constantly changes according to what is politically expedient. Oregon attempted to identify and rank cost-effective treatments to determine what might be covered. Since physician assisted suicide is very cost effective, it ranked quite high up. Is this proper? Assisting somebody in suicide seems to be counter to the entire goal of the medical profession, but nobody could doubt that much expense is saved by terminating the patient. If trans-sexual surgery is covered by government policy, why isn’t all cosmetic surgery covered, since it is aiding to personal well-being and how a person defines themselves? Why isn’t food free, since it is really taken to prevent healthcare problems. Why isn’t our housing and the cost of maintaining housing covered, since it all contributes to me maintaining and improving my health?

What about health itself? How do you define health? Is it just the absence of sickness? If so, then obesity would not be a health problem, or smoking, or any other dangerous activity, until it caused a problem. Some people choose to live through disabilities that would be viewed as insurmountable by others and refuse to identify their disabilities as an “illness”.

A frightening result of having an all-encompassing definition of healthcare that is provided for by government, is that they then must adopt the role of supervising our behaviors in order to maximize the government definition of health and well being. Does somebody really want the government telling them that certain activities are forbidden? Does anybody really want government prescribing exactly what you can eat and how much you can eat in order to stay healthy. When Michelle Obama attempted to regulate school lunches in order to decrease obesity, it was found that the children actually became more obese who were on the lunch program. When do we decide that decisions in our life become none of the government’s business? If we allow that government is responsible for health and well-being, we must realize that we are then completely giving away our freedom.

In reality, the public definition of healthcare is impossible and it would be best if we remove any attempt at defining the realm and coverage of what we think as healthcare.

Government interference

We are constantly being bombarded in the news that a new regime of politicians will correct the messes that former regimes have created in federal health care policy. I will speak of ObamaCare specifically a bit later, but here address specifically issues of government policy in health care. Over the course of the last century, we have gone from a situation where there was no government involvement directly in healthcare, to where government pervades virtually every aspect of the healthcare scene. Government first became involved in healthcare in Germany during the tenure of Bismarck. In 1883, he created a national healthcare system which provided insurance to all citizens. Many countries today follow the Bismarck model, though we do not in the USA. (ObamaCare seemed to be a model that attempted to simulate the Bismarck model though not utilizing many of the most important aspects of the Bismarck model.) Through the introduction of Medicare by president Johnson in the 1960’s, there has been a slow invasion of government into the healthcare scene. Government continues to fund increasing amounts of healthcare, and thus has taken an increasing stance toward controlling health care costs. At the same time, the innocent introduction of internal means of quality improvement (such as the JCAHO, which was started by surgeons as a means of voluntarily improving surgical quality across hospitals in the USA) has evolved into a beast that neither improves the care of patient nor the quality of healthcare delivered. More will be spoken on JCAHO later.

In times past, physicians generally took the Hippocratic oath on graduation from medical school. If not the Hippocratic Oath, then a somewhat similar oath (see article on the Hippocratic Oath) was offered. In the Hippocratic Oath, three parties are involved, which include the patient, the physician, and the god(s). Glaringly omitted from the ancient oaths were the health care system, insurers, the government, and anybody else outside of the three mentioned. This is only right, and an article I’ve written on the oath covers why such an arrangement is so vital to the doctor-patient interaction (http://feuchtblog.net/die-veroffentlichungen/the-hippocratic-and-other-oaths/ ). Healthcare is now run by a multiplicity of bureaucrats and idiot savants, who love to tell physicians and patients what is best for them without any knowledge of either the patient or physician. Government makes a cookie cutter mold that all diseases and persons are supposed to fit into. Diagnoses have a number assigned to them according to the ICD-10 manual, and no diagnosis will fail to have a specific number. Treatments and procedures also have their number, called the CPT code, with a one-size-fits-all mentality.

Government healthcare is run by bureaucrats. These are the self-serving policy wonks and bean counters that control the health care of all occupants of the United States, citizens and non-citizens, consenting and non-consenting, the sick as well as the healthy, the only exception being the politicians themselves. Most often, these healthcare pundits have been in the health care profession as either physicians or nurses, but are now removed from actually providing care, and thus not experiencing the consequences of the policies they implement. Being removed from health care, they may act with heartfelt concern for their colleagues in the trenches, but will never be able to properly address the constantly changing healthcare scene that affects healthcare delivery. In addition, their policies will fail to address all contingencies and variations in the disease process or patient goals and needs.

The government, since they intend on paying for healthcare, are obsessed with the cost of healthcare. Yet, they strangely seem to be the most clueless as to why healthcare costs so much. Perhaps healthcare costs are high because of government interference?

Two organizations from the federal government have been particularly harmful to healthcare, that of the food and drug administration (FDA) and the other the center for disease control (CDC). The FDA started as a well intentioned idea to protect the public from potentially dangerous drugs. The thalidomide incident in the 1960s is instructive. Thalidomide is a medication designed to decrease morning sickness in pregnancy, but was noted well after the fact to occasionally cause phocomelia, very short limbs, in some of the babies exposed to this drug in utero. I’m not sure that thalidomide babies could have been prevented even if the FDA was functioning as they do now, but a good crisis has not gone to waste by the government. It now takes many more years for a drug to go from creation to market in the USA as compared to Europe and other countries in the world. Drug development costs have risen to exceed a billion dollars to get an new drug to market in the USA. Yet, American patients are not safer than European patients, though we are denied rapid access to potentially useful medications.

While the FDA “protects” us against dangerous drugs, the CDC is here to “protect” us from various communicable diseases. I have less of a problem with the CDC than the FDA, yet the CDC remains over-reaching in so much of what they do, and persist in trying to justify their own existence. The flu vaccine is a perfect example. It is close to impossible to predict which flu antigens would be dominant in any flu season, and the antigens of choice are made by “educated” guess. I know of no randomized trials that have proven within reasonable doubt that mass forced administration of the flu vaccine decreases morbidity or mortality from the flu. Health care personnel that work for hospitals are mandated to take the flu vaccine, and we have no other options. It matters not that we might have strong personal preferences against the flu vaccine. Another example, Gardasil, the vaccination against HPV, is sold to prevent genital warts, and thus cervical cancer, and is recommended for all males and females between 10-12 years of age. It is of value only for the sexually promiscuous female, but is strongly encouraged that all children receive this vaccine. Long term effects of the vaccine are essentially unknown. The CDC would love to have this vaccine mandated, and there is great pressure on all children to receive the vaccine, even from family physicians. This represents an over-arching hand that doesn’t allow for patients to make personal choices regarding their behaviors and actions, but assumes that all patients (or children) will be irresponsible and not have to take account of their actions. The CDC in effect takes the roll of parent, and displaces the biological parents as having a say in the behavior of your children.

ObamaCare Mess

ObamaCare is presented as the great revolution in healthcare, the solution to all of our problems, the defining policy that will allow all people in America to have adequate health care without obstructions from inability to pay. The health care bill was so voluminous that nobody in congress was able to read it in its entirety, and demanded that the bill be passed before one could discover what was in it. I won’t belabor the nature of ObamaCare because I have not read the bill, nor have any interest in reading the bill. What I will discuss is how it has affected physicians attempting to care for patients.

Obamacare wished to improve everybody’s access to healthcare, including that of illegal aliens. To do so, health care insurance was mandated to all. If you didn’t purchase healthcare, you were fined. You could either purchase private insurance, or the state would provide options. The rules were tightly defined for enrolling or switching health care plans. The presumption is that all people then had health care. Wrong! The cost of healthcare has continually escalated, and all plans had a copay for any service rendered. Copays were intended to prevent flippant and casual care. In actual fact, it has served to be more restrictive than anything to actual access to care. There are many patients that have turned down a proposed treatment plan for them simply because they could in no way afford the copay. In essence, care became more difficult to get.

ObamaCare also sought to assure that increased value was offered. This had multiple aspects, including patient satisfaction surveys, increased demands on providers to be fully “educated” through CME (more on this later), and increased demands of JCAHO. Patient satisfaction surveys were reported through what are called Press-Ganey scores. For employed physicians, bonuses were heavily dependent of the Press-Ganey scores. While Press-Ganey scores reflected how patients feel about their physician, it had minimal correlation with the competence of the physician. A physician that is the bearer of bad news, no matter how well it is delivered, will often be viewed with less favor than a physician bearing good news. Physicians oftentimes need to reprimand patients or cajole them into healthy behaviors, which is usually not viewed favorably by the patient. Some physicians are quite excellent, but do not have jovial personalities, which patients don’t like. Or, they have a jovial personality but are incompetent, something that a patient might not realize until it is too late. ObamaCare has allowed feelings to supplant honesty and truth, and the end-result will ultimately be disaster. Meanwhile, ObamaCare has flunked in its attempt to define quality in health care, and I’m not sure the ObamaCare act really cares about quality; they simply want the illusion that everybody is getting quality healthcare.

Are people truly having good coverage of their health care problems? The answer is complex, as there are a few people that have coverage that otherwise would have been out. Before government got involved in healthcare, most large cities and all counties had a county hospital that would take care of the indigent. Everybody ultimately received health care. Pharmaceutical firms were good about providing reduced rates on expensive drugs, and almost all people were able to survive. Now, coverage is actually worse, and many no longer have actual coverage of expensive treatments because they are responsible for a copay, which might be unaffordable. The only group of people who are better covered are those who should not have coverage, such as illegal aliens, or those who are mostly responsible for their own illness, such as burned out drug addicts.

Are the physicians getting rich? Definitely not! Over the last thirty years, physicians had to work harder and longer and more hours to make commensurate pay of the past. As a result, physician burn-out has become a true problem. The solution for physicians has been to become employed. I won’t belabor the problems of employed physicians, save to mention that employment essentially strips them of the definition of a true professional. They are nothing but expensive, sophisticated hired hands, and they will behave as such. People who serve administrative positions in health care are getting rich, and hospital CEOs as well the insurance companies are making out quite well. For the most part, physicians are getting poorer.

ObamaCare has not addressed the reason why healthcare is so expensive, and has diverted the attention from health care costs to health care availability. I am grateful that illegal aliens can receive the best health care in the world for free at my expense. In fact, I am waiting eagerly for anybody to provide an honest analysis of health care costs, and an explanation as to why health care costs in the US are much higher than in Europe or the rest of the world. I can think of many reasons, and simple explanations such as the absence of free markets deflects from serious analysis of costs, which has multifactorial roots.

Physician Regulations

The state has deemed it vital to make sure that physicians are competent. In order to define competence, the state has had to set some sort of prevailing standard, which is an amalgam of current practice and best practice recommendations based on the latest research. This assumes that best practice can be codified and then enforced. It assumes that current prevailing practice is the standard for all physicians and all patients,  and that our knowledge of disease pathology and physiological processes for disease are correct and well understood. Sadly, history is replete with countless times where the medical profession has been wrong and has had to eat their words. It is no wonder that much of what I had learned in training had to be unlearned as simply wrong. Medical practice is in constant change, and not necessarily in the correct direction. One dares not fight the system if the system is going in the wrong direction.

The state needs a way of making sure that physicians are keeping up with the latest and greatest developments in health care. The current standard is to require physician recertification, usually every ten years. The other is the requirement for continuing medical education, or CME. There are serious problems with both of these systems. For recertification, the physician needs to be placed in a box that defines who they are. These boxes are the selected specialties that the physician identifies with, whether that be in family practice, pathology, internal medicine, general surgery, or a host of other specialties. But, these specialties are too vaguely defined, such as in my specialty of general surgery. I am a surgical oncologist, and the American Board of Surgery only recently created a board specific for surgical oncology. Surgical oncology itself is heavily fragmented, between melanoma surgeons, breast surgeons, hepatobiliary surgeons, sarcoma surgeons, and a smattering of other organ specific surgeons. Within the last 20 yars, surgical oncology has essentially lost head and neck surgery, endocrine surgery, thoracic surgery, and colorectal surgery. True, one would like their surgical oncologist proficient in all aspects of cancer surgery, yet reality states otherwise. Regional referral patterns and practices also affect a surgeon’s expertise. Certain diseases are just more prevalent in some areas as compared to other areas of the county. In Chicago, I saw much pancreatic pathology. In Seattle, there is very little pancreatic disease, but a proliferation of odd diseases. The truth of the matter is that as a professional, one is always reading and educating oneself, and each individual physician will develop a differing broad area of expertise. A simple test imposed by the state is not capable of defining what only the test of real life scenarios can clearly define. Recertification has become a horrid pain to take. I’ve re-certified twice, have done well in my re-certifications, but swore on the last re-certification that I would never do it again, ever, for any reason. Most physicians reach the same conclusions as I have, and the net result is to drive out the aged but experienced physicians. The only exception is in academia, where the surgeon is somewhat protected.

Keeping up with CME is a pain. It is not enough to simply subscribe to various specialty journals and read them on a regular basis. Now, one must answer sets to test questions to assure that you’d acquired the information attempted to be taught by the article. The Journal of the American College of Surgeons would do this for four articles each month, and I dutifully answered their questions for a number of years. About 2 years ago, I realized the stupidity of most of the questions, and how they were usually completely unrelated to my field of practice. The questions were intended to quiz whether you had read the article, but often assumed you had knowledge well beyond that of the article; thus, there was no education of the physician, and failure to judge whether I’ve read and learned from the article. The problem is compounded when articles relate to my own specialty, since I usually read into the question the controversies involved and uncertainty about the information in the article. The multiple guess questions really fail to assess my true knowledge of a subject, yet is mandated in order to assess whether I’m actually staying on top of my specialty. CME updates are demanded by the American Board of Surgery every three years, and I will be letting the next update slide.

Increasing surveillance of physician behavior is happening. This relates to both social behavior, as well as practice outcomes. Hospitals are simply not turning a blind eye to behaviors that would be publicly unacceptable. There has been a change from historical norms, where previously the physician acted mostly without accountability. This is a good thing, and physician antics with the treatment of patients, colleagues or nurses must be now accounted for. The only problem is that it is the hospital that is performing most of the policing, and they have a very strong bias for protecting themselves. Thus, there is predictably unfair judgement against unemployed physicians, and usually it is by someone clueless. I recall, for instance, being reprimanded by the chief medical officer at my hospital for not responding in person to an emergency room call, even though I was in the middle of a case in the operating room. I informed the CMO to no avail that it would be considered unethical and immoral by the American College of Surgeons for me to leave a patient open on the table to attend to another person. Such madness has only gotten worse under ObamaCare. Physicians are still held liable as “captains of the ship” yet are not given the power or authority to maintain that captainship. We are constantly being told to alter our behavior or practice in the most minute ways that have no real bearing on patient outcomes or hospital well-being. The focus has turned from outcomes to process, without any evidence-based data to suggest that behavior changes would be good.

The discussion of “captain of the ship” bears more intensely on issues of hierarchy within the hospital structure. Historically, physicians were the main drivers for hospital decisions, dominated the board of directors of a hospital, and were held as primarily responsible for the success or failure of the hospital. Now, responsibility falls to the CEO and his minion of subordinates, most of whom are not physicians, though they might be nurses, pharmacists, physical therapists, or simple business types with no training in medicine. Because of the increasing commercialization of medicine, spread sheets and the color of the bottom line have become the most vital aspect at determining the survivability of a hospital. The physicians have silently gone from being the leaders of the hospital to being nothing but another cost center to be dealt with.

Documentation/HIPPA issues

Historically, documentation was performed in paper charts, usually a combination of typed text and handwritten notes along with printed reports, lab work, and outside information. Marginal notes would be made in the chart to facilitate jogging the memory of the physician. A typical note would take a few minutes to write, but would be highly effective at documenting an encounter. With the rise of third party indemnification (insurance), the desire to have confirmation of services rendered demanded improved documentation. The saying, “If it isn’t documented, it wasn’t done” became the hallmark message for mass documentation. This led to automation of means of documenting, including boiler plating encounters and procedures. This naturally led to the reverse problem of the past, in that much “documentation” might not have ever been performed. Because boilerplating made possible getting information quicker into electronic format, and with the rise of improved databasing and need for distribution of data, the electronic medical record (EMR) saw its rise. What was once a convenience became a mandated necessity. Many payors no longer accept handwritten charts, and the federal reimbursement systems require EMR for full reimbursement. EMR systems are very expensive, not only to implement, but also to maintain. They solve the problem of a plethora of charts and storage of these charts, as well as issues of lost charts, and the need for multiple simultaneous access to these charts. The down side is several. First, with a combination of requirement for increased documentation, and through the use of boiler plating, excess information now exists, and it is quite challenging to quickly identify the relevant information on a patient. Secondly, because of multiple sources for input to the EMR and restricted ability of access users to correct faulty information, the EMR slowly becomes less and less reliable. Errors become quite plentiful, from basic patient information, to diagnoses, medications and treatments.

Meanwhile, privacy of the data has become a greater concern. Historically, physicians were instructed not to talk about patients in the elevator with outside people present, or to share patient data with people outside of the immediate family, unless given permission by the patient. Now, privacy has become a fanatical issue. Historically, I would walk onto a ward, and at the nurses station, a chalkboard list of all the patients and their room number was present. At the door of each room, the patient(s) name(s) were posted, allowing for re-identification of the patient. This doesn’t happen any more, all in the name of patient privacy. The problem is that it is now easier to confuse or mix up patients, and more errors occur because of that.

Privacy in electronic data is a greater issue. The need for highly secure servers to manage patient data has become the norm, all mandated by HIPPA (federal policy). Yet, the skill of hackers has not been thwarted from obtaining any private patient data that they wish. True privacy is a myth, but the expense that we go through to maintain this illusion of privacy is astronomical. Indeed, true privacy is impossible. Perhaps all patients should present themselves to the physicians office or hospital in full covering like a Burqua or KKK outfit? Yet, the one area where privacy is zilch is with the government. They now know EVERYTHING about you. I fear the government more than I fear some stranger knowing that I happen to be on a β-blocker or some other medication. Yet, the feds have access to every aspect of my health care record.

Big Pharma

I don’t view big pharma as intrinsically evil, and much of their perceived evil comes from government and legal policy imposed upon them. There is no doubt that the large equipment and pharmaceutical firms have vastly improved the quality of healthcare in our country, as well as throughout the world. It is no doubt that drugs exist and are available today that never would have been possible without these large companies. But, the large pharmaceutical and equipment firms comes at a terrible cost to all of us.

The large pharmaceutical firms must deal with a host of regulatory agencies, the FDA being the largest of them. One would think that big pharma would be fighting the FDA tooth and nail, yet the opposite is the case. The pharmaceutical firms have seen the FDA as a wonderful means of keeping out smaller competition, which is why you don’t see small pharmaceutical firms in this country. The assistance of the FDA in the assault on the nutritional supplement and vitamin industry is shameful. Big pharma has relished the protection to their industry by the FDA, leading them to become even more powerful at controlling the drug market. Concomitantly, we see larger firms buying up the smaller pharmaceutical firms, and thus becoming ever more powerful.

A secondary problem is created when insurers pay for medication costs, so that the consumer never sees those costs. This becomes problematic if a patient is unable to perform a cost-benefit relationship to determine whether a drug is worth taking. The perfect example are the statin drugs to lower cholesterol. I wait eager to see any statin demonstrate improve survival over the best alternative therapies out there. The truth is that statins have a high chance of significant side effects, yet has never been shown to be significantly effective at preventing death from atherosclerotic heart disease. And, they are expensive drugs. Too often, the patient assumes that the physician is using critical judgement in determining the need for a drug, yet the greatest determinant tends to be how good of lunch the drug representative brings to the doctor’s office.

Insurance

A system of third party payment for health care has created the worst possible solution for healthcare. It is a serious misnomer to title health insurance as such, since it does not operate like insurance, but simply as a mode of funding. Insurance supposedly should be most active when there is an acute need, such as with a car accident or a heart attack or a new diagnosis of cancer. Instead, it covers every possible aspect of health care, including runny noses in kids to health maintenance examinations. Under ObamaCare, health insurance is not an optional decision, but mandated by the state. In such a situation, you would expect the health care insurers to making out quite well, and for the most part, they are, with executive of the major insurance companies making exorbitant profits. Yet, the strains are on the system. Insurance is not able to reign in the ever-rising cost of health care, and can only raise premiums and copays to a limit before the system breaks. And, the system is about to break.

Ultimately the big winners in todays system are the insurance companies, but that is a bittersweet win, as they continue to merge with other systems in order to survive. Time will ultimately pass a severe judgement on insurance companies.

Legal Aspects

If you read the popular press, they would suggest that legal issues are a small portion of what’s “broken” in medicine. Whenever malpractice tort reform becomes a subject of referendum up for vote for the public, the advertisements and press attest to litigation being a small part of costs for doing medicine. Yet, those most entrenched in the health care system and actually paying attention what is going on realize that legal aspects of medicine are probably our worst enemy, and that politicians and lawyers who know little of the actual functioning of healthcare are essentially orchestrating how things should be done in the health care world. If a physician suggests changes in the legal world, lawyers tend to attack the physician as ignorant, befuddled, or clueless as to how law actually works. Perhaps outsiders see the legal world a little more clearly than lawyers? Yet, it is most true that lawyers and political meddling in the world of medicine have only left medicine far worse off.

When a physician attends conferences, there are frequently sessions offered on how to avoid or deal with lawsuits. It is made very clear that the physician should understand that everybody gets sued, and that a lawsuit often is the “luck of the draw”, and that a physician should never take a lawsuit personally. Yet, in court, it is presented just the opposite, and the claim is that there is something wrong with the physician that caused the medical “error”. I place the word error in quotes because it is too often that an error is not an error at all but simply the course of the disease. The lawyer presents a disease process as an entirely controllable phenomenon, and that good outcomes will happen when the standard of care is closely followed. Of course, they will deny this mentality until they are in court, where acts of “nature” serve to reward the lawyer quite generously. In public referenda regarding tort reform, there are usually two most serious claims. The first is that bad physicians need to be punished in order to improve the system. This goes contrary to all evidence yet seen. The second claim is that the tort system preserves patient rights. In actual practice, it does just the opposite, and patients end up with less options and choices in their care because of the malpractice climate which physicians and hospitals have to work in.

Whenever a referendum for tort reform hits the public, the claim defending current practice is that malpractice claims are actually decreasing and that malpractice premiums continue to be less expensive on the physician. Especially after a referendum, that is briefly the case, until the public forgets about matters, after which lawyers come back in force, hungry for more litigation. The malpractice situation has not improved, but remains a crapshoot, where a physician remains highly likely, no matter how excellent they are as a physician, to get sued and lose. The tragedy is that physicians can oftentimes see colleagues that truly are dangerous and yet manage to avoid suits. Cases that hit the public scene are often the most revealing. A few years ago, the leading transplant center in the USA made an error in typing an organ, leading to a hefty lawsuit. But, to what avail? Does human error necessitate lottery type outcomes for the lawyers and unfortunate patient. That is what happened in the transplant error to a distinguished center of excellence. There are many more similar stories.

What about if the legal profession is eventually proven to be wrong? Do they refund their ill-gotten gains then? I recall the colossal sums won against Dow Corning for the silicone breast implant lawsuit. Not to long later, it was proven beyond question that the manufacture of the implant or the nature of silicone did not lead to the alleged autoimmune diseases that the lawsuit purported to have happened. In this situation, the funds should have been returned, at least in part. This only shows that truth and justice are not served in courts of law, and the legal system has no interest in pursuing what is right.

My claim that litigation raises cost of everything is quite easily supported. Think about matters for a brief second. When you stay overnight in the hospital, with minimal attention rendered to you, you could expect a bill for upwards from $20K. I cannot think of anything but the most exclusive hotels in the world that would even approach a fraction of that cost, even with servants and the most lavish attention. Why does it cost so much? Medications that are sold for veterinary use typical cost under 10% of what they charge for exactly the same medication with adults. Why? Medical equipment tends to be quite unreasonable in cost compared to similar products in the non-medical market. Oftentimes it is absurd, from a simple little staple gun costing several hundred dollars that if sold as a non-medical item would be several dollars. Why? Incorporated in those costs are both the higher cost of development for the human market, and the potential for litigation. Cows don’t sue, but people do. Yet, there are other subtle cost drivers. Physicians assuredly often act against their best judgement by over-ordering tests and x-rays, and over-treating, all in an effort to protect themselves against litigation. The patient is not given a choice in the matter, or allowed to assume risk. This is because with informed consent, it is still assumed in court that physicians should know better and not have offered choices to the patient if one choice was not assumed to be “standard-of-care”. The physician can’t win, and so plays the game by following the rules, even when the rules are wrong or don’t make sense.

JCAHO

This actually belongs in the “government interference” paragraphs, since the JCAHO is a government organization. Yet, it is so pervasive to all aspects of healthcare, with such overreaching influence on the way medicine is practiced, that it deserves a category of its own. As I write this, my hospital is currently undergoing a JCAHO inspection, and the anxiety of the administration is sky high. They have come by, and declared how various improvements must be made, how there are defects to the system which has so capably served patients. In essence, they are fixing “issues” that are not problems, never was a problem, and never will be a problem. Typically, the fixes are expensive, time consuming, but also require extensive documentation to prove that the fix is actually implemented by the hospital.

One of the most troubling changes in recent years has already be discussed, which are regulations imposed by HIPAA in order to preserve patient privacy. Sadly, HIPAA has failed to recognize that if somebody wishes to bust into the system, it can be done regardless of how intense the security measures are applied to the electronics of the system. The result is the physicians can no longer speak easily with each other about a patient’s care, and the detriment is ultimately to the patient.

JCAHO has long filled any possible useful purpose for itself. Yet, it has become a burgeoning business that must be sustained at all cost. Thus, they have sought desperately to find ways of justifying their own existence. They have accomplished that by creating new and novel regulations each year which they impose on hospitals. They will review hospitals every third year, and if sufficient inadequacies are found, will return a year after their visit to review the hospital for correcting their “mistakes”. During the triennial visit, they will disclose the new regulations, holding the hospital immediately responsible to correct their behaviors and adapt to the regulations. This causes a fleury of anxiety, panic, and hasty development of new hospital policies to match the new regulation. One year, they decided that if a patient was placed in restraints (usually in the ICU), then the order for that had to be renewed weekly. This had never before been a problem, and when there were restraint problems, they were of a nature that a policy would not fix. Another year, it was decided that used instruments or laundry could not be transported to their appropriate destiny in an open environment but had to be completely enclosed. One could hypothesize that bacteria could be spread with these instruments and laundry in open air, yet there has never been an instance where this had ever been a problem. The fix is indeed costly, and must be done in order for a hospital to continue operations. But, the hallway transportation rule defies notion that the hallway itself or the patient room could be transmitting disease between patients. Perhaps the entire hospital needs to be systematically sterilized between patients?

But, JCAHO will continue to work their evil deeds. Health care will become more complex, impersonal, and expensive, and ultimately, less safe. JCAHO is an organization that holds others responsible, but submits to nobody else’s authority. It is a true creature from the black lagoon.

Commercialization of Healthcare

Historically, it was considered immoral for physicians or hospitals to advertise. Pharmaceutical firms were forbidden to advertise prescription products to the public. The American Medical Association held policies forbidding their members from advertising, as found in their code of ethics. The goal for these rules was to keep medicine out of the realm of commercial enterprise. All of that changed in the year 1975, when the federal trade commission considered the AMA ruling as an illegal restraint of trade. The AMA rolled over dead. What was immoral one day was considered right and proper the next day. Advertising among health care emerged slowly. Early in my private practice, there was a rule that physicians in our community would not advertise, or even to have their name in bold print in the yellow pages. That disappeared slowly. Soon, one could see a plethora of drug advertising, with elderly patients in perfect health dancing vigorously across the tv screen, proclaiming the miraculous benefits and health giving effects of a medication with multiple side effects and toxicities. A few little lies won’t hurt, would they?

The end result of healthcare commercialization is that it has caused anybody and everybody to seek for a portion of the health care dollar. The highest paid person in a medical community is often the CEO of the hospital. While hospitals still designate themselves as “not for profit”, the non-profit hospital has gone the way of the dodo bird. Quite often, the most vigorously trained physician taking the greatest risks and responsibilities get the least cut of the health care dollar. The pharmaceutical and medical equipment suppliers are making massive profits unheard of in yesteryear.

One could argue that commercialization has led to improved competition and desire for innovation. Yet, competition has always occurred in health care, and innovation has also taken a great toll on our profession, not commensurate with the benefits offered. The most heavily advertised physicians are oftentimes the most marginal physicians. It would be hard to argue that patients are truly better off with advertising. For the reader interested in a erudite discussion of this issue, please read this article… https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563279/ .

The Flexner Report and its Evil children

The Flexner report was funded by the Carnegie foundation, supporting Abraham Flexner in a review of the existing medical schools in the early 20th century. The report was published in 1910, and intended on promoting standardization of medical education and the removal of marginal medical schools. We now see the evil children of the Flexner report, with regulation of the health care professions at an unprecedented level. The net effect we have had on physicians is increased regulation and requirement for continuing education, which was previously discussed. It has restricted the number of physicians in the health care community, and medical schools have not been able to keep up with the demand, especially in an age where increasing numbers of physicians retire early. It is difficult to just build more medical schools, since the cost of medical education is prohibitively expensive, and the state has had to bear part of the burden of these costs in order to keep the supply of physicians at adequate numbers.

There have been several ways in which the health care community has met the demand. First is through the influx of ever greater numbers of foreign medical graduates (FMG’s) from countries where health care education is not so aggressively monitored. The second is the rise of alternative providers, which include physician assistants and nurse practitioners. Both of these groups of providers have much shorter training periods, which would fail the current minimal standards for medical school training as defined by the results of the Flexner report. In essence, the Flexner report has forced its own extinction, and bred an alternative to the physician.

Conclusion

I am not unhappy that I ever became a physician, and feel that it has been a rewarding career. I am very unhappy with what has happened to medicine. It is like a public good has been stolen and no hope for recovery.

I am particularly sad that most people do not identify root causes for problems, but continually ask for immediate, self-serving, quick fixes to the health care problem. It is a truism that until congress and all of government has to live under the same health care plan that they impose on others, there will be no hope for improvement. I wouldn’t count on it ever happening in my lifetime.

Ultimately, health care will kill itself. It is unsustainable. It has lost its soul. Its original driving force was a Judeo-Christian Weltanschauungen, specifically, the belief that all people, young and old, born and unborn, of all races and creeds, were created in God’s image and of intrinsic value. Humans were not viewed as the accidental product of the primordial slime. Human relations were viewed as important as health itself. Suffering had meaning, which oftentimes led to delays in seeking a remedy. Pleasure and euphoria (feeling good) were not considered goals of worthy pursuit. Among health care professionals, the pursuit of “health” and prolongation of life seem to be more in line with personal challenges and games to be played, the chance of honor for a great discovery, rather than the sympathetic concern for the whole person, body and soul. Purpose and meaning in life are oriented around maximizing pleasure and minimizing pain and suffering. Healthcare is the agent responsible for restoring maximal pleasure, either to the individual or to the community, when things go mentally or physically wrong. The greatest creed of healthcare, the Hippocratic Oath, provided the framework for practicing our profession. Without either a framework or a direction, we flounder. Healthcare, rather than being a true profession, becomes the utility of the state to maintain function and order, rather than the pursuit of a higher good. We have lost our soul in medicine. I am leaving medicine because my profession no longer is a profession of Hippocratic orientation. I have no interest in being a duped servant of an evil state.

Presbyterianism vs Anabaptism

March 31st, 2017

The quirks of Presbyterianism

in relation to my Anabaptist roots

My wife and I are religious schizophrenics—we are deeply rooted in both the Presbyterian and Anabaptist traditions. These traditions seem to be polar opposites, though in many ways, the opposite is true. I would like to briefly explore my thoughts on their similarities and differences.

History

My wife and I grew up in the Apostolic Christian Church (ACCA [Apostolic Christian Church in America] and ACCN [Apostolic Christian Church Nazarean]), which are actually two denominations of the Amish-Mennonite Anabaptist tradition that split in the early twentieth century. It is a denomination, in spite of their quirks, that is still dearly loved by me. I consider myself as having a world view shaped by their teaching, notably that of fervor for God’s word, of intense love for the Brethren (which is a non-sexist word and includes females), and anti-militarism. For various pragmatic reasons, our family attended Moody Church while we were living in Chicago, Illinois when I was in surgery residency, a church we also dearly loved, especially with the preaching of pastor Irwin Lutzer. We attended a Baptist church while I was in the Air Force in Biloxi, MS, and really did not like it at all. There was a PCA (Presbyterian Church in America) church in town, but did not attend there because we felt the Presbyterians were heretics and totally off base. It was during my time in Biloxi that I started reading intensely on Dispensationalism versus Reformed theology, and became convinced that Reformed theology (Calvinism, if you wish), had a more consistent approach to Scripture in its entirety than either Dispensational or Anabaptist theology. I also realized that the description of “Calvinism” by Anabaptists and Dispensationalists was entirely in error. On moving to Puyallup, WA, we attended a generic Christian church for a little over a year. I absolutely hated it for its irreverent worship style and weak theology. On recommendation of a close colleague at the hospital, our family broke down and started attending Faith Presbyterian Church in Tacoma, WA, a member of the Presbyterian Church in America denomination. The pastor was the son of the first president of Covenant Seminary in St. Louis, Missouri, and well acquainted with Francis Schaeffer. He was a large drawing point for us. We have been there ever since, with no plans of leaving. We had never formally left the Apostolic Christian Church, and have no idea whether they still consider us to be “members”. Our departure was more by incidence of our life’s journey, rather than a formal choice to leave the ACCN. Thus, my wife and I still consider ourselves to be a part of both worlds.

Comparisons of Anabaptist/Reformed theology

Theology was the driving force for leaving the generic church and going to a church that has Reformed doctrine. Contrary to many thinkers, Calvinism is everything but “once saved, always saved”. This is especially true of the covenantal manifestations of Calvinism. In fact, what is portrayed as Calvinism and what is the true meaning of Reformed doctrine are unrecognizable. I’ll offer several examples. Perseverance of the saints as a doctrine means that the saints will persevere in holiness. It never was intended to mean that a person could never “lose” their salvation, except for that if one is truly saved, they will persist in holiness. The discussable issue on this topic for both Anabaptists and Reformed thinkers relates to assurance of salvation, even though arguments for assurance will follow different lines of thought. Both Anabaptists and Reformed thinkers share the necessity for godly living. A second topic of contention is that of limited atonement, which is a terrible phase that means particular redemption. Most Reformed thinkers advocate a universal calling, and bona fide offer of the gospel for all. The only realm of contention regarding particular redemption is that the Reformed thinkers will say that Christ’s death was EFFICACIOUS only for the saved, something that even Anabaptists would ultimately agree with, unless they hold to the doctrine of ultimate universal salvation for all. The doctrine of total depravity would be an area of contention between Anabaptists and Reformed thinkers that would not be resolvable. Oddly, this is not an issue commonly fought over. Nobody wishes to consider themselves to be Pelagian, so one will usually default to a semi-Pelagian position regarding total depravity, which in my thinking is a most confused approach to depravity. As GK Chesterton has noted, total depravity is the one and only doctrine which is easily verifiable in real life.

The baptism of infants is a point of contention with Anabaptists which is usually terribly misunderstood. Baptism is considered neither a confirmation of salvation nor a witness to the world of salvation. Rather, it, like circumcision, is a representation of a covenant with God.  This covenant has both promises as well as obligations. Much of the obligation is on the parents to raise their children as Christians, and duly expect them to make a profession of faith throughout their life. Many non-Reformed churches have a dedication ceremony which is neither Scriptural or meaningful, save for trying to imitate the ceremony of infant baptism. In terms of when a person actually becomes a Christian, the Reformed doctrine refuses to define a precise method. In fact, virtually every New Testament conversion that is discussed is different. Some children of believers may be converted in utero, others in childhood, others after a period of sinful life, and others never. The point is that the Christian will always need to persist in their profession of faith until death.

Some of the ramifications of the doctrine of predestination may be troubling to the Anabaptist until they give worthy pause to what is actually being said. Predestination most certainly is NOT fatalism, i.e., that the course of history has been set in motion in which nothing will change. I would refer the reader to J.I. Packers’ “Evangelism and the Sovereignty of God” to grasp this issue. It is certain that we are both totally determined yet totally free in our decisions and actions. The explanation for this remains in the divine wisdom of God which cannot be explained. Finally, I wish to note that when one looks at both the Anabaptists and Reformed churches, there are multiple splits numbering in the hundreds to thousands. Most of these splits are related to some subtle doctrinal issue which presents itself as irreconcilable to the church leaders. Even in my lifetime, I’ve seen a number of splits in churches (both Apostolic Christian and PCA) that are inexplainable save for our persisting depravity.

Both the Reformed and Anabaptist traditions are quite intense about their theology and hold it of great importance. The Reformed thinkers have approached theology in a more systematic fashion, and win out in terms of have a more consistent and organized theological base. Unfortunately, the Reformed church knows this, and it tends to breed a very strong sense of arrogance on their part for having “the best” doctrine. The Reformed folk also manifest a sense of divisiveness in their theology, discussed kindly in a recent internet article by John Frame (http://frame-poythress.org/machens-warrior-children/). This article discusses 21 topics that are highly divisive in the PCA church—I think that he is kind, and under-estimates divisive issues, and I mean divisive enough that various groups would hold charges of heresy against contrary thinking. I have seen Presbyterians approach theology with such opinionated aggressive as to wonder if they were not terminally constipated. A recent move in the PCA condemning the theology of federal vision had a vitriol of extreme proportions, yet one had a challenge even defining what one meant by federal vision!

Anabaptists also excel in divisiveness, and there are countless sub-factions of Amish, Mennonites and the like. This Anabaptist divisiveness can either be theological (like a recent ACCA split debating whether or not a Christian could/does sin) or practical (like whether it is permissible to grow beards or have lightning rods on your house). In the Anabaptist circle that I grew up in, theology was a constant discussion. Our discussions as kids were quite crude and seriously misinformed, but we took theology quite seriously and it was a typical subject of discussion when we would get together. I don’t see that fervor in the Reformed church youth—after all, since they hold the “correct” theology, by bother discussing it?

Church polity/discipline

While this may sound strange, both the Reformed and Anabaptist traditions tend toward the Presbyterian model of polity, in contrast to the Congregational or Episcopalian models. Anabaptists do not generally have a paid clergy, though there are exceptions to this rule. Yet, there are central Anabaptist structures, and national meetings of the elders that are akin to the annual presbytery/synod meetings that occur in Reformed circles. The interest of both traditions is to maintain commonalities in theology and worship that define the denomination. To the surprise of Anabaptists, the conservative Reformed denominations (such as the PCA) take church discipline very seriously, and do exercise member expulsion for various sins or absence of repentance. The terms of expulsion or other forms of church discipline differ, but yet there is a very strong sense of the necessity of the church to exercise discipline of its members, and preach the value of a godly lifestyle in all things.

Worship style

The similarities between Anabaptist and Reformed worship is greater than their differences. Both hold a very high estimation of worship and formality in their church meetings. This is true, even though the Anabaptists do everything possible to remove distinctive display elements to their worship, including the display of crosses in church, the wearing of special garments by the ministry, or other outward displays. Oddly, Anabaptist members usually are required to have special garments, such as specially defined head coverings for females, and distinct dress for men. The Anabaptists would never call their service a “high-church” style, yet it has a formality and regulation that is uniform and consistent between churches and enduring through the years. Both Anabaptist and Reformed thinkers have an equal problem with the current contemporary worship service, which consists of worship as entertainment.

Music

The Reformed churches would love to think that they have the great advantage in music. In this regard, they are sorely wrong. As a matter of fact, Presbyterians simply cannot sing. It is true that many Reformed members go on to become professional musicians and that musical instrumentation in the church is of high value. Many Anabaptist churches, including the ACCA denomination which my parents came out of, never even used a keyboard in their services. Yet, I would estimate that most Anabaptist members had home musical training, and greater than 90% were able to sing in 4 part harmony during worship services. They would stay on tune, even singing a cappella. If you examine closely their hymnody, the Anabaptists mostly drew on the German Lutheran/Bach choral tradition, with far more complex harmonies and melodies than could ever be found in a Reformed/Presbyterian congregational hymnal. In addition, the Anabaptists would sing those songs quite well. Playing or singing the ACC hymnal (Zion’s Harp) is far more challenging than playing or singing the PCA Trinity Hymnal. The Presbyterians are slightly more cautious regarding good theology in their songs, but even there, the ACC hymnal has much better tunes for praise, consecration of one’s life, the afterlife, suffering, and general worship than any Reformed Hymnal. The British and Scots just were not as artful in music as the Germans!

Fellowship

In the Anabaptist family, one feels like family. It doesn’t matter where you go in the world. If you encounter another “AC”, you might as well consider yourself a real brother or sister. You are always welcome in their home, as you would welcome them into your home. Much of your free time would be spent at church or with fellow AC’s. The Presbyterians also maintain a sense of community, but no where near the intensity that is found in traditional AC circles. It is common in Anabaptist communities to see them going out of their way to care for each other. An example are the nursing homes that the ACC’s have developed in conjunction with their churches. These serve several uses. First, they care for the debilitated elderly while keeping them out of the ward of the state. Secondly, they allow elderly in the nursing homes to be useful and active, rather than simply shuttering them in. It is a shame that Reformed churches cannot develop such a modality—I presume that they are in fear of “offending” the state or its ordinances.

The fellowship among Anabaptists extends in other ways. Most of the brethren of the AC church could be assumed to be “trustable”. By that, I mean that if there were business contracts or other dealings that transpired among two brothers in the AC denomination, even if the agreement was verbal and not in print, one could assume that the agreement would be faithfully adhered to. It is not the case in the Presbyterian world, and though members all consider themselves as Christian and adhering to the laws of God, your probability of integrity among the “faithful” in the Presbyterian church isn’t much higher than you’d find from somebody randomly picked from the telephone directory or pulled off the street. Indeed it is a sad state of affairs when professing Christians are no different than the world.

Influence in the world/Politics

The Anabaptists tend to stay out of politics. Yet, a number of its sons do go into politics, such as one of the long-standing senators from Illinois who grew up in an ACCA home. The first Presbyterian politician of great acclaim also shamefully happened to be among our worst presidents—Woodrow Wilson. America would have been better off without Presbyterians in government. Presbyterians have served as a positive influence in society, the best example being that of Francis Schaeffer, though often his actions were at odds with those of the Presbyterian church, explaining why he tended to act independent of any Presbyterian mission board. To this date, Presbyterian actions in politics frighten me. While I appreciate their willingness to act as salt and light in the world, and influence the political structure for good, many of the actions of devout Presbyterians have been more detrimental than good on society. I wait pensively for how Donald Trump proves to be as president since he states that he is Presbyterian—his saving grace might be that he is despised by many prominent Presbyterians of both the conservative and liberal stripes. Contrariwise, the action of Anabaptists have also been a touch problematic in that they have not been willing to confront society in the public square and speak truth. Their policy of “letting the world go to hell as we will maintain our private devotion to God” might absolve them from taking a stand for truth and righteousness in the public square, but their failure to speak out will be ruled against them at the last judgement. In my final analysis, I will act like a Presbyterian in the public square, but will shy away from getting political advice from the Presbyterians and vote like a traditional Apostolic Christian.

Summary

My wife and I are caught between two worlds. We love our Anabaptist heritage, and we love our current Presbyterian situation. We see both the best and the worst of both worlds, and see neither as distinctly superior to the other. I could not have had a better time growing up in the ACCN denomination in Portland, Oregon. It nurtured me well in the faith. Yet, we remain most happy in my current situation in the PCA church. We have a beloved and wonderful pastor, our faith has grown steadily under his preaching, and doctrinally we’ve been challenged and grown in ways which never could have happened in nearly other setting. Thus, we feel doubly blessed.

In a previously quoted article, John Frame speaks at length about ceasing quibbling about petty doctrinal and behavior issues in the church. It is a plea for Christian charity and humility among other Christians. I saw this in action when I took a class in systematic theology from JI Packer, experiencing  graciousness of abounding proportions when angrily challenged and confronted on touchy topics in class. I wish that I could manifest the spirit of Dr. Packer! Francis Schaeffer also wrote much about Christians fighting among each other, and his book “The Mark of a Christian” emphasized that as important as doctrine and behavior may be, love for each other needs to shine out strongest.

We will remain Presbyterian for now, but our hearts (and hopefully our behavior) are Anabaptist. Without a doubt, in heaven, these issues will all work out, and we will not have to take sides as Catholic, Anabaptist, Generic Protestant, Lutheran, Presbyterian, Reformed, Anglican, Baptist, or Orthodox. Christ isn’t divided, and I pray that the church would seek more the spirit of unity in Christ than of obscure technical differences.

Trump: The Art of the Deal

November 30th, 2016

trump

Trump: The Art of the Deal, by Donald J. Trump and Tony Schwartz ★★★★

I received this autographed hardback copy before Donald was elected president, and read it in spurts after that. The book’s value is in giving one an insight into how Trump thinks.  The book was written in 1987, and starts with a review of one week in his life, ending with a follow-up of what became of the decisions of that week. The intervening chapters are a limited autobiography of the man, starting from childhood, through his schooling, and then summarizing his early big deals up to 1987. The details of his wheeling-dealing is not terribly interesting save for realizing a few things. 1. Seeing how Trump makes decisions. He always looks for people that he could trust, and who are the best in the business. His biggest admiration is for people of integrity. 2. Seeing how politics affects the most mundane things in life, and how Trump was able to use as well as was hindered by politics. 3. Seeing how bumbling so many other business executives were. There were many examples of very poor decision making, not just in government real estate projects, but also in private interest projects that should never have gone wrong, but did.

This book is of value to read in order to understand the way in which Trump makes decisions. He is neither conservative nor liberal. He is not Republican or Democrat, his religious leaning is toward Christian predominance, and he is not an extreme moralist (or immoralist–he neither smokes nor drinks). Donald is very much a pragmatist, that tends to set goals and hold to those goals. He is not an ideologue, though tends to have guiding principles. He is a great negotiator who is used to holding his cards close to himself, which might irk the ever-snooping main stream media and liberals. He has a strong tendency toward honest success, which we will probably see in the next four years.

My spin on the presidential campaign-12MAR16 update

March 12th, 2016

24FEB2016

The campaign season is now in full force, and opinions flow freely about who will be our next emperor. The news media is quite busy at their subtle but fake “unbiased” spin as to who would be best.

Even Ron Paul, whom I voted for the last four elections, offers his opinion in which no candidate merits his support. This is all fine and dandy, save that some candidates are the “lesser of evils”, a write-in or blank vote will be worthless, and there is a sense in which some candidates would be truly intolerable. Thus, Ron Paul playing ostrich will not work in this election cycle for presidency.

The press has taken another stance. Headlines speak of “angry voters going for Trump”. Does the press really believe that Trump fans are more angry than Col. Sanders fans or Cruz fans? Do they interpret any sort of cool-headed rejection of the Republicrat Party as anger? How many buildings have angry Trump supporters destroyed, how many cars have been destroyed or street riots engendered with much human bodily injury?  If the press would like to see real anger, try revisiting Ferguson or Baltimore.

There is the milquetoast mass who would vote for Hillarious or Rubio, and certainly the press and Republican National committee seem to make Rubio the clear-cut choice for the Republican nominee, and the DNC and press with Hillarious for Democratic nominee. This is the New York Times stance. Why would I take advice from the most liberal rag in America that intends to indoctrinate the American public?

Fear mongering has been the approach of both Republicans and Democrats. Special interests drive select candidates, as the Feminazi influence in advocating for Hillarious. The press would like us to believe that Trump appeals to the less intelligent and under-educated masses, based on a comment by Trump that the less educated masses love him. The logic of concluding that his statement that “ONLY” the uneducated masses love him defies my sane reasoning.

So, I march through the available candidates for president looking at the pros and cons for each of the active candidates. I left out Vermin Supreme, but then, I decided that I really have no use for a free pony (google or u-tube search Vermin Supreme if you have no clue as to what I’m talking about).

Hillarious:
Con:
1. She’s an inveterate liar and never to be trusted.
2. She’s a war monger who will get us worse into war than Obama has done. We will probably see conflict with either China or Russia during the reign of Empress Hillarious.
3. She’s a part of the established Republicrat regime, and would continue business as usual.
4. We don’t need a Clinton dynasty. They’ve done enough trouble while Billy was in office. I don’t forget the lengthy list of scandals and offenses that occurred during his reign, many with Hillarious in collusion.
5. She has poor health and she is old, benefited only by massive use of make-up. Her VP would probably soon be president.
6. She is allied to too many special interests, such as the Feminazi interests, the gay/lesbian/trans-sexual interests, etc., Goldman Sachs and Wall Street, for a short list.
7. I don’t want a lesbian as president.
Pro:
Absolutely none

Col. Sanders
Con:
1. A socialist by any name is still a socialist. The banks are already teetering to unmitigated collapse, though we don’t know when. The Colonel will only accelerate that ultimate collapse.
2. He’s a fake. He could have voted his heart and supported the audit of the fed bill in the senate, but did not. I don’t trust him.
3. He is really old. I suspect that he is also partially senile. We’ll have a situation like the end of the Woodrow Wilson years, where a presidential advisor essentially runs the nation.
4. His solutions never have a basis is serious reality, whether it be economic solutions, public policy solutions, or foreign policy solutions.
5. His past life was miserably anti-American, which he needs to make account for.
6. The guy was a useless parasite on society before he got into politics, not even holding a job until he was 40 years old. He would remain a useless parasite if he became president.
Pro:
1. He sees the problem of America’s monetary system, and wants to do something about it. He clearly sees the corrupt banking system, the problem of the Federal Reserve, and how Wall Street is about as anti-American as ISIS or Obama.
2. He seems to have a shred of integrity.

Ben Carson
Con:
1. He has minimal familiarity with politics. He would be a lamb among wolves.
2. He doesn’t have a “leadership” persona.
3. He would involve America in war in other countries.
4. He hasn’t expressed a comprehensive stand on many matters of concern.
5. He would not make a great president but would  otherwise be fantastic in Washington on whoever’s cabinet.
Pro:
1. He is probably the smartest candidate, Republican or Democrat. Honestly, he is frankly brilliant.
2. He is  Negro and unlike our current “black-white Mulato” president, and so would very certainly start bringing a correction to race issues in the USA.
3. His integrity and morality are completely impeccable, regardless of accusations of his opponents and the press.
4. He stands first among all the candidates in being a gentleman and man of honor.

Marco Rubio
Con:
1. He would perpetuate and exacerbate the current immigration problem. He would do a terrible job with America’s borders.
2. He tends to be a “company man”, and would march to the beat of the Republicrat regime. It would mean politics as usual.
3. His policies are pseudo-conservative. This might garner liberal votes, but then, if one wishes to vote liberal, feel the Bern.
4. His public persona is awful. He looks like a little kid. He is nigh brain dead in his speeches. He will need a teleprompter just like the Bummer.
Pro:
1. This is a tough one, but he does have some conservative leanings regarding economic issues.
2. He has a reasonable morality. I find it odd that so many presidential candidates come to Jesus during the campaign year, making professions of faith that they could have said before hand but strangely did not.
3. He clearly sees that our current president is super-bad. I think he repeated that 4 times in a recent debate.

Ted Cruz
Con:
1. His public persona is horrible.
2. He doesn’t do the best job at selecting the people around him, a good example being his campaign manager
3. His policy stances regarding foreign wars, economics, domestic issues are weak.
4. If running against either of the democratic candidates, he will lose. The press will make mince meat of him.
5. He would make an absolutely superb Supreme court justice.
Pro:
1. He has good, solid policies on many issues, especially regarding immigration/border issues.
2. In spite of what the press and RNC tried to do to smear him, he is a man of integrity.
3. He is willing to stand up for what is right and speak out when there is a wrong or an injustice, even if it may mean political harm. His action of calling many of the lead Republicans liars was both truthful and proper.

Donald Trump
Con:
1. He is a novice in politics
2. He seems to be taking strong stances and expressing opinions which are often contrary to what he was saying just a few years ago. True, even President Reagan was originally a liberal, but Trump has not had the time to prove to the public that he really has mended his ways and thinking.
3. He has every reason to be self-serving as president.
4. He has a terrible grasp on the constitution. He will approach his job (similar to Obama) more as Führer than as a constitutional president.
5.  If elected president, there is a high chance that some liberal nitwit will assassinate him. (some people might put this in the “Pro” column).
Pro:
1. The press and established Republican Regime hate him, which means he is probably all right.
2. You usually don’t need to worry about him speaking his mind.
3. He seems to be the most outspoken about standing up for USA interests
4. He will not get us involved in crazy and expensive foreign wars without assuring ourselves a benefit from those wars.
5. He is the most clear about fixing the immigration issues. Above all, he understands that “illegal” in the phrase “illegal alien” does not mean anything but the plain reading of the words. It certainly does NOT mean undocumented workers.
6. He has some grasp of economics and would probably look out for the “little guy” in business.
7. He is VERY clear on other important issues, such as terminating ObamaCare as soon as he gets into office.
8. He’ll have Hillarious behind bars, where she belongs.
9. From his life in the business world, I suspect that he would be adept at recruiting competent men around him.
10. He generates very strong reactions from many of my friends about how dangerous he would be as president, accusing him of being a chameleon that will be a different color in office. I interpret those strong reactions (from even the friends that I trust) as all the more reason to vote for him. I find it intriguing that such notable characters as Pat Buchanan (whose opinions I always respect) and Ann Coulter (who I tend to agree with even though I detest her persona, and besides, she’s a damn lawyer), and Alex Jones (a very strange character but who usually gets it right) are all in favor of Trump (at least, at this time).
11. He is not a lawyer. We need a government with more people than just lawyers and political science majors. Lawyers and political scientists have the worst grasp on truth of anybody I know, and which I always count as a strike against them.

I’m sure this list will grow and change over the next few months. You might have noticed that I have not opted in favor of any candidate. Your notice is correct. You might have noticed that I also have some political leanings for this election. That is also correct. I remain moderately undecided at this point. If you wish to change my mind, don’t waste your time, as I’ll probably vote for somebody else just because you tried to persuade me otherwise.

Of course, some of my friends will bring up the question as to whether the candidate is a Christian. I would remind them that I have some very dear (but politically brain dead) friends who lauded Obama for being a Christian. I remember liking Jimmy Carter because he was “born-again”, and what a colossal mistake he was of a president. Our last great president that generally stood for Christian values was Reagan, but he came under attack for his lack of Christian faith. Meanwhile, the Bush clan were lauded as Christians, yet I have serious questions about their integrity and self-serving expectations while in office. I am reminded of the Cromwell regime in England, which stacked the parliament with Christians, but who were incompetent at running a country.

So, I now offer a serious question. Does America deserve a good president? Perhaps not. I see no candidate that will make king Hezekiah or king Josiah style reforms to correct public sins and evil, and foster a more righteous nation. Ultimately, is this not the ONLY thing that matters? Making America great is a matter of making America Christianly moral. But, returning to a biblical foundation will not happen because not even most Christians have a clue as to what that is. Why do so many Christians (like the current Pope Francis) view socialism as a form of Christianity by doing good to the poor? Are they so foolish as to imagine that goodness can be forced and delegated by an evil government? Judgement on our nation looms, and Christians need to get off their Pollyannish pie-in-the-sky-in-the-sweet-by-and-by mentality that God still loves America, and that other countries might be bad, but at least we are not as evil as Russia or China. Just see what Habakkuk says… (You who are of purer eyes than to see evil and cannot look at wrong, why do you idly look at traitors and remain silent when the wicked swallows up the man more righteous than he? Hab 1:13)

Perhaps Christians wish for more social justice. God’s law specifically forbids judgements in favor of “the poor” just because they are poor (“You shall not fall in with the many to do evil, nor shall you bear witness in a lawsuit, siding with the many, so as to pervert justice, nor shall you be partial to a poor man in his lawsuit” Exo 23:2,3). A strong sense regarding personal ownership of property and goods must not be viewed as being evil, but the wish to re-distribute the goods of “the rich” as being very evil (You shall not covet-10th commandment, Exo 20:17).

Our current president has accelerated the process of wickedness in our nation. We are far worse now in being racially divided. We no longer grasp that having a penis means that you are male, regardless of your feelings on the subject. The gay/lesbian/trans-sexual/confused-sexuality agenda has flourished under our current Nobel peace prize gay bath-house visiting “Christian” president. Social programs have removed any moral responsibility from people, so that any sexual, economic, or behavioral issue might get you time behind bars or in the Krankenhaus, but will not result in you suffering the full impact of your inappropriate behaviors. We no longer fear the influx of foreign gods, including Buddhism, the Muslim “god”, Satanism in its various forms, and the god of mammon. The Scriptures are not silent on this. (Beware lest you say in your heart, ‘My power and the might of my hand have gotten me this wealth.  You shall remember the Lord your God, for it is he who gives you power to get wealth, that he may confirm his covenant that he swore to your fathers, as it is this day. And if you forget the Lord your God and go after other gods and serve them and worship them, I solemnly warn you today that you shall surely perish. Like the nations that the Lord makes to perish before you, so shall you perish, because you would not obey the voice of the Lord your God Deut 8:17).

