Thursday, July 31, 2008
sign of assholeness=self involved blog?
Whatever. Its my blog and i'll be narcissistic if i want to be.
Am I becoming an Asshole?
So my summer is dwindling to its last 3 weeks, and i am sitting happily in the plush library with a view of rolling hills and the Golden Gate bridge and endless shelves of leather bound scientific journals.
An assortment of conversations (and a self audit of my summer shopping binges) lately have made me wonder what it is that matters to me. Little things, but somehow huge things. Like my ability to tolerate things. My desire for shining new (expensive) things. The yawning chasms between the highs and crashes of my self esteem. A decreased tolerance for inconvenience. My sudden new found ease at calling people dumb.
Is it age? Cynicism? is it a medical education? A dangerous sense of entitlement that i always swore would never...be...me?
Article: Elitism
"...As globalization sharpens economic insecurity, we are increasingly committing ourselves—as students, as parents, as a society—to a vast apparatus of educational advantage. With so many resources devoted to the business of elite academics and so many people scrambling for the limited space at the top of the ladder, it is worth asking what exactly it is you get in the end—what it is we all get, because the elite students of today, as their institutions never tire of reminding them, are the leaders of tomorrow."
Once I had a fierce pride in my populism, of working my way up by those infamous American bootstraps, which admittedly stemmed from a devastating insecurity of being able to hold my own, against the children of perceived superiors. Its a lot of motivation to work really hard when you think everyone else is intrinsically better than you; or when you envision yourself the scrappy outsider; or when you have something to prove; or have some weird complex of carrying the family honor on your shoulders (the Atlas myth, lets call all of this). Now on the other side of the divide--"wow... you're here, at our amazing school, in our amazing profession, we--and therefore you--are really pretty fucking awesome."
It's hard to resist! Ugh, stroke me some more.
The rise of analysis: "The existence of multiple forms of intelligence has become a commonplace, but however much elite universities like to sprinkle their incoming classes with a few actors or violinists, they select for and develop one form of intelligence: the analytic. While this is broadly true of all universities, elite schools, precisely because their students (and faculty, and administrators) possess this one form of intelligence to such a high degree, are more apt to ignore the value of others. One naturally prizes what one most possesses and what most makes for one’s advantages. But social intelligence and emotional intelligence and creative ability, to name just three other forms, are not distributed preferentially among the educational elite. The “best” are the brightest only in one narrow sense."
I wonder to what extent medical education is not alienating because of the epistemology of science, or by abusive hierarchy, or the sleep deprivation of its interns, or by the banality of memorizing organic chemistry mechanisms in the face of the deepest questions of morality and suffering. I wonder if its fundamentally maybe just about the education process of our universities.
And the inevitable role, of self esteem by standardized test.
"The second disadvantage, implicit in what I’ve been saying, is that an elite education inculcates a false sense of self-worth. Getting to an elite college, being at an elite college, and going on from an elite college—all involve numerical rankings: SAT, GPA, GRE. You learn to think of yourself in terms of those numbers. They come to signify not only your fate, but your identity; not only your identity, but your value. It’s been said that what those tests really measure is your ability to take tests, but even if they measure something real, it is only a small slice of the real. The problem begins when students are encouraged to forget this truth, when academic excellence becomes excellence in some absolute sense, when “better at X” becomes simply “better.”
I don't know if this is deep stuff. The author of the article is definitely a little douchey. But I am surprised by the vitriolic and knee wrenching provokation it wreaks in myself and my friends. It certainly says something interesting, and even things that are true, but most deliciously, it is so very very uncomfortable.
I have more to say, but most of it involves Proust (as most things usually do). Instead, back to work on saving the world and shit.
An assortment of conversations (and a self audit of my summer shopping binges) lately have made me wonder what it is that matters to me. Little things, but somehow huge things. Like my ability to tolerate things. My desire for shining new (expensive) things. The yawning chasms between the highs and crashes of my self esteem. A decreased tolerance for inconvenience. My sudden new found ease at calling people dumb.
Is it age? Cynicism? is it a medical education? A dangerous sense of entitlement that i always swore would never...be...me?
Article: Elitism
"...As globalization sharpens economic insecurity, we are increasingly committing ourselves—as students, as parents, as a society—to a vast apparatus of educational advantage. With so many resources devoted to the business of elite academics and so many people scrambling for the limited space at the top of the ladder, it is worth asking what exactly it is you get in the end—what it is we all get, because the elite students of today, as their institutions never tire of reminding them, are the leaders of tomorrow."
Once I had a fierce pride in my populism, of working my way up by those infamous American bootstraps, which admittedly stemmed from a devastating insecurity of being able to hold my own, against the children of perceived superiors. Its a lot of motivation to work really hard when you think everyone else is intrinsically better than you; or when you envision yourself the scrappy outsider; or when you have something to prove; or have some weird complex of carrying the family honor on your shoulders (the Atlas myth, lets call all of this). Now on the other side of the divide--"wow... you're here, at our amazing school, in our amazing profession, we--and therefore you--are really pretty fucking awesome."
It's hard to resist! Ugh, stroke me some more.
The rise of analysis: "The existence of multiple forms of intelligence has become a commonplace, but however much elite universities like to sprinkle their incoming classes with a few actors or violinists, they select for and develop one form of intelligence: the analytic. While this is broadly true of all universities, elite schools, precisely because their students (and faculty, and administrators) possess this one form of intelligence to such a high degree, are more apt to ignore the value of others. One naturally prizes what one most possesses and what most makes for one’s advantages. But social intelligence and emotional intelligence and creative ability, to name just three other forms, are not distributed preferentially among the educational elite. The “best” are the brightest only in one narrow sense."
I wonder to what extent medical education is not alienating because of the epistemology of science, or by abusive hierarchy, or the sleep deprivation of its interns, or by the banality of memorizing organic chemistry mechanisms in the face of the deepest questions of morality and suffering. I wonder if its fundamentally maybe just about the education process of our universities.
And the inevitable role, of self esteem by standardized test.
"The second disadvantage, implicit in what I’ve been saying, is that an elite education inculcates a false sense of self-worth. Getting to an elite college, being at an elite college, and going on from an elite college—all involve numerical rankings: SAT, GPA, GRE. You learn to think of yourself in terms of those numbers. They come to signify not only your fate, but your identity; not only your identity, but your value. It’s been said that what those tests really measure is your ability to take tests, but even if they measure something real, it is only a small slice of the real. The problem begins when students are encouraged to forget this truth, when academic excellence becomes excellence in some absolute sense, when “better at X” becomes simply “better.”
I don't know if this is deep stuff. The author of the article is definitely a little douchey. But I am surprised by the vitriolic and knee wrenching provokation it wreaks in myself and my friends. It certainly says something interesting, and even things that are true, but most deliciously, it is so very very uncomfortable.
I have more to say, but most of it involves Proust (as most things usually do). Instead, back to work on saving the world and shit.
