Dyar Straits

Pretty sneaky, Death

2008-12-08T20:41:00.002-05:00

So I actually kind of like hospice and palliative care.

My smart-aleck residency colleagues tell me that’s good, because that’s basically what I’ll be doing as an oncologist. I, of course, know differently, and hopefully in twenty years our cancer treatments will be advanced enough for oncology to undergo the same revolution that cardiology has experienced. Think about it – what happened 25 years ago when you had a heart attack? I’ll tell you – you went to the ICU for 6 weeks, and doctors prayed that you had enough living heart muscle left to function. And now? You get rushed to a cath lab, where an interventional cardiologist snakes a catheter up your artery into your heart, opens the blockage in your coronary, and you’re none the worse for wear. This is minimizing, of course, but you see my point.

In any case, despite the potential for oncology to have a similar technologic breakthrough, there’s a kernel of truth in the comparison to palliative care in today’s medical milieu. About a half of the patients I have seen so far this month have been cancer patients, and by and large, the patients on hospice without a cancer diagnosis are older and have multiple medical problems. There’s often a feeling of injustice when you see someone in their twenties or thirties coming to grips with the reality of their own death. And no matter how thick your skin, there is an element of transference – you put yourself in the patient’s shoes, and that person is sometimes my age, or younger.

Now I hear all of you saying, “Why do you like this again? Are you insane?”

I have a couple of theories.

First, the obvious. No overnight call, and no weekends. Hey, a guy has to have some downtime. Also, there’s a unique opportunity to relate to families. I think the crucible of a family crisis provokes deep emotions, and the physician is often placed in a simultaneously gratifying and heart-wrenching position where he has “the talk” with the patient’s family. For that reason, patients and families often have a counterintuitive reaction, where they appreciate the doctor that gives them the terrible news. The honesty and catharsis of that moment is rewarding.

I think, however, the main reason I like palliative care, is because, quite simply, you can’t lose. Almost universally, physicians are conditioned to view death as an enemy. My analogy is this: remember that scene in “The Legend of Bagger Vance” where Will Smith tells Matt Damon to watch Bobby Jones as he enters “the field”? If you haven’t seen the movie, do yourself a favor and rent it – I’m not sure it completely translates to non-golfers, but I think the mystical quality makes it one of the best sports movies of the past twenty years (Field of Dreams was the same way). Here’s the clip from Youtube.

The line that resonates with me is this one: “You can’t look at that flag as some dragon you got to slay.” And, to prove that my thought process is indeed coming back around, medicine, like golf, is a game that cannot be won, only played. To view the target as an enemy only sets yourself up for failure. Allow me one more bit of pop culture wisdom, this one from the great sophist Dr. John Dorian:

Pretty sneaky, Death.

Trying to stall death on a daily basis is, in a word, exhausting. We try and try to keep sick people alive, only to have one thing after another crop up, complication piled on complication. We have successes and cures, to be sure, but ultimately, death and dying is the ultimate universal experience. There is something satisfying about a specialty that acknowledges that. Emergencies are fewer and more controllable, and we see the immediate gratification of patients that are comfortable and pain free, rather than the sickening side effects of chemotherapy or the savagery of surgical scars, which we tolerate for the promise of benefits to come. And when patients die, it is tragic, it is also accepted as natural, which is comforting.

And this month, believe it or not, seeing the good is even easier than normal.

Some random observations

2008-10-08T19:03:00.009-04:00

So I've got several things that have been rolling around in my head, but I don't think I can stretch any of them out into a full post. So, as if anyone really cared, here goes:

- The Cubs are really sad. The degree of learned helplessness in that fan base and organization is approaching impossible levels. You'd think that the law of averages would dictate that they'd win once in a hundred years. Apparently, that curse is way too strong for logic and probability.

- The SI cover jinx is alive and well. My favorite indication of this: last week, when Ole Miss was featured on the cover, proving that the cover jinx trumps the chicken curse. The week before that? The Cubs. How cruel.

- CSI has jumped the shark. I never cared for it much in the first place, but now it's definitely on the way out.

- Family Guy used to be one of my favorite shows, but these last two episodes, the first two of the season, were awful. Seth Macfarlane obviously has a political ax to grind, which is fine on your own time. It may even be OK on your show, but only if you're funny while doing it (just ask Trey Parker and Matt Stone). Please don't do it at the expense of being funny. There has been exactly one funny moment in each of the last two shows, and many more "jokes" that were obviously designed to influence the impressionable teens watching. And if you think I'm exaggerating or reading too much into it, just watch them. You'll be amazed. Or you'll vomit on the keyboard.

- Byrnes High School has the best football team in the state of South Carolina. Including colleges.

- I really wish I could post patient stories. I probably could, but I'd have to change them enough to make the patients unrecognizable, and that would remove all the comedy. I'm on the Infectious Disease consult service, and while there are several cases that are really sad, I did have an all-time best patient story last weekend, or at least top 5. I'm sorry I can't tell you all about it.

- It continues to astound me the people who have a Facebook page.

- My 10 year high school reunion is in a couple of weeks, and we're about to have our first child. But what makes me feel old is Sterling Dyar telling me about the catering for his wedding.

The Rev

2008-10-06T19:19:00.004-04:00

Someone wise once told me that if you have one true friend in your lifetime, you are blessed, and you are in the minority. I have been blessed in my relatively short life to have had more than one friend, and I have as many as half a dozen who I would consider "best friends".

Nathan Brown is one of those people. We have been "best friends" since we were seven years old, and I don't know of many people who are still close to their elementary school pal. We grew up together, playing on the same church basketball teams through grade school, staying over at Ridge Road. The third member of our little group was T.J. Rich (always good for some comic relief), and in 7th grade, a skinny kid named Jonathan Durham moved into town and showed up at Wellford Baptist Church, and became the last puzzle piece into our group of friends.

We played a lot of basketball, watched most every other sport when it was on TV, and eventually figured out we liked golf. We dated girls (or "went with" them, if you want to use the correct terminology), and luckily didn't fight over them too much. I'd love to recount a lot of the stories of things that happened to us, but honestly they weren't that much different than the things that happened to you. I can tell you this - although we were always "good kids", we did a lot of silly stuff back then, and we weren't always as smart as we thought we were (there was an incident involving a golf cart...)

We haven't lived in the same city in ten years, so I wasn't privy to the daily transformation that made Nathan who he is today. But, as that same wise person also told me, true friends are those you can go months without seeing, and when you talk again, it's like you were never apart. Last night, I was privileged to attend a culmination of the last ten years and a commencement for what's still to come. Nathan was ordained into the ministry at our home church, and I've never been to a more moving, meaningful, and emotionally charged ordination service. It meant an incredible amount to me to hear the advice and encouragement from the ministers and role models important to Nathan, and to hear how they felt about him.

I went through a (brief) period last year after Dad died, which I can't describe any better than to call it a "crisis of conscience". My father was one of the finest ministers I knew, which is to say that above all, he was a minister to people. He was a minister of music also, but I think he always knew that his most important role was to be there for the people in the church body. That was never more evident that when he was dying- many of those who loved him drove 3 hours to Charleston to be with us, and many more stood in lines that were way too long to pay their respects. The things that were said about him, the way that his friends and parishioners felt about him, made me want to affect people in that way. And I wondered, why wasn't I called into the ministry like so many of my family and friends?

I've since realized that medicine is my ministry, and a lot of the discouragement that comes part and parcel with the subjugation of residency is only temporary. If I wasn't convinced that it is a calling before, matching into an oncology fellowship certainly affirmed it. But still, it's a bit ironic that my two best friends are now reverends (real reverends, too - not like Al Sharpton or Sun Myung Moon are reverends).

Nathan (I know you'll read this if Jaime tells you that you should) - I'm so proud of you. I mean it. You are a very special person, and have a special wife and children. I have the utmost respect (and a little envy) for your calling, and I know that you will be a minister who places his God, family, and youth above himself. And without being too melodramatic or sentimental, I know there were two people watching from heaven who invested everything they had in us. They are the reason we are who we are, and I'll never forget that.

Oh no, two political posts in a row!

2008-10-01T17:30:00.005-04:00

Dave Ramsey, who is one of my favorite opinionists about finance, philosophy and sociology, has posted a great "common sense fix" that details how the government can intervene without writing a $700 billion dollar blank check, which I have copied below.

For the full transcript and how to write your congressmen, click here.

Years of bad decisions and stupid mistakes have created an economic nightmare in this country, but $700 billion in new debt is not the answer. As a tax-paying American citizen, I will not support any congressperson who votes to implement such a policy. Instead, I submit the following three steps:

Common Sense Plan.

I. INSURANCE
A. Insure the subprime bonds/mortgages with an underlying FHA-type insurance. Government-insured and backed loans would have an instant market all over the world, creating immediate and needed liquidity.

B. In order for a company to accept the government-backed insurance, they must do two things:
1. Rewrite any mortgage that is more than three months delinquent to a 6% fixed-rate mortgage.
a. Roll all back payments with no late fees or legal costs into the balance. This brings homeowners current and allows them a chance to keep their homes.
b. Cancel all prepayment penalties to encourage refinancing or the sale of the property to pay off the bad loan. In the event of foreclosure or short sale, the borrower will not be held liable for any deficit balance. FHA does this now, and that encourages mortgage companies to go the extra mile while working with the borrower—again limiting foreclosures and ruined lives.

2. Cancel ALL golden parachutes of EXISTING and FUTURE CEOs and executive team members as long as the company holds these government-insured bonds/mortgages. This keeps underperforming executives from being paid when they don’t do their jobs.

C. This backstop will cost less than $50 billion—a small fraction of the current proposal.

II. MARK TO MARKET

A. Remove mark to market accounting rules for two years on only subprime Tier III bonds/mortgages. This keeps companies from being forced to artificially mark down bonds/mortgages below the value of the underlying mortgages and real estate.

B. This move creates patience in the market and has an immediate stabilizing effect on failing and ailing banks—and it costs the taxpayer nothing.

III. CAPITAL GAINS TAX

A. Remove the capital gains tax completely. Investors will flood the real estate and stock market in search of tax-free profits, creating tremendous—and immediate—liquidity in the markets. Again, this costs the taxpayer nothing.

B. This move will be seen as a lightning rod politically because many will say it is helping the rich. The truth is the rich will benefit, but it will be their money that stimulates the economy. This will enable all Americans to have more stable jobs and retirement investments that go up instead of down. This is not a time for envy, and it’s not a time for politics. It’s time for all of us, as Americans, to stand up, speak out, and fix this mess.

Warning: rant on media and politics herein.

2008-09-22T18:50:00.001-04:00

I make it a point to watch as little cable news as possible. I will watch Fox News occasionally, but mostly when there is breaking news with frequent updates happening in real time. When you're on a layover in an airport, however, you are a captive audience, and last Monday we were subjected to an hour or so of Lou Dobbs on CNN.

The reasons I don't watch cable news are many; the thinly veiled partisanship that emerges when anchors have too much time and not enough real news, the exaggerated responses to routine news to drive ratings, and the personalites that try to be forceful but end up either overbearing or just downright screeching (see Grace, Nancy).

In a span of about five minutes, Lou Dobbs used the term "crisis" about four times, in referring to Wall Street and the collapse of the financial firm Lehman Brothers. He used words to describe the Dow Jones Index like "plunging" and "precipitous" and "free fall" that conjure up imagery of the Great Depression. (Has anyone else noticed that when the Dow shoots upward, the descriptors are far less dramatic? "The Dow recovered 400 points today after its dramatic collapse")

I know that these are ploys designed for one thing only: ratings. If it bleeds, it leads, as the saying goes. But what really boiled me over was Lou's next diatribe, the gist of which was this: we have to elect a president to FIX THIS!!!

Really? That's what we have to do to fix this? Elect a president?

This, regrettably, is not an uncommon mentality. A quote from Senator Chris Dodd last week: "... our economy... is suffering a crisis brought on by the Administration's failure to stop predatory lending..."

Guess what party he belongs to?

I think it's extremely unfortunate that we've had this perfect storm of events - an election year, the most media-saturated time in history, and a few financial firms with high-profile flubs. I do agree with Senator Dodd on this point: the lending crisis, and specifically high risk consumer loans that are now in default, are mostly to blame for these issues. But who is to blame for the loans? It's politically expedient to blame the opposing party and the media's favorite lightning rod, George Bush. But what about the companies that made the loans? What about the greedy executives and underwriters who approved them? What about (gasp!) the people who borrowed the money when they couldn’t afford it? The $700,000,000,000 bailout which is being presented to Congress (and yes, that is the correct number of zeroes) is another sad example of the lack of accountability that is now rampant in our culture. That’s my biggest problem with this mindset which is being promoted so aggressively by the media and the politicians: they can fix our problems, and we aren’t responsible for the consequences (unless, of course, we elect a member of the opposing party, and then it’s all our fault; the media has already been hoisting “Bushguilt” upon the public for a couple of years now).

