The weekend

We had a busy, culturally enriching weekend and made many further connections with our hosts here. I don't have time at the moment to detail them all as I need to refine a uveitis talk to be given later today. Today is the opening of the Nigerian Opthalmologic Society. Several hundred ophthalmologists from all over Nigeria are expected to attend.

Anyway, I can't wait to share a "walk to a waterfall," which turned out to be much more than that--in fact it was one of the most amazing experiences I have had in all my travels to Africa.

Meanwhile here is a quote (sorry--I can't remember the author at the moment) which rings true:

"Africa's not an issue. It's not a cause or a problem. It's a continent - a complicated, confusing, beautiful continent, with wealth and poverty, peace and strife, success and tragedy. When Africa becomes a cause, we tend to see only one side of the continent - a helpless, dependent, starving side that "needs our help"."

I think that anyone who has been to Africa would certainly agree that this continent is so rich in so many ways, and it does it unjustice to reduce it to a cause...

The first OCT in the History of Enugu Hospital

Dr. Lawrence holding Grand Rounds

Drs. Harrison and Miller

Amelia helping patients

Optical Coherence Tomography (OCT)

We spent much time teaching ophthalmologists in how to use the OCT Machine.
This is one of our patients.

Dr. Alicia Montoya

I inadvertently neglected to mention a key member of our team in yesterday's posting:
Presenting the ocular imagist extraordinaire: Dr. Alicia Montoya.
She is teaching the ophthalmologists here how to image the eye through ultrasonography and optical coherence tomography.
She works at the Barraquer Institue in Bogota, Columbia.
Today she gave severral lectures with beautful images of not only ultrasounds but also pathology slides of enucleated eyes (hmmm...beautiful to an ophahlmologist perhaps)...:)

Day 3 Enugu

Yesterday morning started with a 3 way mind meld between Drs. Harrison, Lawrence and myself followed by a prayer of supplication--- to get the dedicated Nidek laser that had been donated to the hospital to work. To make a long story short, Dr. Harrison alighted on the idea of plugging a nonfunctional transmitter into the back of the laser box; I then had a flashback to my jacuzzi in which a random combination of buttons are required to reset it, and Dr. Lawrence came up with this totally non-intuitive combination of simultaneously pushing 3 buttons on the front laser panel-- after a short prayer (accompanied by the a chorus of live, beautifully harmonized gospel singing; the singers consisting of the staff and patients in the main waiting area----which is the way every morning starts at the Enugu General Hospital). Voila', the laser began counting down to set itself and then the panel alit with the welcoming display of "ready to treat" paramaters. This laser, which cost at least 30K had not been used for many months as no one could figure out how to use it. I will now be able to teach the staff and residents how to do laser for diabetes, vein occlusions, retinal tears etc....Very exciting indeed!

Well this epiphanic start was followed by a marathon session of lectures. The audience of about 30 was stuffed into a small, non air condtioned room, but they were so hungry for knowledge that I ended up lecturing with few breaks from 9:30am to 5:00 pm. The impact of technology is evident in that many people carry usb flash drives. At the end of each lecture I would see many flash drives in front of me with their owners asking for the lecture just given to be downloaded on their drive. Given the lack of readily available teaching material here, it seems like quite a reasonable request.

Drs. Lawrence and Miller also had good attendance at their ped ophth. lectures, while Devin had a full day of clinic consisting of patients with severe corneal disease.

Dr. Harrison saw several patients with bullous keratopathy and severe corneal clouding due to non-state of the art cataract surgery. In many places the highly inflammatory and grossly large 5-0 silk sutures are being used to close cataract wounds (as opposed to 10-0 nylon sutures that are used in most of the world). Unfortunately without an eyebank to procure corneas for transplantation these patients will be blind for life. I don't think there is an eyebank anywhere in sub Saharan Africa. Unfortunately there are many patients who would benefit from corneal transplantation here as the incidence of corneal scarring is so high, from diseases such as measles, trachoma, onchocerciasis, and sometimes post cataract surgery.

Dr. Lawrence has done many courses here on small incision cataract surgery, which hopefully will reduce the incidence of corneal complications after cataract surgery.

Drs. Miller and Lawrence are also doing alot of great work on the rehabilitation of blind children. They also had an unusual patient--a 3 week old with bilateral congenital ectropion--where the eyelids were turned out and were so swollen that the baby's eyes were completely occluded.

Well after a busy day it was back to the hotel bar for some surprsingly good Spanish red wine ("Baron de Villa") consumed with granola bars and trail mix.

During "dinner" Dr. Miller spoke very highly of an ophthalmologist named Larry Schwab, who spent 25 years in Eastern Africa, noting that his motivation was solely wanting "to do the right thing."
Another living example of the maxim that the greatest truths are the most simple. It seems that if "do the right thing" can maintain status as the governor of one's conscience, not only "right things" but "great things" can be done, as in this case...as the obstacles of e.g. physical discomfort/inconvenience etc...fade away....and one raised in the luxurious lifestyle of America can go on to spend most of one's life in Africa.

Our team leader, Amelia Chamberlin, is another person who I find very enigmatic and delightful. Although only 29 years old she has the savvy and moxie, perhaps related to being raised in New York in an extended family of around 20, most of whom consisted of adopted children, to take complete command and control of not only our team but of organizing our hosts as well. She was even called into the Governor's mansion today to meet with him regarding security issues.

"Nurse Sandy" is doing a great job keeping patient flow moving along briskly...

Finally, I also want to recognize the lead ophthalmologist, Ahmed Gomaa, from Egpyt is the consumate diplomat with not only a very pleasant demeanor, but a great work ethic, and much experience in ophthalmology despite being only in his mid 30s.

ORBIS TRIP IN ENUGU

Well I just wanjted to give a quick update on the trip thus far.
First I want to give credit for the ORBIS team for doing a tremendous job in organizing this trip. It is very impressive. Even while here in Nigeria, the two Orbis organizers, Amelia Chamberlin and Dr. Ahmed Gomaa, are absolutely phenomenal.
None of my previous trips to Africa have ever gone this smoothly. These two guys take care of everything for us. So that is one of the neat things about going on a mission trip with orbis. No worries about logistics at all thanks to these two. ORBIS also donated a tremendous amount of equipment, including a new slit lamp and indirect ophthalmoscope. There was also a laser given.

We have 2 pediatric ophthalmologists (Drs. Marilyn Miller and Linda Lawrence), one cornea specialist (Dr. Devin Harrison), one nurse (Sandy Burnet), one specialist in ultrasound (Alicia Montoya) who is from Bogota, Columbia. They are all very well-travelled and skilled in "third world" ophthalmology. They all are extremely generous and kind people as well. It is truly a privelege and joy to be working with them.

Yesterday I saw about 25 retina patients. I saw one Marfan's patient with bilateral chronic retinal detachments and lens dislocations who was completely blind in one eye. Unfortunately the ORBIS plane did not make it here so I don't have any way to take this very unfortunate 28 year old girl to the OR. There is one place in the private sector that does retinal surgeries here in Nigeria...yes, one retinal surgeon for about 200 million people! Unfortunately the cost will be too high for this young lady (~5000$). I got her phone number. Hopefully when the ORBIS team comes next time she can be contacted for surgery...hopefully before she is completely blind in her only remaining eye.

I saw one HIV pt who had complete whitening of all the vessels in both of her retinas and the whitest (i.e. "most dead") optic nerves I have ever seen. She is very depressed as she has three young kids to take care of her. Unfortunately there is nothing that can help her. The good news is that she is on highly active retroviral therapy. Apparently now (and this is different from two years ago when I was here) all pts who are HIV+ can receive such therapy thanks to many NGOs and the government.

I saw another 8 month old on referral from Drs. Miller and Lawrence with profound pigmentary changes throughout the retina and large areas of geographic atrophy in the macula. There was no history of maternal/child illness. It was probably a variant of a cone rod dystrophy; however it looked different than any of the numerous cases of cone rod dystrophy I saw in 8 years at KKESH in Saudi Arabia.
The retina had a white or silvery appearance that was very strking. Dr. Harrison pointed out that this might be Oguchi's disease. Although his retina seemed much "whiter" than what I would expect for that diagnosis. I wish there was a camera here so that I could take pictures of this pathology. Also saw quite a few endstage proliferative diabetic retinopathies. With all the pathology here, it was like I was back in KKESH in Saudi Arabia!