So, my action items are as follows.
1. Pray. God is in ultimate control of everything. Remember that Obama was ordained by God (it doesn’t mean that God loves Obama! Contrary, God truly hates Obama!).
2. Stand up for what is right. Work for a crisis pregnancy center that offers alternatives to abortion. Refuse to patronize businesses that cater to the gay/lesbian/trans agenda (including the YMCA). Speak your mind for truth. Don’t be ashamed that you are a Christian. Go to a real church. Not a feel good, “Jesus loves you, come as you are” “Get in touch with the real-you”, self-empowerment church, but a real church.
3. Quit thinking that God loves America. He doesn’t. Quit thinking that America is a Christian country. It might have been at one time, but it sure is not now. Quit thinking that most Americans that say they are Christian are Christian. Do they truly understand God’s laws, and seek to live by them? (As a father shows compassion to his children, so the Lord shows compassion to those who fear him. But the steadfast love of the Lord is from everlasting to everlasting on those who fear him, and his righteousness to children’s children, to those who keep his covenant and remember to do his commandments Ps 103:13, 17,18). Do you erroneously consider the Older Testament as obsolete and replaced by “grace” under Jesus? Are we all Marcionites now? Are there two different gods in the bible, the old testament and new testament gods? Or did God announce through Jesus that he was just kidding, and really will not be imposing a harsh moral law on mankind from Jesus on out? Do you realize that all of America is enemy territory, the worst being many “conservative” American Christian churches?
4. Pay close attention to practicing a personal morality. It really does matter. Don’t complain when God’s judgement hits, if you are not personally walking with God, and remembering to keep His covenant. Do you encourage your neighbor to seek a biblical faith.
5. Let Scripture alone rule as your moral guide. Memorize it. Start with Ps. 1 and Ps. 2. Psalm 1 is a summary for the entire Scripture regarding the need for personal morality. Psalm 2 is a summary for the entire Scripture regarding God’s ideas regarding politics. They are eternal inviolate truths.
6. Refuse to vote for the status quo. If you do vote, trust that God will establish the perfect person for America. It will probably NOT be the person you wanted to be president.
7. Remember that over ½ of Americans voted for Obama twice over. If you think that our country truly wants what is right and good, you are living under a massive delusion.

Thanks for hearing out my rant.

Though the fig tree should not blossom,
nor fruit be on the vines,
the produce of the olive fail
and the fields yield no food,
the flock be cut off from the fold
and there be no herd in the stalls,
yet I will rejoice in the Lord;
I will take joy in the God of my salvation.
God, the Lord, is my strength;
he makes my feet like the deer’s;
he makes me tread on my high places. Hab. 3:17-19

All Bible quotes in this blog were taken from the English Standard Version, complements to some of my friends who participated in this translation.

 

ADDENDUM: 28FEB2016

You might have noticed that I did not review Kasich. The simple reason is that I have nothing to say about him. I won’t move out of the USA if he becomes president, but I view him as a weak liberal.

I am feeling that Trump is shooting himself with his mouth. I am becoming increasingly concerned about him being president. He will be a better alternative that Col. Sanders or Hillarious, but feel that it would be very risky voting for him as president. I’ve also appreciated Ted Cruz more as time goes on. He’s a sharp cookie, even though he is a lawyer. If I had to vote tomorrow, it would probably be for Cruz. Who knows who my next addendum will prefer? I’ll be glad when the Republican and Democratic conventions are over with. Who knows if there will be a third party candidate? We wait in prayer that God will show at least a modicum of his steadfast love on the USA as a country, that his wrath not be too severe.

 

ADDENNDUM: 12MAR2016

I’m seeing why it was a good reason not to cast my vote firmly. Events of the past few weeks have changed my mind. Issues that have developed with Cruz.

  1. He selected Neal Bush to be on his financial staff. Why in the Sam Hill did he do this? Is he trying to get in good through the back door with the established politicians that we have learned to so thoroughly despise? Wasn’t it Neal that was involved criminally in the Savings and Loan disruption many years ago?
  2. Cruz is throwing unnecessary mud at other candidates, suggesting that he is desperate; not a good trait for a president. He now accuses Trump of stirring up the crowds. But, the crowds stirred up are the worthless chronic parasitic students, Negros, of Chicago. Get out the Kleenex. Like spoiled children, it’s time somebody told them off. Cruz cannot let go of his establishment mentality.
  3. Cruz has some very strange “magical” concepts of Christianity. The Lord told him that he would be King in America, according to his father. I don’t mind Pentecostalism, but they sometimes have the worst approach to truth.
  4. Cruz would make a good attorney general, but an awful president.

What about Trump?

  1. He has shown that he can behave and be presidential.
  2. He pisses off the liberals. Good. Hopefully, he’ll put some of those sorry asses back to real work. Hopefully, he’ll terminate half the funding to colleges, so that we don’t produce yet another generation of totally useless BS’s and BA’s, trained in gender studies, political science, environmental studies, racial studies, or law.
  3. He pisses off neocon conservatives. Good. They can keep their little playacting at party meetings, but they are just as criminal at bringing collapse to America as the liberals. The neocon arguments are ridiculous, and without substance. His hair. He looks haughty (like Hillary, Rubio, and others don’t???). He’ll get us into war (really now, are you so deaf that you can’t hear what Trump has said a million times—if we go to war (ever), THEY will pay!!!)
  4. He is acquiring more and more people that like him. My favorite candidate (above) in terms or morality and wisdom and personality was Carson, and Carson threw his towel in with Trump. The liberal neocon right simply can’t bear that, and are now coming down hard on Carson for stupidity. They lack a mirror. Phyllis Schafly has supported Trump. There are many others that are coming out.
  5. I actually ventured onto Trump’s website, prompted by the baby-ass crying neocons. I reviewed his policy statements. I agree with nearly every one of them, such as his foreign policy (except for his involvement in the South China Sea – we don’t belong there), economic issues, education (he’s listening to Carson! on that one), healthcare reform (abolish ObamaCare), immigration reform, tax reform, eliminating the death tax, and second amendment rights. I love his idea to make concealed carry permits applicable across state lines, like driver’s licenses. There’s almost nothing that I disagree with. Plus, and most importantly, he promised to put Hillary in prison. I hope that he also tries Obama for treason, makes illegitimate all of his actions as president, puts half the Supreme Court before the firing squad for treason, hangs Loretta Lynch for treason, and fires half of everybody in government.

So, I’m not totally committed but would vote for Trump if the ballot was given to me today. This has not been a good election cycle. The worst thing is not who the candidates are, but how the professional politicians of all stripes are responding to the election that isn’t going their way. They are working too hard to protect their own comfortable turf. Because of that, I dearly hope that whoever gets into office removes any retirement benefits for congress and presidents. They don’t deserve it. They get enough already in other royalties. I dearly hope that a law is passed that makes that forces congress and executive office members to live by the same laws that we have to live by. We are not supposed to have a class of royalty. Let’s get rid of them!

 

Weihnachten 2014

January 3rd, 2015

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Weihnachten 2014

Many of you readers are wondering why I took so long to post a Christmas report. Why didn’t it come on late Christmas? Or, at least, on 26DEC. Well, if you are asking, go suck on green persimmons. My top priority in life is NOT to provide the world instantaneous reports of what I just happened to do in the last hour, or what one of my children/grandchildren/nephew-niece or other relative just said that was cute. I will enjoy their cuteness in a hedonistic fashion, realizing to the rest of the world, my child/grandchild/whatever will be viewed as a solipsistic spoiled brat. No, I’m also not going to tell you what I just happened to cook, or what I am currently eating (I just happen to be taking my Abendmedikamente geschluckt mit Bier und eine Dose Rosarote Lachs für Eiweis Anhang); and if you can’t read German, you really don’t need to know what I eat/ate/will eat.

So, today, I went for a short bicycle ride (41 miles) with Russ Anderson and had an inspiration to write this post. The ride was at freezing point, and we returned quite cold. It took about 2 hours to thaw out. I don’t mind those sort of experiences. I get more annoyed when it is too hot, and I am borderline on a heat stroke. But, thinking about Christmas, Christmas tends to be melodramatic. We spend a lot for presents which don’t seem to be appreciated commensurate with the money spent or the time taken to select and purchase those items. This year, we avoided the mall altogether (Betsy and I went once just to visit the Apple Store several days after Christmas-we didn’t buy anything). We had the Hastings over, and sang Christmas carols, which we all really enjoyed.

Christmas Evening – Jon and I attended the 11 pm Gottesdienst. Bei Mitternacht gibt es Kerzenanzundung mit dem Raumlicht aus und das Stille Nacht Lied singen. Und dann, zu Hause. Every year, I make up cinnamon rolls from scratch, make about 8-12 platters of them, and then freeze them, giving them to friends, fiends, and family as gifts (aber, nicht giftig!). You simply set them out the evening before, and they unthaw, and then rise by morning, allowing you to stick them in the oven and have fresh cinnamon rolls in the morning. I made up a prime rib on the Trager grill and we had all the kids over (except for our dearest Rachel and Alex and kids). We had just installed an outdoor fireplace, into which we got a fire going, while the older kids played with the bb gun. Then, dinner.

 

Patrick as marksman on the bb rifle.

Patrick as marksman on the bb rifle.

Sammy as competitive marksman.

Sammy as competitive marksman.

Dean smirking at Patrick and Sammy, knowing that some day he will whip their Arsch on the firing range.

Dean smirking at Patrick and Sammy, knowing that some day he will whip their Arsch on the firing range.

Me cutting up the prime rib.

Me cutting up the prime rib.

Die Kinder devouring the Christmas Dinner.

Die Kinder devouring the Christmas Dinner.

Dean wanted prime rib but enjoying what he got.

Dean wanted prime rib but enjoying what he got.

The adult table.

The adult table.

Then, it was time for the kids to open up presents.

Elizabeth showing off her doll.

Elizabeth showing off her doll.

Elizabeth with mutant Frozen character themes.

Elizabeth with mutant Frozen character themes.

Sammy loves rocks.

Sammy loves rocks.

Dean wasn't sure at first what to do with the presents, but soon figured things out.

Dean wasn’t sure at first what to do with the presents, but soon figured things out.

Afterwards, we decided on S’Mores for dessert. The outdoor fireplace was the perfect place for that.

Roasting marshmallows on the campfire.

Roasting marshmallows on the campfire.

Roasting buttocks on the campfire. Left to right, Doug, Diane, Sarah, Andrew

Roasting buttocks on the campfire. Left to right, Doug, Diane, Sarah, Andrew

It was a wonderful Christmas, with a focus on God and family. Hopefully, each Christmas could be all the more so. By the way, I got the shirt in the first photo from my favorite German patient. It seems to sum up matters in few words.

The Feucht family wishes you all a Merry Christmas and a Happy New Year.

 

Bicycling in Portland 2014

May 28th, 2014


MayCycleRides-576

Riding in Oregon with friends, family, and self, 21-26MAY2014

I had always wished to return to Portland to do some rides that I had tried as a kid, but which didn’t end so well. I wished to ride the Gorge, do Larch Mountain, and run around a number of the places I used to ride bicycles when I was growing up in Portland.  So, this adventure gave me that opportunity. I started by driving down to Portland after work of Wednesday evening. The next morning, Aaron H. came to meet me at the hotel, and we took off north. Riding across the I-205 bridge, we rode eastward along the Columbia River, following the Washugal River once we reached Camas, WA. A short segment brought us back to the Columbia River highway, where we passed Beacon Rock, crossed the Bridge of the Gods (photo above, with Aaron showing off his banana), and then rode back along the old Columbia River highway. The bicycle trail was now complete all the way out to Cascade Locks, though my cycle instructions did not realize that. The ride up to Crown Point and then back to Gresham and Portland was exhilarating. Here is the Garmin data…

The next day, I touched base with brother Gaylon, and rode a ways out the Springwater Trail to Boring, OR. It was boring, and so we turned around and came back. Garmin data…

On Saturday, I had wanted to ride up Larch Mountain with Aaron, but we decided to do something a little less strenuous, and so I came down to Salem, to do a fantastic and beautiful ride with him in the foothills of the Coast Range, and through the farmland of the Willamette Valley. Here is the Garmin for that…

Sunday was a day to relax. I spent about 4 hours with Lewis, which was much needed. I then spent time later again with Gaylon.  The weather was drizzly, and I was worried about Memorial Day, Monday, where it was supposed to rain heavily. On awakening, the weather was cloudy with sun, so I decided to go for it. On Gaylon’s advice, I headed down the I-205 corridor to Sunnyside Road, over to 152nd, down to the Clackamas River, and then back the Clackamas to Oregon City, crossing the old Oregon city bridge into West Linn, riding up to Terwilliger Blvd, headed up Terwilliger past the medical school,  (seeing the Terwilliger trail which I jogged many times while in medical school), crossing back across the Hawthorne bridge, and then (mostly) up Clinton Avenue back to the hotel on 92nd and Stark St.  I had rode the Hawthorne Bridge many times on my bike, but it was much easier now, as the wooden planks had been replaced with a solid platform. Here’s the Garmin, and a photo while crossing the bridge…

MayCycleRides-572

Hawthorne Bridge Crossing

On returning to the hotel, I threw everything in the car and dashed home. My ole BMC was a wonderful bike to do all of this riding, and it proved immense comfort and efficiency. Someday, I’d like to do the Larch Mountain climb. I’ve already worked out with Aaron to return to Oregon for the Crater Lake loop. I need to do much more riding with Gaylon, getting him into a little longer endurance rides. Altogether, it was a delightful and successful trip. Besides bicycle riding, I got to stop in at Powells Book Store, Bob’s Red Mill, and REI, as well as several bicycle shops. I should be back in Portland at the end of the STP in July, and hopefully one more time this summer for some riding.

China with Liao yisheng

April 29th, 2014

China2014-586

I have had a flurry of writing at the beginning of the year, but it has now been two months since I’ve written a review or commentary on my life. So, away we go with a trip to China. Together, Betsy and I took over 1200 photos, so, you are seeing only a small sampling.

Dr. Liao invited us to go on a trip with him to China. He had been suggesting this to me for quite a while now, and we have finally gotten around to going. The trip lasted from 10-26APRIL, and we visited 5 cities, representing central China. The weather was cool, with intermittent rain. The atmosphere was not smoggy, but actually quite hazy, making for less than optimal photographs. Click on the individual photographs for a larger view. Here is the blow by blow of our travels…

Friday Diane tok us to the airport, and we met Mike, before getting on the Hainan express to Beijing. The flight went 1 hour shorter than expected, and eleven hours later, 4:50 the next day, we landed in Beijing. After finding our hotel and checking in, we went out for a quick dinner, and crashed.

Sunday: Mike had arranged a guided tour for today, which included first a visit to the Great wall. It was  great. According to Mao, anybody that visits the Great Wall is a hero, so, Betsy and I are now heros. After that,  we visited the tombs of the Ming dynasty emperors, with a focus on the third, Yongle. We then visited a silk factory and purchased a silk comforter, a jade factory, and a tea specialty house for a tea tasting. That evening, we decided to do some Chinese cuisine, which we enjoyed. This was on what was called “bar row”, where we met a friend, XiaoDong, of Mike, who joined us at dinner. This restaurant was on a lake, which we then walked around before heading home. XiaoDong is a biomedical scientist, possibly in line for the nobel prize, but very delightful in personality.

Dr. Liao at the Great Wall - a real hero!

Dr. Liao at the Great Wall – a real hero! 

The tomb area of Yongle

The tomb area of Yongle

The restaurant menus come as picture books. Here is an example.

The restaurant menus come as picture books. Here is an example.

Out for tea

Out for tea

Monday: first, Tian’nanmen square, which is just a large plaza. We wished to see the Chairman, but his tomb was closed, as well as the Forbidden City. So, we opted for seeing a flower garden next to the Forbidden City, and then going to the Summer Palace. The Summer Palace was build by the Ming dynasty, but burned by the British, and then again by the British and the French, and each time rebuilt. It was massive, with a very large lake in the center. The Buildings were all over the hillside and very ornate. After dinner, Betsy and I were exhausted and crashed.

The gardens next to the Forbidden City

The gardens next to the Forbidden City

Ming dynasty architecture at the Summer Palace in Beijing.

Ming dynasty architecture at the Summer Palace in Beijing.

A stiff climb up to the top of the hill in the summer palace area.

A stiff climb up to the top of the hill in the summer palace area.

Boat trip across the lake at the Summer palace

Boat trip across the lake at the Summer palace

 

Tuesday:   A quick breakfast first was followed by a trip back to Mao’s grave, and then the Forbidden City.  Mao’s grave was most interesting. There was an hour long line, as roughly 200,000 plus people visit the grave each day. You pass through security, and are not allowed to have bags or cameras, no photos were obtained. You are sold white flowers to leave at his grave. In the building, you enter a large room where his statue is sitting in a friendly pose,  carved in giant white stone, similar to the Lincoln memorial. In the next room, his body lays in state, reasonably well preserved. Mao has had a comeback in China, remembering him not so much for his colossal mistakes (the great leap forward and the cultural revolution)  but for his absence of corruption and for uniting the Chinese people.  We then went to the Forbidden City. Mein Gott! This made any European palace system, including Versailles, look like kid’s stuff. The palace and grounds were huge. There were over 8,000 rooms. There were huge squares. Sadly, Chaing Kai Shek looted most of the treasures of the Forbidden City. Schwein! They now sit in Taiwan, and don’t belong to them. Every building was exquisitely decorated in the most ornate fashion. It all made you feel quite small. The evening was spent having Peking duck, and then cha he pijiu (tea and beer) on a rotating restaurant on top of our hotel.

At the enclosure leading to the Forbidden City.

At the enclosure leading to the Forbidden City.

Inside the Forbidden City

Inside the Forbidden City

A small section of the Forbidden City showing its immense size

A small section of the Forbidden City showing its immense size

Wednesday:  Today, we say goodby to Beijing and hello to Xi’an. After breakfast, Mike and I first visited the Beijing Hospital, the best hospital in the country of China. It was a zoo. There were wall-to-wall people lined up various activities, such as waiting to pay for an appointment, waiting for the doctor, etc. There is no such thing as an appointment time as it is first come, first served. The hospital was nice, but just miserably crowded. After that we went to the Beijing Cancer Hospital, the best cancer hospital in the country. We met a doctor friend of Mike’s, and toured the place. It also was a zoo. China needs a better system—they have great doctors but no system. From there, we checked out of our hotel, ran down to the other end of Chang’An Jie (Long Peace Street) caught our high speed train to Xi’an, was picked up by a driver, and delivered to our hotel after having dinner. This hotel would have been a $4-500 hotel in the US, but we paid slightly more than $100. Throughout the travel, including the high sped train, and the hotel, it did not seem like we were in China, as things seemed to be nicer than in the USA. Construction was occurring everywhere you looked.  There was an unbelievable dynamism occurring.

A crowded waiting room at Beijing Hospital

A crowded waiting room at Beijing Hospital

Thursday:  this was another hectic day. After a quick breakfast, we headed off to the terra cotta soldiers of Qin She Huangdi. The site was massive and overwhelming. We then went to a site that had the swimming pools of the emperor’s favorite concubine. After a massive lunch, we headed to the museum and burial site of China’s only female emperor, Wu Zetain. Dinner was again held, with a bit of overeating, but meeting some of Dr. Liao’s acquaintances in Xi’an.

Main area of the Terra Cotta warriors. There are over 6000 that have already been excavated.

Main area of the Terra Cotta warriors. There are over 6000 that have already been excavated.

Terra Cotta soldier wanna be's.

Terra Cotta soldier wanna be’s.

A typical lunch scene.

A typical lunch scene.

Today we got to try duck's feet and duck's heads

Today we got to try duck’s feet and duck’s heads

Mike practices his calligraphy at Mr. Yeung's office

Mike practices his calligraphy at Mr. Yeung’s office

Our most gratious host, Mr. Yeung.

Our most gracious host, Mr. Yeung.

Example of instructions everywhere not to walk on the grass, in poetic form.

Example of instructions everywhere not to walk on the grass, in poetic form.

At the swimming pool of the emporer's concubine. She was reportedly the most beautiful woman in China (next to Betsy, of course)

At the swimming pool of the emporer’s concubine. She was reportedly the most beautiful woman in China (next to Betsy, of course)

Friday: another quick breakfast, and then we headed off to a local Xi’an hospital. This was a private hospital, and they were in the process of building an entirely new hospital, which we toured in the construction phase. It is 27 floors,  1000 beds, with both in and outpatient facilities in the same structure. They then held a conference to ask our ideas on forming a more American style service to the hospital. The hospital is private, in that it was owned 80% by the doctors and nurses in the hospital, and 20% by other investors. After lunch, we went to a museum of ancient history, where relics from s far back as the Shang dynasty were on exhibit, going up to the Tang dynasty. I was amazed at the exquisite character of the workmanship in the bronze material. Xi’an has the largest complete still existing city wall in the world. It was huge, 15 km in length, and bounded by a river. We looked at the gate which was essentially the starting point for the silk road. There were amazingly no tourists there, but it was an impressive site. After paying a visit to a local Catholic church, where they were having a Bible study, we headed off to dinner.

Part of the 15 km wall of Xi'an. It was very large on top, room for 4 lanes of traffic.

Part of the 15 km wall of Xi’an. It was very large on top, room for 4 lanes of traffic.

Saturday: We checked out of our hotel, which was probably the nicest hotel that I’ve stayed in ever. There was even a private sauna in our room. We went to breakfast, and then visited the large Buddhist temple in town. Xi’an was one of the main towns that promoted Buddhism early on in its introduction to China, so it was a significant town for Buddhism. The restaurant experience for lunch was most unique, as Betsy and I saw foods that we never dreamt to be possible. Duck feet and duck heads, chicken feet, squid, frog legs, and vegetables that I have never even heard of before. The food was Anhui, which I’d probably avoid in the future.  We later stopped at the largest hospital in Xi’an, and drifted around. It certainly was large enough for over 2000 in-patients. Next stop was the airport. So far, we’ve been in a city of 22 million, and 8 million. We are now heading to Chongqing,a city of 11 million persons. Small towns just are a bit hard to find. Dr. Liao’s two older brothers met us for dinner. Dinner in Chongqing was at a hot pot, where each seat has a hot plate that has a sauce pan with boiling water with spices. You take various items and cook them yourself to eat. The hot pot was first done done in Chongqing.

Our hotel, on the banks of the Yangzi river.

Our hotel, on the banks of the Yangzi river.

The cross-walk just outside of our hotel.

The cross-walk just outside of our hotel.

Sunday- this was a lazy day. We started out by hitting a McDonalds for Betsy’s sake for breakfast. Mike left us alone to tend to family issues, and we were able to spend a relaxing morning in our hotel room. We took a long walk along the Changjiang (Yangtzi River), while Mike went to help resolve family issues. Later, we met Mike’s brother, who is a physics professor at the University and Susan, who took us to a historical museum in Chongqing where the forces of the Kuomintang slaughtered a large number of Mao supporters who were in prison here. The evening was a family get together, where we met Mike’s parents, and had a large, real Sichuan dinner. Nothing was recognizable except for the kung pao chicken, which was super-hot.

Historical museum of the Chongqing prison.

Historical museum of the Chongqing prison.

Old shopping district in Chongqing.

Old shopping district in Chongqing.

Les Trois Mousquetaires - Two of Mike's three brothers

Les Trois Mousquetaires – Two of Mike’s three brothers

The Liao family gathering in Chongqing. Mike had the sweetest parents.

The Liao family gathering in Chongqing. Mike had the sweetest parents.

Monday- breakfast was at Starbucks! We took a walk again along the Changjiang before checking out of the hotel. Mike’s brother, the physics professor, picked us up from the hotel, and we went down to the center of town, which was a large shopping center with super-rich shops such as would be found in Bellevue, or on the Kö. Lunch included the standard Sichuan cuisine, which was quite hot and spicy, but very flavor-able. Much of the food was unrecognizable to us, and contained very strange creatures. We then dashed to the airport, flew to Hangzhou, and was picked up by Mike’s sister-in-law, who taught traditional Chinese medicine at the medical school in town. This includes using acupuncture, herbal medicines and things of the like. Every hospital has traditional medicine doctors, who are used in treating select illnesses. We got to our hotel by 9pm and collapsed. The area of the hotel is called the Xihu Qu, or the Westlake District, the most expense real estate in all of China. I’m told that Hangzhou was an area of the first experiments in capitalism in China, and there was clear success.

Mike's sister-in-law outside one of the pagodas on WestLake

Mike’s sister-in-law outside one of the pagodas on WestLake

Pagoda on WestLake

Pagoda on WestLake

Tuesday—after breakfast at the hotel, we were picked up by Mike’s sister-in-law, and toured a number of museums and places of interest. The museums in Hangzhou were all free, making it nice. We first went to a silk museum, where they had on display historical silks from many mons ago. They also had a nice display of the silk making process. We went to a large experimental farm established by one of the emperors from several hundred years ago. We toured a ceramic museum, which showed the development of porcelain from ceramics many moons ago. We went to one of the large pagodas on the banks of Xihu. There was lunch, and the took a long walk around Westlake, including a boat ride to one of the islands in the lake. The Xihu (Westlake) area is like one massive park on steroids, very popular and thus very crowded even in slow times, though not often visited by foreigners. It is meticulously cared for, massive flower beds, and most beautiful. We had dinner on the lake. Hangzhou is known for its particular cuisine, which is not hot, but distinctly different from other Chinese cuisines. The food tends to have more fish in it, and tends to have a more slimy character. After dinner we were tired, stuffed, and wanted to crash.

WestLake area

WestLake area

View of part of WestLake from the top of the pagoda

View of part of WestLake from the top of the pagoda

Scene on WestLake

Scene on WestLake

Mike searching for directions

Mike searching for directions

Wednesday—This was a slower day for us. We spent much time walking along Xihu, people watching, buying tea and other things, eating at Burger King (not as good as the US), and then drifting on back to the hotel. We then met Dr. liao’s brother-in-law, who is working on a PhD in constitutional law in Beijing. He took Mike and I on an extended tour of our hotel side of the lake (Xihu). We again visited a number of museums, and then tried this famous local dessert made out of the powder of the lotus plant root. It tasted good, but was a bit slimy in texture, but is well liked by Chinese. We had dinner in a very popular restaurant along the shore of Xihu, and the restaurant where Mike was married. Dr. Liao’s nephew Andy was with us, 11 years old, and who will be starting boarding school in Connecticut this August.

Elderly couples dancing in the park in Hangzhou. This was commonly seen by us.

Elderly couples dancing in the park in Hangzhou. This was commonly seen by us.

Mike's brother in law, talking seriously with Mike.

Mike’s brother in law, talking seriously with Mike.

Outside of one of the museums with Mike's brother in law.

Outside of one of the museums with Mike’s brother in law.

Lotus schleim. I actually tasted good.

Lotus schleim. I actually tasted good.

Scene from the WestLake park.

Scene from the WestLake park.

Girls loved to have their photographs with Betsy.

Girls loved to have their photographs with Betsy.

Thursday—today we were picked up by Mike’s sister-in-law and taken to the train station. The ride was one hour from Hangzhou to Shanghai. In Shanghai, we first found our hotel, and then took a cab ride to the international district. We saw the building where Mao and twelve people wrote the constitution for China, and then we went out to eat at a faux-German restaurant. The beer was good, food very so-so. Afterwards, we walked along the riverfront, looking at the buildings of Shanghai, and slowly drifted home. Hangzhou was a small town of only 3 million people and 8 million in the metropolitan area, but Shanghai had 10 million in the city and 20 million in the whole area, a little bit larger city.

Shanghai architecture across the river from Mike and I

Shanghai architecture across the river from Mike and I

Friday—today is a lazy day, with a focus on shopping. We went to two shopping areas, where we focused on buying tea, porcelain, and gifts for the kids. The first shopping district was close to our hotel, anf a very long shopping road, off limits to cars, and with very fancy shops. We then hopped in a taxi, and went to a very large shopping center with a Ming dynasty architecture motive. This place was huge, we spent all of our renminbis, and had an awesome time. We then got ready for dinner, hopped the subway to the other side of the river that runs through Shanghi, and went into a very large shopping center, larger than anything that I’ve ever seen in the US. It was a total of thirteen floors. Before entering, we got an appreciation for the building architecture of the new Shanghi, which is beyond anything found in America. Dinner tonight was with Drs. En and Mrs. Li. He taught biochemistry and did biochemical research at Harvard University, before getting a job working for Novartis, back home in Shanghai. China, because of its burgeoning economic status, is extremely favorable for scientists, and it is very easy for me to see why. Dinner, by the way, was probably the best meal we ever had in China, though entirely Chinese. En has apparently lived long enough in the US to know what the American taste would like.

Ming style architecture in large shopping district in Shanghai.

Ming style architecture in large shopping district in Shanghai.

Typical buildings in Shanghai

Typical buildings in Shanghai

More very creative architecture in Shanghai

More very creative architecture in Shanghai

Family at a small tea shop where we purchased tea and tea cups

Family at a small tea shop where we purchased tea and tea cups. Note that Oma cares for the baby.

Inside the large shopping mall. This only a small view of the whole mall.

Inside the large shopping mall. This only a small view of the whole mall.

Dinner with our gracious host in Shanghai, Li En and wife.

Dinner with our gracious host in Shanghai, Li En and wife.

 

Saturday—we are eager to get home, though we have most thoroughly enjoyed China, and it is sad to say goodbye. A cab ride got us to the train station, and the train from Shanghai to Beijing was 5 hours, with 5 stops. It was mostly through very flat farmland. In Beijing, a friend of Mike’s picked us up and shuttled us to the airport, a little over an hour drive, and giving us our last taste of crazy Chinese driving. The flight home was 9 hours. We left Beijing at 4:30 pm and arrived in Seattle the same day at noon. It was two days packed into one. After saying goodbye to our dear friend Mike, Sarah shuttled us home. We unpacked, and noted piles of tea, as well as no broken porcelain. It was good to be home.

Thoughts on China…

Just a few minor observations. Cars… Brother Dennis purchased a Chinese vehicle in Belize, which was a total piece of junk. I anticipated that I would see cities full of junky cars and rickshaws, bicycles, and baby taxis, like in India. Instead, there were no rickshaws or baby taxis, almost no bicycles, and the most popular car was the Mercedes Benz, followed closely by the other German cars, BMW and VW. Chinese cars are reportedly next in popularity, followed by American cars,  and Korean/Japanese cars were the least frequent. I did not see a single Chinese made car until Chongqing, but it was a nice looking sports utility vehicle. Supposedly, they have vastly improved the quality of their vehicles. At the end of two weeks, we saw less than five Chinese built vehicles.

Secondly, the big cities do not have slums. They do have poorer parts of the city, but nothing that I would call a slum. The countryside had some very poor areas, but no worse than found in Belize, Jamaica, Cameroon, or Bangladesh, the “third world countries” that we’ve been to. The dress that people wear is identical to the western world. There was no ability to recognize that you were not in the US or Europe except for the Chinese writing, and that everybody was oriental. There is minimal unemployment in China, as there are no unemployment checks, welfare, food stamps, or anything of that sort. In a strong sense, it is more capitalistic than America! Regardless of your status or education, if out of a job, you will take anything in order to survive. The state will not be your nanny. There are no messy employment laws, and you can fire an employee at will. Employers tend to treat their employees well. One morning, we saw at a clothing store and then at a restaurant all of the employees out in front of the store doing Zumba like exercises. Many larger firms will have a cafeteria for free lunch. Our friend also had a large library at his firm for employees to encourage their continued education.

Thirdly, traffic is absolutely horrid in China. Why most the cars do not have bumps and scrapes is a total mystery to me. An American traffic cop would find violations literally every second. People use the shoulders of expressways as a passing lane. People run red lights. Cars do not yield to pedestrians but vice versa. People will aggressively violate every traffic rule on the books to pass a car in front of them. I watched my taxi driver pull into the on-coming lane of a four-lane road in order to beat a traffic light. I could not ride in the front seat of a car. Historically, I feared the taxi drivers of NYC. Now, China has exceeded that 10-fold. Next time I go to China, I bring mass quantities of Valium if I anticipate an automobile ride.

Fourthly, the Chinese put a very high value on family and relationships. This is a little odd, since their value for human life is less than in the US. Everywhere we went, we saw grandparents with grandchildren. I was surprised to see that the state was not raising the child, but the grandparents. In family relationships, the grandparents are usually asked permission for any major decision, such as marriage.  The eldest son held priority in family decisions. Nursing homes did not exist, as the children were expected to care for their aging parents. I did not expect this.

Fifthly, the language and poetry are important. Everywhere you go, you see poetry. Apparently, the Chinese language lends itself easily to poetic expression. We would see signs not to walk on the grass, and it was written in a poetic fashion (so I am told by Dr. Liao).  The Chinese hold those who are masters at poetry in the highest regard. And, the person in recent history who excelled in poetry was none other than Chairman Mao.

Sixthly, Mao Ren Zi (Chairman Mao) is the most poorly represented person in the west. Before my visit to China, I viewed Mao as nothing but a beast who slaughtered millions of people. That is perhaps true, but it lacks the full impact of who this man was. Why is it that Mao now has a near 100% acceptance rating in China? Why is he generally appreciated everywhere in China, and not because it is forced on the Chinese people? As mentioned above, the Chinese knew that Mao was most brilliant, and had a mastery of the language beyond most intellectuals. His poetry is everywhere, because it was very well done. During the years that Mao was chairman, he changed the Chinese language for the good, like having the symbols simplified. The Chinese now read and write right to left, like we do. Why? They used to write up to down and backwards, but Mao had that changed. Mao not only liberated the farmers, but also women, stopping crazy practices like feet binding, and giving them more rights. Secondly, the greatest problem with all Chinese emporers and rulers was serious corruption. If one faulted Mao for anything, it certainly was not corruption. Chaing Kai Shek was very corrupt, and the peasants knew it well, which is why they flocked in support of Mao. Mao had no love for the privileged elite, and exalted the poor peasants to a better living. That is seen well in China nowadays, with there being many multi-millionaires, but the farmers in the countryside have a reasonably good living in comfortable circumstances, and not as it was before 1949. With the current corruption in government, there is a sense of nostalgia for a leader who could act for everybody’s best interest without corruption. People often cite the fact that Mao murdered millions ruthlessly. Actually, most of the deaths under Mao’s watch were from serious mistakes that he made, and most people in China acknowlege that. I am referring to the great leap forward, and to the cultural revolution, which were truly stupid mistakes, which led to millions of Chinese dying, though not intentionally by Mao. One cannot forget history. China is a somewhat diverse group of people, with 56 ethnic groups, multiple religions, and multiple languages. In my reading of Chinese history, I don’t know of a single emporer that did not have to do a major “purge” to acquire unity and control of the country. Now, perhaps unity in China is not a good thing, but that is not something that I would propose—I don’t wish to be like the French, who felt the a united Germany (back in 1870) was not a good thing, since they would lose control of the weak individual German states. In any case, power was used consistently to achieve unity in the country. Finally, many in China view there to be two major revolutions in the country. The first was with the rise of the Qin dynasty, a very short dynasty from 221 to 206BC, and best known for the terra cotta warriors. What most don’t realize, was that the Qin leaders were quite ruthless at leading to the unity of the country. They also unified the language, and standardized many things, such as the width of wagon wheels. Important? Think about India, that has 5 different gauges for the railroads. That wasn’t to happen in China, because of wise but strong leadership. The second revolution was with Mao. Mao is now gone, and we are able to speak freely about him. There is much wrong with Mao, and I don’t think that the ends ever justifies the means. No doubt, Chairman Mao is a complex person, and my attempt to understand why he has such a pull in Chinese society at this time now has a little better insight.

Finally, what about “communist” China? Are they “communist” only in that the leadership is not necessarily elected, and that they do not permit criticism of the government? In China at this time, that is not bad, because the leaders have been capable of brilliant leadership. What about restrictions of speech? Facebook is not allowed in China, as well as many other forms of social networking. But then, homosexuality and pornography are also not allowed. Is that bad? I wish it were so in the USA. Meanwhile, the USA is far more communistic and socialistic than China. Perhaps we need to re-think the corruption and evil than rules strong in Amerika?

In conclusion, this trip to China was fantastic, and Betsy and I thoroughly enjoyed ourself. The food was sometimes slightly wearisome, but was always quite good – just not what we are used to. The mass crowds were also a little challenging. China was nothing like we expected, and the wealth and immensity was overwhelming. I now have a feel for Marco Polo returning to Italy only to find that nobody could believe his fantastic tales of China. China truly is dazzling, and the people everywhere were friendly. Most signs had English translations, suggesting that we Amerikans are still welcome in China. Hopefully, we don’t create an artificial war that treats China like an enemy. They have no interest in war, as their internal problems are great enough. I would hope that politicians could see China as a friend, understanding the differences that separate our two countries.

Superbowl

February 3rd, 2014

Seahawks

Much hype was made over the Superbowl in the Seattle area. Everybody (hyperbole, actually, only about 30%) was wearing Superbowl shirts over the past week, and the mania reached to all branches of life. The super-rich flew to Christie-Land (kind of like Fantasy Land) to personally attend the festivities. There was great apprehension, because the Reds (* see below for explanation of the colors) had the most valuable player. Conversely, the Blue-Greens had the favor of Nero, as well as the Reformed Pope of Seattle (Mark Driscoll).

The game was not watched by me, but I could tell that it was practically over from the start. The only anxiety remaining was whether the Blue-Greens would be able to pull off a total shut-out. Actually, they did accomplish a total shut-down, as the city of Seattle and its accompanying megalopolis rested quietly, all citizens glued to their personal sewer pipes (televisions). The streets were empty, and shops were stilled. Even the houses of worship that still met on Sunday evening were poorly attended—I know, since I went, but heard one of the best sermons ever last night-Zechariah 14. Facebook was littered with photos of home Superbowl parties, photos of nauseating junk food spreads fit for Rosanne Barr or Oprah, and scores were updated on a continuous basis. Since I am friends on Facebook only of Seahawk devotees, I delighted in their spontaneous posts of rapturous praise to the Blue-Green god. The red devotees were not happy, but I never heard from them, and they got what they deserved—dogs and blasphemers never deserve to win.

Now that the Superbowl is over and the Blue-Greens are the victors, all is well in the Land of Oz. The Emerald City has returned to it’s usual helter-skelter. But, there is a noticeable difference. There is now love in the city. No crimes have happened since the clock struck game-time zero the Land of Oz.  There is a prevailing sense of peace. There is joy unspeakable among the residents of Oz. It is a transformation like has never occurred in our great land. Meanwhile, Nero has announced that he was just kidding regarding Nero-Care and is terminating it as of this moment. He is withdrawing troops from Afghanistan, shut down the Federal Reserve, and has confessed to being an inveterate liar, never to lie again. Salvation has come to our dear Pacific Northwest, and we’ve all found jesus. The Seattle Pope has already declared that many of the Blue-Greens have found jesus, and while the rumor exists that while some of the Reds have professed finding the same man, we know most assuredly that that simply cannot be true, as jesus loves sports and would only allow true believers to win.

 

*In Greek and Roman society, the sports teams were named by color, so that instead of the SeaHawks, the Broncos, the Cubs, the Trailblazers, you had the Blues, the Reds, the Greens, the Whites, etc. The White Sox or the Red Sox most closely approximate the ancient standard. The SeaHawks colors are Blue-Green and the Broncos Orange with a touch of Blue (call them Red since an Orange team did not exist in Rome), so they are referred to with color terminology in this post. Ancient Nero, like most of the emperors, was an avid Green fan, so he probably would have been a SeaHawks Blue-Green fan. The reincarnation of Nero in the White House almost certainly is a Blue-Green fan.

Noch ein Jahr vorbei (2013)

January 1st, 2014

Happy New Year! The year has had some great trials, as well as bringing supreme joys.

Joys? Not only has Rachel given us Lily Mae and Adalyn Grace, but Diane also have given us Dean, leaving us with 8 grandchildren. It’s an odd thing to think how much joy one gets out of the grandchildren.

The trials (and trial, literally) last year has been hard, but has been good for both Betsy and me. We have acquired a rich discovery of each other that has been a blessing. It is typical to have the empty nest turn on parents as a strenuous time for each other, but we have found it just the opposite. It has been fun traveling together, and just living together.

The trial from last Spring has been elaborated in a blog entry from April and can be read about there. The supposition is that one gets over a lawsuit, knowing that they are going to happen, and one gets on with life. That has not happened to me. I have felt the horrible injustice of the court system that does not seek after truth and rightness. When a physician does everything right, he still is legally culpable if a problem arises. In response, I have backed down considerably in what I do in my practice, and plan on retiring sooner than later. I see God’s hand in all of this, as it is otherwise quite difficult to slow down one’s practice and yet be able to remain in practice. It feels as though the entire system has you trapped.

Trips have included a bicycle ride with the ACA in Death Valley, a trip with Dr. Tate in upstate Michigan on bicycles, a trip to Germany with Jonny, and a bicycle ride on the eastern side of the Sierras with the ACA and also with Jonny. All of these trips are chronicled previously on this website. I took a brief trip to San Antonio (not recorded in a blog entry) in early December for the San Antonio Breast Cancer Symposium. There were other small trips.

Last year, I noted that I was working through all of my classical music. I have since acquired about 20 days more music, including a complete Wagner (with 2 sets combined), a nearly complete Haydn set, a complete Verdi, and multiple other works. My classical collection is now 66633 songs, consisting of 418.3 Gbytes, which would take me 204 days, 10:22 hours to listen to. At the end of the year, I am now left with 4189 songs, 29.5 Gbytes, and 14 days, 11:31 hours of music. I have acquired a set of the complete Bach organ works by Marie-Claire Alain that I have yet to load. So, I should be completely through my classical collection some time in late February or early March.

Plans for the coming year include more bicycle rides. More people from church have become interested in cycling, including Rick DeMass, the associate pastor. I am planning a week loop in Washington with Jonny, as well as a ride in the Black Hills with the ACA. Before the Black Hills trip, Betsy I plan on driving to Sioux Center to see Alex and Rachel and Lily and Adelyn, who will then meet me in the Black Hills for several days.  Betsy and I will be traveling to China with Dr. Liao in April. I am trying to put together a church trip to Israel with John Delancey for early 2015.  I also plan on going with Betsy to Phoenix in March to meet Dr. Tate and attend the SSO. I might also go to the American College of Surgeons meeting either this year or next. This year, I’d like to do the STP (Seattle to Portland bicycle ride), as well as a ride in Oregon with an old friend Aaron Hughes. There are no plans yet for Germany this year, though a trip in the fall is appealing. I really appreciate my time with all my German friends, including Dr. Herbert, Dr. Hannes and Katja, and Dr. Carsten and family. For 2015, I’d really like to do a 2-3 week Danau Radweg ride (Danube bicycle route) from Danaueschigen to Wien. I have no current plan to change my practice as it is right now, but will be working on forming a more cohesive atmosphere for cancer at Good Samaritan Hospital.

I still have a large stack of books to get through. Some time this year, I plan on reading Calvin’s Institutes, translated by Battles, as well as reading Hermann Bavinck’s 4 volume set on systematic theology. Neither of those books are available (yet) on Kindle.

Most of the sleepless nights that I and Betsy have had have been related to the troubles that close friends have had. Sometimes, it can be harder to endure watching a friend suffer, than to be going through such suffering yourself. Relationships to friends, family and God have become more important over the past year. Sundays at church remain a defining moment in Betsy and my lives. All else becomes meaningless before an infinite, personal God.

Whom have I in heaven but you? And there is nothing on earth that I desire besides you. My flesh and my heart may fail, but God is the strength of my heart and my portion forever… as for me, it is good to be near God: I have made the Lord God my refuge. From Psalms 73

Thoughts about the Pacific Crest Trail

October 29th, 2013

PCTDreams-1

The reader of my blog site may will notice below that I have reviewed a series of movies and books related to hiking the Pacific Crest Trail. This is a trail that runs from Mexico to Canada through the Sierra Nevada mountains, and then the Cascades. It is over 2650 miles, and typically take 4-½ to 5 months for a hiker to accomplish this, doing roughly 25 miles/day. I wish to offer an explanation now for these posts.

If you look through many of my distant past posts, typically end-of-the-year posts, you will notice occasion mentions of dreams for epic adventures. It is not a mistake that the Hobbit/Lord of the Rings trilogy and Der Ring des Niebelungen 4-opera series are my favorite books and operas. They all represent epic adventures. Whether it be a bicycle trip that completely circumnavigates the United States, or a thru-hike of the Appalachian or Pacific Crest trail, such an adventure has been a dream since I was a kid. I remember well as a teenager hearing the account of Luke Huber backpacking around the world. Such a thing could never be done in today’s world. Even then, 40 years ago, Luke was able to do it since he carried a Brazilian passport and not a US passport. His slideshow tale has stuck in my mind as though I had just seen it yesterday. It was a venture like I would have longed to have done but never could have been possible for me.

So, the question remains as to whether I would ever be able to accomplish a epic adventure? Two issues affect my decision. The first issue is Betsy. Regardless of every other affection and desire that I have, Betsy remains the most important person that I have in life, dare I say, even more important than my own personal satisfaction. Outside of my love for God, nothing exceeds my love for Betsy, and desire to be with her and enjoy her. Since she would not be able (or desire) to accomplish an epic thru-hike or epic bicycle venture, I must judiciously tailor my plans and expectations. The second issue is my own personal health, which is good, though I still require low doses of antihypertensive medications.

A third but non-issue is the economics of such a venture, which relates more to being able to get away from work for 3-6 months in order to accomplish such a task. I just discharged a patient from my practice who I treated for #####; he worked for REI in the warehouse in Sumner, and was an avid outdoorsman. He explained the REI policy that all employees at 15 years get to take a 1 year Sabbatical, and then they take a Sabbatical every 5 years after that. I couldn’t believe my ears. I had no clue that one successful corporation in the US actually has some sane employment policy.  When I took a Sabbatical in 2009, it was after a maddening 4 years of medical school, with minimal break to start 8 years of an insanely busy residency and fellowship, with minimal break to start 2 years of life as a military doctor, with minimal break to start (by 2009) 14-½ years of hard slave labor. You can add up the numbers easily enough. Yet, my Sabbatical in 2009 was considered most unusual. It was one of the smarter things I ever did in life, besides coming on my knees to the cross of Jesus Christ, and asking Betsy to marry me. If one considers that a Sabbatical occurs every 7th year, then the year 2016 should be my next Sabbatical year. I’ll be 62 years of age then, and ready to hang it up for good. I will actually retire somewhere between 2016 and 2020, when I will be forced to retire, since I have no intention of re-certifying with the American Board of Surgery. This will get me plenty of time for epic adventures. In terms of cost, the trail is cheaper than daily life at home, especially (when cycling) one plans to spend most of their nights tenting, which is no problem for me.

I cannot speak for the Appalachian trail, but for the Pacific Crest Trail (PCT), there are some good arguments against performing a thru-hike. “Thru-hiking” means that one goes from the very beginning to the very end of any given trail in a single setting, i.e, doing Mexico to Canada from start to finish in a single year, without formally leaving the trail. In order to do that, one must start in the southern California desert at the start of the hot season, hit the high Sierras a little early in the season, when snow still covers most of the trail, arrive in Yosemite at the peak of the bug season, hit Oregon in the still rainy season, and then hope and pray that nothing interferes with your schedule to make it through the North Cascades before an early winter snowstorm. Ideally, Oregon and Washington are best hiked in July and August, the high Sierras in June/July and not May/June, and the desert in March. This means that to thoroughly enjoy the PCT, sectional or chunk hiking is the way to go. You can’t write books or make movies or spend hours bragging of your sub-epic venture, but at least you will not have turned backpacking into a chronic enduring painful drudgery.

There is a third alternative to thru-hiking and section hiking, which is chunk hiking. While thru-hiking attacks the trail in one grand solitary attack, and sectional hiking deals with short excerpts, chunk hiking is to tackle a larger section than section hiking, such as doing the entire state of Washington or Oregon in one setting, or California in several settings. Brian Lewis, in one of the books reviewed below, discusses chunk hiking, suggesting that chunk hiking gives the hiker the best of all worlds, being able to tackle sections of the trail at the right time of the year, while not engaging in the insanity of a 4-6 month ordeal and still maintaining the spirit of a thru-hike.

Chunk or thru-hiking demands a completely different style from regular hiking. Most importantly, much less weight must be carried. Every ounce of weight matters. Nothing frivolous can be engaged. Light-weight stoves or tents are not light enough. Certain things cannot be sacrificed, such as clothing, but even then, extreme prudence needs to be exercised to carry only one change of clothes, and then wash them once every week or two. Meals are typically eaten cold, unless at a re-supply. Since there are long stretches of trail uncrossed by road, a 7-9 day supply of food must be carried, while considering 5000 cal/day to be the norm on the trail. Most people do not use hiking boots, but rather use hiking shoes.  Resupply needs to be accurately planned out beforehand, since one will not carry all the necessary maps at once, clothing and equipment changes on the different sections of the trail, and shoes wear out, hikers usually going through about three pair of shoes.

So, perhaps my epic adventure should be done on a bicycle, and leave the PCT to sectional or chunk hiking. It would be cool to do the Pacific coast trail down to San Diego, and then return on the Sierra Cascades trail back up to Canada and then home, using the path outlined by the Adventure Cycle Association (Pacific Coast & Sierra Cascades). That trip would parallel the PCT on a bicycle, and would take about 3 months total, which is entirely possible. For now, I am planning a week-long backpack with Jon or someone else next year, hopefully doing the Wonderland Trail in reverse from what Jon and I did several years ago. I would also like to do part if not all of the Washington Parks (Adventure Cycle Association) Route around Washington State. Other planned ventures will be mentioned in the year-end report.

Sierra Sampler 2013

September 17th, 2013

SierraSampler-24

Sierra Sampler with the Adventure Cycle Association

(Note – click on individual photos to see larger views of them)

06SEPT2013-Jonny and I were able to leave Puyallup at 1700, arriving in Roseburg, Oregon at 2300. Traffic out of Puyallup was horrid, being stop and go until past Olympia. Portland also had  bad traffic through Wilsonville.

07SEPT2013- we followed Google maps advice, avoiding Sacramento, and arriving at Donner state park at about 2:15. After unloading our stuff, we headed  with our bikes up Donner Pass to the ski area, where we parked our cars and then rode our bikes back to camp, about 7 miles. The view of the lake was fantastic, as well as the  railroad that could be seen with its many tunnels. The Garmin data are below…

Jon on Donner Pass with the rail in the background

Jon on Donner Pass with the rail in the background

On Donner Pass looking down onto Donner Lake

On Donner Pass looking down onto Donner Lake

First day introduction

First day introduction

The food line-at Donner State Park

The food line-at Donner State Park

Jerry showing us how to wash dishes

Jerry showing us how to wash dishes

08SEPT2013 – Truckee to South Lake Tahoe.  This was a little more uppy-downy than I expected, but beautiful. It started out freezing cold, and became quite hot by noon. Fortunately, the ride was completed soon after noon, and all of the riders (33+) all did well and had a great itme. Beer never tasted so good after such a ride. The meals were also catered and were quite delectable. I worried about gaining weight on this venture! The Garmin data are below…

Squaw Valley Ski area

Squaw Valley Ski area

Jon grinning like a hedgehog

Jon grinning like a hedgehog

Lake Tahoe

Lake Tahoe

Jon taking a very brief rest

Jon taking a very brief rest

Lake Tahoe (again)

Lake Tahoe (again)

The mountains around Lake Tahoe

The mountains around Lake Tahoe

Lunch stop on the ride to South Lake Tahoe

Lunch stop on the ride to South Lake Tahoe

Am Stand bei Tahoe See

Am Stand bei Tahoe See

09SEPT2013- Luther Pass- because of the fire, the decision was made to do only the first pass, then turn around. We were then shuttled to a small resort (Virginia Creek Settlement). The climb to Luther Pass started like the day before, quite chilly at first, with the fingers feeling frozen until about 9:30 am. The ride otherwise went well. The shuttle bus ride took us through Topaz, and then south on 395 down to Bridgeport.

Luther Pass?

Luther Pass?

Übernachten hier. Blick droben am Dach - gibt es einen Mann im Fass so dass  du kannst die Fussen sehen

Übernachten hier. Blick droben am Dach – gibt es einen Mann im Fass so dass du kannst nur die Fussen sehen

10SEPT2013- VCS to Lee Vining via Bodie. We were given three options regarding rides before going down to Lee Vining. Jon and I went to Bodie, which is now a ghost town, but once had a population of 15000.  It is now a state park.  The ride was quite a climb, but three miles before the town of Bodie, the road turned into gravel. Unfortunately, the gravel was loose and irregular, making it very challenging to travel on.  Jon and I got shuttled to the town, but on return, the bicycle rack came loose, so we rode the last 50 meters of gravel. Quite a few people actually rode the gravel. The last 19 miles was a ride south to Lee Vining, a small town just below Mono Lake.   The only obstacle was Conway Pass, made most difficult by roadwork, giving large trucks and bicyclists the same lane to contend with.

Where the road to Bodie turns to gravel

Where the road to Bodie turns to gravel

The church in Bodie - as dead as the town

The church in Bodie – as dead as the town

Main street USA

Main street USA

The mines of Bodie

The mines of Bodie

The upper class part of town

The upper class part of town

Conway Summit

Conway Summit

Mono Lake view

Mono Lake view

Another view of Mono Lake more easterly

Another view of Mono Lake more easterly

11SEPT2013- Tioga Pass. This was a there-and-back experience. The climb was a little over 3000 feet, putting us right at the entrance of Yosemite Park. It took us 2 hours to climb, and a most beautiful experience. It was a steady 6-7% grade with a good road surface and adequate shoulder.  My only regret was that we didn’t continue riding down to Tuolomne Meadows, another 8 miles and 1500 feet of elevation back. Oh well. I had done the Pass from the other side on the Tacx trainer, and remember it more difficult than our experience today. It took only 1/2 hour to get down, also an awesome ride with minimal traffic.

The start of Tioga Pass

The start of Tioga Pass

The summit of Tioga Pass off in the distance

The summit of Tioga Pass off in the distance

A Lake near the top of Tioga Pass

A Lake near the top of Tioga Pass

Tioga Pass Lake

Tioga Pass Lake

Jon and I at the summit of Tioga Pass

Jon and I at the summit of Tioga Pass

The Sedona Kid (Norm) also makes it up Tioga Pass

The Sedona Kid (Norm) also makes it up Tioga Pass

12SEPT2013- Lee Vining to Mammoth. This included an appendage 1200 ft 5 mile climb up to a series of lakes sitting north of Mammoth. We took the scenic route into Mammoth, rather than the highway. Since we arrived in Mammoth early (about 11 am), Jon and I decided to head up to Lake Mary. It started to drizzle once at Lake Mary, and so returned to the RV camp in Mammoth where we were staying.

Lake on the June Lake Bypass

Lake on the June Lake Bypass

Deadman's Pass

Deadman’s Pass

Lake Mary

Lake Mary

13SEPT2013- Today was exploration out of the town of Mammoth.  Our first venture went toward the Devils Postpile, but stopped where one entered the park, where there was a great view of the Minarets. Afterwards, Jon and I decided to return to Lake Mary, and go beyond. Oddly, the climb today now seemed much shorter than yesterday, and we had the wonderful opportunity of Tom S. giving us a guided tour of the entire area around Lake Mary, including Twin Lakes, and Horseshoe Lake. Horseshoe Lake was unusual, in that seismic activity has caused carbon dioxide to come up from the ground and kill many of the surrounding trees.

Wandblumen

Wandblumen-Tom, Pete, Norm

Wandblumen at Horseshoe Lake

Wandblumen at Horseshoe Lake

14SEPT2013- The trip home. We were shuttled back to where our cars were parked today. The bus trip was a 4 hour venture. Jon and I promptly loaded our cars and headed home. We arrived in Puyallup at 0130 the next morning, a 13 hour drive through Susanville, Klamath Falls, Bend, Government Camp, and up I-5 to Puyallup. We were tired but had a great time.

Thoughts on the trip:

1. It was a delight to have time with Jon. We need to do this more.

2. The Adventure Cycle Association could not have done a better job at running this tour. The staff were all quite enthused about cycling, and the organization was impeccable. We had to make some unfortunate serious changes to the original route plan. This was in our best interest, and worked out quite well. I can highly recommend this trip (or any trip with the ACA). Special thanks to Melinda, Meredith, Cammie, Jerry, Don, and Bob, you all were fantastic!

3. Camera – The problem with the Canon EOS M camera is that in bright sunlight, it is impossible to see exactly what is being displayed on the screen. I guess I’m too used to looking through a viewfinder. Also, a better variety of lenses is imperative. I’m thinking that this camera is my best option for road biking. Perhaps the new Canon SL1 (super-light slr camera) with 18 mpx and a 18-135 mm zoom would be a lighter option for when I’m on my CoMotion. I’m not going to rush out and buy yet another camera, as I love my Canon 6D, but it is heavy, and best served with a tripod to give the best possible landscape photos.