Tuesday, July 29, 2008
Sex Postive
Can you be cool and hip and sex positive and be kind of a vanilla heterosexual girl? Goddmanit. I think you should be able to.
ps. this um, has nothing to do with anything. nothing.
pps. you know, vanilla is actually a pretty exotic spice
"Vanilla is a flavoring derived from orchids in the genus Vanilla native to Mexico. Originally cultivated by the Totonac, Incas and Aztecs, Spanish conquistador Hernán Cortés is credited with introducing both the spice and chocolate to Europe in the 1520s. Attempts to cultivate the vanilla plant outside Mexico and Central America proved futile because of the symbiotic relationship between the tlilxochitl vine that produced the vanilla orchid and the local species of Melipona bee...Vanilla is the second most expensive spice after saffron due the extensive labor required to grow the seed pods used in its manufacture. Despite the expense, it is highly valued for its flavor which author Frederic Rosengarten, Jr. described in The Book of Spices as pure, spicy, and delicate and its complex floral aroma depicted as a peculiar bouquet...
"In old medicinal literature, vanilla is described as an aphrodisiac and a remedy for fevers. These purported uses have never been scientifically proven, but it has been shown that vanilla does increase levels of catecholamines (including epinephrine, more commonly known as adrenaline), and as such can also be considered mildly addictive. In an in-vitro test vanilla was able to block quorum sensing in bacteria. This is medically interesting because in many bacteria quorum sensing signals function as a switch for virulence. The microbes only become virulent when the signals indicate that they have the numbers to resist the host immune system response."
"The first to cultivate vanilla were the Totonac people, who inhabit the Mazantla Valley on the Gulf Coast of Mexico in the present-day state of Veracruz. According to Totonac mythology, the tropical orchid was born when Princess Xanat, forbidden by her father from marrying a mortal, fled to the forest with her lover. The lovers were captured and beheaded. Where their blood touched the ground, the vine of the tropical orchid grew."
ps. this um, has nothing to do with anything. nothing.
pps. you know, vanilla is actually a pretty exotic spice
"Vanilla is a flavoring derived from orchids in the genus Vanilla native to Mexico. Originally cultivated by the Totonac, Incas and Aztecs, Spanish conquistador Hernán Cortés is credited with introducing both the spice and chocolate to Europe in the 1520s. Attempts to cultivate the vanilla plant outside Mexico and Central America proved futile because of the symbiotic relationship between the tlilxochitl vine that produced the vanilla orchid and the local species of Melipona bee...Vanilla is the second most expensive spice after saffron due the extensive labor required to grow the seed pods used in its manufacture. Despite the expense, it is highly valued for its flavor which author Frederic Rosengarten, Jr. described in The Book of Spices as pure, spicy, and delicate and its complex floral aroma depicted as a peculiar bouquet...
"In old medicinal literature, vanilla is described as an aphrodisiac and a remedy for fevers. These purported uses have never been scientifically proven, but it has been shown that vanilla does increase levels of catecholamines (including epinephrine, more commonly known as adrenaline), and as such can also be considered mildly addictive. In an in-vitro test vanilla was able to block quorum sensing in bacteria. This is medically interesting because in many bacteria quorum sensing signals function as a switch for virulence. The microbes only become virulent when the signals indicate that they have the numbers to resist the host immune system response."
"The first to cultivate vanilla were the Totonac people, who inhabit the Mazantla Valley on the Gulf Coast of Mexico in the present-day state of Veracruz. According to Totonac mythology, the tropical orchid was born when Princess Xanat, forbidden by her father from marrying a mortal, fled to the forest with her lover. The lovers were captured and beheaded. Where their blood touched the ground, the vine of the tropical orchid grew."
Anger, Envy, Ambition and other Vices
Sometimes, when i am in a frenzy, I decide to refile everything. Amid the detritus of crumpled financial aid applications from 2001 and neatly enveloped letters from old lovers--i find other sorts of love letters. Like a paper on the foundations of mathematics by Carnap. Or my lovingly annotated Russell commentary on the devastating epistemology of Hume. In another world (twin earth), i would be intellectually stroking myself on the pristine puzzles of metaphysics and logic.
Today i am in the library with a 6 inch pile of papers by economists, ethicists, policy scholars, and disgruntled professors of medicine. The puzzles of international health governance, medicare payment systems, the politics of clean drinking water--are no less convoluted nor deliciously knotted than any logic proof or how we perceive reality. But these puzzles are effused with despair--for some such position is no mere intellectual wanking--it becomes a policy paper, that makes it way to the idealogues or corporate boardroom--it becomes enmeshed in the strands of power--and then a mass of people motherfucking die obscene deaths of want in a world of wealth. And then, rather than disagreeing with Bertrand Russell as a vigorous and exhilerating game of wits, to pit one's own intellect against the mightiest minds of human civilization...one is instead suffused with moral outrage. Yes, the same rigor is required, but the stakes are high, and rather than respect for your brilliant interlocuter, you hate some douche bag of a Princeton economist for their narrowness and foolishness. They are now but the very clever and powerful enemy. And rather than feeling schooled by worthy teachers, you only feel impotent and useless against the wrongs of the world.
But so moved by your righteousness, that maybe you plot in ways in which to amass power, to fight for the forces of good. But what is the danger of power? would you keep the rigor of Carnap and Kant? The pursuit of truth? Would you remember the kindness that moved you first, before the books?
Doctors have certainly squandered the pwoer of healer, but perhaps they never had much right to it.
Patients distrust doctors
"Others say the problem also stems from a grueling training system that removes doctors from the world patients live in. 'By the time you’re done with your training, you feel, in many ways, that you are as far as you could possibly be from the very people you’ve set out to help.'"
Racial schism of American Medicine
In 1910, when Abraham Flexner published his report on medical education, African-Americans made up 2.5 percent of the number of physicians in the United States. Today, they make up 2.2 percent.
Lawyers and Government?
Justice Department and political nepotism
Senior aides to former Attorney General Alberto R. Gonzales broke Civil Service laws by using politics to guide their hiring decisions, picking less-qualified applicants for important nonpolitical positions, slowing the hiring process at critical times and damaging the department’s credibility, an internal report concluded on Monday.
RIghteousness is a dangerous vice. But then, so is the lack of moral clarity. So is the lack of balls to call bullshit: bullshit. Bringing a written list of questions for your doctor, my ass.
Sometimes the most sensible thing really is a revolution. And alas, that seems to require a tedium of papers, many many people, and a steady drum beat of truth and clarity for however long it takes.
Today i am in the library with a 6 inch pile of papers by economists, ethicists, policy scholars, and disgruntled professors of medicine. The puzzles of international health governance, medicare payment systems, the politics of clean drinking water--are no less convoluted nor deliciously knotted than any logic proof or how we perceive reality. But these puzzles are effused with despair--for some such position is no mere intellectual wanking--it becomes a policy paper, that makes it way to the idealogues or corporate boardroom--it becomes enmeshed in the strands of power--and then a mass of people motherfucking die obscene deaths of want in a world of wealth. And then, rather than disagreeing with Bertrand Russell as a vigorous and exhilerating game of wits, to pit one's own intellect against the mightiest minds of human civilization...one is instead suffused with moral outrage. Yes, the same rigor is required, but the stakes are high, and rather than respect for your brilliant interlocuter, you hate some douche bag of a Princeton economist for their narrowness and foolishness. They are now but the very clever and powerful enemy. And rather than feeling schooled by worthy teachers, you only feel impotent and useless against the wrongs of the world.
But so moved by your righteousness, that maybe you plot in ways in which to amass power, to fight for the forces of good. But what is the danger of power? would you keep the rigor of Carnap and Kant? The pursuit of truth? Would you remember the kindness that moved you first, before the books?
