Wednesday, January 31, 2018

All Dressed Up and Nowhere to Go

one place I will not be traveling soon


The fourth and final (for most of us, that is) year of medical school has breaks built into it both for board exam study and for traveling the country both for the purposes of interviewing for residency positions and so that we all might actually see and experience these places at which we interview. We legally obligate ourselves to spend a bare minimum of a year at any location with which we secure a match; it's more likely three to five years. In extreme situations, physicians in training will spend eight years in the location of their residencies. It only makes sense that a person spend just a bit of time at the place before potentially agreeing to devote multiple years of his or her life to studying medicine there..

The process is both time-consuming and expensive, though it can be viewed as a way to see the U.S. in a way one may never have seen it before.  I traveled as a child and youth with my family, so I've had at ;east some exposure to most regions of the  U..S. Some members of my cohort, though, have traveled no further from California than to the neighboring state of Nevada if that far. Some of the foreign students have seen, other than California, only what you can see of a state from its airport or by flying over it at an altitude so high that sometimes one's only view is cloud cover.  It adds to overall student debt for most of those in medical school to have to borrow additional funds in order to pay for plane tickets and hotel rooms, but it is, for the most part, money well spent. Furthermore, because it doesn't happen until one's final year of medical school, one has a reasonable assurance of completing medical school and eventually earning the money to pay back both the travel debts and the other debts incurred in attending medical school.

Some of our nation's more "innovative" programs attempt to circumvent this process by holding skype or face time interviews.  I can see the financial advantages to conducting interviews electronically, but there's really no viable substitute for actually traveling to a place. We still see only the tiniest sampling of the place. We're told to make it a point to go somewhere besides from the airport to the hotel to the hospital and back again, but the view still is one-dimensional. A candidate sees the place in only one season and is exposed to a mere sampling of the local population. Still, it's the best we can do at this point, and it's better than the best cyber-tour.

I've completed my visits and interviews and am preparing my lists (both U.S. and Canadian) for submission to the national registry. After that, it's simply a matter of waiting until March to learn whether or not one's lists matches up with the list each teaching institution submits with names of desired candidates.  At our institution, students know earlier in the week whether or not they have received a match. (If they haven't, they can still scramble for positions, and in some cases end up with the preferred positions. All is not lost for them.)  Match Day is the biggest celebration -- more so than graduation -- for medical school students. Much drunken revelry takes place, and students typically take off at least one day following the ceremony.

I will have a block of time during which I will have no duties beginning in less than two weeks. The original plan was for me to travel with a group of cohort mates to New Guinea. That trip fell through. Plan B was for me to travel to New Zealand as part of a group trip with medical students from around the U.S. that offered ample individual time in addition to the group activities. That, too, fell though today. My financial advisor had been advised two weeks ago that at least one of my assets needed to be sold in order to finance the trip, and that I needed the check in my hands by yesterday at the very latest. Today would have sufficed as well; it see now that was right about the artificial deadline being necessary. I should have told the moron the check had to be in my hands two weeks ago.  I showed up at his office bright and early at 6:00 a.m. (financial officers tend to work east coast hours here because they're impacted by the opening and closing of the stock market). I might then have had a prayer of having the funds available  today. I called the company sponsoring the trip and offered them every credit card number I have, my first-born child, and possibly even sex if they would take some form of currency other than cash. The answer was no.

So instead of luxuriating in New Zealand, I will spend the time I have off in the hole that I will dig for myself in the backyard of my condo. It will be swell, I'm sure.
another place I'm unlikely to see in the immediate future





Tuesday, January 30, 2018

SOMEONE PLEASE TELL ME THIS GETS EASIER





I'm not sure anyone ever suggested that life in general is supposed to be easy. I'm certainly not finding it to be that way. Some people allude to the placidity and to the carefree nature of childhood. I'm not sure that even childhood was an especially happy-go-lucky era in my life. If memory serves me correctly, most of my childhood was spent walking around on metaphorical eggshells, trying not to make anyone angry and trying not to get into any trouble. Undoubtedly the times of stress were interspersed with good times, but it just seems like, for as far back as I can recall, my raison d'etre was to keep someone from finding out about something, to smooth over someone's ruffled feathers, or to make amends for some real or perceived slight I had committed. It would be easier for me to rationalize this away if I had good reason to believe that I was somehow more the exception than the the rule in this regard, and that most children devoted large portions of their childhoods, at least allegorically, sniffing or plucking wildflowers from fields and meadows.

