Kenneth Feucht

Review of Three Trumpet Albums

The Philip Smith Collection ★★★★★
Philip Smith was chair of the trumpet section for the NY Philharmonic Orchestra for many years, starting in 1978, and only retiring recently. He also taught at the Julliard School (which suggests that he had a huge, possibly direct influence, on Wynton Marsalis), where he also studied music. Much of his early trumpet education was from his father, playing in Salvation Army bands. Smith’s style of performance is distinctive and being quite melodious, and singsongy. His technical capabilities are at the top of the realm of virtuosity. What was most notable to me was his ability to blend in with an orchestra without standing out: it was more like an orchestra with a trumpet, rather than a trumpet with an orchestra. The resulting sound was most outstanding. In this collection of three CDs (two of which needed to be downloaded from iTunes), Smith performs both baroque/classical as well as modern pieces, some of which were written specifically for Smith. It is a most worthy collection to have of an outstanding trumpeter.
The Art of the Trumpet, Håkan Hardenberger ★★★★★
Håkan Hardenberger, a Swedish trumpet player, makes distinction for having a very fluid, crisp style. He performs a combination of the traditional baroque/classical pieces as well as contemporary. His technical expertise, especially with tonguing, produces a very crisp sound that few trumpeters possess. He  never sounds brassy, but keeps a pleasant tone to his playing. Certainly he stands as one of the contemporary trumpet greats.


NakariakovTrumpetORchestraSergei Nakariakov: Trumpet & Piano, Trumpet & Orchestra ★★★★★
This set (of actually two separate albums) are a collection of single CD’s which have been previously published. Nakariakov made his first CD (in the Trumpet & Piano album) when he was only 15 years old, and even then he has a wonderful virtuosic sound. His performances are a mix of the standard baroque/classical trumpet repertoire as well as modern stuff. He plays a combination of instruments, including a flugelhorn. His technical brilliance is unprecedented, save for a few giants like Maurice Andre. Oddly, he doesn’t do Bach’s 2nd Brandenburg Concerto, which is probably one of the most demanding pieces in the whole trumpet repertoire to perform well. Owing to his young age, we can expect many more years of the most superb trumpet music from Sergei, and perhaps even hear more from Bach.

Wonderland Trail 2015

Wanderlust 2015
Ich hebe meine Augen auf zu den Bergen von welchen mir Hilfe kommt.
Meine Hilfe kommt von dem HERRN, der Himmel und Erde gemacht hat.
Er wird deinen Fuß nicht gleiten lassen; und der dich behütet schläft nicht.
Siehe, der Hüter Israels schläft noch schlummert nicht.
Der HERR behütet dich; der HERR ist dein Schatten über deiner rechten Hand, daß dich des Tages die Sonne nicht steche noch der Mond des Nachts.
Der HERR behüte dich vor allem Übel, er behüte deine Seele; der HERR behüte deinen Ausgang und Eingang von nun an bis in Ewigkeit.
Psalm 121