The subtitle under Lou Dobbs' screaming head was "How does the crisis on Wall Street affect you?", as if we were all waiting with bated breath for CNN to tell us about… well, us. Now, I want you to think about it for a few seconds: how has this affected you? Independent of your fears stoked by the nightly news, what has changed in your day to day financial well-being? The biggest financial crunch on most families have been at the gas pump and the relative increase in shipping and goods sold because of it. But are gas prices going up because of this “administration"?

I’ll answer for you: of course not! Gas prices are like any other economic trend, which, at their simplest level, are a function of two things: supply and demand. We have been asking for this for a while, because despite a 500% increase in gas prices over the last ten years, our consumption has almost stayed the same. The oil barons would be crazy not to match price point to the place where demand falls off the curve. Ask yourself, how much will gas be before you change your driving habits? Are we there yet? Maybe some are, but plenty more still drive their Suburbans to the beach for the weekend (Mom, I’m looking at you).

Look, I’m not an “environmentalist” or anything – in fact, the whole “going green” thing is now oversaturated to the point of squeamishness. My point is, if we want gas prices to come back down, we have two choices. We can ask the government to FIX THIS! and control prices (see Marxism) or we can cut back on consumption and force the prices down with our pocketbooks (see Capitalism). It is becoming disturbingly common for the media and certain politicians to remind us that our next president can make it all better, with the mighty corrective hand of the government behind him. God help us if that is the case.

I say all this to say this: don’t let all of the shouting distract you from the reality that the “crisis” is never as bad as they would have you believe. We are not entering the Great Depression, and your life, retirement, mortgage, whatever, will not be fundamentally altered unless you are in the small minority of people working at one of these companies, or you were misguided enough to put all of your financial eggs in their basket (meaning their company stock). Even if you were the “victim” of one of the subprime loans that started the whole domino cascade, life goes on. And please, don’t act, vote, or live out of fear. I’ll borrow a quote from Michael Douglas’s character in the American President: they are “interested in two things and two things only: making you afraid of it and telling you who's to blame for it”. There’s no reason for mass hysterical fear with this or any other potential “crisis”. And you can take that to the bank.

Ten Things I Learned About Southern California - September 11th - 15th

2008-09-17T22:36:00.024-04:00

10. Tim Lincecum – He’s a pitcher for the San Francisco Giants, and we saw him throw a late-season gem on Saturday night against the Padres. He is listed at a waifish 5’11”, 170 pounds, but I think even that’s a bit optimistic – maybe they weighed him after the post-game buffet. After they showed his picture on the JumboTron, Laura asked me how old he was (he’s 24, but I would have guessed 20). And he may not win the Cy Young, but he probably should. He’s 17-3 on the year with a 2.43 ERA, 243 strikeouts and 77 walks (for the uninitiated, those are impressive numbers). My impression of him prior to Saturday night was that he was a young fireballer with a quirky delivery that the league at large would soon catch up to. Now, I think he will likely be a good, if not great, pitcher for a long time in the league. Lincecum pitched a complete game four-hitter and was solid all night long. His breaking stuff and offspeed pitches were very effective, and he was hitting 94-95 on the gun well into the 7th inning despite never having pitched a full major league season. The Padres, while a far cry from the ’27 Yankees, still have some decent hitters, all of who looked out of sorts all night.

9. San Diego – A fabulous city. I had heard good things, but came away even more impressed than I expected. Every time we thought we had seen the best of the city, we meandered into another part of town that was beautiful and unique. I was especially impressed with Balboa Park, which has some amazing Spanish-influenced architecture in its stately museums; the Harbor area, which has stunning waterfront and nautical views (I think I even saw a pirate ship, no kidding); and the Gaslamp Quarter, which has restaurants and shops which have obviously been restored to some of their late 19th century charm. This is not even mentioning the Coronado area, which is supposedly the nicest area in the whole city although we missed it completely (what, you don’t think we did enough?), and the beaches, which each have their own idiosyncrasies and personalities. I look forward to going out there again to do and see even more of the city.

8. The zoo – The San Diego Zoo is world famous for a reason. I don’t think there were any mammals that weren’t represented there. Of course, the pandas are the feature attraction (he’s a live bear, he will literally rip your face off), but the elephants, the gorillas, and the hippos were all feature attractions for me. If you want a photo tour of the zoo, visit Sterling’s Facebook album from last year, complete with animal names which, despite not being, well, real, were much funnier than something I could do.

7. Traffic in LA – I have decided with absolute certainty that I never want to live in a city that has routine radio traffic reports… on Sunday. I knew Los Angeles traffic was bad, and I thought since I had driven in Atlanta I would be somewhat equipped, but sitting in traffic on the 101 outside Hollywood… at 2 PM… on Sunday afternoon… I was out of my league. Driving out of town that evening, I looked at Laura and remarked, “Who are all these people, and where could they possibly be going?”

6. The weather – You know how the pilot always tells you the local time and the weather when you land? Well, when we landed in San Diego, the pilot told us it was 1:08 PM local time, 73 degrees Fahrenheit, and partly cloudy. When we walked out of the airport, there was nothing but blue sky. I told Laura that it must be partly cloudy if someone in the greater San Diego area can see a cloud somewhere. The humidity was down, the temperature was perfect, and the sun was always shining.

5. Hollywood – I was sufficiently impressed with the Hollywood sign, the stars on the Walk of Fame, and Grauman’s Chinese Theater. Really, though, the gist of Hollywood was not as glitzy and glamorous as it seems on TV. Hollywood Boulevard actually reminded me a little of Gatlinburg, with the tourist traps, the overdone “museums”, and the ambivalent impersonators. Beverly Hills and Rodeo Drive, however, were pretty cool.

4. Food – I was hoping that the food in San Diego would be as good as Houston, given the “melting pot” nature of the culture. I consulted my trusty guide for eating out in new towns, the Roadfood forums, and found a couple of places that fit my criteria. All of them were good, but none of them were outstanding. I probably had expectations that were slightly too high, given our experience in Houston. We had: home cooking at Hob Nob Hill, where the lively banter with the waitress was as fun as the food was good; Mexican at El Indio’s, where Guy Fieri had the tamales and we had the enchiladas; pizza at FatBoyz in Mission Beach (single slices as big as half a normal pizza); and seafood at Point Loma Seafoods, which was essentially the West Coast version of the Fishnet (one of my Charleston Roadfood faves). And, we had a couple of burgers…

3. In and Out Burger – ah, yes, the epitome of California fast food, and a veritable cultural icon, which I was really anticipating. And unfortunately, I was disappointed. Good for a fast food burger, to be sure, but not even as good as Five Guys, which is my standard for fast food burgers. However, the relative highlight of the food tour was a different burger joint, a funky, kitschy place in Ocean Beach called Hodad’s. Another Guy Fieri special, this place is probably the closest to true California (although you can’t really define California, now can you?). The burgers were huge and tasty and held in place by yellow wax paper because otherwise, the guts would spill out all over the big basket of fries. There was a booth made out of a VW bus, and old license plates covered literally the entire wall.

2. Saddleback – Rick Warren is every bit as good a speaker as he is a writer. His book, The Purpose Driven Life, is one of the most influential Christian books of the last ten years, and Saddleback Church, the sprawling Orange County campus where he serves as senior pastor, hosted a “civil forum” where John McCain and Barack Obama appeared in person to answer some of the most important questions to evangelicals voting in the November election. It goes without saying that he’s a fairly influential dude. Laura and I visited Saddleback to worship on Sunday morning. Although the campus itself was huge, the worship center and the worshippers were unassuming, and when the pastor emerged from the back, it was evident that was a reflection of him. He wore a casual, untucked button down shirt with dark blue denim jeans, and sported a goatee, as well as a few extra pounds. He spoke on love (they’re starting a series called “40 Days of Love” – I guess they still get pretty good mileage out of the “40 Days” concept), and his sermon was practical, biblical, and accessible. He referenced a dozen scriptures, and in a first for a sermon on love, none of them were from 1st Corinthians 13 (not that there’s anything wrong with that…) He even made a joke about being on the cover of Time (pretty heady stuff, if you ask me). And just to show you that the people at Saddleback know what they’ve got, in the course of the sermon, he brought out a teenager from the congregation who gave up his deposit for Harvard to supply water purifiers for a village in Rwanda. Rick Warren asked the young man if he had anything to contribute to the sermon, to which he replied, “Rick, you’re America’s pastor, and I’m just a kid!” The congregation broke up laughing. I know there are always going to be critics of megachurches and the people who lead them, but Pastor Warren seems like the real deal to me.

1. California Culture – Actually, the California culture was not as much of a shock as I expected. The only thing that really surprised me was a thrift store in L.A. named “Out of the Closet” proudly advertising free HIV testing. Other than that, as well as some minor differences, the signs were for Best Buy, Target, Wendy’s, and Borders. Even the stores on Rodeo Drive were mostly brands that I’d at least heard of before. I don’t know, maybe it’s always been this way, but it seems to me that now, the world is so much smaller than it used to be. Sure, the culture is different, but really, we’re not missing out on so much by being in the little ol’ South.

But I still look forward to visiting again.

Moments

2008-09-08T20:41:00.001-04:00

I was flipping through our digital photos a few nights ago, and realized that in the last 12 months, I have been to a lot of sporting events and venues.

I’ve been to Bank of America Stadium to see the Panthers, to Cameron Indoor to see Duke basketball, Charlotte Bobcats Arena for all eleven games of the ACC Tournament, and to Augusta National for the Masters. I walked around in the Swamp, Death Valley, and the Roost (there was a failed grassroots movement to give Williams-Brice Stadium a cool nickname like that). I went to baseball games in Houston and St. Louis. I’ve even been to a few high school and minor league games, just for the fun of it.

When I put this on paper, it seems ridiculous.

And I’m not done yet. I’ve got tickets to the Ryder Cup in Louisville in two weeks, and to three Panthers games in Charlotte this season. I’m sure I’ll see Byrnes play at least one Friday night this season, and I’ll be in San Diego this weekend, so hey, might as well catch a Padres game, right?

I better not let my wife read this, or she’ll realize how much money I’ve spent this year.

A couple of years ago, I would have found ways to rationalize not attending a lot of these games. I think doing them all in the same year is partly coincidence, but mostly the confluence of otherwise unrelated events. Being in Charlotte, a bigger city with more to do, has helped. So has having an actual job (although, lest any of you think the lifestyle of a resident is a glamorous one, I make less per hour than your average waiter).

And, not least of all, I realized last year that life is often a lot shorter than you expect, and that life, as they say, is a series of moments. I have become an “experience junkie” – looking for the next moment so that later, I can say I was there.

Do these matter in the grand scheme of things? I doubt it. I’m sure most of you think this is a ridiculous waste of time and energy. With a little girl on the way (yes, I said girl), these moments will be fewer and farther between, and in some cases, replaced with other different special occasions (does “baby’s first golf swing” count?). However, I am sure that the “sports” moments will continue to come, and they will be even more special with the next generation to share them. Some of my favorite childhood memories are at games, and I want my children to say, “I was there, with my family”.

So…

Anybody sellin’?

Scrubs

2008-07-10T16:53:00.006-04:00

It's exhausting to write with such life-altering profundity on this blog all the time. So instead of doing that, I'm going to post a few of my favorite moments from Scrubs, one of my favorite sitcoms ever. Not really because of the medical humor, but more because of the crazy one-liners and recurring gags. No show could draw out a running joke like Scrubs (i.e., Dr. Mickhead, Col. Doctor, Snoop Dogg Intern/Resident/Attending, and Seymour Beardface, who made cameo appearances throughout the entire show and originally were introduced only as characters who had funny names suitable for a one-time gag).

And if you don't get the jokes, all the more reason for you to watch the show in syndication or on DVD.

Big Day

2008-06-18T16:35:00.005-04:00

I'm tired.

Today has been an exciting and emotional day. For those of you who read Mom's blog (I mean, Dad's Caringbridge site), you saw that today is my fellowship match day.

The match process is not really unique to medicine- I don't know if other colleges do this, but Furman's sororities do a similar match process to recruit new sisters. Basically, you go through the interview process with individual programs just like you would if you were looking for any other job. However, instead of the hospital offering you the position, they agree to fill their positions through a national matching organization. You, as the applicant, submit a list of programs where you would like to go to this impartial matching computer, and each program/hospital submits a list of applicants who they would like. The idea is you order them based on where you would like to go the most, down through the last one you would be willing to take. If you don't want to go somewhere, you don't rank it - suffice it to say there are medical urban legends floating around about medical students who ended up at the 11th place on their list of 12, and were miserable. The computer then matches people and programs for the best fit, based on their rank lists.

I know, it's complicated.