I'm not blaming this on my parents, either. While we've had our moments a family, as I would assume all families have had, I had caring and nurturing parents. If my relationship with one parent or the other was tense, it was probably because the parent was doing his or her job as opposed to either of them acting in a way that was either overly guilt-producing or punitive. Things at home were, for the most part, tranquil when we as a family were not dealing with something along the lines of a family member's life-threatening illness. Little of my childhood angst was connected to my parents. More often, it was peers or teachers, coaches, music teachers, extended family members, or other miscellaneous authority figures with whom I was continually struggling to navigate relationships and keep in harmony.

I'm finding young adulthood to be more of the same, as in the more things change, the more they seem to remain the same. I'm lucky enough to count among my friends a very small number of individuals who have never given me cause to distrust them or to question their loyalty.  Where time is concerned, though, I do not have the luxury of limiting myself to hanging out exclusively with my tried-and-true homies while pretending to myself that the rest of the world does not exist in a social sense. I must, unfortunately, interact with the rest of the world as well.

Socialization in today's world has grown to be unusually complex in that, in most of our circles, people exist with whom we rarely if ever have contact in the flesh, who, at the same time,  are very real parts of our worlds and of our lives. In the view of many people, this is symptomatic of many of the ills of today's society and is wrong in every sense. We need to be concerning ourselves with what is and who are concrete, real, and physically present in our lives. Emphasis upon and obsession over digital presence in our lives will, in the view of many, ultimately lead to the downfall of society as we have previously known it to be. or at least insist the naysayers.

Whether or not there is any substance to the degree or extent to which the virtual or cyber matters complicate our lives, digital presence and cyber-relationships are here to stay.  Whether they confound our existence to any greater degree than do more physically substantive relationships is a point over which nothing resembling consensus has at this point been reached, if ever it will be reached.  Regardless, I'm in the midst of what appears to be an at least moderately serious rift with a friend as defined under the parameters of cyber-friendship.  Following in very close proximity the fracture of my most recent and most serious romantic relationship to date, this schism has hit hard; to say that it hurts is an understatement.

I cannot share the details to the degree that I would like because friends (our relationship  presumably still falls under the technical category of friends and possibly always will) don't dish on one another just because a friendship isn't as close as it once was. I'm failing miserably at explaining what this is about in such a way as to allow my feelings to be at least cursorily  understood without saying more than I should say, and also to do so in such a manner as to avoid appearing to be the ultimate self-indulgent, self-pitying martyr.  Everyone has fallings out or at least driftings apart with friends. Why should I expect my own life to be sheltered beyond what is endured even among those whose existences would have to be considered charmed by almost any standards in the grand scheme of things?  (I read recently that if a person owns more than a single pair of shoes, he or she is in the top half of the world in terms of the cushiness of his or her lifestyle.  If there is indeed any validity to the link between a single change in footwear and privilege, I can claim no status other than one of extreme entitlement.)

My friend of whom I write is married. An unspoken or sometimes spoken parameter in friendships between members of the opposite sex when at least one is married is that marriage and family trumps all else, period. His matrimonial status hasn't introduced  any significant element of awkwardness in this relationship characterized largely by comfort, yet there was always a tacit understanding, at least on my part.   Any disquietude concerning any real or perceived lack of propriety in our friendship has been circumvented in the past to a great degree by a  considerable physical separation which was a reality of our relationship. It is possible for two or more people to have what is known as "phone sex," but that possibility in no way characterized the reality of our friendship.  Ours was a simple friendship. I'm feeling especially crushed in all of this because I  felt that I took extra care to show respect for my friend's status as a married man and to his marriage and family. 

The vast majority of communications between my friend and myself have taken place through text messages though we sometimes have held actual telephone conversations. My friend mentioned to me relatively recently that the two of us should speak, as in to hold an actual telephone conversation versus to communicate via text messages, concerning physical symptoms of ailments each of us suffer for which some of the symptoms of the two are in common.  I  noted a few times in the days immediately following in which I would possibly be available to talk by phone, then noted that I had no idea what my schedule would be like following that.