The lead photo is taken from Mirror Lake, in the Indian Henry Hunting Grounds region of Mt. Rainier
Jon and I did the Wonderland Trail about 9 years ago, and even then we discussed the possibility of doing the trail in the opposite (counter-clockwise) direction. For those who don’t know, the Wonderland Trail is a hiking trail that circumnavigates around the timberline of Mt. Rainier. It is 93 miles long, with additions that generally make for a 100 mile walk. A few people have run it in a day or two and some killjoys hike it in 4 days, but most will spend 7 – 14 days. A distinct aspect of the trail is that it is typically either going up or down, and rarely is flat, so that by the time one gets all the way around the mountain, they will have climbed at least 20,000 feet in elevation. The trail was built in 1915, and so this year was special in being the centennial year of the trail. The trail has changed much since 1915, and is constantly being revised, as weather and mountain dynamics do not leave for a totally stable walking surface. To do the trail, one must obtain camping permits in order to stay at the camping spots along the trail, and this year, they were particularly challenging to get, in that there were a record number of applicants, and 80% had to be turned down.
We felt blessed in that the weather was near perfect. A week before the trip, the weather was very soggy on the mountain, and the night after we came back, there was heavy rain. We experienced only a few drops on our tent the third night, and had intense fog on the 6th day, coming up the Cowlitz Divide to Indian Bar and over Panhandle Gap. The trail was in exceptionally good condition, with all bridges intact, and no major diversions. Our feet never got blistered, and we got home feeling quite good, with minimal soreness.
On such a long hike, daily routines are necessary. I would usually get up at sunrise (05:30) and Jon soon after. We’d have two cups of coffee and some breakfast bars for breakfast, get the tent down and the packs loaded, and were usually on the trail by 06:30 to 07:00. We would do lunch about 10:00-11:00 in the am, and finish hiking between 13:00 and 15:00. We would quickly set up the tent and unpack our sleeping bags to dry out, pump water for drinking and cook dinner. Several days were special, in that at Mystic Lake and Indian Henry’s, Jon and I took special time to enjoy cigars and wine, while bathing in the beauty around us. At Longmire and Sunrise, we were able to stop into the cafeteria to have real food, which meant a hamburger and Rainier beer at those locations.
One of the delights of such an adventure as this is in meeting people. Now, when you are many miles remote from any road or civilization, the number of people you meet are few and far between. On the Wonderland Trail, there are four types of folk that you encounter, which include…1) the day trip wanderers, many of whom have never set foot in the woods before, and typically found close to the main tourist access points, including Mowich, Sunrise, Paradise, and Longmire. These people tend to be unsociable. 2) Trail runners: these are super-skinny (cachectic) people doing a long distance point to point run, usually 35-50 miles, frequently female, getting picked up distant from where they started, 3) sectional hikers, usually people who are seasoned hikers on a limited time schedule, and 4) complete trail hikers. The complete trail hikers became easy to detect, some of them being on their first day, some on their last, and many in between. The in betweeners were often seen twice if they were going in the opposite direction from us. There were many solo hikers (often female), some quite old hikers (like a solo lady at age 70), and a few large groups. The one large group we saw had a person distinct as a girly-man (man in a Scottish kilt). There was a father-son team consisting of a mainland Chinese man with his 8-10 yo son, a 35-ish female with her 8 year old son, and a 40’ish female with her 20’s daughter, all of them successfully managing the trail. Among the complete trail hikers, there tends to be a fellowship, where you would often stop and chat for while, getting information on the trail, and the best campsites, water spots, etc. for where you were headed. You would concomitantly share advice with your fellow travelers.
The way in which you pack and what you wear on the trail make all the difference in the world. I remember my very first backpack trips as a kid, using backpacks and equipment from a local military surplus store, wearing waffle-stomper shoes, wool coats, and total disregard for weight. We also tended to return home miserable, sore, and with feet heavily blistered. Nowadays, I use an Osprey Atmos 65 pack (to limit how much I can put in), an Osprey hydration unit, summer Feathered Friends down sleeping bag and pillow, a small propane gas stove and titanium pot, high tech jacket and rain coat, and carry nothing that would be frivolous. My boots were Vasque leather boots, the same I used 9 years ago for the Wonderland, and once again, they held up well, with no blisters or foot problems. I did spend much time attending to my feet, using a sock liner underneath REI CoolMax socks, as well as applying an anti-friction ointment to the feet every morning. I used a egg-crate style foam mattress to sleep on, which was a mistake, as the ground was extremely uncomfortable, and will probably go with a Therma-Rest NeoAir pad for future ventures. We used the Big Agnes Copper Spur 3 which was just roomy enough for two people and light. I used REI UL hiking poles, which prevented any falls the whole trip, and was great security for crossing streams and treacherous ground, as well as protecting the knees up and downhill. Things I might do different would be that I would consider bringing a bear vault rather than worrying about hanging your food all the time, and consider bringing an iPad with a lightweight solar charger. I’m tempted to get a Garmin eTrex 35t to record my activities, like I do with bicycling adventures. I would also explore different foods, that would be lightweight, cheap, and efficient, and easy to make on the trail, with minimal dishwashing. Freeze dried foods are popular but not overwhelming filling or tasty. I’ll probably bring more cheese (heavy!!!!) and sausage. Pepperoni sticks oddly don’t last well, but Landjäger (German sort of pepperoni) does quite well in the woods, as well as summer sausage. I’d truly love to find how to bring sauerkraut on backpack trips, but would have to ask my German friends/relatives how well sauerkraut keeps in an unrefrigerated environment after being opened. Gummibären remains the best trail snack food, though Good-and-Plenty’s were easily devoured, slightly different than my impression on cycling trips. It’s odd how tastes differ so radically at home, on the trail, and on the bike.
Day to day events.
Day 1 – Mowich to Golden Lakes. This was a simple downhill, followed by a very long uphill. The campground was next to a beautiful lake where Jon went swimming. There was moderate anxiety still at this time as to the weather, and whether were still capable of a 9 day venture.
