Thursday, July 29, 2010

Good for you!!! And good for you, 2!!!

What to write, what to write...ah, yes...write what I know...which is very little...write WHO I know may just work better. Ideas and Ideals come as easy to us as dreams--but to confront in order to understand, not to combat, that's a gift and skill we covet far too little.

Actually, I recently got into a stream of thought about "What is good" and "Who is good". First off, "He hath shown you O man what is good/and what does the Lord require of thee/ but to do justly and to love mercy and to walk humbly with our God." -from the song from Micah 6:8. So it helps me to come to the table with the attitude that I am "without excuse." When we claim no longer to be able to identify the good things, that is a choice, never an inevitable conclusion. What it means is that we no longer have any taste or desire for the good, and that is a learned response or a jaded response or both.

More difficult and personal is the question, Who is good? If one has any access to one's inner thoughts or dreams, as in the recent movie "Inception", one must give up on the notion that, "I am good, that's who's good!!!" As absurd as this looks on paper, yet we still most often act as if it were true; then there is an even a more absurd thought/action, "Well I may not be all that good--but I'm always right!" As in the tee that states, "You have every right to my own opinion!" And in honor of the absurd we both see and know, we begin to stop trying to achieve "the good"--which is not, sometimes, a bad place to start--or re-start!

Most difficult for us, esp. Christians, is to understand what Jesus replied to the Pharisees and Sadducees. i.e. "Why do you call me good?" Humanists often seize on this as proof that Jesus was a "good" (by what standard???) teacher but not God. The following sentence doesn't make it any easier for humanists or Christians but is ideal for the Deist, i.e. "God alone is good."

But do notice that Jesus did not deny being good any more than he denied being God. Because his questioners were not interested in His answer anyway, Jesus went straight to the Jewish method of answering questions with more questions, in so doing not only contradicting the questioner but exposing his motives as well. The person who starts to question Jesus with the preface, "Good teacher,what must we do....?" was and is usually speaking ironically and possibly sarcastically.

The motive is to dismiss Jesus and thereby dismiss all assaults on our self-made righteousness, which I would claim is a universal human response.

Jesus started with the assumption, and complete knowledge, that these men were in fact plotting to find an excuse to kill Him. And no one knew that better than He did, who also understood what is really Good, not just pleasant to all-too-human ears,the feelings of men, and our religious reflexes just to name a few.

Men in general try to, as Einstein observed, "Dismiss Christ with a bon mot."(my paraphrase) But, we usually say let's just do it, and the sooner the better, lest we be forced to deal with our own inadequacies, and our contradictory lust for Godhood and absolute autonomy, the latter being the greatest of all obvious lies, since we have never been autonomous at all, even at our "inception." Hence it would be better if we abandoned the insane attempt towards absurd levels of autonomy, for which we are so obviously not designed, and attempt rather what the AA slogan says,"Look for The Good", which, with the help of the Designer, is actually a reasonable goal."And your reasonable service."

Isn't Jesus GOOD?

Saturday, July 24, 2010

Papa sang bass--Med School Tales Part III

I supp hose that there may be readers out there who would like me to stay on task, so here goes--I am rained out of the great outdoors soooo



It would only be appropriate to throw in the mention of the fact that, by virtue of my girlfriend and her mother, I was somewhat peripherally involved in a form of religion for about 4 1/2 years while all this was going on. It was based on the philosophy of Rudolf Steiner who was at one time a student of Annie Besant, the woman who founded Theosophy, one of the first successful British movements to embrace Eastern religion, with total rejection of Christianity. Dr. Steiner felt this was entirely inadequate but was still drawn to mysticism and eastern concepts; so his reaction was to found a philosophy called Anthroposophy, which is an attempt to merge Eastern philosophy and Christianity and science, by means of what he called spiritual science, and that involved clairvoyance, which was a pretty big deal at that time in Europe. It was actually an outgrowth of Gnosticism and repeated all the mistakes thereof, perhaps unknowingly, perhaps knowingly. In order to obtain higher knowledge, it was a matter of working towards it, in the usual religious manner of hoisting one's self up by one's own bootstraps and/or petards. In this way an elite is theoretically formed by works, a kind of a priesthood, but not of "all believers".

To my mind all of this is reactionary to the Person of Christ, if not the religion called Christianity, or perhaps both. The desire of probably all of us to belong to some ultraknowing in- group may be universal as far as the human race is concerned. Not once during all this time was I led to acquaint myself with the concept of Grace, all I knew was the tune, not the words much less the reality. At any rate, I am not unfamiliar with religion, both conceptually and experientially. As to the supernatural, I never did attain to any thing like clairvoyance but I did ask God to break in on occasion,albeit in my usual pushy and inappropriate manner. To say that this was undermotivated and halfhearted would be understated!