A text discussion concerning a third party -- a person considered to be erratic at best by those in the know concerning such matters -- ensued.  (In a matter that is really neither here nor there as absolutely no one other than the two of us would care about the details concerning this, we disagree concerning details related to the matter. I don't like to be one of such people who always HAS to be right because I find such people to be most obnoxious, but in this case, I AM correct and have proof. I erase my own  personal texts and those connected for the purpose of preserving the privacy of all, but a nurse texted with my friend using my phone. I never saw the text she sent until recently, much le'
other wma " sort of relationship, you're not the only woman to whom it sounds as such. Keep in mind, please, that our friendship is NOT an "other woman" relationship nor will it ever be, nor would I ever allow myself to be anyone's other woman. I'm giving my friend the benefit of the doubt in assuming that he , neither, has any desire for anything extracurricular by way of any sort of  extra-marital relationship, at least where I'm concerned. No man ever does. I'm simply not that attractive, and I am speaking from my rational self and not from any part of a martyr complex I may possess, nor am  I including this opinion so that others will comment "No, Alexis; it's NOT true! you really are pretty and thus salvage my ego. It's merely that I'm not on any sort of equal footing in this friendship. I understand his need for discretion, as despite the benign nature of it all, perception can be everything where one's spouse and children are concerned.

Because my friend had earlier proposed a telephone conversation, I alluded to it in a text exchange.  Because he had only recently suggested a telephone conversation, I followed up regarding how that telephone conversation was supposed to work. His response was something to the effect of, "If I want to talk to you, I text you and ask if you have time to take the call. If your answer is yes, I call you." Period. Pardon my if I admit to feeling only the most of limited if any relational reciprocity whatsoever under this system. While, I get that he is the partner in our friendship who stands to have a spouse whose feelings could be hurt by random telephone calls, still it seems to be a friendship that is on nothing close to equal terms. If he desires to talk to me -- even if he says he does, then forgets that he ever said anything to that effect -- it's his choice to text me or to call me (occasionally he does not text first, though typically he does. If I were to really want to talk to him, the best possible answer as I can see it would apply is, "Tough shit,"  though I was never told such in so many words. My feelings were bruised by the callousness of the handling off situation, and left me in doubt as to my status a a friend to this person.

For some reason -- and I do not entirely rule out misperception or hypersensitivity on my part --  I felt an immediate impression of relationship-oriented awkwardness to my having mentioned the earlier suggested telephone conversation. I was left with the feeling (again, which may have been nothing more than a misguided feeling on my part) that I was in some way being considered a pursuer or an aggressor of sorts, though the telephone conversation had not been my idea in the first place  My friend did not directly accuse me of any such thing, so I cannot unilaterally blame him for this or for any other feeling on my part. Still, it was a most uncomfortable sensation.  I was left feeling as though I might somehow unwittingly or unintentionally be considered to be chasing the man, or at least, for lack of a better descriptive term,  creating the impression of doing such. This is an action in which I simply do not engage. even in kindergarten, when some little girls chased boys around the playground, I wanted know part in such activity and considered it beneath my dignity.

I immediately dropped the topic of any telephone conversation.  Times attached to text messages are unclear; I don't recall when either he or I last sent a message to the other.  It's been longer than twenty-four hours, but we've never made it any sort of point to message each other on any sort of a regular basis. The interval between our most recent text messaging is not of significance. On the other hand, if I even as much as exchange a text message with this person again, which will not happen unless he initiates the exchange, I certainly will never again broach the subject of a telephone conversation between the two of us. 

I suspect I've somehow, by my reaction to this situation, convinced my friend that I am more emotionally needy than to be  worthy of his or anyone else's genuine friendship. We all know too many basket cases in the flesh to encumber ourselves with those slightly shaky individuals who have somehow managed to attach themselves to us through the cyberworld. I've certainly found such characters out their in the vast online world myself. We all have enough questionable people in our real worlds without taking on the unstable cyber-population among us. My mom tells me my friend is too busy to waste his time assuaging my ego. She's probably right. Live and learn.  