Day 2- Golden Lakes to South Puyallup River. Our permit stated that we were to go to Klapatchee Park, which is high up, and unusually beautiful. We were warned that there was no water at Klapatchee Park, so Jon and I both carried about 10 lb extra water up about 3000 ft climb from the North Puyallup River, only to find ourselves before noon at Klapatchee Park. Wishing tomorrow to be a shorter day, we took the risk of going on to the South Puyallup campsite, and stayed in the group camp site, only to be joined in pitch darkness by a solo lady hiker from New Zealand. There was plenty of room in the group site, and it was not problem for us.
Day 3- South Puyallup River to Devil’s Dream. This day took us up yet another very long climb to Emerald Ridge, and then around to the marvelously beautiful Indian Henry’s Hunting Ground. We had lunch, wine and cigars at Indian Henry’s, took a short side hike into Mirror Lakes, and then collected water at a lake on the way down to Devil’s Dream. The sky turned cloudy, and so for the first time, we put a fly on our tent, and got about 20 drops of rain that night. The clouds went away the next day.
Day 4 – Devil’s Dream to Paradise River. This was 11 miles but with minimal climbing, making it a very easy day, and wishing we had books along to read. We arrived at Longmire in order to pick up our first cache, had lunch at the Longmire Inn, and headed up to our campsite, which was unusually quiet, with us as the only occupants that night.
Day 5 – Paradise River to Nickel Creek. The was also 11 miles with minimal climbing, and thus quite simple. This took us over the entire south side of the mountain, following the road that goes along the south side of the mountain up to Paradise and then over to Ohanepecosh. There were numerous day hikers and kids on the way.
Day 6 – Nickel Creek to Summerland. This was a hard climb day, first ascending the Cowlitz Divide, running up the Cowlitz Divide to Indian Bar, and then going above the timberline to Panhandle Gap. It was cloudy all morning, and so there was minimal visibility, but very comfortable for a hard climb. The clouds parted at the Panhandle Gap, and we descended into Summerland in beautiful sunshine. During this section, we thought that our friends Russ and Pete would meet us on the trail, but never saw them at all.
Day 7 – Summerland to Sunrise. This was a long low-grade descent to the White River, and then on a trail paralleling the road to the White River campground. Approaching the White River, we saw a search and rescue team going up, thinking they might be going after Russ and Pete. There was a slightly treacherous crossing of the White River, followed by a long steep ascent from the campground to Sunrise. The mountain was spectacular, and we were able to pick up our last cache at Sunrise, as well as have another burger and beer. Being rather high up on the mountain, the night was chilly, with a slightly cold sleep.
Day 8 – Sunrise to Dick Creek. Our original plan was to stay at Mystic Lake, but I knew that the lake was beautiful, but the campsite was quite inconvenient, with a long distance from the lake, and no close sources of water. Dick Creek is a very small campsite, but overlooks the Carbon River Glacier and very beautiful, so, we changed. The hike was with perfect visibility of the mountain, and we were able to spend over an hour having lunch, wine, and cigars at Mystic Lake, while Jon took another swim in the lake. There was still a moderate amount of climbing before we descended onto the Dick Creek campsite.
Day 9 Dick Creek to Mowich. This was our last day, but with probably the second most amount of climbing, since we decided on the Spray Park alternate, which takes one from the Carbon River all the way up to the top of Spray Park, over 3500 ft of elevation gain for the venture. The day started out cloudless, and as we got to the high point of the trail, clouds started moving in, so that by the time we were down through Spray Park, the mountain could no longer be seen. We arrived back at the car completely intact and ready for another adventure.
To end (before the photos), I need to include my favorite wandering songs…
Wem Gott will rechte Gunst erweisen… with Heino.
Joseph von Eichendorff, 1788-1857
Wem Gott will rechte Gunst erweisen,
Den schickt er in die weite Welt,
Dem will er seine Wunder weisen
In Berg und Wald und Strom und Feld.
Die Trägen die zu Hause liegen,
Erquicket nicht das Morgenrot,
Sie wissen nur von Kinderwiegen,
Von Sorgen, Last und Not um Brot.
Die Bächlein von den Bergen springen,
Die Lerchen schwirren hoch vor Lust,
Was soll ich nicht mit ihnen singen
Aus voller Kehl und frischer Brust?
Den lieben Gott laß ich nun walten,
Der Bächlein, Lerchen, Wald und Feld
Und Erd und Himmel will erhalten,
Hat auch mein Sach aufs best bestellt.
and also
Mein Vater war ein Wandersmann
(note: there is an English version which does tragedy to the song)
Mein Vater war ein Wandersmann,
Und mir steckt’s auch im Blut;
Drum wandr’ ich flott, so lang ich kann,
Und schwenke meinen Hut.
Refrain 1:
Faleri, falera, faleri,
Falera ha ha ha ha ha ha
Faleri, falera,
Und schwenke meinen Hut.
Refrain 2&3:
|: Hei-di, hei-da, hei-di, hei-da!
Und schwenke meinen Hut. 😐
Das Wandern schaffet frische Lust,
Erhält das Herz gesund;
Frei atmet draußen meine Brust,
Froh singet stets mein Mund:
Warum singt Dir das Vögelein
So freudevoll sein Lied?
Weil’s nimmer hockt, landaus, landein
Durch and’re Fluren zieht.
Was murmelt’s Bächlein dort und rauscht,
So lustig hin durch’s Rohr,
Weil’s frei sich regt, mit Wonne lauscht
Ihm dein empfänglich Ohr.
D’rum trag ich Ränzlein und den Stab
Weit in die Welt hinein,
Und werde bis an’s kühle Grab
Ein Wanderbursche sein!
Fresh at the start of the hike
Golden Lakes
Typical VERY smelly outhouse
Meadow heading out of Golden Lakes
headwaters of the Puyallup River
Jon at Klapatche Park
Me at Klapatche Park
St. Andrews Lake above Klapatche Park
Stiff climbing out of the North Puyallup Drainage
West side of Mt. Rainier
Jon looking quite fresh
Treacherous trail heading up to Emerald Ridge. This trail was being reconstructed.
Suspension Bridge across Tahoma Creek
The mountain from Indian Henry’s Hunting Ground
Jon relaxing at Indian Henry’s
Most of the wildflowers were gone by now. This is at Indian Henry’s
Burger and Rainier Beer at Longmire
Reflection Lakes on the south side of Mt. Rainier
Climbing up the Cowlitz Divide toward Indian Bar
Clouds engulfing us on the Cowlitz Divide
Above Indian Bar headed toward Panhandle Gap
Jon taking a breather at Panhandle Gap.
Coming off of Panhandle Gap toward Summerland, the Gap kept the clouds back so that we could see the mountain
Summerland, in competition for one of the most beautiful places in the world
Afternoon mountain view from Summerland
Early morning alpenglow at Summerland
View of the mountain ascending toward Sunrise
Jon enjoying a burger and beer at Sunrise
High on a ridge out of Sunrise on the north side of Rainier
The terminus of the Winthrop Glacier
Mystic Lake
Meadows below Mystic Lake
Mt. Rainier above Seattle Park and north of Spray Park, clouds beginning to move in.
The end of our journey and ready to do it again.