In any case, at noon today the national matching program revealed the results, and I found out where I'm going from July 2009 to June 2012:

The Mayo clinic, which is one of the finest hospital systems in the country, has a satellite hospital in Jacksonville, Florida (what, you didn't think we would want to live in Minnesota, did you?). I'll be doing a three year fellowship in hematology/oncology at Mayo-Jacksonville. The program has all of the things I was looking for, including priority on clinical training and the smaller size to foster individual learning and attention. I am excited, because this is the first time I know without a doubt that I'll be doing hem/onc (even though I had hoped that at least some program would let me in). Laura is excited because we're going back close to the beach. We won't be leaving Charlotte for a year, so we have plenty of time to say our goodbyes.

And, the other exciting news for the day:

We're having a baby!

Laura's 12 week OB appointment was today, and we got to hear the tiny heartbeat with the Doppler for the first time. She's doing quite well, and has not been very ill at all with nausea or morning sickness (although she is pretty tired after coming home from work). I know a lot of you already have heard the news, but that doesn't make it any less exciting. The due date is January 2nd, and we'll know more (sex, etc.) in a couple of months.

So all in all, it's been kind of a big day.

The Open

2008-06-10T19:16:00.005-04:00

We are dangerously close to entering a dark time in the sports calendar. I love baseball, and the national pasttime holds a special place for me - it was the first televised sport I loved to watch. My parents tell me I would sit transfixed to Braves games as early as two years old, which, for those of you who don't remember the Braves in the 80s, is pretty incredible. I do have fond memories of Bruce Benedict, Dale Murphy, and Chief Noc-a-homa, who was the unfortunate victim of the campaign against Native American defamation.

Anyway, I say all that to say this: despite my love for baseball, July and August are fairly dark times in the sports calendar. Baseball is the only big team sport on the calendar, and it's mired in the self-proclaimed "dog days". Basketball has ended (some would argue that basketball ends the first Monday night in April, when "One Shining Moment" fades out), football hasn't started, and even hockey, which most of my friends only notice because it takes up a few minutes on SportsCenter, is not going on.

The oases in the desert of the summer sports calendar are the golf tournaments, and especially the majors. And the best of the summer majors (I'm excluding the Masters, because it's a springtime event) is the U.S. Open, which is being contested this week at Torrey Pines in San Diego. Tiger Woods is coming off knee surgery to compete in his first tournament since his second place finish at the Masters, and he's paired with the next best golfer in the world, Phil Mickelson. Plot lines abound at the U.S. Open, where the course is groomed so that even the PGA Tour pros look like weekend duffers. The greens are fast, the rough is high, the weather is hot, and the drama is thick.

I was thinking about the U.S. Open this week, and although I would say that the Masters is my favorite tournament, I have more indelible memories of U.S. Opens than any other golf event.

- 1999 - We were at Lake Moultrie near Charleston, and I was chaperoning for the Wellford youth retreat (yes, they let me be a chaperone). We were gathered around a tiny TV with the old rotary knobs and a set of rabbit ears. We watched Payne Stewart sink his epic putt on 18 at Pinehurst #2, and dashed Phil Mickelson's hopes of winning his first major. His fist pump is memorialized in bronze now, and none of us knew that the entire golf world would be grieving his death in a plane crash only four months later.

- 2000 - Same lake house, same tiny TV. This time, we watched what I consider to be the most dominant performance in the history of golf; the second coronation of Tiger Woods, rolling to a 15 shot victory at Pebble Beach. We woke up early (7 AM Pacific time) on Saturday to watch Tiger finish his 2nd round. He hit his 18th hole tee shot into the Pacific Ocean, unleashed a string of profanity which would have made Jay and Silent Bob blush, and promptly went on to demolish the rest of the field.

(Edit: Out of curiosity, I went to YouTube to look for this clip, and lo and behold, it's there. I think you can find anything on YouTube. Anyway, I won't link it here, in case there are any precocious little children reading my blog, but if you want to see it [not for the faint of heart], go to YouTube and search for "tiger woods pebble beach" - you'll know which one it is by the title.)

- 1997 - I watched the final round from my grandmother's hospital room at Spartanburg Regional. She was in the middle of a battle with heart failure, and although most people would have died during that hospitalization, she would live another 15 months. Tom Lehman hit an almost perfect 2nd shot on the par 4 17th. Of course, "almost perfect" in the U.S. Open means "not good enough," and the shot trickled helplessly into the water, leaving Ernie Els as the winner for the second time in four years. My grandma insisted I sit in her hospital bed, while she moved into the chair. I can think of few other people who thought of themselves less and others more.

- 2006 - Phil Mickelson again in the spotlight. Dad and I were on our way to Myrtle Beach for a last golfing jaunt before I started residency. We left the house when Phil was on 16, and listened to XM Radio's coverage while they described the unspeakably awful shot he had hit on the 18th tee at Winged Foot. His one shot lead evaporated, and a double bogey eliminated the possibility of a playoff and left Geoff Ogilvy with the trophy. We thought the radio announcers were exaggerating about Phil's drive. They weren't. Phil would say immediately afterwards, "I am such an idiot."

And many more - I can tell you I was in Charleston for a mission trip when Lee Janzen won at Olympic in '98, in Charleston (this time for vacation) in 2002 when Tiger Woods won at Bethpage, and at Myrtle Beach in '04 when Retief Goosen held off Lefty (again). We watched Angel Cabrera beat Tiger Woods at Oakmont from my first house here in Charlotte last year. I saw Goosen choke his way out of a two foot putt and into a playoff in 2001, and I was eating a chili cheese while he ran away with the 18-hole playoff on Monday.

One of the special things about sports is its uncanny ability to make the years seem closer together and combine new excitement and old nostalgia. I intimated at this a bit in my earlier post about the Masters, but even a rotating-site event like the Open can make you remember "where you were when". And of course, the common thread that NBC always reminds us about is that the final round is always on Father's Day. This Sunday will be difficult, as most of you know. Still, I am looking forward to making another 2008 U.S. Open memory. I think I will need it more this year than ever.

Surprised by Sadness

2008-05-25T14:22:00.006-04:00

My dear "second mother" Geraldine Foreman, who has sustained more loss in her lifetime than any human should have to endure, told us soon after my father died that the biggest events (Christmas, birthdays, Fathers Day, etc.) are not the most difficult, probably because you and others around you are ready. The toughest moments, she related, are those that sneak up on you, because you don't have time to ready your emotional defenses.

I'm a relatively stoic person, which I inherited from my father. Many of those closest to me, including my wife and my mother, have wondered aloud to me if I've grieved enough. And I think I have, but it's been more private than most.

That being said, in the past month or so, three different times certain events have leapt up and grabbed my emotions, and honestly, caught me completely by surprise. I mean, let's face it, it's been almost a year since Dad died, and I've had plenty of time to go through the grief process. Or have I? Nathan Brown, another close friend who unfortunately also has experience in this area, tells me that the grief really is measured in years, which helps me understand why my Mom still pours out her heart at least weekly on CaringBridge.

I want to tell you about the three things that made me miss my father more acutely, and stung like he was here yesterday.

Seeing Augusta National for the first time

Dad and I have fantasized about going to Augusta for the Masters for probably as long as I can remember. Honestly, I'm not sure why we never went - we did enough other crazy things to get into sporting events, we could have scalped tickets or something. For some reason, it never happened, but we had some special times watching the golf tournament every year on CBS.

Anyway, this year I got to go to one of the practice rounds for the first time, and the place was as magical as I imagined. The most indelible impression that it left on me was the sense that everything was unchanged from the days of Jones and Sarazen, Palmer and Nicklaus. Of course, it's changed dramatically - the TV towers, the HD cameras, and the titanium drivers are testimony to that - but the cabins, the concession prices ($4 for a turkey sandwich, chips, a Coke and a Moon Pie), and most importantly, the course, feel untouched by the encroachment of time and commercialism. I imagine that the sons brought by their fathers to see Jack storming down the back nine in 1986, are now bringing their own sons to see Tiger prowling, not just chasing the field, but chasing history itself. And it saddens me that I made my first memory at Augusta without my father beside me.

Brooke White singing "Teach Your Children" with Graham Nash

From the beginning of this season of American Idol (yes, we do watch American Idol), Laura and I mused that Dad's favorite contestant would be Brooke, the fair-haired girl with the folksy voice who looked more comfortable behind a piano or guitar than in the harsh spotlight alone with the microphone. She had a couple of weeks outside her element, and her nerves visibly frayed as time went by, and she went home as the fifth place finisher. But on the finale when they brought back the eliminated contestants to sing, she was firmly back inside her comfort zone. Dad loved Carole King and Carly Simon, and to hear Brooke channeling them and singing his self-professed favorite song - darn you, American Idol, for being so poignant and not knowing it.

"Well Done My Child"

This was the biggest shock of all. Three weeks ago, Laura and I were at First Baptist Indian Trail, the church we've been attending in Charlotte (when I'm not working and we're not in Spartanburg, that is). The special music was an old song called "Well Done My Child", that you Wellford folks remember from the Willing Heart days. The songs that the Wellford quartets sang are burned into my memory (probably because I spent most of my formative years listening to them practiced... over... and over...), and it had been a while since I had heard a Willing Heart song in any context. The lyrics were more pertinent now than they ever were when I was a child.

All this was too much. I sat in a church where my dad never set foot with tears streaming down my face, and it was just like he and Mom were on the stage, where I'm sure most people will see them forever in their mind's eye. The lyrics of the song said it best - "You have fought the fight / You have kept the faith / Enter into the joy of the Lord" - and knowing where he is, I wouldn't have him back for anything.

Still, for just a few minutes, I missed him more fervently than ever.

10 Things I Learned in Houston

2008-04-17T19:47:00.009-04:00

1. Houston has terrific food, from a variety of cultures that are present in the city. In two days, I had barbeque, Italian, seafood, and Mexican, all of which were incredible.

2. Barbeque means different things in different parts of the country. In Texas, this refers to beef brisket specifically, and pulled pork is merely an afterthought. In the Carolinas, the primary dispute is over flavor of sauce, but this is less of a concern in Texas - the sauce we had was tomato-based, a little sweet, a little tangy, and very good.

3. Roadfood is an invaluable resource in a new town. We found out after the fact that the barbeque restaurant where we ate, Goode Company Barbeque, is generally considered to be the best in Houston. One of the attendings I worked with this past week, when I told him I had barbeque in Houston, he immediately asked, "Goode Company?" All of this because I searched for Houston in the Roadfood forums.

4. Houston is a lot closer to the water than I realized. We drove thirty minutes to the San Jacinto monument (which, by the way, is the world's largest monument tower), and literally were right next to the Gulf.

5. M.D. Anderson is enormous. The complex of UT Health Sciences covers what I would guess to be about a square mile or so, and Anderson is a big part of that. The fellowship program takes 14 fellows per year, which is more than double the next largest program I interviewed for.

6. We should have waited to leave on Sunday afternoon - then we could have gone to Lakewood to hear Joel Osteen, and eat lunch with Mark Lowry. We did eat at his favorite restaurant, Ninfa's, on the recommendation of Michael Lord, and it was as good as advertised.

7. The Astros play in a really cool stadium. It looks out over downtown Houston, and has the railroad track past the left field wall, not to mention the infamous hill and flagpole in center field. Oh yeah, and it used to be called Enron Field. Whoops.

8. The Marlins are a really horrible baseball team. (I'm not sure what that says about the Braves, who just lost two in a row to them.)

9. The fact that we sent astronauts to the moon with 1960's technology is insane. However, getting to see historic Mission Control (the new Mission control is in a different room now) was a humbling experience.

10. The rocket that sent those astronauts to the moon is larger than I would have ever imagined.

St. Louis

2008-04-05T12:16:00.010-04:00

In the immortal words of Nelly: "You can find me, in St. Louis rollin' on dubs, smokin' on dubs, clubs, blowin' up like Cocoa Puffs." Well, not so much the dubs and clubs, but I did just get back from St. Louis. I caught a Cardinals game, visited the Arch, rode the Metro, which was a cultural experience in and of itself. Oh yeah, and I interviewed for a job. I didn't take any pictures of the interview, but I did take some of the other stuff.

So this is the Gateway Arch, which is supposed to be the Gateway to the West. It actually doesn't function well as a gate, as there is no fence preventing people from going around it to get to the west. A mere technicality.

Me and a giant steer at the museum of Westward Expansion underneath the Arch.

A ferry on the "mighty Mississip'"

The "new Busch" Stadium, which in addition to having an awesome view of the distinctive St. Louis skyline, is a great place to watch a game. (Click on the picture to get the full, panoramic effect.)

Albert Pujols is a beast.

The Cardinals won the game, 3-0. It rained for part of the time, and was a little cold, but I had fun anyway.

Interview Season

2008-02-17T16:33:00.004-05:00

I realize that by now, dear blog reader, most of you have given up on me. My updates have become less and less frequent as life has infringed upon my free time. I thought I'd at least get a comment on my picture with Winnie the Pooh.