Doctors have certainly squandered the pwoer of healer, but perhaps they never had much right to it.
Patients distrust doctors
"Others say the problem also stems from a grueling training system that removes doctors from the world patients live in. 'By the time you’re done with your training, you feel, in many ways, that you are as far as you could possibly be from the very people you’ve set out to help.'"
Racial schism of American Medicine
In 1910, when Abraham Flexner published his report on medical education, African-Americans made up 2.5 percent of the number of physicians in the United States. Today, they make up 2.2 percent.
Lawyers and Government?
Justice Department and political nepotism
Senior aides to former Attorney General Alberto R. Gonzales broke Civil Service laws by using politics to guide their hiring decisions, picking less-qualified applicants for important nonpolitical positions, slowing the hiring process at critical times and damaging the department’s credibility, an internal report concluded on Monday.
RIghteousness is a dangerous vice. But then, so is the lack of moral clarity. So is the lack of balls to call bullshit: bullshit. Bringing a written list of questions for your doctor, my ass.
Sometimes the most sensible thing really is a revolution. And alas, that seems to require a tedium of papers, many many people, and a steady drum beat of truth and clarity for however long it takes.
Monday, July 28, 2008
Best Student Evaluation
From the University of California, Department of Molecular and Cell Biology, Student Evaluation of Teaching Assistant for Course MCB 136/236: Advanced Physiology, Spring 2008. Best Comment Ever:
"I wish she would have brought us candy"
"I wish she would have brought us candy"
Friday, July 25, 2008
The Writing on the Wall
"Those who live, work, and think in rich material and intellectual environments understandably tend to take for granted their wealth, democracy, and civil society. They may have little direct knowledge or comprehension of how their societies have acquired, and continue to acquire--including through exploitation of distant others--the resources that enable them to lead comfortable lives. They are also remote from the 'world of victims' and from the difficulties faced by colleagues who are endeavoring to sustain universal professional ideals and accessible services in poor, nondemocratic, and oppressive countries, in which a myriad of overt and covert forces influence and obstruct them. The HIV/AIDS pandemic has highlighted some of these issues both in relation ot research in developing countries and in making new therapies available to those most in need. The impact of the SARS epidemic on Toronto was a wake-up call to the fact that privileged societies are not immune to the health, security, and economic threats posed by the emergence and spread of new infectious diseases."
Thursday, July 24, 2008
Sometimes, I hate San Francisco
Its heart is cold, its true, like any other city. And it will take the heat from yours. The friction of strangers only leaves burns. The rent will gut you. The ornate cornices and fluttering vermin will chase the loneliness, in the city of gold. The young women don't believe in love, the young men chase 51 ways to erotically throttle shadows in the alleyways. Madmen have stopped uttering prophesies, they are chided for the carbon footprint of their shopping carts, and the rich women carve identical tattoos to name themselves in the tribe of defiance. i scuttle to the four corners of my single bedroom, the light filtered through the barbed wire outside my window, the air through a hundred years of stale piss. i eat half a burrito everyday and wonder why my friends frown so much.
Monday, July 21, 2008
OMG
My adviser is only like, 35 years old. Well. I guess that's why she's so young and pretty and hip, and perhaps even why she seems more inclined to dash off to Bosnia or Rwanda every so often. But dude!, how did she get so much stuff done?!
How to do it right?
A rather exquisite question. The terrible thing about medicine is that it demands highly educated intellectuals to undertake extremely tedious practical work full of poop and blood and soul-crushing paperwork. This is also the awesome thing about it. The terrible thing about medicine is the single mindedness of it, the way it is such a difficult art, robs you of your personal life and mind's breath, demands and demands and demands, so that you can reflexively dose beta blockers and insert a catheter at 4 am in the morning without slicing a major artery. This is also the enticing, admirable thing about it.
However, a frustration with this article is that it does not question the premise that primary care need not be that fucked up: primary care is hard, but maybe it needs less bullshit (e.g. infuriating Medicare bureaucracy, uncompensated hours) and more support (e.g. more respect from the academic establishment). Or realization that those who "practice medicine at the exclusion of all else," or practice anything* at the exclusion of all else, are frequently sad, fucked up people (see: John Berger, "A Fortunate Man"). Or that cultural and economic trends have been steadily moving away from exactly that sort of lifestyle, and that medicine and law have been struggling to be enticing when pitted against companies like Google (read: time off and* free scooters). And as to the women doctors not working enough--well the fact women MDs tend to take more of those lower paying primary care positions that Jauhar bemoans, or that are cited to be overall more empathetic in all specialties, or that women patients desire women doctors, or that the steady influx of feminism in medicine since the 1970s have resulted in better care for maternal health, STDs, female diseases, less fucked up paternalism--and a myriad other tyrades--that will have to wait another day.
From All Walks of Life — Nontraditional Medical Students and the Future of Medicine
Sandeep Jauhar, M.D., Ph.D.
from NEJM
When I was growing up, my parents wanted me to become a doctor, but I had other ideas. I wanted to be a television journalist, or perhaps a trial lawyer or private investigator — something with panache. In college, intoxicated by the mysteries of the universe, I ended up studying condensed-matter physics, in which I eventually earned a Ph.D. But after a close friend contracted an incurable illness, I began to have doubts about my career path. Seeking a profession of tangible purpose — like many older students — I was drawn to medicine.
When I entered medical school at 26, I was considered to be a nontraditional student — but I was hardly alone. A middle-aged woman in my class had an advanced degree in cell biology. One classmate in his early 30s had been a physician assistant for 10 years; there were also a lawyer and an AmeriCorps organizer among us. We were the new face of medicine, or so we were told, and there was considerable interest in us from professors and administrators, if not from our classmates.
The mean age of first-year medical students today is about 24, though 10% are 27 or older. Medical schools now routinely admit students in their 30s or 40s who already have families or are well into another career before turning toward medicine. In general, these students have been welcomed into the profession. They bring maturity, diversity, broader perspectives, "life experience." But what do these physicists, musicians, actors, lawyers, writers, stockbrokers, and dancers add to the profession? Since primary care physicians are in short supply, doesn't medicine just need more conventional, nose-to-the-grindstone clinicians?
Of course, nowadays, when many medical school applicants boast myriad resumé-building experiences, it isn't always clear what "nontraditional" means. Quirky undergraduate concentrations such as music or film are popular among applicants, and so are dual degrees. Female sex ceased to be a distinguishing characteristic years ago. "`Nontraditional' these days is quite a bit different from what it was back when I was in medical school," notes Scott Barnett, associate dean for admissions and graduate medical education at New York's Mount Sinai School of Medicine. "At our school, 50% of medical students are nonscience majors. Out of 140 students, a quarter are from our [undergraduate] Humanities in Medicine program; 10% are M.D.–Ph.D.s; quite a few are career changers."
Such students "are at the forefront of our school," Barnett goes on. "They are older and have a broader view of the world. . . . We've realized that the conventional biology major may not be necessary to produce competent, morally and ethically upstanding citizen-doctors." In Barnett's experience, most people who adopt medicine as a second career "at some point in their lives thought they wanted to be doctors, but their interests led them elsewhere. Maybe the thought of taking a premedical curriculum was repugnant to them. They thought, `I'm going to take full advantage of the 4 years of college; I'll go back and do it later.' They went into teaching, law, finance, the family business, and then, years later, they realize they made a mistake. I think this particularly applies to the finance people — `I'm just making a lot of money, and what am I doing? I'm not helping people.' I think for most nontraditional students, medicine has been scratching at their brains for a long time."