Cougar Lakes 2015

Cougar Lakes Backpack – 03-05JUL2015
This is the annual backpack trip that I do with the Flanagan grandchildren. This trip included Patrick and Sammy, as well as Andrew, Jon, and myself. We originally considered doing Rachel Lakes/Ramparts in the Alpine Lakes Wilderness, but decided instead on Cougar Lakes. I had been here 3-4 times, the first with Aaron Hughes, and afterwards with Tim Schmidt, later with family. It is just outside of Rainier National Park, but demands a lengthy drive to get to the trailhead.
The drive to the trailhead was a bit unnerving. The road was gravel for six miles, and in much worse shape than I ever remember. Andrew’s Corolla barely made it, and probably bottomed a few times. It wasn’t nice. The trail, after ¼ mile, demands that one walk across a shallow, but swift flowing stream, which we accommodated by switching into water shoes. The trail is a total of six miles, with about 1600 feet of climbing. At 4 miles, the trail passes by Swamp Lake, which is actually a beautiful lake surrounded by rocky cliffs and forest. The trail to Cougar Lakes is unmarked and unadvertised. I had trouble finding it on previous backpack trips. There is no mention of this trail in the most recent guidebooks. I guess the forest service would like to limit the number of people visiting this lake. We saw 5-6 other groups, but for the most part, were completely alone, without anybody else in the near vicinity. Cougar Lakes is pleural because it is actually two lakes, separated by a narrow isthmus, a smaller Little Cougar Lake, which you first see, and the most picturesque, as illustrated above. The second lake is larger, where we camped. Both have much fish, and are great for swimming.
Cougar Lake from our campsite
House Rock from the larger Cougar Lake
Early morning view from our campsite
Happy backpackers
The camp
Dishes out to dry
Little Cougar Lake
We spent two nights at Cougar Lakes. The intervening day was restful, with the kids going on a short exploratory hike, but mostly spending time skipping rocks, and swimming, or relaxing in the tent. The weather was perfect, not too hot and not too cold. Both Patrick and Sam stated that they wished they could have stayed more days.
Frodo and Samwise
Jon and Andrew
Me with the hobbits
To celebrate our hike, we stopped at Wallys in Buckley, where Samwise got his first Waltimate burger, measuring about 8 inches across, with probably 2 lb of meat. He did get some help eating it. Frodo got his Waltimate burger two weeks before after another hike.
The Waltimate burger

Portland to Puyallup Cycle Tour

Day 1 (13JUNE2015)
After a calm morning of knowing that I had packed everything, Betsy and I headed off to the Amtrak station to meet Russ and ride the Amtrak from Tacoma to Portland, where we would begin our grand adventure. We had done much recent roadbiking together, but our last tour was a few years ago. At the train station, I had discovered that I forgot my touring cycle shoes, which are bicycle shoes that had a mountain bike style clip that attaches the foot to the pedal. After a quick decision, I left my bicycle with Betsy and dashed back to Puyallup to get my shoes. I could have easily made it on time, except that this was the first day of the US Open golf tournament in Tacoma, and traffic was suddenly horrid. Finally arriving just five minutes late to the train station, Betsy and I decided we would outrun the train in our car, and catch Russ at the next station. Each station, we were just a few minutes late, and ended up going all the way to Portland to catch Russ. Finally, at 3:30 in the afternoon, we were on our bikes. We decided to skirt Portland by taking the bike route on Marine Drive, which follows the Columbia River. We got to Troutdale by 5:30pm, where we settled in at a cheap hotel, and went out for Chinese food at a very marginal diner.
Russ riding along the Marine Drive Trail, with the Columbia River and Mt. Hood in the distance

Day 2 (14JUNE2015)
This was our most beautiful day, and we were soon on the Old Historic Columbia River Highway. It was not a challenging ride, but we had not been touring with fully loaded bikes for a while, so it was getting the legs used to this sort of riding. This was a Sunday, and every beautiful spot was over touristed, so we rode on and stopped only briefly at the more popular places like Multnomah Falls. There were quite curious onlookers who had numerous questions about cycle touring. We crossed the Columbia River at the Bridge of the Gods, a hairy-scary experience riding on a grate high across a large river, with a car right on your tail. We finally decided to go as far as possible that day without having to camp, and to remain in civilization, which led us to the sleepy town of Carson. There was actually a great restaurant- brewery in town for dinner, but the accommodations were a slightly run-down set of cottages next to a golf couse about a half mile off the road. We were actually quite content, as the owner manager was a most friendly and informative fellow, and the accommodations were more than adequate. See
Russ and I posing at the
Women’s Forum Viewpoint.
Latourell Falls
Overlook of the Bridge of the Gods from the Washington side
Our cottage in Carson.