A lot of my life, as you know, is consumed with patient care responsibilities. In addition to that, though, I am already preparing for the next phase of my training. I've decided to apply for fellowship programs in the specialty of hematology and oncology. This is an additional three years of training after residency, and would last from July 2009 to June 2012. This specialty is focused on treating cancers of all types, including leukemias and lymphomas, as well as benign blood disorders like anemias and disorders of platelets. And I think the most difficult thing about this specialty is telling people the full name and then explaining what it means. It's "heme/onc" for short (pronounced HEEM-onk).

I've sent in all of my applications (eighteen of 'em), and am slowly hearing from programs to set up interviews. It's a very competitive process, so I'm not getting interviews from everywhere, but I've already got interviews at several places. I'm not very much of a national traveler, so I want to hear from you guys. In the six cities I'm going to so far, what should I see, and more importantly, where should I eat?

1. St. Louis - I plan on going to the new Busch Stadium to see the Cardinals, and of course to see the Gateway Arch. But I don't know anything else about this place.

2. Houston - Again, I want to go to Enron... er, Minute Maid Park to catch an Astros game, but I know very little about Houston. I think the NASA center is there, but I don't know if that's even a tourist attraction.

3. Atlanta - I do like the Varsity, though it's not in the same area code as the Beacon. I feel like I have been to Atlanta enough to know the tourist attractions. I have some friends there also.

4. Jacksonville - I have some friends here, too, but don't know a lot about the city.

5. Charlottesville - very much an undergraduate town. I've been here once and liked it, although the juxtaposition between the cosmopolitan college town and its rural surroundings is startling and humorous.

6. Gainesville - the home of the Gators, and other stuff, I'm sure, but I know nothing about them.

7. Winston-Salem - Winston always reminded me of Greenville in terms of size and demographics, and I think Laura and I would do pretty well here. Plus, some of my closest college friends either grew up here or lived here for a period of time, and they know the city.

I'll add some more places as the interviews come in, and solicit more advice.

The catch-up picture mega-post

2008-01-28T18:13:00.000-05:00

When you go this long without an update, it's very hard to write out everything longhand.

Laura and I have actually been pretty good at taking pictures for the last six weeks. So I'm doing a picture post to narrate our lives over that time period. Pictures are probably easier to look at anyway.

Christmas at our house

Laura's and my living room, decorated for Christmas. We realized after we took everything down last year, that we had forgotten to take any pictures. That was our first Christmas decorating our own house. So, we certainly remembered this year. As a side note, this is probably the first time in 18 months that our armoire was closed.

Our tree. We didn't realize how many presents we had until we tried to pile them all up under there.

Laura and I, on our third wedding anniversary, December 18th, 2007.

12/23 - Dyars, Browns, Durhams

Samantha Kate Durham, rocking out on the drum set from "Rock Band"

The girls - Jaime Brown, Laura, Kim Durham
My two closest friends from childhood, Nathan Brown and Jonathan Durham, both live in the Triangle area near Raleigh-Durham, with their wives and children. We don't see them as often as we'd like, but we were able to get together two days before Christmas to have dinner and hang out. Our times together are always special.

Averie, Nathan & Jaime's oldest, and Sami, Jon & Kim's only. She always looks like the happiest kid.

Rockin' out to "Rock Band" - Austin Kate, Nathan & Jaime's youngest, Nathan, me, and Jonathan. For those of you not familiar with Rock Band, it's the new Xbox 360 game from the makers of "Guitar Hero". Instead of one guitar playing a song, you get together the whole band - guitar, bass, drums, and even lyrics. The three of us, with Sterling on the drums, played a little "Enter Sandman". Sterling, by the way, is an excellent drummer.

Christmas Eve - The Dyars

Mom with my Uncle Bill. He does bear a striking resemblance to my Dad - I think my younger cousins and cousins' kids have gotten them confused in the past.

A few of, but not all of, my Dad's side of the family. From the left, Aunt Debbie (Bill's wife), Trish (Tom's girlfriend), Uncle Tom, Chris (my cousin, Teresa's son), Poppy Tom (my grandfather), his wife Jean, and me in the foreground.

I really like this picture. It's kind of a "new beginning" picture. Still, I'm tempted to photoshop Dad in the background.

Sterling and I with my dad's dad, "Preacher Tom" Dyar

Christmas at the Log Cabin

Mom's Christmas tree. It makes ours look kinda puny. And of course, now that the big guy's not here, the angel on top of the tree is crooked - none of us can reach it.

Me, getting my PSP. Which was stolen the next day. (I got another one.)

Sterling is goofy. His only Christmas gift was a PS3, so he spent most of the time watching us open gifts.

Laura opening one of her presents. I don't know if this makes me a lame husband or an attentive one, but I got her 2 inch blinds for our windows and a ceiling fan. She, on the other hand, got me one of the coolest presents ever - tickets to the ACC basketball tournament in Charlotte in March.

Laura, Sterling and I surprising Mom with her big present - a stackable washer-dryer for the nook next to her kitchen. (That's the bottom of it.)

Christmas at the Hollidays

Doc and Linda's beautiful Christmas tree. Again, making ours look puny.

"The kids" on the couch, Christmas night - Laura's brother David, his wife Renee, Laura, me, and Sterling. Notice Sterling's totally awesome shirt.

David and Renee on our second Christmas morning, the 26th. He got the Piggly Wiggly shirt on our trip to the beach in September - apparently, they're all the rage in NYC.

Laura with her ceiling fan. Merry Christmas, indeed.

Andy, the Holliday family West Highland terrier. He kinda blends in with the carpet.

Laura's family - David, Renee, Doc, Linda, Laura, me, and Laura's grandmother, Rachel, in the matriach's seat.

Laura's Birthday - December 27th

A shot from Laura's birthday lunch at Kanpai Tokyo. Laura's birthday is actually the 28th, but we had to go back to Charlotte later that day.

Sarasota, Florida - January 12th-19th

These pictures are from our trip to Florida. One of the benefits of my residency program is that we get a yearly stipend and five days to go to a medical conference anywhere in the U.S. We chose the gulf coast of Florida, because, hey, it's winter and Florida is warm. Or so we thought.

This and the picture above are the views from our hotel room in Sarasota. The downtown Sarasota skyline is in the background.

Our hotel was literally next door to a science museum, GWiz, which is a lot like Discovery Place here in Charlotte. One of the main reasons we went was the exhibit called "Bodies Revealed", which had preserved human cadavers to show organs and systems. It was pretty cool, but probably would have been way cooler for people who haven't gone through Gross Anatomy. We, on the other hand, had a touch of post-traumatic stress.

Laura playing with one of the educational toys.

Wednesday, we headed out to the golf course. And no, Laura didn't play. She just rode along, but doesn't she look like a golfer here? (except for the flip-flops)

Laura took a lot of pictures that day. The course was not a resort course by any means, but still had plenty of picturesque places.

And, a shot of Laura and I on the beach. Notice the gray sky in the background. We kept waiting for the best day to go to the beach, but every day was too cool (high 60s or so). Finally, our last day in Sarasota, we went anyway. And of course, it was 65 degrees and raining. We stayed out there for about 5 minutes.

DisneyWorld - January 18th

Friday in Florida, we skipped out on the conference and drove up I-4 to Orlando. Both of us love the Magic Kingdom, and with only one day before flying out, we had to spend it there. This is my favorite exhibit, the Hall of Presidents. And yes, I realize I'm a nerd.

Laura in front of Cinderella's castle.

Me and Winnie the Pooh.

Laura took a lot of pictures during the parade of characters. This is not my favorite character (although I have no problem with Chip or Dale), but I told Laura that this picture looks like it should go on a DisneyWorld advertisement.

Me with the characters from Song of the South - Br'er Rabbit, Br'er Fox, and Br'er Bear. I hate that Song of the South is now the red-headed stepchild of Disney movies. It's not very politically correct, for sure, but it was a fine movie, and "Zip-a-Dee-Doo-Dah" is still one of the most recognizable Disney songs. This picture is my homage to the lost movie.

And the two of us with our patented self-made picture in front of the castle.

The fireworks show at the end of the night was spectacular.

NC American College of Physicians, Duke University - January 25-26

And finally, last weekend, I presented a poster at the N.C. American College of Physicians Meeting in Durham. We took the afternoon before to walk around the Duke campus. And yes, we snuck into Cameron.

This picture deserves a bit of explaining. At Duke, the undergraduates get the best seats (or, since they never sit, the best standing places) in Cameron for Duke games. There's not a ticket system per se - the students line up prior to games to get the best places to watch. So, for the biggest game of the year, against UNC, students begin lining up early. Very early.

Soon after returning from Christmas break, students set up tents to wait in line for the Carolina game. The lawn outside Cameron turns into a small tent city, which is affectionately known as "Krzyzewskiville". There are strict rules about number of people per tent, and how many people must be present. They have tent checks, and a very orderly numbering system.

I know I made the right decision going to Furman. But man, how I would have loved to experience this part of Duke.

The inside of the beautiful Duke Chapel.

The view outside our hotel room in Durham. The ACP put us up in the Washington Duke Inn on the Duke campus, which overlooks the main campus golf course. Shoulda taken my clubs.

The group of residents from CMC who presented at the ACP meeting. We were very well represented, and had a good time too.

Me in front of my poster. It was a case report of a woman who got a severe hemolytic anemia from taking Aleve. Gotta watch out for those pain medications.

Back to the Unit

2007-12-04T17:03:00.000-05:00

People have asked me why I write here so infrequently. Honestly, as time has gone by, I've found less and less to talk about. I think this is the familiarity phenomenon - no matter how exciting something seems on the outside, the person who does it routinely, day in and day out, becomes complacent with it.

Unfortunately, it now takes an unusual or otherwise interesting case to pique my interest enough to write about it. And today, I had one of those moments.

On December 1st, I started in the Medical Intensive Care Unit - affectionately known to residents simply as "the unit". It tends to be one of the most, if not the most, strenuous months, mainly because of the frequent calls and just how stinking sick everyone is.

A digression: everyone recognizes that doctors use their own language - this usually involves long words with multiple prefixes. Most of the time, we don't realize we're doing it. Sorry. However, with the onslaught of medical shows like Scrubs, House, and Grey's Anatomy, the public has become aware of a different portion of "medicalese" - medical slang. Residents are particularly vulnerable to using this language, and it's remarkably similar to military slang. Multiple authors and people smarter than myself have referred to this as "gallows humor" - young doctors, often dealing with death on a day-to-day basis, begin to use phrases that refer to death in a way that, frankly, most people would consider horribly insensitive.

For example, in the parlance, my MICU patients are "4-plus sick" (a reference to the system used in, for example, urinalyses, which quantifies a positive test as trace, 1+, 2+, 3+, and 4+) or "circling the drain" (the reference is more obvious). Patients who have died are said to have a "d/c to J.C." (in other words, discharge to Jesus Christ) or a "celestial discharge". Many of these terms, and others like them, were popularized by a book called "House of God", which is the residents' equivalent to "The Catcher In The Rye".

Anyway, I digress. When I was on call on Saturday, I got check-out from one of the residents taking care of patients on the regular floor who wanted a higher level of care for one of her patients who was not doing well. For privacy reasons, I won't go into the details, but through the night she did worse and worse, and nothing I did was working. She stopped breathing twice, and was having multiple seizures despite antiepileptic drugs. When I left on Sunday afternoon, she was 4+ sick. I was sure she would have passed away by the time I returned to the hospital this morning.

I wasn't far off - her family members, who, although shaken, were extremely understanding, had decided to withdraw life support this morning. By the way, this process is not easy - if you want to die in peace, don't go to the hospital. During this, I noticed the staff wheeling another ICU patient down the hall, lines and tubes scattered everywhere. And then, to my surprise, they wheeled this patient into the same room as my patient, placing the beds side by side.

This is not usual practice. The ICU rooms are large, but obviously not meant for two patients. When asking around, I discovered the reason. My patient's husband had been on the 5th floor in a different ICU, dying of a completely different cause. And come to find out, the family had planned on Friday to withdraw care after the weekend. The wife, my patient, had been involved in this decision. She had deteriorated so rapidly that now, their family members were faced with the deaths of their father and mother - at the same time.

We did indeed withdraw care, and both of them passed peacefully within a few minutes of one another. I absolutely cannot imagine having to do that with two family members.

Again, another sad story, because these are the ones I remember. And again, subtle reminders of my own reluctant experience in this arena. I keep hoping it's going to make me a better physician, because otherwise, it might be too much to deal with.

And I'm on call tomorrow.

Cameron Crazy

2007-11-02T18:00:00.000-04:00

It's been a while since I've updated the blog. I've just finished up the month in Dickson, after 11 (count 'em) calls for the month of October. So of course, what do I do on November 1st, the day I finish up this month?

Road trip!