Lawrence Smith, former dean of medical education at New York's Mount Sinai and new dean of the Hofstra University School of Medicine (scheduled to open on Long Island in 2010), says that nontraditional students are often a challenge to medical educators. "They're more self-confident," he says. "They're more conscious of what they want to do with their time. They're less willing to just suck it up and go through the rote aspects of medical training. They are the ones you see in the dean's office saying, `Don't inflict this horrible teacher on me.'
"At the same time, they bring an integrative, adult vision of the world to medicine," Smith adds. "They excel in the clinical setting. They ask smart questions. They challenge assumptions. They ask `why?' more than younger students. They're more comfortable dealing with people. I'm not sure they necessarily make better doctors, but I think the class is definitely enhanced by their presence."
Leslie Kahl, dean of student affairs at Washington University School of Medicine in St. Louis, says that the decision of such students to enter medicine is almost always "self-conscious." "My sense is that they're more focused, more goal-oriented, when they arrive," she says. Kahl agrees with Smith that nontraditional students bring diverse experiences that improve a class. "They help traditional students . . . better envision the opportunities in their future. They influence them to bring a different, maybe slightly more mature or empathetic, approach to their own patients."
By and large, admissions committees seem to agree. Although most medical schools do not keep track of how many nontraditional students they admit, the number has almost certainly increased over the past decade and will probably continue to rise in the face of concerns about a looming doctor shortage.
It is apparent in online discussions hosted by the Web site studentdoctor.net that many nontraditional medical students themselves believe they have advantages over their younger counterparts — greater sensitivity in interactions with patients, more certainty about their career choices, a greater ability to deal with emotional distress, and a clearer sense of what they want to do within medicine.
A 46-year-old intern at my hospital, whom I'll call David Burns, went to medical school in his mid-20s, but when he had a health crisis, he decided to forgo residency and become a teacher. He eventually became a top-level administrator in a large hospital system in Philadelphia, with a six-figure salary and six secretaries. Then, he says, "I hit the big 45 and asked myself, `What is this?' I had always wanted to do medicine." So he started doing daily rounds at 6 a.m. with an ICU team at one of the hospitals he was overseeing. "I loved being there," he recalls. "I wanted to be taking care of people.
"For most interns, this is the first job they've ever had," Burns points out. "They have no concept of being a professional. When you're an older student, you have a different perspective. You spend less time whining that the world is unfair." He plans to apply for a fellowship in critical care — though he realizes that he'll be 51 years old when he finishes his training.
Johnny Lops, a 29-year-old psychiatry resident at my hospital, is a different kind of nontraditional doctor. He was an actor before going to medical school, performing off-Broadway and in television commercials, and he continues to act part-time. "I get to do what I love — psychiatry and acting," he says. "I come to work happy, and because I am happy, I can be a better doctor. So many residents are frustrated. I tell them you need a creative outlet."
Moreover, Lops believes his acting background helps him in medicine. "I definitely know how to handle people and situations more easily," he says. "I'm good at improvisation, so I'm quick on my feet. I have a trained eye and ear, so I'm good with families and their politics."
But more generally, are the diverse backgrounds and interests of nontraditional medical students really what the profession needs? Today, most experts believe that medicine needs more doctors who are able and willing to do the difficult work of primary care, especially since shortages of front-line physicians are expected at the same time as the baby boomers begin reaching Medicare age. Diversity of the workforce is an admirable goal, but it brings challenges, too.
For example, the influx of women into medicine in recent decades has been associated with a change in work habits: today, both male and female doctors are less likely than their predecessors to practice medicine to the exclusion of everything else. A recent survey found that 24% of female physicians under 50 work part-time.1 This trend has put pressure on older doctors nearing retirement, many of whom bemoan the lack of suitable candidates to take over their practices. Is it responsible for medical schools to admit older students who may pursue disparate interests and will probably have shorter career spans? And given that Medicare funds much of graduate medical education in this country, shouldn't the government's investment take the population's needs into consideration?
The disadvantages of older age are often glossed over in discussions about nontraditional students. Medical training requires an intensity of commitment and energy that is almost unique among professions. Older students may not have the same kind of reserves to draw on as their younger, more narrowly focused counterparts. Their greater life experience may make it harder for them to conform to the hospital pecking order, among other adjustments.
When I began medical school, I discovered that the determination and focus of traditional medical students, which had seemed alien to me in college, were well adapted for a career in medicine. Such students could study longer and harder than others, unencumbered as they were by outside responsibilities — or a long hiatus between college and medical school. On the wards, they appeared single-minded and were often able to act quickly, almost reflexively. These strengths have undoubtedly proved advantageous to them as clinicians.
Barnett of Mount Sinai acknowledges that the age and inclination of older students must be factored into admissions decisions. "I think it is in people's minds when they interview students: Will admitting this person, who may be taking the spot of a younger student, produce benefit to society?" he says. "I don't know of a cutoff, but maybe around age 50 you start to wonder if this is just an intellectual exercise.
"We're willing for older applicants to make a case of what they want to do for society," he goes on. "If they can't make a compelling case, then the application is not going to fly. But the same applies to the 21-year-old applicant."
Hofstra's Smith says: "This is . . . obviously a societal question. Does individual freedom take precedence over group needs? In some cases, committees may not think admitting an older student is a good use of the limited number of spots. But you have to be afraid of too much social engineering. Look at women physicians: they tend to work less than men. Does that mean we shouldn't be admitting female students?"
For now, medical school admissions committees continue to accept older, nontraditional students. Perhaps they believe that medicine needs new voices — and given the myriad problems of health care, it is hard to disagree. Nevertheless, I think we need more data before we can call this a viable strategy for the future.
However, a frustration with this article is that it does not question the premise that primary care need not be that fucked up: primary care is hard, but maybe it needs less bullshit (e.g. infuriating Medicare bureaucracy, uncompensated hours) and more support (e.g. more respect from the academic establishment). Or realization that those who "practice medicine at the exclusion of all else," or practice anything* at the exclusion of all else, are frequently sad, fucked up people (see: John Berger, "A Fortunate Man"). Or that cultural and economic trends have been steadily moving away from exactly that sort of lifestyle, and that medicine and law have been struggling to be enticing when pitted against companies like Google (read: time off and* free scooters). And as to the women doctors not working enough--well the fact women MDs tend to take more of those lower paying primary care positions that Jauhar bemoans, or that are cited to be overall more empathetic in all specialties, or that women patients desire women doctors, or that the steady influx of feminism in medicine since the 1970s have resulted in better care for maternal health, STDs, female diseases, less fucked up paternalism--and a myriad other tyrades--that will have to wait another day.
From All Walks of Life — Nontraditional Medical Students and the Future of Medicine
Sandeep Jauhar, M.D., Ph.D.
from NEJM
When I was growing up, my parents wanted me to become a doctor, but I had other ideas. I wanted to be a television journalist, or perhaps a trial lawyer or private investigator — something with panache. In college, intoxicated by the mysteries of the universe, I ended up studying condensed-matter physics, in which I eventually earned a Ph.D. But after a close friend contracted an incurable illness, I began to have doubts about my career path. Seeking a profession of tangible purpose — like many older students — I was drawn to medicine.