I'm reasonably certain I never in my own mind built up the intensity of our friendship in my mind to a state it existed beyond what it was in reality.  I never harbored any illusion that my friend would be the officiant at my own wedding ceremony or that he would surprise me by unexpectedly showing up at my medical school graduation.  I always knew my place in the grand scheme of all things relational, which would have placed me in terms of priority behind my friend's immediate family, his extended family, his real friends, his co-workers, he lowest of his low subordinates,  his closest cyber-friends. his bookies, his hair stylist, those who remove his trash from the designate receptacles regular, yard waste, or recyclables from their designated bins placed on the streets, probably his mail man, the technician who schedules his prostate exams, his usual FEDEX deliveryman, and his pest control person as well. Still. I feel somehow cut off by his responses to my questions.. Following my recent romantic breakup, this all happened at a time when, emotionally speaking, I could ill afford to be discontinued in the manner in which I was by someone I had considered a good friend.  The pain isn't literally killing me (I admit to a pet peeve concerning use of the word literally; were the pain I suffer literally killing ,e, I would be either dying in a hospital, or holed up in a corner somewhere, most likely bleeding out. In any event, I wouldn't be typing my "woe is me" story so that I might have the sympathy of all who read it), but it I can honestly admit that the pain makes me want to dig a hole, crawl inside it, and cover the top with a  heavy board, leaving enough air so that  I can breathe but not to allow any light or extra air inside.  Emotional pain isn't as unlike physical pain as those who have lived truly charmed existences would ever know.

I cannot know everything that has gone on nor presently is going ion within my friend's marriage, nor do I have any need to know. Perhaps my friend is wise to snub me at the present time. His  feeling ever so slightly insecure in regard to his  friendships with other females at the moment (assuming the insecurity extends to friendships with females beyond myself) may be for reasons quite logical to anyone in possession of all the facts. Maybe the wife, were she to know of my existence,  would have visions of me as being some sort of young femme fatale, as opposed to the more likely scenario that, were I to be introduced as the love child of Bernie Sanders and Paris Hilton, who unfortunately emerged looking a whole lot more like Bernie Sanders than like Ms.Hilton. (As a saving grace in this fictitious debacle, were I the product of such a union, my intellect would have to be said to more closely resemble that of Senator Sanders than of Ms.Hilton. ) Few to whom the story would be told would be unlikely to have reason to question the account of my parentage. It's far more plausible that this particular story of immaculate conception would have a ring of truth to it that would any of the other  immaculate conception stories that have come about in the past two millennia, give or take a hundred years. For that matter,  no one ever suggested that the conception necessarily occurred immaculately. Ms. Hilton hasn't always been discriminating with regard to her choices in coital relationships.

The situation is not improved by the reality, to me anyway, that at least one mutual cyber-acquaintance and probably a few real-life ones as well would and/or will be most pleased and/or amused by this recent development. Adding publicity to humiliation typically only serves to intensify it. I know this very well. I  was, just about a month ago, unceremoniously dumped by the guy I was dating, who was arguably the best-looking male in our cohort. I'm still the souce of many jokes over that incident, with many casual observers wondering what a man so handsome would ever see in a female who looked the way I look.. Some days it's all I can do to force myself to  leave my condo in the morning for work.

Meanwhile, I must finish my subinternship, the remainder of the this academic year, then ultimately my internship and residency, and I must do it without unnecessarily bogging down any actual friends I've been lucky enough to hold onto, because they also have their own problems with which to deal, and they will not continue to be my friends if being in my presence does nothing except to drag them down with me. Three-and-one-half years ago, I would have guessed that life would be some version of smooth sailing by now, which only goes to show just how little I knew then.









Friday, January 26, 2018

Role Reversal, The Times,:They are a'Changing, etc..



I often type blogs when either my state of rest or my state if vision is such that I'm barely qulified to fluch a toilet, much less to write anything that someone else might actually read. A particular day in November was one such day. The edited version reappears here in the event that you saw the original version. http://alexisar.blogspot.com/2017/11/over-river-and-whrough-woods-change-of.html  While I cannot guarantee that the editing job was perfect, as i do have ointment in my eyes, I can verify that the blog does not contain the word covfefe.  

The blog was written an the conclusionof an emotionally taxing day. I don't remember everything about the day, but what I dio remember is that itsevents underscored for me the point that one day -- sooner raher tha later for mny of us -- we'e going to be making medical decisions for our parents. For me, it may be later rather than sooner. My mom and dad are 52 and 53 respecitvely, and they're a young 52 and 53. Still, things happen, and my brother and I may be forced in the positions of holding power-of-attorney and of making ife-altering choices sonner than we're prepared to do so.