It was very enjoyable to teach the faculty and numerous residents how to use an indirect ophthalmoscope and how to do a slit lamp exam with a 90 diopter lens. They were all very enthusiastic and picked up these skills right away. I was really impressed with their knowledge of ophthalmology. They were able to rattle off differential diagnoses right away for most of the pathology we saw.

Tomorrow I will be giving lectures along with the ped ophthalmologists. I will also be trying to troubleshoot the diode laser and do some optical coherence tomography.

Sorry I can't upload any pics as the internet connection is a bit dodgy and very slow. In fact this is the first time in 24 hours that it has been working very well.
Hope to have more updates in the near future...

Scientists Induce Out-of-Body Sensation

Using virtual reality goggles, a camera and a stick, scientists have induced out-of-body experiences — the sensation of drifting outside of one’s own body — - in healthy people, according to experiments being published in the journal Science.

Another photo from the Lake Tahoe Shakespeare Festival

Shakespeare At Lake Tahoe

This Shakespeare lover had the opportunity to see a fantastic performance of"Romeo and Juliet" at an outdoor venue at Lake Tahoe last week:
The picture says it all...

Actor Dan Hoyle "bringing it home" to Nigeria

Go to the world.org and listen to today's broadcast to hear an excellent rendition of a Nigerian accent. BTW, I will be headed to Enugu, Nigeria in a few days so blogging will be light for a few weeks unless I get internet access there.


Actor Dan Hoyle

Actor Dan Hoyle traveled to Nigeria. He brought home stories about big oil, local warlords, and the people caught in between.

World Clock

This is cool!

China’s Trade in Africa Carries a Price Tag

This article reminded me of a conversation I had with a shopkeeper in Freetown, Sierra Leone last fall. He noted that although there was a great deal of rice grown upcountry in Sierra Leone, his shelves were stocked with rice imported from China. Due to the terrible road conditions in Sierra Leone it was very difficult for the farmers to get the rice to him. Instead he would go to Dubai on a regular basis to import foodstuffs such as rice...(Dubai is a huge intersection point for the Far East, Middle East, Africa and Europe).

To give an idea of how bad the roads are--it took 8 hours to go from Freetown to the hospital in the Bush at which I worked--the distance was about 100 miles.

From South Africa’s manganese mines to Niger’s uranium pits, from Sudan’s oil fields to Congo’s cobalt mines, China’s hunger for resources has been a shot in the arm, increasing revenues and helping push some of the world’s poorest countries further up the ladder of development.

But China is also exporting huge volumes of finished, manufactured goods — T-shirts, flashlights, radios and socks, just to name a few — to those same countries, hampering Africa’s ability to make its own products and develop healthy, diverse economies.

(..)

But China’s growing presence in global trade is wiping out thousands of jobs in countries with fledgling manufacturing sectors like Zambia and South Africa.

Despite relatively low wages in many countries, African manufacturers find it very hard to compete, arguing that China’s currency policies undervalue the yuan and give Chinese exporters a huge advantage.

Many industries in China also benefited at various points from subsidies and free or low-cost government financing, making their costs lower. Beyond that, there are major infrastructure problems in Africa, where industry struggles with inadequate roads and railways, and unreliable electricity and water supplies.

Looking Past Blood Sugar to Survive with Diabetes

Nearly 73,000 Americans die from diabetes annually, more than from any disease except heart disease, cancer, stroke and pulmonary disease.

Yet, largely because of a misunderstanding of the proper treatment, most patients are not doing even close to what they should to protect themselves. In fact, according to the federal Centers for Disease Control and Prevention, just 7 percent are getting all the treatments they need.

Rising Brand of Immigrant: Skilled and Welcome

This article captures well the dynamics of international migration--a phenomenon quite "foreign" to many citizens here..

An economist with a Louisiana doctorate and a Mississippi drawl, he shocked his friends when he left a tenured job in Virginia for the American University of Sharjah, a school conjured from nothing by a sheik in the suburbs of Dubai. But when he lists the benefits of working abroad, Mr. Mitias crows.

He has free housing and utilities. (“Sweet!”) He has international experience on his résumé. (“Huge!”) He has cheap household help, good schools for his children and a BMW and a Mercedes he was able to buy by paying no income tax. Not to mention plenty of American fast food.

“Papa John’s delivers to my house,” he said. “It’s all here!”

This is migrant work, Ph.D.-style — a lesson about labor, a comment on class, a window onto globalization and a phenomenon on the rise.

(..)

He describes life abroad as a successive discovery of freedoms: freedom from taxes, freedom from mortgages, freedom from crime, freedom from the sex and violence his daughters would see on American television. He and his wife have taken them to places as different as London and Vietnam, and to Thailand three times. “The world’s at your fingertips,” he said.

Lobes of Steel

Should I start prescribing exercise for my retinal patients?

Scientists have suspected for decades that exercise, particularly regular aerobic exercise, can affect the brain. But they could only speculate as to how. Now an expanding body of research shows that exercise can improve the performance of the brain by boosting memory and cognitive processing speed. Exercise can, in fact, create a stronger, faster brain.
(..)

Gage’s discovery hit the world of neurological research like a thunderclap. Since then, scientists have been finding more evidence that the human brain is not only capable of renewing itself but that exercise speeds the process.

“We’ve always known that our brains control our behavior,” Gage says, “but not that our behavior could control and change the structure of our brains.”

Emergency flashlight from a Pencil!

Turn A PENCIL Into A LIGHT ! - video powered by Metacafe

Bruce Cockburn Concert

I want to draw your attention to a fantastic artist, Bruce Cockburn, who played here in Reno two nights ago. He is a poet, who sets his lyrics of peace and social justice, to complex insistent, even hypnotic, guitar-based rhythms.

He played as a solo guitarist in the fantastic outdoor venue, Bartley Ranch, in front of a crowd of about 2000. We, the audience, shared an intimate evening with one of Canada's most appreciated musicians. For reasons unclear to me, heis not widely known here in the States.

As the beautifully percussive strumming draws you into his space, it as as though you are moving out of the surrounding darkness into the spotlight with him--to share his and the world's agonies...and beauty at the same time. His lyrics, poignant, passionate, and visually evocative, reverberate with his driving rhythm...in the mind and...the heart. One senses that as he himself gropes toward truth and justice in his music, he asks us to do the same--to brave the dark and mysterious, and to illuminate with love.

Here is a picture my son, Ryan, took at the concert



Here is concert footage from another venue:

How To Save a Live

Any fans of "The Fray" out there?
Here is an excellent mashup of one of my must see websites on a weekly basis (postsecret) with The Fray's "How to Save a Life."

History of Religion in 90 seconds

How has the geography of religion evolved over the centuries, and where has it sparked wars? Our map gives us a brief history of the world's most well-known religions: Christianity, Islam, Hinduism, Buddhism, and Judaism. Selected periods of inter-religious bloodshed are also highlighted. Want to see 5,000 years of religion in 90 seconds? Ready, Set, Go!

Life Beneath Arctic Ice

Beautiful photos here

Millions Flock to Vote in Sierra Leone

Millions of people lined up to vote in Sierra Leone in the first election since United Nations peacekeeping efforts ended two years ago, ready to choose the first new president since the country’s brutal civil war in 2002 and close a grim chapter in the country’s history.
(..)

“The real significance of this election is in its conduct and not really in its outcome,”
(..)

The election is a bookend to a violent era that turned Sierra Leone, a hilly, palm-fringed country roughly the size of South Carolina on the southern coast of West Africa, into an indelible symbol of human brutality.