4. Arriving back in Puyallup, I’m in the rain and again fighting cancer. It’s hard to return to reality. I always rode by bike in the rain and snow when I was a kid, so why is it a problem now?  Does everybody become soft when they become an old fart? This morning, I did the TacX trainer ride up the west side of Tioga Pass and konked out at two hours, drenched in sweat. I think I need another bicycle vacation.

Iron Horse Trail to Snoqualmie Pass

September 17th, 2013

IronHorse-3Iron Horse Trail over Snoqualmie Pass –

The Iron Horse Trail goes across much of Washington state, though it has its interruptions in various spots. The trail is a converted rail track, and is almost entire gravel, thus best meant for mountain bikes or fat tire bicycles. There are a number of tunnels on the trail, including the 2.5 mile tunnel under Snoqualmie Pass.

East side of tunnel

East side of tunnel

West side of tunnel

West side of tunnel

The trail goes over some of the existing railroad bridges. The sights are a beauty. The only problem with the trail is that it parallels I-90, so that one is always able to hear the roar of traffic off in the distance. Except for that, the condition of the trail is excellent, and it never goes over a 3-4% grade. One does need headlights for the tunnel, as it is pitch-black inside. The day that I rode the trail, the weather was good, and so there were many people on the trail. It appeared as though parents would drop groups of children off at the top of the trail (by the tunnel) and then pick them up at the bottom. Those poor children never had the opportunity of what was most enjoyable about the trail, which is the joy of riding UP the trail.

Railroad bridge

Scene of the mountains from the Iron Horse trail

Scene of the mountains from the Iron Horse trail

The Garmin data are as follows…

By the way, I also saw a number of touring bicycles going over the pass. I’m sure they were headed for the distant eastern Washington. I wish them happy trails in their journeys.

Cycling from Salem to Hood River

August 24th, 2013

SalemHoodRCycle-2

 

Salem, Oregon to Hood River, Oregon on bicycles with Aaron Hughes 21-24 August

Day #1 – Salem to Detroit
I stayed overnight with Aaron and Anita, so that Aaron and I could be on the road by 9 am. We took off, following the main highway out of Salem and across Santiam Pass. Our first stop was in Detroit.

The "other" Detroit, which is not going backrupt

The “other” Detroit, which is not going bankrupt

The Garmin map and stats of Day #1 are here…

We stayed in a motel in Detroit, and generally rested up that evening.

Day #2 – Detroit to Timothy Lake
This was the most challenging day, with over 6000 feet of climbing (according to the Garmin). The started at Detroit, heading up the Clackamas River Road past Breitenbush, until the turnoff logging road took us straight up to Timothy Lake. At Timothy Lake, I set up camp, while Anita met us and ran away with Aaron for the night. I camped out at the lake. I did my homework, and learned that the Cove Campground was intended for bicyclists and hikers. When we arrived there, it proved to be anything but that, and the campground hosts rudely informed me that I wasn’t welcome, since everything was full. Fortunately, there were three guys with their kids who immediately offered to let me stay on a corner of their campsite. I had a few beers with them, and offered them cigars. It was a nice evening. The photos were from the lake the evening and morning of my stay.

Riding along the Clackamas River road

Riding along the Clackamas River road

My one man tent and bicycle

My one man tent and bicycle

Timothy Lake

Timothy Lake

Timothy Lake

Timothy Lake

More Timothy Lake

More Timothy Lake

The Garmin data for day 2 are here

Day #3 Timothy Lake to Hood River
Overnight, it had rained quite hard, with thunder and lightning. I stayed dry, but most everything else got wet. I slept in a bit longer than I should have, since I knew I had to meet Aaron and Anita at the junction of highway 26 and 35. Putting away a completely soaked tent, I headed off at about 8 am, saying goodby to my kindly hosts. It was a rather persistent climb to our treffpunkt, but arrived only about 6 minutes late, feeling like dogmeat. I was really tempted to have Anita shuttle me to the top of Bennett Pass, but ultimately decided against that. I had already gone over Blue Box Pass, and we had two more passes to negotiate, that over Barlow and that over Bennett Pass. My legs hung in there, though I did have to walk short distances just to utilize other muscles. Here are photos of the day…

Summit of Blue Box Pass

Summit of Blue Box Pass

Mount Hood from the road

Mount Hood from the road

Meeting Aaron at the junction of 26 and 35.

Meeting Aaron at the junction of 26 and 35.

Barlow Pass Summit

Barlow Pass Summit

Aaron showing good form

Aaron showing good form

Mount Hood from White River

Mount Hood from White River

Aaron patiently waiting for the tortoise to catch up

Summit of Bennett Pass

Mount Hood from the fruit orchards of the Hood River valley

Mount Hood from the fruit orchards of the Hood River valley

The Garmin stats for day 3

Our grand total stats are as follows… total distance 165.89 miles, 12,651 feet of elevation gain, and minimally 7000 calories burned. The road would be rated as five stars from Stayton on, but maybe would have gone backroads out of Salem. The arrival into Hood River was also slightly off of our planned route, putting us into the heart of nasty traffic in Hood River. The entire trip had enormous beauty, and was a superb choice. So, we are already planning a trip for next year. If we could get a SAG vehicle, then Aaron and I will do the Pacific Coast starting in Astoria. We would ride lighter bicycles, and do more distance. We’ll see. In two weeks, I do an ACA tour with Jonathan on the east side of the Sierras, so you’ll be seeing a blog of that trip soon.

Adventures

July 27th, 2013

1. Adventure #1 – cycling with Aaron in the Willamette Valley 12-13JUL2013

Oddly, I didn’t get any cycling photos, as I didn’t want to carry a heavy camera along, and I was riding my new Gran Feuchto, which doesn’t have any racks.  You can see the course of the rides for each of the two days here…

a) Saturday

b) Sunday 

Here of some photos that were taken while NOT riding…

Aaron and I relaxing on the back porch

Aaron and I relaxing on the back porch

Aaron reading in the backyard Hammock

Aaron reading in the backyard Hammock

Anita in the garden. They have raised gardens.

Anita shows her green thumb in the garden. They have raised gardens.

The backyard greenhouse

The backyard greenhouse

Aaron built a shed in the backyard with an extension to hold a hammock. A MOST brilliant idea!

Aaron built a shed in the backyard with an extension to hold a hammock. A MOST brilliant idea!

2. Adventure #2 – Backpacking with the Flanagan Grandchildren to Summit Lake 19-20JULY2013.

I had promised Patrick and Sammy a backpacking trip this year, but wasn’t feeling in tiptop shape so decided on a shorter hike, 2.5 miles but mostly straight up. We decided that since the hike was short, we would also take Ethan. The kids were a total joy to have along, watching them discover the delights of getting out into the wild and discovering the unknown.

Summit Lake. The hill in the background is what we were standing on in the next photo.

Summit Lake. The hill in the background is what we were standing on in the next photo.

A wonderful view of Mt. Rainier from Summit Hill

A wonderful view of Mt. Rainier from Summit Hill

 

The loop around the lake without our packs on

The loop around the lake without our packs on

 

Patrick in great style. The kids were frequently preoccupied with the snow.

Patrick in great style. The kids were frequently preoccupied with the snow.

 

Massive fields of glacier lilies were noted. They grow only in a small region of the NW.

Massive fields of glacier lilies were noted. They grow only in a small region of the NW.

Tired children reluctant to wake up the next morning.

Tired children reluctant to wake up the next morning.

Three happy children and one happy dad at the end of the trip.

Three happy children and one happy dad at the end of the trip.

This was the first trip in which I was able to utilize my new camera, an EOS M. It is a mirrorless camera, with the same resolution and controls as most of the EOS rebel line, 18 MPixel, APC format, but with interchangeable lenses. Its action in focusing and taking photos is a little slow, which okay for mostly scenic and landscape photos. There is no flash, but I have a very small flash designed to work with the camera. One can also put a gps apparatus on the camera.

Canon EOS M.

Canon EOS M.

 

 

 

 

 

 

 

 

 

Dean Kenneth Crum

July 27th, 2013

Dean-1Dean Kenneth Crum, born 09JULY2013 to Doug and Diane Crum. Yet another grandchild, making it 8. He’s a real cutie, and well behaved. May he always grow in wisdom and strength and love for the Lord. Opa will need to take him on his first backpack trip, and help him enjoy his first cigar and beer.

Maiden Voyage of Gran Feuchto

July 11th, 2013

waffen-1Yesterday I picked up my new bicycle. It is a BMC Gran Fondo GF01. It has Shamal Campy wheels, Super Record Campy components (compact chainring, 12-29 cassette), Look pedals, Continental 4-season 700 x 28 tires.

I had extreme hesitation taking the bike out, since I really felt washed out on the last ride (see my last post), and hadn’t ridden at all otherwise since my right shoulder dislocated (again, see my last post). I also had not ridden hard in over a month, from before Jonny and I went to Germany.  I had visions of my wheels slipping out, and re-crashing. The memory of the e-bike incident stuck hard in my head with numerous flashbacks. So, I approached the ride with extreme caution. My highest speed was 64 km/hr. I purposely attacked a series of hills having 18-20% grade. I went a little over 68 km. The ride can been seen on my Garmin page

Assessment. . .

1. It’s the most comfortable bike I’ve ever ridden on. Many of the roads were in terrible shape, and the bicycle handled bumps quite nicely. The frame has enough give to give a smooth ride.

2. The handlebars were several centimeters closer to me than I’m used to. I’m not sure if that is good or bad.

3. Shifting is awesome.

4. I bicycle is very comfortable on hills. It has a slight tendency on the steepest hills to want to do a “wheely”, but the bicycle is also the most comfortable I’ve ever ridden while peddling in the standing position.

5. The bicycle has incredible response to pedaling. This was a most favorable feeling; when you kicked up speed, the bicycle was not sluggish in accelerating.

6. Downhill handling was comfortable. Though I could have gone faster, never did I feel the bicycle wobble or give a sense of instability.

So, I think it was a worthy purchase. I still love my Steelman, and will use both bicycles.

Adventures in up-state Michigan

July 7th, 2013

Michigan2013-18

Adventures in up-state Michigan, with Dr. Peter T.

Peter and I had been planning this trip for many moons now, down to minor details. Actually, most of the planning was actually done by Peter, and he did a most masterful job of it, even with the foibles that will be noted below. I had arranged with AirCaddy.com and shipbikes.com to get my Randonee touring bicycle back to Michigan. I didn’t want to take my better bicycle, the CoMotion for fear of anything happening to it untoward. The bicycle arrived in Harbor Springs in mint condition.

I arrived in Harbor Springs in far less than mint condition. Two weeks before I was to fly out to Detroit to meet Peter, I was in a bicycle accident. I went for a bicycle ride along the Orting Trail with Betsy, she riding her new Stromer e-bicycle, and me on another bicycle. She was experiencing some discomfort in her buttocks, as is usual when one climbs on a bicycle and rides for 15+ miles, and so decided to call it quits. I ran ahead to get the car. After coming back to where she was waiting for me, I decided to ride the e-bike home and let her drive the car home. Without thinking, I jumped on the bicycle and started pedaling before I was situated on the bicycle. The bicycle power assist kicked in unexpectedly and threw me quite violently down onto the pavement. I noticed some shoulder pain and pain in the side, but didn’t think much of it. I soon realized that I was a touch more injured that I thought. After a quick shower, Betsy took me to the hospital ER, where they found my shoulder in a subluxed (partially dislocated) posterior position. It was the same shoulder that I had anterior dislocated several times while rock climbing, and subsequently had a Bristow repair. It worked at preventing an anterior dislocation, but did nothing to stop a posterior dislocation, which can be a bit more serious. The ER doc got my shoulder back in, and during the next week, I discovered massive bruising over my entire right side, especially over my thigh and leg. I could barely walk. The ER doc told be to leave my shoulder in a sling, something which actually increased my pain, and so I removed it. When I arrived in Detroit, I was on Oxycodone and in serious enough pain that I was only sleeping 3-4 hours/night. Peter didn’t realize that he was taking a total train wreck on an adventure.

Peter was waiting for me at the airport, and our first stop that evening while driving up to Harbor Springs was at Frankenmuth. Frankenmuth is a little vacation village north of Detroit with a distinctly German theme. We stopped for German food, which was given to us in excess, but fitted the bill of being delectable. Quite late that night we arrived at Summerview, Peter’s vacation home in up-state Michigan. My bicycle arrived intact via FedEx (see shipbikes above) and was easily reassembled.

29JUN – trial run – we rode our bicycles from Harbor Springs to Petosky, and had lunch in Petosky before riding back. The weather was cool, but with very few clouds. The week before was quite rainy. Final preparations were made for our adventure. We did a short paddle kayak ride on the bay to help warm up our feet.

Peter in Petoskey

Peter in Petoskey

Summerview

Summerview

Summerview Inside

Summerview Inside

30JUN – Day #1, Harbor Springs to Beaver Island
The ride initially paralleled our ride yesterday to Petoskey, after which we headed south. After rounding several large lakes and crossing a small ferry, we arrived in Charlevoix in order to catch the ferry to Beaver Island which left at 14:30. Beaver Island by ferry took over 2.5 hours.

Boyne City, on Lake Charlevoix

Boyne City, on Lake Charlevoix

Peter in Boyne City

Peter in Boyne City

Ferry ride #1 of 5

Ferry ride #1 of 5

The Beaver Islander ferry

The Beaver Islander ferry

01JUL – Day #2, Beaver Island to Indian River
Because the ferry didn’t leave the island until until 11:20, Peter and I had some time to explore part of the island by bicycle. Most of the roads on the island are dirt roads, and not very stable, with a lot of loose sand and gravel. Once the ferry  brought us back to Charlevoix, the ride was at first the most beautiful of all along the lower lip of Little Traverse Bay en route to Petoskey. Past Petoskey, it was another story. Pickerel Lake Road was a bit hilly for my traumatized corpse, but then we hit some gravel road, which was truly not nice. Gravel can be fun to ride on, but this wasn’t. It was loose scree and quite unstable, while the last thing I needed was another fall. We finally made it to Indian River, and not having had lunch, had hoped for a restaurant or store close to our reserved cabin. The cabin ended up being five miles out of Indian River. We arrived there about 6 pm, and everything was closed. It was a resort with cabins beside a lake. It looked great on the website, and was quite adequate for us, but not exactly what the webpage pictured it as. Everything was closed, and dinner would have meant a 5 mile ride back into town. So, dinner became a whiskey sour, gummy bears, and a good cigar. We survived.

King Doug's place on Beaver Island

King Doug’s place on Beaver Island

The cycle route to Petoskey

The cycle route to Petoskey

 

Little Traverse Bikepath was well marked

Little Traverse Bikepath was well marked

02JUL – Day #3, Indian River to St. Ignace via Mackinac Island
The ride to Mackinaw City was quite pleasant, being either quiet country roads or well-graveled rails-to-trails paths. Cheboygan was our first stop for breakfast at Bob’s Big Boy. We then stayed on the highway to Mackinaw City, caught the ferry to Mackinac Island, and did the obligatory loop of the island by bicycle. Mackinac Island does not permit automobiles or motorized vehicles, and so there were many bicycles and horse-drawn carraiges on the island. It was a beautiful tourist trap par excellence, but that did not lessen the delights of beer and ice cream on the island. From the island, the ferry took us to St. Ignace, where we stayed at an old historic hotel, the Boardwalk, right across from the ferry terminal.

Breakfast with Bob

Breakfast with Bob

Ferry #4 to Mackinac Island

Ferry #4 to Mackinac Island

 

Mackinac Island street scene

Mackinac Island street scene

Mackinac Island horse carraiges

Mackinac Island horse carraiges

 

Ferry #5 - a fast ferry

Ferry #5 – a fast ferry

03JUL – Day #4, St. Ignace to Harbor Springs

We had breakfast at the hotel and headed off. They do not allow bicycles on the bridge, and so we had to identify an obscure point where one caught the shuttle. The Garmin map shows us doing a few loops in search of a wooded footpath that took us to the toll gate at the north end of the Mackinac Bridge. Back in Mackinaw City, we headed west along upper Lake Michigan to Cross Village. On the way, we encountered some beautiful sand dunes where we stopped for a rest. From Cross Village, the road went inland and hilly, but never steep. It was typical forest and meadow as is seen in upper Michigan.

Awaiting the shuttle to take us across the Mackinac Bridge

Awaiting the shuttle to take us across the Mackinac Bridge

04JUL – rest day, not doing much. I re-packaged my bicycle, as Peter went to pick up Tina. We went into town to watch fireworks. I felt like I was in a Twilight Zone episode, a thing of the past, with lots of American flags, and red, white, and blue banners decorating the homes. There were many families out for the evening, eating ice cream cones and walking the streets.

05JUL – sailing. Peter decided to get out the sail boat and go for a ride. Tina and I haplessly accompanied Peter on an adventure across the lake, having no clue as to how to sail a sailboat. Fortunately, Peter knew what to do, and we had a marvelous as well as very sunny time on Little Traverse Bay. It’s amazing how peaceful it is on a sailboat.

The boat

The boat

Admiral Peter takes the helm

Admiral Peter takes the helm with Tina watching

Full sail into the bay

Full sail into the bay

First mate Ken

First mate Ken

 

06JUL – it’s never easy to say goodby when one has had a great time. I was feeling better, and the bicycle ride actually removed most of my aches. The Detroit area had many boarded up homes, and the airport was rather empty. It was nice to see Betsy again as I hit down at SeaTac Airport.

Total Ride Statistics

Day #1  69.56 km, time 4:38, 467 meters elevation gain, 2265 cal, 15 km/hr average speed

Day #2 85.29 km, time 4:57, 665 meters elevation gain, 2658 cal, 17.3 km/hr average speed

Day #3 74.07 km, time 4:00, 345 meters elevation gain, 2086 cal, 18.8 km/hr average speed

Day #4 69.83 km, time 3:37, 569 meters elevation gain, 2353 cal, 19.9 km/hr average speed

Total 298.75 km  (186 miles), time 17 hours and 12 minutes, 2046 meters climbed (6713 feet), 9362 calories burned up just from riding.

It is interesting that it appeared that our performance seemed to improve day by day, and since I was slowing down Peter, probably suggested that I was recovering from the trauma several weeks ago.

 

Deutschland 2013

June 18th, 2013

Germany2013-107

Germany with Jonny


My first trip to Germany was in 2003, with Rachel and Diane. Now, I am here with Jonny.  We spent the last few months organizing this trip, intending it at first to be oriented around bicycles. That became logistically challenging, and so I needed to change the trip to focus on what I felt to be important. Our focus was on friends, the Reformation, and music, especially JS Bach.

25MAY-26MAY – the plane left fairly early from Seattle, stopping in Chicago for a five hour lay-over. We arrived in Dùsseldorf at 10 am on 26 MAY. We dropped off our luggage at the Schließfach in the Hauptbahnhof, found our way to the Altstadt and Rhein, had a Döner, picked up our bags, and headed to our hotel. We immediately crashed. Later, we walked back to the Altstadt for dinner. Herbert, unfortunately, had recent doggie problems as well as internet problems, and so we were unable to connect with him.

 

27MAY- Kõln – After having breakfast at the hotel, we wandered down to the train station, and hopped the train to Köln. It was a 1/2 hour ride, with the train leaving us right beside the Köln cathedral (Kölner Dom). After touring the church, we tried to go up into the towers, but that was no longer permitted. We spent much time walking the streets of Köln, going to the Minoritenkirche, where the grave of Johannes Duns Scotus lies. Jonny and I had a bier at the Früh Brauerei, and then walked across the Rhein on the rail and foot bridge, After eating, having a bretzen and Berliner, we headed back to Dūsseldorf. We again went for a walk to the Altstadt, stopping for a bier, and later a Döner. It was a full day!

Kölner Dom

Kölner Dom

 

28MAY-Heidelberg- We arrived at 10 am in Heidelberg. The hotel was immediately next to the train station, so I thought we could try to drop our bags off, since it would be a long walk to the city center. They ended checking us in right then. Jon and I then took off to the city. The main street was about 1.5 km from the train station, and is several km long, lined with touristy shops and restaurants. We visited the Heilig Geist Kirche, where Olivianis and Ursinis preached.  After crossing the Alte Brüche, we ascended a steep winding path called the Schlangen Weg, to come to the Philosophen Weg. We sat there for a bit, watching the clouds all disappear into a gorgeous day, philosophized, appreciated gorgeous views of the city, and then returned. The Heidelberg Castle was next on our list, a short climb from the Altstadt, and noting the moderate number of walls destroyed in the numerous wars that the town had to suffer through. After a bit more beer (Heidelberg beer of course), we retreated back to the hotel for a snooze.

 

Schloss Heidelberg

Schloss Heidelberg

29MAY- Leinach/Würzburg. Today was a busy day. After waking up early and hurrying to the train station, Jonny and I got on the train to Würzburg, transferring in Frankfurt. Hannes picked us up in Retzbach-Zellingen, and took us immediately to Festung Marienburg, the large fortress in Würzburg. Würzburg was uniquely controlled by an archbishop that was also a prince, called an Fürst-Erzbischoff. The fortress was immense and quite spectacular, one of the many homes in the Würzburg area for the archbishop. One of the chambers was a prison cell where the famous artist Reimenschneider was incarcerated for nine months for assisting in the peasants’ war. We returned to Leinach, and moaned over the absence of Herbert.  We then took off to dinner. This was at a hospital in Würzburg started in the 16th century by one of the rulers of Würzburg, the hospital being called Juliusspital. It was an amalgam of part of a medical school, the Röntgen institute (where x-rays were discovered, a hospital, and, to fund the entire venture, a massive (and I really mean massive) winery. After dinner, we toured the winery and then had a long wine-tasting session. The wines were completely superb. Arriving back home, we discovered with great delight that Herbert had arrived and was waiting for us. This ended up being a late night, chatting with Herbert and catching up on matters. The day was quite cold and rainy, and my only regret was that I did not bring my camera for the tour of the Juliusspital. It was like nothing you’d ever find in America, a large winery connected to a famous medical institution. Interestingly, the hospital was largely destroyed in WWII, and so the hospital moved down into the wine cellar until the hospital could be rebuilt. It was a most fascinating day.

 

Festung Marienburg in Würzburg

Festung Marienburg in Würzburg

 

Herbert

Herbert

 

Large Riemenschneider carving

Large Riemenschneider carving

 

Katja, Hannes, Herbert

Katja, Hannes, Herbert

30MAY- Today, we first took Gustav for a walk among the wheat and raps fields out in the countryside. We then took a long drive to Rothenburg, an old medieval city that is still fully operational, though entirely for tourists. On the way to Rothenburg, we stopped in a small church that housed one of the spectacular Riemenschneider carvings. We had dinner at Hannes and Katja’s, and enjoyed the Gemütlichkeit of good friends.

 

Rothenberg

Rothenberg

31MAY- Jonny and I took off early to the train depot, And had a comfortable ride from Retzbach to Würzburg to Fulda and finally to Leipzig. Here we met Carsten at the Bahnhof, checked into our hotel, re-connected for coffee, and then spent several hours at the Bach museum. Finally, we went to Carsten and Annett’s house for a barbecue. It was most wonderful, meeting up with the family again. While waiting for Carsten before coffee, we visited the Thomaskirche, where we were able to see a portion of a practice performance of Wachet Auf.

 

Jonny and I with Carsten

Jonny and I with Carsten

 

Rabea lights the bbq

Rabea lights the bbq

01JUN- Today was very busy with Carsten and Annett. We started out at a museum that documented the DDR years in East Germany. It was well done, and portrayed much of both politics and daily life in the DDR. We then went to Carsten’s parents for lunch and had rabbitt. It was very good. A mad dash to the church allowed us to enjoy a service with the Thomanerchor. They performed Jesu meine Freude, as well as Wachet auf. I got to chat briefly with the cantor Georg Christoph Biller afterwards; he is a very kindly humble man. We visited a large artificial lake outside of Leipzig, and then watched some football (FC Munchen v Stuttgart), and finally took a long walk downtown in the rain. It was hard to say goodby.

 

Thomanerchor in the Thomas Kirche

Thomanerchor in the Thomas Kirche

 

Jonny at the top of the Thomas Kirche

Jonny at the top of the Thomas Kirche

02JUN- Eisenach… Boarding the train early from Leipzig, we headed off to Eisenach. On arrival, we first headed to the church where Luther did many of his first sermons, located right at the city gate. We then headed off to the church where Luther also preached, but where JS Bach was baptized. There was a service going on, so we we unable to go into the church. We dashed off to the Bach Haus, where Bach was probably born. They had turned it into a museum, that had an excellent exhibit of his life and compositions. We then strolled on a forest path up to the Wartburg, where we experienced a tour in English. One of the first stops was the Elizabeth Kaminate, where the Saint Elizabeth from Hungary lived, and who Betsy was named after. It was the most beautiful room of the castle. The last stop on the tour was the Lutherstube where Luther translated the New Testament into the German language. We then headed back the forest path to the train station to Erfurt.

 

Bachhaus Eisenach

Bachhaus Eisenach

 

Festung Wartburg

Festung Wartburg

 

Lutherstube

Lutherstube

03JUN- Erfurt and Weimar. After waking up, we headed into the old town where we crossed the Krämer Brucke, the oldest bridge in recorded history in which shops lined the sides of the bridge. We went to the Augustiner Kloster where Luther became a monk, and saw rooms where he lived and prayed. This was a guided tour, though in German, and a little more extensive than the last time I visited with Herbert and Betsy. We then headed to the Erfurter Dom, a huge church, now Catholic again, on the edge of town. This was the largest church in town, though it only seats a few people. Next to it is the smaller but roomier St. Severus church. After having a Thüringer Bratwurst mit Brötchen, and Budweiser beer (the real Budweiser), we headed back to the train station, and went to Weimar. Weimar was a little more relaxed, with lots of Shiller and Goethe sites, the giant Palace that became the headquarters of the Weimar Republic, and a stroll in the park took us to the house where Liszt lived for a few years. We were ultimately exhausted, and headed back to the hotel, stopping for dinner on the way.

 

Erfurt  - the oldest ever built up bridge over a river

Erfurt – the oldest ever built up bridge over a river

 

Jonny sitting in Luther's spot in church

Jonny sitting in Luther’s spot in church

 

Luther's Schlafzimmer

Luther’s Schlafzimmer

 

Erfurter Dom

Erfurter Dom

 

Jonny enjoys a brat and Budweiser outside the Erfurter Dom

Jonny enjoys a brat and Budweiser outside the Erfurter Dom

 

Liszt Haus in Weimar

Liszt Haus in Weimar

04JUN- Lutherstadt Wittemburg. Today predominated in train travel. We got up early, hopped the train to Leipzig, and then transferred to go to Lutherstadt Wittemburg. A long walk into town gave us a nice glimpse at the historical sights of Wittemburg. Lunch was at a potato restaurant, that was surprisingly good. Our only great disappointment was that the castle church was under heavy reconstruction and thus not open. A long trainride into München put us into town fairly late in the evening. We checked into our hotel, did a quick dash into town, and crashed.

City square in Lutherstadt Wittemburg with Luther Denkmal

City square in Lutherstadt Wittemburg with Luther Denkmal

 

05JUN- Today centered on Schloss Nymphenburg. We walked into town in the morning, saw the Hofbrauhaus and Viktualenmarkt, and then headed on a very long walk to Schloss Nymphenburg. It remained a very impressive palace, after the style of Versailles, incredibly decorated and with massive gardens and elaborate grden houses. There is also a museum in the castle with sleds and carriages, that were stunning in their elaborate detail and artistry.

 

Carraiges in Schloss Nymphenburg

Carraiges in Schloss Nymphenburg

 

Schloss Nymphenburg

Schloss Nymphenburg

 

Grounds surrounding Schloss Nymphenburg

Grounds surrounding Schloss Nymphenburg

 

One of the buildings in the Schloss Nymphenburg estate,  intentionally designed to look like a ruined building

One of the buildings in the Schloss Nymphenburg estate, intentionally designed to look like a ruined building

 

Inside of above

Inside of above

06JUN- Salzburg is not in Germany, but right on the border, and I was able to use the Rail Pass to get us to this city. Going there was problematic in that a small portion of the track was under water, requiring a short interlude on the bus. Salzburg was as awesome as ever, with nice sunny weather. We walked by the Mozart Geburtshaus, but did not go in. We then went to the Festung Salzburg, the large castle that was inhabited by the Fürst-Erzbischoff of Salzburg. This gave incredible views of the city and surrounding mountains. We were back in München by 4 pm, and had dinner at the Hofbrauhaus.

 

Mozart's Geburtshaus

Mozart’s Geburtshaus

 

Salzburg from the castle

Salzburg from the castle

 

Jonny finds a friend

Jonny finds a friend

07JUN- Our last day in Germany was a relatively lazy day, with much walking but little strenuous exercise. Our first destination was the Alte Pinakotec museum, which held paintings of many of the old Dutch painters, including Rembrandt and a large Rubens collections, as well as many German painters, including Cranich and Dürer. The collection was quite awesome, and this museum is well worth a visit. We then went to the Englische Garten for lunch as the Biergarten close to the Chinesische Turm. It was a lazy walk home. That evening, we hopped the city trains to Rob and Jordan Rayburn’s house, and went out to dinner. It was nice seeing these two again, and glad that all is going well, though he is being deployed to Kuwait and she is due to have a baby in September.

 

Rembrandt painting in the Alte Pinakotek

Rembrandt painting in the Alte Pinakotek

08JUN- Home… unfortunately, we have to come home, and I was sorely missing Betsy. She happens to remain my favorite person in life. We had to wake up at 3:30 am, and then catch the S8 train to the airport. We flew first to Frankfurt, and then home, leaving Frankfurt at 10 am and arriving in Seattle at 11 am.

Next trip… hopefully it will be a bicycle ride. We should spend far less time in München, since it is the most expensive city in Germany. I’d like to explore more Southern Germany, the far North (Bremen, Nordsee, Ostsee), and Southeast, including the Schwarzwald, Trier, and areas around there. Hopefully, next time we can connect with the Fuch’s.

Oklahoma 2013

June 16th, 2013

Oklahoma-100

Oklahoma 11-14 APRIL 2013

This is a terribly late posting of a trip we did in April to Oklahoma. Since then, central Oklahoma, where we visited, has gone through some terrible tornadoes. Fortunately, it did not hit our friends. Our main purpose was to visit some old friends, Mark and Penny H. It was a wonderful trip, and always good to see friends that have been gone for a while. The flight was dreadfully long, needing to go through Houston, and thus us not arriving until late Thursday evening, and needing to leave early Sunday morning in order to get home in time for work on Monday. Our time was entirely focused around Mark and Penny. The first day was spent roaming their land, and going to walks.

The dog

The dog

Lindsey in the kitchen

Lindsey in the kitchen

The next day was spent with Mark and Penny downtown. We went out to dinner, and then toured downtown Oklahoma City. It was wonderful, as we did it in a horse and buggy. We even went to where the Oklahoma City bombing occurred. Nothing was left, as they removed the building and turned the square into a large park.

The buggy

The buggy

 

The horse

The horse

 

Place of the Oklahoma City bombing, with memorials to those who died

Place of the Oklahoma City bombing, with memorials to those who died

 

The presence of big oil in the city

The presence of big oil in the city

It was really nice seeing Mark and Penny again, and they will remain dear in our hearts. It’s nice to see their children growing up well, and maturing into young adults. Thank you, Mark and Penny, for the good time.

Oklahoma-103

 

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April 14th, 2013

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Noch ein Jahr vorbei

January 1st, 2013

Another year has gone by. The time is now for letter writing and receiving lengthy chronicles from your friends as to their activities over the last year. The chronicler must not only detail accurately the past year, but make life interesting enough that other people will be interested in reading the narrative. Bragging and hyperbole tend to force a loss of interest in the reader, yet is what is thought by the writer as the characteristic that makes the recall of a year interesting. I’ll try to avoid that. I’ll be following the rough outline from last year, so if last years’ post bored you to death, stop reading immediately and find something more interesting to gawk at.

Last year…

1. In March, the Miami breast cancer conference and SSO meeting both occurred in Florida close together, so I went to both. The Miami conference was a bore, and SSO conference in Orlando was fun, only because Peter Tate was there.

2. I went to Dayton with Russ in late April, and a week later to the ASBS with Betsy in Phoenix. Another ho-hum meeting was attended, though I did go to every talk and paid close attention to all.

3. June was spent enjoying Germany. Betsy went with, and got to meet Katja and Hannes, as well as Hille. We spent time with Robbie Rayburn and with Heinz and Debbie Fuchs. It was a super trip.

4. July had the occasion to do Eagle Creek with Patrick and Andrew. Later, Betsy and I flew to Iowa to see Alex and Rachel. It was a delight.

5. August was the month for Diane’s wedding. Herbert came to visit. It was a delight having him around. Herbert is like a brother. I can talk to him, have fun with him, ask him advice, yet he is not offended by our differences.

6. September was started with the plan to ride bicycles from Eugene to Missoula with Russ. For various reasons, the trip was terminated prematurely in Grangeville, Idaho. It has caused me to re-think how I do tours.

7. The first part of November was the trip of a lifetime to Israel and Jordan with Betsy. Dr. John Delancey was a wonderful tour guide and made the trip particularly interesting.

Each of these trips has a blog page that you could surf to, so I will not reiterate what has already been said.

Plans for next year…

1. Betsy and I hope to visit the Heins in Oklahoma in February.

2. I will be doing a bicycle ride with the ACA in Death Valley in March.

3. In late May, early June, Jonny and I will be going to Germany. The goal is mostly to visit the Bach sites with Jonny, as well as touch base with old friends.

4. I plan on meeting Dr. Peter Tate and Dr. Ara Pridjian, old friends from residency, in July, to ride bicycles in Northern Michigan. Peter may throw in some sailing, which I’d love to try.

5. In September, Jonny and I will be doing an ACA ride called the Sierra Sampler, riding along the east side of Yosemite.

6. I’ll throw some meetings in there.

7. I was invited to China to teach surgery and English. This is in the tentative stages, and so have no definite plan yet. Meanwhile, I am vigorously learning Mandarin. Ni hau!

Music, Reading, Bicycle Riding, etc.

As of 31DEC2012, I yet have 57 days, 15 hours and 06 minutes of “unheard” classical music to listen to. I have heard everything at least once, but am working through my entire collection. Last year, I had over 90 days of music, and have added 5-7 days of music since to the collection, which has been listened to, including the Teldec Complete Bach (reviewed previously). Betsy and I will spend several evenings a week watching movies. We worked through the Joan Hickson editions of Miss Marple, and should be reviewed shortly. We are working on the Poirot series now, and detecting patterns in the writing of Agatha Christie. We have also watched a large portion of the Tom Baker years of Dr. Who.

For reading, I have gotten to I Kings in the through-the-Bible read, starting in mid-November. I am also reading Charles Hodge’s Systematic Theology. A review will follow, but I will note that Hodge tends to address contemporaries that I have never heard of, making it less interesting than I had hoped. I am only about 20% through, so it might pick up. I wished to read Reymond’s systematic theology next, but was highly encouraged by Pastor Rayburn to attack Bavinck’s 4-volume set.  I’ll be reading more photography and photoshop books, and also want to have a slight mastery of Filemaker. That’s for next year.

Betsy and I made a fairly monumental decision to return to Faith Presbyterian Church in Tacoma, under the pastorship of Dr. Rayburn. It was a tough decision since we had friends at Resurrection Presbyterian Church, and appreciated the work of pastor David Scott. Going back to FPC gave Betsy and I the sense of returning home. There are those who might suspect a multiplicity of motives for our change of churches, but those suspicions would simply be conjecture that would probably not be true, so please do not read too much into our actions.

There are a few other details coming up in our lives that would be best recounted after they occur rather than before. We anticipate another grandchild with Diane, and look forward to the day when Rachel and Alex successfully adopt Lily. That will mean another trip for us to Iowa.

I now have an updated model of the TacX trainer (bicycle virtual reality trainer) in the garage which works better than the last, by not crashing so often. It has allowed me to use the bicycle I usually ride on to train, while giving me many strenuous, sweaty hours during the rainy season to still be riding my bicycle. The other “toy” of note has been my dream for a while. I got a Canon 6D for Christmas. I originally wished for a Canon 5DMarkIII, but the 6D had some options, such as gps, which makes it an ideal travel camera. It is full frame, and 20 megapixels. I hope to use my bicycle riding and hiking to be opportunity to get many more photos.

With Obama still in office, it has left some uncertainty regarding medicine. Medicare reimbursements are dropping by 29%, which means that we learn to live off of less, and consider other alternatives to medicine. With an insane tax structure, I have no interest in supporting Obama’s government, and so will take off as much time as possible to still maintain a surgical practice. Already, I am giving away nearly all of my abdominal cases, doing abdominal surgery only when I take call. ObamaCare has a way of taking the joy out of medicine.

 Pastor Rayburn last Sunday emphasized the wish that each of us grow stronger in Christ, and walk closer to Him. As I age, the days of my life look shorter and shorter. Rather than going out with a bang, I seek what John the Baptist said of Christ, “He must increase, and I must decrease”. That is my prayer for all that read this blog.

Thoughts on the Jewish-Arab conflict

November 29th, 2012

Having just gotten back from Israel, I seem to have stirred the ire of friends and relatives in my comments in support of Israel. So, I thought it best to not trivialize the topic and write a bit more in-depth about my thoughts. There was some correspondence on Facebook regarding these ideas, but I realized that the conversation had degenerated to thoughtless responses. Many people automatically form a party line, whether it be a Democratic party, Republican party, Ron Paul party, dispensationalist evangelical Christian party, and respond as such without thinking seriously about the situation.

First, there are a few definite points that I wish to make…

  1. I am not pro-Israel or pro-Jewish. I am not pro-Tazmania or pro-Madagascar. To a great extent, I am not even pro-USA, although I have pro-USA sentiments only in that this is my homeland.
  2. I am not pro-Arab, nor am I anti-Arab. Too many of my dear friends are Arabian, or Iranian, or Turkish or something of the like. The Jews tend to be better thinkers for intellectual conversation, but the Arabs/Iranians/Turks tend to be more enjoyable people as friends. It’s hard to be anti-Arab once you know a few of them. By the way, the term Arab is often confused with all Muslim mid-East peoples. This is a collosal mistake. Turkey and Iran, for instance, are NOT Arab. And, there are a large number of non-Muslim Arabs.
  3. I do not view Israel in an eschatological sense as referring to people in a homeland that is now referred to as Palestine. I am not dispensational, and do not consider the return of Jews to Palestine as of highthened significance or a reflection of the fulfillment of any prophecy, since I do not see the Jews as having found their Messiah.
  4. I am uncertain about the continued biblical significance of the city of Jerusalem. Is it the place where Christ returns? Does it remain special among the cities of the world in God’s eyes? I don’t think so.
  5. I find no good evidence to suggest that the Jews living in Palestine today are not descendants of Jacob, though not always descendants of Judah (thus, the slightly loose terminology, which I’ll persist in. I won’t use the term Judahite because I don’t use the term “Jew” to specifically refer to those from the tribe of Judah). There is exceedingly poor evidence that the “Jews” are actually a mishmash of Edomites and races other than people descendant from Jacob, and the evidence for British Israelitism is even worse.

I also have made various observations regarding the situation in Palestine…

  1. The news media often makes overt lies about the situation in Palestine, and often is exceedingly deceptive about the situation, usually always with a pro-Arab bias. It is nearly impossible to know the exact situation, and visitors to Israel will often come back with very mixed feelings about the situation. My sense of inability to know the truth of the situation has been criticised as being defeatist in suggesting that we can know no truth about the situation, thus not allowing us to make decisions about Israel. I agree, but, it is NOT ours to make decisions about Israel, as I’ll clarify later on.
  2. Arabs in Israel outside of Gaza are in a vastly better situation that Arabs anywhere else in the mideast. The average salary of an Arab in Jordan is $30 / month. The Arabs on the west bank has a vastly greater income, and this is true elsewhere in Israel outside of Gaza (I say that because I simply do not know the situation in Gaza). The Jewish situation has served the Arabs well, and many of them know and appreciate that.
  3. I am told that the current population of Israel is about 6 million Jews and 2 million Arabs. Many of these Arabs live outside of the west bank or Gaza and in Israel itself. There are many towns that are solely Arab, such as Cana and Nazareth. These Arabs are free to come and go as they please. Their land is not encroached on by Jews.
  4. There are a number of towns and locations in the West Bank that are completely off-limits to Jews except by special permission. These places include Jericho, Bethlehem, and many locations in the northern West Bank, such as at Shechem.
  5. Most of the Jews, as well as most of the Arabs, that I have gotten to know have had a desire for a peaceful resolution to the issues in Palestine. Neither group has had a strong desire to eliminate the other party. Most seem to express a bona fide desire for some sort of settlement of issues, even if it resulted in some personal loss.
  6. Unlike most Americans whose knowledge of history is shoddy, both the Jews and Arabs remember history. The Jews in particular have a very strong memory of the Masada, and swear to never allow that to happen again. They have a distinct memory of being cast out of Great Britain, Spain, Italy, France, Germany (the holocaust) and Russia. You can see this memory every day as you walk the streets of Jerusalem. They have a particular fixation on never loosing their homeland again.
  7. Hamas rhetoric has been defiant about challenging the Jewish right to their so-called homeland. Hamas has persistently stated their desire eliminate the Jews from Palestine. Hamas, if you’ve forgotten, has been voted in by the Gaza population in a democratic election.
  8. Many of the current Jews in Israel are descendant of those who came out of Russian, bringing the Marxist/Communist ideology with them, as noted in the formation of the Kibbutzim. External capital has been necessary because of this faulty economic ideology. Historically, much of the money has come from sordid sources, such as the Rothschilds. The Rothschilds seem to have promoted a number of European wars through their money lending, and have tended to seem more interested in profits than in peace. Whether they are a part of a vast conspiracy I’ll leave to others to decide, though the Rothschilds are on the lips of most conspiracy theorists.

A number of people have accused the Israelis of apartheid. Is that true? I’ve not been to South Africa to know and understand the nature of apartheid, but I fear the word “apartheid” might be used a bit too freely. Apartheid simply means separation on account of race. That’s a terrible definition in this setting, since it is mostly impossible to distinguish an Arab or Israeli by race alone. With their clothes off, they look alike! The real issue is cultural differences that separate the two factions. Arabs and Israelis dress differently, have different religions, behave differently, and have completely different goals and aspirations for themselves and for their land. If you wish to identify apartheid occurring, it must be on the basis of religion, economics, dress, or something else. Yet, isn’t that a phenomenon that occurs virtually everywhere in the world? Has Saudi Arabia, Iran, Iraq, Egypt, Turkey, Europe, or the USA ever been seriously accused of apartheid? Yet, all countries have very distinct separation based on personal attributes. You can’t go to China or Japan and expect to be treated exactly like a Chinese or Japanese. I haven’t seen anybody accuse China or Japan of apartheid. So, I suppose, something else is really meant.

Could it be that the Israelis purposely force an economic disadvantage on their Arab countrymen? I can’t answer that question. The facts are quite obvious that Arabs tend to flock to Israel from the surrounding countries of Jordan, Lebanon, Syria and elsewhere because their is a strong economic advantage to living in Israel. Gaza inhabitants want the borders open because of the economic advantage of the Jewish influence, and wish to work and recreation in Israel proper. So, it is possible that the Arabs are relatively disadvantaged as compared to Jews, yet distinctly advantaged as compared to their treatment in other Arab lands. There are many stories of Israeli atrocities on the Arabs, and I suspect that many of them are true. Yet, it is difficult to be in such a removed position to act as the final arbitrator and judge on the situation. We are presuming too much! So, apartheid simply is a false accusation.

A pressing question is, whose land is it? I refer the reader to a documentary analysis of the land question in the book From Time Immemorial by Joan Peters. By strictly historical standards, it belongs to the Canaanites, since they owned it first. The Canaanites no longer exist. Philistines had a long occupation of the land, but they were invaders. The Israelites (and now Jews) have had the longest possession of the land, yet it was given to them by God on a conditional basis, which they have not met. The land was forcefully taken from them in a manner that defies description. The Muslims were invaders. Christians briefly owned the land during the Crusader era. The Ottomans (Turks) were the last owners before the British took occupation of the land. So, a historical precident goes weakly to the Jews. From a population point of view, during the Ottoman occupation, almost nobody lived in the land. Migrations began at the beginning of the 20th century, but these migrations were not natural, with the British forcefully blocking Jewish immigration in a near Nazi fashion. Even still, by 1948, there were approximately equal number of Arabs and Jews in the land. So, population itself does not answer the question. The West Bank was last owned by Jordan, who never had a longstanding right to ownership of that part of Palestine. The same goes to Egypt and the Gaza strip. The Golan is not heavily occupied, and mostly by Arabs that are disenfranchised from the Muslims of Syria, who (Syrians) also have no longstanding right to ownership of the land. TE Lawrence promised all of Palestine to the Arabs for their assistance in fighting the Germans, a promise made singularly and immediately not withheld by Great Britain, who also has no longstanding right to the land. On a simple land basis, Arabs own large portions of land within Israel proper. If Jews don’t belong in the West Bank, does the reciprocal idea hold true? Should the Jews force the Arabs out of Israel proper if the Jews are forced out of the West Bank? Jewish settlements in the West Bank have for the most part been purchased lands, and not “stolen” or booty of war, as the news media would lead you to believe. Perhaps the real apartheid is being forced by the Arabs on the Jews!

What is an appropriate military response of the Israelis to an attack on their area of Israel? Most people would respond that the Israelis have a right to respond, but that it needs to be a measured response commensurate with the destruction of the attack. Statistics are often given that show much greater damage and lives taken out by Israelis than by the Gaza Arabs. Two issues need to be clarified. First, when rockets are fired on a civilian population and statements made by the Palestinians that they intend to eliminate the state of Israel from the map, that does not sound like an act of terrorism, but rather, a declaration of war. Since when does a war limit the response of either party to commensurate damage? Secondly, the Palestinians have intentionally placed military operations in populated centers in order to stir an international reaction. The dupes are those Westerners who fail to take these matters into account and utilize the statistics for  precise analysis of the situation, and not emotional knee-jerk opinions.

I object seriously to the US response to the entire situation. Those who know me know that I am a Ron Paul supporter, and that I support his stance of aggressive non-intervention in the entire situation. I don’t always agree with the rationality of Ron Paul, but I do agree with his ultimate conclusion here. Ron Paul comments that we should should immediately cease and desist from supporting every faction in this conflict. I couldn’t agree more. Why are we sending millions of dollars into Israel, millions in Gaza, millions into Egypt, millions into Syria, and millions more into the other nations in the mid-east. Is this not serving the opposite of its intended purpose, by not forcing all parties to a more amicable solution.

Why has the church not developed a peaceful solution to the situation? Why have we not had our brightest and best thinkers propose solutions that would promote the Kingdom in the states of the mid-east? Why have we not insisted on non-military solutions? Where are the missionaries that could be streaming into these nations that need a true answer to the dilemma? Doesn’t Christ suggest that peacemakers are the most blessed of all people? Or, do we persist in the military rhetoric of the last 100 years that can peace comes through war? Hasn’t the last 100 years taught us that war only begets more war? If we honestly feel dispensational enough to think that the land of Palestine belongs to the Jews and that they need to re-conquer the land as Joshua through David did, are we willing to concede that genocide to wipe out the “heathen” populations of the land, as Joshua was commanded to do, would be appropriate? Or, do we find it strange that David employed many military personnel that were not Israelites! Perhaps you haven’t noticed that Bathsheba’s first husband was Uriah the Hittite, and he was listed as one of David’s mighty men?  Or, that David would sacrifice Israelites to avenge the wrongful deaths of Gibeonites, who were Canaanites? Clearly, the Scripture points to a higher ethic than just the preservation of a race.

The bible does ask Christians to do three responses for Israel. The first is to pray for peace in Jerusalem. When was the last time you did that, or the church specifically got together to pray for peace among Arabs and Israelis? Secondly, the church is to act as a peacemaker. When was the last time the church refused to take sides in the Arab/Israeli conflict in order to truly seek for a lasting peace? Thirdly, the church is responsible for promoting the kingdom. When was the last time the church considered bold responses in bringing the kingdom of God to Palestine? There are many Arab Christians, and a few Israeli (Jewish) Christians. Have we supported and prayed for their ministries? Have we fought for their freedom to deliver the gospel in Israel? It is said (I can’t verify it) that Israel is very restrictive to Christian missionaries—when was the last time the church filed a formal complaint to the US state department regarding this? Perhaps we are not quite so interested in peace and promoting the Kingdom of God as we’d like to think!

In conclusion, we Americans are poor arbitrators of the situation in Palestine. Our information is unreliable, and there are too many forces at play that we cannot account for. Besides, it is not ours to arbitrate and side one way or another. We must ask ourselves for biblical “Christian” solutions, and those solutions will be the most radical of all. The Arabs as well as the Israelis need Christ, and if that isn’t our highest priority and concern, then we’ve lost it.

Jordan-Israel Adventure Part 1

November 26th, 2012

Jordan/Israel Tour

Here is at last a brief summary of our Jordan-Israel tour. We took many photos, over 1300 actually, so only a few will be shown. Because of the length of this, I decided to split it up into three parts, published in reverse chronological order to make it flow normally.

Day 1/2—awoke at 3:30 am to get ready to go. We got to the Seatac airport by 6 am, and was hassle-free getting on the plane. The flight toDulles-Wasghington DC was 4.5 hours, and we then got to meet our companions. We lost three hours from jet-lag. The flight to Wien was overnight, an 8 hour endeavor, with another 5 hour jet-lag loss. The final trip from Wien to Amman was another 4.5 hours, 2 hours more jet-lag loss, and we hit Amman a bit tired, but ready to tour. Our first encounter was with Mo, who would be our guide for the Jordan duration of the tour. He was superb. We had dinner buffet style in the hotel, took a walk around town, and then crashed.

Day 3—awoke at 5:30 for breakfast at 7. We needed to be completely packed for breakfast, since the bus left immediately after breakfast., Our first stop was at the excavasion of  the large Roman Decapolis city of Jaresh, just outside of Amman, it was rather impressive for its size.

Mo

Amphitheater at Jaresh

Part of the group

From there, we went on to Mt. Nebo, where Moses viewed the promised land, The sky was a bit hazy, so you couldn’t see the best’. Jerico and the plains of the Jordan River stood out. The evening ended with a long ride through the desert in darkness to our hotel at Petra. A few people took a night walk through Petra, but Betsy and i decided to lay low and catch up on Jetlag.

 

Foggy view of Jericho from Mt. Nebo, standing exactly in the spot where Moses stood.

Day 4 Petra—  We were up early for our Petra adventure. They did a light show walk the night before, but Betsy and I turned it down. Petra is much different than I imagined. The Treasury is the most famous building, known to Indiana Jones fans, but the narrow passage is much longer than I thought,, and goes way beyond the Treasury. Betsy and I went beyond, up to the Monastery, where one could see the Negev, and the whole region. I also climbed up to another site, which was called the high place, where the Petra folk would hold sacrifices. It was about 15 miles of walking, and most of that was climbing, but well worth it.

 

Begin of the walk into Petra

Graves on the way into Petra

The walk into Petra, not with Indiana Jones but with Washington Betsy

The Treasury – actually a mortuary site

Camels guarding the Treasury

Trail up to the Monastery

Jon, Betsy, Lynn, Peta, and Ward resting from the climb

Still climbing

A view from higher up the Monastery trail

The Monastery

A marvelously beautiful lady waiting for me on top

Man with Hooka on the trail

Donkey on the Trail

Day 5—Aqaba and the Red Sea.  From Petra, we headed south on the main trade route across the mid-east, headed toward Aqaba. Half-way there, we stopped for a truck ride into the desert at Wadi Rum, made famous by Lawrence of Arabia. There is actually a mountain there called the seven pillars of wisdom. We stopped to visit some Beduins and buy tea from them. We Finally made it to a fancy Radisson hotel in Aqaba and enjoyed the sunset. We also learned of Obama making it a second term.

Seven Pillars of Wisdom in Wadi Rum

Desert Jeep ride

Bedoin Tent

The Desert

Betsy loved the camels

 

Aqaba, the Red Sea

Continued in Part 2…

 

Jordan-Israel Adventure Part 2

November 26th, 2012

Day 6—we took off from Aqaba to the Dead Sea by a circuitous route. The crossing into Israel demanded a change in buses. Our first stop was at the southern copper mines, with the pillars of Solomon. They had a mockup of the wilderness tabernacle here. We then traveled northeast to several very large craters south of the Negev. I was fairly overwhelmed by the irregularity of the landscape. I have no idea how Moses with a million plus people could have made it through. We stopped at the grave of Ben-Gurion,and was able to overlook the valley of Zin, where Moses sent out the spies to the land of Canaan. Finally, we made it to Dead Sea just as the sun was going down.

 

Temple mock-up

Overview of tabernacle

Wilderness of Zin

Day 7—An early rise and breakfast was followed by travel along the west coast of the Dead Sea. First, we stopped at the Masada, where in AD73 a group of Jewish zealots were finally brought to an end by the Romans building a massive siege ramp up to the fortress. This was followed by a hike up En-Gedi, where David encountered Saul in a cave. We stopped at Qumram, the site of discovery of the Dea Sea scrolls. Finally, there was a stop at the archeological dig at Jericho, where one could see the fallen walls of the old city. By then, nightfall had hit, and we drove up in darkness to Tiberius on the Sea of Galilee for our hotel.

 

Cable car to the top of the Masada

The cliffs off the top of the Masada, overlooking the Dead Sea

The Springs of en-Gedi

Rock Coney, at En-gedi

Jericho ruins

Day 8— This was a busy day. It had started raining, so that everything was quite muddy. We started out by going to the top of Arbel, a peak with a very steep cliff, and a similar adjoining mountain with a narrow canyon between.  It is in this canyon that the road from Nazareth to the Sea of Galilee runs. We then went to Yardinit, where they have a commercial production of getting baptised or re-baptised. I was a bit astonished to find that Betsy and I were the only people in our group that said no to this. It is like suggesting to get re-circumcised. It cheapens baptism to a simple show or action that we do. Anyway, from there, we traveled to the town (excavation mostly) was Magda, which used to be one of the larger cities on the Sea of Galilee and from where Mary Magdalene came. Traveling north, we saw a boat which had been discovered in the mud of the sea of Galilee, and showed what a typical fishing boat it Jesus’ time looked like. We went out a short ways on the sea in a wooden boat, a form of crass commercialism that they called the Jesus-boat. We went up to the mount of the beatitudes, and, first avoiding the “church” the Papists built in the 1930s, but rather sat on the slope where Jesus probably gave his sermon. It was interesting that the stony ground of basalt amplified the voice in that area so that one could speak to a large crowd and be heard. Going inside the church was a small comedy that was more an idol to the Papists than a reverential area. We last went to Caperneum on the north side of the sea of Galilee, to see the synagogue where Jesus taught, and to see the alleged house of Peter. The Papists built a giant flying saucer over the home to protect it, which they also called a church. Back to our hotel in Tiberius, we were a little exhausted, enduring many crowds and a constant rain.

On top of Arbel, overlooking the Sea of Galilee

Tree and beautiful Frau on summit of Arbel

It rained all day, leaving a very wet John

Drei Engeln am Jordan Ufer

Schöne Frau am Jordan Ufer

On the Sea of Galilee looking back at Capernaum and Arbel

Slope where Jesus probably taught the sermon on the Mount

Unmasked caped crusaders at the Beatitudes mount church

Day 9—    And yet another very busy day. I hope I can remember everywhere we went! We started by heading north of Tiberias into the Hula valley. On the right, you could see the hills of Naphthali, which border Lebanon. We visited the archaeological dig at Dan, seeing mostly Old Testament history, notably the high place that Jeroboam created. From there, we headed up into the Golan Heights, stopping at Castle Nimrod, a Crusader era Castle built by the Muslims, and fortress on the Damascus Road. We skirted the side of Mt. Hermon, stopping at a Nature Preserve of one of the three sources of the Jordan River. We drove up to the top of Mt. Bental,  where we were able to look onto Syria. There had been some Syrian fire toward Israel yesterday, and as we left the mountain, we saw two attack helicopters flying over us, only to learn later that there was more fire toward Israel, and that Israel launched a retaliatory return fire. We visited a partially restored Talmudic house from the time of Christ, and then an olive oil factory. Lastly, we stopped by the ruins of Bethsaida, home of Philip and Andrew, and probably where Jesus performed the miracle of the feeding of the 5000.

In the area of Dan, at one of the three sources for the Jordan River

The high place at Dan, built by Jeroboam. The metal frame attempts a reconstruction of the possible form of the high place.

The entrance of the ancient Canaanite city of Dan. Abraham probably walked through this portal.