Day 3 (15JUNE2015)
We headed out early, and there were no restaurants open for breakfast at 7am in the town of Carson. Russ and I ended up eating breakfast at the local Carson market that had coffee and breakfast sandwiches. This was actually a great deal since it allowed us to chat with more locals. The ride demanded climbing over a 3000 foot high pass, appropriately titled Oldman Pass. It wasn’t too challenging and we arrived in Swift Creek Reservoir right when the temperature was starting to get too hot to ride. It was my first granny gear day. The granny gear is the smallest gear in the chainring, in which are the three gears in front on a triple chainring. It is called the granny gear since you can gear way down for long fatiguing climbs with a heavy loaded touring bike. There was no restaurant in the area, but a convenience store that had cold beer and frozen pizza. The cabins had no electricity and certainly no WiFi or internet. Lighting was with propane gas lamps. We met a couple, George and Megan, who had been on touring bicycles the last three months, riding from Florida in a meandering path through the US, and enjoyed some pizza and brandy with them, accompanied with delightful conversation (sorry, but no photos of them). Note that the Garmin for today and tomorrow are not accurate, since they will understate our time, feet of climbing, and distance. This happened since we were in dense forest with tall mountains on both sides, preventing the Garmin from getting an accurate gps reading.
Old man Andersen at the pass.
Old man Feucht at the pass.
The cabin at Swift Creek Reservoir, called Eagle Cliff Store and Campground.

Day 4 (16JUNE2015)
Today was another early start day, with another significant pass to cross. Elk Pass was more of a grunt than Oldman Pass, but we felt great at the top and continued on. This was another granny gear day. At the summit of Elk Pass, we saw an RV with a guy that was obviously a bicyclist getting out of the RV. We stopped to talk, and he offered us a coke and a large piece of cold watermelon, asked if we would stay for lunch, and explained that today was his day to sag a group of seven cyclists doing the Sierra Cascades route from Canada to Palm Springs. Once we left these folk, the ideas with Russ and I discussed fast and furiously how we could also do such a thing. The ride was spectacular. Russ and I decided to do a variant of the Sierra Cascades route by riding Cline Rd. and avoiding much of route 12. Cline Road was quite spectacular, though a bit more hilly than route 12. Later on route 12 we met a young man, riding without a helmet, heading home to Eugene, Oregon. He had been on the bike for 5 months, going places like to Hanoi, Viet Nam. I was amazed at how long distance cycling has taken off in the US. Later, after we pulled into Packwood, got a hotel, went out to dinner, and then stopped by the grocery store, we again met George and Megan, and talked them into staying at our hotel. It was the same hotel that Russ and I stayed at several years ago when we did a touring loop around Mt. Rainier.
Overlook of Mt. St. Helens, and a valley that was completely wiped out by the volcano. It is now growing back quite nicely.
A very friendly cyclist pulling duty at manning the SAG wagon, but also being very hospitable to us.
Deep forest on the ride to Packwood
Russ at a river crossing on Cline Road

Day 5 (17JUNE2015)
Home. It was a 72+ mile venture. The weather was phenomenal, and we had one pass to go over, 1500 feet of climbing over Skate Creek. The climb was over about double the distance of the other 1500+ foot passes, making it much easier to get over. It still was a long plod, now in entirely familiar territory where we had ridden many times before. We stopped for lunch at the back porch of an abandoned house on Ohop Lake, and rode on. The only disgusting part of our entire ride was that of the last 10 miles through South Hill and Puyallup, with nasty traffic, no bicycle shoulders, and mean drivers. We were glad to get home.
Our view of Ohop Lake
Russ preparing a sandwich on Ohop Lake at an abandoned house.
After a ride, I immediately unpack everything, and jotted down ideas and thoughts for the next trip. I had no idea how beautiful this trip would be, and the weather was absolutely perfect for our adventure. It’s not only a delight to ride, but also to meet so many other bicycle enthusiasts, as well as hotel managers, local personalities, and people on the road. Bicycling is NOT a lonely sport, though it mostly is just you against the road and hills that it gives you. Each day of the ride, we felt a little bit stronger, and could have kept going, should the journey had demanded it. Neither of us were terribly sore, and we were blessed with no major injuries. Both of us are eager and ready for more adventures. Hopefully, next time, it might be with my brother Gaylon, who is eager to do a cross-country tour. With all the people we met who have been on their bike on the road for over 5 months, it is no longer looking like a highly unusual plan.