Some of you may be acquainted with Esperanza Schools, which are Steiner's most notable legacy and his most widespread currency of influence.

Meanwhile, back at the ranchero de Guadalajara, I was pressing said girlfriend to get me an early interview with her medical school, Chicago Medical School, in hopes of gaining an early entrance to avoid Vietnam and Mexico both, as well as get back to the girl. Even though I was learning a lot, much more than I knew which would eventually be most useful (Spanish), I did not want to do a second semester at the Automata.

Amazingly enough, she actually managed to do this so that I was actually able to get an interview and an acceptance while I was still in the United States for Christmas vacation!!! I suppose it didn't hurt anything that there was a profound Jewish influence at this school, so that Christmas vacation didn't get in the way very much!

Thus, I never returned to Mexico except for a brief vacation in Veracruz during my semester -long sabbatical that was to follow. The next six months were filled with activities such as getting interviews with the University of Illinois and Loyola, both of which went very well for some reason, unlike my experience at Stony Brook a year earlier. It was also six months of intense independent study. I found one of the first programmed texts, ironically on neuroanatomy, which gave me a very solid education on my own brain, at least as much as we knew at the time--compared to now, not very much. I am one of the few to graduate from medical school with almost no acquaintance with any cadaver! But I am getting ahead of said self...
Next time: THE TEST

Tuesday, July 20, 2010

When in doubt...

Here are a few excerpts from a letter of CS Lewis dated February 24, 1961 to Mary Willis Shelburne:

"... And as the comic Beatitudes says,' Blessed are they that expect little for they shall not be disappointed.'" -- Apparently Mary was getting married....

(I have been using this in modified form since I was at Northern Illinois University in 1967. I have not heard it very much since so I began to think it was original with me. Double rats! On the plus side, it actually works pretty well in many instances. Universal application is contraindicated.)

Resuming the MS:

"I hope and pray you will be able to do them some good, but probably if you do, it will not be by any voluntary and conscious actions. Your prayers for them will be more use. Probably the safe rule will be,'.When in doubt what to do or say, do or say nothing.' (Moriarty: "Curses, foiled again!" Stop)

"I feel this very much with my stepsons. I so easily meddle and gas: when all the time what will really influence them, for good or ill, is not anything I do or say but what I am. And this unfortunately one can't know and can't much alter, though God can. Two rules from William Law must always be in our minds:

1. 'There can be no surer proof of a confirmed pride than a belief that one is sufficiently humble.

2. I urge earnestly beseech all who conceive they have suffered an affront to believe that it is very much less than they suppose.' "

And finally for my father and all cat psychologists:

"I hope your vet is not a charlatan? Psychological diagnoses even about human patients seem to me pretty phony. They must be even phonier when applied to animals. You can't put a cat on a couch and make it tell you what it dreams or produce words by free association. Also -- I have a great respect for cats -- they are shrewd people and will probably see through the analyst a good deal better than he would see through them."

(And if you think there is a great deal of consistency between "scientists" of the behavioral kind in regards to the diagnosis in any given individual I have some interesting studies to share with you! It really still depends on the atmosphere of the moment and on even more so on what the patient wants you to believe. As I've said before, usually people are either exactly what they say they are or the exact opposite. Telling the difference is opaque even to the most brilliant, or should I say, especially to the most brilliant minds who have a far greater capacity to rationalize and deceive themselves than the rest of us.)

Monday, July 19, 2010

Message from Moriarty

I keep wanting to share this but forget:

The best take on Sherlock Holmes is of course done by John Cleese in "The End of Civilization as we Know It."

The best joke, and the worst one in the movie are all rolled into one. Famous diplomats are being picked off one by one starting with Henry Kissinger. The heads of all the famous detective agencies are gathered together to solve the case. They even consult a primitive "Hal" the computer, then shoot it because it was too sarcastic.

Finally they hit upon a plan. They know Moriarty is somehow involved in spite of being dead; and they know that Moriarty would stop at nothing in order to rule the world.

So, the plan is "We do nothing. Because if we do nothing......... he'll have to stop at it....."


so glad I got that off my chest

Tuesday, July 13, 2010

Med school tales Act II

When we last left our gyro he was languishing in Guadalajara, which incidentally would have been a great place to spend a vacation. So far as I know, Vietnam has never acquired that status, so I still considered myself most strangely blessed to be in a place where I could go in my spare time to a Bach organ concert in the local cathedral. Schweitzer never had it so good, but I digress.