It doesn't seem quite right. It was a mere nine yearsw ago, I believe, when my dad snuck into my room in the wee hours of the morning to administer a flu immunixation while I was still sleeping that I had steadfastly refused to be given. His choice had been to hogtie me or to give me the shot before I was alert enough to do anything about it. My response was to wake up the entire neighborhoodeith my screaming tirade. Now, I could be doing the very same thing to him within a relatively short number of years.  

From my point of view, we as humans grow up too slowly but grow old too rapidly. I don't want things to change in this way. I want my parents to remain in the primes of their lives forever. Alas, what I want and what are likely to happen may be two very different things. 

It wasn't all that long ago in the grand scheme of things that my brother was, in a voice laden with both threatening and glee, reminding my parents -- my father in particular -- that he, my brother, would be the one who selected my dad's retirement facility, so my father would be wise to take that into account when making choices involving my brother between now and then. Now it's something even my brother doesn't relish. We both hope it never happens.  It's peculiar how much a person's perspective can change in such a relatively short period of time.


Poop, Glorious Poop: Most of us get past fecal obsession somewhere around second grade, but others of us are not quite so fortunate.




Work life is a bit difficult at the present. Such is becoming a cliche for me, and I feel redundant, guilty, and apologetic for repeatedly reporting my work life as such.

No one is treating me with less than the respect I am due. My working conditions themselves aren't especially arduous.  My coworkers are professional when not outrightly cordial, and they're usually cordial.

I'm finishing up a subinternship that I have already technically fulfilled [and for which I received favorable reviews the first time it came around]  but health issues got in the way of my having given the subinternship what I felt was my very best effort. Instead of taking on an extra specialty by way of clerkship rotation, I elected to put the extra four weeks into another stab [figuratively, not literally; I approach surgery with precision and not with stabbing motions] at at pediatric surgery subinternship. The consensus on the part of my superiors was that the full four weeks usually devoted to a subinternship would be overkill, and that two-and-one-half additional weeks would more than suffice, particularly by virtue of my having passed the rotation with floating if not flying colors.

This all would have been peachy were it not for a major flare-up of ulcerative colitis having chosen this particular time time to rear up [no pun intended] its ugly head.  Some specialties lend themselves to the minor inconvenience of having to quickly excuse oneself and run out of a room to take care of business when a sense op urgency pops up. Surgery is not one of such specialties. Nevertheless, excusing myself is my only option in some instances.

Immodium-type products are far less than optimal for my condition. They typically work too well for me. Most people have the luxury of giving little thought to such issues, but constipation, which can be caused by strong anti-diarrheals, can be not merely inconvenient or uncomfortable, but legitimately dangerous. Constipation carried too far can lead to a condition known as ischemic colitis, less commonly referred to as necrotic colitis. It involves inadequate blood supply to a part of the colon, potentially killing off that part of the colon.  It's not uncommon among the elderly but relatively rare among the younger population.

I encountered my one-and-only  [thus far; knock on wood] case of ischemic colitis when I took a strong anti-diarrheal drug in anticipation of a surgery when I had been experiencing colonic urgency and frequency. I did this without the medical advice of any health professional, which was my first mistake. Even licensed physicians shouldn't treat themselves; medical studentls who do so act with even greater stupidity. Everything still might have been OK had I taken a strong stimulant laxative following the completion of the surgical procedure in which I strongly desired to participate, but I didn't. I functioned under the idea that what comes in must eventually come out, and that constipation is a self-limiting condition.

I was wrong. Twelve days later, following a majoir bleed-out, I learned just how wrong I was. Despite being almost as sick as I ever was in my enitre life (double kidney failure probably left my body in a more ravaged state, but it was a close call between the two) I got off relatively easily, with no permanent damage. I could have suffered all sorts of organ failures in addition to shock and bleeding to death, and probably came within two hours of not surviving. Luck and excellent healthcare were both on my side, and I now live to tell the story.

In any event, my colon is not being especially cooperative in this stint of my medical education. The consensus among my job superiors is that I do not scrub in for a procedure if I feel symptoms coming on. If I feel fine and things change during the course of the procedure, I endure as long as I can, sometiomes making it through the procedure. Sometimes I excuse myself and am then finished for the day and sometimes even for the next day. It's a play it by [r]ear situation. My job superiors are being most gracious in dealing with my infirmity. 

I was able to turn my Hawaii trip into a bit of a working vacation with the cooperation of the hospital professionals there, which gave me the opportunity to scrub in successfully for a few procedures. My only failure there happened right after the erroneous missile alert. Emotional upsets tend to bring on ulcerative colitis flare-ups for me. Still, I completed four procedures while there.