The war began in 1991, when a band of rebels led by a retired soldier and journalist named Foday Sankoh attacked from a jungle hideout in western Liberia. Trained in Libya’s insurgent camps and backed by the Liberian warlord Charles G. Taylor, Mr. Sankoh’s Revolutionary United Front unleashed a tide of death and misery that would leave hundreds of thousands of people homeless, maimed, raped or dead.

The war’s signature atrocity — the amputation of hands, feet and ears — arose in part as a bloody answer to a campaign slogan in the 1996 election, when Ahmad Tejan Kabbah, who was elected president that year and is to retire after this election, told his supporters that the future was in their hands.
(..)
But many of the problems that led to the war persist. The vast gulf between the richest citizens — who control political power, and the country’s diamonds and other resources — and the poor masses remains larger than ever. Efforts to tackle endemic corruption have foundered as entrenched political elites have thwarted attempts to loosen their grip on the country’s purse strings.

Most troubling of all is the country’s huge generation gap. Unemployment among young people — more than half of Sierra Leone’s population is under the age of 35 — stands at 80 percent.

Water, Water Everywhere, but Guilt by the Bottleful

While I am not an ardent over-the-top environmentalist, there are two environmental issues that really bug me: styrofoam and single-use containers for beverages and foodstuff. This article highlights some of the issues....

In the last few months, bottled water — generally considered a benign, even beneficial, product — has been increasingly portrayed as an environmental villain by city leaders, activist groups and the media. The argument centers not on water, but oil. It takes 1.5 million barrels a year just to make the plastic water bottles Americans use, according to the Earth Policy Institute in Washington, plus countless barrels to transport it from as far as Fiji and refrigerate it.
(..)

Over the last 15 years, the bottled water industry has been astonishingly successful in turning a product that once seemed an indulgence into a daily companion. Savvy marketers even managed to recast this mundane product as a talisman of sexiness — Jennifer Aniston is the new face of Glacéau SmartWater.

But the fickleness of fashion may be tilting against the industry.

Galaxies Clash in Four Way Merger

Four gigantic galaxies have been seen crashing into one another in one of the biggest cosmic collisions ever seen.

The clashing galaxies are expected to eventually merge into a single, behemoth galaxy up to 10 times as massive as our own Milky Way.

Man Regains Speech After Brain Stimulation

A similar principle is at work in ophthalmology with respect to the implantation of a subretinal chip in patients with retinitis pigmentosa...

A 38-year-old man who spent more than five years in a mute, barely conscious state as a result of a severe head injury is now communicating regularly with family members and recovering his ability to move after having his brain stimulated with pulses of electric current, neuroscientists are reporting.

THE INCREDIBLE COURAGE OF MIA FARROW

Mia Farrow has written a letter to Omar Hassan Al-Bashir in which she will give up her freedom so that Sulemein Jamous, the humanitarian coordinator of the Sudan Liberation Movement, can travel for a medical procedure...

I am therefore offering to take Mr. Jamous’s place, to exchange my freedom for his in the knowledge of his importance to the civilians of Darfur and in the conviction that he will apply his energies toward creating the just and lasting peace that the Sudanese people deserve and hope for.

China Insists on Naming Living Buddhas

The things that make you go hmmm....

BEIJING - Ratcheting up its control over Tibetan Buddhism, China on Friday asserted the sole right to recognize living Buddhas, reincarnations of famous lamas that form the backbone of the religion's clergy.

All future incarnations of living Buddhas related to Tibetan Buddhism "must get government approval," the official Xinhua News Agency said, citing the State Administration for Religious Affairs.

Who’s Minding the Mind?

Fascinating article on the power of our unconscious guidance systems

In a recent experiment, psychologists at Yale altered people’s judgments of a stranger by handing them a cup of coffee.

(..)

Findings like this one, as improbable as they seem, have poured forth in psychological research over the last few years. New studies have found that people tidy up more thoroughly when there’s a faint tang of cleaning liquid in the air; they become more competitive if there’s a briefcase in sight, or more cooperative if they glimpse words like “dependable” and “support” — all without being aware of the change, or what prompted it.

More fundamentally, the new studies reveal a subconscious brain that is far more active, purposeful and independent than previously known. Goals, whether to eat, mate or devour an iced latte, are like neural software programs that can only be run one at a time, and the unconscious is perfectly capable of running the program it chooses.

The give and take between these unconscious choices and our rational, conscious aims can help explain some of the more mystifying realities of behavior, like how we can be generous one moment and petty the next, or act rudely at a dinner party when convinced we are emanating charm.

“Well, we’re finding that we have these unconscious behavioral guidance systems that are continually furnishing suggestions through the day about what to do next, and the brain is considering and often acting on those, all before conscious awareness.”
(..)

What You Don’t Know

Using subtle cues for self-improvement is something like trying to tickle yourself, Dr. Bargh said: priming doesn’t work if you’re aware of it. Manipulating others, while possible, is dicey. “We know that as soon as people feel they’re being manipulated, they do the opposite; it backfires,” he said.

And researchers do not yet know how or when, exactly, unconscious drives may suddenly become conscious; or under which circumstances people are able to override hidden urges by force of will. Millions have quit smoking, for instance, and uncounted numbers have resisted darker urges to misbehave that they don’t even fully understand.

Yet the new research on priming makes it clear that we are not alone in our own consciousness. We have company, an invisible partner who has strong reactions about the world that don’t always agree with our own, but whose instincts, these studies clearly show, are at least as likely to be helpful, and attentive to others, as they are to be disruptive.

I'm Ripping You Off

One measure of the inanity of our national farm policy is that you, as a taxpayer, are paying me not to grow crops here in Oregon. Democratic House leaders have rammed through another grotesque farm bill on the assumption that the only people who will pay attention will be the beneficiaries. Let’s hope that they’re wrong, because this is a classic example of weak-kneed politicians caving in to special interests.
(..)

The benefits overwhelmingly go to producers of just five crops — wheat, cotton, corn, soybeans and rice — with livestock producers mostly left out. The majority of payments go to commercial farmers who earn more than $200,000 annually, while 95 percent of farmers get little or no benefit from the farm bill. That’s why my friends from my F.F.A. days speak contemptuously about those who make a living “farming the government
(..)
The average American family pays $320 a year in farm subsidies, through higher taxes and food prices, according to a recent study by the Heritage Foundation. And those subsidies, particularly for cotton, exacerbate poverty in Africa by depressing prices of crops raised by small African farmers.

A nice tutorial on identifying constellations

Learn your constellations!

Sierra Leone

I jreceived a call this morning from my friend, Sam Pieh, in Freetown, Sierra Leone.
He is a great man with a heartfelt commitment to improving his homeland.
In fact it is my hope that he will one day become president of Sierra Leone.
Anyway he tells me that they could use thermometers, blood pressure cuffs, and other assorted medical equipment for the clinic in Tiama.
In addition, due to recent heavy rain, ponchos would be useful.

If you are so moved please feel free to contact me with any potential donations and I will see that Sam gets them.

Thanks...

Legal Hurdles Stall Rape Cases on Native Lands

I had one of those proverbial NPR driveway moments when I heard the first in this series of reports on sexual assault of Native American Woman. (Where you turn your car off in the driveway and remain seated to hear the end of the story).

It is astonishing to me that one of every three Native American women will be raped in their lifetime.


Native American women and Alaska Native women suffer disproportionately high levels of sexual assault compared with other women in the United States. They're also the least likely to receive justice, according to a report from Amnesty International. Aid workers say most of the crimes are not perpetrated by Native American men. The report says that the perpetrators are most often outsiders, who know that little will be done to stop them.

'Kill Them All'

One thing that has always amazed me is how people who have suffered so much cruelty and evil retain their faith in God. I found the same phenomenon over and over in Sierra Leone on my last trip there in the Fall of 2006. One of the most interesting quotes was from a friend I made there named Mohammed. He and his 5 year old son was forced to watch the repeated raping of his wife by a rebel leader. The rebel leader kept his sonand wife, and told him to "run for his life."To make a long story short, he ended up with a compound femur fracture and withered away in the bush down to about 50 pounds over the course of about a month. His quote was "God seemed to answer my prayers quickly in those days. Now I am not sure when my prayers will be answered...