County: Life, Death and Politics at Chicago’s Public Hospital

County: Life, Death and Politics at Chicago’s Public Hospital, by David Ansell ★★
David Ansell offers his personal reflections as a resident and then junior attending in internal medicine at Cook County Hospital in Chicago, Illinois. This book was to complement another recent read by Dr. Guinan et. al. titled The History of Surgery at Cook County Hospital. Having been a resident in surgery at CCH from 1982 to 1989, this book was of great interest to me. I do not recall ever having encountered Dr. Ansell, but there was minimal contact between the surgical and internal medicine residents at the County. Part of the reason for that was the highly inconsistent care that our patients received under the internists at CCH, necessitating that we as surgeons care for most diseases that would usually fall in the realm of needing an internist.
I have very mixed feelings about this book. I appreciated DR. Ansell’s candor and honesty, which was not always seen in the History of Surgery. Ansell was willing to speak at length about the wantonly corrupt Chicago politics and how CCH was considered by the politicians as a nuisance rather than a necessity for the county. He spoke at length about a system completely overwhelmed, and yet ignored by the powers in public office. He gives a nice feel about the frustrations of a doctor in that system trying to do the best to provide for the patients that come under his care.
Unfortunately, Ansell is over-burdened by his ideology, and this has controlled his behavior as a CCH physician to an extreme degree. Ansell is at least honest about how his was a public agitator, and often acted against his superiors to promote his vision of “the good”. Yet, he remains completely blind to how his personal politics and behaviors have perhaps made matters worse rather than better for the poor of Cook County. He labors hard to expose the corrupt Democratic machine that runs Chicago, yet offers no alternative to that Democratic machine, speaking very demeaningly of the other political party. His oft repeated delusion that “health care is a right” (i.e., and not a privilege) suggests that Ansell will not be happy until at health care in the US is reduced to the quality found at CCH, so that there is an equalization of care among the “rich” and the “poor”. I’m sure that even then Ansell would be a dis-satisfied character.
I was particularly annoyed when Ansell spoke so disparagingly of my mentor, Dr. G. Dr. G. happened to be Bangladeshi in origin, probably one of the finest surgeons I had ever met in my life, and a role model of acting in a thoughtful and non-discriminatory manner. The entire episode of his interaction with Dr. G. suggests to me that Ansell was more a blind ideologue than a brilliant innovator. This is not unusual for the Chicago system, and we are now having to suffer under a community activist but now national Führer from this same corrupt Chicago  system.
That Ansell now sits on the Cook Country Board for the hospital is testimony that Stroger Hospital will be the same failure that its predecessor was.  I wish that Ansell could spend a lengthy amount of time working in a truly destitute health care system, such as I have done in Extrem Nord Cameroon or in Bangladesh, to see that a bleeding heart doesn’t solve the problem of disparity in health care. Ingenuity does allow for solutions that Ansell (and for the most part, the entire American health care system) will not allow. This has nothing to do with financial reasons, but rather for legal, sociological, political and ideological obstructions to providing for the poor.
I’ll mention just one example. Ansell heavily criticizes the large open wards that once were at Cook County Hospital. I’ve never had a patient complain about that, and we as physicians would work hard to preserve the privacy of our patients. Yet, the large ward allowed a nurse to quickly assess in a few glances if everything was ok. I would frequently ask a patient to watch out for the patient in the bed next to them if they were doing poorly, and to report that immediately to the nurse. A little care was able to prevent the spread of infection from one patient to another. The total cost of care was vastly less for the same quality as the private rooms that we now have throughout the US.
I read this book a bit frustrated and with great disappointment–Ansell seemed to care for the indigent patient of CCH, but allowed his personal ideology and obnoxious behavior to dominate his stay at the County. For that reason, this book would  be most fittingly titled “Clueless at County”.

The Merry Month of May 2015

May was a busy month. I had three main activities that consumed my time.
1. Adventure Cycle Association Leadership Course
This course is required by those who wish to lead ACA tours, but is also an excellent source of information for leading one’s own bicycling adventures. The classes were held at Champoeg State Park in Oregon, south of Portland and along the Willamette River. It was three packed days of most classwork, but also with short rides mixed in. Much discussion was held in discussing the ACA philosophy of leadership, being that of allowing tour participants much freedom of individual decisions and responsibility. The ACA regimen of daily cycling activity, and conflict resolution were also discussed. I had a great time, met some delightful people, and hope to be assisting in the leadership of tours soon.
The Willamette River at Champoeg State Park
Camping at Champoeg State Park; my tent is on the far left
Classroom discussion with Joyce
Wally and the staff make dinner
Chowing down
2. Dayton, WA bicycling
It has been several years since Russ A. and I have gone to Dayton, WA for bicycle riding. Another friend of Russ, Pete, also comes with, and is a great complement to the rides. This year, our first ride was loop down to Walla Walla, starting from Howie’s cabin, half way from Dayton up to the Bluewood Ski Resort. The second day was a mountain bike ride up into the Blue Mountains, and a most serious grunt. The third day took us to Starbuck, and north of Dayton. The weather was perfect, and rides were most delightful.
Second day mountain bike ride, just after a beastly climb
The Three Musketeers
Russ at home in the Blue Mountains
3. Hikes to Indian Henry’s — two variations
On two consecutive weekends, Jon and I hiked up to Indian Henry’s hunting grounds, a most beautiful spot on the timberline of Mount Rainier. The first hike took the Kautz Creek route, which goes straight up a ridge following Kautz Creek up to Indian Henry’s, wrapping around Mt. Ararat. The top photo is of Mt. Ararat engulfed in clouds. On this hike, the weather was overcast, and we could not see the mountain. Close to Indian Henry’s, we hit much snow, which eventually led us to turn back. The second weekend, we followed the Wonderland Trail going counter-clockwise around the mountain. The weather was spectacular, and most of the snow at Indian Henry’s had since melted. The views of the mountain were awesome.
More flowers
And More flowers
Jon on the Kautz Creek hike
Me on the Kautz Creek hike
Approaching Indian Henry’s. Lots of flowers and little snow.
Indian Henry’s Hunting Grounds via the Wonderland Trail
Leaving Indian Henry’s
We camped here before on the Wonderland Trail, and will be camping here again in August when we do the Wonderland Trail again.