My record here is three completions and one walk-out. During the time I needed off following the walk-out, my SP (supervisiing phsysician) had overheard a discussion between myself regarding a discussion between myself and others concerning the  preparation of a prospective phsysician or physician's assitant in training for the interview process. As the SP's  daughter will join the pool pf medical school applicants next year, it piqued his interest. He has given me the assignment of researching the tiopic among peers and what is available on the Internet, and is giving me credit for my compiliation to compesnsate for any missed time on the job. For this I am most appreciative.

Everything I've discussed here and some of what I have not has created serious doubts as to whether surgery is the ideal option for me as a physician. The correct answer remains to be seen. Fortunately, if my residency option works out as planned, I will finish my program with dual certifications in both general pediatrics and with general and pediatric service certifications (contingent upon sucessful completion of board exams, but standardized exams tend to be my strong suit).

The idea here is that stress compounds my condition. Medical school is stressful. My internship and residency aren't likely to be a walk through Golden Gate Park in broad daylight, either, but the hours of duty in the residency program I plan to rank as my first choice are limited beyond what is customary.  Following the residency, I work however many hours I need to work to pay my bills. I'm optimistic that stress can be managed, and that, if all else fails, I can work as a general pediatrician.

I have another two weeks to strut muy stuff on the sub-internship. Suturing is a particular relative strength for me, and I take every advantage of showing off my prowess in that area. Following the completion of the sub-internship, I have a block of time off. Following the block of time off, I have a single clearkship rotation. I will travel for a portion of my time off, but will return to campus for the all-important Match Day, at which our university holds a ceremeony announcing, among those of us fortunate to have received matches with existing institutions, where we will spend the next phases of our training.  This ceremony is, even more than commencement, the culmination of everything for which we've been working. I'm nervous yet excited and optimistic.  



Saturday, January 13, 2018

Fair Weather Friends and Family



I stayed in bed late this morning because i was sick during the night. my traveling v=compsnion, who had an adjoining room, left early with our shared rental car so tht she could hike elsewhere on the island.  As i was resting in bed after having tossed cookies for hours, an alarming sound came from my cell phone, which was across the from from me. I got out of bed to check it. upon checking, I saw the message pictured above.

I haven't a clue as to where to go on this island to seek shelter. It's not likely that this particular island would be the soecific target of ant ballistic missile, but with Kim Jong Idiot in charge, regardless of the intended target, the missile would be as likely to hit this island as any other. I was alone in a hotel room without a soul that I knew within miles of me. To say that I was frightened would be an understatement.

I telephoned my dad. He didn't answer. i telephoned my mom. She didn't answer, either. I texted both of them, but received responses from neither. I telephoned and texted two aunts and uncles, all with similar non-responses. I messgaed  a close friend. He ignored my messages as well.

My friend doesn't really owe me words of reassurance or anything else. I just thoughr, mistsakenly, it would seem, that we had the sort of relationship in which that sort of thing would be provided. 

My family, on the other hand, does owe me something. I've given plenty of myself to them.

Thirty-eight minutes later, we received through emergency text the message that the earlier message was a "drill."  We've since been told by authorities through the news media that the "drill" was human error. "Someone" pushed the wrong button. if such was the case, why did it take the goons thierty-eight minutes to compose the message that it was a drill, false alaem, or whatever they wish to claim it was? You accidenr=tally hit a button warning everyone in the islands that missile attack is imminent, so you immediately type a retraction. It's not rocket science, and it shouldn't have taken thirty-eight minutes. People on the mainline knew it wasn't legitimate before we did. Speculation is that it may have been a hack and that government officials are reluctant to admit such was the case. I don't know what to believe. They're all a pack of liars.

Regarding the responses or lack thereof from my family and friend, it reinforces to me the concept that a person should expect very little from anyone. If one expects little or nothing, one will not be disappointed ot hurt when little or nothing comes.

As a cautionary tale to "family" and "friends," if you are ever again in need of bone marrow, or if you need a kidney, or even if you need just a few words of comfort during a stressful time in your life, you might not want to count on me to provide it. It's possible that I am the same sort of friend or relative that you are.