Jonathan, Nate and I had hatched a plan to get together this weekend, and we were trying to get the logistics worked out. On Wednesday, a group of us were talking before rounds about the upcoming basketball season. Even though Charlotte now has an NBA team (I bet at least a couple of you didn't know that), they are, in all likelihood, the fifth most followed team for residents of the city, behind North Carolina, Duke, Wake Forest, and NC State. And maybe even sixth, behind the other Charlotte - the college 49ers who play in the Atlantic 10 conference. Anyway, we were talking about college hoops, and one of the pharmacy students mentioned that he had two tickets to the Duke game the next night in Cameron, and was looking to give them away.

My head spun around so fast that I almost gave myself whiplash.

I'm sure a lot of you know that I grew up as a huge Duke basketball fan. I started cheering for them because of the 1990 team that lost in the national title game to UNLV. Duke lost that game, in the biggest rout in NCAA title game history, no less. For some reason, though, as an eight year old, I remember thinking that there was something about the Duke team that I liked. Of course, the next two years Duke won back-to-back titles in dramatic fashion, and I was hooked as a Duke fan. I was born into a USC family, but I have also continued to follow and enjoy Duke athletics, and especially basketball. I know there are people who feel that it's duplicitous to divide loyalties like that. My feelings on that could fill another blog entry, but briefly, I love ACC basketball, I came within a hair of going to school there, I suffered through bad seasons and didn't fall off the bandwagon (remember 1995?), and most importantly, I'm grandfathered in as a fan at this point anyway.

Duke basketball is the most polarizing object in college sports. This is even more true now that Notre Dame football has fallen from grace. Fans of other schools, especially ACC schools, hate the perceived snobbery of the school, the (over?)zealous nature of the students, the national media attention they garner, and mostly, the fact that they continue to win. One of the things that is distinctive (and reviled) about Duke basketball is the arena where they play. Cameron Indoor Stadium was built in 1940, still has the quaint feel of an old-style venue, and is loud. It has been universally considered to be the best place in America to watch a basketball game. And, because of the fact that it seats less than half of most modern arenas, getting tickets to a game is almost as difficult as getting tickets to a Hannah Montana concert. For example, take a peek at the tickets available for this year's Duke-UNC game (make sure you're sitting down).

So you can understand why my head snapped around. The pharmacy student was generous enough to unload the tickets on me, and after being on call for 24 hours on October 31st, I struck out for Durham the next morning. Silly? Yes. Idiotic? Yes.

I convinced Jonathan to go with me to the game, knowing that he can't turn down basketball, even though he is a dyed-in-the-wool UNC guy. Anyway, Cameron is the kind of place that you have to visit at least once if you're a college hoops fan, regardless of your feelings about Duke. They were playing Shaw University, a small D2 school from Raleigh. Of course, Duke absolutely annihilated them, and looked very good doing it. The freshmen played very well, especially Kyle Singler, the 6-8 combo forward who has jumped right into the starting lineup. The building was extremely loud for an exhibition game, and the Cameron Crazies were already in midseason form. In fact, Jonathan and I stole a couple of cheer sheets, the papers that the students pass out before games to coordinate chants and general mockery of the other team. My favorite bit of wisdom on the cheer sheet: "Keep cheers clever, witty, and classy. If you want to use profanity, go to Maryland."

Even though I would have been embarassed to take so many pictures when I was younger, I simply don't care anymore. I know I'm getting old, because when I saw people going out on the floor after the game, I told Jonathan that I needed to go out there, just to be on the floor one time.

Here are some of the better pictures we got:

Outside Cameron. The architecture of the arena is consistent with the rest of the campus, and I'm quite sure there's nowhere else like it.

A wide view of the whole arena from our seats. Believe it or not, these were taken from the second-highest row in the place. There are no bad seats because the arena is so small. I laughed and told Jon we were in the nosebleed section.

The Cameron Crazies - best fans in college basketball.

Lance Thomas throws one down.

Jon Scheyer elevates for the jumper.

The final score. Ouch.

And finally, me, on "Coach K Court". I dreamed about being on this floor as a kid, although not exactly like this.

I had a great time at the game, but I had even more fun seeing Nathan, Jonathan, and Kim (and Jaime, I missed seeing you and the girls - you have to come see us when you come through Charlotte). I'm always reminded how much I miss seeing them when I visit. You guys are awesome, and Jonathan - thanks for going with me into "enemy territory" - I hope you enjoyed it half as much as I did.

Underrated Movies

2007-10-26T21:13:00.000-04:00

My tastes in movies and TV are somewhat removed from popular culture. Maybe not as much as I think, but I still feel like the ones that I like are the ones that get cancelled, or do badly at the box office. Still, I find that many times, when I'm talking about movies with people and mention a lesser known movie that someone else has seen, they tend to agree.

That being said, here's my top ten list of most underrated movies of my lifetime (since 1981). Of course, by no means am I the first person to do this. Bill Simmons from ESPN.com Page 2 ran a column on this a few years back. He included criteria for most underrated movies, from which I will shamelessly borrow:

- If it's playing 20 times a week on TNT, TBS, HBO17, TNN and everywhere
else, it can't be considered "underrated." Cable stations beat movies like
"Scarface," "Road House" and "Rounders" into the ground only because people keep
watching them. It's that simple."

(My movies that fall into this category and are therefore excluded:
Field of Dreams, The Shawshank Redemption, Kill Bill)

- Cult movies and underrated movies aren't necessarily the same thing.
People love "This Is Spinal Tap," "Dazed and Confused," "The Warriors" ... how
could they possibly be considered underrated?"

(My movies that fall into this category: Memento, Pulp Fiction,
Boondock Saints)

- Concentrate on movies that when you mention them to someone, they get
excited about it, and both of you feel like you're in a special club. To me,
that's the definition of an underrated movie. You love it, someone else loves
it, and neither of you can believe that everyone else doesn't love it, too. It
almost makes you angry.

One criteria for my list which I added: the movie must have an actor/actress who is not considered "A-list", but is nonetheless terrific and gives a great performance.

The Top Ten:

10. The Muppets Take Manhattan (1984) - the Muppets do get plenty of love, but most of it goes to the TV show and the original movie. To me, this one has better songs (it's set behind a Broadway musical), better cameos, a better plot, and better jokes.

Great Actor: umm... Gregory Hines? (although the Swedish Chef does deliver a subtle, nuanced performance). OK, so not the best example. They get better, I promise.

9. Moulin Rouge (2001) - I see the musical theme evolving here, and although I am happily and heterosexually married, I do have a soft spot for musical theater. Moulin Rouge had mixed reviews, but musically and visually it was stunning, and was really revolutionary in terms of format.

Great Actor: Ewan McGregor - certainly better known for his work in the Star Wars trilogy (the new one), but he actually is very talented and did all of his own vocals.

8. Primal Fear (1996) - A movie out of the "Usual Suspects" mold - the movie twists you in one direction throughout, and then snaps you back at the end (I won't spoil it for those of you who haven't seen it). Probably the most disturbing movie on the list - certainly not for the kiddies, or even for the squeamish adults.

Great Actor: Edward Norton - he plays the young altar boy on trial for murder. Very convincing portrayal of mental illness and anguish, coupled with cruelty.

7. Finding Forrester (2000) - A story of an old talented writer who takes a young talented writer under his wing in modern-day New York City. The boy, however, is an African-American who also happens to be a star basketball player. Great story-telling, and commentary on the expectations of those within and outside of our culture.

Great Actor: Sean Connery - OK, so everyone knows that he's a great actor. But come on... that accent? "I'll take 'The Rapists' for $200."

6. Kingpin (1996) - An underrated comedy, and one of the Farrelly brothers' best.

Great Actor: Randy Quaid - stars as Ishmael Borg, the Amish bowling phenom whose naivete about the ways of the world is played against Woody Harrelson's "one-armed bandit".

5. Match Point (2005) - I thought Woody Allen was washed up as a director, and I probably wouldn't have even rented this one if I had known he had directed it. I was stunned with the intricacies and psychological depth in this movie. A dark drama rife with tension, both romantic and violent.

Great Actor: Jonathan Rhys Meyers - a young Irish actor who is making his way into American cinema, although certainly not in the footsteps of Colin Farrell. He perfectly plays off Scarlett Johansson, who probably is the best young actress in Hollywood today, and is a very convincing femme-fatale.

4. Eternal Sunshine of the Spotless Mind (2004) - I really like the "indie" feel of this movie, and the high concept doesn't take away from the human element of the story.

Great Actor: Jim Carrey - Lots of good actors and actresses in this one - Kate Winslet has impressed me ever since she set the bar so low in Titanic - but Jim Carrey has really come into his own as a dramatic actor, and this one convinced me that he could consistently pull it off.

3. Out Of Sight (1998) - Steven Soderbergh is one of my favorite directors, and the cinematography in this "lighter" crime drama is classic. Elmore Leonard wrote the original novel, and he is a master at creating believable characters placed in unbelievable situations.

Great Actor: Don Cheadle - somewhat of a limited role, but he is incredibly diverse, and his character, "Snoopy Miller", adds even more color to the rest of the cast (Clooney, JLo, Steve Zahn, Ving Rhames, etc...) as an boxer-turned-thief.

2. Major League (1989) - People have gradually begun to appreciate this movie. The baseball scenes are depicted faithfully, and the comedy is classic. The movie is eminently quotable as well, with Bob Uecker delivering most of the one-liners as play-by-play man Harry Doyle. "Heywood swings, and crushes one toward South America..."

Great Actor: James Gammon - He plays the manager - you know, he's the guy with the raspy voice. He's also the "other" best source of quotes from the movie.

"Nice velocity."

"Sounded like it."

..."96 [mph]."

"Better teach this kid some control, before he kills somebody."

1. Vanilla Sky (2001) - Cameron Crowe is also a favorite director of mine. What I like so much about this movie, is the number of layers it exists upon. There are intricacies in the plot, visual hints, and beautiful imagery, as well as great acting (even though I don't particularly care for Tom Cruise). I've found that people, critics included, tend to either love this movie or hate it (or think that it's OK). I fall in the former category - this is one of my favorites.

Great actor: Jason Lee - now known primarily as Earl Hickey, Jason Lee plays Tom Cruise's faithful best friend.

Random, Funny Memories

2007-10-15T19:34:00.000-04:00

I'm sure a lot of you who read this blog also read my dad's Caringbridge site, which my mom has turned into her own personal blog, telling stories and posting pictures about Dad. She's a great storyteller, and I know she wants everyone to remember the best things about Dad, and how much he meant to her and the rest of us.

It seems like every day, less now than at first, but still multiple times, something reminds me of him. Very rarely is this something life-altering; usually it's something very small, almost trivial. Geraldine Foreman, the "second mom" to most of us who grew up at Wellford, told us after Dad passed away that the big things would not be as hard, because we would prepare emotionally. I think that's true - I've had a much harder time when these random thoughts creep in during the day, than during big events or things that I thought would be difficult.

But at the same time, these random occurrences have also been uplifting, because it reminds me of the wonderful times we had together. Mom is posting funny or otherwise memorable stories of Dad, so I would like to supplement that by posting little things that I have been reminded of over the last three months. Most of these you guys probably don't know, because they're funny little idiosyncracies that I never thought about before. Also, as I think of things, I'll probably just edit this post to add them as I go. If you guys have any other funny memories or things to add, please comment...

- Dad loved oyster stew, but I always felt like it was more tomato soup. He would ask for no oysters, or take them out himself, and then squirt ketchup into the soup until it was basically pink.

- Southern gospel was his favorite style of music - he loved the old southern gospel quartets, like Gold City and the Cathedrals - but I think his second favorite style of music was 1970s singer-songwriter stuff, like Carole King, Harry Chapin, James Taylor, and Neil Young. He always told me his favorite song was CSNY, "Teach Your Children". Very appropriate, I think.

-Of course, he never listened to this music, at least when the whole family was in the car, because we were always getting ready for the next Christmas, Easter, or other choir musical. We usually started listening to the Christmas musical on our summer beach trip. Starting that early was kinda like pancakes; all exciting at first, but by the end, we were sick of 'em.

- Sterling and I inherited our weird sense of humor from him. He loved Mel Brooks films (Young Frankenstein especially), and introduced me to a lot of the fine comedic cinema I know and love. As much as Sterling and I quote from movies, he could quote with the best of them. "Whose brain did I put it?" "Abby someone." "Abby someone? Abby who?" "Abby... normal."

-He was the one who instilled the love of golf in me. I kidded him that he should have pushed me harder when I was little, and maybe I would have ended up on the PGA Tour. But seriously, he never pushed me to do anything like that, and I eventually came to the game (sort of) on my own. He would always take Sterling and me along when we were young, even though I'm sure we weren't helping him to relax.