A History of Surgery at Cook County Hospital

A History of Surgery at Cook County Hospital, edited by Patrick Guinan, Kenneth Printen, James Stone, and James Yao ★★★
This book was of great interest to me, since I did my residency at Cook County Hospital during the years 1982 -1989. At that time, we were never given much of a history of the place. There was the operating amphitheater which was being used as a large storage area. There was Karl Meyer Hall, which was rarely used except as a place to grab some food at the 1st floor cafeteria, as we usually slept in unused beds at the hospital when on call. There was Karl Meyer’s residence, which was then being used as the trauma office. We were never really told much about Karl Meyer, or how Cook County Hospital created so many legends. Thus, I found the book of great interest, and since I prefer to read books on my iPad, that is how I purchased the book. I have mixed feelings about the book.
First, the book was exceptionally poorly edited. Spelling errors and other errors were everywhere. The organization of the book created multiple repetitions, and a clear linear timeline of history of CCH was never well developed. The most early history, being that before the 1915-2002 building was erected, are sketchy at best, and not well laid out. I don’t get a good feeling as to how surgery developed in Chicago, and since Cook County Hospital was so dependent on the rise and development of Northwestern, Rush, University of Illinois, and Loyola University, the history of those residency programs should have been better described. The book is written in a manner that if one never set foot in CCH, they would have no clue as to what was being talked about–the book’s value is primarily for former surgery residents of CCH.  I get the feeling that the book was haphazardly slopped together without much thought for the potential audience.
Secondly, I was left with the feeling that surgery training at CCH was rather haphazard and chaotic, that instruction came mostly from the chief resident, and that attendings were not often present, owing to the voluntary nature of the surgical leadership. To some extent, that actually was my experience at CCH, with a mixture of absolutely superb attendings (such as Dr. Abcarian and Dr. Jonasson) and absolutely horrid, possibly even incompetent attendings, whose names will go unmentioned, though some were mentioned with praise in the book. The attitude of the residents at the time of my residency was of pompous arrogance that the CCH residency in surgery was the greatest in the world, and  that it was one of the few that truly produced consistently great surgeons. I didn’t see that at all. Perhaps the punishment of the system led some residents into a minor form of Stockholm Syndrome, where the abused become attached and fall in love with the tormentor. This book hints at such a possibility. Unintentionally, the book does more to disparage the training one received at CCH rather than compliment it.
Thirdly, there were many historical inaccuracies (or, perhaps, incomplete truths) in the book, at least related to the years that I was a resident. The real reason for Dr. Baker’s departure goes (and should go) unmentioned. The cause for Dr. Jonasson’s departure was greatly misrepresented, since she was fired by the Cook County Board, as we were told at the time. I’m left wondering about the real cause for Freeark’s departure, since he never again set foot in CCH. The editors chose political correctness, rather than indicting the most politically corrupt city & county government in the United States for poor management of their hospital. The “dirty laundry” of Cook County Hospital was swept under the rug, leaving us only half a history of the place. Other details were minor errors. For instance,  I remember some of the windows of the operating room still being able to be opened, and battling flies in the operating room. (Even in the 1980’s, we still occasionally used the windows at X-Ray view boxes and as air-conditioning units!) There is a mention of contending with the AIDs problem in the 1970’s, yet it wasn’t until 1987 that we knew enough about the HIV epidemic to take any actions, such as actually wearing gloves in the trauma unit when doing procedures.
Fourth, there was much history that was glossed over. What about the county jail on the 8th floor of the A building? How did the A building come to be? How did the Fantus Clinic emerge to the place and character that it was throughout the 1970’s – 1990’s? Could one have elaborated more on Karl Meyer and his living arrangement in the hospital? Surely there were anecdotes about the highly quirky elevator operators and other employees of the hospital that formed a special characteristic of the place. Many people with great histories were glossed over, such as Dr. Lowe in trauma, and way-too-short  histories of certain individuals such as Dr. Abcarian, Dr. Walter Barker in thoracic surgery and Dr. Jonasson, all true giants in the world of surgery.
There was much good in the book that made it enjoyable to read. I appreciated the elaboration of the development of various departments of the hospital. Most relevant were the development of the trauma unit and blood bank, both being nation’s first. Having worked in many of the departments mentioned, such as the orthopedic, colon rectal, thoracic, pediatric, and burn services, I would have appreciated having a better understanding of the history of the department when I was still a resident. Thirty years later, it is still fascinating to read about how these departments came to be.
The personal stories at the end of the book were a total delight. These stories and vignettes of the old County hospital make for the best memories. When I started surgical residency, one of my first encounters was with Dr. Robert S., who had just graduated from the County residency, and was then doing a fellowship in Cardiothoracic surgery at the University of Illinois. He would spend countless hours with me, relating stories of the Greeks, of cases that he had done, and how things worked at CCH. I am sure that virtually every resident that graduated from CCH has a book full of stories, myself included, of unusual and interesting events that transpired while serving at CCH. For me, there were stories in the ER dealing with drug addicts and prostitutes, the trauma unit with famous (infamous) criminals, with survival tactics while working the floor or taking call, with various quirks of attendings (both good and bad), and with living an experience that nobody could ever repeat at this time, since there is no more CCH.
It was with great sadness that I learned that the old hospital was removed and a new, much smaller facility was built in its place. Many of the buildings needed to be removed or were completely obsolete, such as the nursing building and Karl Meyer hall, as well as the Children’s hospital and the “A” building. The Children’s hospital also held the burn unit, and was so run down during my time as a resident, that it was downright spooky to go into. The only thing good about that building were the elevators, which were fun to ride. But, it is only fitting that the new hospital be named Stroger Hospital, as it is no longer Cook County Hospital. Cook County Hospital has died, and a new beast has arisen in its place. It is unlikely that Stroger Hospital will generate any surgical giants, save for total happenstance. Thus, I am delighted that a history of the old Cook County Hospital, written by those that had a long experience with the place, has been produced. For all its faults, this is still a history worth reading by those who have spent a few years of their life within those halls.

