Vietnamese Communal Street Culture

A typical small street in Saigon with mom-and-pop shops

One of the amazing parts of Vietnamese culture is the "night scene." As in many societies - perhaps because of a lack of air conditioning and lighting - people typically take to the streets in the evenings and then retire early. In Vietnam this daily routine is codified as arising one or two hours before sunrise, starting to work about 6 - 7 am (sunrise), taking a siesta in the middle of the day, returning home about 5 - 6 pm, and hitting the streets. Because of the now "stable" electricity (rolling blackouts are the subject of another day), people often stay out past dark, but in general, the country goes to sleep about 9 or 10 pm.

Saigon stays out a little later than the rest, maybe due to the expatriate influence, greater electric stability, westernization - who knows. Anecdotally, the majority of people in the city still go to sleep at 9 or 10 pm like the rest of the country, but their are enough people in the city that a vibrant culture from 10 to midnight still exists.

A "hẻm" (small alley) during the day where most people live 

This street scene is enhanced by the communal nature of Vietnamese family culture and the living proximity of people in the country. Vietnamese society, like most Asian societies, live in large family structures. Typically three or four generations in a household. This creates a large network of closely related people to interact with on a nightly basis. Also, it manifests itself in gastronomical ways: family dinners are usually social affairs where many dishes are placed in the center of the table for people to share as they talk and joke.

Vietnam has a population density of 280 people per square kilometer, according to the World Health Organization. Ho Chi Minh City has an even higher population density - 9450 in 2006 - and according to Vietnamese research, the inner city (old Saigon) has approximately 30,000 people per square meter!*

The same alley alive around dusk as everyone comes home 

*In comparison, the United States of America's density of 34 people/sq. km, and the two most dense cities - Washington D.C. and Los Angeles - have densities of 3886 and 2750, respectively.

What all this close living does is create not only a "night scene" as thought of in America - clubs, bars, restaurants, etc. - but a small community "night scene" with local alleys (hẻm) alive with children running and playing, women gossiping, families and friends eating, and old men drinking coffee or beer and playing chess. These "micro-communities" are the true social structure of Saigon, and any visitor would be remiss to not experience it.

The flight over

Korean airlines is the best airline in the world. I hear that Singapore Airlines is wonderful also, but Korean Air is top dog. My wife says I love them because the stewardesses are hot. She is correct ( they employ incredibly good looking people), but that is not all. What sets them apart from the rest is their customer service.

Flying over this time was as enjoyable an experience as 37 hours of travel can be. I had an aisle seat near the rear of the plane and received prompt service for all my needs. More to the point, a few rows ahead sat two families with small children about the ages of my two. One family was just a mother and the kids, and I couldn't help remember my wife's ordeal with bringing our two to Vietnam just two sort months earlier, and how it was made light by the helpful staff.

Many times I saw a steward or stewardess sit with the children while mother stretched her legs or use the restroom. Nobody complained when the toddler got tired and cried. Instead, they immediately brought games, things to help the child sleep, and offered in any way possible to help the young mother in her defensive efforts.

Consequently, thirteen hours later, an entire plane unloaded happily, and with sanity and hearing intact.

Years ago, when taking my son as a baby, Korean Airlines helped us with formula after an idiotic Vietnamese official read a poorly translated copy of international flight requirements. Then, when his bad parents let him fall out of the bassinet, they helped us get to see a physician in the airport to make sure he was OK and not have to worry about flight arrangements.

So yes, Korean Airlines is the best airline in the world ... and it doesn't hurt that they're pretty too.

In-N-Out Burger and LAX

There are few things in life as amazing as a hamburger from In-N-Out. Anyone who has lived in California understands what I'm talking about. I think they secretly put drugs in the burgers because how else could they be so addictive? Seriously, part of the draw is the fresh - almost HEALTHY - taste of their burgers, and another part is the secret menu. It's so secret that even the menu posted online doesn't have everything that they actually offer. Each time I go, i invariably learn something new on the menu.

Well, when I booked my ticket to Vietnam, i realized that I would have about five hours at LAX before boarding my flight for Korea. This had me wonder on Facebook if it was possible to grab some delicious grub while waiting. Thanks to my friend Daniel, who pointed me to a forum about this exact subject, i realized I'm not the first ( and surely not the last) to think these same thoughts.

It looks like there's actually a pretty established way to get there. Following these tips, i walked about 25 minutes with my carry-on, to reach In-N-Out. On arrival, i found the line out the door, and the line of cars out the parking lot. Seems everybody loves In-N-Out. A little ahead of me in line was a middle aged Hispanic woman with a suitcase - i want even the only airport denizen there! LOL.

Of course the food was delicious, and I couldn't have asked for a better finals meal in America. I hear In-N-Out has finally reached Texas. Perhaps I'll be so lucky as to one day see it in Louisiana. We can only hope...

Tam biet,

Home Run by the CDC

Let me join the blogosphere in congratulating the CDC on a job well done. The recently published "Social Media: Preparedness 101: Zombie Apocalypse" is an excellent example of the use of social media to convey a message and awareness of target culture to make the message meaningful.*

The CDC webpage starts with this:

We’ve all seen at least one movie about flesh-eating zombies taking over (my personal favorite is Resident Evil (External Web Site Icon. [rate:6.4] 78,991 votes), but where do zombies come from and why do they love eating brains so much?