I settled in finally into a little "loft" which was in the backyard of an anesthesiologist and which he kindly rented to me, complete with maid service. He was from the "other" universidad but don't ask me how I found this place. It was ideal for someone who needed a lot of privacy; and I started learning recorder and writing poems about my new environment. When I look back it was really an exciting time and place, but I seldom looked at it that way. I was more concerned about getting back with my girlfriend, who was really the only one I was close to at the time. In my "adventures" I have had the tendency to move around a lot and not get much involved in non-romantic friendships.

(This kind of nomadic detachment is fabled in song and story--"So long its been good ta know ya/but I gotta keep movin' along" --gee thanks Woody that's such grate ad vice-- but I have always felt it to be more of a character defect, particularly when looking back. It's a Zen thang. Apparently.)

It was good for me to tour the large university hospital where my landlord took me for a day, to see some actual surgery which I had never experienced before. I might have shared with him that earlier in my tour, in a physiology class, I had my first experience with vasovagal syncope, i.e.,fainting. A group of four of us were dissecting a turtle and I was just holding the leg--problem:this was a live turtle and no anesthesia. I felt like a curtain was going down over my eyes, not really dizzy; and the next thing I knew I was in another room with the teacher and many students around me, and my glasses all bent and twisted. Since I now knew the warning sign, I haven't fainted since, but come darn close.

When I was at my host's OR, I was able to come and go as I pleased as long as I didn't touch anything--which I was anything but eager to do,of course! I first looked in on an orthopedic case, and hooks were being inserted everywhere and muscle tissue was being flayed into the air. I lasted only a few minutes then ran back to the dressing room and put my head between my knees. This does work, by the way. I went gack no I mean back to the OR into what I thought would be a gentler scene, which was eye surgery. I went a little longer this time, but considering the fact that I over-react whenever anybody even comes close to my eyes, I'm surprised I was able to stay as long as I did. But the curtain did start to go down on Act II so I fled for a second time for the dressing room of the stars. But by the end of the day I was able to stay through most of an open heart case and even respond to some teasing from the surgeon who seemed quite amused to have me there. (I wonder if he saw me with my head between my knees earlier)

I learned a lot about desensitization that day--and that one day was literally sufficient for the rest of my career. I now understand that people can get used to almost anything, no matter how viscerally unnatural, and can do so in less than 24 hours!!! I had been told earlier that I was much too squeamish to be in medicine, and by my previous lights I was very much afraid they would be right and I would have to seek a career in public health or psych. But after this, I didn't bother to put my squeamishness into my calculations.

So when diabetics tell me that they can't change their diet, which they usually don't, I do for the record sometimes tell this story. I have always figured that if people can stick burning leaves in their mugs or enjoy rotgut whiskey, people can get used to almost anything;any food,any environment or any people group. One of my current reading projects is Dostoyevski's "House of the Dead" which portrays his own prison experiences in Siberia, which so far is really about all the clever ways people do more than just tolerate a dank environment, but learn quickly to profit by it. But there has to be some fair amount of desire and purpose, even just the raw will towards survival will do: but if these simple teleological elements are lacking people perish in even the best of situations, complaining all the while that life is not fair.

to be cont.

Sunday, July 11, 2010

"MY BAD"

I probably should be napping but it's not always easy when you're on call..But I did think of something. Do you know where the sports phrase ,"My bad!" came from?

According to World magazine, it was from basketball pro Manute Bol, in his time the tallest in the NBA at 7' '7". He was also a Christian from southern Sudan whose salary mostly went right back to his home country to build local schools, etc. His English was poor and, "In early practices when he missed a shot, Bol, who never had a formal education and knew little English, told his teammates, "My bad." Players repeated the phrase to poke fun at him, until it spread into sports and then mainstream vernacular."

It goes on to say that Manute, whose name means "special blessing", loved his homeland to death. He prolonged his last visit there too long because carpetbaggers from Khartoum were buying votes in the south and he wanted to stay long enough to make sure that the elections were fair. He was well known back home especially for his generosity, and was given the "special blessing" of considerable influence with his poor neighbors who were sorely tempted by the well-fundedJanjaweed bosses. But his kidneys began to fail and a medication given in Nairobi caused a fatal reaction. (Our bad.)

I was considering earlier the title of the Francis Shaeffer book, "No Little People" when I came across this. I don't know how many times I have felt jealous of people who are taller, stronger, more attractive to the eye, more talented etc. It's pretty much a known fact that musicians, say, who are short and fat, will have to have 10 times the talent of their taller competitors to be able to make a dent in, say, "American Idol".

(This is of course is a generalization, but my whole modus operandi is by default statistical. The individual application is the hard and uncertain part. So if I seem to veer crazily between extremes, that's how doctors do it!)