When I entered medical school at 26, I was considered to be a nontraditional student — but I was hardly alone. A middle-aged woman in my class had an advanced degree in cell biology. One classmate in his early 30s had been a physician assistant for 10 years; there were also a lawyer and an AmeriCorps organizer among us. We were the new face of medicine, or so we were told, and there was considerable interest in us from professors and administrators, if not from our classmates.
The mean age of first-year medical students today is about 24, though 10% are 27 or older. Medical schools now routinely admit students in their 30s or 40s who already have families or are well into another career before turning toward medicine. In general, these students have been welcomed into the profession. They bring maturity, diversity, broader perspectives, "life experience." But what do these physicists, musicians, actors, lawyers, writers, stockbrokers, and dancers add to the profession? Since primary care physicians are in short supply, doesn't medicine just need more conventional, nose-to-the-grindstone clinicians?
Of course, nowadays, when many medical school applicants boast myriad resumé-building experiences, it isn't always clear what "nontraditional" means. Quirky undergraduate concentrations such as music or film are popular among applicants, and so are dual degrees. Female sex ceased to be a distinguishing characteristic years ago. "`Nontraditional' these days is quite a bit different from what it was back when I was in medical school," notes Scott Barnett, associate dean for admissions and graduate medical education at New York's Mount Sinai School of Medicine. "At our school, 50% of medical students are nonscience majors. Out of 140 students, a quarter are from our [undergraduate] Humanities in Medicine program; 10% are M.D.–Ph.D.s; quite a few are career changers."
Such students "are at the forefront of our school," Barnett goes on. "They are older and have a broader view of the world. . . . We've realized that the conventional biology major may not be necessary to produce competent, morally and ethically upstanding citizen-doctors." In Barnett's experience, most people who adopt medicine as a second career "at some point in their lives thought they wanted to be doctors, but their interests led them elsewhere. Maybe the thought of taking a premedical curriculum was repugnant to them. They thought, `I'm going to take full advantage of the 4 years of college; I'll go back and do it later.' They went into teaching, law, finance, the family business, and then, years later, they realize they made a mistake. I think this particularly applies to the finance people — `I'm just making a lot of money, and what am I doing? I'm not helping people.' I think for most nontraditional students, medicine has been scratching at their brains for a long time."
Lawrence Smith, former dean of medical education at New York's Mount Sinai and new dean of the Hofstra University School of Medicine (scheduled to open on Long Island in 2010), says that nontraditional students are often a challenge to medical educators. "They're more self-confident," he says. "They're more conscious of what they want to do with their time. They're less willing to just suck it up and go through the rote aspects of medical training. They are the ones you see in the dean's office saying, `Don't inflict this horrible teacher on me.'
"At the same time, they bring an integrative, adult vision of the world to medicine," Smith adds. "They excel in the clinical setting. They ask smart questions. They challenge assumptions. They ask `why?' more than younger students. They're more comfortable dealing with people. I'm not sure they necessarily make better doctors, but I think the class is definitely enhanced by their presence."
Leslie Kahl, dean of student affairs at Washington University School of Medicine in St. Louis, says that the decision of such students to enter medicine is almost always "self-conscious." "My sense is that they're more focused, more goal-oriented, when they arrive," she says. Kahl agrees with Smith that nontraditional students bring diverse experiences that improve a class. "They help traditional students . . . better envision the opportunities in their future. They influence them to bring a different, maybe slightly more mature or empathetic, approach to their own patients."
By and large, admissions committees seem to agree. Although most medical schools do not keep track of how many nontraditional students they admit, the number has almost certainly increased over the past decade and will probably continue to rise in the face of concerns about a looming doctor shortage.
It is apparent in online discussions hosted by the Web site studentdoctor.net that many nontraditional medical students themselves believe they have advantages over their younger counterparts — greater sensitivity in interactions with patients, more certainty about their career choices, a greater ability to deal with emotional distress, and a clearer sense of what they want to do within medicine.
A 46-year-old intern at my hospital, whom I'll call David Burns, went to medical school in his mid-20s, but when he had a health crisis, he decided to forgo residency and become a teacher. He eventually became a top-level administrator in a large hospital system in Philadelphia, with a six-figure salary and six secretaries. Then, he says, "I hit the big 45 and asked myself, `What is this?' I had always wanted to do medicine." So he started doing daily rounds at 6 a.m. with an ICU team at one of the hospitals he was overseeing. "I loved being there," he recalls. "I wanted to be taking care of people.
"For most interns, this is the first job they've ever had," Burns points out. "They have no concept of being a professional. When you're an older student, you have a different perspective. You spend less time whining that the world is unfair." He plans to apply for a fellowship in critical care — though he realizes that he'll be 51 years old when he finishes his training.
Johnny Lops, a 29-year-old psychiatry resident at my hospital, is a different kind of nontraditional doctor. He was an actor before going to medical school, performing off-Broadway and in television commercials, and he continues to act part-time. "I get to do what I love — psychiatry and acting," he says. "I come to work happy, and because I am happy, I can be a better doctor. So many residents are frustrated. I tell them you need a creative outlet."
Moreover, Lops believes his acting background helps him in medicine. "I definitely know how to handle people and situations more easily," he says. "I'm good at improvisation, so I'm quick on my feet. I have a trained eye and ear, so I'm good with families and their politics."
But more generally, are the diverse backgrounds and interests of nontraditional medical students really what the profession needs? Today, most experts believe that medicine needs more doctors who are able and willing to do the difficult work of primary care, especially since shortages of front-line physicians are expected at the same time as the baby boomers begin reaching Medicare age. Diversity of the workforce is an admirable goal, but it brings challenges, too.
For example, the influx of women into medicine in recent decades has been associated with a change in work habits: today, both male and female doctors are less likely than their predecessors to practice medicine to the exclusion of everything else. A recent survey found that 24% of female physicians under 50 work part-time.1 This trend has put pressure on older doctors nearing retirement, many of whom bemoan the lack of suitable candidates to take over their practices. Is it responsible for medical schools to admit older students who may pursue disparate interests and will probably have shorter career spans? And given that Medicare funds much of graduate medical education in this country, shouldn't the government's investment take the population's needs into consideration?
The disadvantages of older age are often glossed over in discussions about nontraditional students. Medical training requires an intensity of commitment and energy that is almost unique among professions. Older students may not have the same kind of reserves to draw on as their younger, more narrowly focused counterparts. Their greater life experience may make it harder for them to conform to the hospital pecking order, among other adjustments.
When I began medical school, I discovered that the determination and focus of traditional medical students, which had seemed alien to me in college, were well adapted for a career in medicine. Such students could study longer and harder than others, unencumbered as they were by outside responsibilities — or a long hiatus between college and medical school. On the wards, they appeared single-minded and were often able to act quickly, almost reflexively. These strengths have undoubtedly proved advantageous to them as clinicians.
Barnett of Mount Sinai acknowledges that the age and inclination of older students must be factored into admissions decisions. "I think it is in people's minds when they interview students: Will admitting this person, who may be taking the spot of a younger student, produce benefit to society?" he says. "I don't know of a cutoff, but maybe around age 50 you start to wonder if this is just an intellectual exercise.