Advice from Two Brass Players

Prelude to Brass Playing, by Rafael Méndez ★★★★★
Brass Playing is No Harder than Deep Breathing, by Claude Gordon ★★★★
These two books are very similar, in that they are written by the best of the best trumpeters of yesterday, offering advice to young (and older) students regarding improving their playing. Such topics as care of the horn, warming up, practice style, developing breath, developing embouchure and tone, increasing one’s range and speed are all covered. Mendez writes as though he was speaking directly to you, covers advice for the very young beginning trumpet player and their parents, and is more thorough than Gordon’s text on the nuances and discipline of trumpet playing. Both are worthwhile reads for trumpet players of any experience.

The Trumpet Shall Sound

Maurice André – The Trumpet Shall Sound – 2 CDs
Of the greatest trumpet players of my lifetime, the three that stand out are Rafael Mendez, Maurice André, and Marsalis Wynton. Mendez was probably the technically greatest player of the bunch, overcoming enormous obstacles and endless practice to achieve status on the trumpet similar to Paganini on the violin — he completely re-defined the media for both classical and jazz players. Maurice André wins the prize of overall excellence in the classical sphere. He had the most extensive repertoire, even converting solos for other instruments like the bassoon or oboe or flute into trumpet solos. His technical fluency is most remarkable. He is best known for his command of the piccolo trumpet, though there isn’t a trumpet piece on either the regular or piccolo trumpet that doesn’t sing in his hands. Common to all three players is the endless practice schedule from dawn to dusk to maintain the extraordinary proficiency on the instrument that they possessed. Playing the trumpet may look easy, but it is as challenging as any other musical instrument, if not more.
This album of two CDs is a smattering of André’s performances, mostly in the baroque realm. It is a total delight. His playing never grates or irritates the listener. His command of the instrument is both smooth and majestic. This album is a wonderful showcase of a man who has truly mastered the instrument of the trumpet.

Bach Among the Theologians

Bach Among the Theologians, by Jaroslav Pelikan ★★★★★
This book explores the theology of Bach, written by an eminent conservative Lutheran theologian who taught church history at Yale University. It is a delightful easy read. JS Bach, while known as indubitably and unquestionably as the greatest composer to ever have walked terra firma, also had an interesting theological side to him. Bach was known to have an exceptionally large library of theological texts, and most of his texts were heavily annotated by him, as seen as column notes in all of his books in his own handwriting. An analysis of his musical output demonstrates that this interest in theology had a highly significant impact on the music that he wrote. In particular, Bach was caught in Germany during the struggles of Pietism (centered in Halle, not far from Leipzig), and the Aufklärung (Enlightenment) mentality. Pietism sought for a strong personal religion without the public sphere and without “fancy” music, which Bach strongly opposed, while in conjunct with the Pietists, pleaded in his music for a strong personal relationship with God. Contrary to the Aufklärung, which sought to “de-mythologize” the Scripture, Bach sought through his music to emphasize the fundamental doctrines of the Christian faith in opposition to Aufklärung thinking. Thus, Pelikan would call each cantata of Bach also a sermon in music by Bach.
Pelikan provides marvelous insights into the theological culture of Bach’s time, and shows how Bach confronted culture with his music. Much of the second half of the book details Bach’s thinking in the two existing Passions and the H-moll Messe. With the H-moll Messe (B-minor mass), Pelikan shows how Bach thoroughly “Lutheran-izes” the mass, making it a more Catholic mass than just the confines of the Roman Catholic church. Pelikan’s final discussions counter a contemporary move to make Bach an essentially secular thinker, highlighting the much smaller volume of Bach’s secular works. Even here, Pelikan is able to show that Bach is thinking sacred in his secular music, and that it is impossible to strip Bach of a religious, theological context.
This book is a must read for anybody that enjoys Bach and delights in vast array of music that he produced. It also gives one a greater interest in not only listening to the cantatas, but following along the words of the cantatas to hear the “sermon” that Bach is preaching through music.