An older and struggling English band, The Alarm, put out an album portraying themselves as young people/male models on a new album cover and the same work they had been doing as a "mature" outfit put them right back on top of the hit parade! (Great at Cornerstone, and with a great point too.)

But if there are no little people, does that also mean that there are no outdated people? No ugly Betty except in our prejudiced eyes? Does this not mean that jealousy and certain types of competition are roughly equivalent not only to real and possibly lasting idolatry, but also declare that God is not to be trusted? And that "fair" does not exist? It's only logical that what is right and fair to God would necessarily seem grossly unfair to us. We just don't get it and maybe never will.

Logos, right?


Obviously even the tallest most gifted of people can not only be humbled but choose humility as well. Knowing only this little about Bol I can't presume to say much more. But like Bonhoffer, he returned to where God gave him life, and knew how sick he was getting, and stayed anyway. Now, that's a Big man!!!

Friday, July 9, 2010

Med school tales part 1

Meanwhile, back at the ranchero................we join again our rank hero.....

Life got very busy recently with the rapid onset of many admissions, so it hasn't been very easy to communicate even on Tuesdays. But over our long weekend in Green Bay, that great city of the North, I got to thinking about how I got into medical school, by a very strange and circuitous route which very few people know. It might make a good story for some even though I am not much of a storyteller.

Flash back to the Vietnam era. With the urging of my girlfriend at Shimer, we both applied to various medical schools but she requested that, Shimer being such a small school, that I not compete with her for the "easy" -to- get -into med schools, i.e. the Illinois schools, her theory being that they would only take one of us. It may not have ocurred to me that I would not be accepted so I applied to out-of-state schools and even Canadian schools, thinking that surely I would get into one of them. I was aware that the competition was stiff because acceptance into medical school would defer being draft eligible for up to six years or more. But only for males of course. Perhaps I was not appreciative of how many people were applying, many of them for exactly the same reasons that I was applying. When I was turned down by all the schools, I was summoned to Chicago for my armed services physical and passed with flying colors, being declared 1-A. Therefore I did what many Americans were doing, and enrolled at the autonomous University of Guadalajara , a very easy school indeed to which to gain admission. The only problem was that I had to move to Mexico!

Not a good thing for a true romantic!! To say that this changed my life would be an understatement. It in fact changed all my relationships and it certainly did not feel good at the time. But as a test, it excelled. I would not have gained any fluency in Spanish without this experience, for one thing. This alone changed the character of my future medical practice to a profound degree. But there is much more than this. I will have to serialize this experience in order to do it justice. More later.

Friday, July 2, 2010

"In" "Dependence"

For those who may not no: a word very often found in medical records is "noncompliance": there is even a code for it, one of the few I have memorized:V15.81.Rare is the day when I cannot apply that to at least one patient; in fact if I think about it, I don't know that I know anyone who is 100% compliant with my orders much less my strong suggestions! Which is a good thing in many cases; it keeps the multiplier effect from amplifying my mistakes and misapprehensions. But in many other cases, it leads to the ER, the hospital, and not infrequently, death. ("premature death" is a very iffy concept in the big picture. But those of us who believe in the validity and efficacy of choice tend to at least value human decision-making.)

Like many terms in science, this word "noncompliance" has more than a whiff of the Absolute about it. I prefer the word-if there is such a word- "hypocompliance". Just as it is hard to find a person who is totally compliant, it's equally hard to find a human being who has absolute zero redeeming aspects, or who is 100% wrong all the time. We use truth and the idea of truth all the time;but not fully;we are very selective, like our memory and cognition in general--by necessity as I have said before.

Likewise, "sin" is a much broader--yet much more specific--term than we care to apply. Sin is what other people do, right? Jesus was rejected by his hometown and even his brothers when he quoted Isaiah one day, and reminded the people that God healed a Syrian leper but no Israeli ones. What are you saying, Jesus? That I'm not good enuf? That my grandmother isn't good enuf???!!!

So God Himself had to preserve His Son from a "premature death" in Nazareth, from the crowd crowding him to cliff's edge.

"Sin" is often defined as "missing the mark." to somewhat soften the meaning and to usher it into the category of understandable mistakes, made by basically good and well-meaning people. I'm less and less sure that this is adequate; it certainly has no odor of infinite offense to it, much less of proportionate consequences. There are times, in the big picture, wherein hypocompliance becomes absolute noncompliance. When doctors play God or substitute themselves as gods, they take over Absolute--and rather unforgiving--terms that really apply only to God and to no one else. And many other prerogatives we take as well, according to the God-vacuum so many of us have, in God-terms--such as, "It doesn't get any better than this!"