A victim of a recent militia attack in eastern Congo describes her horrific days in captivity.

In June, the Hot Zone reported the details of a recent massacre reportedly committed by Rwandan Hutu militia in eastern Congo in which 18 civilians, including six children, were killed.

One of the surviving victims, a 23-year-old woman we called Kahumba, provided a harrowing eyewitness account of the incident in which her brother was murdered in front of her and both she and her twin sister were sexually assaulted. The twin, who we'll call Mirenge, was kidnapped by the attackers and taken back to their camp. After weeks in the jungle, she escaped and returned to her village, but her suffering is far from over. This is her story, as told to reliable humanitarian sources on the ground in eastern Congo.
(..)

"I was suffering so much. One day I told them I was feeling ill and they tied me to a tree and three of them raped me. I felt like there was no more reason to live.
(..)
"We went to the river and decided we had to escape and return to our homes. We all slipped away into the jungle. It's only because of God that I am alive today.
(..)
"Now I am feeling very tired all over my body, I am urinating with much pain. I have constant headaches and backaches. When I stand up I am dizzy. When I remember what they did to me I wish I were dead.

"It is not important for me to get treatment because there is no difference between me and people who are dead.

Rodney Jones Soup Bone

Presenting one of the coolest jazz cats around...Rodney Jones.
This is the kind of amazing culture that makes me wnat to move to "The City"

Eight Americans graduate from free Cuban medical school

I am curious where they will get a residency...
HAVANA (AP) — Eight Americans who graduated from a Cuban medical school say they will put the education paid for by Fidel Castro's communist government to use in hospitals back home.
(..)

"I will be heading back to the United States with a great advantage over the American students who have stayed there," said Wing Wu, from Minneapolis, Minnesota. (uh...okay)

The Antiwar, Anti-Abortion, Anti-Drug-Enforcement-Administration, Anti-Medicare Candidacy of Ron Paul

What an interesting, principled presidential candidate--Ron Paul. I didn't know much about him before this article...Worth a read

Real Life Sea Monsters - 24 Bizarre Creatures of the Deep

The sea contains untold numbers of strange and bizarre creatures. It is said that we know more about our own solar system than we know about our oceans.

New Yorker Magazine Rocks!

Some great articles in this month's New Yorker magazine this month:

An editorial on the complexities inherent to healthcare reform by surgeon/writer, Atul Gawande, M.D.



An article on an orthopedic surgeon who has a near death experience after being struck by lightning and then becomes obsessed with piano music. (abstract only available on the net)

Finally, there is a great article on recent Pakistani politics and human rights activist Asma Jilani Jahangir by William Dalrymple that brings alive the dyanmic of political tensions in Pakistan. It seems that Musharef is facing many of the same issues that the Saudi government is facing today and that the Iranian government faced before the revolution...(The web version is audio only)

Libya Frees Foreign Medical Workers in H.I.V. Case

Finally!

SOFIA, Bulgaria, July 24 — After more than eight years in jail in Libya, five Bulgarian nurses and a Palestinian doctor stepped off the French presidential plane here in Bulgaria’s capital early this morning where they were greeted by crying relatives and Bulgaria’s top officials.

Why Bungee jumping is bad for the retina

From the latest New England Journal of Medicine:

A 25-year-old woman with no clinically significant medical history and with normal coagulation and hematologic studies went bungee jumping from a vertical height of 150 ft (45.7 m). Immediately afterward, she noticed a substantial decrease in vision in her left eye

Abraham Laboriel

A taste of the great Mexican Bassist, Abraham Laboriel

New Leaders Say Pensive French Think Too Much

Still, the French seem to be divided about the best way to get rich. On Thursday, a widely reported TNS-Sofres poll of more than 1,000 people concluded that 39 percent of the French think that it is possible to get rich by winning the lottery; only 40 percent believe that getting rich can happen through work. Certainly, the veneration of money more than ideas is new to French politics.

RICARDO COBO IN CONCERT

I recently learned of an organization entitled the sierra guitar society, headed by Larry Aynesmith of Incline Village. They aim to bring classical guitarists to Reno. We were fortunate to see the beautiful Paraguayan guitarist Berta Rojas last month. Her musicality blew me away. There are only two guitarists I have seen who have opened my "ears and eyes" to new ways of approaching the guitar--Jeff Beck and Berta. (Also Berta signed my CD: "To Deep with Love..Berta)." :)

Next week the Columbian guitarist, Ricardo Cobo, will be coming to Reno. I think we will try and see him at the Trinity Church--a fantastic venue for music. Hope to see you there.

TWO CONCERTS
JULY 22
Concert: 7:00pm Sunday July 22, 2007
Location: Cal Neva Resort, Frank Sinatra Celebrity Showroom,
2 Stateline Road, Crystal Bay, NV

JULY 24
Concert: 7:30pm Tuesday July 24, 2007
Location: Trinity Episcopal Church, 200 Island Avenue, Reno, NV

Tickets for each concert at door, $10 to $25
Tel.: 775-338-1671
Email: sierraguitar@yahoo.com
Web: www.sierraguitar.org

Los Lobos

"The wolves" put on a great concert last night at Barley Ranch. Originally from East LA, Los Lobos put together a great night of Latin flavored Rock and Roll last night. They thankfully asked the fans to supercede the "Rules" from security and to get up and dance. The crowd willingly obliged!
It was a festive night. We were fortunate to share the evening with our good friends who are very Latin oriented as well!

Here is a video of Chuco's Cumbia.
BTW, if you are local to Reno, do make an effort to check out some concerts at Bartley Ranch this summer it is a great venue. The concert listing can be found at 1moe.com.

Ciao's

For all local Reno-ites, if you haven't checked out "Ciao's" lately, I would highly recommend it. In fact, this is the first time I have been inspired to write a restaurant review on this blog! We had a fantastic dinner with great friends their last night.

The dining area is elegant and subdued-the tables spaced out far enough to allow initimate conversation with our friends. We all agreed that from the mojitos on, the entire meal was delectable.

Items we tried included a mushroom and cream soup topped with fontina cheese, after which one of our companions remarked "I am balanced and in harmony with the world." Every bite was to be savored... The most interesting of the salads we ordererd was one with succulent heirloom tomatoes, festooned with caramelized watermelon slices, and fresh mozarella-- drizzled with a balsalmic reduction. For the entrees, we had eroasted escalade with a basil chiffonade and ricotta stuffed pascilla pepper, halibut with zucchini flowerettes, and filet mignon with olive oil shipped potatoes and calabria chile demi glace--all elegantly presented and perfectly prepared. The desserts were a flourless chocolate torte (which my wife orders every time we dine here) and a savory dessert consisting of heirloom tomatoes and some minimally sweet cherries in a pie crust accompanied by a basil and mint sorbet.

Overall it was a wonderful time shared with our friends in a charming and intimate setting, whilst enjoying exquisitely prepared cuisine. Not only was great detail evident in the preparation of each component of the meal, but our waiter was attentive and actually quite entertaining in an "English or perhaps it was "Welsh" sort of way...

Give it a try. There is also a quaint outdoor patio to enjoy our pleasant summer evenings and an extensive Italian wine list!

A Partnership of Minds

Here is a fantastic oped by David Brooks of the NY Times (subsription required)--perhaps one of the finest he has ever written--
which beautifully highlights the interconnectedness of lives, experience, life and death...

Douglas Hofstadter was a happily married man. After dinner parties, his wife Carol and he would wash the dishes together and relive the highlights of the conversation they’d just enjoyed. But then, when Carol was 42 and their children were 5 and 2, Carol died of a brain tumor.

A few months later, Hofstadter was looking at a picture of Carol. He describes what he felt in his recent book, “I Am A Strange Loop”:

“I looked at her face and looked so deeply that I felt I was behind her eyes and all at once I found myself saying, as tears flowed, ‘That’s me. That’s me!’