...The Zombie Survival Guide identifies the cause of zombies as a virus called solanum.

While I agree that Resident Evil (the first one) might be my favorite movie as well, we need to thank the spread of the Zombie Survival Guide to image boards like 4chan.org. Many meme's start from its sundry (and not all safe-for-work) pages, including the infamous "you got Rick Rolled" meme.

KnowYourMeme.com explains the origins of a now ubiquitous Zombie Survival Sheet on 4chan.

According to the Lurkmore wiki the meme originated from the 4chan’s /k/ board, a board about weaponry, around the late October 2008.
The board began to be invaded by what they called “zombie threads” in which they were asked to give pieces of advice about the best weaponry choice and plan when facing a zombie outbreak. It was usually resulting in a division between those who wrote the most accurate response they could find and those who didn’t believe in zombies, leading to fiery arguments between the two.

...The 29th of October 2008, the meme went to /b/ where another zombie thread popped up. There, the picture began to be reused to fulfill the requests.
It then came back to the /k/ board, having more and more threads created.

Instantly, the meme expanded to other boards and other chans, mainly those that got a zombie board.
That kind of zombie threads, since then, are always present on a regular basis on 4chan as well as other boards.

It's now almost 24 hours since the CDC tweeted about zombie preparedness, and it's still trending worldwide. In the 30 seconds it took to snap the picture, over 100 new tweets mentioning the CDC zombie preparedness guide rolled in.



Two opinions on this PR coup by the CDC:

1. Whomever had the idea for this should get a raise and promotion. Good fresh thinking needed in the government.
2. This provides a great avenue to remind the public that the CDC isn't wholly comprised of staid, stogy professors sitting in laboratories doing esoteric research. It very much is comprised of smart and lively men and women who often live and do very interesting things. They are much more than the sparse natural disaster warnings that we read about.

For example, the CDC Epidemic Intelligence Service (EIS) is a 2-year postgraduate fellowship for applied epidemiology. Eyes glaze over? Let me tell you again. The EIS is a small group of people who leave at the drop of a hat to investigate outbreaks like SARS and Ebolla. They fly INTO the eye of the storm while everyone else wants to get away from the diseases. Pretty cool, eh?

Congratulations, CDC, on a job well done. Now, back to polishing my AA-12.



*I'll also add a shout out to President Obama, who, for reasons he's responsible for or not, has presided over a government that has made progress by leaps and bounds in the "use of social media" and "awareness of target culture" departments.

TweetDeck 2.0 for iPhone

In the new age of microblogging, I spend more time tweeting than blogging. Twitter has become one of the most useful and influential companies in the world, although it has yet to turn a profit.

One of the reasons it has a hard time turning a profit is because it is often accessed by a multitude of 3rd part applications, and one of the most popular is TweetDeck.

TweetDeck smoothly integrates A user's twitter feed and facebook update feed. What it didn't have was a touch-screen friendly, iPhone-optimized interface. So, it was rebuilt from the ground up and now achieves both wonderfully.

I've been notoriously fickle about Twitter apps, preferring to sacrifice Facebook for less crashing, better access to links and pics, etc. with the native Twitter application. I've tried TweetDeck before, but crashes pushed me away.

TweetDeck 2.0 has solved most of these issues and made me an early, but not 100%, convert. However, I've already noticed some no-brainer wants for 2.1.

1. Position support - every other program changes when you turn your phone upright or on it's side. TweetDeck should too.
2. Timestamps - nothing I hate more than opening TweetDeck and not knowing if the "breaking news" tweet waiting for me was a minute or a hour ago.
3. Colors - you have themes on your desktop version. Bring them here!
4. Facebook comment fix - when commenting on Facebook, the screen doesn't scroll with you as your comment goes longer than the screen. Makes it really hard to write.
5. Hashtag bar - TweetDeck has a new wonderful follower bar for adding a twitter handle. Now duplicate it for hashtags.

Alright. Those are gimme additions. Add those and amaze me. For those looking to get onto twitter or get a new app, TweetDeck is on the recommended list.

Happy Anniversary

Thirty two years ago today my parents were married. As all of us married-folk know, marriage is a journey and an experience fraught with ups and downs, elation and depression, wonder, excitement, boredom, and contentment.

It is a testament to my parents' tenacity, strength, moral character, and love that they have made 32 years. The divorce rate in the USA is about half of the marriage rate (3.5 per 1000 people to 6.8 per 1000). And the probability of divorce is staggering.

"The probability of a first marriage ending in separation or divorce within 5 years is 20 percent, ... [and] After 10 years, the probability of a first marriage ending is 33 percent." (Cohabitation, Marriage, Divorce, and Remarriage in the United States. Series Report 23, Number 22. 103pp.
(PHS) 98-1998.)

Most sources quote the average length of marriage to be 7-10 years. So my parents have tripled this, and AND beat the 33% divorce probability at 10 years.

Wikipedia gives us this wonderful graphic about marriage and divorce:



This shows us that my parents chose a great state to live in for their marriage. Texas and east of the Mississippi river have a high proportion of counties with married couples. Conversely, the West Coast is dark blue - divorce! On the other hand, Texas is not the Southeast USA, whose inhabitants clearly have breakup issues, because they are the ONLY part of the country with high separation rates (yet low divorce rates). AND Houston somehow misses the high widow rates of Texas and the Eastern USA (the reason why both my parents are still around!).