The world also now casts the word, "dependency" into the same bed as many other things that seem evil not only to the secular mind but to all who practice "practical atheism" and breathe deeply of the fogs of nihilism as per Flannery. But as Dylan pointed out once, we are all utterly dependent, and usually we choose many masters and many teachers and much family depending--there I go again--on our felt needs at any given moment. "Independence" when one really considers it in the human sense, is not only relative but truly is only a theoretical concept, rather like absolute zero in physics--in more ways than one.

"Independence Day" therefore is about as meaningful as the movie of the same name. "Hubris Day" would be far more accurate.

Happy 4th of July then;and happy third of July to my Dad, also, who'll be x years old in the AM. May you score triple digits and the triple word box score as well!!!

Hasta Martes-maybe

Thursday, July 1, 2010

O BY THE WAY

If anyone would like to see pictures of these cartoons or who would welcome relevant photos in general, I would be happy to transmit them by phone to your addresses--but since I don't know what they are, and I don't want to be nosy, if you would like to receive pix, you can give me the desired email etc. address to my phone, which is
wschuler@ vzw.blackberry.net.

If anyone knows any easier way to do this, I would love to know how to post photos on the blog itself, but so far no one seems to know.

I would also like some feedback on the background for the blog. I find that white on black is easier on my eyes and more in line with my personality, but there are thousands of others, so if you would like to see a change, please let me know!!! I always welcome suggestions--as I tell my patients and colleagues alike. And even administration!

Don't skip previous post, also new if not "fresh!"

Freedom--from what? For what?

I have noticed that the New Yorker has developed quite an interest in religion. Perhaps it is like what CS Lewis said about devils. There are two errors that one can make, the first of which is to disbelieve in them entirely which would be the Christopher Hitchens mistake; the second error is to believe in them and to have an intense and unhealthy interest in them. In fact, in some Christian circles we refer to a "spirit of religion," as being a pernicious influence meant to distract and draw some away from Christ Himself or perhaps even more significantly, the Holy Spirit Himself.

Anyway, one of the lead cartoons in the last issue shows a group of parishioners coming out of church with those big foam mitts pointing skyward emblazoned with "#1" and a woman is talking to a man with an Elvis hair cut and a mismatched suit and tie, saying, "It's true-- we totally have the best religion!"

The point is made by exaggeration of course, I have never seen anything like this in church or outside of it -- but Americanism tends to wave flags and banners and when Christ is crucified afresh by being made the equivalent of our favorite team or gridiron hero, Americanistic Churchianity seems to deserve all the scorn due to it for being idolatry.

I have found that religion is only mentioned twice in the New Testament and half of those references are not favorable! James basically says that religion is limited in scope and has to be judged by its fruits not by its doctrine. Therefore, not too many churches really talk about being a religion at all, especially in these days.

On the other hand, even a brief survey on Internet strongly suggests that Islam would say exactly that -- that they are the best religion and do not mind being regarded as a religion, and as religious or even super-religious. There are unfortunately many inside and outside of churches who say, "Lord, Lord!" to whom Jesus must eventually say, "I never knew you." If this does not give a religious person pause, I don't know any stronger way to put it.

For all the interest in religion, I do notice that the New Yorker does not print cartoons about Mohammed or Islam. Interesting. They do not seem to have the same bravery as, shall we say, "South Park", who, to be fair, also mock Jesus and take pride in being a "team" who mocks everyone equally. This also sounds like a religion to me -- they believe in the show! And they certainly live for it!

Christopher Hitchens, naïvely, seems to think along the lines of Voltaire and that "freedom from religion," is actually an achievable goal-- by human effort alone. It seems wise to abandon this train of thought which is almost akin to saying that religion does not exist, only ignorance and anti-scientism. And to maintain that the world is less religious than it was 50 or 100 years ago, or since Darwin, Marx, and Freud, is quite easily disproven. But to say that most of religion per se is reactionary may be closer to the point; mainly a reaction to our own inadequacies and our drive to seek interpersonal approval for our "good works." But also to say, "That's all there is, folks," is equally reactionary and equally religious, not based on evidence or logic but simply the heartfelt desire to be autonomous and accountable to no one, as we see in "The Plague." -- In virtually everyone, thief and doctor alike. Christopher Hitchens does have a particular dislike for Islam -- but he seems to be getting over it, under pressure from his colleagues. But does it not seem ironic that the New Yorker supports Salman Rushdie but dares not imitate him--esp. in the cartoon section. The Danish debacle and the murder of Master Van Gogh in the Netherlands has had a palpable impact on the "nether lands", has it not?