December 2011

End of Year Ramblings

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
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 the 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 us. We will be going with the Rev. Dr. John (, 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 the 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. The 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 behaving. 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 highly selected group of individuals based on the bias of the judge, people who would rather be anywhere than sitting 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 lose 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 lose. 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 loser pays all court costs. 2. Use Biblical law, which truly punishes offenses to others and demands restitution or the 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

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 an 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 lose love or faith (in Christ), we never wish to cause a person to lose hope. But, hope in what? I am on rare occasions 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 of 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 professional will provide health is a misdirection 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 lose 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.

Born Again

Born Again, by Charles Colson ★★★
Here is a book that I’ve suggested others read, yet have not (until now) read the book. It is the second book that I read on a Kindle.
This book is a truncated autobiography of Chuck Colson, known of Watergate fame. It details his rise to power within the Republican organization through low-handed politicking. Eventually, he was chosen to be one of the special consuls for Richard Nixon. He served through Nixon’s first term and then intended to go back to his law practice when the Watergate scandal hit the fans across the country. During the time between Nixon’s second term and the Watergate scandal, pressure on Colson eventually led him to seek counsel from a friend when he became a Christian. Colson eventually was convicted, and served 7 months in federal prison, before getting released to then focus on prison ministries.
There are many aspects of this book that can be addressed. Certainly, Colson offers his own running commentary on his view of Nixon, Watergate and crisis that occurred. Much of the book is Colson coming to know himself and realizing that he had a tendency to take control of matters. His fall from (political) grace forced a rethink of his own political arrogance. In this regard, Colson was truly moving. Colson’s change of heart to truly desire God’s will is none other than miraculous, and a testimony that we all must take to heart.
Colson always professed innocence in the Watergate events. I tend to find his testimony believable. Apparently, he had no clue as to what happened. Colson ended up being the first person to plead guilty, which he did because he felt he did obstruct matters of investigation of the Watergate event, done mostly to protect the president. Oddly, Daniel Ellsberg, who was giving away top secret state information got off scot-free.
It is a little bothersome that by the end of the book, Colson ends up as a pentecostal. I certainly hope his thinking has matured a bit since his release from prison. He also tended toward social do-goodism, defending prisoners against an unjust prison system. Sadly, this has two sides, since too often punishment in prison is not commensurate with the crime committed. Colson has a tendency to focus on wrongful imprisonment when typical imprisonment for many is only too kind. Colson does make a good argument against the explosion of the prison system in our country, yet offers too few suggestions as to how to really fix that.
Being a lawyer, Colson goes way too soft on addressing the problem of law and justice in our country. He tends to suggest that there are a few bad lawyers that ruin the soup. In reality, the entire legal system is rotten to the core, and Colson simply won’t admit it. His own conviction was based on the most eminent lawyers in the land, who did NOT make the judgment against Colson based on either evidence or due process of law, but rather out of pressure from a small but very vocal public sentiment. Unfortunately, with the loss of constitutionalism in our court system, we can only expect this to get worse with time.
I agree with Colson in that the prison system is way overused, and tends to serve contrary to its mission, which is to reform the inmates. Supposing that Colson was truly guilty of his crimes, the best punishment would have been 39 lashings, total disbarment, obligatory public service of 7 years duration at minimum wage, and no diminishment of sentence based on good behavior, though an extension of sentence based on bad behavior could be enforced.
Colson was kind on the news media. The Watergate scandal was essentially a creation of the news media. Ellsberg should have been behind bars and is not, thanks to the liberal press. It is no wonder that the large news services are dying. I’ll shed no tears for CNN or MSNBC. Colson was kind to liberals. He tended to feel that anybody that called themselves brother was acceptable. Yet, the content of belief does matter. I hope Colson has learned this since his conversion. Those belief structures will order our thinking as well as behavior. For Colson to find vehement enemies that suddenly become best friends once discovered that they are Christians is a terrible witness of the “worst enemy-best friend” people, regardless of how “spiritual” they conducted themselves.
So, I truly enjoyed reading the book but gave the book only three stars for lacking the depth it could have had. Colson is a delightful writer, but I do not intend to read any more of his books, which I understand are quite a few at this time. I am most delighted at his conversion to the Christian faith, and see in Colson’s story a common tale that reflects God calling us to Him, and NOT us accepting Him. I wish that Colson could have seen that in his conversion. I’m glad that God saves us in spite of ourselves, and Colson stands as a most visible example of this truth among every one of us that call ourselves Christian.