“And those simple words brought back many thoughts that I had had before, about the fusion of our souls into one higher-level entity, about the fact that at the core of both our souls lay our identical hopes and dreams for our children, about the notion that those hopes were not separate or distinct hopes but were just one hope, one clear thing that defined us both, that wielded us into a unit, the kind of unit I had but dimly imagined before being married and having children. I realized that though Carol had died, that core piece of her had not died at all, but that it had lived on very determinedly in my brain.”
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Carol’s death brought home that when people communicate, they send out little flares into each other’s brains. Friends and lovers create feedback loops of ideas and habits and ways of seeing the world. Even though Carol was dead, her habits and perceptions were still active in the minds of those who knew her.

Carol’s self was still present, Hofstadter sensed, even though it was fading with time. A self, he believes, is a point of view, a way of seeing the world. It emerges from the conglomeration of all the flares, loops and perceptions that have been shared and developed with others. Douglas’s and Carol’s selves overlapped, and that did not stop with her passing.

I bring all this up in an Op-Ed column because most political and social disputes grow out of differing theories about the self, and I find Hofstadter’s social, dynamic, overlapping theory of self very congenial.

It emphasizes how profoundly we are shaped by relationships with others, but it’s not one of those stifling, collectivist theories that puts the community above the individual.

It exposes the errors of those Ayn Rand individualists who think that success is something they achieve through their own genius and willpower.

It exposes the fallacy of the New Age narcissists who believe they can find their true, authentic self by burrowing down into their inner being. There is no self that exists before society.

It explains why it’s so hard to tackle concentrated poverty. Human beings are permeable. The habits that are common in underclass areas get inside the brains of those who grow up there and undermine long-range thinking and social trust.

It illuminates the dangers of believing that there is a universal hunger for liberty...

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What’s being described is a vast web of information — some contained in genes, some in brain structure, some in the flow of dinner conversation — that joins us to our ancestors and reminds the living of the presence of the dead.

Saudi Wife Shows us into her Home (part 1)

A very nice video from a female reporter from the Saudi Gazette Journal that focuses on what it is like for a woman living in Saudi Arabia. She is a very pleasant woman--reminds me of many of my friends in Saudi. There are some nice shots of Riyadh as well. At the end of the video she notes that many Saudis are just as if not more knowledegeable about fashion trends and haut coutre as their Western counterparts. I had a friend in Riyadh, originally from London, who was a buyer from major Fashion houses. Saudi Arabia was one of his best markets...

Overall, this is a very nice video that puts a "human face" on the side of Saudi culture that is not often nor well-depicted in the Western media.

Killing Us Softly 3: Advertising's Image of Women

There are some amazing statistics regarding how many advertisements Americans are exposed to over the course of our lifetimes. My big concern is how these ads may eventually impact my 6 year old daughter, who now is just so innocently living life in the moment...

Hope Found Beneath War-Torn Darfur

But it could apply to one of the root causes of the ethnic conflict: drought, at least according to observers including scientists, Britain’s foreign secretary and retired American military officials.

If only we had known … about an underground lake the size of Lake Erie in Darfur.

A team of geologists from Boston University discovered the imprint of a “megalake” using radar. Farouk el-Baz, director of the study, urged the digging of 1,000 wells to start tapping into it.

“If you find water for the farmers, in addition to that for the nomads, for agricultural production, to feed them, to give them grain, then you resolve the problem completely,” he said.

A Pale Blue Dot

"We succeeded in taking that picture [from deep space], and, if you look at it, you see a dot. That's here. That's home. That's us. On it, everyone you ever heard of, every human being who ever lived, lived out their lives. The aggregate of all our joys and sufferings, thousands of confident religions, ideologies and economic doctrines, every hunter and forager, every hero and coward, every creator and destroyer of civilizations, every king and peasant, every young couple in love, every hopeful child, every mother and father, every inventor and explorer, every teacher of morals, every corrupt politician, every superstar, every supreme leader, every saint and sinner in the history of our species, lived there on a mote of dust, suspended in a sunbeam.

Global Fishing Trade Depletes African Waters

Poor Nations Get Cash, The Rich Send Trawlers; A Dearth of Octopus
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Wealthy countries subsidize their commercial fishermen to the tune of about $30 billion a year. Their goal is to keep their fishermen on the water. China, for example, provides $2 billion a year in fuel subsidies; the European Union and its member nations provide more than $7 billion of subsidies a year. Such policies boost the number of working boats, increase the global catch and drive down fish prices. That makes it more difficult for fishermen in poor nations like Mauritania, who get no subsidies, to compete.

The end result: African waters are losing fish stock rapidly, with ramifications both to the economies of Africa's coastal nations and to the world's ocean ecology. Over the past three decades, the amount of fish in West African waters has declined by up to 50%, according to Daniel Pauly, a researcher at the University of British Columbia.

Stop Trying to Save Africa

This author makes some very compelling points about the West's relationship to Africa. It is a must read. One of the most difficult things when talking about any group of other people is to convey their humanity and "sameness" to the audience to which one is speaking...while at the same time recognizing and appreciating the unique attributes of the other. It seems ithere is a tendency to either dehumanize or exoticize the other. The only way to supercede this simplification is to be engaged, to spend time with "the other."

Last fall, shortly after I returned from Nigeria, I was accosted by a perky blond college student whose blue eyes seemed to match the "African" beads around her wrists.

"Save Darfur!" she shouted from behind a table covered with pamphlets urging students to TAKE ACTION NOW! STOP GENOCIDE IN DARFUR!

My aversion to college kids jumping onto fashionable social causes nearly caused me to walk on, but her next shout stopped me.

"Don't you want to help us save Africa?" she yelled.

t seems that these days, wracked by guilt at the humanitarian crisis it has created in the Middle East, the West has turned to Africa for redemption. Idealistic college students, celebrities such as Bob Geldof and politicians such as Tony Blair have all made bringing light to the dark continent their mission.
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This is the West's new image of itself: a sexy, politically active generation whose preferred means of spreading the word are magazine spreads with celebrities pictured in the foreground, forlorn Africans in the back. Never mind that the stars sent to bring succor to the natives often are, willingly, as emaciated as those they want to help.

Perhaps most interesting is the language used to describe the Africa being saved. For example, the Keep a Child Alive/" I am African" ad campaign features portraits of primarily white, Western celebrities with painted "tribal markings" on their faces above "I AM AFRICAN" in bold letters. Below, smaller print says, "help us stop the dying."

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There is no African, myself included, who does not appreciate the help of the wider world, but we do question whether aid is genuine or given in the spirit of affirming one's cultural superiority. My mood is dampened every time I attend a benefit whose host runs through a litany of African disasters before presenting a (usually) wealthy, white person, who often proceeds to list the things he or she has done for the poor, starving Africans. Every time a well-meaning college student speaks of villagers dancing because they were so grateful for her help, I cringe. Every time a Hollywood director shoots a film about Africa that features a Western protagonist, I shake my head -- because Africans, real people though we may be, are used as props in the West's fantasy of itself. And not only do such depictions tend to ignore the West's prominent role in creating many of the unfortunate situations on the continent, they also ignore the incredible work Africans have done and continue to do to fix those problems.

Malyalam blues

The Keys to Happiness, and Why We Don't Use Them

The road toward a more satisfying and meaningful life involves a recipe repeated in schools, churches and synagogues. Make lists of things for which you're grateful in your life, practice random acts of kindness, forgive your enemies, notice life's small pleasures, take care of your health, practice positive thinking, and invest time and energy into friendships and family.

The happiest people have strong friendships, says Ed Diener, a psychologist University of Illinois. Interestingly his research finds that most people are slightly to moderately happy, not unhappy.

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"Research shows that people who are grateful, optimistic and forgiving have better experiences with their lives, more happiness, fewer strokes, and higher incomes," according to Easterbrook. "If it makes world a better place at same time, this is a real bonus."

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Lethargy holds many people back from doing the things that lead to happiness.

Easterbrook, also a Visiting Fellow at the Brookings Institute, goes back to Freud, who theorized that unhappiness is a default condition because it takes less effort to be unhappy than to be happy.