Schlomo on Mount Bental overlooking Syria

Day 10—  It was sad leaving the peaceful serenity of the Sea of Galilee. We drove through the town of Cana, which is now a fairly large town, and skirted Nazareth, an even larger town. We did not go into Nazareth itself, since nothing there resembled what might have been found in Jesus time. Instead, we went to the precipice outside of town, a very steep cliff that drops off into the Jezreel valley. It gave a great view of Mt. Tabor, Mt. Gilboa, and the whole Jezreel plain. You could also see where the town tried to through Jesus off the cliff. We ventured from there to the Archaeological digs at Mediggo, having both Canaanite as well as Solomonic and post-Solomonic findings. The next stop was the top of Mt. Carmel, where Elijah challenged the prophets of Baal. Traveling down the coast in the plain of Sharon, we arrived in Caesarea, a town with harbor. Built by Herod, and visited often by Paul, but also where Peter met Cornelius.  We arrived by nightfall in Jerusalem, where we took a walk that evening into the old city, and  visited the wailing wall. We wailed.

 

Mount Tabor and the Jezreel Valley from the precipice

Jezreel valley looking back to Nazareth from Mt. Carmel

Remains of seaport at Caesarea

Mediterranean Sea from Caesarea

Aqueduct which brought water to the city of Caesarea

Continued in Part 3…

 

Jordan-Israel Adventure-Part 3

November 26th, 2012

Day 11— yet another hectic day. We started in the old city of Jerusalem, first visiting the pools of Bethesda, and then wandering through the via dolorosa, visiting the stations of the cross. Unfortunately, much of what we saw were just churches built over sites, or small patches of the real thing underground, and thus not realistic. After lunch, we proceeded first to the Herodian, a massive fortress like the Masada, built by Herod as an escape, and probably in view of Mary and Joseph from Bethlehem. We went to the shepherd’s fields, and then into Bethlehem itself. This was a massive zoo. We skipped the alleged manger site, and visited right next door the church holding the study room and grave of St. Jerome. I have a deep admiration for Jerome. We came home tired but with a rewarding day.

Garden of Gethsemane – old olive tree

Bethlehem from the Herodian

John in the Shepard’s cave – where the angels announced the birth of Christ

Tomb of Jerome

Day 12—More Jerusalem today. We started with the western wall, then took a walk underground where the western wall was being excavated.  We then went to a museum that had a large mock-up of the second temple. In that museum were pieces of the Dead Sea scrolls on display as well as the Aleppo book. The next stop was a holocaust museum, very moving but very Jewish in its sentimentality. The last stop was very notable in that our tour guide, Schlomo, took us to his brother-in-law, who is an orthodox Rabbi and scribe, who demonstrated how he would hand produce the Torah on parchment, which would take him over a year to accomplish. Everything had to be kosher, including the paper, the ink, the writing utensils,  no letter could touch another, and no letter could be either too tall or too short. We arrived back at the hotel happy from a full day.

 

Wailing

More wailing

And more wailing

Tree at Holocaust museum dedicated to Corrie Ten Boom and family

The Scribe

The scribe scribing

Day 13— Our day started with a scheduled tour of the temple mount, only to discover that it was an unexpected Muslim holiday, and thus it was not open. We retreated, toured the old city of David, and watched a 3D movie which made it super-clear where David’s city sat. Over the years and many changes to the city walls, the terrain has become somewhat unrecognizable, and the old Canaanite city of David actually no longer sits in the city. We got to walk through hezekiah’s tunnel, and saw William’s shaft, which it perhaps how Joab’s army got into the city. Our focus then turned to the sewage system of the Tyropean Valley, over which Robinson’s arch stood and where merchants lined the paths. We looked at the southern walls, the stairs leading up to the entrance of the temple in Jesus’ time, and was how Jesus typically entered the temple. We made a mad dash to Gordon’s Golgotha, a convincing site, through Christ was probably crucified below the cliff, and not on the hill. The garden tomb also seemed convincing contrary to the official catholic site. The best archeological evidence still favors the Catholic site, according to Dr. John. We took it easy in the evening, preparing for one last day.

Descent into Hezekiah’s tunnel

Walking Hezekiah’s tunnel

The steps to the pool of Siloam

Bar Mitzvah family at Wailing Wall

The stairs to the southern Gate, where Christ probably entered the temple

A strange couple lurking in the Old City of Jerusalem

Day 14- This was a free day, and we spent our time wandering through the old city. We tried to walk the walls of Jerusalem, but it was off limits since it was Friday. We went up to the top of the Lutheran church (Kirche unser Erlöser) for a great view of the city. The remainder of the time was spent relaxing. That evening, I took a taxi with John and several other people up to the top of the Mount of Olives, and then we walked down, walking past the Eastern Wall and back to the hotel.

Tomb of Jehosaphat and Absalom

The Golden Gate, sealed by the Muslims to prevent the Messiah from entering

The Golden Walls of Jerusalem

Israeli police guarding the temple site from loonies

 

 

O Jerusalem, Jerusalem… how often I would have gathered your children together…and you were not willing. See, your house is left desolate. For I tell you, you will not see me again, until you say “Blessed is He who comes in the name of the Lord”.

Day 15- It was a long flight home. Our plane out of Tel Aviv was a bit hurried when they learned that there was rockets coming in from Gaza. Since we were gaining 10 hours from the flight, it seemed to take forever to get back home. But, all went well and we were grateful to be back in our own comfortable surrounding.

Thoughts on the trip…

The trip was a perfect overview of the Holy Land. John was a super leader, and I would heartily recommend him to anybody considering a trip to Israel, Jordan, or elsewhere in the mideast.

Things that we would have liked on the trip include…

1. A little less busy pace. Some excursions could have been edited out. We barely had time to enjoy the situation. We usually arrived at the hotel after sundown, making enjoyable visits to the Dead Sea and other spots an impossibility. Also, I was interested in just seeing the lay of the land from the bus, but often the travel ended up at the end of the day in darkness, making it impossible to fully appreciate the land.

2. The Israel part of the trip was a little too heavy with the orientation around modern Jewish affairs. Some sites were nice, but there was perhaps too much, with visits to David Ben-Gurion’s grave, Rachel’s grave, the Holocaust museum, etc. Instead, many biblical sites were completely ommitted, including Beer-Sheva and Hebron, the Sheffela, Bethany, the Jericho Road, Shechem and Mt Gerizim/Ebal, etc. It was supposed to be a Bible lands tour, not a modern Israel tour.

3. Egypt. We initially signed up because the trip included Egypt. Then, the Muslim Brotherhood went on the rampage. Oh well. Maybe someday.

What we liked about the tour far exceeded any criticisms. These included…

1. John was very knowledgeable about the land, the archaeology, and the scriptural correlates to what we were seeing. He was a superb teacher. He watched his orientation so as to remain doctrinally neutral on some touchy subjects like eschatology.

2. The hotels and facilities, the bus, the meals, the guides were all first class. It could not have been better planned.

3. John was adept at bringing in biblical lessons to the places we visited. He had a heart for worship while on tour, being able to bring glory to God by pointing to us scriptural correlates in what we saw.

This trip gave me new insights in several ways…

1. It made historical reading of the narratives involving the land of Israel more clear. I could understand the idea of Jesus being led out of Nazareth to be thrown off a cliff. I could understand the sermon on the mount context, the sea of Galilee experiences, the wanderings of David while watching sheep in Bethlehem, the difficulty of Abraham chasing the four Mesopotamian kings from Beer-Sheva to Dan and beyond.

2. I used to read the Bible through every year, but haven’t for several years. This generated interest in again committing the Scriptures to a cover-to-cover read. Historical sections make more sense.

3. Learned more about the Arab-Israel conflict, much from an Israeli viewpoint. I’ll speak more about Jews vs. Arabs in another blog.

4. Insights into the spiritual condition of Israel.

a) Arabs – hard to judge. They have prayer towers virtually everywhere, including throughout the Jewish and Christian quarters of the old city of Jerusalem. You can’t go anywhere in Israel without seeing prayer towers. Having religious control of the temple mount (the Israelis have military control) leaves Arabs in control of the ultimate religious say in the country.

b) Jews – they continue in the sins of the time of Jesus. The reason they remain in their current state reflects their inability to acknowledge their Messiah. Perhaps their religious orientation is even more intense for ritual than ever. Their worship of the old temple wall is disgusting. They remain lost.

c) Christians, including all sects of Christians, pose a new form of idolatry, the idolatry of place. Is there not perhaps a reason why God allowed the sites in Israel where history occurred to be lost? Whether it’s identifying the cave of Machpelah to the site of the crucifiction, we really don’t know. Yet, so many sites are worshipped and venerated, like the “site” of the nativity, the “site” of the burial of Jesus, the “site” of the sermon on the mount, to name just a few. Protestants have the same failing, feeling that a baptism in the Jordan River confers something special. In the end, they make a mockery of the significance of baptism. So one “walked today where Jesus walked”, talked where Jesus talked,  fished today where Jesus fished, or ate today where Jesus ate. The importance is on the person and not the place.

5. Desire to pray for peace in Israel. Every solution proposed fails. Fund Israel more. Quit funding Israel. Exterminate the Palestinians (that’s right, I heard this solution offered by a member of our group). Send the Jews to Antartica. Get both sides talking. Be nice. Etc. Etc. Etc. Virtually every solution is a fantasy land of wishfulness, that everybody would just love each other. Make love, not war. It won’t happen until the prince of Peace returns in the clouds, where every eye will behold him, and all tribes of the earth will wail on account of him. Even so, AMEN! (Rev 1:7) For now, we pray for peace in Jerusalem, and that the tribes of Israel will acknowledge their Messiah, the Messiah of Jews, Muslims, Arabs, and even Germans.

A black day for cycling

October 22nd, 2012

Sir Lance-a-Lot Lost was stripped today of his seven Tour de France titles. Such is a black day for a great sport. Thankfully, the European Cycling Commission (UCI) decided against awarding anybody the title for those seven years, since most of the riders in second place had also been accused or highly suspected of doping. Sir LanceLot is not the first knight fallen from the Round Table, and probably is not the last. The black day is not for Lance, though I’m sure he will experience massive depression over this news. It is for a sport that has placed inhuman demands on people, not only in the Tour, but so many other bicycle races that have been contrived, including the RAAM (ride across America). Riders will continue to devise techniques of enhancing their performance in an artificial fashion. Cheating will then rise to new levels.

The evidence against Armstrong is overwhelming. I won’t belabor recalling the evidence since the USADA has done that quite well, well enough to convince the UCI that he was worthy of being stripped of his titles. There are good arguments against taking away the titles. After all, Lance was a formidible athlete. One can detail the brilliant strategies that Lance often used to win those titles. Yet, to not act decisively will forever color the sport as doping-permissive, and where it is so pervasive, such radical actions are necessary and should be lauded.

Lance appears to the public as their type of hero, winning in the face of the worst adversity (cancer), pushing on through honest determination to succeed and conquer. His friends feel otherwise, that is, what few friends he still has. When one looks at the entire life of Lance, there never was a time when Lance and his public persona were even close to matching. Lance was always a “win at all cost” person, somebody who would run over his own mother to win a race. His arrogance and ruthless striving had no morals and no bounds. Is this what we want to see in an American bicycle hero? I don’t think so. It is unfortunate that most of life in American culture is now with the Armstrong persona. There is no aspect of life that is not affected by the American-Armstrongian win-all mentality.

As far as we can tell, Einstein did not dope. Nor did he win the Tour-de-France. Such were the better years of cycling, when the sport could be enjoyed, and when exercise and entertainment could be mixed together into one grand activity. The bicycle is one of the more fascinating intentions of the 19th century, and it is not surprising that the airplane was invented in a bicycle shop. There is no other device that better promotes fitness, efficiently harnesses energy for movement, is mechanically simple and inexpensive, doesn’t pollute, is orthopedically gentle on the body, can be ridden at all ages, and has a plethora of uses outside of exercise and leisure activities. Like all good things, they can also be abused and used for evil intentions. That is the curse we live under, that we cannot be happy with the goodness of life, but must always pervert it or destroy its good intentions. There is one race worth running, and is spoken of by an anonymous preacher man, saying “Therefore, since we are surrounded by so great a cloud of witnesses, let us also lay aside every weight, and sin which clings so closely, and let us run with endurance the race that is set before us,  looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross, despising the shame, and is seated at the right hand of the throne of God.” Hebrews 12:1-2. Drugs and performance enhancement medications are unnecessary in the race that we confront, and the prize far greater than a silly little Tour-de-France title.

 

Laverne Swanson Rayburn, R.I.P.

October 14th, 2012

Betsy and I have just returned from the funeral for a most remarkable person, the mother of our pastor. I wondered who would be officiating the funeral, since I never thought that a pastor would perform the funeral service for their own mother. Yet, Dr. Rayburn noted that he also did the funeral for his father as well as his oldest sister. The sermon was remarkable in that it not only honored mom, but reminded all of us how we are all new creations in Christ with personal exhortations.

Laverne was a special person in our life. We met her when she moved to Tacoma from St. Louis, Missouri. Her husband was the founding president of Covenant Theological Seminary, but died in 1989, leaving her a widow for 23 years. She moved to Tacoma in 1999. She would hold coffee clatches for women, of which Betsy often went. She was always at church, sweet and friendly, but motherly in her firmness to what was right.

Laverne had a life that was mostly quiet and behind the scenes. Yet, the number of people that she influenced in her life is difficult to count. I think of the great influence that her husband had on the world, in establishing Covenant College and Covenant Seminary, in forming the PCA denomination, in commissioning and sending Francis Schaeffer to Europe, in influencing countless students that attended Covenant Seminary and are now pastors or leaders in church and society. Little of that influence would have happened if it wasn’t for Laverne being there.

To the family, including the children, grandchildren and greatgrandchildren of Laverne, Betsy and I offer our deepest sympathies. The loss is only assuaged by knowing that she is with the Lord and we will all too soon be with her also. To Laverne I offer a song often sung at German funerals, and a favorite of mine…

1. Wo findet die Seele die Heimat, der Ruh?
Wer deckt sie mit schützenden Fittichen zu?
Ach, bietet die Welt keine Freistatt mir an,
Wo Sünde nicht kommen, nicht anfechten kann?
Nein, nein, nein, nein, hier ist sie nicht,
die Heimat der Seelen ist droben im Licht!

2. Verlasse die Erde, die Heimath zu sehn,
Die Heimat der Seele, so herrlich, so schön,
Jerusalem droben, von Golde gebaut,
Ist dieses die Heimath der Seele, der Braut?
Ja, ja, ja, ja, dieses allein
Kann Ruhplatz und Heimat der Seele nur sein.

3. Wie selig die Ruhe bei Jesu im Licht!
Tod, Sünde und Schmerzen, die kennt man dort nicht.
Das Rauschen der Harfen, der liebliche Klang
Empfängt die Erlösten mit süßem Gesang.
Ruh’, Ruh’, Ruh’, Ruh’, himmlische Ruh’,
Im Schoße des Mittlers, ich eile dir zu!

4. Bei aller Verwirrung und Klage allhier,
Ist mir, o mein Heiland, so wohl stehts bei dir!
Im Kreise der Deinen sprichst „Friede!“ du aus,
Da bin ich mit deiner Gemeinschaft zu Haus!
Heim, heim, heim, heim, ach ja nur heim!
O komme, mein Heiland, und hole mich heim!”

http://www.youtube.com/watch?v=BCi37wnGkEs

Deutschland 2012

June 17th, 2012

Deutschland JUN01 – JUN15, 2012

The above scene is a panorama shot of the old town of Passau. You see the Donau (Danube) River below and the Inns above, running together. There is a third river, not seen also running into the Donau, the Ilz, and so Passau is often called the Dreiflüssenstadt, or City of Three Rivers. Such a photo represents the overwhelming impressions one gets while visiting Deutschland, and of the nearly 400 photos that I took, I could only show a small fraction of them. Pity.

Our trip started by arrival to Düsseldorf. We were just given notice from Herbert that his plumbing gave out, and so there was no running water in the house. Thus, we stayed in a hotel in Düsseldorf, and dropped in twice to Herbert’s Haus to pick up the bicycle and visit a dear friend. We also must bring Herbert his annual load of Jamaican Jerk sauce.

Herbert’s Haus

Betsy and I then went to München, and met Peter Tate there. The time was spent riding our bicycles, and seeing the city. On our last night, we were able to meet with old friends, Robbie and Jordan Rayburn.

Peter in Marienplatz

05OCT. First bicycle day ride 3:27 riding time.  50 km total riding, ascent 105 meters, 2416 cal, ride around München, Nymphenburg, Olympia stadium, Enflischer Garten,, then SW of city.

Peter in front of Nymphenburg Palace
Olympic Stadium area
Peter pumping up the Olympic Mountain
Overview of the Olympic Park from the top of Olympic Mountain
Bavaria, in the Theresian Weise
06OCT., second riding day in the München area, 4:41 riding time,  74.65 km, 3315 cal, 283 m climb , trip from München to Wolfratshausen and back, mostly on variants of the Isar Radweg.
Quaint house on the Isar
Woods along the Isar
Somehow, we lost our way on return from Wolfratshausen, and ended up on a very muddy mountain bike alternate of the Isar Radweg. Not good.
We then took the train to Würzburg, where we dropped Betsy off with the Wagners, and went on to begin the Main Radweg from Würzburg to Frankfurt.
07 OCT,  first day on the Main Radweg, starting at 12:30, for a total of 3:54 riding time, 77.19 km, 108 m total ascent, 2847 cal burned,  trip from Würzburg to Markt Heidenfeld. TOTAL RAD!
Castle in the Lohr area, close to the REAL sleeping beauty castle
Hotel in Markt Heidenfeld
08OCT 5:48 riding time, 102 6 km, 3425 cal, 181 m ascent.  Trip from Markt Heidenfeld to Aschaffenburg.  Miltenberg was awesome!
Poppies on the way
Numerous castles were seen along the way
Me in Miltenberg
in Miltenberg
Aschaffenburg Castle
09OCT 4:10 riding time, 67.43 km, 2453 cal, 137 m Aschaffenburg to Frankfurt, and then Zellingen to Leinach. We took the train back from Frankfurt to Zellingen, and then rode our bikes up to the Wagners in Leinach. Peter left to Munich the next morning. I went for a walk with Hans-Jurgen and Gustav.
Frankfurt on the horizon
Flowers were everywhere
Der Hund und der Meister
Dorf Leinach ohne Nebel
Back in Leinach, we went for one day to the Fränkisches Freilandmuseum in Bad Windsheim, where many of the old Fachwerk houses were reconstructed into a museum setting.
Nicht die Meisterin mit Gustav
Sheep dog in museum herding sheep the old way
One of the many Fachwerk Houses in the museum
Hannes and Katja and Gustav

Betsy and I then hopped on the train to Passau, and was met by Herbert’s sister Hille. She showed us around Passau, and then let us stay overnight at her place in Rotthalmuster. We got to walk the town the next morning.

Kloster across the Inn River in Passau 

Largest pipe organ (in the world?)
Inn River flowing into the Donau
Downtown Rotthalmünster 

Betsy and Hille
Betsy and Hille
Donald Duck

We then took the train back to Würzburg, and then the next morning to Benningen. There we met some dear old friends from the past, Heinz and Debbie Fuchs. That evening, we got to watch the Europa Meisterschaft, with Deutschland playing Niederland. Deutschland won, of course. The next day, it was off to the Castle in Ludwigsburg.

Betsy at Ludwigsburger Schloss
Flowers at the Schloss
Debbie and Betsy

The castle had a Märchen (Fairy Tale) Garden, where many of the Grimms tales and Max and Moritz were displayed in anamatronics type format.

The big bad wolf from Little Red Riding Hood
Lehrer Lampel from Max and Moritz
Onkel Fritz from Max und Moritz

 

Inner court of Ludwigsburg Palace
Stairwell of Ludwigsburg Palace

Unfortunately, they would not let me take photos on the tour of the Palace. It was stupendous. That evening, we bid Debbie goodbye, and took the train up to Frankfurt, flying back home the next morning.

This trip was fun, rewarding, and inspiring for returning as soon as possible to do Germany again. This time, I’d like to predominate the bicycle travel, thinking about either some portion of the Donau Radweg, or perhaps the Romantische Straße, which runs through western Bayern.
Betsy and I need to thank everybody who made this trip a pleasure, Sarah at home who got the mail and watched the house, Herbert for advice and inspiration, and attempts to accommodate us, Katja and Hannes for their incredible hospitality, Hille for putting up with us on the fly, Heinz, Debbie and family for their accommodations and willingness to watch my bicycle and use it once in a while, Robbie and Jordan for touching base with us, and helping Peter care for the rental bike, and for Peter for making an awesome cycle partner. 

Quotations from Machiavelli

June 17th, 2012

 

“To begin with, there has never been a case of a new prince disarming his subjects. Indeed, whenever he found them disarmed, he proceeded to arm them. For by arming your subjects, you make their arms your own. Those among them who are suspicious become loyal, while those who are already loyal remain so, and from subjects they are transformed into partisans. Though you cannot arm them all, nonetheless you increase your safety among those you leave unarmed by extending privileges to those whom you arm…

When you disarm your subjects, however, you offend them by showing that, either from cowardliness or from lack of faith, you distrust them; and either conclusion will induce them to hate you. Moreover, since it is impossible for you to remain unarmed, you would have to resort to mercenaries, whose limitations have already been discussed. Even if such troops were good, however, they could never be good enough to defend you from powerful enemies and doubtful subjects. Therefore, as I have said, a new prince in a newly acquired state has always taken measures to arm his subjects, and history is full of examples proving that this is so.”

From chapter 20 of The Prince by Niccolo Machiavelli. “Machiavellian” is a word that means cunning, scheming, and unscrupulous in politics and in life. If you read The Prince, you will realize that Machiavelli simply describes the behavior and nature of current politics, both in the rule of the state and in the rule of the church. The observation he made regarding disarming and arming subjects could not be more true. When president Obama has to have his soldiers in Afghanistan disarmed in order to come into his presence, as happened recently, it is a sign of absolute distrust and disrespect. Removing arms from loyal citizens is offensive and eventually destructive of the strength of the strength, since the military of itself is never sufficiently adequate to defend a state.

 

RAMRTD 2012

May 27th, 2012

RAMRTD 2012

The RAMROD is a well-known ride held every year in the state of Washington, known as the Ride Around Mt. Rainier in One Day. Well, we did it in two days, thus RAMRTD. Ramrod riders will use the sleekest and lightest bicycles, light clothing, and utilize supply stations. We utilized larger, heavier touring bicycles, and carried all of our necessities plus with us.

We headed out from our house at 8:30 on Friday morning. Russ was the main pacesetter, with me tagging behind at my own pace. We headed down to the Orting Valley, and then out to Kapowsin and Eatonville. Taking the Eatonville Cutoff Road, we stopped by good friends of mine, B & N Lindsey, who live on the highway going up to Mt. Rainier. They took some photos of us, which they e-mailed to me. Here is the Russ & Ken show!

We then rode through Elbe, stopping at Scale Burgers for the best burgers in the state of Washington, and run by an old patient of mine, whom I always need to say hello to. When in Elbe, there is only one place to eat, and say “hi” to Cora. From there, we rode up to Ashford, got on the Skate Creek Road and dropped down in Packwood. While in Ashford, we visited the Visitor’s Center, and was informed that there was a MAJOR swap meet occurring in Packwood, and that it was unlikely that we would ever find a hotel. The nice lady at the visitor’s center was able to call and find us one last room. The scenery on the way to Packwood was incredible, and one stand of trees really caught my attention.

Here is Russ coming up on me on the summit of the Skate Creek Road…

We made it to a very packed city of Packwood. It was interesting to see how everybody had tattoos, and ate the worst greasy food imaginable. Definitely not our crowd. I was unable to make a connection with AT&T on my iPhone in Packwood, and the hotel had Wi-Fi, but it didn’t work. So, we remained out of communication in Packwood. Packwood was an interesting phenomenon. According to my bicycle computer, we rode 75 miles, burned up 5545 calories, and climbed 2600 feet. We went to sleep early.

The next day, we headed north, aiming for Mt. Rainier Park, and Cayuse pass. It was a lengthy climb. The summit had up to 10-12 feet or more of snow in spots, though the road was clear. From the photo, we don’t look tired, but we were faking it.

The descent was fast, and freezing cold, but fun. We had to stop and get photos at the park entrance.

The remainder of the ride was mostly downhill to the Orting Valley through familiar territory. I had Betsy pick me up at VanLierops not wishing one last awful grunt up to the top of South Hill. Russ did it (to his regret) without his panniers. Saturday was 82 miles, 5800 feet elevation gain, and 6800 calories burned. Was it worth it? Absolutely… I’m ready to do it again. We just need a little more care at limiting the extent of riding when we are mostly climbing, like of Saturday. On multi-day rides, it is perhaps not wise to push yourself too hard on your first few days of riding. We knew that we’d have rest on Sunday and Monday (Memorial Day), so, it didn’t matter.

Bicycling has got to be the best geriatric sport that there is. Jogging beats up the bones. Backpacking is hard on the back. Swimming is flopping around in somebody else’s pee. Cycle touring is adventure, meeting people, seeing the world, and going places you’d otherwise never go at a leisurely pace, slow enough to really see where you are, and feel the environment around you. It’s great exercise, and a nice way to spend time with a friend.

On Writing

April 25th, 2012

Writing tends to be my weakness. I’ve never felt comfortable composing a sentence, let alone a paragraph, chapter or book. Those that read what I have posted will quickly identify grammatical errors, spelling errors, and nonsensical sentences. When pointed out to me, I can immediately identify what I did wrong, though I rarely see these mistakes during the composition of the writing. Perhaps this was the fault of the public school system and me not getting Mr. Boniwell for senior high school English class. College English classes were a total joke, and didn’t require one to be able to write or even to spell. Much of the writing done in college is in a technical style, which has some rigid forms and much easier to master than writing on things philosophical or as commentary. Regardless, one will note that I have written a modest amount (see the Veroffentlichungen section of this webpage). I also am chiefly responsible for Occasional Specimens, a newsletter that our practice sends out every 3-4 months. Unlike my Reading List which is quite lengthy, I have no aspirations to write anything major at this time except for short blurbs on this blogsite. I will die without a magnum opus, unless you call my Ph.D. thesis a magnum opus—it is more like an opus dei.

My fascination with writing is provoked by seeing others writing and getting published. Particularly, I noted that brother Dennis used to have an ACC Journal, edited by him and Jim Fodor, and eventually Joe Haring. These journals came out during the years 1983-1987 at a time when I was living in Chicago and enduring residency and doing my Ph.D. work. Dennis had attempted to reform the AC Church to thinking more about their doctrine and belief systems. These Journals have been recently scanned and posted on the internet, with only 1 issue missing. In the long run, I’m not sure if the publication did any good, but I’d have to allow the editors to speak for that. Dennis no longer belongs to the ACC and lives out of country. Joe Haring is dead, and Jim Fodor now teaches at a Papist college, with a belief system that I’d identify as theologically liberal (i.e., non-Christian). Many of the other authors no longer belong to the ACC, or have moved on in life. Maybe they were writing to themselves?

Which leads to the question as to why we write? Perhaps most writing is writing to the self. Perhaps it is a clarification of the mind, an organization of thoughts, a systemization of concepts, a way to pass time. I wonder of all that is written, how much is actually read. Anything longer than what I have written up to this point tends to be passed over, as the contemporary mind cannot tolerate an attention span greater than about 30 seconds. because it is easier for anybody to write and publish to the world, we are barraged with massive volumes of “important” script that we could not possibly have the time to read, even should we be able to read for 24 hours/day and live as long as Methuselah. This constrains me to write less, write pithy, write summaries of thought rather than volumes of detail. Anything more than what can be read in several minutes will be a matter of writing to the self.

So, I will read much, and write little.

 

Hospital Ramblings

April 17th, 2012

Several days ago, I was asked to attend a meeting put on by the hospital in conjunction with outside consultants, seeking ways to improve the working environment in the hospital. The focus seemed to be directed at the operating rooms and surgeons. The consultants were ex-Air Force fighter pilots who now work in the private airline industry flying jets and running this consulting firm. The theme of the discussion was that by utilizing various organizational and procedural methods, the airline industry has been able to significantly cut back its accident rate, implying that the same methods can be brought into the health care industry to reduce the amount of mistakes.

The discussion immediately began to focus on critical aspects of relations between physicians and nurses and techs at GSH. There was a prevailing notion that the old behaviors and attitudes of surgeons would no longer be tolerated, as it was destroying the ability of nurses and techs to work constructively and contribute to the well-being of patients. Surgeons, so it is said, do not listen, and operate under behavior patterns that assure that mistakes will happen. Procedural techniques to fix this problem include creating pauses before cases, and having debriefings after cases. During regular operations, hostile relations will be sought to be removed in order to allow the free interchange of information among all parties involved in patient care.

There is much good to this model. It realizes that the surgeon is not God and cannot have command of all aspects of things in the operating room or on the patient floors. It appreciated that various other disciplines such as nursing, dietary, physical therapy and others have contributions that should be considered in the physician decision making process. This model realizes that when there is a breakdown in comfort among various groups interacting in a hospital, mistakes are going to be made that were otherwise preventable. I raise absolutely no objection to these ideals, and feel that GSH needs to recruit assistance from outside themselves to correct these relational issues. Yet, there is something missing from the discussion noted by the surgeons but nobody else. To that I will address.

The grass was never greener in the past. Yet, it seems like the hospital is now trying to fix something that they spent the last twenty years destroying. I am not sure that the airline industry and the plethora of consultants have a grasp as to what is really broken. I recall the years when I would make rounds twice a day. During these rounds, I was usually accompanied by either the patient’s nurse or the charge nurse. Ideas were exchanged, thoughts on patient care discussed, and then some social exchange occurred. I knew the name of all the nurses on the surgical floor, as well as their hobbies, family situation, and length of time that the nurse had been at GSH. None of this occurs anymore. It’s not just the nurses’ fault. With declining reimbursement, I had to be busier to maintain a solvent practice, meaning that more surgical cases had to be performed, leaving me less time for other things. Tension between family, hobbies and work usually meant that compromises had to occur at work. About ten years ago, I stopped doing evening rounds. About that time, nurses also stopped rounding with the doctors. Because the hospital had to cut back on employee costs, nursing aides were the first to go. This meant that nurses had no time to round. Then, electronic medical records came into being, which meant that nurses had not only less time with the physician, but also less time with the patient.

Meanwhile, inappropriate behaviors by physicians had become of increasing importance to hospitals. All it takes is one mean-spirited, demanding physician in a bad mood, or, perhaps a kind but incompetent physician in any mood, to make life miserable for everybody in the operating room and on the ward. Oddly, throughout the 20 years of my time at GSH, there has ALWAYS been one or two physicians under extreme fire from administration. Somehow, when one naughty physician is appropriately silenced or removed from staff, another physician rose to take their place. Often, this was a physician who may have had just slightly inappropriate behavior in the past, but then received the spotlight, which assured that the intensity of maladaptive behaviors would increase. The physician might have been sent to anger management training (no comment on that, watch the movie Anger Management!), or worse yet, sent to Seattle for psychological investigation and therapy. Should a hospital need to appropriately remove a physician from staff, lawsuits could be expected, unless the hospital had adequate documentation to support their claims of persistent and enduring physician misbehavior. Thus, the evolution of incident reports. Incident reports are written now for every possible behavior that might be interpreted as maladaptive, including walking onto the wards with crossed eyes. Any joke, any statement, any reference that might be overheard and misinterpreted by the hearer would lead to an incident report. When a real incident occurs, then the hospital will enquire of all employees as to comments or statements that might have been uttered by the doctor producing the incident. These are all kept in files outside of the purview of the physician. Oddly, the only person in this grand production that was not writing incident reports was the physician, regardless of the misbehavior of the employee toward that physician.

Not surprisingly, the ultimate result of this has been a widening rift between physicians and the hospital. Those physicians who are most dependent on the hospital, the surgical specialties and OB/Gyn, have had the hardest time adapting. Surgeons have complained bitterly in the past about the widening rift between the surgeon and the hospital employees, but this has fallen on deaf ears. Thus, when the hospital shows an interest in correcting the alienation of surgeons with the rest of the hospital community, it represents a favorable move that hopefully is not too late in coming.

I had mentioned that surgeons and surgical subspecialties have been defined as having the greatest behavior problems at the hospital. What is it that is different about surgeons that makes them bad boys? Is it that it takes a certain greater amount of ego and ambition to be a surgeon than other specialties of medicine? Only a select few wanted to go into surgery in the past, since the training was extreme, and the risks that the surgeon would take were extreme. I saw many bright young doctor drop out of surgical residency in order to go into a specialty that possessed a tincture of sanity. The few that survived residency often went into fellowships, which were even more demanding on the person. After about 5-9 years of abuse in the training program, the young surgeon would be spit out onto the community in order to practice their trade. Their ability to do brutal things to a patient and yet have them survive could for the most part be attributed to ingrained habits, routines, and developed skills that occur automatically. Success in the operating room is possible when the techs and nurses mesh with the particular style of the surgeon. Of course, this is far more critical for large, complex cases than for small routine procedures. The stakes on complex surgeries tend to be huge, and the ultimate responsibility rests upon the surgeon to get the patient through. It is known that post-operative care is just as critical as the intra-operative care, and so similar demands are placed on the nurses and ancillary personnel on the floor to perform commensurate with the expectations of the surgeon.

What happens when the system breaks down? Complications occur, patients die, and fingers get pointed in all directions as to responsibility. Physicians become angry, nurses and techs become frightened or despondent, and further disruption of the system into a fatal spiral occurs. The hospital responds with checklists and policies. Niceness is enforced. Feel-good sessions are enacted. The root problem is ignored.

The surgeon used to be considered as captain of the ship. The airline pilots who were consulting for GSH acknowledged the importance of having a captain on an airplane. The pilot of the airplane has sole responsibility, and is allowed the final decision for matters of concern that occur on an airplane in flight. Because of the breakdown in relations between surgeons and nurses/techs, there is no captain of the ship in a hospital. Decisions are made my meetings and multiple consults. Everybody deserves an equal say in the decisions. If a nurse or other employee feels the physician to be in error, they have the hospital support to correct that decision and change the physician’s order or not fill the doctor’s order. This has happened to me many times, and has happened many times to other physicians that I know of. To respond in an emotional manner would generate an anger management recommendation to the doctor.

The airline equivalent is appropriate here. In order to keep things totally safe, we should spend the rest of our life taxiing our airplanes around on the tarmac. The stewardess (now called flight attendant) would have a chance to drive the plane on the tarmac once in a while. Everybody will feel warm and fuzzy.

It is hard to compare the world of the airline pilot and that of the surgeon. The example of following protocols is often given of Captain Scully landing the AirWest plane in the Hudson. It was a tremendous decision. Oddly, he didn’t call a case management conference. He didn’t hold a discussion of options. He didn’t worry about offending the co-pilot, who happening to be flying the plane at the time. He immediately took total control of the plane. He would have not tolerated a stewardess protesting his decision, and might have even acted in anger if the stewardess had the audacity to do such a thing. Surgery is always operating under an adverse event. Things are never normal, which is the reason for surgery. Much is not predictable. The human body is not a finely tuned aircraft whose every part and function is known. If we really had to compare the airline and health care industry, then we should force the Airline industry to operate mainly in inclement weather, with a 30% unreliability placed into all the instruments. The pilot could never totally trust his instruments. I really don’t think we’d see the same industry-wide track record for the airline industry. We might see more pilots forced into anger management classes for failing to respond  properly to extreme stress.

Physicians used to be the orienting factor for quality health care. Many of the great clinics, such as the Mayo Clinic, Oschner Clinic, Cleveland Clinic, Virginia Mason Clinic, and others were created around a single surgeon who attracted patients. These physicians set the tone of excellence for the entire clinic. Today, hospital advertising tends to promote first class facilities, and techniques such as laser surgery or robotic surgery. Doctor names are rarely ever mentioned. When doctors are illustrated, it is typically a room with either a team of physicians and nurses and ancillary people, or a group of physicians together. In a sense, this is understandable. But, it is like advertising an orchestra while focusing on the second violins and never mentioning the conductor. The second violins are vital, but nobody really cares who is playing second violin if the conductor is von Karajan.

The old paradigm of private practice medicine tended to keep the physician stable in the community. Now, physicians tend to be employed by hospitals or large physician groups, and their life situation tend to be far more mobile. As an example, hospitalists have been at GSH for at least 7-10 years, with 10-15 physicians in the group, yet only three of the hospitalists now at GSH have been at GSH for over 2 years. It becomes hard to build functional teams when most of the physicians and employees on the team are transient. Worse, without the stable physician base, it can be challenging for hospitals to promote physicians on their team. Thus, the public focus is on things that do not promote quality, such as new hospital buildings, new computer informatics systems, and new gizmos in the operating room.

My solution to this whole problem was somewhat novel, and required a Sabbatical to realize. After returning from Sabbatical in 2009, I decided that the safest solution was to never, ever do a complex case again. My patient outcomes at GSH historically have been superlative for thoracic cases, hepato-biliary and pancreatic surgery, gastric and esophageal surgery, and complex oncologic cases. Regardless, with a system that I viewed as broken, I was uncomfortable having my patient risk the hospital experience under my responsibility. I do not feel that the hospital has yet allowed surgeons to be the lead driving force for quality improvement. Therefore, I have advised complex surgical cases go to the university for their surgical treatment.

The system is broken between physicians and the hospital and its employees, and I’m delighted to see the hospital taking a preliminary move toward identifying the problem and trying to fix it. I do NOT want to be misinterpreted as implying that this is a problem limited to my hospital. It is a problem that exists in most hospitals in the US, and represents the changing culture of health care. For my hospital, it is most vital that they respond quickly to an ever deteriorating condition of dysfunctional relationships. Thus, my strong support for bringing in an outside agency to help restore a workable dynamic in the hospital.

 

Odds and Ends 10MAR2012

March 10th, 2012

Odds and Ends (February to March 2012) Mostly trip reports…

The year actually started out with a bicycle ride with me and Patrick. Look at the kid. He’s awesome!

Betsy and I celebrated her birthday in early February with a trip to the Oregon Coast. We dropped by Portland on the way, and when visiting brother Gaylon, noted some highly suspicious activity around Gaylon’s pad. We suspect that they were looking for space aliens. Oder? The photo is above.

We then headed to the coast. Betsy got a surprise in the hotel room, where she had balloons, cake and champagne waiting…

The coast photography didn’t turn out the best, but I’ve included a few shots…

Sea Lion caves

Tillamook Cheese Factory

 

Making and Packaging the Cheese

Getting photographs

Gosh!!!!

Last Thursday (08MAR2012) I finally decided to do an outside ride since the weather was fantastic. I rode from home up to the Rainier National Park entrance at Carbon River, about 112 km and 985 meters of climbing. It took about 5 hours. It was very windy, and I was in snow at the end of the ride…

Carbon River entrance of Mt. Rainier National Park 08MAR2012

So, I bid you auf Wiedersehen.

Go Ron Paul!!!!!

March 3rd, 2012

Ron Paul

Today was Caucus day, and I went very reluctantly. Believe it or not, Ron Paul showed up in Puyallup. Betsy and I got to shake his hands, hear him speak, and cheer him on. The caucus was the most attended ever, and I think that Ron Paul supporters had a lot to do with it, even though few knew that he would be in Puyallup. In all, the 25th district gave Ron a very strong showing!  Here are a few photos of the meeting…

They expected only 750 caucus members, and over 2000 showed. This was the largest ever, spirited on by strong Ron Paul supporters, few of knew he would be here.

Ron was able to give a short speech. He is quite articulate without notes or reader board.

Dr. Bruce Romig and Dr. Ron Paul

My friend Wally Nash was there. Wally tends to make good decisions, but he's for one of those other characters that remind me of Barry Obama.

This afternoon we’ll go to the post-caucus party. Rooting on Ron!

 

 

On Reading

February 25th, 2012

I tend to read quite a bit, and even once had a full page add written up in World Magazine with my photo, about my love for books. I’ve occasionally been accused of reading too much. I recently encountered the blog page of M.N. (http://www.allthingsexpounded.com/) who I find also has a tremendous fascination with books. There are friends of mine who are quite fascinated with books, one person in particular, D.D., who probably owns about 10 x as many of books as me, is quite familiar with the content of the books he owns and the public sentiments toward the book, can recommend just about any book on any topic and be correct, but has rarely ever read a whole book. It reminded me of brother Lewis, who had a library full of books, all with bookmarks about 30 pages into the book. M.N. seems to be more like me, with a long list of books, and a book doesn’t get filed until it is either read, or I realize that it is not worth reading. I read a modest amount on the internet, mostly for news. Facebook annoys me, especially for its triviality, yet it remains a good way of staying in touch with many people without fear of going deeper than superficiality.

My old list of every-morning internet news pages has changed. I rarely ever read World Net Daily any more. The only columnists that I read regularly are Pat Buchanan, Judge Napolitano, and occasionally George Will. My favorite internet sites for news are…

1. http://www.drudgereport.com/
2. http://patriot-newswire.com/
3. http://www.infowars.com/
4. http://townhall.com/
5. http://www.newsmax.com/
6. http://www.spiegel.de/
7. http://www.bild.de/
I skim through World Magazine every other week, and Bicycle Magazine once monthly. A friend subscribed me for a year last year to National Review, which I enjoyed reading, though I had some problems with its Neo-Con and Papist orientation. My current reads, of which you will be seeing reviews, include God & Time – Four Views, and Dostoevsky by Peter Leithart (Kindle edition).

My reading list this year is….

Kindle – wise

The Gambler – Dostoevsky
The House of the Dead – Dostoevsky
The Idiot – Dostoevsky
Gulag Archipelago –  Solzhenitzyn
In the First Circle – Solzhenitzyn
The Rise and Fall of the Third Reich – Shirer
The Prince – Machiavelli
Babbitt – Sinclair Lewis
Affirming the Apostles Creed – JI Packer
History of the Christian Church – Schaff (read once already)
Devotional Treasures from the Holy Land – Delaney
Systematic Theology – Charles Hodge
Durch die Wüste – Karl May
Kinder und Hausmarchen – Grimm und Hauff (read once already)

Hard Books

The God of Miracles – Jack Collins
Enjoy every Sandwich – Lipsenthal
The Emperor of all Maladies
Cutting for Stone
Life Together – Bonhoeffer
The Revelation of God – Jensen
The Person of Christ – MacLeod
Collected Writings on Scripture – Carson
Christ of the Covenants – OP Robertson (read once already)
Mein Kampf – Hitler
Die Deutschen – Guido Knopf
Redemption Accomplished and Applied – Murray
The Reformed Doctrine of Predestination – Boettner
Historical Theology – Cunningham
Several Photography How-To Books
The Systematic Theologies of
Horton
Turretin
Bavinck
Shedd
Dabney
Reymond
Erickson (maybe???)

There are other books on the shelves, but, that’s enough for now. I think it will take me about 3 years to get through all these texts, but then I’ll probably add on another dozen or more in the next year.

 

Jimmy Obama

February 12th, 2012

Need we say more?

Jimmy_OBama

Hit on Jimmy OBama to play…

 

End of Year Ramblings

December 31st, 2011

The year is over. We are still alive in spite of Obama. Life goes on. The end of the year gives us pause to reflect on where we’ve been and where we’re heading for the year to come.

2011 has been a good year. My surgical practice has slowed down a bit, and I am giving Obama just a little less support than in years past. I have not done as many bicycle rides as I wished. Betsy and I have been able to spend more time together, and that has been most enjoyable. One particular highlight of the year has been our trip to Europe, having Betsy meet Katja und Hannes for the first time, and getting to see Italy. It’s always a treat to touch base with Onkel Herbert. Russ Anderson has been very special this year in providing a real friend to go bicycling with. The elaboration of those trips last year can be found on the various blog posts in feuchtblog.net.

Betsy and I are thinking about next year. I will be going to about four surgical conferences, including the Miami Breast conference with Betsy and Society of Surgical Oncology meeting with Dr. Tate in Orlando, both in March. I’d like to go to the American Society of Breast Surgeons meeting in Phoenix in late April. Betsy and I also plan to go to the American College of Surgeons meeting in Chicago in October.  We anticipate a trip to Germany and Switzerland in early June, hopefully where I could do some bicycle riding with Russ and Carsten (and maybe Peter?), as well as seeing Katja and Hannes, Herbert, Hille (Herbert’s sister), Marike (student in Bonn whom we met in Cameroon, Udo Middelmann in Switzerland (Francis Schaeffer’s son-in-law) and our good friends Mike (and Carolyn) who is doing a year teaching Sabbatical in Lausanne, Switzerland. That might be a little too packed of an agenda, but… In November, Betsy and I are seriously planning a trip to Egypt, Jordan and Israel. We’ll do the tour sort of thing. I’ve never been to the Holy Land, but have always wished to go. If you are interested, come along with. We will be going with the Rev. Dr. John (http://www.biblicalisraeltours.com/), who I found after a long internet search.

I continue to ride my bike. Yesterday was enjoyable in taking Patrick for his first long bicycle ride. He did about 8 miles. Not bad for an 8 yo kid on a 20 inch bicycle. It got rather cold at the end, the sun going down about 15 minutes before the end of our ride. Typically, I’ll ride the trainer. It’s one of my bicycles hooked up to a virtual reality trainer (Tacx). I’ll usually have iTunes going. This last year, I’ve been working through the series on Romans by Martyn Lloyd-Jones while training. I am now down to about 97 more 50 minute sermons out of 353 sermons. That’s a lot of sermons on Romans, and tends to be repetitive. You’ll get a review on that series once I’m done with it.

While sitting at my computer, I listen to music. My iTunes has a total of 721 gBytes of music and lectures, etc. One may wonder what I do with so much music. Well, I listen to it. It’s mostly classical, a total of 359 gBytes, or 175 days of constant listening. Making a smart playlist, I started working through everything a little over a year ago. I’m now down to 94 days, or 196 gBytes of classical music left. Right now, I’m listening to a little known piano concerto by Mendelssohn, which is actually quite good and doesn’t deserve obscurity — a trait true of much of classical music.

I continue to read every moment possible. Currently I am working through Gregg Allison’s Historical Theology, and am about 1/2 way through. I am reading Crime and Punishment by Dostoyevski on the Kindle. I have a massive lineup of books remaining on my shelves and in the Kindle store that I must read. I’ll need to quit medicine just to get my reading done. For time with Betsy, we’ll usually watch things like Teaching Company series together, and are currently working on a series about Oceanography. We are becoming adept at speaking about the pelagic vs. neridic realms of the ocean, knowing the difference between plankton and nekton, etc., etc., as well as understanding the various forces that make the ocean a wonderful world. For a lighter note, Betsy and I will watch movies. We have just started the films of Clint Eastwood, a total of about 40 that we’ll be seeing. Reviews for those films will have to wait! We still don’t have television, and I refuse to pay for cable. When we must watch something, we’ll watch it over the internet if it’s available.

I will be turning 58 in 2012. I’m not sure how much longer I will want to continue practicing medicine. It’s a serious love-hate relationship. I love the practice of surgery, but it’s everything else that one needs to put up with. Government has taken complete control of medicine, and turned it into an uncaring prohibitively expensive beast. Desperately needed tort reform is now a long-gone wish. As one pundit commented, “America is no longer governed by the rule of law, but by the rule of lawyers”. Such a statement could not be closer to the truth. Political processes are always preempted by court decisions. Democratic or Republic behavior no longer exists in the USA. We are governed by the tyranny of the courts. It wouldn’t be so bad if lawyers were behaved. Unfortunately, lawyers have devolved into a subhuman species. It’s hard to know what to compare them to, but the cyclops  is most fitting. Cyclops have only one eye, are monsters seeking to destroy anything alive that is not one of their own, will act even more intentionally and violently when their one eye is put out, a threat to anything else in existence. That’s the good part about what I have to say about lawyers. Don’t get me going on their bad side.

Those of us that work in the public realm have occasions from time to time with lawyers. Much of this we are not allowed to openly discuss for privacy concerns, and so will discretely tailor my statements. Physicians are advised to avoid a jury trial as much as possible, as juries tend to ignore the facts and are easily swayed by emotion. There is no rule of law in the courtroom. The selection of juries has become a joke. It used to be a trial by your peers or neighbors. Now, it is a trial before the a highly selected group of individuals based on the bias of the judge, people who would rather be anywhere than setting on a jury or people who are so worthless in society they have nothing better in life to do. The instructions to the jury often counter the constitution, which is why I will not set on a jury. I’ve written more on this elsewhere. The prevailing consensus among Joe Public is that justice no longer exists, and that is for the most part true. Why do we do everything to avoid the courts? If our neighbor sues us for using the wrong type of fertilizer that gives him asthma attacks, the costs in court will be prohibitive, it will be unbearable stress, and a flip of the coin will determine which way the judge may lean, even after hours of defending your case. It’s too easy to create a case, as you have little to loose in the process. Lawyers will determine the case based on their merit, which means, if it is possible for the lawyer to make a good profit off of a case. In the end, the plaintiff and defendant lawyers win, and the plaintiff and defendant loose. I’ve seen so many people destroy their lives by taking someone else to court, get lost in a long court trial, and even if they win the trial, much of the money ends up squandered or in the hands of the lawyers. Nobody but the lawyers win. We were taught well as kids to never sue, and for the most part, that remains true. There are three prongs to the solution. 1. Go back to the European court process where the looser pays all court costs. 2. Use Biblical law, which truly punishes offenses to others and demands restitution or death penalty in serious cases. There is no prison term in Biblical law. If you are a violent murderer, you die. If you stole, you repay. If your debt is too great, you become an indentured servant (slave) for 7 years to the person you owe to. Bankruptcy would not be tolerated, and Donald Trump would be picking cotton for the next 30 years. 3. Return to a Christian society that thinks in a Judeo-Christian fashion and holds Christian morality as the highest of all possible goods. Unfortunately, this isn’t going to happen, even if every non-Christian were immediately terminated. So, we tolerate matters, try to keep our nose clean by living morally, and if one must suffer for doing good, they will get their blessing and reward in the end. It is good that for a Christian, this short life is not the totality of existence.

So, I wish you all a happy New Year.  Keep looking up, and keep  your stick on the ice.

Never Lose Hope

December 30th, 2011

It has been uncommon for me to write commentaries of late, in part because there seems to be minimal feedback from the internet community. In my earlier years of web blogging, I used iWeb and it facilitated readers adding comments for feedback. I would never wish to go to a social networking type style, such as with FaceBook, in that it tends to breed short, abrupt thought processes that do not have premises, reasoning, and conclusions demonstrated. It is meaningless prattle. No, even if I love you, I’m not interested in your kid graduating from pre-school, or where you went out to eat last night, that is, unless these events have a significant meaning in your life, and you offer explanation as to how these events were significant life-events.

Hope. It is one of the three Christian virtues. Faith, hope, and love. Just as we don’t wish to ever cause another person to loose love or faith (in Christ), we never wish to cause a person to lose hope. But, hope in what? I am on rare occasion accused of causing my patients to lose hope. Generally, I try to tell the patient the exact truth. If I don’t, they’ll get it over the internet. I feel that integrity is a foremost virtue for a physician. I have heard many doctors argue otherwise. Dr. Lauren Pancratz argues vehemently that if a lie (deviation from the whole truth) contributes to the betterment of a patient, then we should lie to our patient. I disagree entirely. Truth must be presented graciously and skillfully, but it must be presented all the same.

I see many patients that come from other doctors, mostly medical oncologists, who were never told the significance of their cancer. For many medical oncologists, hope  in “the system” must be preserved. Perhaps much of this is self-serving. I find that only 5% of patients do not wish to know the truth of their condition. Most patients welcome it, often are relieved and are happy that they can better understand their condition and make long-term plans with better knowledge of their condition.

There is a balance that physicians struggle with. If there is a reasonable expectation that the health care system can significantly improve their condition, then I will strive to be positive, even if the short term outcome is expected to be dismal. In one sense, there is always hope, but that hope depends on the objectives of the physician/patient encounter. If the expectation is to prolong life no matter how miserable that life might be, the treatment options are going to be different than if the objective is to simply offer comfort measures. Both contain hope that the therapy will work, but the outcome expectations are different. Thus, in a real sense, hope is never lost.

The source for hope is my greatest concern. Patients usually do well or do poorly in spite of me. Health care professionals have less control of a situation than they would like to believe. To trust that the health care profession will provide health is a mis-direction of one’s trust. It is always a pleasure when a patient comes to me, realizing that only God can give them hope, and trust in Him is of greatest value. It is a pity that so many devout Christians have a seriously displaced hope, trusting entirely in the physician, and not seeing that even the best physicians have feet of clay. Balance is important. To ignore the physicians that God provides is unwise. To expect that physicians always know best is also unwise. Many Christians run to Hookey-Pookey medicine (Chiropractors/Naturopaths) feeling that they are more “natural” or “christian” than mainline medical practice — that is also highly unwise.

We don’t want our patients to loose hope. We wish for them to have the correct source for their hope. We wish them to have realistic expectations. We wish them never to give up. We wish them to be able to change expectations when the facts suggest it. Mostly we wish them to maintain the three Christian virtues, faith, hope and love, up to the very last breath that they take.

Tea

August 14th, 2011

I have given up most of my coffee consumption and turned to tea. At first, I used tea bags, and had about 10-15 different varieties. I was always in amazement when Dr. Liao would decline having tea, as he commented that he just didn’t like the taste of the tea that I brewed up. So, I asked him to bring me back some good chinese tea on his next trip to China. He did, and brought me a box that had eight different flavors.

Since then, I’ve slowly evolved into using only tea leaves. You can see my tea cabinet. Only a portion of the teas I brew are visible, and some are actually just using old containers.

I brew the tea in a white ceramic pot or cast iron pot, kept warm over a tea candle apparatus.

I use a Finum strainer for the tea. These are very nice, since you can remove the tea leaves after the appropriate infusion time, and can reinfuse the leaves quite easily. The lid also serves as a convenient base to prevent tea from getting on the counter.

At the office, I use a larger ceramic pot, with a hot water pot to boil the water.

Learning how to properly brew tea takes practice, experience, but a good book also gives one an idea as to techniques for making the perfect pot of tea. The book below also discusses the various types of tea, their origin and their differences. Generally, there are Chinese vs. Indian teas. Africa does produce some teas like Rooibos, which I’ve found to be quite distasteful. The Chinese/Indian teas vary from black, Oolong, green, flavored (like Jasmine), mixed (like Earl Grey), or moldy (like Pu-Erh). Pu-Erh tea is actually quite interesting, in that the 2-5 infusions are all quite good. The tea smells like a barnyard, but the taste is very nice.

The Tea Enthusiast’s Handbook, by M. Heiss and R. Heiss ???

This book is a good introductory summary for the tea lover. Happy brewing!!!

Alaska 01-07AUG2011

August 14th, 2011


Alaska 01-07AUG2011

This trip had several objectives. The first was to meet with Dr. Lattin and give a breast cancer update talk at his hospital. The second was to achieve a brief rest and relaxation while meeting friends, including not only the Lattins whom we met in Bangladesh, but also the Bankers, who attended Resurrection Presbyterian church with us in the past. We spent 3 nights in Anchorage, followed by three nights in Soldotna with the Lattins.

The first day in Anchorage was to simply settle in. We drove downtown, and shopped for moose hats and other Alaska paraphernalia. Betsy fell in love with the moose.

The second day, we drove up to Wasilla, and then out towards Tok. The mountains were stupendous. In the evening, we met with Jeff and Ellen Banker, and went out to eat. The seafood was incredible! The beer was quite good also.

The third day was mostly resting. I met with Jeff again, still recovering from hand surgery, and ran up to the top of Flattop Mountain. The most distinctive feature of Flattop Mountain is its flat top.

The fourth day, we checked out of our hotel and headed down to Soldotna. The drive is quite beautiful, with the seashore on one side, and immense mountains on the other side.

The fifth day, I gave my cancer talk. Later, we went out to dinner, and then drove to the beach in Kenai. We were able to see Mt. Iliamna and Mt. Redoubt.

The sixth day was a walk for life for Betsy and Anna, and a fishing trip for Jason, Nathan and myself. We drove down to Homer, and took off on a chartered boat out into Cook Inlet.

We spent much time with the kids.

Joshua

Noelle

Esther

I let Nathan run around with the camera for a bit, and noted that he wasn’t taking care to compose his shots. To illustrate the importance of adequate view in a photo, I took a photo of him. Included are photos Nathan took of the parents.

Nathan

Dad according to Nathan

Mom, according to Nathan

It was sad for Betsy and I to leave Alaska. It was more enjoyable than our last visit, and suggested returns, especially with friends. I also noted that the roads typically had quite wide shoulders and thus makes it quite conducive to cycle touring. All we need to worry about are moose and bear.

Special thanks to the Bankers and Lattins for making this trip quite special.

Thoughts on Blogging

July 11th, 2011

It was almost two years ago that I was forced to move to this new blog site. Before then, I was using the Apple proprietary program iWeb, and it allowed for some capabilities that I have not been able to recreate through WordPress. Yet, WordPress doesn’t crash resulting in the loss of data. The older site is still up, though I am unable to add further entries to that site or revise the pages.