Note by Note

Note by Note: The Making of Steinway L1037 ★★★★
I’ve always wondered how a piano was built. I didn’t realize that Steinway concert grand pianos were entirely built by hand, and are probably one of the only concert pianos still made by hand. This movie walks one through the year-long endeavor to build a piano. One starts in the lumber mill, where wood is specifically selected for the piano case and sounding board. Slow and meticulous processes eventually lead to the developed project. Many scenes are also shot of professional musicians in the NY Steinway piano store trying out pianos. I guess that even with Steinway pianos, the action can vary enough that a concert musician may need to try 10-15 pianos before finding the instrument of his liking. There are a lot of extras with this movie, but the feature attraction was itself a fascinating journal behind the walls of the Steinway piano factory in New York, with interviews of many of the piano building craftsmen. Steinways have many hand-carved features, constructed to precise millimeter tolerances. The tuning is all by hand, and not electronic like most other piano builders. The keys and their actions are all meticulously adjusted by hand to properly strike the strings with appropriate action on the key. One was left realizing that there may be a day where much of the art and skills of hand piano construction may be lost, and then we will be stuck with cheap Japanese imitations. Oh well!!!!

How the Earth Works

How the Earth Works, by Michael Wysession (Teaching Company Series) ★★★
This teaching company series, taught by a Geophysicist, discusses the mechanisms and processes that make the earth the way it is. Wysession is able to interlay the various processes, whether they be geologic, biologic, or astronomic, in discussing what gives us our world. The lecture series can be divided into three parts, with grading on each part…
I. Plate Tectonics – 5 stars – the longest part of the course, it also is the best part of the course, taught where Wysession is most expert. Details of how the continents were created, how plate tectonic theory was developed, how earthquakes and volcanoes occur, are all discussed in popular lay terms that can be understood by anybody.
II. The Weather – 3 stars – though the weather is an important process in molding the earth, another Teaching Company course on Meteorology has done a far superior job of detailing how weather is formed, and the processes that lead to our climate and living conditions.
III. Biology and “My Soapbox” – 1 star – Wysession adequately discusses the role of biological organisms in helping to form the earth. He does a far worse job of playing biologist. Much of the last lectures of the course are more a soapbox on various subjects such as climate change, humans elsewhere in the universe, and the destiny of man, which would have best been left out of the course. Many of the last lectures have no relation to discussing how the earth works, but rather create a dummy pulpit for Wysession. I do credit Wysession for maintaining a sense of scientific uncertainty about matters such as climate change, and he doesn’t become preachy like Algore.
The course could be improved in many ways. Most importantly, I wish Wysession would have spent a few lectures discussing in-depth the mechanisms for studying earth. He could have better discussed the various instrumentation for “sounding” the depths of earth. He could have given us more detailed explanations of land formations that help us understand the world we see, to allow us to engage in the process of being junior geologists. I would have been interested in having a rough feel as to how a geophysicist mathematically models things like earthquakes.
Wysession is an excellent teacher and adequately uses props and visuals to get his point across. This is a series worth watching, though the final lectures would be best deleted or changed as mentioned above to get the discussion back to the intended topic for the course.