"If you are looking for something to complain about, you are absolutely certain to find it," Easterbrook told LiveScience. "It requires some effort to achieve a happy outlook on life, and most people don't make it. Most people take the path of least resistance. Far too many people today don't make the steps to make their life more fulfilling one."

GW Micro's VoiceSense: PDA for the blind

Fort Wayne, Indiana based company GW Micro has developed a new type of PDA designed specifically for the blind and sight-impaired, called the VoiceSense.

Tuck Andress - Europa (live)

Presenting the incredible guitar fingerstyle master: Tuck Andress:

The Karate Chimp

(via NPR)

Libya Backs H.I.V. Case Death Penalty

I cannot believe this case has not been resolved yet!

The Libyan Supreme Court today once again upheld the death sentances imposed on five Bulgarian nurses and a Palestinian doctor who were accused of intentionally infecting more than 400 Libyan children with the AIDS virus in 1998.

The court rejected the results of a 2003 investigation by two of the world’s leading AIDS experts, which found that unsanitary medical conditions at Benghazi Children’s Hospital were to blame for the children becoming infected with HIV. The nurses and doctor have now been in jail for nearly a decade.

Still, their fate remained uncertain today, despite the court’s ruling on the one hand, and months of recent negotiations to secure their release on the other. The European Union and the United States have repeatedly pressed the Libyan government to free the six, and groups of Nobel laureates have visited Tripoli to plead their case with the Libyan leader, Moammar Ghaddafi.

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In the past year, the European Union has given substantial financial aid to Libya in hopes of resolving the case. One high-level union diplomat, who spoke on condition of anonymity because of the sensitivity of the case, said the total amount was equivalent to more than 10 million euros ($14 million) for each infected child. The union has set up treatment programs in Libya for the children, built medical facilities and purchased equipment.
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Dr. Zdravko Georgiev, the husband of one of the jailed nurses, said in a telephone interview from Libya today that the families of the nurses were dismayed by the ruling. “After spending more than eight monstrous years in Libyan dungeons, we are exhausted to death,” he said. Dr. Georgiev was himself initially charged and jailed in the case; he was released after four years, but has not been allowed to leave Libya.

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The six were arrested in 1999. In the initial indictment, which reads like a spy novel, Libyan prosecutors claimed that the nurses intentionally infected the children as part of a plot by Mossad, the Israeli secret service, to undermine the Libyan state. Prosecutors claimed that the nurses confessed to the crime, and that investigators had found vials of tainted blood in one of the nurses’ rooms. For their part, the nurses said they were tortured and raped while in custody, in order to extract confessions from them.

Ten Politically Incorrect Truths About Human Nature

Why most suicide bombers are Muslim, beautiful people have more daughters, humans are naturally polygamous, sexual harassment isn't sexist, and blonds are more attractive.

AIDS in Africa: Rising Above the Partisan Babble

It is hard to remember when AIDS was just a simple epidemic disease. Long ago it exploded into a global rallying cry for ideologues of every stripe, politicizing the science and the social science alike. A small army of academics and consultants now stake careers — and millions of international aid dollars — on specific and often conflicting theories of how to reduce behavioral risks for acquiring and transmitting H.I.V.

Amid the partisan babble, Helen Epstein has for years generated some of the most sensible commentary around, posting dispatches from AIDS-afflicted countries in Africa to The New York Review of Books and other publications. As a scientist morphed into a journalist, Dr. Epstein combines an understanding of the biology of AIDS with a coolly impartial view of the political and social landscape of Africa. She has now assembled more than a decade’s worth of reporting into an enlightening and troubling book.

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That said, however, Dr. Epstein’s basic point is quite true: the drugs alone will never save Africa. Prevalence and transmission rates are too high, the health care infrastructure is too weak, there are too many other threatening diseases, and the costs are impossible. Instead, experts agree that hope lies in a still-distant vaccine, and in the “invisible cure” of Epstein’s title: dramatic behavioral changes to prevent new infections.

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Interrupting this perfect storm requires a clear understanding of its origins, and we still cannot fully explain why heterosexually transmitted H.I.V. exploded in Africa while remaining confined to very specific communities in the West. Theories abound, and Dr. Epstein does a nice job of reviewing them.

The fiction that Africans are more “promiscuous” than Westerners has been disproved; studies have found that Africans often have fewer sexual partners during their lifetime than Westerners do.

But accepted patterns of sexual activity seem to have ignited the tinderbox in Africa. Sex there crosses social boundaries more often than in the West, and the habit of having concurrent partners — simultaneous long-term relationships in which friendship and trust may thwart routine condom use — means a single person’s infection may spread rapidly through a group.

Spineless on Sudan

The latest from Kristof on Sudan...

In May 2006, President Bush declared: “The vulnerable people of Darfur deserve more than sympathy. ... America will not turn away from this tragedy.”

Since then, Mr. Bush has turned away — and 450,000 more people have been displaced in Darfur. “Things are getting worse,” noted Mudawi Ibrahim Adam, a human rights campaigner in Sudan.

One of the most troubling signs is that Sudan has been encouraging Arabs from Chad, Niger and other countries to settle in Darfur. More than 30,000 of them have moved into areas depopulated after African tribes were driven out.

In the last few months, Sudan’s government has given these new arrivals citizenship papers and weapons, cementing in place the demographic consequences of its genocide. And if Sudan thinks it has gotten away with mass murder in Darfur, it is more likely to resume its war against southern Sudan — which seems increasingly likely.

Within Darfur, aid groups have increasingly become targets, and in April alone three aid workers were shot and 20 were kidnapped, while hijackers tried to seize aid workers’ vehicles at a rate of almost one a day. As for African Union peacekeepers, seven of them were shot dead the same month — so they’re in no position to rescue aid workers.

The cancer has also been spreading into Chad and the Central African Republic, compounding each country’s intrinsic instability. Last month a 27-year-old French woman, Elsa Serfass, on her first assignment with Doctors Without Borders, was shot dead in C.A.R. as she drove through an area where militias had been burning villages. So Doctors Without Borders has had to suspend much of its work in the area.
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Much of the news on Darfur has been a bit optimistic lately, because it has focused on recent flurries of international diplomacy. While it’s true that China is belatedly putting some pressure on Sudan to admit international peacekeepers, at the same time China continues to supply Sudan with the guns used to slaughter Darfuri children. China also just signed a 20-year agreement to develop offshore oil for Sudan, and in April China pledged “to boost military exchanges and cooperation” with Sudan.

Let’s hope that athletes who go to Beijing for the Olympics next year will wear T-shirts honoring the victims of the genocide that China is underwriting.

Americans Give Record 295 billion dollars to Charities Last Year

Americans gave nearly $300 billion to charitable causes last year, setting a new record and besting the 2005 total that had been boosted by a surge in aid to victims of hurricanes Katrina, Rita and Wilma and the Asian tsunami

Giving historically tracks the health of the overall economy, with the rise amounting to about one-third the rise in the stock market, according to Giving USA. Last year was right on target, with a 3.2 percent rise as stocks rose more than 10 percent on an inflation-adjusted basis.
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The biggest chunk of the donations, $96.82 billion or 32.8 percent, went to religious organizations. The second largest slice, $40.98 billion or 13.9 percent, went to education, including gifts to colleges, universities and libraries.


About 65 percent of households with incomes less than $100,000 give to charity, the report showed.



"It tells you something about American culture that is unlike any other country," said Claire Gaudiani, a professor at NYU's Heyman Center for Philanthropy and author of "The Greater Good: How Philanthropy Drives the American Economy and Can Save Capitalism."
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He said Americans give twice as much as the next most charitable country, according to a November 2006 comparison done by the Charities Aid Foundation. In philanthropic giving as a percentage of gross domestic product, the US ranked first at 1.7 percent. No 2 Britain gave 0.73 percent, while France, with a 0.14 percent rate, trailed such countries as South Africa, Singapore, Turkey and Germany.
(Tip of the hat to DocFreeze for the link)

Playing Doctor

This humurous article brought back fond memories of similar experiences I had as a third year medical student, learning how to do physical exams on volunteer patients...