"We're willing for older applicants to make a case of what they want to do for society," he goes on. "If they can't make a compelling case, then the application is not going to fly. But the same applies to the 21-year-old applicant."
Hofstra's Smith says: "This is . . . obviously a societal question. Does individual freedom take precedence over group needs? In some cases, committees may not think admitting an older student is a good use of the limited number of spots. But you have to be afraid of too much social engineering. Look at women physicians: they tend to work less than men. Does that mean we shouldn't be admitting female students?"
For now, medical school admissions committees continue to accept older, nontraditional students. Perhaps they believe that medicine needs new voices — and given the myriad problems of health care, it is hard to disagree. Nevertheless, I think we need more data before we can call this a viable strategy for the future.
Thursday, July 17, 2008
Hobbies as of late
Reading about the devastating, far reaching, abominable suffering of world poverty characterized by families living on the purchasing power of a mere $2 a day--while drinking a cappuccino that costs $2.70, in order to fuel such readings.
Monday, July 14, 2008
huzzah! science, writing, competition
favorite things!:
Share your ideas on the current state of science
Seed is pleased to announce the Third Annual Seed Science Writing Contest.
For science to achieve its transformative potential across society, it is essential that we understand both what catalyzes science and what inhibits it. Last year we sought ideas to catalyze science literacy. This year, we ask:
What is the most significant force acting against science in society today? How can it be overcome?
Submission Deadline: August 1, 2008
Maximum Word Count: 1,200
First Prize:
$2,500 Prize
2nd Place:
$1,000 Prize
Please send your submissions as a Word document along with your full name and mailing address to writingcontest@seedmediagroup.com.
Please read the Official Rules » For more information, go to seedmagazine.com/writingcontest
Share your ideas on the current state of science
Seed is pleased to announce the Third Annual Seed Science Writing Contest.
For science to achieve its transformative potential across society, it is essential that we understand both what catalyzes science and what inhibits it. Last year we sought ideas to catalyze science literacy. This year, we ask:
What is the most significant force acting against science in society today? How can it be overcome?
Submission Deadline: August 1, 2008
Maximum Word Count: 1,200
First Prize:
$2,500 Prize
2nd Place:
$1,000 Prize
Please send your submissions as a Word document along with your full name and mailing address to writingcontest@seedmediagroup.com.
Please read the Official Rules » For more information, go to seedmagazine.com/writingcontest
Sunday, July 13, 2008
Eulogy
A familiar family: stalwart old guard revolutionaries. young tattood girls. beautiful gay men. Faces from before, but now with babies, doctorates, new tattoos, same smiles. Everyone seems timeless...Exactly how I last saw them, even if i hadn't met so many of them. We are in a secret courtyard behind the church, which i did not even know existed, a secret sanctuary. A massive oak hangs over. A crucifix of old branches rests peacefully behind climbing vines. Tables with orchids, lit by clinical lamps, strewn with potato chips and photos of the beloved. There is genial conversation, an epic soundtrack, and occasionally a sobbing embrace.
He ran away from North Carolina, away from his father, a commanding Methodist minister, he ran away to Berkeley, to spend 38 years in a radical free clinic--in the basement of a Methodist church.
We tell our tales. I tell mine. My speech. i agonized all day, for a few weeks, turning over and over...the profound role of my teachers at the free clinic. In the end it would always be deficient, so i stay dutifully within my five minute limit. I listen to the stories of others, deeply moved by the impact of one human on the lives of many. I am honored to be a part of something. JD, ever the wise motorcycle sage, speaks softly and eloquently of Scotto's impact on the myriad physicans, nurses, PAs hundreds of workers, who then go on to impact the souls of others. This then, the way things unfold.
my speech.
"The Spanish philosopher Jose Ortega Y Gasset once cruelly noted, 'A revolution only lasts fifteen years, a period which coincides with the effectiveness of a generation.' But the legacy of that revolution, of its teachers and institutions can generate a force that lasts 30, 40, 50 years, that ripples deep into the psyche of the next generation and rumbles across continents and seas.
I arrived to the Berkeley Free Clinic entirely by accident, an earnest do gooding 19 year old, full of angst, restless, and fierce in my own bumbling 19 year old way. I wanted very badly to make many wrongs in the world right. And so I arrived, and so I met Scottosaurus.
Scottosaurus was crotchety, perpetually wary, incorrigible. He endured my endless questions: why was his name Scottosaurus? Why did he have a torchlight strapped to his hat? Where were the condoms? How do I shut off the alarm? The toilet has exploded, what now? He always answered thoughtfully, often with a note about history of the Digger’s movement, or the last time the clinic flooded in the late 1980s. We spent many slow shifts discussing the merits of an assortment of science fiction literature, Kantian metaphysics or the changing nature of information and its relation to power. It was Scotto who introduced me to Pete’s coffee, which he typically brewed to the strength of gasoline. He often lumbered about, supremely disgruntled, but his mind was bright, sparkling and nimble. He could mobilize a dense architecture of rapid fire bullet point arguments, exquisitely interwoven clauses, exceptions, and footnotes drawn from endless vaults of profound clinic history and obscure facts about vacuum tubes.
Scotto made me believe in the revolution. The one that may begin in riots, but bleeds deeply into the daily work of life. His life is inseparably and intimately interwoven with this clinic. The impact of the Berkeley free clinic, of its people and vision, cannot be overstated. The people of this place have been teachers, models, inspiration, and comrades in the search for thoughtful impact towards a better world, they illustrate what the steady and rather piecemeal work of Revolution actually entails—long meetings, unclogging toilets, reaching beyond ideology and inflated rhetoric to listen—to listen to clients, to one’s own self, and one’s fellow workers.
Scott himself was a thoughtful connector, a hub in the clinic’s erratic, dynamic and fluxing existence. He observed events, people, and exchanges with the astuteness and analysis of science, and artfully sought to relate, connect, and synthesize a collective wisdom. He was also completely unafraid to tell you were dead wrong and piss you off royally. But he was ceaselessly passionate for the work and for the vision. He cared deeply and indubitably.
My heart is heavy for this loss, heavy that I had not spoken sooner, that I could not express directly these things to Scotto. That in my brief 3 years in the IRC, I had been profoundly moved and transformed. It is true, that many of us, 5, 15, 30 years later, are still full of questions, of angst, of fierce restlessness to make the many wrongs of the world right.
But in that brief time, I gained immensely, what I have learned here has launched me with boldness and knowledge to undertake the good fight—in the clinics of San Francisco and Tanzania, in the marble halls of policy and advocacy, to join others in upholding dignity of each human, and the collective spirit of justice in all action.
Antoine du Saint Exupery, the famed pilot and author of the fearless 'Little Prince' advises 'If you want to build a ship, don’t drum up people to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.'
Scotto’s legacy is a pillar of this clinic, and the clinic in turn launched a thousand lives—curing pimples on penises, or empowering each other to learn their own bodies, or by letting people stumble into the courage to make the world “a little less ridiculous,” by knowing there are others who will stand and work with them. Chirp!"
He ran away from North Carolina, away from his father, a commanding Methodist minister, he ran away to Berkeley, to spend 38 years in a radical free clinic--in the basement of a Methodist church.