And so I say "Congratulations!!" May you enjoy another 32 great years. In honor of your example and accomplishments, I leave you this gift, from one of my wife and my favorite relationship movies:

Vietnam's Succession, Part 2

The comment on my previous post ended with,

Everybody sighs, the price is higher and higher. I hope that in the future i won't take a bag of money to buy a loaf of bread.

Quite telling, because we've seen this happen within the last hundred years in Europe and Africa ... and, to a lesser extent, Vietnam.

The price of Vietnam's mishandled and stymied growth is inflation joined with the VND weaking against the USD concurrently, all within a culture conditioned over the last 35 years to distrust banks and investment in their own economy.

"How does this hit me?" you ask.

For example, let's say you and a friend graduate college and start teaching English on this exact date last year (February 9, 2010). At that time, you and your friend are given the option to be paid in USD or VND.

(Now, you might say I'm stupid, and everyone would get paid in USD, but that partially highlights the lack of confidence the Vietnamese have for their currency which feeds into this problem.)

Your salary would be $8 USD/hr and your friend's 147,759.884 VND/hr at the exchange rate of 18469.9855 VND per USD on Feb. 9, 2010.

Now fast forward one year later. The exchange rate today (Feb 9, 2011) is 19500.0366 VND per USD. Inflated 5.6% over a 1 year period. Or, in other words, you would still be making $8 USD/hr, but your friend would now be making $7.58 USD/hr.

That slight difference ends up costing your friend about $6 million VND per 40 hour work week which is no laughing matter. Your choice 1 year ago nets you $24 million VND MORE than your friend per month.

I hope you treat your friend to a nice lunch every month ...

The real crunch comes because,
1. Businesses understand this phenomenon so they write their contracts in VND in order to take advantage of the VND weakening against the dollar, and
2. when coupled with the general inflation the country experiences as, on a whole, it gets richer, the common worker has less liquid cash than previous, and
3. 70% of GDP is in Ho Chi Minh City, so although you might survive the numbers crunch in the city, few people unlucky enough to be born/live outside TPHCM will have the money necessary to move to the city for education or a better job.

(All data from www.mataf.net)

Expensive Health Care

Over the last year, as we in America have been swept up in political wrangling over health care, and the inherent power struggle between democrats and republicans that is ultimately at the bottom of it all, I have had the opportunity to have a front row view. I sat on the board of trustees for the Texas Medical Association and sat through numerous conference calls and strategy sessions with doctors in Texas, the American Medical Association, and politicians in Washington DC.

For sure the problem with healthcare is multifactorial, and our solution undoubtably must be as well. However, a favorite argument thrown out by both sides is the "cost of health care." One need not look far or read many webpages to hear someone opine about needing to reign in those outrageous costs (and his or her solution). This past July, Veronica Gunn, MD, chief medical officer for the Tennessee Dept of Health spoke to us about this and other topics.

The scare tactic she used was common: put up a graph that shows $12.7B spent on healthcare in 1950 and $2400B (yes, $2.4 trillion) spent in the USA in 2008.

"Holy cow!" you say?

Yep. That's right. An almost 188-fold jump in spending. That's like going to McDonalds and wanting a $1 hamburger only to be told it now costs $188. You'd choke then & there - way before you got the hamburger! Anyone and everyone should rightly be concerned about such a jump.

"Why would the hamburger cost so much," you ask?

Well, McDonalds gives you the standard answer: yesterday we made hamburgers, but our board decided overnight to do a couple things. We now have all new state-of-the-art machines for making patties the same size every time, and a super fryer that makes our delicious fries even more so - and healthier! We've also decided that you have to buy your own buns separately - but only the ones we decide for you to buy (and write you a prescription to get) and the bun makers say they have special no-fat buns that taste good but cost a fortune to invent. Oh, and don't forget the new program to give free hamburgers and fries to everyone who comes in without the money to pay.

You see, we've decided it's immoral to refuse hamburgers to someone who doesn't have the cash on them, so we give it out free and charge you more. But don't worry. If $188 is too much, we'll allow you to pay $40 a month (whether you'd have eaten 40 burgers a monh before or not) to another company who pays us, and then you can get each dollar hamburger for $1.

Now, before we hear the cries of "Health care is a right! Eating hamburgers is not!" I want you to put aside your righteous indignation at an admittedly flawed (but I still think decently effective) parable, and follow me to the numbers.

Ms. Gunn said $12.7B spent on healthcare in 1950 and $2400B spent in 2008. If adjusting for inflation according to the consumer price index, $12.7B was really $112.4B in 2008 dollars.
Now, that's still a large gap, but the 188-fold difference that made your eyes pop out of your head has dropped to 21-fold. Crazy large? Yes. Space-time continuum splitting? No.

Now let's adjust for population. 1950 - 152,271,000 people. 2008 - 301,621,157. That increase in spending just dropped to 10-fold.

10-fold is a lot different from 188-fold.

Essentially McDonalds is saying, "Our hamburger now costs $10 a burger, from $1 in 1950. So, pay us $40 a month regardless of the amount of hamburgers you eat, and you can have your hamburgers for $1, plus, we can give free hamburgers out to people who can't pay for them."