Friday, January 12, 2018

How Alexis Came Into Existence



I'm now close to the wettest spot on Earth, but it's not raining. It is a bit chilly, though. Instead of enjoying the beautiful outdoors or taking advantage of the free music, I'm holed up in my room, under the covers of my bed. My parents would be thrilled to know that I spent thousands of dollars to travel to the tropics so that I could stay in bed all evening, but my stomach hurts, and besides, leisure is an individual thing.

Speaking of my parents, I've never shared the sequence of events that led to my existence. i may as well do so now.

My maternal grandmother succumbed to pancreatic cancer the the beginning of summer between my mom's junior and senior years of high school. Then my grandfather's home base as an airline pilot was moved from Nebraska to Hawaii shortly prior to the beginning of my mom's senior year of high school.  Her twin brother was attending an air force academy prep school near Colorado Springs, so he wasn't impacted by the move except that he would be flying to Hawaii instead of Nebraska for vacations -- a prospect that didn't exactly disappoint him. My mom was, predictably less than thrilled, though she recognized that there were worse places than Hawaii to which her father could have been transferred. They quickly packed up, moved briefly to a hotel until they could fuind a suitable house or apartment, and went about the process of finding an acceptable school for my mom.  She wasn't a great fit for any traditional school. Public schools in Hawaii tend to be rough, and the locals aren't typically fond of the white kids, who are referred to as haoles (pronouced howlies). It's not considered a term of endearment there.

As a high school senior my mom was a mere fifteen years old.  Because self-defense wasn't a particular forte for her, public school was off the table as an option. My grandfahter immediately began asking everyone he knew in the area about Catholic high schools. An airline executive who happened to be a trustee at an esteemed private school on the island of Oahu overheard the conversation and mentioned that he had connections with a high-quality private school. He explained that the school very rarely accepted  upper-classmen, but that he might be able to  pull a few strings on my mom's behalf if she scored well on the school's entrance exam.

Where self-defense was not my mom's forte, paper-to-pencil tests were a particular strength.  Her overall test scores were supposedly the highest the school had seen in several years. Once a few formalities were covered, she had scored an admission into what is arguably the most prestigious school in all of the Hawaiian islands . (People for the Kamehameha Schools would almost certainly dispute this.)  My mom finished her senior year with honors, then made her way back to the mainland to attend Stanford University, where she completed dual degree programs in music performance and mathematics. Following her stint at Stanford, she obtained a master's degree from U. C. Berkeley.

My mom completed her master's degree mid-year. Finding jobs isn't always easy in Decemeber and January.  When her former high school administrator called her and informed her of a need for a long-term substitute  at her high school alma mater, she jumped on the offer. She was able to live rent-free at her dad's apartment, and her dad  bought a reliable used car for her. Her teaching assignment was going well enough, though the night life left something to be desired.

Then a father of one of her students asked her about her performing experience. He owned a nghtclub in Waikiki, and needed entertainment four nights a week. The main issue was that my mom was as haole as haoles come, and the tourists who frequented the joint expexted someeone a bit more authentically Hawaiian.  A spray tan, a quick hair dye job, and a bit of practice at the local dialect later, my mom was transformed. By day, she was Miss Erin Fitzsimmons, the music teacher. By night, she was Kalani Kanama, the ukulele- and keyboad-playing singer and hula dancer.  She knew a lot of the songs she would need to sing just from her year in a Hawaiian high school and from her teaching assignment,  and the rest she learned as she went.  She was a hit, and attendance at the night club on the nights she worked rose steadily.

One night, someone in the audience requested the song "Hawaii Aloha."  It's not the usual night club fare, but one needs to please the audience. My mom explained that she would sing it, but that the song was best peformed with harmony. Up jumped a young man who insisted he knew the song and could sing it with her. He was cute, she said, so she took him up on the offer.  He even borrowed a guitar that belonged to a musician who would appear later and provided the accompaniment. Much to my mom's shock, he did actually know the song and, furthermore, was good. He sang a few more songs with her. By then, her set was finished. They went off for a late dinner.  The rest is history. They've been making either music or babies together ever since.


          "Hawaii Aloha" as performed by the Punahou graduating class of 2005.