- When I started to play more and get more serious about it, we had some great father-and-son outings. I have a lot of fond memories of playing golf with him - the first time I ever tied him (we both shot 87 the summer before I started college); the first time I ever broke 80, at Eastport in Myrtle Beach; and probably my favorite recollection, when he and I went to the beach right before I started residency, and played 54 holes in two days. The last time we ever played together was November of last year at Links O' Tryon, with Doc. Obviously, we had no idea it would be the last time. I tried to get him to come and ride with me after he was diagnosed, but he felt like he was too weak. I would have given anything to play another round with him.

- A lot of people (especially AMRBC folks) knew Dad as a strict vegetarian, but I think he loved meat as much as anyone. One of his favorite (and my favorite) places to eat was Little Pigs Barbeque in Anderson; their beans were his absolute favorite, but they were cooked with barbeque pork in them. It was almost comical, watching him eat the beans to get the "meat flavor" and trying to avoid the actual meat!

-When I was younger, he and Mom used to give me big presents by having me open the smallest ones first, and they usually were terrible gifts unless you knew what was coming. I believe it was my 7th brithday, I opened a water dish and a bag of dog food. I actually started to tear up, until they brought out a new puppy. He always figured out a way to make special events really special.

- Probably the most memorable gift he gave me were tickets for him and me to a Duke-North Carolina game in Cameron. It was 2000, when Jason Williams and Mike Dunleavy were freshman, and Shane Battier was a junior, the year before Duke won the National Championship. He got the tickets through a ticket broker - I'm still not sure how. The broker actually met us at the door with the tickets - we were both terrified, right up until we had the tickets in hand, that it was a scam. Luckily, it wasn't, and we got to experience one of the most exciting events in sports in person. I still can't believe he managed to score those tickets, but he would have done anything for Mom, Sterling, or me.

OK, I think those are plenty for now. I'll keep writing stuff as I think of it, especially the strange, funny things that y'all probably don't know, but that I remember. Those are the things I don't ever want to forget.

The other ten best videogames

2007-10-14T12:49:00.000-04:00

Sterling, the videogame savant that he is, has posted his top ten games of all time. It's a pretty good list, and I started to comment about one or two he left out. Every time I listed one, I thought of another, and eventually, I realized I had to post a response. Dueling blogs! (Cue the banjos)

The (other) Ten Best Video Games of All Time

10. Area 51 (Arcade) - My favorite first person shooter in the arcade.

9. Sports Talk Baseball (Genesis) - The first sports game (that I remember) with announcers who said player names and realistic commentary. Well, mostly realistic. "Off the wall!"

8. Street Fighter 2 (multiple platforms) - I bet 90% of my generation could still tell you what character they played with. I am an E. Honda fan.

7. Grand Theft Auto III (PS2) - not for the easily offended or faint of heart, but was pretty revolutionary, and darn fun to play.

6. Crazy Taxi (Dreamcast) - This game was so fun and revolutionary when it came out, it has to be included.

5. Pilotwings (N64) - "Ooh yeah!"

4. Mike Tyson's Punch-Out (NES) - Everyone supposedly "knew a guy" that could beat Mike Tyson. I still don't believe it's possible. But armed with the secret code (007 373 5963), anybody can try.

3. Vegas Stakes (SNES) - Jonathan Durham and I stayed up until 6 AM one night when we were kids trying to beat this game.

2. The Legend of Zelda; Ocarina of Time (N64) - now that I think about it, the best measure of the quality of a game may be how late you are willing to stay up to play it. I stayed up until 5 AM my freshman year of college playing this one. During finals week. In someone else's dorm room. My name is Stephen, and I'm a game-aholic. (Everyone in unison: "Hi, Stephen.")

1. NCAA Football series (PS2, 360) - Recruiting and roster editing = almost as fun as the game itself. I say series because each year's version has its perks and drawbacks, but I think it's generally agreed upon that 2004 was overall the best game for gameplay and fun factor. Has transitioned seamlessly onto the next-generation platforms as well - 2008 is super fun, and the dynasty mode is revamped and much deeper.

And a couple not on the list but included for completeness' sake:

Fuzion Frenzy (Xbox) - would be on the list, but the game cheats for Sterling.

And of course, Dr. Mario (NES), which transcends the list. Awesome.

Update

2007-10-11T13:32:00.000-04:00

It's been a while since the last update, so here goes:

Our car was found! This is definitely a good thing. Last Saturday, Laura's parents and grandmother came up to Charlotte to visit. That afternoon, we got a call from the Charlotte-Mecklenburg PD, saying that a cop had located our vehicle. They asked if we wanted to come pick it up, and I said, "Sure, what towing yard is it in?" The dispatcher paused, then said, "Actually, it's still in a residential area. But the cop says you can pick it up yourself, if you have a screwdriver to start it."

I said, "Go ahead and tow it."

We picked it up on Monday, and although the paneling around the passenger window was ripped off and the ignition was damaged (we did have to start it with a screwdriver), and the battery was dead, everything else seemed to be pretty much OK.

In other news, I've been on call in the Dickson Heart Unit (CMC's cardiac ICU) every third night this month. I've mostly been taking care of heart attack patients, which is not too bad. The tough part is getting poor or no sleep every third night. You have enough time to recover, and then have to go back. You can see why the quantity and quality of my blog is suffering. It'll pick up again in November, when I do two weeks of Psychiatry consults. Those always make for interesting stories.

I've also been working on some "scholarly pursuits" - I've submitted an abstract (or a summary) of a case I had in the hospital to the American College of Physicians competition. I'm also completing a research paper on a new combination of breast cancer chemotherapy drugs. The writing is much more stale than what I write on the blog, let me tell you.

Also, my brother has started a blog. His first post was about him, and his second post is about Guitar Hero.

So obviously, you can see why I've had to wait a week to post again - nothing too interesting going on here. I'll come up with something else soon.

An Interesting Weekend

2007-10-03T20:31:00.000-04:00

My blog posts so far haven't tended to be about my life, primarily because nothing interesting happens to me. I spend most of my time in the hospital, sleeping because I didn't sleep at the hospital, or sleeping to get ready to not sleep at the hospital. And honestly, most of the days off I've had I've spent in Spartanburg, trying to help my mom with things or just seeing family. I love reading Jaime's blog because her two lovely children are ready-made anecdotes. I don't usually have anything like that, but enough happened to us this past weekend that it warrants a post.

First, we woke up on Saturday morning in the log cabin, as Sterling and I were going to the Carolina-Mississippi State game. Because I'm on call every third night in October, and my chances of getting tickets to the two home games in November are slim to none (Florida and Clemson), we really wanted to get to Williams-Brice for a game this season. As we all walked out of the house, each of us laughed/screamed in succession, as we saw three cows walking through our yard.

Yes, that's what I said. Three cows.

The ones of you who read my dad's CaringBridge site, which is now essentially my mom's blog, probably know this already, so I won't repeat the whole story, but you should definitely read her version of it. Suffice it to say we were surprised.

Anyway, the game was incredibly fun since Carolina won, and we picked up take-out from the Beacon for tailgating, so all in all, a perfect day.

Anyway, Sunday was really the day all the excitement happened. Laura and I went to church at Anderson Mill on Sunday morning. It's hard to believe, but it was the first time we had been back since Dad passed away. We actually had been to Wellford one Sunday morning, and although it was difficult being there, for some reason being back at Anderson Mill was much more emotional. I've heard that your emotions tend to creep up on you when you're not expecting it, and maybe that's what happened. Also, they talked about the search for a new music minister, and talked about Dad's ministry. In any case, Laura and I spent a lot of time talking about my Dad and how everything had changed so dramatically, and our emotions were already primed at that point.

We pulled into our neighborhood at about 9:30 Sunday night, and Laura first noticed something - her car was not in front of our townhouse. After we pulled up, we saw a note attached to our front door. The first sentence grabbed our attention, and told most of the story:

"Your car was stolen last night!"

You can't be serious.

After speaking with our neighbors, we found out that at about 2 AM the night before, one of our neighbors heard some noise outside and saw two teenagers over the passenger side of the car. The neighbor called the police, but (probably wisely) didn't go outside. The thieves made off with the car before the police could get there, and all that was left was the door handle. We filed a report that night, and haven't heard anything yet.

Of course, now that our car has been stolen, everyone has said, "Oh yeah, those Accords are the most popular cars for people to steal." The guy at the car rental place even guessed what year it was - apparently these cars have some design flaw that thieves have figured out. How come no one ever told us this before?

Oh well - I can't say that this is charted territory for us, but our insurance company has been great, we've got a rental car for now, and we've started to look for a replacement vehicle (if anyone has any advice about used sedans, let us know...). It was really tempting for us to ask what else could go wrong, but honestly, after the initial shock, this just reinforces to me how God is taking care of us in the midst of everything that has gone on. He certainly isn't going to stop providing now.

And hey, at least I have something interesting to write about.

NFL Picks Week Four

2007-09-28T22:41:00.000-04:00

Record through 3 weeks: 16-26-6

MINNESOTA (+ 1.5) over Green Bay
Houston (-3) over ATLANTA
N.Y. Jets (-3.5) over BUFFALO
CLEVELAND (+4) over Baltimore
St. Louis (+13) over DALLAS
DETROIT (+3) over Chicago
MIAMI (-4) over Oakland
SAN FRANCISCO (+2) over Seattle
CAROLINA (-3) over Tampa Bay
Pittsburgh (-6) over ARIZONA
SAN DIEGO (-11.5) over Kansas City
INDIANAPOLIS (-9.5) over Denver
Philadelphia (-3) over N.Y. GIANTS
New England (-7) over CINCINNATI

College Picks
Record Through 3 Weeks: 7-7-1
Mississippi State (+13.5) over SOUTH CAROLINA
GEORGIA TECH (+3) over Clemson
OREGON (-6) over Cal
FLORIDA (-18) over Auburn
Alabama (+2.5) over FLORIDA STATE

The Comprehensive Guide to Fall TV

2007-09-27T19:10:00.000-04:00

Fortunately or unfortunately, DVR has completely changed the way Laura and I watch TV. For example:

Exhibit A - I now turn on football and basketball games an hour after they start and "catch up" by fast forwarding through commercials and time-outs. Laura is an especially huge fan of this. Although I must admit, not watching it live does take away from the crowd/band ambiance, and it also turns me into a "recorded TV hermit", refusing to answer phone calls or check the Internet in fear that I'll find out the score by accident.

Exhibit B - I have an excuse to search for and keep old movies and shows from my childhood. FYI - American Gladiators = still cool (especially seasons 2-3); Bill and Ted's Excellent Adventure = not nearly as funny as fifteen years ago, although still eminently quotable. By the way, since Guitar Hero Rocks the 80's brought back "Play with Me", that song from the mall scene, I have a new respect for Extreme.

Exhibit C - Serial dramas like "Lost" and "Friday Night Lights" are much easier to watch, now that you can be assured of not missing an episode. Otherwise, my Wednesday nights would have been completely centered around a television show.

Exhibit D - Any time a promo for a new show comes on, I can TiVo it without a second thought, and watch it later to decide if it's worth repeated viewings. This is what I've done this year, plowing through the network premieres and grabbing anything that looked remotely interesting.

So, in that vein, I give you Stephen's New and Recurring Shows to Catch (and some to skip):

New Shows Not To Miss:

Chuck - the previews for this one did not pique my interest as much as some other shows, but I'm very glad I recorded the pilot. The premise sounds almost too silly: the protagonist Chuck (it's not just a clever show title) is a college graduate, but underachieving employee of the mega-electronics chain Buy More. His college roommate (who has since become a CIA agent) sends him a copy of an e-mail laden with government intelligence secrets. Hilarity ensues. No, seriously. The supporting cast is great, and the writing is clever without being too weighty or too frivolous. I especially enjoyed the transposition of Chuck's old job with the Geek Squad - oops, the Nerd Herd - at Best Buy - oops again, I mean Buy More - with his new gig as increasingly capable, knowledgeable superspy.

Journeyman - Unsuspecting man goes back in time to help others and put right what once went wrong. I know what you're thinking; "I liked this one the first time I saw it - when it was called Quantum Leap." There are enough changes in this version to distinguish it from Quantum Leap - journalist instead of scientist, remaining himself and not leaping "into" someone, leaping back home between leaps (maybe they're called something different than "leaps" this time, but does it really matter?). Most importantly, there's the added intrigue of Dan, the main character, being able to intervene and participate in his own personal history. And there was one other twist revealed in the pilot which has some intrigue - I wont divulge it here in case anyone wants to catch the show themselves.

Pushing Daisies - Well, technically, this one hasn't aired yet, but the premise is so intriguing that I had to include it here. Man whose day job is pie maker, also fingers murderers by night. How does he do it, you ask? Well, his touch can make dead things come to life. Ergo, touch the corpse, ask who killed him/her, bada bing. The visuals look pretty stunning and remind me a lot of the movie "Big Fish". The reviews are uniformly great also. I'll keep you posted.