This blog site has had a different character, in that I spend much more time reviewing books, music, and movies, and less time talking about political, religious or medical issues. Perhaps that was a mistake. I found that political topics tended to generate the most interest. To date, I have written 225 blogs and gotten 101 responses. Many of those responses were from my brother Dennis, whose comments I always appreciate. I have published all of the responses to date, except for one dude, unknown to me, who wrote a quite vitriolic comment regarding my “naivete” for believing in creationism and rejecting evolution as a valid hypothesis for origins of the world as we know it. I would have approved his comments, except that they were quite foul mouthed, and failed to reflect any substantive thought process. Please understand that I often do not agree with comments that come back to me, but I still post them. I have occasionally had friends personally e-mail me regarding articles on the website. I assume that these comments were intended to be kept private, and so have not posted them. I will often have friends mention that they’ve read a certain posted blog, but not comment. I do the same for others blogs, but realize that it leaves the blog author slightly uncertain as to the number and identity of the population that you’re writing for.

I have rejected the thought of developing a presence in the social networking work of Facebook, Twitter, or other similar sites. I continually receive messages to have certain people “connect” with me on Linked In, a network that truly confuses me as to its utility. If I wished to connect with you, I would find your e-mail address, and e-mail you. Why do I need Linked In? The standard social networks like Facebook create a larger issue, in that they encourage brevity of thought and absence of connectedness in ones’ thinking. Those networks are the ultimate in encouraging mindless prattle that occurs between two or more people. One is demanded to express themselves in short brief statements that fail any sort of real development of thought. Worse, Facebook best facilitates emotional expressions rather than discussions on important issues. For these reasons, I have not been on Facebook for years, and will never go on under the current environment of Facebook.

I have learned that one must not manifest diarrhea of the mind on a website. Since these are public forums, care needs to be exercised as to what is said. It is not that I would mutter extremist or revolutionary views, since that is not my cup of tea. Simply watching how the press destroys various politicians for fairly tame statements suggests that political correctness rules the social interactions among members of our society. Casting aside political correctness, I will try never to offend anybody.

I anticipate that this website will probably contain more personal interest articles, and discussions as to what is transpiring in the lives of me and Betsy. I also wish to start using Lightroom to create photographic presentations. This might take some experimenting in order to get it into WordPress. I welcome comments and suggestions as to where to go from here. Or, just drop me a line and say “hi”.

Ken F. von Puyallup, WA

 

 

Selkirk Loop

June 8th, 2011

The Selkirk Loop Bicycle Ride 02-06JUNE2011

Russ A. and I had been planning this loop for quite a while. We had other loops in mind, such as going to Glacier National Park, but realized that the snow conditions were not permissive of a ride anywhere we wished. There is a website that promotes this loop (www.selkirkloop.org), so we decided that this would be  perfect choice. We drove to the start of the loop in Newport, Washington in a driving rain, hoping that the weather would clear. We stayed in a cheap motel and took off the next morning. Here is a map of the loop, and then our Garmin statistics…

03JUNE – Newport, WA to Bonners Ferry, Idaho, riding time 4:21, 101 km, 295 m ascent, 3755 calories – mostly cloudy weather, no rain; stayed in a hotel in Bonners Ferry

04JUNE- Bonners Ferry to Gray Creek, B.C., riding time 6:29, 125.5 km, 949 m ascent, 4872 calories – perfect weather, stayed in our tent at an RV park at Gray Creek, on Lake Kootenay

05JUNE- Gray Creek to Salmo, B.C., riding time 4:56, 88.54 km, 848 m ascent, 4098 calories  – again, perfect weather. Hard climb noted out of Nelson.

06JUNE- Salmo, B.C., to Newport, WA, riding time 7:33, 147 km, 623 m ascent, 5864 calories, we took the LeClerc Road variant, which was very flat, along the Pend Oreille River. The weather was perfect, but we drove back to Tacoma that evening, noting a very hard rain on the drive from Newport to Spokane, WA.

Total stats: 23:19 hours riding time, 462 km (287 miles), 2715 meters elevation gain (8907 ft), 18,689 calories burned off. We essentially accomplished the loop we wished, though it took us a little less time than anticipated. The only significant plan alteration was that we hoped to go to Kaslo and New Denver on the extended upper loop, but the weather did not look like it was going to stay perfect long enough for us to enjoy an entirely dry trip, and thus gave reason for doing the standard Selkirk Loop rather than a variant. Besides, we needed an excuse to return. Also, Russ had an injury to his thigh on the second day of riding, which suggested that it be best that we not push matters too hard.

In all, it was a delightful ride, and I had a wonderful time with Russ, and am already planning our next touring trip. It would be helpful if we knew what to expect in towns, and maps like the Adventure Cycle Association would be nice to have for all towns. Some towns on the map were essentially ghost towns, others had stores and motels and other provisions, and it was impossible to know what to expect along the route. This made it harder to plan for stops. Here are some photos of the trip…

Russ with the Selkirks in the background

Me on my loaded Co-Motion bicycle

Lake Kooteney in British Columbia

Lake Kooteney scene

The Glass House - built out of embalmers bottles

Lake Kooteney

On the Ferry crossing Lake Kooteney

West Arm of Lake Kooteney looking at the town of Nelson

Our hotel in Salmo, B.C.

Russ humping up a long steep hill out of Salmo

Russ and I in Metaline Falls

Last day - along the Pend D'Oreille River

So, we’re back. Tired, but, it was a wonderful trip.

Synology

May 27th, 2011


Synology DS1511+ with 5 Western Digital 2 tbyte Black Caviar hard drives and DX510 Expansion module with 5 Western Digital 2 tbyte Black Caviar hard drives ?????
This is my new system of memory. It came at the recommendation of Jason L. Not being a techno-guru, I had some concern regarding configuration problems and setup, yet it worked immediately after assembling all the hard drives and putting the thing together. I made one small mistake in that I tried to make both the main unit and the expansion module into one volume, which simply won’t work. I have it running in RAID 5 configuration, so that each module consists of 20 tbytes of memory, but I functionally am working with 14 tbyte (giving me at total of 28 tbyte), and if any single hard drive goes out, I can simply swap it out and have no data loss. Now, I need to cat5 wire our house, so that I might leave this system elsewhere in the house. Not that it matters, since the system has no fans, runs completely cool, and makes no noise.
I have all my movies and music and photography stored on this system, with volume left over. My only frustration so far has nothing to do with Synology, but with Apple iTunes, which will not allow me to make the Synology as my main location for iTunes playing on a remote computer.

United Bicycle Institute

March 27th, 2011


United Bicycle Institute- Ashland, Oregon 21-25MAR2011
Back to school! This time, it was bicycle repair school. The drive was 7 hours each way. I had heard about the UBI from the General during the Adventure Cycling Association Introduction to Touring class, and wanted to learn more about bicycle repair. This introduction was very well done, the instructors not only very knowledgeable, but very patient and superb at teaching. It was a most enjoyable week of not only getting away from work, but of actually learning something useful.
I drove down to Ashland from Puyallup on Sunday. I stayed about 3 km from the Institute at Cedarwood Inn, an inexpensive but nice motel. Monday was focused on wheels. We first learned how to change a tire, and the different types of tires. We learned about taking the hub apart, removing the gears, re-packing the bearings, and getting everything back together. A short discussion on truing wheels was made, but little hands on.

Nathan (instructor) tells a joke and Dan looses control!


Bryce works on his mountain bike


Tuesday was pedals, cranksets and bottom brackets. I completely disassembled my bottom bracket and put it back together. We also learned about removing, inspecting and changing chains.

Tom was my bench partner


Matt (instructor) helps Jose


Dan the Canadian, not laughing this time


Wednesday was derailleur day, starting with the rear derailleur, and then the front. Oddly, the front derailleur is more touchy to tune up than the rear derailleur. In the evening, I went for a bicycle ride. I went up route 66 headed for Klamath Falls, but got only about 14 km before the weather became a little concerning, and it started to get dark.

Route 66


More Route 66


Lake on Route 66
Gnarly trees on Route 66- Mirkwood
Thursday was brake day. We had to completely dis-assemble caliper brakes, and then re-install them on the bicycle correctly. The instructors were a bit fussy about doing things correctly, since a bad setting for brakes could have serious consequences on the road. The weather was horrible today, with a mixture of rain and snow, so no thought of riding was possible.

Rich helps Tom


Matt shows us how to really wash a bicycle


The framebuilding shop with Robert (student) on right


Friday entailed pulling off the handlebars, headset, and removing the stem from the bike. This was fairly straight forward. We learned the correct method of washing and oiling a bicycle. After getting a tour of the frame building shop, we were handed certificates of completion and “graduated”. There was no test, since the true measure of success was in how well the bicycle worked.Bryce needed a lift up to Portland which provided me a delightful companion to keep me awake on the road, and then I was able to get home by 2300 Friday night.
To Matt, Rich, and Nathan I say “Thank You”. To everybody else who enjoys riding bicycles, this is a class very much worth taking. It’s fun. Matt, Rich and Nate are delightful characters that add a tremendous enthusiasm to not only cycle repair, but to cycle riding in general. A class like this could someday save your life, if you are out and away, with a broken bicycle. It has my highest recommendation.

The workbench


Our class - from top left clockwise - Michael, Bryce, George, Ryan, Jordan, Rico, me, Bridget, Don, Tom, Rebecca and Dan.

San Antonio SSO Meeting

March 12th, 2011


The Society of Surgical Oncology Meeting in San Antonio, 01-06MARCH2011
Dr. Tate is pictured in the photograph trying to remember the Alamo. We remembered it for several minutes, then paused to enjoy a cigar while sitting on park benches just across from the Alamo. We inquired of the status of PeeWee’s bicycle in the basement of the Alamo, and learned that the Alamo actually has two small basements, large enough to hold a bicycle. You can’t believe everything that you see in the movies. The meetings were long and arduous, but we were able to get 34 CME credits for this venture. The conference literally went from dawn until dusk, and so we did not have a lot of time to spend reflecting on the Alamo, but we did get around a little bit. The conference was at the large conference facility just next to the river walk. We’d go down to the river to eat our lunch.


You can see that we were dressed up to the hilt. This is sort of a snobby conference, as most surgical meetings usually occur in more casual attire. The pathologists were having their meeting next door to us, where I was able to encounter one of the Puyallup pathologists. Notice his more casual attire.

We were able to see the San Antonio imitation of the Seattle Space Needle.

It was one of the better conferences that I’ve gone to as of late. Most notably, it was announced that we must stop doing so many axillary dissections, and that while it would have been malpractice a week before to not complete an axillary dissection when the sentinel lymph node was grossly positive, we are now committing malpractice to do the same. The Surgical Oncology gods have spoken and we must obey. NCCN guidelines will be slow to correct the new change in practice recommendations, but we will be patient. So, I return to Puyallup full of vim and vigor, and will be plagiarizing one of the talks I heard in presenting to the other surgeons and oncology doctors the new revelations from the randomized trials.
p.s. too much academia becomes hard to endure…

The magical god?

February 28th, 2011

Brother Dennis wrote an article for the American Scientific Affiliation several years ago arguing against “magic” in the works of God in creation. Though this article is directed toward “magic” in creation, Dennis would consider any act of God in His created world that acts outside of the natural law that God formed when He created the world to be outside of His nature. Thus, Dennis would propose that all miracles of Scripture would have a physical, natural law explanation, such as the turning of water into wine, the raising of the axe head, or even the ascension of Christ, which Dennis explained probably happened by a flying saucer picking up Christ and escorting Him off into the Heavens (where, I don’t know, perhaps somewhere close to Betelgeuse). In order to discuss Dennis’s article, I have enclosed a copy of it for non-ASA members and can be found at the end of this blog following my discussion.
First, Dennis presupposes that the concept of God working miracles as supposed by most Christians is that God has a larger magic wand than the pagans, and thus is more effective. Included in this supposed concept is the assumption that God acts without constrain and is fickle in His actions. Most devout evangelical Christians would not agree with this summary of their concept of God and miracles, feeling that God does offer restraints on Himself, but those restraints are a product of God’s own ontology or nature, and is not dependent on external law, either law coming from God’s declaration or man’s development.
Even the pagans understood the difference between miracles and magic, so perhaps it would serve the reader to elaborate those differences.
1. Magic generally is a means whereby man might constrain if not force the god’s to cater to man’s desire or will. In contrary, a miracle is a request of “the gods” to consider the desire or bidding of man. Miracles may occur at the internal behest or desire of the god himself, acting according to his own nature or in his own best interest.
2. Magic requires learning the right incantations, or going through the proper forms in order to compel the supernatural forces or gods to follow the magicians’ bidding. The only requirement of a miracle (when requested by man) is the right sincerity in man’s interaction with the god.
3. Magic tends toward relatively few themes, including seeking after health, life, or erotic love, or perhaps the curse (or breaking/blocking of the curse) on another person. Miracles tend toward a diversity of interests, and generally performed for public display in order to manifest a lesson from the gods.
4. Magic demands clandestine, secret techniques, often learned after years or through occult means and held by a relatively few initiates. The technique of miracles is quite open, and limited to prayer or open request of the god to act on the person’s behalf.
5. Magic exalts the magician alone. Miracles mandatorily exalt the god alone.
6. Magic requires the innate force of the magician to accomplish its effect. Miracles function best with the utter helplessness of the requestor.
It is true that there are common themes with both magic and miracles that may cause the unobservant to miss the difference. Both magic and miracles violate natural laws in their undisturbed course. Both may also utilize natural laws to accomplish their effect, but in both cases, the roll of natural physical law will never be either 0% or 100%, but somewhere in between. Thus, God may have parted the Reed Sea with an east wind, yet the timing remains inexplicable outside of God interacting with nature, and the precise details such as the ground being entirely dry could not be explained by simple natural phenomenon. Both magic and miracles believe in a spiritual world that interacts and affects the natural world in such a manner that influences the desire or will of the god.
Dennis continues his discussion by supposing that God would never ever violate His own physical laws, yet Dennis makes a serious mistake in this analysis. First, he supposes faithfulness by God as discussed in Scripture to include restrains on His physical actions in the world. Dennis mistakes God’s faithfulness to His own nature, which acts as the restrain on His actions. Dennis confuses God’s promise to never violate His moral law, by supposing that God really meant that He would not violate the physical “laws” of the universe. This is patently absurd, in that God’s own existence violates physical “law”, and thus any action of God and the physical universe must entail a transgression of physical law. If one believed that God, who exists outside of physical law, would never violate physical “laws”, then that person would be forced to be a functional deist by restraining God to the initial events and then being impotent to affect the “wound-up watch”. Dennis’s discussion laboring over God’s covenant faithfulness remains irrelevant to presuming that God acting outside the system denotes an absence of faithfulness. It also reflects the notion that the “laws” of science are as immutable as God’s word. Though God’s word remains immutable over the centuries, I typically need to buy a new science textbook on any topic every ten years to remain up to date, and every fifty years to grasp the entire change in paradigmatic structure of the current science.
Dennis would tend toward a theistic evolution similar to what is offered by Francis Collins. Though Collins is quite well known as head of the NIH as a most prominent scientist and also a professing Christian, Collins (like Dennis) has sold God down the drain by placing theology in a subservient roll to science. In theistic evolution, you remain with a quandary. You have two choices. First, God may have created the world in a fashion that He occasionally needed to stick His finger into the system to betray His natural laws, such as with the formation of an organized DNA for the first primitive living organism, and later with the transformation of the last “pre-human” into man. Or, secondly, He may have created a system from the initial first billionth of a second of the big band, where the universe possessed a personality, that is, an anthropic principle built into the system. I find neither explanation as satisfactory, and thus am left with a God who was and is and always will be active in the creation, maintenance, and outcome of His universe, and yet who exists above the “laws” of the universe.
Dennis’s greatest mistake is in trying to be both a scientist and a theologian, of whom he is neither, but rather a theological dilettante with training in electrical engineering and an insatiable curiosity about the world. His theological discussion shows many mistakes, such as his definition of h?se? as being “faithfulness” when it implies “lovingkindness”. Such mistakes are excusable except for when somebody is attempting a scholarly defense against prevailing notions. Dennis insists on nomenclatural exactitude, yet fails even in his definition of the word “magic”. His final plea is in the importance of making careful distinctions. Dennis fails to persuade me that the prevailing distinctions of mainline evangelicals are necessarily wrong. Worse, he fails to offer any substantial proof that it is pagan to believe in miracles performed by a God or His agents that generate events that cannot be explained by the natural laws of the system. Perhaps Dennis’s notion of science is the most pagan of all in being a closed system that restricts God from interacting with the system according to His divine will?

____________________________________
Does God Wave a Magic Wand?
By Dennis L. Feucht
One of the great unfulfilled tasks before the people of God, and in particular those of ASA orientation, is to help recover among God’s people a biblical view of how the Creator interacts with the creation. I continue to encounter Christians whose view of God’s activity in creation is essentially that of the gods of paganism, who were capricious and wielded power in an incoherent and inconsistent manner, effecting their desires much like decadent ancient Greeks might. The difference is that the Christian God has a bigger magic wand.
This pagan view of God is manifested in church meetings by those who advance the argument that “God can do anything” and therefore does. The tacit assumption underlying the motivation for this line of thought is that God is also not constrained – not even self-constrained – in how he operates. The magic-wand notion of God’s ways appears when events in scripture are given little description. Eschatology is a favorite playground for such imagining, as are miracles. Events for which we can give no rational, scientific explanation are tacitly assumed to not have any underlying rationality at all. A terminal cancer remits without explanation; God has waved his magic wand. Moses’s rod becomes a snake before Pharaoh; God’s magic wand is now in Moses’s hand. The farther the event is from explanation, the stronger the magic-wand approach becomes. The resurrection of the dead and the creation acts in Genesis 1 – do they not call for some kind of magic wand in God’s hand? Each day of creation, he emits his abracadabra and it is so. God waves his wand and “poof”; the dead are brought back to life. Not only do we not know the underlying rational structure of these events, by the pagan view of God, there are none.
While as Christians we do not deny that both scripture and life have their inexplicable events, it is how one regards them beyond our present ignorance that is critical here. Are they indeed irrational events arbitrarily brought about by God in much the same way that the ancient gods of the pagans would order events in their respective regions of nature? Magic-wand Christians will affirm that all events fit into God’s larger plan, but how they fit into his ongoing activity of upholding the universe remains to be better examined.
Consistency and predictability were not important to the pagan view of how the gods behaved. They were fickle and difficult to appease. This is perhaps the largest difference between paganism and the biblical view of the Yahwist God. In the pagan view, there is little thyme or reason to the events of nature. What purposiveness the gods might have in on the order of people who have not yet discovered the importance of setting goals. Paganism, consistently appreciated by the intelligent mind, is the grounds of atheism, of seeing reality accidentally, as “just one darn thing after another”. In this view, there is no underlying rational structure to history because the forces of history – the gods – are not rational in their behavior.
In contrast to this (and for me, one of the best evidences for the extraordinary nature – indeed, the truth – of scripture) is the existence in history of a thread of humanity set apart from this vast sea of paganism with a radically different view of reality. The Hebrews, as scripture tells us over and over, understood Yahweh as having some characteristics antithetically opposed to those attributed by paganism to the gods. One of the most featured of these characteristics – indeed, the one that stands out above the others to me – is that of God’s faithfulness. “The Rock, his work is perfect, for all his ways are justice. A God of faithfulness and without iniquity, just and upright is he.” Deut. 32:4 (ESV) The Psalms dwell extensively on this one distinctive characteristic. Its consequences for God’s ancient people were explored and appreciated. Fellowship with God was based on the legal covenant, giving a stable and dependable form to the relationship between Israel and Yahweh. The sitz im leben (sic) of it was God’s consistency and predictability in keeping his obligations of the covenant. If you want to know how Yahweh will behave, look at the covenantal agreement. The Hebrew word sedeq, found often in pre-Christian scripture and often translated “righteousness” was this faithfulness in keeping the covenantal obligations. As Gerhard Kittel wrote (Theological Dictionary of the New Testament, 2109, 110, 115): “There is no firmer guarantee of legal security, peace, or personal loyalty than the covenant… It means legitimate order as opposed to caprice, uncertainty, and animosity.” Or as Leon Morris put it (The Apostolic Preaching of the Cross, pp. 232, 233):
The Old Testament consistently thinks of a God who works by the method of law. … Among the heathen the deity was thought of as above all law, with nothing but the dictates of his own desires to limit him. Accordingly, his behavior was completely unpredictable, and while he made demands on his worshippers for obedience and service, there were few if any ethical implications of this service and none of a logically necessary kind. Far otherwise was it with the God of the Hebrews. The Old Testament does not conceive of anything outside Him which cold direct His actions and we must be on our guard against the thought of a law which was over Him. But Yahweh was thought of as essentially righteous in His nature, as incorporating the law of righteousness within His essential Being. Accordingly He works by a method which may be called law –
It was millenia later, in a Christian setting, that the wider consequences of this understanding of God’s ways were applied, though instinctively at first, to the creation itself. Those who dwelt deeply upon the nature of God in scripture would inevitably generalize in their understanding how this same God would act relative to his own creation. The characteristics of faithfulness in God’s upholding of creation gave it a certain knowability of a repeatable and predictable kind that could be relied upon. The theater-prop world of pagan neoplatonism in medieval religion – a world of appearances, lacking an underlying rational structure – were swept away by early men of God in science, who dared defy the pagan gods with the alternative belief that if a God with the characteristics of Yahweh created the universe, then those same characteristics should be manifested in his creative behavior. A Being consistent in relating to Israel must also be consistent in upholding the created order. Yahweh’s hesed, his covenant-faithfulness, should apply to the physical world. And they found that it did. It is the history of the scientific enterprise.
The rest of that story has been well told, of how this faith relating God’s faithfulness to nature has been abundantly rewarded in a growing understanding of nature that has turned it from being capricious and fearful to humanity to instead becoming the servant of humanity, and increasingly under the subjection of those who have participated in this faith, whether explicitly or instinctively. (Hebrews 2:5 – 8 refers to this subjection of the creation to man, and to the archetypal “son of man”, but in its quoting of Psalms 8:4-6 leaves no doubt that the everyday physical world is included in this subjection regarding the future world in Hebrews). Today, much of science has degraded to the status of an instinctive participation, while often denying the underlying foundation for it in the hesed of the Creator. Nevertheless, God distributes his blessings through technology, a human activity that relies upon the faithful patterns of the Creator that have been discovered in the creation, even to those who deny him as the source of this hesed manifested in nature through science. (Eph. 4:8; Psalms 68:18).
This view of science and of the creation is often not shared by other Christians. It is inconceivable to some of my non-scientific Christian friends that God might behave in all of his activities with an underlying rationality and consistency – a covenant-faithfulness – that might conceivably be discovered and understood in the ongoing subjugation of the creation to humanity in the future. Wider access to space-time might allow the information content of the dead to be acquired. In the future, life will eventually be understood, conceivably to the point of the engineering of new, improved human hardware. And “booting up” the dead on instantiations of this hardware, though still science fiction in our sober understanding, is not inconceivable. A physicist of Baptist roots, Frank Tipler of Tulane U., has written a book, The Physics of Immortality, (Doubleday, 1994) that offers some plausibility arguments based on such means in the hands of a redeemed humanity functioning as his servants under the earthly rule of Christ to effect the equally wild-sounding scenarios of scriptural eschatology.
As engineers who follow in the scientific tradition in which the creation doctrine of the early scientists is embedded, the task of mitigating the latent pagan creation doctrine of a magic-wielding god and its pervasive influence upon our fellows in Christ is ours to effect. We, and our fellow Christians in science, if anyone, are both positioned and motivated to such a task. Babylon casts a shadow through the millenia upon civilization, and it reaches even into the innermost thought processes of fellow Christians today. Where to start? Any Bible-reading church eventually comes upon the many texts of scripture extolling the covenant-faithfulness of god. These texts provide opportunities in Bible classes or lectures to make explicit some of the wider implications of these characteristics of the biblical God. While most Christians will not deny that God is rational, they do not carry through this assertion to his actions in processes that he brings into being in a way that is consistent with his other processes, might turn on some new lights or at least point to the light switch. Then, the next step is to clarify that science, properly so-called, is the human effort to understand God’s ways in creation.
Error is often a result of failure to make necessary distinctions. In avoiding scientism, it is too easy for many Christians to fall into a pagan creationist view of God instead. Hopefully, scripture itself, expounded upon in these ways, will bring new thinking and save some from an essentially magical conception of God and creation.

Trip to Belize — 05-11FEB2011

February 16th, 2011

Saturday 05FEB.   Betsy woke up at 2am and I an hour later in order to catch a 6am plane to Houston and then on to Belize. The flight went well, and the only real abuse was in customs in Belize. It was actually the worst we have ever been treated in going through customs, and even Bangladesh and re-entry into the US were never so bad, with them insisting on looking through our bags and then charging us customs on “suspicious” items, as well as taking away several blocks of cheese that we had with us. We ultimately met Dennis and Jonny and drove in darkness to their home.

Sunday 06FEB.   Day of rest, Dennis gave us a tour of the “colony”. It is impressive to see somebody surviving without public electricity or water. There was a relative drought, and so we had to be careful about water usage.

Monday 07FEB. Today, we rode into Belmopan, which is the capitol of Belize, in order for Jonny to renew his visa. We then toured San Ignacio, which is the largest town close to Dennis and Dottie’s house.

Tuesday 08FEB. It rained, and so plans were changed. Betsy went visiting with Dottie to various neighbors and I stayed home. Betsy and I later had coffee with the Schiemanns, a Geman couple living on Dennis’ land.

Wednesday 09FEB. Dottie toom us to 5 Sisters rezort and waterfall. It was south of Dennis and Dottie’s home and on the way to Caracol. The waterfalls demanded a short hike. Afterwards we went to Blancaneux resort, owned by Francis Ford Coppola and had lunch. This was a truly impressive resort… One that Betsy and I wouldn’t mind returning to some day.

Thursday 10FEB. Today, Dennis drove us to Spanish Lookout, an area of Belize owned by the Mennonites and in appearance like Iowa, though with palm trees. The Mennonites, in trying to escape the world, brought the world with them. Dennis needed to stop at a few hardware stores. Ralf Schiemann was with us, and was able to give me instruction in the German language. I enjoyed him.

Friday 11FEB. This day was a leisurely trip back home, with our plane leaving Belize City at 12:30 and arrival back in Seattle at 8 pm.

So, what did we accomplish? These are NOT in order of importance or significance!

1. We were able to get the slide scanner working for Dottie.

2. We had a wonderful time with Jonny.

3. We had a wonderful time with Dennis and Dottie.

4. We learned a lot about Belize culture and land.

5. We had multiple lectures from Dennis regarding “what’s going on” in the world, as well as theology/history lectures on the virtues of British Israelism.

6. Betsy and I had a nice break together.

7. We explored the possibility of buying land in Belize.

8. We got to meet many wonderful Belizeans, both immigrants as well as native Mayans.

We appreciate all that Dennis and Dotie did to make our trip a comfortable success, and recommend considering making Belize a possible vacation destination. When we return, we’d like to explore more of Belize, perhaps staying on the coast for several days to do some scuba diving, and definitely try to see Corazol, the large Mayan temple at the end the road Dennis and Dottie live on, and much farther south.

Genesis vs. evolution

November 14th, 2010

I recently posted a blog regarding my stand on the first chapters of Genesis, attesting that there is not sufficient information in the Scriptures to lead absolutely in favor of old earth versus young earth creation. Not being a Hebrew scholar, or expert linguist, or having formal extensive training in religious studies, my comments have to reflect ultimately my synthesis of the writings of others. I am a scientist, and thus may take liberties to look critically at scientific data, feeling myself to be a competent judge of the scientific literature. This combination of scientific training and religious readings allows me to draw certain conclusions about the nature of creation.

Linguistic and philological studies do not demand that the word “day” hold to a literal 24-hour period, although the context of Genesis 1 strongly suggests a 24-hour period. Day is very often used in both the old and new testament to refer to more than a 24-hour period. The “day of the Lord” refers in the prophetic writings to an epoch or a dispensation. Stylistic and textual studies suggest that the order of creation is not necessarily as stated in Gen 1. There are those that argue that the order is merely poetic, which I object to, as it is written as a historic account of creation. Yet, the converse argument is also not true, in that quite often in the historical writings of Scripture, strict chronology is not always followed. The Gospels are excellent examples of that, and numerous examples exist in Joshua through Chronicles of historical inversions, usually done intentionally to emphasize an effect or theme. The beauty of Gen 1 is that is a perfect merger of poetics and history, being perfect poetry, and yet perfect history, as defined by a Hebrew mindset.

Neither a pro-scientific nor anti-scientific viewpoint should be forced on Gen 1. One should not seek to merge the Genesis data into the prevailing scientific models. Science may used to substantiate the statements of Genesis but not necessarily to aid in the interpretation of Genesis. As an example, the big bang gives strong credence for a creation ex nihilo yet should not be used to force an interpretation of Genesis. As an anti-science example, it is hard to imagine that plants were created, and day and night were occurring before the creation of the sun, moon and the stars. Young earth-literal 24-hour day explanations fail miserably to offer an explanation for the order of creation. Most young-earth creationists end up being terrible scientists, Henry Morris possibly being one of the worst. It would have been better had he simply offered the absence of explanation rather than to write many scientifically weak volumes that have caused more to leave the young-earth camp than to join it.

To demand a rigid scientifically plausible explanation for creation does injustice to the Scriptures. Too many of the miracles defy a scientific explanation. How might I explain the sun standing still for Joshua? Or, the virgin birth and resurrection of Christ? How might I explain something so simple as the turning of water into wine, or the unlimited cask of oil in Elijah’s time? Those events all go contrary to even our most imaginative forms of quantum mechanics. It is clear that God doesn’t feel limited by the physical laws of the universe, and there is no reason to expect that He was held bound in the creative events of the universe.

An evolutionist theology of creation has no credence, since evolution itself has no credence as a science. Evolution is a pseudo-science so poorly conceived and inadequately substantiated as to not deserve mention, let alone serve as a framework for modeling our theology of creation. Yet, many Christians have argued in depth for what is now called theistic evolution. This includes Francis Collins (see his website, www.biologos.org), Bruce Dembski, and sadly, some conservative theologians, including Bruce Waltke and Tim Keller. In arguing against a creationist model, Biologos specifically states “Because BioLogos includes belief in a creator, it is sometimes thought to be a version of Old Earth Creationism. However, because BioLogos does not require that God miraculously intervened in the process of evolution in the sense of working outside the laws of nature, and because BioLogos also claims that biological evolution is the way by which God created the world, it is not a form of Old Earth Creationism.” The first statement, that does not require to God to work outside of the laws of nature (thus suggesting that He usually always works within the laws of nature), is totally nonsensical and a clear return to Hume’s Scottish rationalism. Isn’t the entirety of Scripture the account of God intervening in the world outside of nature? He created the laws of nature, often works with them, but not necessarily. The parting of the Reed Sea and all the miracles of the Exodus narrative, the miracles and resurrection of Christ, the salvation of a dupe like me, are all miracles outside of natural laws. Perhaps Collins could tell me how Christ naturally turned water into wine (revised, of course, to make beer!). Collins offers a seriously weak argument for the possibility of miracles, which fails to be convincing. His second statement on the insistence for biological evolution does injustice to both science and Scripture. Quite honestly, I believe that Collins sold his soul to the devil in order to achieve political ascendency. How could he ever achieve and remain head of the NIH if he were a “creationist”? The theistic evolution camp develops a serious theological problem, in that if it were true, then Paul is sorely mistaken and Romans should be stricken from Scripture. He would have had to attest that at the time of Adam and Eve in the garden, there were a plethora of humans, sub-humans, humanoids, human apes, etc. and that Adam (& Eve???) stood as the federal head of whoever. If one held to theistic evolution, one would be forced to burn all the existent theology texts, and start over. I don’t think theology should be so dependent on a weak scientific theory!

Collins draws a distinction between three theories of creation.

1.Theistic evolution—all events of Scripture including creation are bound by natural laws. This forces God to be subservient to natural law rather than the God to which natural laws serve.

2.Intelligent design—this is not actually a theory of evolution, since it takes no stance other than to argue against a purely random evolutionary scheme.

3.Creationism—this has two camps, including the young earthers (7 24-hr day creationism) vs. old earthers (longer than 7 days for creation).

My stance is against theistic evolution, but refuses to commit to either a young vs. old earth camp. You might call me a generic creationist. Both types of creationism are possible, do not seem to do violence to Scripture, and do not force a reinterpretation of the corpus of theology as we know it. There are reasonable arguments for both creationist camps, and I’m not sure arguments among the two creationist camps are where the true battle is raging. Together, we must combat other insidious, rationalistic forms of atheism or deism, disguised as Biblical and theological truth.

Bruce Waltke, who resigned from professorship at Reformed Theological Seminary because of his stance on evolution, has been a focus for defining the nature of the theistic evolution discussion. Because I am currently reading his book An Old Testament Theology, I find it necessary to interject a few thoughts regarding his comments.

1. In a footnote on the word “day” as found in Gen 1, Waltke admits that it more probably refers to a 24-hr period just from linguistic constructs, yet he later shows how the textual usage of the word “day” in in Gen 1 & 2 could not possibly mean a 24 hr period. Doesn’t make sense to me. I’m no scholar of Hebrew or textual criticism, and have to beg an inability to resolve this tension in the first chapters of Genesis.

2. Towards the end of the Cosmos chapter, Waltke admits there that he has been mostly influenced by a) BB Warfield, who stated a belief in evolution, and b) Francis Collins’ book The Language of God. I find it to be terribly disappointing to think that Collins has influenced the thinking of Waltke.

In order to sort out the science vs. Scripture dilemma, one needs to take a closer look at science. Science can be categorized into two parts.

1. Observation of God’s world, and development of new methods of observation. This we are encouraged to do in Scriptures. It is God’s world, and we are to delight in it, and the Creator who made it. Our senses are not entirely to be trusted, but our ability of observe the world in different ways often (not always) brings resolution when there are conflicting observations.

2. Interpretation of the observable data. Data demands a framework for its interpretation. By abandoning a biblical framework or Weltanschauung of Scripture, science becomes its own god.  This creates a problem when we fail (like Collins) to see what we have done, in that Collins tries to merge a secular atheistic interpretation of scientific observation onto Scriptures.

Waltke in his text spends much time talking about a parallel ancient near east myth of creation, which has many close resemblances to the biblical creation story, but clearly far more vulgar and fantastic. He proposes that the biblical creation was written as a rebuttal of the Marduk mythology. There are several problems with this.

1. It is not characteristic of Scripture to BEGIN any writing or major thesis as a rebuttal or defense. Scripture needs no defense. God is a big boy, and doesn’t ever come out fighting to defend Himself. How else could I say it? It is too atypical to suppose that the creation account is a DEFENSE (!!!!) against ancient religions?

2. I am deeply puzzled why Waltke could not have given the simplest explanation of the Marduk account, that is, that the Marduk account is a perversion and degeneration of the creation story passed down from Adam to Moses, and probably corrected by God in an inspiratory fashion to Moses.

3. Theistic evolution can be likened to recruiting the Marduk myth to enhance the meaning of the creation story, that is, to use another god (science in its second meaning above) to offer us further insights into the creation story. If evolutionary theory wasn’t such a pathetic replacement of the creation story, I might be tempted.

Science in its first meaning is legitimate, and observations can influence exactly how we see Scripture. The Scriptures speak of the four corners of the earth, and we know only from our reasonably un-interpreted observations of the planet earth that there aren’t four corners, so we do utilize to some extent how we see the world and how we read Scripture. I do not stand strongly in favor of either a young earth or old earth creation, because I say we simply have insufficient information from either Scripture or our observation of the world to decide between the two. Maintaining a “neutral” scientific stance allows only the statement that we don’t know exactly how and by what mechanism God created the world and all that is in it, but simply that He did it. We can’t state a precise time period or order, but just that God was active in creating all that we know of the universe, including all of the laws of physics, matter, energy, anti-matter and anti-energy, and everything else.

Perhaps the best old-young earth merger is the possibility that the seven days of creation are seven 24-hour periods separated by lengthy segments of time, and that the days do not necessarily reflect a perfect chronological order. The gaps between days would explain the saltatory effects of the fossils, i.e., that the fossils don’t show a steady progression, but demonstrate spurts and jumps with large gaps, suggesting miraculous creative activity, interspersed by lengthy periods of creative inactivity. Even here, I’m reluctant to offer this as my absolute stance, since the exact progression and timing of creation will not be known outside of further revelation and clarification by God himself. It is possible that your comments will help persuade me one way or the other!

Im Vaterland mit Fahrrad

September 2nd, 2010

It was time to go to Germany, and discover the world of bicycle riding in Europe. Dr. Peter Tate was to meet me in Berlin with his bicycle, and I was bringing my Novara Element with the intention of leaving the bicycle with Onkel Herbert. Daughter Diane was able to get away from work and go with us, and she seemed content to take care of herself when Peter and I were out riding. Our plan was for a Blitzreise, spending three days in Berlin, three days in Leipzig with Herr Doktor Kretschmar, and three days in Krefeld with der berühmte Herr Doktor Feucht. Diane left us after Berlin to go see a friend in Frankfurt, and we met again in Krefeld. The trip included much learning about how to survive with a bicycle. It was especially the case with learning how to travel on public transportation with a bicycle, like riding the Bahn. Once arriving in Berlin, the first order of attention was to assembling the bicycle, and then to going out to get some Döner. We were able to take Peter on a walk around Berlin in order to show him the main sites, like the Bandenburger Tor.

21 AUG 20 km ride around Berlin– riding a bicycle around Berlin was easier than expected. Bicycles need to observe the same rules as cars, though they usually have special bicycle paths for bicycles. The rest of the day was spent taking a long walk with all three of us together and Diane as Stadtführerin.

22 AUG 108 km ride to Potsdam from Berlin, with bypass to see Sans Soucci and to loop around several lakes in the Potsdam area. This was a long ride, and the weather was perfect. On this trip, we learned how confusing it could be to try to find your way around, and we often went in circles. Streets are not often clearly marked, and they frequently change name for no good reason. To make matters worse, I was depending on a gps card for my Garmin Edge that would give me streets in Europe. The gps unit refused to accept the card, and so was left without a reasonable means of orientation and poor maps. I couldn’t have been more upset. Needless to say, the ride was awesome, and the palaces around Sans Soucci were overwhelming in their size and grandeur.

24 AUG Dresden. 4:30, 81 km3500 cal, 120 m– Peter and I arrived in Leipzig on 23AUG, and was picked up at the Hauptbahnhof by Dr. Kretschmar, whom I met last year while in Cameroon. He arranged for us to stay at a Ferienwohnhausrun by one of his friends. We were able to meet his parents and to have supper with them. The home-made sauerkraut was awesome. They also took us on a quick tour of Leipzig. On 24 AUG, Karsten, Peter and I were able to take off on our bicycles to the Elberadweg. We drove about 1 hour to our planned start, and off we went. The route was unbelieveably well cared for, and many people were on the road. It was fascinating to see a very large number of quite elderly people out riding their bicycles. We passed through the towns of Meißen, where the famous porcelain comes from, Dresden, and on. As we rode up stream, the canyon walls got steeper, and more impressive. There were multiple castles and elegant palaces along the way…. Nothing like one would ever see in the US. We then stayed in a very large Herberge, which looked like an old castle with a Turm, and nestled on the side of the canyon wall.

Peter and Carsten

Meißen

Peter in Dresden

Frauenkirche

Semper Oper

Our hostel was the upper right white “castle”

25 AUG. Konigstein to Neuhirschstein 90.6 km 5:17  3593 cal, 215 m ascent– the next day, we first rode 10 km up the Elbe to Konigstein, making a fairly steep climb up to the largest fortress (Festungen) in all of Europe. It was overwhelming. The trip back along the Elbe attempted further variations in order to see different things. At the end of the trip, it was very sad for me to have to say goodbye to Carsten, as I really appreciated seeing him and family again. I’ll definitely want to see him again in Cameroon, as well as spend time with him again in Deutschland.

Königstein

Königstein

Summer palace in Dresden

End of the ride in Hirschstein

26-27 AUG — we took the Bahn from Leipzig to Krefeld, and then rode our bicycles from the Krefeld Hauptbahnhof to Herbert’s Haus. The next day, Diane, Peter and I rode the regional transport to Düsseldof. We also spent much time looking for a bicycle box in order to sent Peter’s bibcyle back to the US on the airplane with him. We finally found a box for him at the Rückenwind bicycle shop.

28 AUG Krefeld to Ossenberg and back.   5:42,  100.7 km     3673 cal, 127 m ascent. Today, Peter and I took off on our bicycles to ride up the Rhein. The bicycle path was reasonably well marked, but the road was not in nearly as good of shape as the route along the Elbe. Also, since we were in the  Ruhrgebiet, we saw a huge number of very large factories. At the end, the weather got us, and we were caught in a squall. Peter wanted to stop for a beer, but I just wanted a warm shower and dry clothes.

It’s been hard saying goodbye again to so many friends. Carsten, Herbert, Katja and Hannes and Peter. Having left a bicycle with panniers at Herberts Haus, I now have no excuse not to return to Deutschland for another ride. I’ll either do the upper Rhein, the Schwarzwald, or perhaps something over in the Franken/Spessart area, heading to Prague. Hopefully, the next trip might be a little longer, and focused on just one region, to prevent spending a lot of time just getting from one place to another.

Telling God how He did it

August 15th, 2010

Brother Dennis opened up some thought processes when he made some comments regarding a book that I reviewed by Dempski called The End of Christianity. In particular, he comments on God sticking His fingers into the process of Creation/Evolution by saying “This is a key issue between intelligent-design theorists and evolutionary creationists. Why God should have to tinker with the creation after he establishes the laws of the universe along with initial conditions is unclear. Has he not gotten it right from the start?”.

Simultaneous with Dennis’ comments, I receive an e-mail from NH, a physician and Christian thinker whom I respect dearly. His note is as follows…

“I would commend to you a careful reading of these two items:

http://www.modernreformation.org/default.php?page=articledisplay&var1=ArtRead&var2=1137&var3=issuedisplay&var4=IssRead&var5=112

in which 8 geologists appeal to the PCA to accept the “old earth view.”  It is a pitiful piece when looked at from a theological perspective, and actually quite poor from a scientific perspective (the analogies in particular are often invalid). Hopefully when you read it you will anticipate the arguments made in this point-by-point rebuttal by another geologist:

http://www.reasonablehope.com/node/117

Both the links are worth reading, the second article being a rebuttal of the first. You may determine for yourself the strength of his rebuttal, though I consider it as standard classical argument of young-earthers.  Clearly, NH is a 7-literal day creationist. I am very reluctant to trash either Dennis’ or NH’s comments, yet offer a slightly different approach.  The first difficulty is in creating a discussion. The 7-day creationist (if you wish, young-earth folk) consider their stand as a litmus-test of orthodoxy, and any disagreement is considered either an inability of believe the Scriptures or inability to hold Scripture as the infallible word of God. The old-earthers look at disdain at young-earthers as somewhat scientifically naive and guilty of the sins that possesses many medieval theologians that fought against Kepler and Galileo. Neither side is right.

I proffer several foundational statements.

1. The word “day” in Genesis 1-3 does not necessarily denote 24 hour spans. This argument is ably developed by both Hebrew scholars and biblical scholars that look at the use of the word “day” throughout Scripture.

2. The genre of Genesis 1-3 is neither strictly poetic nor strictly literal-historical. Those who develop the construct of Genesis 1 as simply being an apologetic against the Egyptian gods are wrong, though an apologetic is implied by the structure of how Moses constructs Gen. 1. Nor does it utilize language and terms that suggest an accurate detailed historical approach to creation.

3. The implication that God commands events to happen in each of the days of creation suggest a divine interference on a “daily” basis. Dennis’ comments, of which I’ve heard many times before, suggests that there is a “anthropomorphism” in the very substance of the atomic structure of the universe, that demanded that this is the sort of universe only that could have come out of the “big bang”. This seems to lean dangerously to Deism, if not Animism, whereby Nature itself is offered the source of personality, and that the universe, once wound up, can take care of itself.

Thus, there remain a few questions of relevance…

1. What is the level of involvement of God in the process of creation/evolution? At what stage, or, at what time in history, did God decide to cease active interventional work in the universe outside of the laws of nature, and thus work through the “laws of the universe” in his actions in the world, including his miracles as described in Scripture? This is simply an unanswerable question. Scriptures give us no clues, and science could never answer such questions.

2. Is it morally deceptive of God to create things that are aged? To what extent would he have done that? In my opinion, it is neither right nor proper to ask such questions.

3. Do the questions of creation/evolution really need to recruit discussions of a universal flood? Are these not ultimately separate questions?

4. Can we ultimately claim an exegetical basis for establishing the genre-type of Gen 1-3? I bring this up, because young earthers wail long and hard about the abandonment of a strictly literal interpretation of the Scripture. Yet, John Gerstner, in Wrongly Dividing the Word of Truth, waxes long and hard against dispensationalists who force literal interpretations when the genre doesn’t permit a literal interpretation.

My own personal stance leaves me neither a strictly young nor old earth creationist. I feel that we assume too much when we attempt to engage in the creation argument. I feel that discussions have not allowed for a plastic middle position, and focused on how far from that middle one needs to go before one falls off the edge. It could happen both ways. I feel that Dempski falls off the edge, when he removes God from the much of the processes of creation. Morris from the Creation Research Institute falls off the other edge by pushing his agenda so hard he simply does poor science. It would be better for Morris to simply be a fideist than an apologist. Yet, I also accept that much of science will eventually be proven wrong, that our standard tools such as carbon dating will be replaced, and that new paradigms will replace old. Like Hugh Ross, and others of the conservative old-earth school, I see how we may use science as an apologetic for a Christian worldview, even though the science may evolve with time. As an example, the red-shift observation in the stars led to the “big-bang” theory, which is entirely consistent with Christian thinking that there was a time when the universe was not, and then came instantly (almost) into being. The intelligent design argument wonderfully argues against a laissez-faire universe explained entirely by random events. God clearly interfered with natural processes at all stages throughout the development of this world, though we will never know the balance of interference/natural process nor the speed/acceleration by which he had natural processes occur. To me, the arguments sit around trying to tell God how He did things. I’m sure He’s not so amused at our undertakings.

Since we are on the topic of God interfering with nature, there is one more thing that bothers me. I just wish to know why Jesus didn’t turn the water into beer rather than wine.

Bangladesh 2010

July 4th, 2010

07JUN2010 I’m currently sitting in the airport at Muscat, Oman. It is a very nice airport, and thankfully, all have been very helpful to me. I discovered only a few days before leaving that CheapOAir changed my reservations such that I was left with a 28 hour layover in Muscat, the thing that I dreaded most, being stuck in an airport for lengthy periods of time. There was no way that I could correct matters, though there was a glimmer of hope yesterday with Lufthansa suggested that I could be bumped for a day, which would have left me a 4 hour rather than 28 hour layover. Oh well. The trip started in Seattle. The checkout person was German, so we did the entire exchange auf Deutsch. I was pleased to discover that I was also able to fare quite well in the Frankfurt Flughafen, my German ever so slowly improving, though mostly in interpretation, and not in ability to communicate. I’ve been able to read two large books so far in my travel, well as study some German and Bengali. I sadly discovered that I left my light yellow rain jacket on the last airplane, but won’t discover until this evening whether it showed up in lost and found. The airport is quite fascinating, and am surprised at the amount of liquor that could be found here, even though it is a strict Muslim country. I’ll probably pick up some frankincense on my way back from Bangladesh. I wish that Betsy was with me. I miss her, even though she seems to be constantly anxious about any sort of imaginable trivia. I’ve seen only a few spooks so far, and most people seem to be dressed in Indian western dress. I am quite surprised at the prevalence of Western culture, and especially English, in remote parts of the world, such as here in Oman.  Watching Muslim and Hindu families come by, seeing people interact and converse, it amazes me that cultural differences are over-emphasized, and how similar the characteristics of all humankind tend to be.

08JUN2010 Finally in BD. Babil got me at the airport, and we went for lunch at a local Bangladeshi restaurant. I’m eating with my hands again! You don’t use a spoon and fork in BD but pick up your food with your hands. It was wonderful to see old friends here in Chabagong, including Steve K, Steve W., Jason & Anna, John Tripura, Poromil, Uttam, Sujan, and the Collins. They make the trip worth it! Please forgive me if I left your name out…

20JUN2010 A 12 day interlude is now noted. I have been quite busy at the hospital, and enjoying my interactions. Like before, I have spent much of my free time in either talking with friends (of whom are both Americans and Bangladeshis), and reading. A number of books have already been devoured. Several books will not be reported in my website for the sake of Christian charity. Dr. Lattin has also loaned my some old copies of First Things.  I find First Things quite fascinating with a mixture of feelings. About a 1/3 of the articles are delightful and of interest to me. They utilize English at its best, a subject which leaves me rather jealous, because, try as I may, I find it impossible to write well. Every time I re-read what I write, I find grammatical errors, confusing statements, inappropriate use of words, self-manufactured words, and other stupidities. Brother Dennis only points out the most glaring examples. Yet, while reading First Things, I am able to obtain a vicarious joy in the best use of the English language, and the thoughtfulness of the articles. I am less inclined to delight in First Things because of its replete Romish Catholicism, as well as its slightly too liberal stretch of “co-belligerency” to Rome, Eastern Orthodoxy, Judaism, etc. Yet, Neuhaus is a first class writer, and often strikes a cord of agreement with me that I am able to appreciate.  My time is also spent in reflection on life in general. I miss Betsy tremendously. I do not feel complete without her. I’ve reflected much on the nature of missions, especially missions in a Muslim realm. Modern Western sympathies for Muslim culture and religion seem to lack an appreciation of the working of Muslims when found as the predominant cultural or religious group in a community. This has been seen by me both in BD as well as in Cameroon. It is a religion of slavery, joylessness, oppression. It offers minimal respect for women, disguising the depersonalization and subjugation of the female population all in the name of modesty. Yet, devout Muslim men seem to be the most lustful of all of God’s creatures, and the presence of a Burqua doesn’t quench their lusts. Generalizations tend to betray the large amount of quite decent living and courteous Muslim people that I’ve encountered, who have been most helpful in my travels. Like last time in BD, probably the hardest thing to endure is the persistent beggarliness of all Bangladeshis. It’s hard not to respond to that, though agreements with the mission to not give more than meager gifts to the natives must be observed. A typical BD native seems to view the missionary Christian as the equivalent of “wealth”, and I remain perplexed as to how to personally respond. I sometimes feel that my presence in BD is perhaps more a problem than good for the gospel.

27JUN2010 I have just finished my last day of call, and will be wrapping things up this week. Call kept me up both nights, the first to do a D&C, and then next night to answer questions about a patient who decided to go into the dying mode. It is monsoon season, and rain occurs unlike anything in the Northwest. It will rain torrentially for about twenty minutes, and then it will be sunny. Rains occur about 2-3 times a day. I tried going out once in a downpour, with an umbrella, and found that I was soaked from head to toe, as the rain falls horizontally with a small wind. You’re always given a minute or so premonition of coming rain, as the wind begins to blow. You don’t see dark storm clouds, just a wind. I’ve now met with all my friends on the hospital compound, and feel like I’ve been able to spend quality time with them. I haven’t taken enough photographs, and will need to spend one last day running around with my camera. Nurul (his name sounds more like Noodle as the Bengalis do a different sort of “r”) will be taking me up to Chittagong. Meanwhile, only one thing is on the mind of most Bangladeshis—the World Cup in soccer. Oddly, the nation cheers for only two teams, Argentina and Brazil. It will be tragic when both of those teams loose.

02JULY2010 I’m now sitting in the airport in Chittagong. It’s the first time in ages that I’ve been able to access fast internet (and free, also!!!!). A few Taka and the airport assistant was able to shuttle me through to the head of the line, and get me through without a problem. The airport scanner was broken, and so they quickly let me through when I told them that I was a daktar (doctor). The ride to the airport was with Nurul, who drove quite decently, and we arrived in generous time to catch the plane. Although Cameroon roads were the worst I’ve ever encountered, Bangladeshi roads are not exactly super-highways, and more than once, we almost hit a dog, rickshaw, and oncoming bus. I can’t believe that more accidents don’t happen in this country. Later… I’m now in the airport in Muscat, Oman, waiting for my Papa John’s pizza to cook. I happened to be the only white person on the plane from Chittagong to here, and it’s nice to see a few English speaking people around. Bangladeshi behavior is close to hilarious. They are very pushy in line, always trying to get ahead of anybody else. Once the plane hit ground, almost immediately, about half the passengers popped their seatbelts and were standing to fetch their overhead items. Strange. Papa Johns was quite good, not greasy, close to what one would eat at home. I ordered the super Papas, since they didn’t have the Arabian Always special. I presume it was halal. The checkout lady was in black dress, not a full burqua, but had absolutely no personality; no smile, no regard for people, nothing.

Papa Johns in Muscat, Oman

Flowers of Bangladesh

Selling Jackfruit in Chabagong

John and Nimmi with hospital schematic

In the market with Sujan

I now think about the trip summary. I feel that it was a valuable trip, especially being able to meet old friends, and acquire new friends in Malumghat. I was able to give Steve K. free time to work on the design of the new hospital with the architect. I especially enjoyed meeting John M. and his wife Nimmi, who live in North Carolina, though they come from Chennai (formerly Madras) India. What did I forget? 1. Insect repellent. The last four days, the bedbugs came out, and I was covered head to toe. Interestingly, at the same time, I read recently that an Abercrombie and Finch was closed in New York City because of bedbugs. Go figure. 2. Flashlight (headlamp) – the lights go out way too frequently, and I have to ride a very bumpy road on my bike at night to get to the hospital when on call. 3. Voltage converter/adapters- the only thing that wouldn’t work was my beard trimmer, but sticking a three prong plug into the outlets provided tended to put a terrible strain on the plug. It would have been better to have an adapter.

I am considering a return in late January/early February 2011 with Betsy. If we go, I think I will try the oriental route, and maybe stay several days in Bangkok. Jason noted that the town was quite interesting, and fairly modern, worth a visit. We’ll see how the Lord leads.

So, as soon as we arrived home, Betsy and I went out to purchase a new vehicle. Diane needed our RAV4, and we sold it to her since we were considering a pickup. We ended up with a Toyota Tacoma.

Life Update 19APR10

April 19th, 2010

Cannon Beach
It’s been over three months since I’ve posted about events in Betsy’s and my life. A lot has gone by, like, Easter! I had out the Österlamm that Herbert gave me about 6 years ago.

So, here is a quick catchup, mostly with photos…

1. Deutsch Unterricht– I restarted Saturday AM German class. Between reading the Magazine Deutsch Perfekt and going to German class at the Tacoma German Language School, I’ve been able to keep from totally loosing my language skills. Here are some photos of the class, as well as the teacher, Yvonne. She is from Dresden, Germany, and is unbelievably patient with us old farts.

2. Oregon Coast– in early February, Betsy and I took a trip to the Oregon Coast. The lead photo was from Cannon Beach. The Oregon Coast is one of the most beautiful coasts in the world.

3. Cycling & trainer– Betsky now has a new bicycle, named Meggie II, after her first bicycle. We took a brief 10 mile ride recently…

Betsy also let me get a Tacx Virtual Reality Trainer. These are quite nice at being able to cycle train in bad weather or when you only have an hour to spend on a bicycle and need a hard workout. It works by connecting a computer to a gizmo that your back bicycle wheel sets in. When you are going “uphill”, the wheel offers resistance in proportion to the steepness of the hill, and when going downhill, it may actually spin your tire for you. It is close to reality.

You can see that it really chews up your training tire. Meanwhile, you watch a video screen, which you set to a number of rides that you may wish to experience, throughout Europe. As you pedal faster, the scene moves faster, quite comparable to reality.

The screen will also show your power output (in watts), cadence (how fast you’re pedaling), heartrate, bicycle speed, time, and distance. This allows you to monitor closely how well you are improving on your endurance. Here is Jonathan on the bicycle trainer…

4. Bicycle Tour 15-18APRIL2010. This trip was to celebrate tax day, April 15. Russ A. and I drove to Chelan, WA, and took off from there. Our first stop was 52 miles later in Twisp, WA. The road either followed the Columbia River, or tributaries, leaving us at a resort town just east of the North Cascades pass.

The next day went from Twisp to Coulee Dam, a 85+ mile ride, with fully loaded touring bikes, and about 7000 feet elevation gain. Here was our first challenge, that of crossing Loup Loup Pass. We were concerned about the weather since it had snowed on the pass just a week before. It was quite cold, but we were working so hard to cross the pass that we were over-heated anyway.

We then ended up in Omak. We met a kindly elderly gentleman on the street to enquire about our options, and he suggested that we NOT go the way we had planned, but instead take an alternative route that was marked on the map as gravel road, yet in reality was fully paved. He also suggested that there were minimal hills. The route indeed was far less hilly than our planned route, but was persistent in multiple sections of 6-7% grade uphill, and a lengthy 8-9% grade section at the beginning and end of the new route. We were quite pleased to have done this alternative route, since it took us by some absolutely spectacular scenery, like Omak Lake.

We eventually ended up at nightfall quite exhausted but looking at the Grand Coulee Dam. We stayed in a motel that faced the dam.

The next day was 61 miles and another 5000 feet of climbing. From the photo below, the intuition would remark at how flat the terrain was, yet, on a bicycle, it was quite rolling hills, with lots of 6% grade climbing. We were still moderately tired from the previous day, which made it harder to do even simple hills.