Thursday, January 11, 2018

Fitness to Serve Versus Right to Privacy



President Donald Trump is scheduled to undergo a medical examination, after which he has promised to disclose the results.  I'm unsure as to how much  to trust the results as disclosed by President Trump, by my pal Sarah Huckabee Sanders, or even by the medical examiner himself or herself. After all, President Trump has already proclaimed himself to be a "very stable genius,"  which I find to be difficult to believe for reasons too innumerable to count. In explanation, suffice it to say that most "very stable geniuses" do not describe themselvs as such.  The only sorts of individuals who might choose to use such words in self description might be members of the Mensa organzation, who  often pride themselves on their supposed high intellect if not their stability as well, and might feel compelled to make such  declarations. Among other "very stable geniuses," it would seem to allow both their stability and their intellect speak for themselves.

Think about it. When is the last time you heard a bona fide genius refer to himself as such? I cannot recall a single time in modern history when such has happened.

As to the reporting of the results of the proposed examination, whether it be physical, mental, or both, who is to share the results, and how much stock should be placed in the veractiy of said reports? Trump himself can say anything he wants or direct any member of his staff to do the same about the results of his medical exam. Whether the facts shared with the public are genuine and truthful information and data or those of a more alernative nature of facthood remains to be seen.  My understanding of the situation is that the president has the same rights of privacy concerning his health information as protected by HIPAA laws as does everyone else in our nation. He can choose to inform us about his health or choose to keep the information to himself. Keeping the infomation to himself could lead to wild speculation and could ultimately hurt his cause should he seek reelection, but still, the information is his to diclose or to sit on.

Perhaps the law is unjust in this instance. Perhaps we as the public have the right to know if our president  is facing a terminal illness or a chronic illness that might affect his outlook. If, for example, he's not going to be around for long to deal with the after-a=effects, his decisions concerning the use of nuclear weapons could be skewed. Furtherore, if he suffers from a neurological condition impacting reasoning, memory, or thought processes otherwise to the extent that his cognitive functioning might interfere with his ability to carry out the functions of his job, I'm of the opinion that such is something the public has the right to know.  My opinion notwithstanding,  laws presently standing prohibit the release of such information. The nation's only protection from such a scenaeio is the Twenty-fifth Amendment to the consititution. We could only hope that those working closely with the president would recognize the signs of such impending decline and would be able to put partisan politics aside for the good of the nation.

The Twenty-fifth Amendment represents an extreme scenario. What is far more likely to happen is that the physician or physicians conducting the exam might possibly point out areas of concern, either physical or mental.   It would be then up to POTUS to take this report and use it to his advantage. He cuold choose to report it in full, to report the parts of it that support his self-proclamation as a "very stable genius," or to lie about the report in its entirety.  This is the latitude with which I take exception.

I am presidently vacationing in a tropical region. If the Supreme Ruler of North Korea were to launch nuclear weapons in the direction of the United States, while his weapons might not reach the mainland of the United States, it's more conceivable that they could reach the region in which I am presently vacationing. This gives me cause for pause. Forget that for a moment, however, as I delve into more pressing matters.

While I can  reluctantly go along with  the President of the United States holding the same right to privacy wth regard to health information as does every other citizen of this nation, I dispute his right to specifically prevaricate in terms of reports of his health. I believe that if he chooses to share the findings of his physical examination, he has an obligation to do so truthfully. I believe that it is the obligation of the practitioner or practitioners who performed said examinations to set the record straight if  the president is less than forthcoming in sharing the results of his health examination. While such is presently illegal and could result in the loss of  the physician's or physicians' license(s) to practice medicine, i feel that such should not be the case.

Kim Jong Un, as does our chief executive,  probably proclaims to his people something to the effect that he is a very stable genius. Do you believe such to be the truth? Most likely you do not, nor do I. Merely stating something does not make it true. In some cases, the actual statement makes it less likely to be true than had it never been verbalized.  What is the need for such a statement to be made? Usually  such "truisms" are stated only when the subject has had reason to be called into question.  I personally question both the intellectual competence and the emotional stability of both Kim Jong Un and Donald Trump. The fact that both are in control of nuclear weapons is a daunting prospect. Perhaps physical (including neurological) examinations as well as those establishing mental competence are in order, and perhaps the results should not be protected by HIPAA laws. While being President of the United States affords certain priviliges, perhaps responsibilities should accompany those privileges, and perhaps proving one's vitality and stability should be among those responsibilities.  The stakes are too higb for such not to be the case.

Wednesday, January 10, 2018

Hallelujah and Praise the Lord!



My devices are finally working properly and i am no longer locked out of my accounts. I can now continue my tropical vacation with peace of mind.