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Sometimes it was hard for me not to laugh. Dr. A was so sweetly flustered that in a perfect Chaplinesque slapstick, he would drop his reflex hammer on the floor, bend to pick it up, and then discover that his pen had fallen out of his white coat. Dr. N wasted the first eight minutes of the exam trying repeatedly to get a blood pressure reading. The panic in his eyes seemed to say, "She appears to be alive, yet she has no vital signs." He finally solved the dilemma when he realized he was listening to my arm with the wrong side of the stethoscope. (My blood pressure readings, which require technical skills on the part of the doctor, varied from 87/60 to 125/90.) Sometimes it was hard for the student not to laugh. Shy and mousy Dr. B, after peering into my eyes and ears, said, "Now I have to look up your nose!" and let out an embarrassed snort.

From the moment petite, blond Dr. C came in the room, she took command. Before she started, she briefly told me what the exam consisted of, then explained each procedure before she did it. Her touch was confident, and she did all 45 parts of the exam without hesitation. She asked me to tell her if anything hurt or made me uncomfortable. After she listened to my abdomen and proclaimed, "Good bowel sounds," I felt gratified I was able to please her....

In France, Jogging Is a Running Joke

The sight of the new French president, Nicolas Sarkozy, jogging -- often wearing his favorite NYPD T-shirt -- has fired up a tempest in a Reebok in France and Britain this summer. Sarkozy's running is an un-French, right-wing conspiracy, suggests Paris' left-wing newspaper Libération. In response, British commentators gleefully conclude: The French have lost their mind again.

On the primary state television channel, France 2, Alain Finkielkraut, a leading French intellectual, recently demanded that Sarkozy give up his "undignified" exercise. Not only did he imply that exposing the boss's naked knees is something that never would have occurred in the time of Mitterrand, much less Louis XIV, Finkielkraut claimed strolling is the proper activity of the thinking person, from Socrates to the poet Arthur Rimbaud."Western civilization, in its best sense, was born with the promenade," said Finkielkraut. "Walking is a sensitive, spiritual act. Jogging is management of the body. The jogger says I am in control. It has nothing to do with meditation."

Sarkozy has fueled a French suspicion that running is for self-centered individualists like Americans, reports Charles Bremner, Paris correspondent for the Times of London.

"Patrick Mignon, a sports sociologist, noted that French intellectuals had always held sport in contempt, while totalitarian regimes cultivated physical fitness," Bremner writes.

"Jogging is of course about performance and individualism, values that are traditionally ascribed to the right," Odile Baudrier, editor of V02 magazine, a sports publication, told Libération.

"The Sarkozy jog, say his critics, is a sad imitation of the habits of American presidents, and a capitulation to 'le défi Américain' (a phrase that was the title of a book published here as 'The American Challenge') as bad as the influx of Hollywood movies," writes Boris Johnson, a British member of Parliament and confirmed jogger, in the Telegraph.

"I am not deterred . . . by the accusation that jogging is right-wing," he says. "Of course it is right-wing, in the sense that the facts of life are generally right-wing. The very act of forcing yourself to go for a run, every morning, is a highly conservative business. There is the mental effort needed to overcome your laziness.

"Charles de Gaulle . . . moved with the stately undulation of a giraffe, and never broke into so much as a trot..."

Giving Till It Hurts

But nonprofits say they are receiving an increasing number of "stretch" gifts, donations seemingly out of proportion to the givers' resources. To the shock or chagrin of friends and family, these gifts often require donors to make sacrifices or at least live more modestly than their income would allow.

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People who follow philanthropy say donors like Ms. Hergenhan and Ms. Kajitani set examples that extend far beyond the gifts they make, simply by causing those around them, including children, family members and friends, to at least reconsider how much they give and how they might feel if they gave more.

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Academics who study wealth say more aging Baby Boomers are choosing charity to add meaning to their lives -- and to get a buzz that lasts longer than the kick that comes from splurging on a designer watch or expensive car.

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Not all family members are thrilled by these stretch gifts, however. Neurosurgeon James Doty recently gave stock currently valued at about $28 million to charity -- a gift that represents about 99% of his net worth. As a result, instead of retiring early Dr. Doty will have to save money to put his 3-year-old son, Sebastian, through college, and to fund retirement.

"I would have kept at least some of it for us," says Dr. Doty's wife, Masha Zhdanovich Doty. Though she sends money every month to relatives in the former Soviet Union -- "I believe in charity, especially in helping people directly" -- she wasn't completely supportive of her husband's giving. At ages 39 and 51 respectively, she and Dr. Doty need to plan carefully for the future of their young family, she says.

Africa: Land of Hope

President Kigame of Rwanda
In the early 1990s, Rwanda reinforced all the worst stereotypes of Africa: wretchedly poor, torn apart by war and seemingly destined to be an international basket case forever.

Yet now it has become the little nation that could. It is clean, safe and enjoying economic growth more than twice as fast as the U.S. or Europe. And Rwanda underscores something that is easy to forget: There are signs of a turnaround in Africa, and plenty of reason for optimism.

This is the last column from my win-a-trip journey in Africa with a student, Leana Wen, and a teacher, Will Okun, and the stories have been long on gloom and suffering. But there is also a cheerier side to Africa, and Rwanda reflects the continent’s potential when there is both stability and good governance.

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In the early 1960s, most of Africa was richer than Asia and many economists expected Africa to zoom far ahead of Asia. Back then, the World Bank named a group of African countries that it projected to grow at 7 percent annually.

Instead, Africa drove over a cliff. Of those countries with good data, one-third now have lower per capita incomes than they did at independence (typically about 1960), and the five worst-performing economies in the world from 1960 to 2001 were all in Africa.

What went wrong? The two most important reasons were that Africa was terribly governed and that it was torn apart by wars.

The problem of conflict is as bad as ever (Darfur sums it up), but governance is getting far better.

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And when African countries have enjoyed stability and sound policies, they have often thrived. Indeed, the fastest-growing country in the world from 1960 to 2001 was Botswana (South Korea was second, and Singapore and China tied for third).

More and more African countries are now following the Botswana model of welcoming investors and obeying markets. Aside from Rwanda, countries like Mozambique, Benin, Tanzania, Liberia and Mauritius are among those trying to build a future on trade more than aid.

“We’re not going to say ‘We don’t need aid,’ ” Mr. Kagame said. “But there’s no question about trade being more important than aid. There’s no question about that.”

Blame It on Mr. Rogers: Why

Signs of narcissism among college students have been rising for 25 years, according to a recent study led by a San Diego State University psychologist. Obviously, Mr. Rogers alone can't be blamed for this. But as Prof. Chance sees it, "he's representative of a culture of excessive doting."

Prof. Chance teaches many Asian-born students, and says they accept whatever grade they're given; they see B's and C's as an indication that they must work harder, and that their elders assessed them accurately. They didn't grow up with Mr. Rogers or anyone else telling them they were born special.

By contrast, American students often view lower grades as a reason to "hit you up for an A because they came to class and feel they worked hard," says Prof. Chance. He wishes more parents would offer kids this perspective: "The world owes you nothing. You have to work and compete. If you wanjavascript:void(0)t to be special, you'll have to prove it."

I will take some Pachabel with my coffee this morning...

Ten Questions with Scott Berkun, Author of "The Myths of Innovation"

Guy Kawasaki interviews former microsoft developer, who has just written a new book: "The Myths of Innovation"

n epiphany is the tip of the creative iceberg, and all epiphanies are grounded in work. If you take any magic moment of discovery from history and wander backwards in time you’ll find dozens of smaller observations, inquiries, mistakes, and comedies that occured to make the epiphany possible.

The Musical Genius - Derek Paravicin

The stone-age whale hunters who kill with their bare hands

Their way of life hasn't changed for hundreds of years - a group of skilled fishermen using only their bodies and extraordinary bravery to catch 75ft-long sperm whales to provide enough food and materials for their whole village.

t is like a scene from Moby Dick, except the odds are stacked even higher against the captains of each tiny wooden boat.