Our last memorable scene was from the Columbia plateau, getting ready to descend down to the Columbia River. In the distance, you could see Lake Chelan and the town of Chelan. It was a 8-12% grade descent for about 5 miles. Awesome! I’d sure hate to come up that hill on a loaded touring bike!

5. Future– so much has gone by. A niece, Laura, won a beauty pageant.

Laura, we are so proud of you. It takes not only beauty but true talent and skill to get to Teen Colleyville.  Thankfully, you didn’t have to have uncles dying in the car and brothers spazzing out on you to get into your contest, like in Little Miss Sunshine. We had old friends from many moons ago, Aaron and Anita visit us. They remain quite special. I especially appreciate being able to do outdoor things with Aaron. We plan on seeing Jonny off to Belize for the summer, and perhaps longer, to visit and study with Uncle Dennis. Dennis has been doing well, as is attested by this recent photograph…

Once he gets out of jail and quits playing with poisonwood, he’ll be back to his old self, I’m sure. Dennis is not really in jail; he is just showing us the miracles of Photoshop. I’d really like to visit Dennis some day. Belize is looking increasingly appealing, especially with our Destroyer-in-Chief Obaminator as el Presidente ruining all that we count as precious in our country. He will go down with Woodrow Wilson and FDR as the worst presidents ever of the USA.

I hope to do a few more cycle tours this summer. I also plan on spending the month of June in Bangladesh, and will be in Germany for the last 2 weeks of August, if all works well. More blogs will follow. I haven’t had many book or movie reviews since I’m listening to 2 lengthy Brahms compendiums, which I wish to review together, watching a lengthy tv series with Betsky, and reading a very large and ponderous book. So, more blogs will be in the works in the future. Meanwhile, please stay in touch.

Surgery and the Airline Industry

April 19th, 2010

I’ve written about this before, but the topic doesn’t go away and I’m growing weary of it. Hospital regulatory agencies in our state, and in most states, are being instructed the the way in which the airline industry has become safe was through the use of certain regulations and imposed rituals. Especially being pushed on the medical community are the use of checklists, similar to what are used before and after a flight to assure that all procedures are carried out correctly. Our state is now instituting a checklist standard with 100% compliance by hospitals in our state, and celebrated by meeting at the old Boeing plant in Seattle, Washington with an author of a favorite book detailing the use of airline safety procedures in the health care industry.

I’m all for airline standards, but not in the “pick and choose” standard that is being shoved down our throats. There are too many other airline industry differences that are simply ignored, at the patient’s peril. I’ve discussed many of them in the previous post. Let’s re-hash a few of them.

1. Airline personnel work hours. The airline industry, as well as the government, has strict standards on the amount of fly that a pilot can do, or work that a repairman can do, before exhaustion leads to inefficiency as well as mistakes. Nobody would ever dream of climbing on an airplane, where the pilot has been up the last 24 hours, and is now exhausted. I have personally called for reform in this area with deaf ears listening. It is hard to imagine that a truck driver is our state is forbidden from driving his truck for greater than 8 hours straight, and yet physicians frequently work for 48-96 hours straight with nary a comment from the state about the dangers that this is imposing. I’ve asked both the medical society as well as state legislators to consider this problem, and it is swept under the rug. Yet, if there are any actions that could be taken to eliminate errors in medicine, this is certainly the most important. Even airline pilots, on long flights, have replacement pilots in the plane to prevent the pilot from having to fly for over 8 hours.

There are 2 main stresses on an airline flight, that of taking off, and that of landing. True, decisions may need to be made in the air, but the main stresses are the start and end of the flight. In medicine, the initial patient consult, the care during a moment of extreme instability, or the trip to the operating room, may be likened unto the takeoff and landing stresses. The period that physicians spend on call sitting by their beepers could be likened to the time in the air. It is similar, since the physician is still being called, and must make consequential decisions. Many of those decisions are made when awakened from sleep, and more often than not, a night on call will rarely give more than an hour of straight sleep in a night. Yet, we not only have to make significant decisions during the night, but must show up at work and consult on new patients or operate the next day. Would anybody feel comfortable flying on an airplane where the pilot had no sleep in the last 24 hours? Thankfully, most patients have no clue how much sleep their surgeon had in the last 24 hours! Comparable to the airline industry, it would be like saying that the only legitimate work-time for the pilot was the time on takeoff and landing, and then who cares how much time is spent in the air, since flight time is low stress.

2. Co-pilots. It used to be that almost all surgical cases had two doctors in the room. For smaller cases, it was the surgeon and a family doctor, and for larger cases, it was two surgeons. Nowadays, it is almost impossible to get two surgeons both in the room at the same time. It is economically unfeasible, and we’ve been forced to adapt. This has mostly been to the greater risk of the patient. Two surgeons on a case always goes quicker and better than one surgeon alone. It could be compared to the airline industry deciding that a co-pilot is too expensive to maintain, and thus eliminating that position. Maybe it’s time to return to the co-pilot in surgery practice?

3. Retirement – My pilot friends tell me that the airline industry bumped up the age of mandatory retirement from age 60 to age 65. Frightening! Pilots need to go through more rigorous pyschomotor testing to assure that they have good reflex timing as they age. Why aren’t they doing this for doctors, especially those who do procedures on people? We are required to take ever expanding CME classes and tests to prove our mental competence, though it is dubious that either accomplish their intended task. At the same time, we are required to take courses in things we never intend to see or would not manage even if we encountered such a situation, since courses of themselves are absolutely no replacement for real-life experiences. I recently took a mandated pediatric trauma on-line course in order to maintain my ability to serve our hospital. I felt like I was in the military–dotting all my “i”s and crossing all my “t”s, yet realizing that I had not acquired any true competence at pediatric trauma. We don’t have simulators that can exactly match what a flight simulator can do for a pilot. There are no surgery simulators that will spray blood in your face and give you AIDS if you screw up.

At this time, I have no recommendations for the medical profession, but pray that it soon die the same death that all it’s patients will eventually experience. Physicians are unwilling to defend their profession from external abuse, but complain bitterly about the loss of their profession. Medicine – R.I.P.

Checklists

April 19th, 2010

Below is an article that I wrote several years ago, that is now more true today than when I wrote it. At the time, we had a flamingly incompetent Chief of Staff (called Dr. Bigshot, since he remains very prominent in politics at our hospital) and the staff of our hospital was all given an article by Dr. Guwande from the New Yorker regarding the virtues of checklists in saving lives. My apologies for not being able to give you the exact reference for this article, as I threw it in the wastebin. I have no problems with checklists. I have a serious problem with assuming that checklists are what saved the airline industry, and that people would be saved if only we used checklists. So, I re-post my article. The next post carries on with the same theme, now written contemporarily. BYW, Dennis, I found most of my grammatical errors, but feel free to inform me of others.

Several years ago, tort reform became the cry of the medical profession. We felt that our profession was being destroyed by a litigious culture which was strongly supported by a government that seemed to thrive off of a healthy legal industry. We lost that battle. In return, the law industry laid claim that the health care industry was careless and did not attend properly to quality control or error reduction. In turn, we responded with multiple programs. There were state and national programs that were initiated, such as the 100,000 lives campaign (I await eagerly the 250 million lives campaign). Even in Pierce County, our medical society invited various quality control pundits to speak to us. The rallying cry was to become like the airline industry. After all, did not the airline industry take an intensely complex system, and produce methodological algorithms (such as checklists) to eliminate human error? As I learned in flight surgery school, the number one cause for airline fatalities was a loss of situational awareness on the part of the pilot. Checklists helped to reduce routine operational error, thus, decreasing the one aspect of fatal error.

The article by Atal Guwande in the New Yorker further fosters this idea that if only the health care industry model itself after the airline industry, then error reduction would significantly fall, and lives would be saved. I certainly agree with Dr. Guwande that checklists can serve some useful purposes in our profession. Yet, I also see certain problems with what he proposes. The first problem discusses differences between the airline industry and medicine, that disallow the airline model. The second details the evidence that Dr. Guwande himself provides claiming that checklists can solve many of our woes.

First, what are the differences between medicine and the airline industry? There are a number of issues that I can list.

1. We can?t control the circumstances. In the airline industry, if bad weather hits, the airlines shut down. We can?t do that. We “fly” in any circumstances. If a patient arrives in immediate need for surgery when the operating rooms are already filled and the patient already has multiple system organ failure, we aren?t allowed to “stop all flights (surgeries)” and wait, in order to get control of the situation.

2. We don?t aim for 100% survival. Ultimately, all of our patients will die, which is 0% survival. Unlike airplanes, we have a poor means of predicting personal survivability. We can quote population statistics, which do not apply to a given individual. Checklists or not, eventually everybody will die on us. In fact, we have very poor means of measuring when we are actually successful in medicine, as it is not necessarily survivability at low cost without complications.

3. We cannot set the circumstances for surgeons or health care personnel like we can with pilots and flight attendants, airline mechanics, etc.. I would love to have the same working circumstances as a surgeon as a pilot usually lives. There are strict controls of working hours, and time that a pilot is allowed in the cockpit. We have no such controls. Yet we know that human error is our biggest source of health care error, just like situational awareness is the biggest problem in the airline industry. Establishing mandatory retirement ages, mandatory work-hours, mandatory spontaneous drug testing would kill the industry. I have operated countless times high on antihistamines in the symptomatic treatment of seasonal URI?s, yet such drugs would have grounded me in the airline industry. Are we willing to have our health care personnel subjected to such demanding regulation as the airline industry has done? Why not? The object is to eliminate human error, and such airline regulations would accomplish that.

4. Human systems back-up cannot compare. A pilot has not only a second backup (the copilot) always at his side, but also the capabilities of autopilot. Generally, we virtually never have a second physician (with the same expertise) simultaneously participating on a case. Auto-doctors remain to be invented.

5. Which leads to brutally serious question…why have auto-doctors not been invented yet? Autopilots work because one can “figure out” most the systems issues and expected problems in the operation of an aircraft. The “machinery” (the human body) that we work with is infinitely more complex than the machinery (the airplane) that the airline industry works with, and the expected problems vastly greater. While Dr. Guwande tends to disparage the “art” of medicine, heralding the virtues of scientific medicine, it remains without question that the complexities of medicine demand both intuitive as well as methodological decisions, and the intuitive decisions cannot be check-listed. An equivalent comparison would be to devise an airplane that is so complex, the ground support personnel never really understand how the airplane works, or exactly what the proper procedures are to repair. The pilot could never be sure whether pushing the joystick to the right would move the appropriate wings or flaps in the proper direction, and would be told that any control panel action would have only an 80% or less response rate, as well as a highly unpredictable nature of whether all the monitors or gauges on the control panel were ever monitoring the correct information. Yet, we live with this all the time in medicine.

6. The economics are different. If the airline industry is asked to institute an industry-wide change, they would raise rates to passengers to pay for that. We cannot do that any more in the health care industry. In fact, our pay would either remain stagnant or cut, in spite of elimination of error.

7. Training and retraining. We call retraining CME, yet CME only remotely pertains to our practice of medicine. A flight-simulator has never been invented for the health care industry, probably for reasons explained in #5. Our expertise comes solely from experience, coupled with the maintenance of an innovative mindset. When we increase physician educational demands and demonstration of competence through increased testing, the net result is not increased competence among physicians, but a decreased number of physicians, who drop out rather than re-test. This doesn?t mean that we can?t learn from the airline industry. It only means that we need to be very cautious in selecting what methodological algorithms we acquire from the airline industry, and then be highly selective in exactly which circumstances or activities would be well served by these algorithms. It is possible that some systems in medicine would actually be harmed by blindly applying the airline industry methodology of error prevention.

What about Dr. Guwande?s claims that checklists can significantly reduce error in medical care? Dr. Guwande discusses his thesis with unbridled enthusiasm. In a most unscientific manner, he fails to discuss multiple variables that should have been examined, especially since his thesis of the virtues of checklists are now being mandated throughout hospital systems in the USA. Which variables did Dr. Guwande follow? Survival? Costs? Turnover rates of health care personnel? Patient and family satisfaction? Days of hospitalization? His studies of checklists were limited to highly specific and controlled circumstances, such as the management of central lines. This is a relatively non-complex system compared to many systems seen in medicine. Does he propose that all operational systems will be helped by check-listing? Does he have evidence for that? Newly enacted checklists tend to eventually breed familiarity, that in turn lead to loss of effectiveness. Dr. Guwande has only short-term follow-up of his check-list system, so it is not surprising to see short-term improvements. What do you suppose we will see after ten years of checklisting and familiarity itself leads to error? I suspect it will lead to even more detailed check-lists, probably orchestrated by a computer program, rather than a human, such as the nurses that Dr. Guwande used in his catheter study. This in turn will not only drive up the costs of medical care, but also the depersonalization of medical care.

Outside of checklists, the failure to communicate has been identified as the other great sources of medical error. There is a great amount of truth to this, and check-lists certainly serve the function of forcing a brief episode of communication among the team, many of whom often don?t even know each other?s name, let alone the most rudimentary facts about the other people on the team in the room. But, we don?t dare tread on that. We must remain scientifically impersonal. Yet, when I work with a team that has known me for years, typically, minimal communication ever occurs about the patient or medical care we are rendering, save for occasional teaching points for the team (we do talk about other things!). We know how each other does things, and we expect things to be done that way. This is true for nurses and techs in the OR or recovery room, as well as experienced nurses on the wards. Sadly, regimented communication cannot fix the problem of operational harmony, something that only time and experience with each other as a team can fix. Which is why “teams” are probably more important than check-lists. Another communication issue, handwriting, was fixed thirty some years ago with computer-order entry, quite the norm in Chicago, IL where I trained, but still unknown in these parts.

Dr. Bigshot comments that resistance to checklists is an “ego” issue. I doubt it. True, there are ego issues when one has a nurse policing the doctor. Not even the airline industry has stooped that low, having a stewardess tell the pilot to push the rudder right rather than left when the airplane is going down. But that is exactly what is happening in medicine. You can escape hierarchical disorientation by being independent, which is exactly what Dr. Bigshot has done. Hospital bound doctors like surgeons and intensivists don?t have that luxury. Is it ego-istic to ask questions pertaining to the efficacy of checklists? I don?t think so. Many of us could have easily gone into research rather than clinical medicine. Our training teaches us to ask questions, look for alternative solutions, explore the unthinkable, to agonize over a solution that doesn?t exist in a textbook, journal article, or on a check-list. Yesteryear, that made you a good physician. Now-days, it makes you a non-team-player, radical, disruptive, or perhaps, worst of all, egoistic.

We will turn to checklists. We will love them with religious devotion. The Joint demands it. We will comply. Yet, it feels like we are driving just another stake into our coffin. R.I.P.

Speling-fore mi bwuder

January 26th, 2010

Deer Denis;

I weally twy to katch awl mi speling mysteaks. I weally doo. Butt i m knot a superman lik Obama. I doen’t haf a telle-prompter lik himm. So i meak misteaks. I awso gouf oup mi grammer wonce in a whil and doen’t katch it. Sowwy.

Bwoder kin

Church

January 17th, 2010

I am prompted to write an article on the church, owing to a number of comments made to me, and internet articles that I’ve read recently, that reflects what seems to be a new thinking regarding the role and form of a local church. Because this new thinking has some serious implications as to the nature of what we may see of church in America in the future, I felt it relevant to jot down my reflections of church.

A person that I knew from early on in life became a local celebrity in Portland for her authorship of a article about her problems with church (click here to read). Though the title is “How to Survive Church”, it would be more appropriately titled “How to survive in spite of church”). In this article, Becky P. describes her problems with her childhood church, and subsequent churches that she has attended. Her final solution was essentially to not take church so seriously. She states in conclusion

I’ve also learned what not to expect from church. In the past, my whole life–family, friendships, social activities, vacations, even employment–revolved around church. As a result, church crises impacted every aspect of my life, and leaving a church meant losing my entire support system. Church is still an important part of my life, but it’s no longer the center of every friendship or endeavor. I interact more with the world around me and pursue relationships outside of, as well as within, my church. Most important, I’ve learned not to put too much stock in human institutions or leaders, who will inevitably let me down. Psalm 118:8 reminds me, “It is better to take refuge in the LORD than to trust in man.”

I had always wanted to give Becky feedback, since I feel that her conclusions are not only quite dangerous, but just the opposite of what Christ wishes for us to experience with the church, and what I’ve been able to experience the last 16 years. Over the past few years, I’ve learned that

  • church is my high-point of the week
  • church is the most relevant activity that I do
  • church as a formal structure is far more delightful than as an informal structure
  • church is where my worship is at its highest and where I am closest to God
  • church is where I best see myself for who I really am and God for who He really is
  • I survive because of church and not in spite of church

In essence, I am offering a 180° counterpoint to Becky P. Perhaps I should begin with Scripture references to orient and set a reference of how I view church.

One thing I have asked of the Lord, that will I seek after, that I may dwell in the house of the Lord all the days of my life, to gaze upon the beauty of the Lord, and to inquire in his temple. Psalm 27:4

How lovely is your dwelling place, O Lord of Hosts. My soul longs, yes, faints for the courts of the Lord; my heart and flesh sing for joy to the living God… Blessed are those who dwell in your house, ever singing your praise… For a day in your courts is better than a thousand elsewhere. i would rather be a doorkeeper in the house of my God that dwell in the tents of wickedness. From Psalm 84

I was glad when they said to me “Let us go to the house of the Lord” Psalm 122:1

A few relevant theological & historical points need to be made.

  • Unlike dispensationalists and other new-church thinkers, I consider the Old and New Testaments to be one book, describing one set of behaviors, by a single God with a single similar character and expectations in the Old and New Testaments.We can thus consider any model of “church” or temple worship in the Old Testament as reflective of the similar form of worship we should be offering corporately at this time.
  • I cannot find ever in early church history where church was modeled as house micro-churches. Because of structural limitations, churches were not huge, but Christians always, I repeat, always, built churches or larger structures when the law and absence of persecution permitted it. In the apostolic age before the fall of the temple, worship still continued for Christians in the temple!
  • Throughout church history, God always worked through the greater visible church, and not through autonomous individuals. This is not to say that he did not use individuals, or that these individuals never went against the belief structure, but that these individuals always functioned as though part of the greater church.

Biblical and historical references have gone by the wayside in an age where the church and post-modernism have become dear friends, so that many people are rethinking and speaking out or writing about new concepts of church. The so-called cell-group as a during-the-week extension of church has been turned into “church” itself. Hypocrisy and ill-sought gain of many clergy have led many to disavow many of any possibility of clergy in their life. Therapeutic models of church have been found to have the same efficacy as voodoo medicine, and unhealed people conclude that church no longer has a purpose. Entertainment and seeker models of church have worn themselves thin, as electronic and television churches provide an ample replacement, in the convenience of ones’ own home, sipping coffee and eating donuts in a lounge chair while receiving the weekly heavenly instructions and motivations for life. Some will expect church to be a quasi-paradise where theology is all non-controversial and people get along with such contentment for each other that one would think they were at an LSD party —only to discover the truth of Luther (simul justis et peccator), that all Christians are hypocrites and sinners, oftentimes worse than one would encounter on the street, and thus justifying an exit from fellowship with all but a few chosen believers in the comfort of ones’ own home, or at the local coffeehouse or breakfast restaurant.

And so church goes by the wayside. Church has been found wanting, and Christians who desire true worship have found that they must create that environment for themselves. They may still attend church, mostly out of guilt of needing to follow Biblical instructions to not forsake the assembly of other Christians, yet their true worship is found in the loneliness of their private time, one-on-one, tete a tete, with God. If a given church fails to meet ones’ needs, or if it proves either controversial or too impersonal, then one can simply pack their bags and go church-shopping for a fellowship that most satisfies an individuals’ personality. The smorgasbord of churches are huge. There are mega-churches and tiny 2-3 family fellowships struggling for existence. There are young-upstart-meet in a local school building churches, middle age churches, and dying or dwindling churches. There are churches of entertainment, churches with almost no structure to the liturgy, high churches with a rigid structure and formality, pastor as big screen television church, pastor as gee-I’m everybodies friend church, pastor as layperson struggling to survive church. Churches could be oriented around football and sports, movies and entertainment, drama and music; you can find special interests group churches, politically oriented churches, environmental churches, god-save-America-gee-I-love-my-country churches, commie-pinko-freak churches, social justice “feed the poor” churches, and even wife-swapping churches. All of these churches are filled with members that consider themselves not only Christians, but evangelical and with a higher plane of spirituality than the hoi polloi of this world. Yet all of them are doing everything but what a church should do, so it’s no wonder that church itself is driving many sincere folk away.

What then should church be? I could do no better than to quote J.G. Machen, the last paragraph of his seminal book Christianity and Liberalism. He states…

Is there no refuge from strife? Is there no place of refreshing where a man can prepare for the battle of life? Is there no place where two or three can gather in Jesus’ name, to forget for the moment all those things that divide nation from nation and race from race, to forget human pride, to forget the passions of war, to forget the puzzling problems of industrial strife, and to unite in overflowing gratitude at the foot of the Cross? If there be such a place then that is the house of God and that the gate of heaven. And from under the threshold of that house will go forth a river that will revive the weary world.

Scripture establishes the nature and order of a church. Berkhof in his Systematic Theology describes the marks of a church in particular, being 1) the true preaching of the Word, 2) the right administration of the sacraments, 3) the faithful exercise of discipline. We will deal briefly with each of these issues. Regarding true preaching of the Word, this discriminates against heretical churches such as the Mormon church of Jehovah’s Witness, where a false gospel is being offered, or a false Christ. Preaching is the cornerstone of a church service, and about which all revolves. It is here that we offer respect to Scriptures as being alone our motivation, our driving influence, and God speaking directly to us. In the modern church, the message is more often conveyed in other portions of the service, such as the music, the drama, or the personal worship/fellowship time, yet the administration of Gods’ Word is the entire pivotal portion of a service. Too often, a preacher will read a Scripture passage, yet the sermon will be on everything but an attempt to expound the meaning of that Scripture to us. Those are false preachers, preaching of themselves, rather than solely of Jesus Christ and Him crucified. The administration of the sacraments have taken an enormous hit in recent times, since “new-think” tells us that the sacraments are devoid of meaning or significance. In regard to the sacraments, I am referring to baptism, the eucharist (communion) and marriage, and not the extended sacraments of Rome. While the Roman Catholic Church has turned the Sacraments into something too much, almost magic, the Protestants have progressively devalued the sacraments into an optional, ritualistic activity symbolic of corrupt institutionalized denominations. They have de-sacralized the sacraments by allowing the administration of the sacraments in a casual fashion by laity and clergy alike, so that you could be baptized by your favorite person, rather than a minister of the church, or have a communion session in a coffee shop with friends. My scriptural basis for the sacraments is found in the orderliness of ecclesiastical practice as described in the NT, noted throughout Paul’s and Peter’s epistles, as well as the even stronger example of the OT, where professional clergy were strictly described. It is a grave error to consider that the OT does NOT provide instruction regarding our liturgy and administration of our sacraments. Finally, the church administers discipline for the growth of the body of believers. Ecclesiastical discipline has been truly been demoted in both the Catholic and Protestant churches, now that you have a supermarket of churches all competing for your attendance and possible donations. To remove oneself from the possibility of discipline would be to remove oneself from anything that you could legitimately call church.

Before I end my statement on church, I will note that church models have been everything that described in Scripture. The growth of mega-churches leaves one wondering why they even waste calling themselves “church”, save that a church can impose God’s wrath as a threat for encouraging financial giving or tithing. The pastor of many churches nowadays serves more as an administrator than a godly messenger conveying and opening Scripture up to the congregation. It is no wonder than church services leave most people feeling empty, something that must be made up with the smaller cell-group meetings or an individuals’ quiet time. It is no wonder that church has taken such a serious hit in recent years.

The church has weathered many storms, and it will weather the current onslaught or accused irrelevancy. I bring to mind a great Anglican priest and song writer, Samuel Stone, who grew up in south London as a pugilist (boxer) until his conversion. He went into the ministry, working with the roughest and meanest folk in London. It was said that he once even boxed a disorderly parishioner, knocking them out, but later apologizing for that. He wrote the following song as a glorification of the institution that we have now so bitterly devalued.  Stone was a high-churchman. He was not speaking of the fad of do-it-yourself church-ism. He was referring to the grand visible institution of the church of which he was a very dear part of.

The Church’s one foundation
is Jesus Christ her Lord;
she is his new creation,
by water and the word:
from heaven he came and sought her
to be his holy bride;
with his own blood he bought her,
and for her life he died.

Elect from every nation,
yet one o’er all the earth,
her charter of salvation,
one Lord, one faith, one birth;
one holy Name she blesses,
partakes one holy food,
and to one hope she presses,
with every grace endued.

It is in the third and fourth verse that Stone speaks of a heresy going on in the Anglican church in South Africa during the 1860’s. The church has taken many beatings, and will receive many more until the Lord returns, yet Christ’s body will continue to the end.

Though with a scornful wonder
men see her sore oppressed,
by schisms rent asunder,
by heresies distressed;
yet saints their watch are keeping,
their cry goes up, “How long?”
and soon the night of weeping
shall be the morn of song.

Mid toil and tribulation,
and tumult of her war
she waits the consummation
of peace for evermore;
till with the vision glorious
her longing eyes are blessed,
and the great Church victorious
shall be the Church at rest.

The last verse concludes with the proper view of church. It is mystical, yet ordinary. It is an exercise of living with Saints before the face of God. It is an entirely imperfect experience on earth, but reflective of an entirely perfect experience in the life to come. For those who choose to remove themselves from church, to devalue church, or to redefine church as anything less than this description of the church given by Samuel Stone will be all the worse off, and to be pitied indeed.

Yet she on earth hath union
with God, the Three in one,
and mystic sweet communion
with those whose rest is won.
O happy ones and holy!
Lord, give us grace that we
like them, the meek and lowly,
on high may dwell with thee.

I conclude with a plead for individuals to return to a grander image of the church, and for the church to return to a grander image of itself. Our frustration with church should manifest itself by correcting our vision of what a church is, and then encouraging the church leaders to do the same. It is to seek for a church that has a high view of itself, and to be involved. It is not to expect the church to be therapeutic or non-hypocritical, but to be reflective of our own sinful state, a place where together with other sinners we can worship and pray and glorify the God of heaven. May God grant us the view of the church of JG Machen or Samuel Stone, and we will realize that we survive not in spite of the church, but rather because of the church.

The Source of All Problems with Health Care

January 13th, 2010

Please see my prior recent blog on healthcare. On the left sidebar, click on the “Feuchtblog” category or “medicine” tag, and that will take you right to this article and the prior one.

Many people have asked me about my views on ObamaCare, and what I would offer as a reasonable fix to the healthcare “crisis” in our country. I have no hope that our wonderful government will be able to fix the mess of healthcare. This is why I support the Obama health care plan. If it goes through in its entirety, it will destroy medicine. Then, we could start over. Maybe. Unfortunately, too many conservatives blame the government for the health care problems of the USA, while the liberals wish to give the government everything. Neither makes sense, because neither side takes the time to ask what is really wrong with American medicine. My final answer is that everything is wrong. There is no party or group that doesn’t stand innocent of our mess. Specifically, finger pointing must include all parties, including government, the lawyers, big Pharma and the health care industry, physicians, hospitals, insurers and third party payors, and patients themselves. I will be very brief in how each party is making a mess out of medicine.

1) Government. Government would love to control medicine. It is intrinsic in government to have control of the people, whether that government be a democracy or a totalitarian regime. Our constitution was established to restrict the power of government. Now that our constitution has become a “living” document, it may be interpreted and changed at will, usually to the effect of offering the government more power, and us less. I cannot think of a single government in the world and throughout history that I would trust my body and my life to, yet, that is essentially what we are asked to consider with the health care plan of St. Obama, the patron saint of the infirm. Medical ethics will become what is good for the masses, rather than what is good for the individual, since government will always seek global, rather than individual solutions. Decisions will be made that are most politically correct, and not what is most morally correct, or what maintains the highest dignity and honor to the individual. It has been argued that health care delivered by government would be less expensive and more efficient, yet, I cannot bring to mind any federal agency that delivers efficient services without graft and corruption. A simple look at pure government health care systems, the Veterans Administration and military medicine show highly inefficient and expensive systems with shoddy health care delivered in a haphazard fashion, always at the whim of an incompetent and fickle congress. One only need to pause at the countless ways in which the government has made physicians lives currently unbearable, including ever increasing and expanding agencies to regulate and control health care. Need I mention JCAHO and the totally ridiculous demands them make on hospitals, or Medicare and its “fraud” provisions on honest and hard working physicians. To the feds I say, no thanks.

2) Legal. Many conservatives have argued hard for legal reform, feeling that it is the legal system in most part which has destroyed American medicine. Arguments have returned from our legal colleagues of the necessity of our system to safeguard and protect a vulnerable public from increasingly greedy and immoral physicians. In fact, conservatives refuse to look at the breadth of the source of problems of our current health care debacle, and lawyers refuse to accept that we need more protection from increasingly greedy and immoral lawyers than that of physicians. Estimates that suggest that the current legal climate drive up the costs of medicine by 40-50% or more, are off by about 1000%. There is no longer any bang for the buck; the health care consumer has discovered that it is cheaper to fly to India for major heart surgery, and yet receive reasonably equivalent safety in their health care. The lawyers have not protected us, but instead, have stifled creativity, autonomy of physician-patient relations, and made health care unaffordable. Every drug that I purchase, and every medical device that I use, has a cost that tends to be 10x-1000x more expensive than non-medical or veterinary equivalents. Malpractice has driven up the cost of practice of countless physicians who have chosen to switch trades, retire, or sell their soul to an employment situation rather than endure unsustainable malpractice premiums, regardless of whether they have ever been sued. Lawsuits themselves have no correspondence with the personal competence of a physician or hospital. I see quite competent physicians occasionally being sued because they choose to manage riskier cases, and incompetent physicians that have never been sued. Somehow, lawyers don’t connect. When a surgeon goes to trial, they usually try to avoid a jury trial, only in that they know that a jury will be another form of wanton injustice, since juries will always sympathize with the party that can generate the most tears, rather than the party that claims the moral high ground. The practice of our trade lacks absolute control-biological systems, being overwhelmingly complex, can have only partially predictable behaviors. Since physicians can only know limited facts of any given medical case, there always remains the possibility of things going wrong, outside of our control, regardless of how careful we happen to be. The legal system simply cannot correct that. Efforts to build in increased safeguards in hospitals have only served to sweep problems under the rug, and no serious study has ever shown a hospital to be safer with the use  of recently enacted safeguards over those hospitals that do not exercise those safeguards. The driving factor for all this madness is the accusation of the legal system that health care needs to clean up their act. The legal system remains clueless about the true nature of medicine, and will only make healthcare problems worse rather than better with their well-intentioned efforts.

3) Big Pharma and the health care industry – There was an epoch in American history where physicians and health care industry was not permitted to advertise. Physicians felt that advertising would degrade their profession with distraction for economic gain from medicine. Indeed, for the most part, this has happened. With the combination of appeal directly to the public, and government regulations that supposedly protect the public but more importantly protect the mega-health care industry from competition, and protect markets, it is not surprising that big Pharma has erupted into a multi-billion dollar industry. We see how this has led to major corruption, such as the Martha Stewart shady investments in Erbitux, a drug that cost well over a billion dollars to develop and bring to market. Big Pharma naturally has a lot to loose, should a drug like Erbitux suddenly be discovered to have untoward unforseen side-effects, or if it proves to be less effective than originally believed, or less useful than other drugs on the market. Naturally, such pressures would be overwhelming for a large corporation, and easy fudging of the numbers (many ways to do that!!!) tends to protect great investments. In the end, we are all hurt. Are we much better off with Erbitux? Perhaps a little bit, as it is a useful drug in many circumstances, such as in head and neck cancer. Yet, patients truly are not living too much longer with as compared to without the drug. Big Pharma continues to appeal to the general public. You can see elderly people dancing across the tv screen in a proverbial retirement paradise, all thanks to Viagra or Flomax or Arimidex, or etc., etc.. The message is conveyed that the drugs bring a fulfilled life, happiness and joy, peace and prosperity. This advertising is an overt lie, and the advertisers know that. I do not wish to indulge into Big Pharmas’ cozy relationship with Big Government, and their desire to overwhelmingly protect themselves rather than the patient. Notice how little they protest the FDA or the legal climate in the US, even though those two factors so steeply drive up the costs of new medicines. I don’t believe Big Pharma really cares at all about you and me.

4) Physicians – I wish I could say that physicians were not a part of the problem, yet we are as much of the problem as anybody else, but for differing reasons. First, physicians have not stood up to their oaths of morality. The Hippocratic Oath is no longer used anywhere in the US, but entirely replaced by Oaths, sadly, including the Christian Medical and Dental Society Oaths, which focus more on population and societal ills, as a focus on the patient themselves. Physicians are not politicians–we have in our care only one patient at a time, and our morality evolves around that patient. We were historically bound to patients by covenants. The legal binding now is a contract, which in turn diminishes our profession into an occupation similar to that of a garbageman or plumber. Our major Medical societies have rolled over dead when reprimanded by government, rather than standing up for what is right. I refer specifically to government forcing rulings on various drugs, forcing the AMA to remove their restrictions on physician advertising, and forcing the health care community to accept and comply in the murder of unborn children. Now,we are even complying with the murder of the elderly. We have lost our morality, allowed medicine to be turned into a business rather than a high profession, allowed government and Insurance companies to intervene between us and the patient, and then we scratch our heads wondering what went wrong. We did it all to ourselves.

5) Insurers and Third party payors – In the eyes of some people, it is the health care insurors who receive all of the blame. Certainly, Michael Moores’ movie Sicko seems to cast much of the blame for America’s health care woes on the Capitalist pigs that govern the major insurance companies. This might be the only theme in Sicko that Moore has partially correct. Contrary to Moore, it is the act of third-party indemnification, whether that third party be a “capitalist” insurance company, or a government, that creates serious problems. First, it places a fourth player in the game of the covenant between doctors-patient-God, as defined by the Hippocratic Oath. It removes much decision making from the patient, and gives it to the insurance company or to the physician. The patient assumes minimal responsibility on an economic basis for the health care decisions that they make, especially if the funding for the patients’ health care came from an employer insurance policy, to which they paid nothing (save for lower wages). In reality, health care insurance no longer functions as an insurance plan, except for those plans that are high deductible or catastrophic. The contracts that and insuror makes with the patient loose their legitimacy when a patient demands high expense procedures, such as transplants or major cancer therapy, and insurors often are forced to comply regardless of the contract. In some states, there is no “pre-existing” clause, so that patients may obtain insurance whenever they wish, without penalties. Insurance companies have sought for survival, but usually at the expense of higher premiums to all, rather than fighting public and government insanity in court.

6) Patients – I love most of my patients, and so I must be quite careful about what I say about them. All the same, in our state, it was over 50% of my patients that voted against tort reform, even though they deny that in the exam room. It is many of my patients that demand free or almost free care. Co-pays are greeted with disdain. It is many patients that expect me to be available 24 hours a day, 7 days a week, 365-366 days a year, and never make a mistake or error in judgement. It is many of my patients that live a life of wanton self-abuse, and then are angry at me that I can’t miraculously fix them in a day or two. It is many patients who lie to me, abuse me, take advantage of me, expect perfection of me, and have no qualms at suing should an opportunity arise. Ultimately, it is the greater than 50% of patients who allow government to get away with murder, vote in idiots such as Obama and Reid and Pelosi, and demand free health care for all. It is the same patients who are so severely protesting ObamaCare, but who refuse to admit the serious problems in the current system, especially with Medicare. I am grateful to God that a good number of my patients see the problems that exist in health care, though they remain powerless to enact a change.

So, I return to my original statement. I hope that ObamaCare succeeds, since it will destroy medicine. Maybe afterwards, a better system could resurrect. Maybe not. Ultimately, our trust is in God, and not doctors. As I grow older as a physician, I realize how powerless I am to add time onto a patients’ life. It still seems to remain entirely in Gods’ hands. Too heavy of reliance on physicians seems to do as much harm as too little reliance on them. But for now, I simply do not foresee any viable fixes to the healthcare crisis, unless the entire system, from the patient to the government corrects. I doubt that that will happen. To attempt a fix of only one aspect of the health care problem will only make the entire health care crisis worse. I don’t wait with hopeful expectation for a solution.

Changes in Medicine

January 12th, 2010

In Feuchtblog, I will be publishing several articles regarding healthcare and medicine. This article, as well as several to follow, will be short reflections of mine regarding the status of medicine in our country.

Following my heart procedure and then subsequent Sabbatical, I’ve had time to think about medicine and what is different about my profession from when I began as a private surgeon in 1992. The opportunity of being away from medicine for a year has been especially helpful in delineating what seems to bother me about the “New” Medicine.

1. The feminization/effeminization of medicine: The percentage of physicians that are female have sharply increased, so that in many medical schools in this country, there are now a majority of females. This is especially true in surgery, where the shift toward female doctors have taken a sharp upward turn. As a female, different expectations are held toward the profession. It is often the activity that conflicts, rather than supports family life. The female psyche of being more a nurturing person changes the approach to the patient. Oddly, this feminizing effect on medicine has affected even males. They are no longer supposed to be aggressive. They must be gentle and never lose their temper or raise their voice. They must now approach their patient as an advocate, friend, sympathizer, rather than as the authority and aggressor against their illness. As we have seen the effeminization of male movie stars, who previously were masculine and tough, Clint Eastwood types, but are now boyish girly men, male doctors have had a tendency to become girly men in the ways mentioned above.

2. The foreign-ication of medicine: I will be the first to comment on my absence of objection for foreign doctors. I believe that foreign physicians stimulate thought and provide wonderful new perspectives to American medicine. My favorite doctor of all time ever, Dr. Das Gupta remains a role model and mentor, though he was born outside of the USA. Yet, I can’t help but think that there is a problem when greater than 50% of our physicians are foreign medical graduates, and not necessarily assimilating into the American cultural belief systems. Besides religion, they differ in such drastic things as how they view the nature of science, medicine, and life itself. Many come here, assuming that wealth and lifestyle will be an automatic given, and often end up frustrated or disappointed when that doesn’t happen.

3. The accelerated gentrification of physicians: we see both an effect on the older physician, and a response that older physicians are giving to their profession in this gentrification. First, modern technology demands rapidly changing practice patterns in order to keep up on the latest-greatest. This often results in ping-ponging of management, that is, certain techniques or management methods are forbidden, then encouraged, and then later forbidden again. Otherwise, newer technologies or treatment plans come in that are often demanded by the patient, but offer no distinct advantage, are far more expensive, but take seemingly forever to discover the errors in their thinking. We see physicians retiring early, or, as soon as possible. They simply don’t wish to put up with the arrogance of younger doctors and competing technologies that seem to be more hot air than distinct helps to the physician or patient. We also see a loss of respect for the older physician. They tend to be out-dated, not with it, hopelessly lost in the past. It takes years to make the best physician judgements, yet these older physicians are no longer respected. A most functional medical community would allow the older physicians to slow down, and work with younger physicians to help them develop skills. This is not happening, and an increasing generational gap happens between younger and older doctors. In times past, the older doctors were able to hone their practice to allow for their decreased ability to be as physically agile or supple as the younger doc. It is more difficult to stay up at night, to have great physical strain in caring for sick patients, yet, there is no reprieve for the aging physician. Thus, for an aging physician, it only makes sense to get out asap.

4. Economic and legal dis-incentivation of physicians– The cost of medicine continues to rise. Prices on medical commodities continue to inflate at standard or accelerated rates, rent and employee costs continue to rise, taxes fail to go down, all of this eating away at physician profitability. Meanwhile, reimbursements continue to fall. When one subtracts costs from reimbursements, you get a number that is essentially your profit. If you divide that profit by the hours that you work, you get an essential pay rate. Currently, when accounting for inflation, I made more as an apprentice typographer than I am currently earning as a physician. Ultimately, physicians will deem the effort not worth it, and consider an employed situation, volunteering, or switching professions. Worst of all, many physicians will remain in their trade, while playing other trades such as gambling with the stock market or real estate investments in order to make a reasonable income commensurate with ones’ education and overall “sweat factor” to get where one is. Remember, most physicians started as quite competitive throughout high school, college, and even competed seriously in medical school, if one desired a more challenging specialty. Residency could be quite variable, but usually seriously limited ones’ lifestyle in years past. As an example, I spent essentially 16 years in “school” past high school to get to a point of being able to earn a living, and all the while accrued hefty school loans. Meanwhile, friends who started to work after high school were able to establish families, purchase homes, and become quite established. Others, who enlisted in the military or worked government jobs immediately after high school were 4 years from retirement by the time I was able to earn my first dime. I don’t pull out too many Kleenex when people complain about doctors’ earnings. But, what about legal dis-incentivation? It is not infrequent nowadays to see articles in surgical journals lamenting that certain surgeries are safer at high volume centers, and even though one may examine their own track records and see competitive  morbidity and mortality rates, the pressure is still extreme to transfer those patients on. When deciding to tackle a more complicated case, the reimbursement is no higher than a simpler case, yet the amount of time spent could be quadruple to ten-fold. At the same time, one is not legally protected for medical “heroics”, but could always be faulted for assuming care of certain patients. Thus, there is every reason to stick with simple cases, and transfer off more complicated, high risk cases. This does a terrible service to many patients, where travel away from families and known surroundings and a known medical community makes life more difficult, and often increases the risks to the patient. I have often seen where patients go off to these “centers of excellence” only to receive vastly inferior care to what would have been provided back home in a smaller hospital. The legal climate offers me no incentive to attempt to retain these patients.

5. The rise of public medical pseudo-professionalism with de-professionalization of physicians–Patient empowerment is a good and a bad thing. It is good when a patient comes to a true specialist and then gets a more complete picture of their current illness or situation. It can be bad when patients determine that they are more knowledgeable than the physician. I wish to add one caveat here. Patients always know themselves best, so that a decision for or against a medication or a surgical procedure is something that they need to choose in their own mind, and it is not good for a physician to force a treatment plan on a patient against the patients’ better sense, no matter how wrong it may seem to the physician. Contrary, when a patient attempts to force the hand of a physician for a treatment that the physician feels to be wrong, you could expect only trouble if the physician gives in. Much public pseudo-professionism is a result of a combination of the internet and big Pharma direct patient marketing. Another way in which pseudo-professionalism manifests itself is with the “2nd opinion”. In the past, a second opinion was often required by an insurance company. Now, many websites encourage seeking a second opinion. The problem with the second opinion is that a patient will never be able to adequately and critically choose between two doctors without a large amount of personal health care experience. Rarely is second opinion thinking correct. I have had patients turn me down because their second opinion physician gave them a kinder hug at the end of the session, or had a slicker office, or had better name recognition from advertising. When I discover that I’ve just wasted an hour or more with a highly anxious patient who just saw me as a second opinion and now is even more anxious in needing to decide between physicians, I will ask them for what criteria they would be using to determine who would be the best physician for them–typically, their answer betrays the other physician promising false security or over-rated expectations of what is physically or humanly possible. Therefore, I refuse to see second opinions, and will immediately cut off a second opinion visit unless the patient swears that they intend to stay under my service. I am not an entertainment committee to amuse the curiosity of needy patients. They can watch a medical soap on television for that.  Meanwhile, while patients become the “professionals”, physicians are rapidly loosing their concept of “professionalism”. I already railed about physician advertising, the loss of a true moral creed for physicians, and increasing dishonesty with physicians. Since the advent of the 80 hour residency workweek, personal time and comfort has taken a strong priority over the care of the patient. I was taught that one always sacrificed personal time when a patient needed your care. Residency meant almost never planning an event, since your primary responsibility was for your patients, and not the movie or restaurant you would be attending that evening. It was considered immoral to be an employed physician, as that meant confused loyalties. All of that is gone, and physicians have become nothing more than highly intensively trained plumbers or electricians. We are no longer professionals, but sophisticated and highly educated blue-collar workers. In return, we no longer have the right to expect to be treated like professionals.

Concomitant with these changes among health care professionals and patients, are changes that are occurring throughout our society, which influence medicine and the attitude of physicians.

1. Loss of personal integrity. I am called by the chart reviewer and asked to up-grade a person’s admission for no reason other than increased reimbursement by Medicare, and Medicare would allow it. The whole idea seemed quite dishonest to me, or at least encouraged serious inconsistencies, that would leave us physicians always wondering from moment to moment whether we were being “honest” rather than violating some crazy medicare rule. Physicians no longer desire integrity as a supreme quality. Efficiency and profitability come first.

2. De-personalization of others. While walking home one day recently, I passed a number of people, and would usually smile at them and either nod my head or say hello to them. The typical response was for the passerby to walk on, head slightly turned away from me, and not even acknowledge the presence of another person. De-personalization has affected medicine in many similar ways, so that people have become more and more fragmented, consisting of lungs and livers and intestines. This attitude has been true of the past, but distinctively truer now, and more obvious on the wards.

So, where does that leave me? In a sense, I dread being back in the bathtub of medicine, since the water now has become quite filthy. The next feuchtblog will talk about who is responsible for breaking medicine. I might eventually write a blog about my thoughts regarding what could be done to fix the healthcare crisis that we are in.

Dar Essalam

January 9th, 2010

Mike and Anne S. were good friends from first moving to Puyallup. Mike was a doctor at Good Samaritan Hospital, but retired in order to do medical work in Morocco. Since then, cousin Dee and her husband Abdellah started a Moroccan restaurant in Wilsonville just south of Portland. So, it was decided that Mike and I would run down to Portland with our wives to have Moroccan food. I’ve reported on this restaurant in prior blogs on the .Mac site. Now, we were taking two friends in love with Morocco with us.

Mike & Anne

Mike and Anne

Dar Essalam Group

Mike, Anne, Ken, and Betsy

We came dressed in Moroccan and Cameroonian outfits. Dee and Abdellah were again most hospitable, and the restaurant was packed to the brim, so both Abdellah and Dee as well as their two sons were working quite feverishly.

Carter and Zack

Zack and Carter

Abdallah and Ken

Abdallah and Ken

Dee in the restaurant kitchen

Dee working feverishly in the kitchen

My siblings also showed up…

Brother Gaylon

Gaylon

Gloria and friend

Gloria and friend

Lewis & Carol

Lewis & Carol

Once again, the food was absolutely stupendous. I had no idea that Moroccan food could be so good. It is certainly much better than French cuisine, and most Amerikan food. But then, I’m told that Cousin Dee is probably the best Moroccan chef in the entire world, including Morocco. If you live in the Northwest, and haven’t gone to their restaurant, it is totally worth taking the drive. You’ll find directions at their website (click here). This truly is a 5-star restaurant for quality of food and ambiance.

End of the Sabbatical

January 2nd, 2010

The year 2009 is now gone, but I am thankful for all the events of the year. In summary, I started by spending 5 weeks in Germany, mostly going to language school at the Goethe Institut in Düsseldorf, but also spending time with Herbert and with Katja and Hannes.  On return home, Betsy and my time was spent preparing for Bangladesh, and we spent 10 weeks there working at Malumghat Christian Hospital. After returning home, I had a wonderful summer, riding my new bicycle and doing some simpler hikes. Another attempt with Jonny and Russ A. to hike the entire Wonderland trail  met in retreat because of rain, but we did some wonderful bicycling around Crater Lake instead. Betsy and I then headed out to Northern Cameroon, working at l’Hopital de Meskine. On coming home just before Thanksgiving, I decided to return to work 3 weeks early so that I wouldn’t spend time at home getting on Betsy’s nerves. At New Year’s beginning, we were blessed with the visit of Alex V., who is now my son-in-law. We could not have been more blessed, and Betsy and I both regard him as a perfect person for our Rachel, and we are most proud to have him in the family. See the separate blog covering the wedding.

The only crisis during the year was the iWeb crash. Should you wish to refer to my previous adventures, reviews or blogs, you will need to go back to my old site on .mac. This current site has a great advantage, in that, as I learn XHTML and .css, I’ll be able to have much more freedom in modifying the site to my pleasure. Also, there is less of a chance for a serious crash. You will have the ability to RSS this website, in that you can tell your mail program to receive RSS feeds from http://feuchtblog.net . I will not be sending out notices every time the webpage is updated, and will update this site a bit more often. Please feel free to write comments, especially if you disagree with me. Unlike a few of my commie pinkie freak relatives/friends/fiends who refuse to publish certain comments from me that don’t exactly jive with their Weltanschauungen, I will not block your entries unless your writing is overtly offensive or obscene. Therefore, remember that comments do not necessarily reflect my point of view. If you are too timid to make a blog comment, then drop me an e-mail.

Nota Bene

You have not heard from me in website-communication since late September 2009. Since then, I have reviewed 20 plus books, multiple movies and pieces of music, and have posted the Cameroon adventures. You are welcome to go back a bit to review those blogs. Everything (except for one or two entries) are entirely new and have not been published on the old site. I have not quite mastered the art of xhtml mark-up, and so photos don’t always fit in correctly. Those will be corrected over time.

Alex and Rachel’s Wedding

January 2nd, 2010

Alex proposed to our daughter Rachel after our visit to Sioux Center, Iowa this summer. They decided to have a winter wedding. Betsy had the preponderance of responsibility for organizing the wedding, and she did marvelously. We are most delighted to have Alex as a son-in-law as he and his family are very pleasant and entirely delightful to be around. I did not attempt to obtain a massive number of traditional photos, but did get some of the action shots that the wedding photographer may not necessarily have taken. Here they are…

Preparing Rachel's hair for the wedding

A surprised Alex coming in before the wedding

Preparing the decorations inside the church

The reception dinner area

Sir Patrick - grandson

Alex calm as a cucumber

Alex and Dad before the ceremony

The Groomsmen

The brides area

Sister Sarah with Rachel

Carol making the Cake

The cake - strong work, Carol

Photo time before the Wedding

Hannah the Flower Girl

Just Made Man and Wife

Alex & Rachel VanV.

Pastor Rob makes sure everybody leaves in order

Newlyweds

Reception frolics

Alex Cuts the Cake

The limo waits

Full speed to the hotel, please!!!!

And they disappear into the night...

The Sabbatical Begins

December 31st, 2009

The two Iowa girls made it home, letting us have Christmas together complete as a family. The above photo shows Jonathan, Sarah, Rachel and Diane. It was wonderful having all four children together. The only distress was an extra visitor (Schmutzie die Wutzie)-actually, she’s a cat, something we didn’t really expect, and Katze has not been very happy about her new feline roommate. The girls have gone back home, but they left the cat. That’s ok. We still love the Iowa kids.

 

Meanwhile, my practice has slowed down so that I have had time free to get packing. Not having made many 5 week trips out of the country, it is a little difficult to determine exactly what to bring. So, minor indecisiveness prevails while I decide on my favorite things to bring. As I write this, I notice that the temperature in Düsseldorf is -8°C, meaning that is absolutely freezing. No way I’m going to ride a bicycle and come home with frostbite. I’ll stick to walking and public transportation in Germany, for now.

 

Getting travel issues straightened out with my other trips to Bangladesh have been made much easier through the agency of Samaritan’s Purse. They will essentially be the organization that sends me off. They also have done this before, and so they have been superb at helping neophytes like Betsy and me organize the trips.

 

Snow. Yes, this year is experiencing global cooling. Next year, it may return to global warming. But, we had a moderate amount of snow, that sits in patches by the side of the road. It snowed just before Christmas, giving us a wonderful Weiße Weihnacht. Here are a few photos…

 

 

 

Of course, Christmas was celebrated as usual…

 

 

I was able to do a home visit to one of my patients who is now in his last days, on whom I performed a major cancer operation. I had learned that he had an absolutely incredible story of escape with his family from Eastern Germany during the cold war. We then discovered that he was my student teacher in German class in high school. I was so excited about that, that I decided to help him write his autobiography. Using my typographical skills, we slowly got his story together, which included scanned photos from many aspects of his life. I would encourage you to read the story, which can be found in Die Veröffentlichen as Meine Geschichte (My Story). Helmut has a strong love for the Lord, which takes some of the sorrow out of the soon-passing of a dear patient but also dear friend.

 

Exercise continues. After the accident on the trainer, I have my bicycle repaired, and am pushing the training each day. I finally figured out how to use the Garmin 705 in training mode, as I was having a problem with it making a wireless connection with the rear sensor that would tell me speed, distance, and cadence. Together with a heart monitor, I am totally in the know on my rides that go nowhere. The Garmin is actually a slave-driver

since it forces me to maintain a steady speed and cadence, and usually shows me that my cadence is too slow. Cadence is your pedaling speed, and you like to keep it between 70-90, but I usually go 60-70. Well, I have the winter to work on that.

 

While pedaling away, I’ve managed to work my way through Heidegger,  Wittgenstein, the Frankfurt School including Habermas, Quine, Hayek, Popper, Kuhn, the Structuralists Saussure and Levi-Strauss. There are only a few lectures left to go, covering to deconstructionists, Rohrty, MacEntyre, and Nozick. So, what has this availed me? The designers of this series have left out various schools of thought, such as the existentialists, for reasons that elude me. Truth has taken a hard hit, and nobody, save for perhaps MacEntyre, even believes in a notion of truth. Many of the lectures, including those about Habermas, Quine, Popper, Kuhn, & Rawls deal only with the nature of social interactions and language in forming a constructive society. Democracy has rightfully taken a serious hit, as these philosophers abandon the polar opposites of both socialism (esp. Hayek), and democracy in its raw form. In addition, Wittgenstein essentially destroyed the possibility of language (based on commonly accepted philosophical pre-suppositions), yet the structuralists and late 20th century philosophers don’t wish to abandon the possibility of communication, as least until they’ve spoken their mind. Popper and Kuhn, while seemingly restoring a philosophy of science, have essentially destroyed the possibility of science demonstrating ultimate truth, since the paradigms of research determine the interpretation of outcomes. Yet, we still do science since there is utility in it. Bottom line—it seems to me like the pragmatists have won; philosophers have despaired of philosophizing, and are no longer asking questions of ontology, morality, or epistemology, but simply ascertaining how to produce a functional society at peace with itself. In essence, they have become nothing but political scientists and sociologists. Francis Schaeffer again proves right, when he spoke of personal peace and prosperity being the summum bonum of the late twentieth century, rather than truth or morality. Enough philosophizing.

 

Many continue to ask about my plans for the Sabbatical. Here is a rough outline…

02JAN-07FEB Deutschland, esp. Düsseldorf, where I will be spending four weeks in language school. Betsy didn’t want to go. I think she suspects Germans to all be closet Nazis or jack-booted Prussian militarists, myself included. During that time, I’ll be spending time with Onkel Herbert, visiting a childhood friend and her husband (Heinz und Debbie Fuchs) in the Stuttgart area, hopefully getting up to Bremen and Hamburg, and then going with Herbert to Würzberg to visit Katya (Herbert’s, and soon to be, my friend) and eventually on to Praha (Prague).

 

February – cross-country skiing, and maybe some downhill skiing. I’ll be spending a lot of time organizing for Bangladesh.

 

02-07 March – Phoenix, to go to the Society of Surgical Oncology meetings. Betsy I plan on spending time with Dr. Peter T. and also delighting ourselves in one of the most fascinating characters of the twentieth-21st centuries, Peter Megyesi, who is Betsy’s brother. Peter and his wife Linda live in Scottsdale, and are always enjoyable to visit, with never a dull moment. I’m not sure how Linda puts up with Petie, but they seem to remain madly in love.

 

15MAR-15MAY Bangladesh. I’m ready. Betsy’s psyching up. Pray for us!

 

Summer – will be spent in the Pacific Northwest. One does not leave the PNW in summer, as it is paradise here. Plans are to hike the 93 mile (150 km) Wonderland trail around Rainier with Jonny (again), do the entire loop of Crater Lake on bicycle with Luc A and father while camping out with Aaron H., doing the Seattle to Portland (STP) on bicycle in one day, only 203 miles (327 km) of fairly flat terrain. I also am considering a touring ride across the state of Washington with the Cascade Bicycle Club.

 

September-December – to Africa. Too far away to think seriously about, except to pencil in the days that we will be away.

 

While in Düsseldorf, I will try to make a blog page every week with the events of the week. I will NOT be announcing the publication of the page, in part to not burden you with unnecessary junk mail. Please stay in touch and drop comments as appropriate.

 

Final Days in Cameroon

November 23rd, 2009

08NOV2009 The photo below shows  the Lutheran church in town, one week ago. It is a much smaller church that the one in Meskine that we usually attend. We did appreciate the service quite a bit, though it was a touch more formal than the other church.

Yesterday I took a bicycle ride from the hospital up to the mountains. This was done with Carsten and Scott. We took off at 6 am, rode for two hours, and went nearly 20 miles. It was over dirt road, and so mountain bikes were imperative.

I think the natives were more puzzled about us than we were about them. You can see their standard home structure, with a cluster of Boukarous and mud walls enclosing the village.