Even if you believe ideologically that you should give free hamburgers to the poor, spending $40/month is a lot harder to stomach when the price of the hamburger is only $10 and not $188. The Democrats and certain special interest groups (including many physician organizations) understand this, so they play up the $188 burger. Health care becomes an easy way to redistribute wealth.

[+/-] read/hide the rest of this post

Which Cause is Mine?

Now that another year of March Madness is upon us, the most common question I receive from people (and myself) is "What cause should I play for?"

Who do I play for this year?

I admit that in past years it wasn't so hard. First was the wanton disregard to human rights in Tibet. So I played for Students For A Free Tibet. Then I was touched on my Pediatrics rotation by the trials couples face losing a newborn, and I found Now I Lay Me Down To Sleep, a great organization that provides photographers - free of charge - to take professional-style portraits of families with their newborns before that young child passes away.

But this year I'm indecisive. So to help me (and any of you in the same boat) here are some resources:

First, a great website I've talked about before is Charity Navigator. You can search for charities there, and the site ranks these organizations based on how efficiently and productively they run.

Perhaps you want to give to an organization to help Haiti or Chile after the horrible natural disasters recently? Follow those links to lists of quality organizations working in those countries.

Also, here is a list of all the organizations represented the previous two years:

Heifer International (winner 2008)
Ovarian Cancer National Alliance
Students For A Free Tibet
Diabetes Research & Wellness Foundation (winner 2009)
Now I Lay Me Down To Sleep
National Alliance on Mental Illness
Autism Speaks
St. Jude's Children's Research Hospital
American Cancer Society
Save Darfur

Remember, you have only until Thursday at noon to fill out your bracket. Do it now so you don't forget! Good luck!

100 Books to Read

Obviously I'm not writing much. Why? Because I've spent the last year and half going insane. About a year ago, I went to work in the research lab and I was talking to my professor, when he made an interesting comment.

"So, it's good to see you looking happy," he said.
"Well, I am. I really am."
"A lot of people have a hard time with third year [of medical school], but you seem to be doing well."
"Umm...I think I really like third year much better than the first two. I feel like I'm really learning medicine, and I get to work with people -- no more nose in my textbooks all day long."
"That's good to hear. A lot of students that move to the wards have a hard time with it. Over my years, I've seen a lot of them crack under the pressure."
"Well, I dunno about that, but we did have one girl drop out a month or so ago."
"No, I mean they really need to see psychiatrists. They just can't handle the responsibility and the change from being a student."
"Oh... That's not me. I'm liking this much better than before."

His reference to people cracking under the pressure rang too true then and now. I've been ruminating over it for the last four days. Mainly, I find that doing medicine all day, every day, kills me. I need a release. Mostly, I need a book to read.

Throughout third year, I longed for the day when I could read what I wanted to read, because it piqued my interest, not because I had to. Even medical books -- I used to go down to the medical library in the Texas Medical Center and read medical journals for fun, because I found them interesting. Now those same journals are a chore, because I'm forced to read them daily.

Things turned for the better when my friend posted a list of 100 books on his facebook page. Supposedly the BBC thinks the average American has only read 6 of the 100. I've read 29. But therein lay my release! I'd been wondering what to read to get my mind off of medicine, and now I'd decided: I would read each book until I'd read all 100.

As my fourth year of medical school got underway, I was amazed at how much free time I truly had. Medicine started to become fun again - outside of the required courses, I could study what I wanted and typically had a little free time to read something outside of medicine.

Trying to find the list online, I ran into some other lists. Every list is a little different, but there are many similarities between them, which I think speaks to the strengths of those respective books.

http://artofmanliness.com/2008/05/14/100-must-read-books-the-essential-mans-library/
http://www.time.com/time/2005/100books/the_complete_list.html
http://www.randomhouse.com/modernlibrary/100rivallist.html
http://www.guardian.co.uk/world/2002/may/08/books.booksnews

Here's one list from the BBC that had the most interesting (to me) books. In April 2003, by popular vote (one person, one vote), it tried to find the most popular book of all time among UK readers. This is the list in order:

1. The Lord of the Rings, JRR Tolkien
2. Pride and Prejudice, Jane Austen
3. His Dark Materials, Philip Pullman
4. The Hitchhiker's Guide to the Galaxy, Douglas Adams
5. Harry Potter and the Goblet of Fire, JK Rowling
6. To Kill a Mockingbird, Harper Lee
7. Winnie the Pooh, AA Milne
8. Nineteen Eighty-Four, George Orwell
9. The Lion, the Witch and the Wardrobe, CS Lewis
10. Jane Eyre, Charlotte Brontë
11. Catch-22, Joseph Heller
12. Wuthering Heights, Emily Brontë
13. Birdsong, Sebastian Faulks
14. Rebecca, Daphne du Maurier
15. The Catcher in the Rye, JD Salinger
16. The Wind in the Willows, Kenneth Grahame
17. Great Expectations, Charles Dickens
18. Little Women, Louisa May Alcott
19. Captain Corelli's Mandolin, Louis de Bernieres
20. War and Peace, Leo Tolstoy
21. Gone with the Wind, Margaret Mitchell
22. Harry Potter And The Philosopher's Stone, JK Rowling
23. Harry Potter And The Chamber Of Secrets, JK Rowling
24. Harry Potter And The Prisoner Of Azkaban, JK Rowling
25. The Hobbit, JRR Tolkien
26. Tess Of The D'Urbervilles, Thomas Hardy
27. Middlemarch, George Eliot
28. A Prayer For Owen Meany, John Irving
29. The Grapes Of Wrath, John Steinbeck
30. Alice's Adventures In Wonderland, Lewis Carroll
31. The Story Of Tracy Beaker, Jacqueline Wilson
32. One Hundred Years Of Solitude, Gabriel García Márquez
33. The Pillars Of The Earth, Ken Follett
34. David Copperfield, Charles Dickens
35. Charlie And The Chocolate Factory, Roald Dahl
36. Treasure Island, Robert Louis Stevenson
37. A Town Like Alice, Nevil Shute
38. Persuasion, Jane Austen
39. Dune, Frank Herbert
40. Emma, Jane Austen
41. Anne Of Green Gables, LM Montgomery
42. Watership Down, Richard Adams
43. The Great Gatsby, F Scott Fitzgerald
44. The Count Of Monte Cristo, Alexandre Dumas
45. Brideshead Revisited, Evelyn Waugh
46. Animal Farm, George Orwell
47. A Christmas Carol, Charles Dickens
48. Far From The Madding Crowd, Thomas Hardy
49. Goodnight Mister Tom, Michelle Magorian
50. The Shell Seekers, Rosamunde Pilcher
51. The Secret Garden, Frances Hodgson Burnett
52. Of Mice And Men, John Steinbeck
53. The Stand, Stephen King
54. Anna Karenina, Leo Tolstoy
55. A Suitable Boy, Vikram Seth
56. The BFG, Roald Dahl
57. Swallows And Amazons, Arthur Ransome
58. Black Beauty, Anna Sewell
59. Artemis Fowl, Eoin Colfer
60. Crime And Punishment, Fyodor Dostoyevsky
61. Noughts And Crosses, Malorie Blackman
62. Memoirs Of A Geisha, Arthur Golden
63. A Tale Of Two Cities, Charles Dickens
64. The Thorn Birds, Colleen McCollough
65. Mort, Terry Pratchett
66. The Magic Faraway Tree, Enid Blyton
67. The Magus, John Fowles
68. Good Omens, Terry Pratchett and Neil Gaiman
69. Guards! Guards!, Terry Pratchett
70. Lord Of The Flies, William Golding
71. Perfume, Patrick Süskind
72. The Ragged Trousered Philanthropists, Robert Tressell
73. Night Watch, Terry Pratchett
74. Matilda, Roald Dahl
75. Bridget Jones's Diary, Helen Fielding
76. The Secret History, Donna Tartt
77. The Woman In White, Wilkie Collins
78. Ulysses, James Joyce
79. Bleak House, Charles Dickens
80. Double Act, Jacqueline Wilson
81. The Twits, Roald Dahl
82. I Capture The Castle, Dodie Smith
83. Holes, Louis Sachar
84. Gormenghast, Mervyn Peake
85. The God Of Small Things, Arundhati Roy
86. Vicky Angel, Jacqueline Wilson
87. Brave New World, Aldous Huxley
88. Cold Comfort Farm, Stella Gibbons
89. Magician, Raymond E Feist
90. On The Road, Jack Kerouac
91. The Godfather, Mario Puzo
92. The Clan Of The Cave Bear, Jean M Auel
93. The Colour Of Magic, Terry Pratchett
94. The Alchemist, Paulo Coelho
95. Katherine, Anya Seton
96. Kane And Abel, Jeffrey Archer
97. Love In The Time Of Cholera, Gabriel García Márquez
98. Girls In Love, Jacqueline Wilson
99. The Princess Diaries, Meg Cabot
100. Midnight's Children, Salman Rushdie

So, since last June, I've tried to broaden my reading, and perhaps read the books on these lists. So far I've read:

All 7 Harry Potter novels
All 5 Dan Brown novels
Blink by Malcome Gladwell
Watchmen by Alan Moore and Dave Gibbons

and I'm currently reading Open by Andre Agassi.

Plus, my scholastic freedom culminated last month on ultrasonography. There I worked 8 to 5 but could read whatever I wanted, allowing me to study things I found interesting. Since I didn't work nights or weekends, I had the freedom to read Watchmen - a decidedly un-medical novel - to help me unwind. That was a truly great month.

So, as I continue my exploration outside of medicine, how many novels on the list above have you read? What are you currently reading?

Health Care Reform

I haven't blogged about the health care reform bills going through Congress (nor anything else for that matter) because I've been doing what good medical students do, and have had my head in a book (or my hands inside someone's body) for the last three months now. This probably won't change.