Shows You Might Want to Watch:

Kid Nation - Neat idea for a reality show - plop down forty kids into an Old West ghost town, and have them make their own food, do their own grunt work, and govern each other. How very "Lord of the Flies". Although the show itself is not quite as microcosmic as I would have hoped - the kids already had a "town council" appointed for them, they have reward competitions where they can win things like a 45 foot waterslide (no kidding), and while there may not be adults leading the way (the host is an adult, by the way), there is an old "pioneer journal" which basically gives the kids instructions about what to do next. Clean slate, indeed.

Bionic Woman - I don't know if fans of the original will be elated or disgusted. Certainly the CGI gives it a visual edge, but there should be more to it than that. Michelle Ryan as Lindsay Wagner as Jaime Sommers is a bit distracting as well - she may work into the role eventually, but for now it seems a bit big for her. There were some unexpected philospohical questions that were worked in as well, and may have potential in the long run, although it felt a little unfinished as of yet (maybe that's the point). Honestly, the pilot just left me wondering which way this show would go, because I think it has potential either way.

Survivor: China - I've never gotten full-bore into the Survivor series, but this one has more interest for me, since three of the contestants are from South Carolina; Jaime, a USC student who went to Spartan High (and who's shining moment in the first episode was her candid observation that she wasn't wearing a bra); Erik, a Furman alum from the year behind me (2003) who I somehow managed to never meet; and Leslie, a mid-morning DJ from 91.9, the Christian radio station here in Charlotte. Leslie's first bit of camera time was a less-than-flattering depiction of her leaving a Buddhist temple after being asked to kneel in a "non-religious" ceremony. Good job, girl.

The Big Bang Theory - another Chuck Lorre creation (the guy who brought you "Dharma and Greg" and "Two and a Half Men"), which means that the first 10-20 episodes will probably be funny, after which time the jokes will begin to get stale. I'll admit, however, that the pilot was funnier than I thought, and with the sitcom crop becoming weaker and weaker each year, there's a distinct possibility this will be the best there is.

Shows to Skip

Life - The premise is this; a cop who was wrongly accused of murder and imprisoned for twelve years, is finally released and becomes a cop again. He has a new knowledge of the criminal justice system, but (surprise!) can't work a cell phone and has no idea what IM is. This felt a little like NBC is still trying to make up for Law & Order's general demise. This show, however, is no Law & Order. The techno-ignorance gag is already getting old, and the main character doesn't really have enough charisma to carry the show.

Private Practice - The backdoor pilot of this show aired last year during a supposed episode of "Grey's Anatomy". Addison Montgomery, the (former) neonatal surgeon from Seattle Grace has moved south to Los Angeles, and although the cast certainly seems to carry some weight (Taye Diggs, Amy Brenneman, and Tim Daly are regulars), the writing and character development are seriously holding them back.

Back to You - Again, fine cast of experienced sitcom actors (Kelsey Grammer and Patricia Heaton are the main characters), but the plot and the jokes are so formulaic that they are essentially handcuffed by the script. It will have to improve dramatically, and establish something unique.

And Finally, 5 Old Shows that if You haven't Started Watching Yet, What Are You Waiting For?

The Office - the best comedy on TV, and Jim and Pam are the most compelling will-they-or-won't-they couple since "Ed".

Friday Night Lights - the ratings were borderline, but critics and people who actually watched it agree - best new show last year, and potential for even more growth this year.

Grey's Anatomy - well, I know everybody's watching it anyway, so whatever.

Scrubs - most realistic medical show on TV. Seriously.

Lost - without a doubt, the best show on TV. Go get the first three seasons on DVD - you will be hopelessly addicted.

A Brief Patient History

2007-09-24T21:04:00.001-04:00

I think a lot of people have a healthy degree of what I call “medical curiosity”. I get a lot of questions from friends and family not just about health issues, but about how things work in the hospital. Of course, I’m happy to answer all the questions I can, but there’s a pretty big barrier to these questions a lot of the time. For instance, Nathan, Jaime, and Austin Kate came up to visit me when I was on call last month. Weekend calls at CMC are the worst, because they last 30 hours – from 7 AM to 1 PM the next day. Having them come up to see me was great because it broke up the day, but at the same time, I felt a little bad, because I couldn’t really show them what I do. I took them briefly to one unit, and then we went and sat in the Internal Medicine Break Room for an hour. I wish I could have taken them around to nurses’ stations, introduced them to people, or showed them my horrible handwriting in a chart. And of course, I couldn’t do that because of patient confidentiality.

Now of course, patient confidentiality is important (federal law says so), but it makes things tricky, especially when sharing stories about what I do on a day-to-day basis. Many of the uplifting, humorous, or depressing things that happen to me, I have to leave out key details, or not tell them altogether.

That being said, I’m going to do my best to fulfill everyone’s “medical curiosity” without revealing too many patient-specific details. So I want to share a story about a patient who I’m currently treating, with some changes to protect confidentiality.

This man was from up north, down here visiting some family, and went out for an afternoon walk. He started to feel some tingling and numbness in his legs.

And two hours later, he was paralyzed from his chest down.

We rushed him to MRI and called a neurologist, but essentially, the damage had already been done. The scan showed significant inflammation in his spinal cord, consistent with a disease called transverse myelitis.

Some of these people get better; most do not.

We did everything we could, but ultimately we discharged him to a rehab facility, essentially so he can learn how to live as a paraplegic.

I don’t want to belittle the tragedy of a young person suddenly losing the use of their limbs because of a car accident or a violent attack. But something struck me about this situation in particular: this man was not only normal beforehand, but he is now paralyzed without any explanation – he was not sick, had no preexisting conditions that would have led to this, and put himself in no high risk situations. He just got sick.

People think that doctors have all the answers; in fact, a lot of people get upset when we tell them we’re not sure what’s wrong. It’s comforting to think that we can explain things away based on our knowledge or insight. But the fact is, a lot of times we are just as clueless as the next person, and we can only hope for the best. I think that many of my colleagues believe faith is a good coping mechanism for patients, but I have to have faith of my own. It comforts me when I have no answers, and (I like to think) it comforts my patients as well.

I probably should share a more uplifting success story first, but, to be honest, these are the ones that you remember. No matter how many you see, it is disarming to take care of these kind of patients. We’re all human and this is a stark reminder of our frailty. I don’t have a lot of profound wisdom about this, what seems to be a tragedy. What I do have is faith – in that God has ordained my life and the patient’s life, and that His plan is perfect, no matter what may come in the future.

Psalm 139:14-16
14 I praise you because I am fearfully and wonderfully made;
your works are wonderful,
I know that full well.

15 My frame was not hidden from you
when I was made in the secret place.
When I was woven together in the depths of the earth,

16 your eyes saw my unformed body.
All the days ordained for me
were written in your book
before one of them came to be.

NFL Picks Week 3

2007-09-20T20:15:00.000-04:00

Week 3:

Record through 2 weeks: (10-19-3)

Indianapolis (-6) over HOUSTON
Buffalo (+16.5) over NEW ENGLAND
N.Y. JETS (-3) over Miami
PHILADELPHIA (-6) over Detroit
San Francisco (+9) over PITTSBURGH
TAMPA BAY (-3.5) over St. Louis
San Diego (-5) over GREEN BAY
BALTIMORE (-8) over Arizona
Minnesota (+3) over KANSAS CITY
OAKLAND (-3) over Cleveland
Cincinnati (+3.5) over SEATTLE
Jacksonville (+3) over DENVER
Carolina (-3.5) over ATLANTA
WASHINGTON (-3.5) over N.Y. Giants
CHICAGO (-3) over Dallas
Tennessee (+4) over NEW ORLEANS

College Picks:

Record through 2 weeks: 4-5-1

South Carolina (+16.5) over LSU
Clemson (-7) over N.C. STATE
Georgia (+3.5) over ALABAMA
Penn State (-2.5) over MICHIGAN
ARKANSAS (-7) over Kentucky

Ahoy, today is national Talk like a Pirate Day. Aye, me parrot concurs.

2007-09-19T10:26:00.000-04:00

Or, translated into modern English, today is National Talk like a Pirate Day. This title brought to you by the Pirate Speak Translator.

So feel free today to throw in random phrases like "Savvy, mate?" instead of "Do you understand?" or "Shiver me timbers" instead of "I'm surpised". Or, my personal favorite, instead of saying, "I see your point, and I concur," you can say, "Yarr..."

In tribute to Talk like a Pirate Day, I would like to commemorate my top ten favorite pirates throughout history...

10. Long John Silvers

By the way, the pirate name creator on their official site says that my name is "One-Eyed Willie the Squeamish". Rock on.

9. Jack Sparrow

Ushered in a new era in pirate popularity. Should have won an Oscar. No kidding.

8. Stan Belinda

Former Pittsburgh Pirate pitcher near and dear to my heart, because he gave up the single to Francisco Cabrera in the 1992 NLCS, creating the dramatic scene ending with Sid Bream, slowest man in human history, scoring the game and series winning run. Belinda became a journeyman reliever (hence the Reds hat), and actually pitched briefly for the Braves. Interestingly, was diagnosed with multiple sclerosis while still pitching in the majors.

7. This guy:

6. Jimmy Buffett

He may be a pirate, but he's two hundred years too late. Unfortunately now, the cannons don't thunder, and there's nothing to plunder either.

5. Steve the Pirate

"The dread pirate Steve be in no man's debt. I'll make a barter with ya; true as the north star. In exchange for your kindness, I'll be sharing me buried treasure with ya... once I find it, that be."

4. The pirates from Garfield's Halloween Adventure

My favorite character is really the cabin boy, but he's not a true pirate. "They know who we are!!!"

3. Captain McAllister

"Have you ever seen the sun set at 3 PM?"

"Aye, once... sailing round the Arctic..."

And Captain McAllister's revelation...

2. Napster

Ah, for the good old days, when Internet piracy was cool and Napster was free.

And finally, the most fearsome pirate of all time...

1. Hal Harrison

Arrrrr...

Week 2 NFL Picks

2007-09-14T15:16:00.000-04:00

Well, I definitely whiffed on some of the NFL picks last week. The biggest was Pittsburgh and Cleveland. Wow, the Browns are really terrible. And my pessimism obviously paid off, because picking against my two teams (South Carolina and the Panthers) resulted in big wins for both of them. On to the picks:

Current Record (after one week): 6-8-2

1. CAROLINA (-6.5) over Houston - The Panthers proved me wrong big time last week. Their defense stepped up in the second half and squelched the Rams. I think that part of that was how well they match up with St. Louis, but I see no reason for the defense to let up this week. Houston and Matt Schaub are likely 1-2 years away.

2. Kansas City (+12) over CHICAGO - too many points to give up for the anemic Chicago offense. I fully expect the Bears to win, but K.C. is not going to give up on the run so easily this week.

3. San Diego (+3.5) over NEW ENGLAND - Will Videogate be a distraction? I doubt it, but the Chargers have the intangibles on their side and will be out for revenge after last year's playoff loss.

4. Washington (+6.5) over PHILADEPHIA - The Eagles were decidedly unimpressive against the Packers last week, and while they likely will pull it out, I think a touchdown is too much.

5. JACKSONVILLE (-10) over Atlanta - The Jaguars looked bad last week, abandoning the run game and idling offensively. But the Falcons looked worse. Much worse. Worst team in the NFL worse. They auctioned their future by signing Vick to a huge contract, chasing season ticket sales instead of a winning product. And now, they'll pay the price while Vick waits for his sentencing.

The rest of the games:
Indianapolis (-7) over TENNESSEE
ST. LOUIS (-3) over San Francisco
N.Y. GIANTS (pick 'em) over Green Bay
PITTSBURGH (-9.5) over Buffalo
Cincinnati (-6.5) over CLEVELAND
New Orleans (-3.5) over TAMPA BAY
Minnesota (+3) over DETROIT
MIAMI (+3.5) over Dallas
Seattle (-3) over ARIZONA
N.Y. Jets (+10) over BALTIMORE
DENVER (-10) over Oakland

College Picks:
(Clemson and Carolina have no spread this week)
FLORIDA (-7.5) over Tennessee
Arkansas (+3) over ALABAMA
GEORGIA TECH (-6.5 ) over Boston College
Southern Cal (-9.5) over Nebraska
Ohio State (-4) over WASHINGTON

Beachin'

2007-09-13T18:35:00.000-04:00

So Laura and I, along with her family, have been enjoying life since last Saturday down here at Myrtle Beach. We're staying in a cool little house in North Litchfield, and I've been pleasantly surprised, because it is absolutely deserted down here. I guess people don't think about going to the beach after Labor Day, and people who have school-aged kids are limited by their schedules, but September is really a great time to come down here. The weather is still great (except for some scattered thunderstorms), it's much less expensive to rent during this time, and the only people around are senior citizens. No kidding. The only problem with this is that the early bird specials are very crowded.

In any case, this is the first weeklong vacation that Laura and I have had since my second year of med school, so we have truly enjoyed the relaxation. It's also been great to have her brother and his wife down from New York, as we don't get to see them as often as we'd like.