The Meskine missionaries invited a priest from the Anglican church to come give meetings for four days.  He was heavily influenced by the teaching of the Toronto Blessing, which is an form of Pentecostalism. There were many “words from the Lord” and talk about healings. Some basic doctrines of the faith, such as the doctrines of Christology, were brought into question. My feeling was that though the missionaries wished for “revival”, a revival of emotions without revival of the primacy of God’s word is doomed to failure, frustration, and a worse end than if nothing at all occurred. You are left momentarily with the haunting notion that maybe there is a form of Christian faith, a technique or belief structure, that will magically transform you into somebody that can heal on command, read minds, and hear God directly. Unfortunately, there is no magic, but there are the Scriptures, with God speaking about as plainly as imaginable. So, our doubts about missing a “higher blessing” are relieved by knowing that attendance to God’s word alone gives the highest blessing.

That evening everybody went out to dinner, and we had sauerkraut. It wasn’t the best sauerkraut that I’ve ever had.

Today, we attended the main church in Meskine, partially skipping out of the healings and words from the Lord. It is quite a dramatic event, and so I include a short portion of video. The natives here are excellent musicians, and Betsy and I both enjoyed native African beats with Christian songs.

MVI_2014

There is general singing, mostly in Fulfulde, but also in French. Then, various sub-groups will get up to sing in their particular dialect. When it came to the time for us Western folk to sing, it was just Carsten’s family and Betsy and I, so we had Betsy sing “Amazing Grace” as a solo. It was well received. Sermons and more singing occurred. The entire service lasts 2.5-3 hours. As you can see, the worship is quite animated, and there is more body movement than in Western churches (except for the Pentecostals, of course!).

13NOV09 Time is quickly coming to an end. Having felt light-headed soon after arrival in Cameroon, I solved matters by cutting my blood pressure medicine in half. I am already on the lowest dose possible, so now I am just about taking naturopathic doses the last 4 weeks. I measured my blood pressure during the stress of a busy surgical day, and it was 100/60. I am beginning to draw further conclusions as to the probable cause and treatment of my hypertension. I just wonder what my weight and cholesterol levels are doing. We are preparing for a trip to Roumsiki with the Kretzschmar family this weekend. It is a small resort town located on the Cameroun/Nigerian border. There are supposed to be some interesting volcanic formations, and it is known as one of the more beautiful parts of the country. Though it is only 80 miles at most away, it will take us about 4-5 hours to get there, since the road is anything but ideal. More on that later.

I showed up at the operating room this morning, and the techs invited me into their own room for brunch. They were sitting around a bowl of what they called “soup”, and sticks of French bread, which they would break off, dunk in the soup, and then eat. It was quite spicy, and tasted great. I suddenly realized what had occurred at the Lord’s supper, as I joined into the common pot.

The brunch was served with Cameroon tea, which was quite sweet, and tasted just like lal cha from Bangladesh. That will be one of my more memorable experiences, and it really touched me that the techs would honor me like what they did, inviting me to join with them.

17NOV09 We have just returned with the Kretzschmars from Roumsiki, one of the few resort towns of Cameroon.

It actually was very nice. We stayed at a resort that is maintained by a Swiss man and a native Cameroonian lady. The resort has the comforts of a typical Western hotel, including a swimming pool.

The area is known for its volcanic granite rock formations, that are seen throughout the horizon.

We took a hike one day down into the valley enclosed by these formations, and actually entered Nigeria. The path, though steep, is heavily traveled by donkeys bearing large loads of goods from Nigeria, as well as ladies carrying massive volumes on their heads.

The donkeys are essentially the Cameroonian equivalent of large transport trucks. We were also able to step foot into Nigeria. Here is Betsy and I in Nigeria.

The next day, Carsten and I tried to climb Roum, which is the mountain around which the town is made. He did okay, but I was slipping too much from poor shoes, and decided to opt out of the very last few hundred feet. This the mountain to which the Kapsiki speaking people escaped to from the Muslim terrorists-I mean, invaders. You can see caves where they hid out.

We later went to visit a house of an animist. Each of his many wives has their own home, while he has the biggest, close to where the goats are kept.

Afterwards, we realized that Betsy was having a high temperature, and quickly realized that she was having a bout of malaria, so got her going on Co-Artem.

The ride home was a little difficult with sick Betsy and sick children, since, if you look at a map, it looks like a major thoroughfare, but in actuality, it is dirt road of the worst possible condition.

Diane, if you are reading right now, look closely, as it’s not a cow nor a horse, but a donkey.

19NOV09

Over the last few days in Meskine, the morning temperature has dropped as low as 73ºF, and many people, nationals and ex-pats alike, are wearing heavy jackets and wool hats. Babies are bundled in extra sets of thick clothing. It has become very cold for people accustomed to living in 110ºF weather.

Last night, I did prayer rounds with Martin, one of the evangelists at the hospital. 6/8 people we prayed for were Christian. It is amazing how many Christians are in this mostly Muslim area. The missionaries and many of the native Christians will make rounds on every hospital patient each Tuesday evening, and that has been an interesting way for me to see the patients in a totally different light from that as a physician. It is especially delightful to be able to spend time with the Natives. My pre-conceived conception of them as being a tad bit primitive, living in mud huts, etc., is entirely wrong, and I am amazed at their wit, intelligence, and awareness of world events. Most people have cell phones. Most Natives speak at least two languages, many as much as 4-5 languages fluently. It is not loin-cloth jungle savages barely commanding what lays a few yards beyond their existence.

23NOV09 We are finally home, with a moderate case of jet-lag. Yet, we are thankful to see family, and to touch base with our home and surroundings, while sustaining good health. I now have a laundry list of chores to do before I go back to work on 07DEC. Before then, I’ll probably publish some reflections on the past year, which will go unannounced by e-mail. So, stay in touch.

Crazy Days in Cameroon

November 4th, 2009

21OCT2009 – Please also read “First Days in Cameroon”. I tried publishing blog updates from Cameroon, and it would not go through, so, the trip to Cameroon will be a series of several blogs. The above photo shows Sadjo and Carsten in the OR. Sadjo is Muslim, though a most friendly person, and most intelligent. He was one of the first employees at the hospital, brought in when he was a young man, and trying to earn a living as a tailor. He now spends most of his time sewing people.

Today, I did a oophorectomy/hysterectomy on the Pyles cat. This was performed in the quiet of their back porch, using Ketamine as the anesthesia, and Kalabasoo helping with the surgery. It was a bit floundering, but the cat seemed to survive our ordeal. At 1700, Carsten dropped by for our first bicycle ride. He rode out into the fields surrounding Meskine, noting that cotton and Millet were the main crops. Both seemed to be doing well. There are mountains surrounding Meskine, and several have large monkey populations. Our hope is to have a little more time to ride further. Since it gets dark at 1800, we were limited to about 20 km ride today. You must use mountain bikes, since the roads are dirt, and are not in terribly good shape.

I am still doing a lot of operating, and fortunately, able to give Carsten a break more often. This has been good for him. We have also been discussing ways to help Meskine get back into general orthopedics, like bringing the SIGN-nail to Meskine. This is an intramedullary nail that you run down the middle of a long bone in order to stabilize a fracture. They are then able to return to function much quicker. Carsten has been absolutely delightful to be around, and we have been able to work well together. I think that I need to learn better German in order to communicate with him and my other German relatives and friends.

On 23OCT, I did a D&C, today a cystolithotomy (removing a stone from the urinary bladder), as well as herniae repair and abscess drainage. The types of surgery seem to be rapidly expanding. It has been an enjoyable experience in the OR. I am still frustrated by the inability to perfectly communicate with Carsten, but fortunately, he is moderately patient. Simple things are easy, but when trying to describe precise details of an operation or procedure, I don’t have the vocabulary in either French or German to adequately communicate.

27OCT, no changes. It rained yesterday, and the temperature fell to 80ºF. It was the first night here where we slept without the air conditioner running. I’m working feverishly on my French, so that I may communicate a little better.

30OCT, our time seems to be winding down. This AM, I went to the hospital 15 minute prayer service, opening with the songs “How Great Thou Art”, and “To God be the Glory”, in French of course. It was interesting to see how joyful the Africans were, in that they could not even sit down to sing these songs. They tend to be far more animated than Western folk. I compare that to the woeful sound of the call to prayer heard 4-5 times/day over loudspeakers in the village mosque next to the hospital grounds. Islam is such a sad religion compared to Christianity. Later, Scott Pyles and I went to do a reading to a young Muslim man showing some interest in the faith. This is similar to a reading that Betsy went to a week ago, where a missionary will go to a Muslim house, and will have bible stories, that they will read. In this instance, it was a bible story of the tabernacle in the wilderness, written in Arabic script, but using the Fulani language. All in all, it was a very pleasant experience.

The bottom photo shows some of the students of the person we went to read to. They learn to read and write by writing the Koran out on a large wooden board, which they are displaying. Once they have one page memorized, they erase the board, and put on the next page. This person lived in a one room house, inside a large compound of about a city block, housing several hundred people, including 90 some children, many barnyard animals and goats. His wife had just had a child, and the tradition is for the wife to stay with her mother for forty days after the first child, in order to learn how to raise the child.

Diane, it’s not a cow! It’s a goat!

Though missionaries may be chided for trying to “sell” religion, I would remind the dear reader that coercion or force is never used by the Christians like the Muslims, as many Muslims would readily convert if the societal pressure and intimidation was not so great. Also, the missionaries are almost always the first to form languages for remote peoples, and to teach them how to read and write. Contrary to M. Mead who would love to “preserve” ancient cultures, those ancient cultures all desperately wish to move into the 20th century like the rest of mankind, and Islam, unlike Christianity, is doing absolutely nothing to assist in mankind trying to improve their lot. I show a child trying to learn the Koran. Though many children might recite the Koran in Arabic, they have no clue as to what it says or means, as they do not understand Arabic. It would be like Christians insisting that one recite the Scriptures in Latin in order to find favor with God. Fortunately, our God is multi-lingual.

03NOV09 Today, I turned into a Urologist. We had a patient whom was thought to have a vesico-vaginal fistula. We could not find the fistula by instilling blue dye in her bladder, but noted serious urinary incontinence. So, we happened to have some bladder suspension kits, and I had seen it done several times, and went ahead and did it. In spite of that, we still noted a small amount of urine persistently coming into the bladder. So, I suggested we wake her up, do an IVP, and assess the problem. That would be true in the US or Europe, but not here. We proceeded to open her bladder, searched hopelessly for a fistula, but noted that there was absolutely no urine coming out of the left ureter. Again, I suggested a work-up. Sadjo suggested otherwise. We opened her up,  and found a markedly dilated left ureter, and much scarring surrounding the most distal ureter. So, our decision was to simply re-implant the left ureter into the bladder. This we did in a standard fashion, Sadjo paying close attention, since he will not only repeat the surgery someday, but probably do it better next time. It’s quite incredible working with these guys. As mentioned above, Sadjo was nothing but an ambitious young tailor, hired on for the hospital 17 years ago, fluent in Fulfulde, French, English, Arabic, and some German, now in his mid-forties, owning a large cattle ranch, working evening in the tailor business, as well as pursuing his love for surgery. He and Barbar are a total joy to work with.

The weather is cooler now. It was only 85ºF last night, which now seems cool to us. This time of year, winds from the north commence, causing a red dust to fill the atmosphere. The surrounding mountains no longer appear crisp, but a blurry red. This causes the temperature to cool down, but also leaves dust everywhere. I now remain a touch more congested, and am constantly sneezing from the irritation of the dust.

Just a little mention of all those who have made our stay memorable.

Sadjo and Barbar are the two main techs. Sadjo is Muslim, Barbar Christian, and totally opposite personalities, Sadjo being quiet and thoughtful, Barbar expressive and impulsive, alway saying “Ah cha cha”.

Tijani and Walko, quiet workers, Tijani’s uncle is chief of the village, and Walko is a tech that does much of the minor things in the operating room, as well as much of the anesthesia.

Saido,Roger and Falkamo also do anesthesia. It is usually spinal (rachidienne) or ketamine. All are absolutely superb. They can also do general intubation, but the OR is not well set up for that.

Vadera and Wome also do a lot of the minor activities like wound debridements and rapproachments (wound closures).

So now I turn to the missionaries that we have met. We loved all of them. Each one has become special to us in their own way. So, let’s start with Scott and Lee. They, along with Danny and Frances, started this place. It was their vision and hard work that led to the founding of Hopital de Meskine, and it continually shows. Scott is responsible for the main leadership, and possesses an uncanny sense of wit and humor about him. He is always able to break a tense situation with a word or comment that leaves a smile on others. Lee is amazingly hard working, and keeps everything in the surgery end of things running well.

So now I turn to the missionaries that we have met. We loved all of them. Each one has become special to us in their own way. So, let’s start with Scott and Lee. They, along with Danny and Frances, started this place. It was their vision and hard work that led to the founding of Hopital de Meskine, and it continually shows. Scott is responsible for the main leadership, and possesses an uncanny sense of wit and humor about him. He is always able to break a tense situation with a word or comment that leaves a smile on others. Lee is amazingly hard working, and keeps everything in the surgery end of things running well.

David and Patsy have been most special. David runs the informatics side of things, and keeps communications going. They are more quiet workers, but always possess a gentle loving spirit. Their hospitality will always be remembered. One day, Betsy was commenting on her bad back, and the next day, David dropped by a special chair that was very comfortable on her back. That really touched us, just the caring for little things in another person’s life.

Andrew and Kari have had two young adopted children to care for and so we have not had the opportunity to get to know them nearly as well as the other missionaries. They are also a bit newer, and so are working on learning the languages and becoming effective on the mission.

Carsten, Annette, and their children Rabea, Lucas, and Aaron (here, shown with Betsy and Marike in Roumsiki) have become quite well known to us. I have spoken more about Carsten in other places, since I have been working with him in surgery, but their entire family remains special. Carsten and Annette grew up in the former DDR in Leipzig. He and Annette are both very musically enclined, and he happens to like Bach, which makes them very much true friends. I truly hope to visit them in August in Leipzig, if the Lord wills.

Carsten and Annette have a young German girl named Marike (here shown with Rabea) from Baden-Württemberg helping out with teaching the children, and also working in the hospital, since she would like to eventually go into Medicine. She has been very special to us, since she has been able to help us better converse with Carsten and Annette, since she is fluent in German, French, and English. Her maturity and love for the Lord has been especially noticed by us.

Me with Josephine, Melissa with Aisha, Sarah, Kari and Ruth. Josephine is a general practitioner from the Netherlands, Melissa a short-termer from Louisiana, and Sarah a PA from Michigan. I’ve not had much of a chance to interact with Josephine, but have really appreciated getting to know her. She very sweet, is fluent in Dutch, German, English, French, as well as Fulfulde, and also a superb, caring doctor. I don’t know how she does it. Sarah has been wonderful to have. She is a real take-charge person, very industrious, and very capable in the tasks she has at the hospital. She rarely makes bad decisions, and has been a joy to work with. Kari is a physical therapist, whom I haven’t had the ability to get to know well. I appreciate her sweet temperament, as well as her loving demeanor around natives and patients. We had just gotten to know Ruth, who is working mostly in Chad, and quite fluent in Arabic.

First Days in Cameroon

October 17th, 2009

Betsy and I left home on 26SEPT. Dr. King took us to the airport, and we flew out on Air France to Paris, with an eight hour stopover and then on to N’dJemena, Chad. Adama picked us up at the airport, and drove us to the guest house, that had not quite prepared for our arrival. We made do, and was able leave by road to Meskine the next day, driven by Adama. The roads had multiple large potholes, yet Adama still drove at roughly 60-80 mph, the exact speed not known since the speedometer constantly read “0”.  One of our four boxes had not arrived, though we were assured that it would be in in several days, and promptly delivered to us. On 30SEPT, I started working in the OR. It is much different than in Bangladesh, in that the surgeon does very little ward care, but spends most of his time in the OR suite, or seeing consults. It will take me a few days to get used to things. The workers all speak a little English, and I spent much of my time speaking German with the other Surgeon, Carsten, who is from Leipzig.

02OCT, our final box arrived, missing only a few items, such as clorox wipes, which we can survive without. Surgery has been busy, with a few very odd cases. One was a 12 yo boy, gored by a bull, coming in several days later (how many, we don’t know), and his only injury was a complete division of his common bile duct. We did a Roux-en-Y reconstruction, but he died later that night. There are too many other cases to talk about, and I’m sure you’re not interested, so, we’ll let it slide.

10OCT, we had a fairly busy week at the hospital, but able to relax on the weekend. All is going well. I haven’t taken too many photographs, and I am not getting out of the compound too often. The US State Dept. informed us of a cholera epidemic in town, though we will still to go in to eat tonight. It is a bit harder than Bangladesh to acclimatize to the heat, and I’m not sure exactly why. Otherwise, save for a bout of travelers’ diarrhea which resolved quickly in both Betsy and myself, all is going well.  A few days later, we spent with Carsten and Annette on the river flowing through Moroua. This river is now just a stream, but will fill its banks at some times of the year, and in a month, will be completely dry.

The main church in Meskine has about 100 adult members, and though church starts at 8 o’clock and lasts until 10:30 AM, most people arrive between 8 and 9 am, filtering in slowly, and sitting with their own people group. The various groups are then invited sequentially to sing a song for the remainder of the folk, including a time for us white people, who usually sing in French some hymn.

Notice, the Christmas decorations remain, like in Bangladesh. Our house is quite nice, and here are some photos.

Yes. The bed has mosquito netting. No mosquito bites at night. The main crop in this area is Millet, which looks a bit like corn.

Firewood also is in huge demand, as they prefer firewood over natural gas, even though firewood is more expensive than gas!  Getting photos in the community has been a serious problem, because, unlike Bangladesh where everybody fought to have you take their photo, the natives will turn and run if you get out your camera. Both situations below witnessed this happen…

Here is the whole missionary group at Annette’s birthday party, with real ice cream made from powdered milk!!!! …

We’re having a good time, and feeling like we are contributing a bit to the entire effort. More to follow…

P.S. Aren’t you glad I didn’t include any political discussion. Though we’ve stayed in touch with American and World news, and watched the Stalk Market (sic!) and price of gold fluctuate, it seems a touch removed from us, where our patients simply are wondering if they will have food for the next day. We have much to be thankful for, in spite of our national distresses. The next few years are going to be time to re-think the real battles that face us, and hopefully they are not simply battles for peace, security, and prosperity, as the end result will probably be the opposite of what we seek. Fortunately, Betsy and I have had time to read and think (see Bookblog) and talk, and it has helped in keeping us on track together about our goals for the coming few years, as I return to work.

Obama Cares

August 27th, 2009

My best friend kindly rebuked me for my absence of propriety in discussing issues sensitive to race. He is correct. But, it is a hard balance. Any political commentary against the reigning Führer is deemed to be racial, as evidenced by Jimmy Carters‘ comment about Wilson’s inappropriate (though true) epithet in the joint (congress).

As Pat Buchanan said regarding Carter’s comment, “Carter’s contribution to the national debate represents a truly rare blend of malevolence, ignorance and moral arrogance.” (click here for reference)…  Unfortunately race is being used as a witch-hunt accusation against anybody who seems to be strongly opinionated in a non-liberal fashion. Similar accusations happened recently with sexual orientation. I can’t wait until we get a cross-dressing gay/lesbian for president—my comments will then be delivered in an unrestrained though personally detrimental fashion.

ObamaCare!!!!. . . I would really like to obtain a Medizinmann outfit like Obama is wearing as pictured above. Maybe I’ll be able to purchase one while in Cameroon. I think that my patients would love that. We must not act judgmentally against those who hate the AMA/Big Pharma/Medical Industrial complex. After all, there is a dominant role for  the chiropractic, naturopathic, transcendental meditation, Christian Science practitioner, Voodoo, alternative medicine, Medizinmann health care provider within general medical practice. Just ask my brother Dennis!

We reflect back on the Obamaphilia the nation experienced a half year ago. School children sang in solemn reverential worship about Obama. People displayed their ecstasy over Obama now being able to rescue their bank accounts, put food on the table, clothe them and give them comfortable shelter, regardless of their ability or desire to work for those things. He was even likened to a saint that we could pray to.

He may not have come through yet with providing those material items of sustenance, yet, like God in heaven, he watches over our very thoughts, and will hold us accountable if we rise in rebellion against him. Thus, we are no longer policed just for our actions, but also what we might perhaps, perchance, vielleicht, peut-être, possibly, could have been thinking.

In terms of commenting on the virtues and failures of ObamaCare, I believe that I have said more than enough.  So, now I’ll tell you what I really think of Obama. He is a corrupt, dishonest racial bigot hell-bent on an agenda that is polar opposites of the beliefs and philosophies of the founding fathers of America. He is a traitor to the state that has doubtful constitutional credentials to serve as our president, speaks with forked-tongue, smooth and slick, yet working toward philosophic ends that when embraced by other nations has always led to their inevitable ruin. Though he shows signs of intelligence, he lacks any sort of true wisdom to adequately guide a nation, and instead will dupe the masses with his worm-wooded tongue. In spite of that, the masses voted him into office, and they deserve what they will get, so I wish Obama total success with two to four or more terms in office as president. The only regret is for those who wish to maintain honest quiet lives with a separate morality from our Obamination-in-chief, like my children and grand-children. So, to our new national anthem, needing just a few substitutions of words….

The Mickey Mouse Club March

Enough of that! The last month was quite event-filled.  Most of it was filled with bicycling and reading. I attempted to backpack the Wonderland Trail for a second time, with Jon and Russ, but was heavily rained out the first night. We drove home, dried out, and headed down to Crater Lake for two fantastic rides. The weather has remained quite desultory, with rain constantly threatening, but with weather breaks leaving us wishing that we were in the mountains.

Other events… Alex, Rachel’s fiancé, came to visit. I was able to take him around Mt. Rainier. It was nice having him here, and I am very proud to be able to call him a son-in-law. The wedding is on 02JAN10.

I learned to do Panorama shots, using a tripod, and then stitching together various panned shots using photoshop. Here is a view of Rainier that I did on top of the first Burroughs Mountain Summit…

This photo can be blown up to a huge photo, since it is about 7 photographs put together, with 12 megaPx definition, taken on a tripod, so it is a sharp image even at huge magnifications.

With Diane’s help, we also mastered the art of making Pico de Gallo. Here is the top secret recipe…

1 scotch bonnet pepper

2-3 Jalapeno peppers

1-2 Serrano peppers

1 Green pepper

8 cloves garlic

Clean them all out, wash out the seeds, and chop them VERY fine in a food processor. Add…

1-large Walla Walla sweet onion

1 large bunch of fresh Cilantro, with the stems removed

This time, chop them moderately fine in the food processor. Then, remove all the ingredients from the food processor, and add the juice of two fresh limes, and two tbsp. of salt. Finally, take 12 Roma tomatoes, wash out the juicy innerds, chop by hand modestly fine, and fold into the pepper concoction. This makes a great Pico de Gallo, that is not too spicy. Please do not give away this recipe to anybody, as it is TOP SECRET!!!!! It is the mixture of the various types of peppers with lots of lime juice that creates a pleasant taste. But, beware when cleaning the peppers, as they are highly toxic!

Liam was baptized, our fourth grandchild. That was a wonderful experience, and Pastor Scott did a nice job of officiating the event. That same day in the evening, Resurrection Presbyterian church became a real church, loosing its mission status. Thus, we elected elders and had Pastor Scott appointed as the official minister. I feel very good about both the choice of elders, and David Scott’s ability to serve as a pastor. Scott seems to have grown in pastoral skills by leaps and bounds since we first met several years ago, and we have deeply appreciated his ministry in Puyallup.

As you can see, we had the kids over for ice cream afterwards. They also got to experience our new deck, built since the old deck was rotting out, and actually becoming dangerous. We found a carpenter with a good price, and so was able to follow up on a project that I started 10 years ago. It seemed like forever to finish this deck. Here are some photos, though it is not quite finished, including getting a roof on the gazebo…

I was able to do one last bicycle ride with Russ. We rode from the top of Chinook Pass down 27+ miles, and then back. Later, we stopped at our favorite ice cream stop, Wapiti Woolies, famous, since they make the cap that every great contemporary climber from the US has worn in the Himalaya expeditions, including Ed Viesturs… They have photos from a smorgasboard of the hall of fame of American climbers on their wall, showing themselves on the Summit of Everest or Annapurna or where-ever in Wapiti Woolie hats…

The last photo is Russ on the right with Bob, who owns Wapiti Woolies.

Meanwhile, we need to pack for Cameroon. We leave on the 26th of September, and will be in Cameroon for two months. I must learn French. I prefer to talk German as my second language. French has too many silly grammar rules. French used to be the language of the self-acclaimed intellectual snobs in college. I took Russian instead. I tried to talk Russian with a German accent. My Russian teacher always needed to correct me. Except for the articles, German seems the closest of any foreign language to English. I’ve finished Part I of French in Action, which is the most entertaining language program I know, but I still feel most comfortable sitting down and listening to a German podcast or reading Der Spiegel on-line. German just kind of clicks in my brain, even though I don’t understand all of what is being said. I’ve also just finished a book written by a missionary surgeon in Nepal titled “Don’t Let the Goats Eat the Loquat Trees”. It was an enjoyable read, and certainly seemed to reflect what I’ve seen in Bangladesh more than any other book that I’ve read so far. You can see the full review in the books section.

Unless the internet connection in Cameroon is fantastic, you will probably not see any more posts on this site until we return to the US, which is thanksgiving time. Expect to see a lengthy post at that time. Remember to keep us in your thoughts and prayers as we serve in Cameroon, and e-mail us if you think of it. We fly into N’Djamena, Chad, and the travel to the Maroua, Cameroon area, where we will be staying.

Obama Will Save Us

August 5th, 2009

I’ve written often regarding the new health care system under our national clown – Obama. Whether or not the health care agenda of Obama goes through remains to be seen. Yet, it really doesn’t matter, since any failure of the democratic agenda only means that it will take just several more years for all the facets of his plan to settle into place. The greatest disappointment was receiving an e-mail from Dr. Lunzy Britt, who I know quite well, who as the director of the American College of Surgeons Board of Regents, informed us that our college is siding with the Obama agenda. I presume that skin color may be playing a small role, since both the Lunz and Barack originate from a race with innately darker skin than the pilgrims that settled this land. We wait with baited breath. The American College of Surgeons has almost no private practice surgeons in its leadership, and so increasingly don’t speak for the surgeon in the trenches. Maybe it’s time to drop out of the ACS?

Schöne Sommerszeit

July 27th, 2009

This summer has been awesomely beautiful, permitting a delightful ability to ride my bike, go backpacking, or just sit outside enjoying the sun. It’s been truly marvelous. Since my last post, I’ve been able to do the STP in one day, backpack Eagle Creek, and then do the Seattle Century. I’ve had time to spend with family, and get some reading in, as well as listening to music. It’s also been a time when I am able to do other sundry projects, such as to write test questions for PAACS, and study French in preparation for our trip to Cameroon. I prefer to learn German, and find that I am understanding German speech much more, especially on news channels, where the language is more clearly spoken, and less idiomatic than you would find in movies.

 

We are also blessed with our fourth grandchild, Liam Isaac. He was born on 22JUL09, healthy and cute. His photo is above. The other children seem to appreciate their new brother, as well as Oma.

Sammy had a birthday two days later…

He loved the cake, but would not eat my favorite food…

… sauerkraut mit Wurst und Senf.  Yum. I always shop for German-made sauerkraut, as the stuff made over here tastes terrible. It might explain why so many Amerikans don’t like sauerkraut.

 

I brought my Lungi on the Eagle Creek backpack trip, and found out that it is perfect for wearing around camp in the evening. Yet, when I sent Hannes und Herbert Lungis, they developed a wonderful new use for them, that I must show you…

 

I love Herbert!!!!! There is something about him that tells me that we are of the same blood.

 

Before sending out this Blog today, I was able to do the Sunrise ride. I’ve blogged this before, but it has now become just another fun ride, though probably the most beautiful ride in the world. Photos fail. It is 10 miles (16 km) of 6-12% grade uphill, unrelenting, averaging about 8% for a total 3000 ft elevation gain. In truthfulness, the last time I did it, I stopped several times to rest, but not this time. This time, I couldn’t keep up the speed of Russ A., but he stopped to clean rocks off the road. Luc A. started about 5-10 miles before our start, and he arrived on top at about the same time as us. He is totally awesome power on a bike. Jonny just ordered a new bike but couldn’t pick it up, so rode my Touring bike, which is too heavy of bike to just be running up to Sunrise. At the same time, the RAMROD was occurring (Ride Around Mt. Rainier in One Day), a 150 mile 10,000 foot elevation gain circuit around Mt. Rainier. I would never formally do the RAMROD, though would like to just try it in a self-supported fashion. Today would have been a terrible day for the RAMROD, as the ending temperatures in Enumclaw were 96°F (35.5?), which is just too hot to ride. Fortunately, we were at 6200 ft elevation on top of Sunrise. Here is what we looked like on top. The photo from left to right shows Luc, me, Russ, and Jon.

The ride down was totally exhilarating, though I’d never ever wish to miss the ride up.

You may review my many adventures and other activities during the last month at BikeBlog, BookBlog, Hike-Ski Blog, MovieBlog, and MusicBlog.  Stay in touch and keep your stick on the ice.

  1. I lift up my eyes to the hills.
  2. From where does my help come?
  3. My help comes from the Lord,
  4. who made heaven and earth.

 

4-7JUN Trail Skills College, Dee

June 8th, 2009

I needed to take a trip to Portland since I had just purchased a new Apple computer, and had it delivered to Gaylon. Lew seemed to be tied up, and Karen and Steve were in town, but too busy to get together. Delores had invited us to her restaurant in Wilsonville, so, we decided to go. Delores is a cousin, and she married a Moroccan man, whose mom taught Delores how to cook Moroccan. She had asked us many times to come down, but now I finally had the opportunity. This was an absolute feast. I had no clue that mid-eastern food could taste so good, but Dee made it especially well. She gave us a sampling of many items, from appetizers, to her lentil soup, to the main meal (I had lamb with a raisin sauce), and then dessert. It was absolutely unbelievably good. Dee gets 10 stars for incredible cooking. Most of the food was very nutritiously cooked, such as the vegetarian couscous, which tasted like no couscous that I have ever eaten before, but also very spicy, using similar spices to that of Bangladesh. All in all, it was a most sumptuous feast. Thank you, Delores and Abdellah!

I spent the night at Gaylon’s, hooking up an old Airport, and also connecting a hard drive to his Mac Mini. The next day was off to trail college. I was a little doubtful, almost wondering if I should skip out and head home. I slept out in my tent, and relaxed for several days. The first day, we went out to a portion of the Pacific Crest Trail, and studied trail maintenance, including how to provide trail rain runoff, so that the trail doesn’t become a highway of a grand mudpuddle. We also learned about how to condition a trail, using McLeod’s and Pulaskis. It was a rainy day, we were all soaked and muddy at the end of the day. The next day was lectures in the morning, and then we went up onto a recently built trail. At first, it looked fairly good, until we began to realize that there were multiple design mistakes. We talked about designing a proper trail, using proper construction techniques to maintain a solid trail base, so that the trail would manage rain water without becoming a mud puddle, and spent time actually punching out a hypothetical new trail. It was a blast. I will forever have a much greater appreciation for trails, and will never look on a trail the same way ever again, knowing how badly a trail could thoughtlessly be constructed.

 

Why I won’t leave the Northwest

June 1st, 2009

I went on a bicycle ride today from home up to the Carbon River entrance of Mt. Rainier National Park, and this was what I saw along the way. The Carbon River entrance remains closed owing to previous rains washing out the road, but the ride to the entrance and back was 72 miles (116 km) and moderately steep uphill most the way, allowing me to burn off over 5000 calories in the 5 hours that it took me to do the ride. Here’s proof…

Yes, I am still using the Trionfo, as my Steelman bicycle is not quite done yet. I did visit my bicycle dealer, with Tacoma bike, a super cool guy named Mike Brown. I bought him a lungi, and here we are together in his bike shop.

The mail came today, and I had a box from Hannes und Katja aus Würzburg. When I visited them this February, they knew that I desperately wanted a Universität Würzburg t-shirt, as I collect university t-shirts.

What an awesome gift! As you realize, not only is it (the U of W) an ancient university by American standards (founded in 1402), but it has had significant Nobel prize winners, including Röntgen, who discovered X-Rays here. Well, I’ll soon be sending Hannes and Herbert (sorry Katja, only men wear lungis) their own personal lungis from Bangladesh. Unfortunately, I won’t be there to teach them how to tie the lungi. Oh well… it’s an excuse to visit Germany again.

 

But!!!!!! I’m omitting the most important event of the last week!!!! Yes!!! Betsy and I flew back to Iowa so that I could visit Rachel & Diane, and Rachel’s boyfriend (not yet engaged). it was a wonderful time, and I really liked Alex from the very beginning, as not only a wise and prudent young man, but also a strong Christian man.

We will be praying that the Lord be in that relationship. Meanwhile, we also went boating in Lake Obijobi.

We also got to meet Alex’s family, as well as his new dog, Bentley.

I’m sure you will be hearing more about this in my next blogs, but, we’ll leave it at this for now.

 

Apnara amader bondhu

May 20th, 2009

It was not easy for me to decide exactly how to do the reports on the trip to Bangladesh. It was impossible to publish a webpage update while in Bangladesh, unlike while I was in Germany. Thus, I created a large Bangladesh report in the “Travel” section. Here, I offer overall assessment and reflections on the trip. First, you may be wondering about the title. It means, you all are our friends. After such a long episode of silence and absence of correspondence, many of you felt that we had abandoned you as friends. That is simply not true. There was a combination of 1) poor internet connections, 2) mac incompatibility, 3) inability to download appropriate programs to connect my mac, owing to large program size and slow internet connections, and 4) suspicion that the Bangladeshi government was keeping an eye on correspondence. It was not that we felt that we might say something that offends our Bengali friends, but only that we wished to avoid even a remote suggestion of wrong-saying or wrong-doing. Thus, our silence.

 

So, reflections on our trip. Many of you have written to us, acknowledging the sacrifice that we have made to serve the Bangladeshi people. I guess that Betsy and I don’t really view it as a sacrifice. What were our motives? I hope they were genuine, in having a love for the people we served. I certainly have a much deeper compassion for reaching out as a Christian to the Bangladeshi people and other unfortunates in this world. Perhaps there was also this curiosity, or spirit of adventure. Perhaps Betsy and I were “absolving sins”. I hope not. I leave with two thoughts. 1) I have the most extreme respect for Memorial Christian Hospital, and their ability to not only provide medical care to the mostly Muslim community that we served, but that they were also able to deliver the message of salvation only through Christ, in a consistent and honest fashion. 2) I have acquired the utmost respect for the long-termers, who faithfully work year after year, mostly unthanked, mostly unregarded, yet they serve without grumbling or complaining, delivering medical care and spiritual hope with joy and gladness. For this reason, I have listed a few people in the trip section that have especially been an influence to me.

But, what about Bangladesh? My biggest surprise was the number of people in this country. When you look on a map of our area of stay in Bangladesh, you see only two cities, Chittagong and Cox’s Bazar. Yet, except for a few rice paddies and rivers, it is almost wall-to-wall people between those two towns, with many large villages between. And, Chittagong has a population of about 4-5 million, Cox’s Bazar of a million. Dhakha itself is roughly 15 million people. The country has about 160 million people, in a state the size of Wisconsin. It is the equivalent of moving everybody east of the Mississippi into the state of Illinois. If you look on a map, you will not even see the town of Chabigong where our hospital sets, yet the 30 mile radius around the hospital has approximately 6 million people. Except for the Chittagong hills, which are not terribly high, it is essentially flatland, and a giant vacuum for typhoons. In spite of the crowdedness, they grow 95% of their food, and unfortunately, also grow a poor quality of tobacco, and poor quality rubber (the rubber starts out okay, but poor standardization of processing ruins the quality of the product).

 

There are four main religious groups in Bangladesh, being Muslim (approx. 90%), Hindu/Buddhist (10%), Animists mostly found in the Chittagong Hills (?%),  and Christian (less than 1%). Buddhists are mostly located in the strip of land south of where we are. Hindus live sporadically throughout the country, but tend to stick to their own sections of town, living together. Wealthier Hindus will also own land in India, owing to a serious lack of trust of Hindus for their more dominant Muslim neighbors. Muslims seem to dominate the scene. Many mornings, they will wake us up at 5 am with prayers roaring over the loudspeakers (their god is now slightly deaf), or late at night on Thursday. They tend to be reasonably pleasant folk as a whole, and we have found many of the Muslims to be quite enjoyable.

 

But, we also see the problems of the Muslim religion. It is definitely a man’s religion, and the wives are often treated no better than dogs. Besides an obliteration of their personality through the Burkha, they are expected at all times to remain at home, while their husband socializes at the local tea shop or town square. We have seen many instances of husbands dumping their wife when they fail to deliver a desired boy child. Joy seems to be totally absent from their religion.  It’s hard to not imagine that religion maybe plays some role in the prevailing morals of this country. When one ventures to the wealthier Muslim countries, one doesn’t see the situation any better. Indonesia, Saudi Arabia, United Arab Emirates and many others have no freedom of religion, and Muslim converts are usually put immediately to death. The situation is only slightly better in Bangladesh. We get many patients in our hospital from Saudi Arabia. Bengali workers will go to the Middle East with the lure of money. It is not uncommon for serious injuries to occur to these migrant workers, since the Bengalis are given the worst and most dangerous jobs. If they have any life left in them at all after an injury, they are usually thrown on the next airplane back to Bangladesh. If you think that the Saudis have any value for human life, think twice. The appeal of their religion remains a mystery to me. Muslim is the only religion that teaches their children to hate at birth. The more religious the Muslim is, the greater the scowl you get from them on the streets. Yet, even the most radical bitter Muslim will soften after a time in our hospital, seeing that we truly care for them, and have no intention of shoving religion down their throat. The less religious will often return a smile once they realize that you are looking upon them as a person and not just as a “Muslim”. It is certain that unloving Christians have done more harm than good.

 

Again I am NOT saying that all or that even the majority of Muslims are mean and nasty, because we have become friends with many kindly Muslims, such as the Mayor of CB, though they often tend to go unnoticed sitting quietly on the side.

 

Hindus tend to not exhibit the passivity that would be expected from their religion. They can be violent, when they are in the majority. Sadly, we have seen this behavior even in Christian countries. All in all, there seems to be a common behavior of man, in spite of their religion. This confirms the Christian doctrine of the total depravity of man. Man cannot escape their “mannishness” through religion. It is sad to see that as the west escapes from its Christian base, we are reverted more and more to the prevailing behavior and moral base of the rest of the world.

 

The tribal people are hated by all, especially the Muslims, which leads to the tribals having a very poor image of the religion that dominates the country. This leads to serious unnecessary oppression of the tribal people by the Muslims, increasing the hate factor between the two peoples. I find the tribal people to be the most friendly folk, and there are many tribals at the hospital that we’ve gotten to interact with.

 

I suspect that there will be a day when white ex-pats will be asked to leave the country of Bangladesh. That day is possibly soon, as economic jealousies and racial tensions as well as Muslim fundamentalism intensifies in the country. I pray that the Christian Nationals in the country have the fortitude to stand for Christ, even when it means persecution or death.

 

What have we accomplished personally by the trip? I was able to catch up a little on my reading, going through 33 books on the trip. We (Betsy and I) had our first real experience with third world medical missions. We had much time together in devotions, and in really thinking about our plans for the future. It was a great time to escape our culture and see the world through the eyes of a non-European. It was a time that we hope to repeat. We will probably keep our trips a little bit shorter, but hopefully, will be able to do at least one trip somewhere each year. And, hopefully, that will mean returning to Malumghat more times in the years to come. We have new friends on the complete other side of the globe, that are more dear than most of our acquaintance (friends) at home. I’m not sure we will ever be the same, once we return home.

 

Coming home has had minor challenges. It’s called foggy brain syndrome (jet lag). I’ve never been hit worse with it. It has disoriented cay and night for me and Betsy to the extreme degree, so that we are getting barely nothing done. We’ll have to try to figure out a solution.

 

I should be posting additional thoughts and reflections on our trip in blogs to come. This whirlwind trip left us with many questions and thoughts that we will need to explore in the coming months. Our next medical mission in coming up in late September through November, and hopefully, a restful summer will provide more time to meditate and prepare ourselves for the work ahead.

 

For a blow by blow account of our trip to Bangladesh, please turn to the section on “TravelBlog”. I have tried to be discrete in my discussions, and to not leave anybody out. Considering the technical difficulties that I had, I may have inadvertently said something too strongly or offensively, or failed to mention somebody. Please graciously drop me an e-mail if you feel that have noted a website problem, and I’ll do my best to immediately correct the issue.  Note that I have divided the Bangladesh account into three sections to allow for easier editing and downloading.

 

I will be giving slide shows of various other aspects of this trip, such as the work at the hospital. I would normally include it on the webpage, except that it would be photo heavy and quite laborious to download. Also, I am using iWeb, which is acting up on me, and behaving unbearably slow. It took me about 36 frustrating hours to accomplish what usually takes me about two in making up this website. I’ve figured out pretty much what I’ve been doing wrong, and will be re-designing this site for more speed. In the meantime, it is forcing me to do a smart move, which is to reorganize my website with “blog” style for all my entries. This will allow you to comment on particular book reviews, trips, etc. You should see this organization on my next post.

 

Phoenix SSO

March 9th, 2009


I’ve often commented about the Northwest being a Paradise in summer. Actually, I was slightly inaccurate about that comment. It is also a paradise in winter. True, it rains all winter. But… it can be paradise if one enjoys skiing. Both downhill and cross-country skiing appeal to me, though I definitely enjoy cross-country skiing more than downhill. So, I got to experience my first downhill night skiing this year. It was a blast. I was with somebody who was definitely a much better skier than myself, but it was still very delightful. The photograph of this precious event was not so helpful at showing that we really had a blast.

Cross-country skiing has many varieties in the Northwest. One day, Jonny and I was able to go at a fairly fast clip on groomed trails. The next,  Jonny and I did true cross-country skiing, plowing our way through steep slopes, in the woods, powder up to our hips, which made it extremely difficult since we were on fairly steep slopes attempting to go up. It would have been easier with Mountaineering cross-country skis, with skins attached. (If you don’t know what I’m talking about, don’t worry!).

 

The snow hasn’t been particularly plentiful in the mountains. That is a little surprising, since, as I write this piece, it is snowing for the fifth time this year outside. This is unusually strange, since I’ve never seen it snow more than twice in a year. Surely this is global warming! Either that, or God intends to make a total fool of Algore.

 

I was able to make it down to Portland. During that visit, I discovered that a new Bengali language text was out on the market. The problem is that it didn’t have a CD, which is not available yet from the publisher. It looks a lot better than the only other real text out there, which is totally useless, the Teach-Yourself-Bengali text by Wm. Radice. I am completely frustrated with the language teaching modalities used in Radice’s text. I’ll have to wait for Bangladesh in order to re-commence my studies. Meanwhile, I was also able to see my youngest brother Gaylon. We went out to a “German” restaurant (Gustav’s), and I noted that there was about nothing on the menu that was similar to what I had in Deutschland. So, I endured, enjoyed a good beer, and left it at that. I ate much better in Germany for a fraction of the cost. The photo shows Gaylon in his pad.

 

So, off to Phoenix. The first two days were spent with brother-in-law Petie Megyesi. He is a wonderful cook, his wife is an even better baker, and they have the most loving dog named Bubba that would eat your leg off if you ever came near to him.

Petie runs a business that makes on-hold messages for the telephone. If you need some 1st class stuff done up for your office telephone system, give him a call (1-800-678-9971). I then went to the Society of Surgical Oncology meetings. It was nice meeting my old friend Dr. Peter T.

There was nothing new at the meeting. I didn’t learn much. In the old days, we fought cancer by looking at very large metabolic charts that hung on the wall, and devised means of blockage of various metabolic enzymes. Now, we have very large charts that hang on the wall with lots of regulatory substances, all named with three letters, like ras, raf, fos, kit, etc., etc., and now we are devising blockade for them. Then, we do a few limited bench studies, herald the drug as a “promising” new treatment for cancer, after which we run countless expensive clinical trials to find out that the drug gives a possible 1% survival benefit, which is definitely statistically significant, even though the effect lasts for only 3 weeks – 9 months. I had to contain my excitement. There were a few good talks. I wish they would spend their time funding sole basic research, especially looking at embryology, the genetics of development, and the mechanisms of differentiation, de-differentiation, and phenotype expression. It’s not so glamorous of research, but it would be challenging to convince the Feds to pour billions of dollars into this sort of research, though, I suspect that it is here where the ultimate cure for cancer will be found, and not in the endless search for another metabolic or regulatory pathway to blockade.

 

Final preparations have commenced in earnest for our trip to Bangladesh. Our bags are slowly getting packed, unpacked, and repacked, very indecisive about exactly what may be needed for 2 months in Bangladesh. Betsy also has several outfits for Bangladesh, as you can see in the introductory photo. When we return from BD, I will make up a packing list for future ventures! We have our visas, and Samaritan’s Purse has been exceptionally helpful for Betsy and myself. Meanwhile, I’d like to remind all you dear readers that I cherish all of our e-mails, even though I don’t respond to every single one of them. We will try to stay in touch, and even update our “Feuchtblog” once in a while, though I’m not sure how good the internet will be in BD for such a task. I WILL NOT be sending out notices of blog updates which in BD, so please check the webpage from time to time if you are interested.

 

Apnar nam kenneth

February 11th, 2009

I now have to prepare for Bangladesh. Part of preparation is getting a feel for the language. Bengali is the most deprived language in the world. I’ve only been able to find one instruction book in Bengali, with a limited CD that gives you a rough impression as to what the words sound like. No major language instruction company offers any help. Berlitz? No Bengali. Rosetta Stone? You can take Welsh, spoken by 750K people total in the world, or Irish, where only half the population of Ireland speaks Irish, and then, mostly as a second language. Then, there is Bengali, the 6th most common language in the world. Nothing. Nichts. Nada. Nichivo. So, I slave away. Countless pages of Sanskrit later….

 

A return to semi-reality has just occurred. I was able to touch base with the office and surgery center, as well as do lunch with Dr. Liao. I ran over to the hospital to talk with The Lord High Grand Inquisitor. It was a rather cold event. I’m troubled by the statements that I’m a valuable character in the MultiCare system, and yet do not get the impression that I’m particularly wanted. They realize that I am the character able to bring major abdominal cases as well as breast cases to the hospital. Otherwise, the cases will be totally lost to elsewhere. It was sort of like a “wake-up” for me. Several movie wake-ups come to mind. The first is in the next-to-last scene of Conan the Barbarian (the best movie of all time) when Conan wakes up to the siren voice of Thulsa Doom. The second is deep in the earth when Puddleglum wakes up to the sweet talk and enchantment of the witch, in the movie, The Silver Chair. Somehow, I don’t have a good feeling about things to come. Then, I get the Surgical News, and always enjoy reading the occasional articles by Dr. Cossman, who is a vascular surgeon in Los Angeles. He seems to hit home every time. The article this month speaks of the death of private practice general surgery, and he is absolutely on the mark. I have included an exerpt in the Veröffentlichungen. Please read it in whole to get a good feel of what I’m going through. So, I remain uncertain as to what to do for the future. With the Franciscans, I will need to throw out any chance of doing any more thoracic or gynecological work, and I’d have to work with surgeons that I don’t trust. That doesn’t turn over well with me. I’d consider moving to Portland but the job market there is a zoo like it is in Tacoma. There is the thought of either figuring out a way of staying in Missions work until retirement, or doing nothing but locum tenens. Please pray for me that the Lord will guide Betsy and me in making proper decisions.

 

So, national news continues. A chimpanzee attacks a lady and nearly kills her. We now learn that apes can be quite vicious. Why didn’t Margaret Meade tell us that? If you accept the simple schoolbook -what you’ve learned in college- teaching on evolution, then we are the random product of a fairly violent species. No wonder I don’t feel safe in Harlem, or Washington D.C..

 

The Pope has now made several declarations that have ruffled many feathers. The first was to pardon and remove excommunication from a bishop who declared that the Holocaust did not occur. The second was instruction that Catholic politicians (such as Nancy Pelosi) must vote pro-life, or risk church action. Wow. My first reaction to the first declaration was a fit of anger. How dare the pope do such a thing? But then, I got to thinking… who cares what Pope Joe declares? Do you really take him seriously in these sorts of matters? I don’t.  Secondly, I don’t know where there is an injunction in Scripture to hold in excommunication those with stupid beliefs. The strength of Christianity is that it tends to look beyond politics and our own screwed-up-ed-ness. Yes, it is possible that the Marxist  bleeding heart liberal Tony Campolo might even make it into heaven. It’s definitely not ours to judge. So, perhaps it is proper for the church to stay out of issues such as belief in the Holocaust. I know of nowhere where the Constantinopolo-Nicene creed, the Apostolic creed, the Heidelberger Katechism, Westminster Confession, or any Roman Catholic creed insists on a belief in the Holocaust as a ground for orthodoxy… But, Pope Joe just can’t stay out of politics, or perhaps, just has bad timing on his statements with heavy political implications… He now declares that pro-death politicians cannot be good Catholics. Certainly, I’d wonder if anybody that strongly supports abortion or PAS should even waste their time identifying themselves as Christian. I’m not talking about many, who tend to wring their hands on the issue of abortion or PAS. Like I said before, lot’s of confused and uncertain people will be going to heaven someday. I’m speaking of the Gloria Steinems or Nancy Pelosi’s, who view themselves on a mission from (god?) to make abortion common, accessible, and completely socially acceptable. These politicians should quit wasting their time with the “Christian” or “Catholic” label. Meanwhile, Pope Joe must learn that he can’t be selective about when he practices politics, or when he practices Christianity.

 

Katze 19.FEB2009. Katze threw up everywhere in the house for the umpteenth time. We realized that we would have a serious problem with Katze, being that we would be gone much of this year. So, we decided to have Katze returned to the Animal shelter where we got her 5 years ago. We gave Katze a good 5 years, and it was not without plentiful tears to wish Katze goodbye. We had Sarah take Katze to the pound as we could not bear to see her go. We will miss Katze’s vomitus on our rugs and floor. She was otherwise a good Kitty.

 

So I end my ramblings. Kreuzberger Nächte sind lang, aber denn? (For my English readers, I’m referring to the lead song, which was a German hit song in 1978. It remains for you to figure out what the song is all about.)

 

Nebel im Dorf – Nach Hause

February 8th, 2009

I’m home! Thank you to those who made this trip special. Tops of the list is to Herbert Feucht. Then, to Katja and Hannes, Debbie and Heinz, and of course, to the teacher who endured me for four weeks, Roman Truhlar. I feel much more comfortable with German, but also see that I have a ways to go to survive comfortably. After visiting the town of Feucht, we returned to Würzberg, where I went dog-walking in the countryside with Hannes and Tasso.

It was quite foggy in the Mainztal, giving the entire walk a surrealistic impression. We returned home, and attacked the currywurst restaurant…

As you can see, many German restaurants allow you to bring your dog. Arras peers over the tabletop, not wanting the currywurst, but the Rheinania Alt. Our last day, we went to der Pott, which is a term used for the Ruhr region of Germany. In its hey-day, der Pott was the massive industrial area of Germany, occupied by massive coal mining, and heavy steel works. The industry continues, but competition from elsewhere has lead to much less steel production than in the past. The best designed coal mining facilities, which also included the massive machinery for separating and cleaning the coal, was the Zollverein Schacht XII, which was turned into a UNESCO site. We did a tour of the complex.

The entire facility was absolutely massive, mining and processing, if I remember correctly, about 60,000 tons of coal a day.So, I have two cups in memory of Germany, one is white for Betsy, one black for me…

The first says “Ruhrpott”, and the second is a quote from the Coffee Cantata of JS Bach, commenting on how good coffee tastes.

 

So, I am back to Puyallup, and I have a mad dash to prepare for Bangladesh. Germany was wonderful, and the only failure of the trip was the awfully cold weather, making it impossible to do bike riding. This gives me a reason to return! I’d especially like to ride in Franken. More adventures will follow, so stay in tuned.

 

Logic

February 2nd, 2009

Why are Fire Engines Red?

 

They have four wheels and eight men;

four plus eight is twelve;

twelve inches make a ruler;

a ruler is Queen Elizabeth;

Queen Elizabeth sails the seven seas;

the seven seas have fish;

the fish have fins;

the Finns  hate the Russians;

the Russians are red;

fire engines are always rushin’;

so they’re red.

 

It’s good when a little poem can help make you a more solid and logical thinker. A little jingle like the Fire Engine question clears out cobwebs, and teaches one how to make logical constructs in a methodological fashion, observing the multiple and varied rules of logic that we had to learn as children. Or, did we? I don’t think I was ever taught formal logic in either grade school, high school, or college. Isn’t that a touch strange? I had to learn logic on my own afterwards…..

 

January was a truly uneventful month, winding down from the holidays. It was a month of struggling with the hospital, and trying to come to terms with one’s identity as an aging surgeon. I had the wonderful joy of going out to lunch with a patient of mine of whom I thought was long dead. I helped him write and publish a 100+ page autobiography with multiple photographs, since I thought him to be such a fascinating character. He tells of his boyhood, growing up in Germany, escaping East Germany as a young child, in a most miraculous fashion, and then adapting to the USA.

 

January was a month of being involved in a new church start, helping Pastor David Scott in the development of Resurrection Presbyterian Church in Puyallup. Since I did the sound system for a short while atFaith Presbyterian in Tacoma, I am able to do the sound for Res Pres. We meet only Sunday evenings, until the church can find a permanent home. More to come on that…..

 

I’ve updated the Movie, Music, and Book reviews. Please feel free to comment regarding my reviews on my blogsite. Occasionally, readers have sent me e-mail comments of my kritik, the comments of which would be most suitable for all readers to appreciate. Rather than e-mail me, please post your comments below.

 

You might have noticed from the initial photograph that Samuel is now trying to imitate the Indians. Or, perhaps that is actually blood on his face, and he shows the contentment of Jack the Ripper, or a son of Sam. Simply not true. Sammy is so harmless, why, he wouldn’t even hurt a fly. Just look at the sweet boy. . .

So, we’ll let little Sammy off the hook. Meanwhile Patrick and Ethan continue so be charmers in their own right…

Mini-me

Ethan/Jonathan

 

I had hoped to post photographs of a ski trip with Jon into the woods today, but, alas, when we arrived at the trailhead, we realized that we had one of the wrong pairs of skis. It was a sad trip home, not being able to freeze ourselves in the snowy hinterlands of Mt. Rainier. Oh well… my next post should have photographs of Betsy and me in Big Sky, Montana, getting CME credits by learning how to build snow caves.  Cool.

 

Aus Düsseldorf – Franken und Sachsen

February 2nd, 2009

This next post is a bit long. It was a very full week! Sadly, photos cannot compete with experiencing the sights and smells and tastes of Deutschland.

 

I have now finished studies at the Goethe Institute. All went well, but I feel like I am even closer to actually feeling competent with the language. The hardest part for me remains understanding language on the street, as well as remembering the articles. If German had no articles (die, der, das), it would be incredibly simpler to learn. At the end, we had a little test, and I did the worst in Grammar, the best in conversation. So, that means that I must study the Grammar more.

 

In the last week, I did a short trip down to Köln in order to run up to the top of the Kölner Dom.

It is difficult to describe in photos the massive nature of this church, standing as the most prominent edifice on the Köln skyline. The bell itself was about 16 ft high, with four other surrounding bells.

 

I had finally started to get to know most of the classmates, so it was a little sad saying goodbye on the last day of class.

Photo shows Fatima (Libya), Anna (Italy), Ela (Poland), Shigi (Japan), Nazim (Turkey), Aliraza (Iran), Evana (Uraguay), Elana (Russia), Nadia (Russia), Tseje (Japan), Mia (Japan) and our teacher Roman Truhlar.

 

I decided to walk home after the last class, since the weather was so nice. It was about 8 km and it took me about 50 minutes to complete.  That same last evening, a number of us from the school went out to the Füchschen for dinner. I tried the Eisbein, as no such thing can be ordered in Amerika.

 

It tasted great, far more than I could eat. All in all, it was a great time, with lots of food and beer, and yet not terribly expensive. Most of the group then went out for Salsa. Me? No way, José! Ich bin nur ein alter Knacker. Staying up way into the ungodly hours just doesn’t suit me anymore, unless I’m forced to do so, or am climbing Mt. Rainier, or ….

 

After touching base with Herbert, we headed out to Würzberg the next day. Our destination was a close couple of Herberts’, Katja and Hannes. They live in a small village close to Würzberg, so from there, we were able to see the Altstadt of Würzberg. This included many nights of chatting, mostly in German, about Alltag in Deutschland.

Much of Würzberg was not destroyed in the war, so many of the old buildings were still intact. *Correction: Würzberg was heavily damaged in the war, owing to an absolutely pointless and idiotic bombing raid by the Brits, in spite of the fact that Churchill had studied in Würzberg and should have known better than to bomb the town, achieving zero military advantage. It was at the end of the war, when there was no question as to the end of the war. It leaves me always wondering about who the most evil character was in WWII: perhaps it was Churchill and not Hitler or Stalin.  You can read about the damage (in German) athttp://home.arcor.de/christoph_rose/wuerzburg/zerstoerung_von_wuerzburg.htm.We went on a tour of the Residenz. Würzberg has an archbishopric here, and the Residenz was the home of the the Archbishop. It was probably nicer than many of the palaces I saw in Europe.  The Altstadt also had the place where Röntgen discovered x-rays (sorry, no photo), and the many churches in the area.