Foxe’s Book of Martyrs

Foxe’s Book of Martyrs, by John Foxe and ???? ★★★
This is the first book that I have read in electronic format, on a Kindle. I have mixed feelings about the Kindle, and then comments on the book itself.
The Kindle is a great idea. I received the Kindle Touch about a month ago. I really didn’t wish for a microscopic keyboard and heard that there were problems with the color edition of Kindle, so opted for the Touch. There are problems with it. 1. The touch mechanism doesn’t always work consistently 2. if you accidentally bump the screen or try to clean off the screen to read it better, it will react. 3. since you always have to touch the screen to read, such as with changing pages, the screen is always being made dirty again. 4. After reading Foxe, the Kindle has shown a drastic reduction in speed, and multiple crashes, almost like it got a virus.  5. There is no mechanism for reading in dark circumstances, as you need an external light to see the screen.  6. Maneuvering through a book that you are reading can be a challenge, especially if the table of contents is not well constructed. They don’t have a reverse function like surfers have, so you can’t instantly go back to where you came from.  The advantages of the Kindle are 1. It’s a great idea, 2. when it works, it has great functionality, like keeping track of where you are in a book across all systems. My solution to the Kindle dilemma is to use Kindle on an Apple apparatus. I am just waiting for iPad3 to come out.
Now, for Foxe’s Book of Martyrs. I didn’t realize until I contacted my book resource David Davis that the original Foxe is about 7000 pages, and anything we read is a serious abridgment of that text. In addition, since Foxe died in 1587, any details after that are additions to his book. Thus, the hardcopy edition of Foxe’s Book and the Kindle edition do not resemble each other at all in their organization. Strangely, Wikipedia and most Google internet sources don’t clue you into this. The Kindle edition has multiple stories up to about 1830, many of which are quite rambling. At the end are very brief biographies of the main reformers, which are too brief to be of any value. The greatest value of Foxe’s Book is in his discussions of the martyrdoms around the time of bloody Mary. There is prolific language against the Papists and popery, all of which should NOT be forgotten by the present-day church. The Romish church has not changed significantly since the 16th century, and we shouldn’t forget that. The Pope and his minions have not made a kinder gentler church that has learned its lessons. It is a superb defense of the notion of Protestantism.
The book and its “editions” have left out much, including Savaranola, the Scottish martyrs, and persecution of the church by protestants on protestants. The revisions include lengthy details of the Quaker movement, which was unnecessary, and lengthy details of a person in Lebanon who was under pressure to conform by the Marionite church. The quality of the additions to John Foxe is low and should have been left out. So, read the book, but not the Kindle edition.

Come Let Us Reason Together

Come Let Us Reason Together, by Baruch Maoz ★★★★★
I had met Baruch Maoz at church a number of years ago, and found him to be quite thought-provoking regarding the nature of the Messianic Jewish movements. Maoz is Jewish, grew up in Israel, and now is retired, though served many years as a pastor and evangelist to a Jewish Christian church in Israel. I decided to read this book after noting how some Christians are quite enamored with things Jewish, many of whom incorporate Jewish traditions into a Christian worship service and speak Hebrew phrases in an attempt to have a Jewish flavor to the worship. Maoz notes that there is a wide range of Messianic Jews, many of whom are actually Gentiles, to some who would not even call themselves Christians, to a few that would disavow the doctrines of the trinity.  Maoz notes several things.
1. Messianic Jewish movements often have the wrong focus, being more concerned about Jewish tradition than on the Lord Jesus himself.
2. Jewish tradition, especially in Gentile hands, is often seriously confused, misplaced, poorly performed, and oftentimes insulting to real Jews, of whom this movement is attempting to reach.
3. Rabbinic Judaism is to be adamantly repudiated, since it places focus on a works righteousness, and is definitely not Biblical.
4. Well-intentioned Messianic Jews often do more harm than good by forcing a Jew-Gentile split, yet failing to adequately reach Jews. As evidence, it is noted that most Jews that came to the Christian faith did it outside of Messianic movements.
While reading this book, there were many times when I wished to give it only 3 stars. It is very poorly edited, and often one will find incomplete sentences. The content and arguments in this book are superb, Maoz is highly competent, reformed, and exceptionally knowledgeable in matters of Christian faith and Judaism. This is a book that many should read and take to heart. Maoz skillfully focuses the attention away from traditional Jewish cultural practices, to focus on the Bible alone to guide worship and Christian practice.