We tell our tales. I tell mine. My speech. i agonized all day, for a few weeks, turning over and over...the profound role of my teachers at the free clinic. In the end it would always be deficient, so i stay dutifully within my five minute limit. I listen to the stories of others, deeply moved by the impact of one human on the lives of many. I am honored to be a part of something. JD, ever the wise motorcycle sage, speaks softly and eloquently of Scotto's impact on the myriad physicans, nurses, PAs hundreds of workers, who then go on to impact the souls of others. This then, the way things unfold.
my speech.
"The Spanish philosopher Jose Ortega Y Gasset once cruelly noted, 'A revolution only lasts fifteen years, a period which coincides with the effectiveness of a generation.' But the legacy of that revolution, of its teachers and institutions can generate a force that lasts 30, 40, 50 years, that ripples deep into the psyche of the next generation and rumbles across continents and seas.
I arrived to the Berkeley Free Clinic entirely by accident, an earnest do gooding 19 year old, full of angst, restless, and fierce in my own bumbling 19 year old way. I wanted very badly to make many wrongs in the world right. And so I arrived, and so I met Scottosaurus.
Scottosaurus was crotchety, perpetually wary, incorrigible. He endured my endless questions: why was his name Scottosaurus? Why did he have a torchlight strapped to his hat? Where were the condoms? How do I shut off the alarm? The toilet has exploded, what now? He always answered thoughtfully, often with a note about history of the Digger’s movement, or the last time the clinic flooded in the late 1980s. We spent many slow shifts discussing the merits of an assortment of science fiction literature, Kantian metaphysics or the changing nature of information and its relation to power. It was Scotto who introduced me to Pete’s coffee, which he typically brewed to the strength of gasoline. He often lumbered about, supremely disgruntled, but his mind was bright, sparkling and nimble. He could mobilize a dense architecture of rapid fire bullet point arguments, exquisitely interwoven clauses, exceptions, and footnotes drawn from endless vaults of profound clinic history and obscure facts about vacuum tubes.
Scotto made me believe in the revolution. The one that may begin in riots, but bleeds deeply into the daily work of life. His life is inseparably and intimately interwoven with this clinic. The impact of the Berkeley free clinic, of its people and vision, cannot be overstated. The people of this place have been teachers, models, inspiration, and comrades in the search for thoughtful impact towards a better world, they illustrate what the steady and rather piecemeal work of Revolution actually entails—long meetings, unclogging toilets, reaching beyond ideology and inflated rhetoric to listen—to listen to clients, to one’s own self, and one’s fellow workers.
Scott himself was a thoughtful connector, a hub in the clinic’s erratic, dynamic and fluxing existence. He observed events, people, and exchanges with the astuteness and analysis of science, and artfully sought to relate, connect, and synthesize a collective wisdom. He was also completely unafraid to tell you were dead wrong and piss you off royally. But he was ceaselessly passionate for the work and for the vision. He cared deeply and indubitably.
My heart is heavy for this loss, heavy that I had not spoken sooner, that I could not express directly these things to Scotto. That in my brief 3 years in the IRC, I had been profoundly moved and transformed. It is true, that many of us, 5, 15, 30 years later, are still full of questions, of angst, of fierce restlessness to make the many wrongs of the world right.
But in that brief time, I gained immensely, what I have learned here has launched me with boldness and knowledge to undertake the good fight—in the clinics of San Francisco and Tanzania, in the marble halls of policy and advocacy, to join others in upholding dignity of each human, and the collective spirit of justice in all action.
Antoine du Saint Exupery, the famed pilot and author of the fearless 'Little Prince' advises 'If you want to build a ship, don’t drum up people to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.'
Scotto’s legacy is a pillar of this clinic, and the clinic in turn launched a thousand lives—curing pimples on penises, or empowering each other to learn their own bodies, or by letting people stumble into the courage to make the world “a little less ridiculous,” by knowing there are others who will stand and work with them. Chirp!"
Saturday, July 12, 2008
Why I love the British
Perhaps in my deepest, I am fundamentally a tropical girl--given to sentimentality, fussiness, shameless hedonism, clingy neediness and unbridled passions. I cry and laugh with utter transparency and express my love with food.
And perhaps forever on, I will be on all functioning accounts an American girl--fiercely ambitious, equally earnest, gruesomely optimistic, stimulation junkie, self absorbed, individualistic and given to expressing all affection couched in the language of legal consent.
But somewhere in between, i would like to think that weaving the distance in continents and oceans, is the cheerful work of the british, who were always so exquisitely polite when endeavoring to wipe out your civilization and grow tea plantations on top of it.
Their infamous stiff upper lip, lined always with a comical handlebar mustache, smelling vaguely of tobacco, bacon and bureaucracy, these men and women provide models of grace and sly dowdiness, be they faced with armies of disgruntled heathens, the demise of their empire, tropical weather ruining their tweed suit, or that final Tea Cup in the Sky--mortality.
Someday i will question what the English language has made of my brain, and write it out, in this language that has colonized me--and I who have colonized it.
And perhaps forever on, I will be on all functioning accounts an American girl--fiercely ambitious, equally earnest, gruesomely optimistic, stimulation junkie, self absorbed, individualistic and given to expressing all affection couched in the language of legal consent.
But somewhere in between, i would like to think that weaving the distance in continents and oceans, is the cheerful work of the british, who were always so exquisitely polite when endeavoring to wipe out your civilization and grow tea plantations on top of it.
Their infamous stiff upper lip, lined always with a comical handlebar mustache, smelling vaguely of tobacco, bacon and bureaucracy, these men and women provide models of grace and sly dowdiness, be they faced with armies of disgruntled heathens, the demise of their empire, tropical weather ruining their tweed suit, or that final Tea Cup in the Sky--mortality.
Someday i will question what the English language has made of my brain, and write it out, in this language that has colonized me--and I who have colonized it.
Against perfectionism
“Don't worry, be crappy. Revolutionary means you ship and then test... Lots of things made the first Mac in 1984 a piece of crap - but it was a revolutionary piece of crap.”
Guy Kawasaki
Guy Kawasaki
Thursday, July 10, 2008
Fortune Cookie says: "You will discover new frontiers"
I miss the taste of revolution in my mouth.
That old hooligan of a prophet Nietzsche warned: “If you gaze long into an abyss, the abyss will gaze back into you.” Phblt. what would it find but more abyss? And there's the crux of the matter: heaving, devouring darkness peering intently at each other. This is what ambition amounts to, and the alchemy lies in making light.
The heat has been hammering at me. Nothing can be done. All of civilization, with its whirring air conditions and defiant stretches of parking lot, is nothing for our blazing father star. The sun is merciless. Philosophy, chemistry, nothing. Economics the rise of the information age, useless. Gay pride parades and the Geneva Convention, these things have melted. In visceral exhaustion nothing means anything.
Nothing, anything to be done, but alas, to google image search puppies.
Until then, the case for moderation: “Those who hate most fervently must have once loved deeply; those who want to deny the world must have once embraced what they now set on fire.”
That old hooligan of a prophet Nietzsche warned: “If you gaze long into an abyss, the abyss will gaze back into you.” Phblt. what would it find but more abyss? And there's the crux of the matter: heaving, devouring darkness peering intently at each other. This is what ambition amounts to, and the alchemy lies in making light.