But, as I take a five minute break from studying cardiology, I wanted to share with you this:

The New York Times (7/30, A19, Goodnough) reports that the Massachusetts legislature "failed to restore enough money to the budget to provide full benefits for 30,000 legal immigrants." But, lawmakers did "provide for partial coverage, relieving some supporters of the program, who had feared that the cuts would be deeper." The legislature had "eliminated health insurance for the immigrants, which cost about $130 million a year" in order to cover the state's budget deficit. Now, $40 million will be restored, "leaving unclear just how much care the affected immigrants would qualify for." At issue is coverage for "permanent residents who have had green cards for less than five years." Currently, "the affected immigrants are covered under Commonwealth Care, a subsidized insurance program for low-income residents." Under federal law, "the 30,000 immigrants affected by the loss of coverage do not qualify for Medicaid or other federal aid." But, "Massachusetts is one of the few states...that nonetheless provide at least some health coverage for such immigrants." [emphasis added]

The reason I point out this article is that this is what we must come to expect from any government intervention in health care. If Washington D.C. is going to draft a new health care system for America (and they are), then whether you like their plan or not, you better be ready for this to happen to you sometime down the road.

In any system where politicians decide funding, cuts will come based on what is expedient politically. In any system where funding comes from a government that also funds other sectors, cuts will come based on what is fiscally necessary at that moment. When they are together (as we see in Massachusetts and will undoubtedly see in any national plan), cuts come from either or both of those reasons.

This means that nobody is guaranteed coverage, or the same coverage, from year to year. While yes, some people who may not have any coverage now will be covered, WHAT will be covered is not guaranteed. And for those who have coverage now, the same goes. So, in a system where it's already hard enough to understand what your insurance covers and what it doesn't, how will you feel if those rules change yearly?

That may be palatable now, but wait until you get sick. Maybe this year you can get your medicine, but next year, who knows?

Tea Party Pictures

Well, it's over ... or has it only just begun? Is it begun or began? Shifting thoughts is a flight of ideas ... flight of ideas is a classic sign of bipolar disorder, manic episode. Am I manic? But I digress...

yesterday was my first protest. I guess I am no longer a virgin protester anymore. Quite the experience. I got there about 4pm (the official start time of the tea party) and police/security had already stopped letting people into the plaza. Supposedly, from information on the web, Jones Plaza has official capacity of 5000 people. After that the fire marshall closes it. My only guess is that there must have been over 5000 people there because I could not get onto the plaza.


However, the sidewalks were just as packed. Everywhere I turned people stood shoulder to shoulder, some with placards and signs, listening to the speakers and cheering. Businessmen in suits and ties and women in skirts and blouses stood side by side with rednecks in overalls holding misspelled posters. This was definitely not a one-party, one-socioeconomic class group of protesters.



Eventually my wife and son came to see what all the ruckus was about. By that time people had started to leave, and it was easier to move around the plaza and listen to the speakers. Many people had children holding posters. Organizers passed out petition lists to take roll and set up tables to sell shirts and bumper stickers. Entrepreneurs sold tea bags or buttons.

All in all, a wonderful experience, and hopefully the beginning of continued discontent. Yesterday's tea parties were the rumbles before the earthquake. Three men on the light rail heading towards the protest had a conversation about the tea party and one said,

"the American Revolution started with the Boston Tea Party and escalated to violence in the name of American liberty and values. These tea parties are the equivalent of the Boston, but are Americans ready to take the next step if necessary?"

That is an interesting question.

More pictures:
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Houston Tea Party

For those of you who don't know, today is a big day. Yes, today is April 15th, tax day, but that has significance for the way we are protesting those taxes and pork.

A grassroots organization, the Tea Party Society, started organizing tea parties -- protests -- around the country in response to the wanton spending that our leaders in Washington d.c. Have done. Not just since Obama took over, but during the Bush regime as well.

Most people's boiling points were hit when the stimulus package was passed. It makes me mad (as you've heard me say) that Obama promised to have every bill wait five days before signing so the public could read and react yet he has kept his promise on NOT ONE BILL.

Also, although $787B of ''stimulus'' was passed, not a single person (not even Mr. Obama) read the bill in it's entirety before signing it into law. In addition, much, if not more than half, of the funds will not be paid out in 2009. That's quick stimulus!

So here we are, over 5000+ strong, in downtown Houston, one of hundreds of cities around the country holding these protests, to tell people that we're sick of this outrageous spending.

If you have time, come down to 601 Louisianna in Houston, Jones Plaza, and join the movement. Visit http://www.houstontps.org/ for more information. Facebook page here.

Pictures to come!
--- Sent with System SEVEN - the new generation of mobile messaging

Are All Charities Good?

With the success of another TBE Play For a Cause campaign evident, and the economy in throes, the non-profit organizations we play for have taken a larger place in my little brain lately.

Not all charities are created equal. This thought gained prominence when I stumbled across a blog about Diabetes while trying to help Dennis find a Diabetes charity to represent. This blog, Diabetes Developments, had a post describing the largest diabetes charities and their efficiency.

He steered me towards a great website, Charity Navigator, that gives you the information to make a good decision on who to support.

Look at diabetes organizations. The largest are probably the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation International, Diabetes Research Institute Foundation, Joslin Diabetes Center, and Diabetes Research and Wellness Foundation.

Charity Navigator lets you know how much of their budget is spent on programs (which is what you are donating to support), administration, and fundraising (yes, money to ask for more money). Granted, no charity can exist with $0 in admin and fundraising, because people who work full-time for these organizations must be compensated, and it takes money to advertise a cause to get people to support you. BUT, obviously an organization that spends 90% of its money on programs is more efficient than one that spends 70%.