These amazing images were taken during a whale hunt in one of the last places on Earth where people still use traditional methods to fish for one of the largest creatures in the seas.

Drought Forces Desert Nomads to Settle Down

These same forces of climate change are intertwined in the Sudanese conflict between Arabic nomads and native African farmers as Lake Chad continues to dry up...
BTW, there is a very nice, narrated slide show if you go to the link below...

Climate change threatens ice sheets and ecosystems, but it also threatens human cultures.

For centuries, the Tuareg people have lived as nomads, herding their animals from field to field just south of the Sahara Desert in Mali, near Timbuktu.

"Our life is basically the animals we have, so we protect them and we feed them," says Mohamed Ag Mustafa, a herder living the traditional nomadic lifestyle. "Whenever we need tea or grain or clothes, we take an animal to the market and sell it and buy something."

But this way of life has become impossible due to a change in the climate.

Over the past 40 years, persistent drought has forced the Tuareg to give up their wandering way of life. To survive they have had to start settling in villages and cultivating land to secure a food supply which is less susceptible to drought.

What We Can Do to Help

One of the most common comments we get goes: “What can I do to help? You guys talk so much about the problems, and now I want to do something.” I don’t like to bring up problems without proposing solutions. In this second-to-last entry, I propose concrete action steps to channel passion and idealism into activism and action.

Be forewarned that I don’t think that giving money is usually the best way to help. I believe that education, awareness and tangible actions multiple many times over. They are actions that, during your lifetime, will far outweigh infrequent monetary contributions.

The HIPPA mess

Keeping Patients’ Details Private, Even From Kin

Sick Joke

More from slate.com on "Sicko.."

In one of the movie's best segments, insurance-industry insiders frankly admit that their profession is rapacious

A former medical director for an HMO, testifying before Congress, delivers a scathing rebuke both of the insurance industry and of her own role in denying patients care. Another whistle-blower describes the industry's tactics with stark clarity: "You're not slipping through the cracks. Somebody made that crack and swept you toward it." A woman who does customer service for a major insurer weeps as she recalls denying sick customers coverage, then adds, "That's why I'm such a bitch on the phone to people. … I just can't take the stress."

Michael Moore and the Beige Bomber

He's got the indictment of health care right, but not the fix.

Where Are the Doctors?

Nicholas Kristof's, two traveling companions in Africa, are producing some excellent entries in their blog, including this one, which hits upon the lack of medical infrastructure and the associated brain drain of physicians in Africa. When I was in Nigeria year before last, one of the medical chiefs at the ECWA hospital in Jos estimated that at least 1/3 of his graduating class had emigrated (mostly to Europe). This excellent post articulates the many reasons for the brain drain.In ophhlmology, there is about 1 eyeMD/million population vs 1/10,000 in the U.S...

“Can you take me back to the U.S. with you?”

Dr. Rudasingwa loves his country. He also cares about his own future. He wants to pursue specialty training in neurosurgery, which is not available in Rwanda. Everyday, he sees patients who need brain surgery, heart surgery, chemotherapy, or other specialized treatments to survive. There is no doctor who can provide these treatments. The best he can do is to watch the patients die. The only person he was able to “save” recently was a high-level official who was airlifted to South Africa after a head injury.

The problems with health care access in Africa are often attributed to lack of resources, but a more insidious and perhaps more difficult problem is the dearth of doctors.

Africa is facing a severe crisis of doctor shortage, on a scale almost imaginable in the U.S. and Western Europe. Rwanda, a country with 10 million people, has about 500 doctors — a ratio of one doctor per 20,000 people. This is less than 10 percent of the World Health Organization recommendation. The vast majority of the country will not see a physician in their lifetimes. The Congo and Burundi have similarly poor ratios. Suburban U.S. hospitals could have more than 200 doctors on staff, while in Burundi, 165 doctors serve 8 million people.

To be schooled by Segovia

This is a video in which a currently very famous guitarist, Michael Chapdelaine (who has won both national classical and fingerstyle guiarist competitions) goes to a masterclass with Segovia--very enlightening indeed!

When Is a Pain Doctor a Drug Pusher?

And they call it a "Justice" system--unbelievable story....

Ronald McIver is a prisoner in a medium-security federal compound in Butner, N.C. He is 63 years old, of medium height and overweight, with a white Santa Claus beard, white hair and a calm, direct and intelligent manner. He is serving 30 years for drug trafficking, and so will likely live there the rest of his life. McIver (pronounced mi-KEE-ver) has not been convicted of drug trafficking in the classic sense. He is a doctor who for years treated patients suffering from chronic pain.
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Prosecutors are in essence pressing jurors to decide whether an extra 40 milligrams every four hours or a failure to X-ray is enough to send a doctor to prison for the rest of his life. One doctor, Frank Fisher, was arrested on charges that included the death of a patient taking opioids — who died as a passenger in a car accident. A Florida doctor, James Graves, is serving 63 years for charges including manslaughter after four patients overdosed on OxyContin he prescribed — all either crushed and injected their OxyContin or mixed it with alcohol or other drugs. “A lot of doctors are looking for safe harbor,” Caverly said. “They want to know as long as they do A, B, C, D or E, they’re O.K.”

A Student, a Teacher and a Glimpse of War

Kristof's latest from the Congo...

There was nothing special about Yohanita except that she was in front of us. In villages throughout the region, people just like her are dying by the thousands — of a deadly mixture of war and poverty.

Instead of spending a few hundred dollars trying to save Yohanita, who might die anyway, we could spend that money buying vaccines or mosquito nets to save a far larger number of children in other villages.


And yet — how can you walk away from a human being who will surely die if you do so?

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What almost killed Yohanita was starvation in a narrow sense, but more broadly she is one more victim of the warfare that has already claimed four million lives in Congo since 1998. Even 21st-century wars like Congo’s — the most lethal conflict since World War II — kill the old-fashioned way, by starving people or exposing them to disease.

That’s what makes wars in the developing world so deadly, for they kill not only with guns and machetes but also in much greater numbers with diarrhea, malaria, AIDS and malnutrition.
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ne measure of the international indifference is the shortage of aid groups here: Neighboring Rwanda, which is booming economically, is full of aid workers. But this area of eastern Congo is far needier and yet is home to hardly any aid groups. World Vision is one of the very few American groups active here in the North Kivu area.

Just imagine that four million Americans or Europeans had been killed in a war, and that white families were starving to death as a result of that war. The victims in isolated villages here in Congo, like Yohanita, may be black and poor and anonymous, but that should make this war in Congo no less an international priority.

Carmela Got Gold Jewelry. Hillary Wants a White House.

The New York Times satirist, Maureen Dowd, on Hilary Clinton's recently revealed campaign song...

The satire was a video on Hillary’s Web site to whip up attention for the winner of her online contest to choose a campaign song.

nfortunately, the winner, “You and I,” is definitely not for you and me. (I look forward to Obama’s new campaign ditty, “I Am Thou.”) It doesn’t bode well for the cultural health of the country that Hillary picked a song by Celine Dion, who combines the worst of Vegas and Canada.

World Refugee Day

Today is World Refugee Day

In the mood for chili peppers this morning?

Here to Take Your Order (and Biting Their Tongues)

The decline of American culture through the eyes of waitstaff...

When I began researching “Hey, Waitress!,” I had two inklings. One was that waitresses, among the underheard icons of America, would have many important things to say about their work. That inkling proved true. The second inkling was that they might challenge a revered notion: that the United States of America is essentially classless.

Challenge the notion? They obliterated it.

“I had this guy the other day say to me, ‘Are you ready to take my order?’ Because is not your existence to serve and take orders?” recalled one waitress at a seafood restaurant in Kennebunkport, Me.

“What do you want? Eye contact?” an impatient man asked another waitress, who had offered to recite the specials and was waiting for his response. The scene took place at an excellent restaurant in Seattle.

Patterns: Aspirin Linked to Lower Risk of Cancer and Heart Disease

Regular aspirin use may significantly reduce the incidence of both cancer and heart disease, according to a large new study, but other nonsteroidal anti-inflammatory drugs, or Nsaids, have no effect.