The next day, we went to Bamberg, also a city with an Archbishopric, and not heavily damaged during the war. There we saw the Altes Rathaus, which has river flowing on each side of it.

We also walked the streets, went up to the Bamberger Dom, where King Heinrich II and Queen Kundigunde were buried in the early 11th century. Awesome. There were many art artifacts, including the Bamburger Reiter (seen in the top-most photo and below).

We also had dinner in a quaint restaurant, and drank the beer unique to that area, which was a dark beer with a smoky taste, called Rauchbier, or Smoked Beer. It actually tasted incredibly good. Of course, we also ate Bamburger und Nurnberger Wurst with sauerkraut. Like I said in previous posts, the food doesn’t get any better than this.

Finally, we had to say goodbye to Katja and Hannes and headed up to Leipzig. Leipzig was not in our original plans, but instead, we were going to visit Hille in the Rothalmünster area, but she had a case of the Grippe (flu). So, plans were quickly aborted, the internet searched, and new arrangements made. From Leipzig, we will be going the Nürnberg, again to Katja und Hannes, and then back to Krefeld. Shown below is the Kakelofen in their house, typical for Germany, and their dog, very gentle like a Golden Retriever, but a bit larger, and behaves more like a watch dog.

 

By the way, I have in the title “Franken”. Northern Bavaria is a region of people that are called the Franken, and do not like to think of themselves as Bavarians. In fact, they have been to Oktoberfest only once or twice, and then, did not enjoy themselves. Nürnberg, Würzberg, and Bamberg are all in Franken. There is also a small region called the Spessart, close to where we are made famous by the story about the Wirtshaus in Spessart by Wilhelm Hauff. Unfortunately, I’ve never seen it translated into English.

 

Leipzig. The road to Leipzig was on a new autobahn, that included 5 very long tunnels, the longest being 7800 meters. It was snowy.

We arrived in Leipzig at about 3 pm, so didn’t have much more expected daylight. We first ran to the Volkerschlachtdenkmal, built to commemorate the victory of the German people over Napoleon, at the battle of Leipzig. It was a massive slaughter, but started the end of the “French Hitler”. Oddly, Napoleon is still adored by the French.

That evening, we went to the St. Nicholas church, where Bach regularly performed, to the St. Thomas Church, where Bach was cantor, and to the famous Auerbach’s Keller, described in Goethe’s Faust.

Herbert and I were able to enjoy a beer in the Keller, and Mephisto never showed up.

 

Here is the St. Nicholas Church. It was in 1989 at this church where students held regular non-violent protests that stirred the East Germans to protest, leading to the fall of the Communist DDR regime.

 

The St. Thomas Kirche was truly impressive, being a very large church. The original organ no longer exists, though the present organ is quite impressive. I’m sure Jonny would have loved to have his fingers tickle the ivories of that organ.

Bach was originally buried in the Kirchhof (church grounds) of the St. Nicholas church, but was moved to the St. Thomas Church because of the destruction recieved to St. Nicholas church in WWII.

 

Off to Nürnberg. Much of the city was preserved, including much of the old city walls.

There is much I could say about the city, including the churches, the streets, the statues, etc., all of which were overwhelming, with a mix of the ancient and modern. The most impressive site of all was the castle (Kaiserburg), which was visited by every King of Germany since the early 11th century, including Heinrich IV and Heinrich V, Barbarrosa, etc.

The third photo shows the Turm (tower) that is the symbol of Nürnberg, and well as the well house, where a well 150 ft. deep through solid rock was dug to supply water to the Burg. The fourth photo is the room where the first Reichstag meeting was held for every new Kaiser of the Holy Roman Empire. The last was the chapel with a balcony where the king and queen sat, the regular floor where the dukes sat, and then a floor underneath, where the common people sat.

 

We then went to the Reichspartei grounds of the Nazi era. Unfortunately, we walked around alot, but I just didn’t take enough photos. The most significant was the Zeppelinwiese, which most people should recognize from the large rallies which were held there. I had to have Herbert take my picture standing in the place where Hitler stood 70 years ago.

 

Lastly, Herbert and I made a mad dash down to the town of Feucht. Not too many people have a town named after them, but we do.

It was truly a beautiful town, very quaint, extremely clean, everybody was polite and courteous, the most perfect place to have named after ones self. Eat your hearts out, dear readers.

 

I’ll be home this week. Thank you everybody for your e-mails and comments. I don’t respond to many of them, but always enjoy getting them.

 

Hamburg

January 26th, 2009

I’m not sure if hamburgers were invented in Hamburg, but I decided that my only hamburger on this trip would be in Hamburg.  The photo of the Hamburger hamburger is above. Don’t worry Betsy, I didn’t eat all the fries. It actually didn’t taste very good. American hamburgers are a zillion times better. The food here in Germany has otherwise been most extraordinarily good, and yet never so tempting as to over-eat. My main diet has been a piece of bread or pastry in the morning with coffee, and then either a Wurst mit Brötchen or a Döner in the afternoon. That’s it! The Döner in Düsseldorf are absolutely awesome. I have no idea why some Turk doesn’t take the idea to the US and open a Döner restaurant. He’d make a killing. I’ve also had sauerkraut here in Düsseldorf that was unbelievably good. It makes the Steinfeld’s sauerkraut at home taste like Hundefutter (dog food). In Stuttgart, I don’t remember the names of the things I ate, but they also were remarkable. No wonder our grandparents were such good cooks. It has been said that the best cooks in the world come from France and China. I don’t believe that for a second. While I love Chinese food, Thai and Korean food as well as Indian food competes quite amply. It was the Italians that taught the French how to cook. The best bakery goods in the world are not found in France but in Austria and Germany. I’d take a meal in Deutschland any day over the best French restaurant. This is not meant as an offense to my French friends, as they have much to be commended for. Jamaican food also is in a class by itself, and nobody could compete with Jerk as one of the best foods of all time. But, back to Germany.

 

Classes have continued. I find it easier to speak and read. I’m continually hindered mostly by remembering genders of things. It is very frustrating. Why should a wall be feminine and a window neuter? Why is a auto neuter but a wagen (car) masculine? It makes no sense to me, and frustrates my learning. I find that only after unbelievable repetition, one finally gets it. It’s probably why I will never be perfectly fluent unless I live in a German-speaking country for a while, but then, I don’t think that Betsy would tolerate that, and she’s the most important thing to me, than just learning another language. Oh well.

 

I’m getting around town a bit more, and finding my way downtown without problems. I’ve found some good bookstores, and even the bookstore where Heinrich Heine was born in the Altstadt, so I had to buy a book of Heinrich Heine poems in that store.

For my studies, I must say with Heinrich (Henry!)

Anfangs wollt ich fast verzagen,

Und ich glaubt ich trüg es nie,

Und ich hab es doch getragen,-

Aber fragt mich nur nicht, wie?

 

A rough translation (I hope is correct!) … At first I thought that I would despair, and believed I could not bear it. Yet, I did it, but don’t ask me how!

 

And a poem for Betsy’s and my Wander-year…

Wo wird einst des Wandermüden

Letzte Ruhestätte sein?

Unter Palmen in dem Süden?

Under Linden an dem Rhein?

 

Werd ich wo in einer Wüste

Eingescharrt von fremder Hand?

Oder ruh ich an der Küste

Eines Meeres in dem Sand.

 

Immerhin mich wird umgeben

Gotteshimmel, dort wie hier,

Und als Totenlampen schweben

Nachts die Sterne über mir.

 

Just like Shakespeare or Edgar Allen Poe fails when translated into German, Heine or Goethe fails when translated into English. My apologies to my English-speaking friends. Try learning some Deutsch! Eat your heart out, Doug Bond! Shakespeare sucks!

 

As mentioned before, the most expensive shopping mile in Germany is in Düsseldorf, on the Kö, or, Königsberger Allee. I take walks at least several times a week to the Altstadt, and so have to cross the Kö.

There’s also a large open-air market nearby in the Altstadt…

There is this strange fixation in Germany on Amerikan politics, and many bakeries now offer Obama bagels and Hillary donuts…

Both are fitting. The Obama bagel has a large hole in the center, and the donut has a central hole, plus sugar and spice but nothing nice. I don’t think that they intended those interpretations, but they are most fitting.

 

Hamburg. Hamburg was a beautiful city, and I enjoyed it thoroughly.  The Elbe river runs through the city, which you could see from the Jugend Herberge (Youth Hostel) where we stayed.

The Elbe is a bit larger than the Willamette where it runs through Portland, Oregon, but not as large as the Columbia in that same area. You don’t see bridges going across the Elbe, I presume in part because Hamburg has huge shipping traffic and a very large bridge would be required. A century ago, the first tunnel was dug under the Elbe, and we were able to walk it…

We went to the Speicherstadt, which was a part of town were duty-free goods were unloaded in the past, resulting in Hamburg becoming the 2nd largest container port in Europe. It looks like Amsterdam. It’s funny what the absence of taxation does to the overall economy.

We visited the St. Michaelis Kirche, and were able to go up to the top to see the city from an excellent view…

 

We visited the Rathaus, which does NOT mean “house of rats” but rather, is the City Hall. It was stupendous, with a large fountain in the center court…

By evening, we made it past the Music Hall, which had a Memorial (not seen) commemorating Johann Brahms, who came from Hamburg.

The next day, we went to the FischMarkt, took photos of Hamburg, and took a boat ride up and down the Elbe, looking at the massive harbor cranes and ships in the harbor…

 

They also do ship-building and repairs in Hamburg, and the last photo shows a massive ice-breaker in dry-dock for repair. Finally, one of the students, a Russian-born kid, now living in New Zealand, speaking both Russian and English perfectly, insisted on going to KFC for lunch. As per my comments above about Hamburger hamburgers, KFC in Germany is not as good as at home.

The last photo shows the group with Marcel and Hannes, who were our German Zivis. They were wonderful. We also visited a Modern Photography Museum, and all agreed that it was awful (sorry Diane, but modern art is just plain sick-it’s not that modern art doesn’t say anything, but that what is says is offensive).

 

So, now I’m back in Düsseldorf, and I’m wrapping up the last week at the Goethe Institute. My next post should be coming from Herbert’s Haus. Until then, hang in there.

 

Noch in Düsseldorf

January 19th, 2009

The memorial words of JFK “Ich bin ein Berliner” were laughed at by the Germans. The above photo shows you a Berliner. It is a jelly filled doughnut. Don’t worry, Betsy, I bought only one, just to say I had a Berliner. JFK should have said “Ich bin Berliner”.

 

Last week, I returned to Krefeld, and spent the weekend with Herbert. I had a wonderful time practicing German, and Herbert had a not-so-wonderful time listening to the most horrid butchered German one could generate. I am finding that I know more German than I thought, but far less than I’d really like to have. Conversations are becoming easier, and I’m constantly learning more abstract words, and daily phrases, to allow for better rapport on the street. I am amazed at how many people speak English. Virtually all the students from Japan are fluent in English, the student from Iran, the student from Turkey, the student from Italy, and the students from Russia all are quite fluent, and will often ask me to explain a German word or phrase in English to them. I am also overwhelmed by the extreme kindness that others from foreign lands are to others. I’ve never felt the sense of “hating” the dirty American. The German people also have been outstandingly kind to me, so that I just haven’t seen the Prussian Militarist type sentiment yet in Germany.

 

While with Herbert, we went to Venlo, which is an ancient town on the Maas River in Holland. It was a little strange having to contend with yet another language. Dutch is sort of a form of bastardized German. All you need to do is either say the word in English (Street vs. Straße), or add a “j” here or there, and double some of the vowels. Then you have Dutch. My apologies to my Dutch-speaking friends. Venlo was nice, and we went to the Altstadt, where it is now many shops on several streets. Here are some photogs.  One building had the most grotesque door header. I have no idea what it was meant to symbolize.

Other street scenes showed many shops and old buildings.

This last week, no Stammtisch. It occurs too late at night. I wouldn’t get home until about midnight or later. So, you probably won’t get any reports about Stammtisch. The snow is now mostly melted, and the only thing that makes one uncomfortable is that it is a little windy. It is now much easier to walk the streets. Classes are going well, and I am doing nothing but speaking, reading, and even thinking and dreaming in German.

 

This weekend, I had the most wonderful time with an old friend Debbie (Gasser) Fuchs and her husband Heinz. Heinz had moved to Portland soon after Betsy and I moved to Chicago for residency. During that time, they had gotten married and moved to Germany. So, I knew Debbie quite well as a young girl, but had never met Heinz. It was a most unusual meeting. I took the train from Düsseldorf to Stuttgart, and then transfered to the train going to Benningen, where Heinz and Debbie live.

I should mention that train travel is incredibly easy in Europe. You can easily go just about anywhere, and at a very low cost, if you purchase Eurail passes in the US. The trains and busses run unbelievably on time, even on the day when there was a horrible snow fall. It should be the envy of Americans, though even our best city transportation is horrid compared to the transportation system in Germany. While visiting Heinz and Debbie, besides the wonderful fellowship I had with them and their family, I did four things.

  1. 1.Visited the Schloss Ludwigsburg. This is the largest palace in Europe outside of Versaille, and the magnificence was breathtaking. It was not damaged during the war, so has been kept intact. Some of the many scenes follow…

    There was a full theatre with orchestra pit for opera, a large chapel, hunting lodge, enormous gardens, etc., making the splendor beyond imagination.

  2. 2.Finsterott – Heinz offered to take me to Finsterott, about 30 km away, which was where my grandfather came from. By the time we arrived, it was fairly late at night, so I couldn’t take the best photos. It is a very small village, up on a plateau that was quite hilly, mostly used for wine growing. Just north of Finsterott was the Evangelical Taufer Gemeinde Kirche, which is almost indubitably the church that grandfather and great-grandfather attended. There is a connected Altenheim (old folks retirement center) where I wish I could have asked the folk about our grandparents.  Here are photos.

  3. 3.I went to church with Heinz and Debbie at the Ludwigsburg ETG church. What a delight! It was absolutely wonderful hearing Zion’s Harp songs (from our old church Hymnal) being sung, except auf Deutsch, and other songs, such as “How Great Thou Art” being sung entirely in German. Fortunately, I was able to understand over 90% of the sermon. They serve lunch in the church immediately after the service, and I was able to talk to a number of folk and eat traditional Wurttemburger food. Just awesome! The church had a wonderful mix of young and old, with many children. I felt totally at home.
  4. 4.Stuttgart. Heinz and Debbie took me to this hill overlooking Stuttgart, I don’t remember the name, but it is where the WWII rubble was stacked as a remembrance of the war.

    The last photo is overlooking Stuttgart.

I’m back in Düsseldorf now, and ready for another week of study. Stay in touch. Viele Grüße auf Düsseldorf!

 

Nach Düsseldorf

January 10th, 2009

As I sit in the Chicago airport, with a four hour delay until my next flight to Düsseldorf, I am barraged by the sewer pipe. I learn that Obama now is opening up and growing up. Wow. I earn that there is a mess in Israel (Gaza strip), that is a very hard problem. I heard that phrase before, when the intellectual elites discuss things such as medical ethics. It a really hard problem to tell somebody that their physician will not kill them(?). I don’t think so. If somebody were to go on a lunatic rage, all would have no problem identifying the person as crazy. But, what if an entire group of people go on a lunatic rage? Then whose fault is it? Why do we treat groups of people completely different from individuals?  There is such a thing in medicine as a Folie a deux, where two people are insane when together, but normal when separated. Can such a thing happen to groups of people? I think so. Maybe the world is crazy? I learn from the Gaza strip games that sane people do very insane things. Both sides! It is the worst setup for disaster.

 

I simply could not sleep on the airplane, but it was most delightful to Herbert waiting for me in the airport. The next day was spent at the Düsseldorf zoo, but I’m not sure on which side of the cage stood the most dangerous animals.

 

Monday AM. Woke up, the alarm clock was keeping time, but making no sound. Looks like I need a new Wecker. I eventually discovered that my iPhone has a clock in it with an alarm, and it is working just fine for that function.

 

It had snowed the night before, and there were at least 8 cm of snow on the ground. I couldn’t roll my baggage, and so had to carry it to the Bushalterstelle where one catches a bus. I needed one connection (Umsteig) in downtown Krefeld, and then was off to Düsseldorf. The busses ran on time, though traffic on the Autobahn was in standstill (Stau). The people at the Goethe Institut (from now on GI) were all very friendly, and I proved an efficiency of about B1-B2, so they decided to stick me into B1, which was what I preferred, since I needed nothing but a lot of practice speaking, and Grammar work, so an easier class would suit me fine. I took the taxi to my Hausmutter, a very pleasant older couple, who had an upstairs room for my use–alles sehr bequem (very comfortable). So, tomorrow I start my German lessons.

The last photo shows the stairwell up to my room. It’s a fairly steep climb. The bus ride takes about 20 minutes, but it’s a 10 minute walk to the bus stop, and a wait from 5-20 minutes, so ties up about 1/2 -1 hour to actually get from “home” to the class and then the same time in return.

 

Lessons are with a middle-aged male teacher named Roman. He is actually quite adept, and much of the time is spent repeating and repeating various sentences, with many corrections. It’s nice to learn from the mistakes of other students. I spend a little time after class, which ends at 1 p.m., and study in the Media room. It is there that I am also able to make internet connections to you all.

 

I haven’t had much ability to explore the city. The temperature remains below zero, and it is really biting cold. They had a walking tour today that I skipped out of, since it was too dastardly cold to consider staying in any longer than I needed.

 

Thursday 08.JAN2008 The temperature has finally warmed up a touch, though most of the snow remains.Here is the outside photo of where I am staying… it is still early morning and quite dark outside when I leave in the morning.

It was comfortable enough to take a walk downtown, and see Königsallee (Kö), the most expensive shopping district in Germany. It was. I didn’t buy anything.

This evening will be our first Stammtisch. You’ll hear about it next time. Until then, keep your stick on the ice. I’ll stay in touch. BTW, it is extremely difficult for me to write this is in English. Ich hätte nur auf Deutsch geschrieben. Bis bald.

 

Es Weihnachtet ein Wenig!

December 18th, 2008

For English only speakers, the title means, “It’s Christmasing a little”. Yes, it is Christmas time, that most happy time of year. We should be having all the children home, including Rachel, who originally thought that she couldn’t make it. We are cutting costs a touch this Christmas season, not so much because of the economy, but rather owing to my pending absence of salary for a year.

 

The week before Christmas is cookie time, and we have been baking cookies fast and furiously. It wouldn’t be Christmas without Christmas cookies! Recently, I also made up a bunch of Jerky and smoked salmon. The stuff you get in the store is more like leather than good jerky, so I like making my own. Essentially, you cut of a 2 cm thick piece of tough steak into thin 3-5 mm strips. They then get brined over-night, in my own personal secret solution.

The pieces are then washed and dried, peppered, and placed on racks to insert into a smoker.

Finally, the jerky is allowed to cool, and then placed in Ziploc bags in the refrigerator, to help keep them very fresh.

 

The Krankenhaus continues to be built, and it slowly is taking form. The hospital administration is telling us that it will be completed in December 2010, though the construction workers tell me that it is more realistic that a June 2011 timeframe is more probable. Here’s a few photos for you.

Parking Structure

Main Building

View with old hospital in the background. It’s coming along fairly steadily. We wait anxiously. Meanwhile, I am cleaning out my locker. The photo of my locker at the hospital is on the top of this blog. It is the only locker in the men’s changing room that has any stickers at all. I will not miss my locker or Good Samaritan Hospital, but will miss my patients seriously. There are too many patients that I have had very close interactions with. Many are giving me a call in the last few weeks. I hope that I can come back to Puyallup as a surgeon, though I will never return to the situation of call and administrative arrogance that has been plaguing me for the last few years. We’ll see what happens…

 

It remains my duty to continue philosophizing. I’ve appreciate Udo’s comments on Ayn Rand, and remain to be corrected. Adam Smith remains the Grundlage of conservative economics, yet it is not surprising to learn that he was a very close friend of David Hume, of whose thinking we owe the downfall of Christianity in the British Isles. His statue sits right outside of St. Giles Church in Edinburgh where John Knox preached for many years. It was Hume who essentially stripped the Scriptures of any form of miracle, identifying reality as only that which could be known by sense or experiment. As a polar opposite to Adam Smith was Karl Marx, who oddly found his safe haven in Londinium, after being expelled from Deutschland and France. Marx’s railing against capitalism identified that capitalism alienated the person from his work and social environment. Oddly, Marx failed to realize that his thinking alienated the person from himself. The self, in Marx’s system, has no sense or meaning save for what is conferred on that person from the state. Neither capitalism nor communism succeeds in the end since it fails to identify the true object of our alienation in the world. Both capitalism and Marxism are systems of greed, with Marxism actually being a more perverse form of greed, since it concludes that because everybody cannot have everything, everybody will then have nothing. Governmental forced wealth distribution according to Marxian principles will ultimately lead to the vast majority of the population being poor, with only a few having all the wealth. It is interesting to note how few societies had a substantial middle class such as has been seen in the non-Marxist Western world in the last 200 years. As society becomes more socialist, we are quickly loosing our middle class with the increasing separation of the very rich and very poor and fewer people in the middle. Scriptures speak of personal capital, suggesting the error of Marxism, yet makes very clear that our personal wealth is a gift from God, and not to be hoarded or acquired by means that are either dishonest or at the unfair advantage somebody else.

 

Und so ich weihnachte. Time to think about Christmas, God becoming man, a totally unique event in the history of mankind, and irreproducible, thus undiscoverable by Hume-ian methodology. Yet, the incarnation remains the most logical event that ever happened, the event that defines all existence and meaning. This makes Christmas is a most joyous time of the year. No time for sadness or philosophizing, but of family, friends, Christmas cookies, and Christmas carols that honor the Christ-event.

 

Frohe Weihnachten und Prosit Neujahr!

 

My next update will probably come from Düsseldorf, where I will try to update on a weekly basis, and thus will not announce with each new blog that comes out. Stay in touch, and drop me a line while I’m in Deutschland.

 

Habe nun ach! Philosophie

December 6th, 2008

Habe nun, ach! Philosophie,

Juristerei und Medizin

Und leider auch Theologie

Durchaus studiert mit heißem Bemühn.

Da steh ich nun, ich armer Tor!

Und bin so klug als wie zuvor;

Heiße Magister, heiße Doktor gar . . .

 

Yes! The immortal rantings of Faust in the prelude to the poem written by Goethe that has swept the world by storm. It just sounds so much better in German than English. It’s like trying to translate Shakespeare into another language – it just shouldn’t be done! There are too many days when I feel like Faust. I’ve even memorized the opening lines to Faust. They really are as good as anything from Shakespeare.

 

So I sit listening to philosophy lectures. I’ve worked through the Greeks, Bacon, Hobbes, Descartes, and Spinoza, then Locke, Hume, Kant, Hegel, Marx, Rousseau and Adam Smith. The nineteen and twentieth centuries await. All of this is done through the agency of the Teaching Company recordings titled Great Minds of the Western Intellectual Tradition. I’m doing this while I exercise. Yes. True, I miss a little bit, but I catch a lot also. This lecture series is done by a group of 12 lecturers. I’m not sure how they split things up. As an example, Adam Smith is taught by Jeremy Sheamurs, who is a bleeding heart Marxist, and speaks blatantly against Adam Smith from the very start. As a result, he not only misrepresents Adam Smith, but also Karl Marx. All of this professorial blathering brings me to mind one of my favorite quotes, offered by Paul Johnson, the British editorialist and historian, writing in 1991, in a book “To Hell with Picasso”

 

“Universities are the most overrated institutions of our age. Of all the calamities which have befallen the 20th century, apart from the two world wars, the expansion of higher education, in the 1950s and 1960s, was the most enduring. It is a myth that universities are nurseries of reason. They are hothouses for every kind of extremism, irrationality, intolerance and prejudice, where intellectual and social snobbery is almost purposefully instilled and where dons attempt to pass on to their students their own sins of pride. The wonder is that so many people emerge from these dens still employable, though a significant minority, as we have learned to our cost, go forth well equipped for a lifetime of public mischief-making.”

 

I will now include Teaching Company series and other lecture series in my book review section. All of this philosophy stuff has brought back to my mind how my thinking has been so thoroughly influenced in the college years by the writings of Francis Schaeffer. It’s maybe time to re-read his works. It seems like his writings, though 30-50 years old, remain contemporary.

 

I haven’t written much about my reflections on politics. This is mostly because I choose to be hopeful in my depression. I would have been profoundly depressed had McCain become president. I feel the same about B. Hussain O. Neither candidate has a strong concept of economics. BHO is profoundly inexperienced—something that no amount of personal élan or cabinet appointments could make up for. So, we wait with baited breath. Meanwhile, do you know who John Gault is? I’ve reached the point where I need to re-read Ayn Rands’Atlas Shrugged. You will learn who John Gault is in this book. I now have an audio version of A.S., and so might just listen to it. Ayn discusses the possibility that the few movers and shakers of society, those that really are productive (not the George Soros’s of the world who get wealthy by spending their time trading stock, but those who actually generate wealth in a society) if they were to go on strike. Well, my year off for Sabbatical is slightly a reflection of my agreement with Ayn Rand. It’s time for Atlas to shrug.

 

Will Cut for Food

November 16th, 2008

Dr. Mike Brown was the anesthesiologist, and we got the team together for a photo of my last elective case at St. Samaritan Hospital. I am still performing smaller procedures at our surgery center, but have refused to take any further hospital call at GSH and so am restricted on performing elective cases at the hospital. That’s okay with me, but their underwhelming friendliness and willingness to accommodate to my particular issues induces a reluctance on my part to ever return. Who knows? There is always locum tenens, the Fransiscans (another hospital group in our region), or possibly focusing primarily on mission work. Meanwhile, it is a little slower at work since I am not taking on the huge cases, and elective hospital cases that I see in clinic are fed to my partners, so that they are busier with paying cases.

 

I’ve been saying goodbye to many patients, and will miss them. One patient had a total esophagectomy by me, followed by a major colon resection, and is alive and well ten years later-one of my miracle patients. He used to drive a beer truck, and would always ask me for a beer. His first comment whenever I’d walk in the room was “&*^#@!, hurry up, I don’t have all day!” So, his last visit I gave him a few brews to take home.

 

Bicycles… Another Mike Brown is my bicycle consultant, and he has ordered my Steelman bicycle. I am waiting anxiously. I will probably get a cheap Rennrad (road bicycle) in Düsseldorf in January to get around with. Perhaps later in the year, I could return to do the Rhein or pop down into France and do the Alpes d’Huez (yea, mon!!!). Meanwhile, I did the almost unthinkable. I always thought that I would be totally safe with my bicycle mounted on the trainer in the garage. Well, three weeks ago, for some unknown reason, the back wheel flipped out of the trainer, and completely wrecked the back wheel. I had to completely replace the back wheel. Schade!  So, I am back pumping on the cycle. I must be the only person to ever have totaled a bicycle while on a trainer!

 

I’m ready for the year off. I can’t wait to touch base with Herr Doktor Herbert Feucht in Krefeld. I’ve always enjoyed visiting him. Hopefully, I could be a little more independent in Düsseldorf, and thus be forced to speak German. With Herbert, he usually talks English to me, and spoke for matters when we were out. So, I’m cramming my German right now, while also teaching myself the Sanskrit of the Bengali language (much slower progress!) and a few Bengali words. Bengali definitely is an indo-european language, and I can see similarities in many words, such as numbers.

 

Our (Betsy and I) only significant activity was a trip to Maui for a Wilderness Medical Society meeting. I didn’t really enjoy Maui. It’s expensive, and crowded. I find that it is hard for me to just lay out on the beach and get any serious reading in. So, we didn’t lay on the beach or at the pool even once. We did get around the island a bit, and that was enjoyable. While in Maui, we learned that we now have a little Commie Pinko freak as president. I wasn’t really crazy about McCain and so voted for neither McC nor BHO (I wrote in Ron Paul), and do not feel that mine was a wasted vote. But, I was still a little disappointed about the election. BHO’s presentation at the Democratic convention would most appropriately be called the apotheosis of BHO. Later, school children would sing songs worshipping him on television. Older folk of all intensities of skin pigmentation on television would lapse into trances of rhapsody for their savior and redeemer from the capitalistic pig, a behavior more fitting for a Pentecostal church service than a political rally.  It really seemed like BHO was competing with the Almighty as #1 of the Universe.

 

I was even more dejected by the vote in our state to approve physicians’ ability to help a patient commit suicide. You don’t need a physician to do that. Any dimwit can figure out how to kill themselves swiftly and cheaper than a physician. It just isn’t our role to assist in killing. So, I am a bit leery about even practicing medicine in our state any more. Now that we have seen the death of Hippocratic Medicine, I am left frightened by what will take its place. Medicine no longer has a definition as to its goals. Is it to simply prolong life? Is it to maximize the profits of the pharmaceutical firms? Is it a means of giving the State control of the most personal aspects of our lives? Is it entirely a utilitarian function of maintaining maximal functionality of the States’ citizens?

 

I am left thinking about St. Basil the Great. Basil the Great of Caesarea (in Asia Minor) was one of the Cappadocian church fathers in the 4th century, one of the brightest theologians ever of the church, who also started the first hospital. Sick people were left out in the woods to die by getting eaten by wolves—certainly a convenient way of dealing with the sick! Basil decided to re-incorporate the sick back into society through the use of hospitals.

Kudos to St. B. Is it no wonder that Christianity took the world by storm, without force and without might, but rather by its’ adherents simply being obedient to Christ and being servants of others? Lord, give me both the wisdom and caring heart of St. B.

 

Finally, thanks to Dr. Middelmann for noting some German grammatical errors on the blog site. I’ve hit the one-year mark for my blog/web page. My children, who inspired me to start a blogsite, are no longer diligent at maintaining their blogsites. FaceBook has kind of stolen the show. What next?

 

Treading Among Immortals

October 19th, 2008

OK. I have a confession to make. I’m absolutely nuts about J.S. Bach. And the more I listen to his music, and learn about him, the more I appreciate the absolute genius of his character. I’ve spent some time re-listening to the Greenberg lectures on Bach and the High Baroque (www.teach12.com) and remain amazed at the sheer complexity of his compositional technique, engaging in musical styles that took until the 20th century to grasp, such as Stravinsky’s technique of having two simultaneous key signatures being played (and sounding great!), odd-metered timing, 12-tone rows of Schönberg, and the likes.

 

I don’t review all the music that I listen to, and notice that over the last 30 days, I’ve listened to over 84 hours of music, just while sitting at my desk, reading or doing the computer. These have included the symphonies of Glazunov (well worth hearing & owning, though they still don’t come in a compiled set), and much of the piano performances of Alfred Brendel, including the Beethoven piano sonatas, and Schubert piano sonatas. Both are wonderful performances by a superb Wiener Klavierspieler. I know of no better Schubert interpreter than A. Brendel.

 

Now that autumn has arrived, I have my bicycle mounted on a trainer. The summer was wonderful for cycling, but very disappointing for backpacking. Maybe next year will be better. I have a new bicycle on order, a steel framed bike with Campy Chorus components and Campy Neutron wheelsets, that hopefully will arrive by early February. I am ordering this wonderful little machine from a friend of a friend, Mike Brown, who is just opening up a bicycle shop in Tacoma. The frame is coming from California, and you can look over their website atwww.steelmancycles.com. This cycle should last me the next 20 years, unless it gets stolen or run over by a car.

 

I’m nearing the end of call  –forever. October 28 is my last call day. I will never again take call under the conditions that we have been having to endure. It will be either 12 hour shifts, or hospital call with substantially more assistance. For two months, I’ll be winding down my practice, in preparation for the year Sabbatical starting 01 January 2009. More on that in future blogs. For now, I need to prepare for a month at the Goethe Institute in Düsseldorf. I’m also doing a little brush-up on my French, while teaching myself the Sanskrit style writing of Bengali.

 

It is the political season. I hate politics. I’ve just read a blog of a relation that makes them sound like a little commie pinko freak. Scary! I didn’t think that we had that in our blood. Amerika seems hell-bent on socialism. Though the public has massive distrust for our “leaders”, they wish to put even more responsibility on their laps. The Gov is now responsible to make sure we never have an economic downturn and so is taking possession of our banks (i.e, our money, our wealth). The Feds are responsible for “educating” our kids. We want to give them the care (and control!) of our bodies in the form of health care for all. We don’t respond in horror when a near-president suggests that we have to “spread the wealth around”. Lenin, Stalin, and Mao were effective at spreading the wealth. It looks like Amerika will be re-inventing their failed experiments in economics. Plan on a 10-20 year depression.

 

It’s not fair to end on a depressing note, since I don’t really feel depressed. Probably best to end quoting the prophet Habakkuk…

 

Though the fig tree should not blossom,

nor fruit be on the vines,

the produce of the olive fail

and the fields yield no food,

the flock be cut off from the fold

and there be no herd in the stalls,

yet will I rejoice in the Lord,

I will take joy in the God of my salvation,

God the Lord, is my strength,

he makes my feet like the deer’s;

he makes me tread on high places.

 

In memoriam

September 11th, 2008

This week, I received the shocking news that one of my special mentors in Surgical Oncology passed away. Dr. Michael Walker was a fellow for the year that I did my internship, and then stayed on as an attending, and serving as an advisor for me. He was one of my favorite attendings, and very influential in getting me to go into surgical oncology. A quiet and private person, he was patient, kind, with excellent bedside manner, very bright, and most exemplary as the kind of doctor that I myself wanted to be. Michael was quite physically fit, ran all the time, and never had much fat on him. He worked hard, and that got him a position at Ohio State. It was an e-mail from Dr. Das Gupta that informed me of his death. My heart goes out to his wife Lee. Dr. Walker will always be remembered with pride by me.

 

The only person that ranked higher than Mike, in my opinion, was the professor, Dr. Das Gupta, who still remains the greatest doctor I’ve ever worked with, ever, and there were many greats.

 

Of all of my mentors in Surgical Oncology, Dr. Henry Briele remains the most quoted. Cut! Cut! Cut! Today! were repeatedly screamed at me in a sharp, staccato fashion, with me gasping in frustration, worried about cutting the wrong place or the wrong thing. We always used these large blades that looked more like sabers, which I continued to use until they became unavailable.  I still say Cut! Cut! and Today! to others in the operating room, and there are countless techs that have heard of Dr. Briele, even though they have never ever met him. Another favorite quote…I’ll have the electrocautery turned way up, and then say, “If they didn’t want it to go that high, they wouldn’t have made it go that high”.

 

Well, I can go on, but I’d do a disservice to my real hero, Dr. DasGupta.  I don’t quote him much, except something he told me when I was taking too long to close a mastectomy, “If you keep up this pace, you’ll never make it downtown”. Dr. DasGupta will be proud to know that my average modified radical mastectomy with sentinel node biopsy (and completion axillary dissection) rarely takes more than 60-90 minutes. I’ve gotten faster, but also much more precise in my surgical technique.

I decided to do surgical oncology research, since the surg onc docs seemed to be the most intelligent and caring surgeons in the residency program. When they criticized, it wasn’t just to make you miserable-they were actually trying to teach you. The very first day of research, Dr. Das Gupta sat Dr. Tate and myself down in his office, asked Peggy the secretary to turn off the phone, broke out a very expensive bottle of Port, and offered Dr. Tate and myself a good cigar. We were his boys. He was our boss. We called him “the Boss”. The only other thing we ever called him was “Scooby”, from what a patient called him once. Dr. Das Gupta once was asked by a patient whether he was German, since his name had “Das” in it. I believe that his response to the patient was something like, “yes, I’m from VERY east German!”. My favorite quote of Scooby was to let a patient know that they got better “in spite of us”. Dr. Das Gupta was, more than anybody else, responsible for me getting a Ph.D. He has always been my superior, but also my friend. It is nice to be able to occasionally still ask him for advice or direction. A few years ago, Dr. Das Gupta made the news because he apologized to a patient after making an operative error. The national news lauded this as a unique and unusual form of behavior for a physician. Yet, this honesty and forth-rightness were taught to me by him from my first day on service with him.   There is no person in all of Surgery that I would be more proud to call my mentor than Dr. Das Gupta.

 

The lead photo is a surgeon from the Cameroon who was visiting Puyallup. I shall be spending some time next year in Bangladesh, so am now actively trying to teach myself Bengali. It’s hard. I may also spend some time in Africa with Ngoe in Cameroon. My hope is to find the best fit for myself, or be able to be available, so that I could spend 3-6 months every year overseas.

 

I am unfortunately persistently agonizing over the absence of respect that is given to the older surgeons by our hospital. I keep getting the feeling that they want to get rid of me, yet, when I give them firm statement that I really, really am leaving, they come running like lapdogs, trying to make amends and promote unity. Today, the Lord Grand High Executioner informed me that I cannot go on courtesy privileges, finding about any loophole possible within the text of the hospital bylaws to refuse me courtesy status for two months while I cover my service but not actually take hospital call. He finally agreed that he would pay me for call, but, my price is not cheap. I am not a well-worn whore. Several days ago he send me a letter reprimanding an order I placed in a chart. I had a patient on whom I did major and serious abdominal surgery, and she remained with an unusually prolonged ileus. Finally, one day, I walk in the room, and, rather than vomiting on me, she begged me to get her an iced Cappuccino. YES! She opened up! I promptly ordered “Iced Cappuccino, i po qh prn”. Two months later, I get this lengthy reprimand stating  that the hospital simply could not provide the cappuccino, so I made the hospital look bad. Oddly, nobody ever spoke to me, or called me to inform me that the order was unfillable, but that alternatives were possible. I would have personally walked over to the hospital and purchased her an iced cappuccino. Unbelievable paperwork was generated by nursing, dietary, and then administration over an iced cappuccino order. Dudes, this goes on all the time. It’s sad to see the “caring” profession to be the least caring people of all, and especially those that try to protect the patient from the “uncaring” doctor.

 

I fixed the “comment” device, as it wasn’t working well. Please feel free to leave comments. I’ve also included reports of some more bicycle rides, movie, music and book reviews. Some time soon, I’ll leave  more detailed note of our future plans.

 

A wet August

August 25th, 2008

It’s been a busy but wet August, probably one of the wettest that I can remember. I did a moderate amount of training for the Portland Century, but often had to fight the nasty rain. The Portland Century was dry, but it started raining quite heavily as soon as we completed the ride. You can read about the Portland Century in the “Bike Rides” section. I noted that after riding the Century, there were those that had done only 25-50 very flat miles, and were struggling to get up a very mild hill on Broadway in downtown Portland as it goes south. Oddly, that would have been me a year ago. Fortunately, except for minor leg cramping, I couldn’t have felt better on this ride. Other outdoor activities have been limited by the amount of rain that we’ve had.

The top photo shows progress in the construction of the hospital addition. Note the cloudy skies in late August. The construction goes on feverishly, rain or shine.

You might notice that I rearranged my website to make my other events more accessible. In particular, I added a number of movie reviews, music reviews, book reviews, a pitifully failed hike, besides my bicycle rides, to the respective pages.

After great reflection in the past month I probably will NOT
a) hike the complete PCT at one time ever
b) ride my bicycle completely around America ever
c) sail all the seven seas ever
This doesn’t mean that I don’t want to do some serious hiking or cycling. I’d like to get a real touring bicycle (Cannondale Touring I), and possibly a real road bike someday-I’m currently looking at a bicycle that would be a Torelli frame with Campagnolo Chorus components, and Campagnolo Eurus wheels. There is a shop in Tacoma that assembles the bicycle for you if you buy their components, and they are reasonably cheap.

My heart is becoming increasingly desirous of
a)  doing time in a foreign hospital, the current list being possibly China, Bangladesh, or Cameroon. Any would work for me, and hopefully, Betsy and I could try out several places.
b) spending more time in Europe, especially Germany, possibly taking language classes, and hopefully having a decent bicycle to ride around Europe with.
c) taking a break from American medicine. I’ve never felt more at peace about a decision than when I decided to check out of my practice for a while. I am absolutely decided not to continue practice with call at Good Samaritan Hospital, or any other hospital in the US without adequate compensation and limited work hours (less than 12 hours/day) on call. I don’t think that will happen soon at GSH. So far, my group has agreed to allow me to drop to courtesy privileges at GSH as of 01NOV08, and then take a 1 year Sabbatical during the 2009 calendar year. This will give me opportunity to explore a) and b) above, and to also consider what to do with the rest of my life.

 

Ich genieße Deutsch zu lernen

August 5th, 2008

Manchmal lernte ich Franzozisch mit «French In Action». Und dann, habe ich Onkel Herbert kennengelernt, und er sagte, dass ich sollte Deutsch lernen. Ich dachte, dass Deutsch war sehr schwer, weil die Sprache haben Zeitformen und jedes Wort eine Geschlecht, alles das ist nicht für mich gewöhnlich, oder leicht zu errinern. Aber, ich habe sehr viele Freunden und Freundinnen die könnte Deutsch zu mir sprechen. Und denn hatte Tochter Diane «Deutsch Perfekt» mir empfolen, und es macht spa?, Deutsch zu lernen. Werde ich wieder Franzozisch lernen? Vielleicht, weil «French In Action» mit Pierre Capretz ist wirklich wohlgetan, und die beste Sprachkurse noch dass ich erfinden haben. Bitte, wenn du kannst diese Schreibung lesen und verstehen könnte, schreibe mir nur auf Deutsch!!!

 

Since most of my readers don’t read either French or German, I will stick mostly to English. Please note that I have added a page that includes a number of writings (Die Schriften) that I have done in the past. So, far I have up a number of articles that I wrote which were published in the Pierce County Medical Society Bulletin. Much has happened this month, and so will have a bit longer blog than previously. Please note one thing…I don’t heavily re-read my blogs, and will find grammatical errors in my writing. Please ignore them, as I am also aware of them!

 

  1. 1)As a continuation of my language study, we were visited by a French student who is here in America to learn English. So, it was a crash re-learn of French. I can’t believe how much I forgot. I need to review French once in a while to keep my brain active.
  2. 2)Bicycle riding– on 02-04AUG, I did the Courage Classic, a three day bicycle ride across three of the higher passes in Washington. The details can be found in Kritik/Bike rides. It was 172 miles (277 km) total, and about 5000 ft (1500 m) climb every day, but went well, and mostly beautiful weather. I think that we last went across Snoqualmie pass this winter during the most harsh winter storm. And to think that Stevens pass and Blewett pass were barely crossed at the same time by several visiting relatives, the Dietrichs from Oregon and Mosers from Iowa. I’m sure they will see the posted pictures and fail to recognize anything with the snow gone and wonder how anybody could get across those passes on a bicycle!
  3. 3)Sammy had his 2nd birthday. Cool!!!!

  4. 4)Decisions, decisions… time for a Sabbatical. Hopefully, my group can adjust to a year’s absence. It has become clear to me that I must take a year’s break to prevent absolute and total insanity from hitting. See below for thoughts on this…
  5. 5)Diane returns home. That will happen this coming Saturday. Rachel comes in early next week. I’ll be taking a week off to do some backpacking with them. I am discovering more fully and deeply that my best friends are my own family (sorry, Ara and Petie!–you’re still my best friends.). And, I’ll be training to do the Portland Century on 24AUG. I hope to do this with Lucas Anderson, who was with me on the STP, goading me on. He’s a super rider and a super-guy, a real pleasure to spend time with him. This will all be in my next blog.

 

OK. That’s the month. What’s on my mind? There are several things that I would like to do in the coming year.  First is to do some overseas medical/mission work. I now have a number of opportunities arising. a) Bangladesh would be my preference, although it doesn’t seem to be sorting out well, for reasons I don’t know. b) China. I helped an Oncologist in town get settled into practice, and so he will be looking for a hospital in mainland China where I could spend some time. He will be back to China for the Olympics, and then touch base with a number of hospitals for a possible place for me and Betsy. Apparently, the Chinese are desperate for American trained surgeons to teach and instruct them, since they do not have Western exposure to our surgical traditions, and are trying to incorporate into the Western world. c) Thirdly was a possible opportunity to go to Africa.

 

I also would like to do some thru-hiking. What that means is when one hikes for longer than just a few days at a time. Considerations include doing the Pacific Crest Trail (PCT), and 2600 mile trail which goes from Mexico to Canada, and takes about 4-5 months. See the PCT websitefor details. The main problems with simple Mexico to Canada thru-hiking is that one never hits many of the most splendid sections of the trail at the right time of the year. The other possibility is to do sectional hiking, which is to do portions of the Appalachian, Continental Divide, and Pacific Crest trail in order, hitting them at the right time. As an example, one of the most beautiful parts of the PCT is the high Sierra around Kings’ Canyon/Sequoia National Park, which you are hitting in early June when it is still under snow. Better to do it a little later in the year. I am looking for friends to do some thru-hiking with me, and I already am encountering a number of people my age in medicine or at church who have hit the “burn-out” phase of their life in their early 50’s, looking for a diversion like this. Sign up early at a discount…

 

I would also consider a long-distance bicycle ride, either across country, or from Mexico to Canada along the coast, or possibly in Europe.

 

The only thing that discourages me from long-distance hiking or bicycling is that Betsy would probably not do it with me, since that doesn’t seem to be her cup of tea. That’s okay, but, she’s the only person in life that I really enjoy being with for months to years at a time. If I do something long, I’ll probably try to get her to drive a car along as a support vehicle. That would work for either hiking or bicycling, and be a super support and make the organizational strategy much simpler. But, I haven’t talked to her yet about this, so give me a chance to break it in slowly with her!

 

Other news. I now am going off of Plavix, which is a drug which inhibits platelet activity. Multiple bruises and painful joints later, I can stop that cursed drug.  I’ve been given a SecurID from the hospital. I have no idea what to do with it, and it’s just another thing to tie up the multiple thingies that I need to constantly keep on my key chain. It’s that silly blue and grey thing in the upper left hand corner.

I’m going to need a larger pocket for my keys. I also gave up the regular cell phone and Palm pilot for an iPhone.

I got Betsy a white one, and me a black one. They are wonderful, especially since I use Macs, I am able to integrate my scheduling calendar, contact list, phone, iPod music, and everything into a small gadget that I toss in my shirt pocket and goes unnoticed.

 

Finally, I received notice that Aunt Dolly was fighting a fairly advanced gastric cancer. Since our family moved out west, we really never got to know our uncles or aunts very well. Dolly and Emma were the two that I remember most of the aunts, and uncle John, Raymond and Gus of the men in dad’s family, though I also have vivid childhood memories of many of the others like Alfred, Carl, and Paul. Apparently, after Dolly, there are only two uncles left on dad’s side of the family, and neither are in the best health. It is pause for reflection that sometime soon, as another generation passes, that we too will soon be a past generation, and that every one of us will have to give an account before God of our life on earth. I will end with a saying of the wisest of all men, found in Proverbs 16:1-9

The plans of the heart belong to man,

but the answer of the tongue is from the LORD.

All the ways of a man are pure in his own eyes,

but the LORD weighs the spirit.

Commit your work to the LORD,

and your plans will be established.

The LORD has made everything for its purpose,

even the wicked for the day of trouble.

Everyone who is arrogant in heart is an abomination to the

LORD; be assured, he will not go unpunished.

By steadfast love and faithfulness iniquity is atoned for,

and by the fear of the LORD one turns away from evil.

When a man’s ways please the LORD,

he makes even his enemies to be at peace with him.

Better is a little with righteousness

than great revenues with injustice.

The heart of man plans his way,

but the LORD establishes his steps.

 

So, Betsy and I carry on, these are our marching orders, plotting and planning, but trusting in God to so order our lives to please Him, giving thanks to Him for our life and health and for the life He gave for us.

 

Not Bad for a Heart Cripple

July 14th, 2008

A little over a year ago, I was having stents placed in my coronary arteries. Thirty pounds of weight loss and lots of exercise followed, as well as a focus on stress reduction. I purchased my bicycle (a Novara Trionfo) in early September, and found that I could only do about 10 miles before becoming exhausted. But, I decided in October to do the STP this year (an annual Seattle to Portland bicycle ride). It was a wonderful feeling to do 203 miles at a reasonable pace and yet never feel really drained. I’m already thinking about doing it again, hopefully in just one day. We’ll start a little bit earlier in the day, before daybreak. My main problem is mis-tuning of the bicycle had the chain coming off. My bicycle worked perfectly well until I took it in to be tuned at REI several weeks ago. I have never had such a bad time with chains coming off. Fortunately, we had no flats on the trip, though my tires looks rather chewed up, and in need of replacement at the end of the trip. I hope that son Jonathan would be able to do the STP with us next year. He’ll have to get riding a bit. I also hope that Ara could make it out next year. Start riding, dude! I’ve learned to tune my own bike, and feeling comfortable about riding long distances, I don’t anticipate any problems next year.

 

Today is Bastille Day! Vive la France! J’adore le Français. Our family is relishing the wonderful freedom we have from our revolutionary forefathers. That is why we try to suppress the spirit of revolution, because it’s already been done for us. Now, our benevolent and all-caring politicians will supply our every need, big or small. If your name is Freddie or Fannie, and you just somehow squandered 3-4 trillion dollars, hey, no problem, Uncle Sam will bail you out. Freddie and Fannie might get a slap on the wrist, or given a few additional regulatory orders, but that’s it. The kind and ever gracious benevolence of our dear politicians also wishes to provide for your’s and my healthcare. They will make the rich pay. The rich are anybody that are not buried six feet under.

 

When I put on my libertarian Ron Paul hat, I demand that the health care system be as far removed from government as humanly possible. There are several problems with that. 1) The feds require that health care be provided for all. Though the emergency room is only for emergencies, eventually every disease will become an emergency, in which you can go to an emergency room and demand care for free. 2) The feds have imposed massive rules on health care that make it nearly economically unstable. These rules are most prevalent in hospitals, governing the most inane items, such as initials that have been used for orders since the development of medicine, and are uninterpretable only to the clueless, like lawyers. 3) The legal profession has defined an ethereal standard of care which forces maximal possible care in all situations, and makes you guilty even when right. 4) The feds have defined pricing for all but the most elective procedures, such as plastic surgery and dermatology procedures. This means that we have absolutely no control over pricing. We take what we can get, and rarely is it comparable to other highly professional services rendered and always without the extreme risks that are assumed by the physician. 5) The feds have removed value from the cost of medicine, forcing costs to sky-rocket. 6) The third party payor system has removed cost impact on the health care consumer, thus removing any sense of value to any drug or procedure performed. How much is an appendectomy worth? What about a perforated appendectomy in 500 lb diabetic smoker with heart disease that stays in the hospital for 2 weeks. Under medicare, the surgeon gets about $400 for any case of appendicitis, slightly more if the appendix is ruptured. That is barely enough to cover overhead costs. Medical care no longer has value, and the public expects it for free. 7) Our current system was based on a historically previous better economic arrangement for physicians, which allowed them to often render services for free, such as caring for indigent patients or offering their time as “community service” to the hospital as call. With the loss of any margin to health care, most physicians (especially surgeons) can no longer freely give of their time, creating extreme tension between physicians and hospitals, with physicians now demanding to be paid for their hospital service call and hospitals insisting that such care continue to be rendered for free.

 

The only difference between the current US health care system and most European health care systems, such as that in Great Britain, is that the socialized system in the US is funded mostly by entrepreneurial private dollars, while that the socialized system in Great Britain or Canada funded by public funds. In reality, we are giving the feds a very foolish deal. They can carry on the most asinine regulatory actions, pretend to offer tort reform, offer grandiose promises to the public, and act truly sincere about caring for the health care provider. They reluctantly save the health care system at the last moment after doctors throughout the nation have kissed the derriere of their local politician with begging and pleading not to enact Medicare cuts (which still is a cut, since current inflation is estimated at between 3-16%) thinking that we should be ever grateful for them. As a response to decreased Medicare reimbursement, private enterprise is trying to become increasingly creative about making a profit. Historically, our response to decreasing reimbursement was simply to work harder. Now, we are working as hard as possible in order to maintain financial equity. Several years ago, a colleague announced that he was going to take a week a month off, since that would then give him the equivalent of an eighty hour work week and provide some sanity to his life. Several months later, his revenues plunged to not even supporting his overhead. He is now back to much less time off, and making a modest profit, though his investments are probably more financially rewarding that his profession itself, and he rarely ever seems to be happy or enjoying himself at work.

 

With all of this under consideration, I have several proposals. 1) Private enterprise quit funding federal health care programs. We should back out of investing in health care, whether it be for our own private offices, or for community driven ventures. 2) We should encourage medical care to go to a purely socialized venue like Canada. This will force the feds to live by the insane rules that they create, since they will be creating them for themselves. This will also not allow for “boutique” practices, which is healthcare that tries to escape from the “system”.  3) We should quit funding the entire bureaucracy through taxes. The state is currently sucking us dry. If you count all the taxes that we are forced to pay, including Medicare, income, property, sales, telephone use, vehicle, and many other taxes, all but the most poor are paying over 50% of our income into taxes. Stop working. Retire. Go on Medicare. Leave the country. Find another profession. Live off the inheritance you were planning on giving to your children. 4) The final solution (Enderlösung!) is to find a system whereby the hospital or state assumes all of your overhead, and truly pays you on a per hour basis that is commensurate with your skills and level of training. This would also allow you to work as much or as minimally as possible without incurring major debts through massive overhead. Sadly, such a system doesn’t exist. If physicians would uniformly refuse to continue funding the system and allowing to hold us in forced servitude and quit, go on strike, shut down, or terminate virtually every state and third party payment, the system might be forced to correct itself. Until then, the fed is going to be content with letting private enterprise fund their health care follies.

 

With all of this under consideration, it would be best for me to get out of medicine altogether. Yet, I continue to look for alternatives, with less stress and less work hours. I will not be a sacrificial lamb to the state.

 

Vive la France!

Dennis, if you comment, please keep it short, and mention something about your celebration of Bastille Day.

 

Time to Blow this Popsicle Stand

June 24th, 2008

The photo is that of me in from of the Wiener Staatsoper. Betsy and I had a most wonderful night at the opera in Vienna, forever fixed in our memory. The only sad thing is that of returning to the reality of Puyallup, WA.

 

As I write, this, the little bird in the cuckoo clock will periodically emerge from her den and remind me of who I am. That Vögelchen happens to be the most honest person in my life. Whenever she comes out to say hello, I greet her with great joy. Her running commentary remains the same, which at least suggests that one of my friends is persistent and unchanging. God happens to be the only other person in my life with a strong sense of true honesty. It must be that God is now speaking to me through my pet birdie in the clock. Other cuckoo clocks will sing Edelweiss or “Somewhere my love” to you, but my little feathered friend just lays on the cold hard facts, speaks her mind, and then shuts up for another 1/2 hour.

 

Today convinced me that I am too old to continue practicing medicine where I am at. The “chief doctor and Lord Executioner” of my hospital just informed me that I was a very bad boy for not dumping my asleep patient on the operating table to care for a trauma patient that was undergoing CPR in full cardiopulmonary arrest in the ER. I informed him that I would never abandon a patient in the operating room under any circumstance, and he went into a tizzy. E-mail or call me for details–I want to watch my language on the blogsite and not publicly speak evil of anybody. Well, I’m going to relieve him of some tizzy-ness. I’m quitting. October 31 is the very last day that I’m contractually obligation to St. Samaritan Hospital, and then I will either a) just retire, b) accept a deal from the Franciscans in Tacoma, c) leave the state and move back to Portland, and find a job pumping gas, etc..  d) work out something with my group to be on employed rather than partner status.

 

Regardless of which of the above I do, I would like to do missions work. My friend from Bangladesh  wants me to come. I’ve been suggested to go to the Cameroon or Niger. My Bangladesh offer sounds the most appealing, since 1) it is cheap, and I could semi-retire and still do missions, 2) my wife could be involved as a nurse (hopefully), 3) they are attentive to preaching the gospel while delivering health care–there is no point to saving the body but not the soul, 4) I really like my friend in Bangladesh, even though I don’t know him well, 5) I’d love to learn some Bengali, and 6) if a short-term goes okay, and they like me, I can always return and feel like I’m really helping somebody, without fear of violation of some kooky government regulation or a lawsuit.

 

The other thing that will be factored into our life is me doing the PCT. In case you are wondering, the PCT stands for the Pacific Crest Trail, which runs from Mexico to Canada. It’s only 2800 miles, and can be done in an easy 5-6 months, starting in late April. I would like to solicit people to join me for sections of the hike. I’ve already gotten several people from the hospital, as well as my wife. You too can do it. Hike a 100 with ole’ Cuckoo Ken. I’m contemplating this in either the year 2009 or 2010, preferably the latter (2010). Time to start planning is now. I’d like to chronicle the event, and have a decent camera to photograph the whole event. Stay in touch if you have any other ideas about the PCT, and when/if you would like to join me for sections of the trail.

 

It’s been a year since I had my stents placed. My laboratory evaluation shows normal serum lipids. I refused to take a statin d