Here's how Charity Navigator stacks up the aforementioned diabetes organizations:



And, just so you know, here's how Heifer International, last year's winner, stacks up:



What surprised me was the ADA. They are so large, so well known, and looking at this, you find out that giving money to them is a waste. The money's better spent on one of the other diabetes organizations.

So next time you give, maybe you'll look a little first. It doesn't hurt to make sure your money is being used how you really want it.

I love (miss) X96

So, leaving Utah, there have been (surprisingly, for me) many things that I have missed. I've actually missed the snow, devotionals, hydroplaning in my car on ice, late nights at Walmart, freezing bleachers for BYU football games, enlightening classes, J Dawgs, mountain biking, and great people.

But perhaps the thing I miss most of Utah is X96. It's easily in the top 2 radio stations I've EVER heard. I never realized how much its morning show, "Radio From Hell," was a part of my day until I moved back to Houston from medical school and didn't have it. I spent many mornings streaming it online while studying biochemistry. Even today, as I finished up my work at the hospital, and went to study pediatrics, I had that irresistible urge to listen to Kerry, Bill, and Gina. iTunes now has a podcast of it, and calls it,

"Radio From Hell is the longest running radio program in the Salt Lake City-area market, and is consistently one of the top-rated programs in the area. ... Rolling Stone cited KXRK as one of the top-five rock and roll stations in the U.S."

Yesterday I was doubly blessed, because while feeding my hunger for X96, Corey O'Brien, the DJ from 2pm to 7pm MST, released ten codes to download the new Nickleback album, Dark Horse, for free. What do you know? I got one! Bonus! When I get home, I'll listen to the new album and let you know how it is.

Long Live Comrade Obama!

Clearly the American people have spoken. Most, nearly 80% purportedly, made up their minds over two months ago. Most in my county, nearly 60% I last heard, voted straight party tickets -- leading to a historically Republican county going 51% to 49% for Obama.

Obama obviously ran the best campaign, so it's no surprise he won. McCain was incredibly and inexplicably inept at streamlining his campaign's points, becoming assessable to the people, and changing direction when the hot topic moved from Foreign Affairs to the Economy.

Secondly, McCain was a very poor debater. Numerous times he had opportunities to pin Obama on vague remarks and wrong assertions. Whether done on purpose or not, McCain clearly never took advantage of these moments and hence never took advantage of the debates.

I can and will go into the interesting points of this election at a later date, but now I want to say,

"Long Live Comrade Obama!"

Yo, Washington DC! Uphold the Second Amendment!

[Edited 26 July 2008 -- Absolute % of murders were transposed. Now corrected. The corrected error actually strengthened my argument. Sorry for the inconvenience.]

That, in effect, was what the Supreme Court said today when it ruled 5-4 that Washington D.C.'s sweeping gun ban was unconstitutional.

Two points interested me:

1. Chicago, IL was one of a few cities that have enacted gun bans similarly tough and filed amicus briefs on behalf of the defendant (Washington D.C.). Barack Obama comes from said city, and has made no qualms about his desire to limit gun ownership if he is president.

2. The writer makes the statement

City attorneys urged the high court to intervene [overturn appellate court ruling], warning, "The District of Columbia -- a densely populated urban locality where the violence caused by handguns is well-documented -- will be unable to enforce a law that its elected officials have sensibly concluded saves lives."

There were 143 gun-related murders in Washington last year, compared with 135 in 1976, when the handgun ban was enacted."

An astute commenter asked,

What I want to know is what point is being made by saying this statistic?

There were 143 gun-related murders in Washington last year, compared with 135 in 1976, when the handgun ban was enacted

Okay, so they had roughly the same number of murders 32 years ago before the ban as they did with it last year. Of course lets leave out the part about population change, culture change, increased drug usage, higher poverety (sic). This statisic (sic) doesn't say anything for or against guns, it's just a pointless statistic.

My sentiments at first also. However, after reading the comment, I wondered if his and my assumptions were true.

I won't tackle every variable, but I think the crux of the statistic quoted is population and murders.

Contrary to my belief, the population of Washington D.C. has actually decreased since the 1960s. In 1976, the population was 702,000 (according to these data). 188 total murders and of those, 135 gun-related murders (according to CNN). That's 1 gun-related murder per 5200 people. In 2006, D.C.'s population was about 581,530 and 169 total murders (143 gun-related last year). That's 1 per 4067 people.

So, by banning guns in 1976, gun-related murders increased from 0.0192% of the population to 0.0246% -- an absolute risk increase of 0.0054%. A small increase in murders for banning guns? For denying people a constitutional right?

Wait! Wait, you say. Total murders dropped. Isn't that a good thing? Possibly, except that 72% of murders in 1976 were gun-related and that rose to 85% last year.

In between 1976 and last year, murder rates actually ballooned (to a high of 481 in 1991) and then fell to current levels all while the population steadily declined.

My question is thus: If banning guns is so effective, why did gun-related murders rise during the succeeding 30 years? Why did the percentage of murders that were gun-related increase? Why did murders rise from 188 in 1976 to 481 in 1991 before falling to the current level? What happened in 1991 to reverse the trend?

I think the Supreme Court made the right decision today. Now let's find out what D.C. really did to cut down on crime.

Do you read?