The heat has been hammering at me. Nothing can be done. All of civilization, with its whirring air conditions and defiant stretches of parking lot, is nothing for our blazing father star. The sun is merciless. Philosophy, chemistry, nothing. Economics the rise of the information age, useless. Gay pride parades and the Geneva Convention, these things have melted. In visceral exhaustion nothing means anything.
Nothing, anything to be done, but alas, to google image search puppies.
Until then, the case for moderation: “Those who hate most fervently must have once loved deeply; those who want to deny the world must have once embraced what they now set on fire.”
Sunday, July 6, 2008
%#&%@&* HOME!!!!
This is the five day forecast for Lancaster, CA from Weatherunderground.com. I will arrive Monday and leave Friday.
Monday
103° F | 70° F
39° C | 21° C
Clear
Tuesday
108° F | 70° F
42° C | 21° C
Clear
Wednesday
108° F | 72° F
42° C | 22° C
Chance of T-storms
20% chance of precipitation
Thursday
106° F | 72° F
41° C | 22° C
Chance of T-storms
20% chance of precipitation
Friday
103° F | 70° F
39° C | 21° C
Chance of T-storms
20% chance of precipitation
YEAH!
Monday
103° F | 70° F
39° C | 21° C
Clear
Tuesday
108° F | 70° F
42° C | 21° C
Clear
Wednesday
108° F | 72° F
42° C | 22° C
Chance of T-storms
20% chance of precipitation
Thursday
106° F | 72° F
41° C | 22° C
Chance of T-storms
20% chance of precipitation
Friday
103° F | 70° F
39° C | 21° C
Chance of T-storms
20% chance of precipitation
YEAH!
Saturday, July 5, 2008
i hate steam punk
just as much as i hate all the circus nonsense and Seed magazine. I hate it because i thought of it first, and i hate it even more because the last clause is entirely untrue and i only wish i had thought of it first. i may only have muttered it in repetition when someone else said it, but it was* before it showed up on the new york times trends page. Sure i read all of Blake, Lewis Carroll, Romantic mysticism and acquire much of my morality from South Asian culture that absorbed British 19th century prudery wholesale. But maybe i only talked alot about the Victorians more than actually converting my ipod into a brass steam engine. le sigh. When did stodgy ideas from dusty books become so much less sexy than design? Clearly, long ago, while i was not paying attention. i feel so disempowered.
Tuesday, July 1, 2008
Chronos and kairos
"There is a pervasive form of contemporary violence to which the idealist, fighting for peace by nonviolent methods, most easily succumbs: activism and overwork. The rush and pressure of modern life are a form, perhaps the most common form, of its innate violence. To allow oneself to be carried away by a multitude of conflicting concerns, to surrender to too many demands. To commit oneself to too many projects, to want to help everyone in everything is to succumb to violence. The frenzy of the activist neutralizes his work, because it kills the root of inner wisdom which makes work fruitful." (Thomas Merton)
Merton was himself what most would describe as an activist in the antiwar movement of the 1960s . Yet in this passage he identifies both the daily lives of many activists, and the personal habits of almost all modern physicians, as a way of participating in violence against human values, rather than ways of promoting peace and health.
For many students the most important distinction offered that between chronological or 'clock' time, on the one, and contemplative time on the other. Relying solely on the first and devaluing the second pushes otherwise laudable impulses—for example, to serve others—into the realm of violence. The reading which seems to make the lasting impression describes the difference between two Greek words for time. While chronos refers to what can be measured by the clock or calendar, kairos refers instead to time that cannot be measured, time that is separated instead into periods of meaning. In reflection one temporarily steps outside of chronological time to see things from a different level and with a more broadly purposeful perspective (Bloomquist, 1997). In many ways the distinction between chronos and kairos parallels Covey's distinction between the urgent and the important. Helping students learn to value kairos in their lives, and to resist being swallowed by chronos, is a critical goal of spirituality teaching.
We describe a variety of exercises as aids in regular reflection. These include transcendental and other forms of meditation, yoga, relaxation response, contemplation, and journaling. Each is a means toward an inward focus, a way to find space within oneself despite a culture so much at odds with it. The intensity and sensory over-stimulation of contemporary life almost deny the reality of anything quieter. Again, however, the course does not encourage spirituality as escape from the world. On the contrary: an inner life is part of, and nourishes a full and balanced life…
The medical curriculum emphasizes scientific and technical skills, and stresses that, without continuing education, physicians become unable to care for their patients. Practice is needed for technical skills—even the best physicians soon become rusty if they do not do a procedure for a while. The humane skills that constitute virtuous behavior—such things as imparting hope, and showing compassion through intensive listening—likewise require practice. The physician's ability to promote healing depends on both sets of skills. Covey (1989) has shrewdly observed that ability and character tend to go together; allowing one's abilities to atrophy through inadequate practice commonly reflects a character flaw. And, as Richard Gula notes, 'We must practice virtuous activity so that the virtues become habits, or second nature to us. We become trustworthy by doing acts of trustworthiness; we become altruistic by doing acts of altruism.'
Judith Andre, Jake Foglio, Howard Brody, "Moral Growth, Spirituality, and Activism: the Humanities in Medical Education"
Merton was himself what most would describe as an activist in the antiwar movement of the 1960s . Yet in this passage he identifies both the daily lives of many activists, and the personal habits of almost all modern physicians, as a way of participating in violence against human values, rather than ways of promoting peace and health.
For many students the most important distinction offered that between chronological or 'clock' time, on the one, and contemplative time on the other. Relying solely on the first and devaluing the second pushes otherwise laudable impulses—for example, to serve others—into the realm of violence. The reading which seems to make the lasting impression describes the difference between two Greek words for time. While chronos refers to what can be measured by the clock or calendar, kairos refers instead to time that cannot be measured, time that is separated instead into periods of meaning. In reflection one temporarily steps outside of chronological time to see things from a different level and with a more broadly purposeful perspective (Bloomquist, 1997). In many ways the distinction between chronos and kairos parallels Covey's distinction between the urgent and the important. Helping students learn to value kairos in their lives, and to resist being swallowed by chronos, is a critical goal of spirituality teaching.
We describe a variety of exercises as aids in regular reflection. These include transcendental and other forms of meditation, yoga, relaxation response, contemplation, and journaling. Each is a means toward an inward focus, a way to find space within oneself despite a culture so much at odds with it. The intensity and sensory over-stimulation of contemporary life almost deny the reality of anything quieter. Again, however, the course does not encourage spirituality as escape from the world. On the contrary: an inner life is part of, and nourishes a full and balanced life…
The medical curriculum emphasizes scientific and technical skills, and stresses that, without continuing education, physicians become unable to care for their patients. Practice is needed for technical skills—even the best physicians soon become rusty if they do not do a procedure for a while. The humane skills that constitute virtuous behavior—such things as imparting hope, and showing compassion through intensive listening—likewise require practice. The physician's ability to promote healing depends on both sets of skills. Covey (1989) has shrewdly observed that ability and character tend to go together; allowing one's abilities to atrophy through inadequate practice commonly reflects a character flaw. And, as Richard Gula notes, 'We must practice virtuous activity so that the virtues become habits, or second nature to us. We become trustworthy by doing acts of trustworthiness; we become altruistic by doing acts of altruism.'
Judith Andre, Jake Foglio, Howard Brody, "Moral Growth, Spirituality, and Activism: the Humanities in Medical Education"
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