Today L. Gordon Crovitz, in his article, "The Digital Future of Books," for the Wall Street Journal, said,

"The not-so-positive case is that, at least so far, we're not giving up on books for the same words on screens – we're giving up on words. Pick your data point: A recent National Endowment for the Arts report, "To Read or Not to Read," found that 15- to 24-year-olds spend an average of seven minutes reading on weekdays; people between 35 and 44 spend 12 minutes; and people 65 and older spend close to an hour." (emphasis added)

They obviously didn't poll medical students. Right now I average 14 or 15 hours reading a day. I average 5 minutes of seeing my son (while he's awake) and 30 minutes of meaningful conversation with my wife (while she's awake).

How much do you read?

My Church in the News

Today many people from the congregation ("ward" as Mormons call it) I grew up attending were interviewed about the polygamous sect in North Texas. Unfortunately, many people today still believe many misconceptions about Mormons, including that we have many wives. FALSE! Trust me, one is enough!

I don't always understand why these misconceptions persist, since polygamy in my church ended over 100 years ago -- I think it's similar to assuming that everyone from England still dressed like they do in "Pride and Prejudice" and shipped convicts off to Australia. With the past president of our church, Gordon B. Hinckley, appearing regularly on Larry King Live, and two prominent Mormon politicians (Mitt Romney and Harry Reid), you'd think people would have ample opportunity to be educated out of their flat-earth beliefs.

Some of it stems from overtly harmful and false remarks made by evangelical preachers to lead their flocks astray, but I firmly believe that's the exception (small exception) not the rule. Mostly, I think people hear it through the grapevine, and don't care enough to invalidate the absurdity of it all.

Nevertheless, with the circus in North Texas regarding the polygamous sect, my church has once again started clarifying the misconceptions and for that I'm glad. Any opportunity to build good will and educate people is a blessing. It's a short video from a local Houston television station, but I think the point is good for everyone.

I was going to embed the video here, but channel 39 has poor code, and it wouldn't load. I tried for too long, getting Youtube to work easily, but never this video. So, you'll have to click the link and see it for yourself in it's native webpage.

Local Mormon Congregation explains beliefs

I know many of my close friends at medical school have had lots of questions for me over the last month, so don't be shy to ask any in the comments section. I will respond, albeit possibly slow since I'm in the middle of finals.

Them Fightin' Words

I'm not a Clinton supporter, but let's face it, Obama is a snake oil salesman

Finally, something's happening. The gloves are off. Clinton should have done this three weeks ago, early into Obama's run of 11 straight state popular vote victories.

(CNN) -- A visibly angry Sen. Hillary Clinton lashed out Saturday at Sen. Barack Obama over campaign literature that she said he knows is "blatantly false," while Obama called her outburst "tactical."

Clinton jabbed the air with her hands as she told a crowd in Cincinnati, Ohio, that two Obama mailings spread lies about her positions on universal health care and the North American Free Trade Agreement.

"Shame on you, Barack Obama," she said.

...With Ohio Gov. Ted Strickland nodding in agreement behind her, Clinton accused Obama of emulating the tactics of Karl Rove, President Bush's former political director who is reviled by Democrats.

Obama "is continuing to send false and discredited mailings with information that is not true to the voters of Ohio," Clinton said.

Now, I'm not a Clinton supporter, but let's face it, Obama is a snake oil salesman.

He comes to town and he spouts change. He talks of hope. People love his charisma, so they forget that he has ZERO experience. He spins it by saying he's not from inside the beltway. People forget that he has ZERO experience outside the beltway too. He pulls fast ones on us -- saying he doesn't support outright bans on selling guns, but wants a law that would outlaw selling guns within five miles of any school or park (if you look, you'll quickly realize, that's tantamount to banning guns in almost every state but Montana). He makes you yearn for the good old days of 1963 (although we forget that those "good old days" included a populace overcoming its second war in as many decades, an entrance into a Vietnamese conflict bound for disaster, and the start of incredible growth of illicit drug use and std's). Yeah, I guess those were the good old days.

Clinton, until now, has been content to be his lapdog. She fawns at him during debates. He reciprocates. You'd think the two were dating. Now it's clear that people are buying what he's selling. People want hope. They're willing to forget that the strongest executive in the world could be run by someone who has NO executive experience, because they want to believe America is -- they are -- still great.

Clinton, until now, has been content to be his lapdog ... You'd think the two were dating

The only way to stop a snake oil salesman is to expose him for what he is -- a fraud. You have to catch him in lies, show his product to be nothing more than lemonade (understand my last post now?). When a candidate's whole platform is based on hope and change, he must be credible for that to work. Clinton is now finally attacking that chink in his armor. She holds the moral high ground after that stunning blow at the end of a losing debate, when she talked about her faith, and soldiers, and trials. Now, if she can show Obama isn't as clean as he says, she has her victories.

But she can't stop now. She should have done this three weeks ago. Now she must be angry, vindictive, the woman scorned. We have all seen her cry, and wax philosophical, now we must see what happens when a mother sees her baby hurt. We must see her go for the jugular. The next debate needs to be vicious, it needs to be fiery. Each word needs to be a blade to dig into the man of hope. She needs all her staff to find other examples of "untruths," and she needs to turn this love fest into a credibility war. Turn it ugly, and she has a chance. If she doesn't, it's over. They'll head into the National Convention separated by about 150 delegates and they'll be wrangling over super delegates' votes, and nobody will come out the better.