Probably the highlight of my week (so far) has been the golf we've played. Even though our round was rain-shortened, we got in nine holes at a cool course called World Tour Golf Links. The premise is neat - every hole (they have 27) is modeled after a famous hole or holes from courses around the world; for example, Amen Corner at Augusta, Nos. 1 and 18 at St. Andrews, the 18th at Winged Foot (now best known as the site of Phil Mickelson's meltdown in the 2006 U.S. Open), and lots of others. That aside, however, I really enjoyed the course, and would recommend it independent of the "world tour" aspect. In fact, because we got a 9-hole rain check, we're going back tomorrow to try and get in 18 (weather permitting).

Although I'm not as good at chronicling my life in picture format (see Brown, Jaime), we took some pictures that turned out OK.

The front view of the clubhouse. For those of us who have never darkened the doors of a championship country club, this was pretty cool.
The same clubhouse from the 9th fairway. The lake in the foreground is an homage to the 11th at Bay Hill.
David's fantastic form from the fairway. (Alliteration aside, I'll take my chances).

Doc from the tee on the par 3, modeled after the 12th at Augusta. It's funny playing a course that you have never seen, but you still sort of know. I knew this was a sucker pin (it was the traditional Saturday pin placement), but I still dumped it in the front bunker.

Stephen driving on the next hole, modeled after Augusta #13. The Nelson bridge is in the background (well, not the actual Nelson bridge, but you know). By the way, I did not go for the green in two because I drove it through the fairway, but I still made par. You guys who watch the Masters religiously know what I mean.

David and Doc on the Hogan bridge.

That's it for now. College/NFL picks tomorrow.

NFL Picks

2007-09-06T19:02:00.000-04:00

Although high school and college football have already kicked off, tonight marks the beginning of the NFL season, which is primarily important for two reasons. Number one, it effectively stretches the football weekend from Thursday to Monday, leaving only Tuesday and Wednesday as pathetic football-less days. And second, it means fantasy football gets underway. For those who haven't drunk the Fantasy Football Kool-Aid yet, I'll be writing about that shortly. In the meantime, I wanted to post my NFL picks and a couple of college picks for the weekend. As long as my schedule allows, I'll try to post my picks every weeks so either I can look back and prove I guessed right, or y'all can make fun of me. But keep in mind, the first week in the NFL is always the hardest to pick.

I'll also try to give some commentary/insight on a few games, just to keep it interesting:

1. ST. LOUIS (-1) over Carolina - This game is actually quite difficult to pick, as these are two teams that are in the middle of the pack and could go either way. After watching the Panthers' first team defense get shredded by Tom Brady, Laurence Maroney, and the rest of the Patriots' offense, I shudder to think about Steven Jackson plowing through the front seven, and Torry Holt running wild in the secondary. Here's hoping I'm just being pessimistic.

2. Detroit (+1.5) over OAKLAND - The combination of an improving Detroit team, plus a brand new coach and no significant personnel improvements in Oakland, equals a Lions' victory. Paging JaMarcus Russell...

3. SAN DIEGO (-6) over Chicago - This line is a little too high for my liking, especially since the Bears' defense is so stifling. Still, I can't shake the feeling that San Diego is going to make a lot of good defenses look average this year. My guess is that it starts Week 1.

4. Indianapolis (-6) over New Orleans - People forget how soft the Saints' schedule was last year en route to their division title and NFC Championship appearance. Their defense is still suspect, and this is exactly the wrong team to start. I look for Peyton and co. to pick up right where they left off last year.

5. CLEVELAND (+4.5) over Pittsburgh - I'm not sure why, but this one has the makings of a "first game home underdog upset" to me. Pittsburgh will end up being a pretty good team, I believe, but I think four and a half is too many points to lay on the road.

The rest of the games:
Denver (-3) over BUFFALO
Miami (+3) over WASHINGTON
JACKSONVILLE (-6.5) over Tennessee
Kansas City (+3.5) over HOUSTON
Philadelphia (-3) over GREEN BAY
Atlanta (+3) over MINNESOTA
New England (-6.5) over N.Y. JETS
SEATTLE (-6) over Tampa Bay
N. Y. Giants (+5.5) over DALLAS
CINCINNATI (-2.5) over Baltimore
SAN FRANCISCO (-3) over Arizona

College Picks:
GEORGIA (-4) over South Carolina
CLEMSON (-27) over UL Monroe
Virginia Tech (+12.5) over LSU
PENN STATE (-17) over Notre Dame
MICHIGAN (-8) over Oregon

Labor Day, College Football, and the Anatomy of an Upset (I think)

2007-09-03T10:20:00.000-04:00

This has been a great weekend. After being on call the night of the 31st (Friday night), I was turned loose from the hospital about 9 AM on Saturday morning, and I had the whole weekend off! This is the first time I've had two consecutive days off since the 28th and 29th of July, so I've been using the time to recuperate and spend some time with family here in Spartanburg. We stopped in at the Beacon, ate at the Clock, went to church at Wellford Sunday morning, which is always wonderful. Plus, I got to enjoy the first full day of football on Saturday, so I'll give you a couple of thoughts about the first week of the season.

The Gamecocks did pull one out, 28-14 against Louisiana-Lafayette, but they obviously haven't hit their stride yet (the real question is, will they hit their stride at all?). Most concerning was the defense, which gave up no fewer than three sustained drives, with almost all of the yardage given up on the ground. Winning next week between the hedges can't happen with an effort like that, but Steve Spurrier seems to pull his team together for these kinds of situations.

Bobby Bentley's first game at Presbyterian showed some flashes of the Byrnes offensive magic, but it was pretty clear he doesn't have the horses to run with the big boys in Division I yet. My Paladins took care of business at home in a 40-16 game which wasn't really that close.

But of course, the biggest news in football, and the story getting mainstream national news, is the 34-32 upset of Michigan by the Mountaineers of Appalachian State. I doubt anyone hasn't heard by now, but App, who plays in the Southern Conference with Furman and Wofford, went to Ann Arbor and beat the Wolverines, who were ranked #5 in the preseason poll and were favored by many to win the national championship.

The sports commentators and talking heads have spared no hyperbole talking about the magnitude of this upset, calling it the greatest upset in the history of college football, and maybe in the history of sports. This is absolutely absurd. I have now spent close to ten years following I-AA football (the classification below I-A, now called the "Football Championship Subdivision", since they decide a national champion on the field instead of in a computer). The level of football is not as good as I-A, of course, but the gap between the two is not nearly as wide as the media makes people believe. For one thing, whenever teams from the two classifications play each other, the game is always at the home of the bigger team. This is a purely financial situation, but creates imbalance nonetheless. Of course, the resources of the athletic department, the boosters, number of scholarships, and generally the student bodies themselves are much larger at the DI-A schools (for example, App has one of the larger enrollments in the SoCon, about 15,000 - Michigan has 40,000). And finally, the media attention given to the larger schools perpetuates this situation further.

I'm not lamenting the fact that I-AA (sorry, FCS) schools don't get enough attention; I think it's fine that they aren't recognized on a national scale. But, when this is called the biggest upset in college football history, it is out of an ignorance and lack of respect for the FCS as a whole. App State has won two consecutive national championships, at the highest level of college football that actually decides a champion on the field. I certainly wouldn't have expected them to win, but I for sure expected them to put up a good fight, and to surprise these national media types who, for some reason, still think that the Big Ten schools and Notre Dame are the only institutions that play big-time college football. Coming from someone who has watched a lot of Furman football since 1998, I know how good of a team App is. I-AA schools play much bigger schools in major conferences every year, and although there are plenty of mediocre teams that are sacrificial lambs, there are also teams like App, Furman, New Hampshire, and Southern Illinois that have beaten the big boys recently. This is not a new phenomenon, especially in basketball where there are many more games on the schedule, and "mid-majors" have consistently garnered enough wins to gain respect on the national level. Football has taken longer to catch up, but two main factors have finished the job: the addition of a 12th game, and the relaxing of the rules in I-A regarding wins over I-AA teams counting towards bowl eligibility. Expect to see more of this in the coming years, because the talent level is leveling out as more college football players are leaving behind big programs for playing time at smaller schools, and the deluge of college football news coverage has now spilled over, even to the little guys.

Let me share a personal example to wrap this up. There are two Furman football highlights that stand out in my mind from my time there. One is October 30th, 1999, at Kenan Stadium in Chapel Hill, NC, when the (I-AA) Paladins went on the road and thrashed (I-A) North Carolina 28-3.
The other was December 15th, 2001, in Statesville, GA, when the (I-AA) Paladins upset the (I-AA) Georgia Southern Eagles 24-17 to advance to the national championship game. Ask a national media pundit which of those victories meant more, and I'll guarantee he'll get it wrong.

Then again, that's the same guy who thinks that Appalachian just pulled the greatest upset in sports history.

The Heat

2007-08-29T17:28:00.000-04:00

Yesterday was a big day in Christian music. Casting Crowns' new album came out, The Altar and the Door. I haven't heard any of it yet except for the new song, East to West, which is great.

But more importantly (to me), one of my great friends and college roommates, Joe Stillwell, and his band NeedToBreathe have released their sophomore effort. It's called The Heat, and I had the privilege of hearing it last month before it was released. Their first album, Daylight, was very good, but this album is a new high for them. The first single is called "Signature of Divine", and is so fresh and catchy that I won't be a bit surprised when Christian radio stations everywhere start playing the fool out of it. I already heard it on the XM Christian station, and that was even before the album dropped.

Here's the video of the new single, so you can tell I'm not just hyping them for no reason:

The whole album is available at any of your fine local music retailers, on Amazon, or for download on iTunes.

Joe - you guys rock. Keep up the good work, and we'll see you when y'all come to Charlotte.

Dining in the Carolinas

2007-08-28T20:52:00.000-04:00

And now, for something a little more light-hearted...

Laura and I are not particularly adventurous people. We are both creatures of habit, of routine. We have settled firmly into a “restaurant rut” – we tend to eat out (too much) at the same places. So we were excited when Nate, Jaime, Jon and Kim came to town, because we had an excuse to get out and try a new place. I had heard good things about Lupie’s Café here in Charlotte, and we trekked over there for lunch last Friday. It was billed to me as a meat-and-three, but it was more eclectic than that. The mac and cheese was not as great as advertised, but the chili was fantastic, and the tea was so good it made the trip worthwhile.

Even though we haven’t completely come to grips with the restaurant scene in Charlotte, I feel pretty comfortable with eating out in most places in North and South Carolina. So without further ado, I give you Stephen’s Top Ten Restaurant Picks, one for each major city in the Carolinas.

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Happy Anniversary

2007-08-27T17:36:00.000-04:00

Today is both a happy and a sad day. Thirty years ago today, my father and mother were married at Holston Creek Baptist Church.

I've spent the day thinking about the meaning of an anniversary in this context; that is, after the death of a spouse. I was doing a little reading about this, and stumbled on this parable in Matthew, which I remembered only after I read it again:

Matthew 22:23-33
"That same day the Sadducees, who say there is no resurrection, came to him with a question. 'Teacher,' they said, 'Moses told us that if a man dies without having children, his brother must marry the widow and have children for him. Now there were seven brothers among us. The first one married and died, and since he had no children, he left his wife to his brother. The same thing happened to the second and third brother, right on down to the seventh. Finally, the woman died. Now then, at the resurrection, whose wife will she be of the seven, since all of them were married to her?'

"Jesus replied, 'You are in error because you do not know the Scriptures or the power of God. At the resurrection people will neither marry nor be given in marriage; they will be like the angels in heaven. But about the resurrection of the dead—have you not read what God said to you, "I am the God of Abraham, the God of Isaac, and the God of Jacob"? He is not the God of the dead but of the living.'

"When the crowds heard this, they were astonished at his teaching."

After reading this, I thought, "How can I reconcile this with still honoring anniversaries after the death of a spouse?" Jesus actually says that people will neither marry or be married in heaven. Does this mean that anniversaries are, for lack of a better term, invalid after death?

A few thoughts came to my mind out of thinking about this. First, Jesus was speaking to Sadducees who were very adversarial and opening trying to trick him into contradicting himself or Scripture, so he had to be both guarded and explicit about his words.

I also think about another passage of Scripture, in Revelation 21:

"Then I saw a new heaven and a new earth, for the first heaven and the first earth had passed away, and there was no longer any sea. I saw the Holy City, the new Jerusalem, coming down out of heaven from God, prepared as a bride beautifully dressed for her husband. And I heard a loud voice from the throne saying, 'Now the dwelling of God is with men, and he will live with them. They will be his people, and God himself will be with them and be their God. He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.'"

This passage was referenced more than once at Dad's funeral, referring to Death being no more. But I want to focus on verse 1-2, which use the analogy of the new Jerusalem as the "bride of Christ". I think the eternal nature of this bond is echoed in marriage. I don't think when Jesus said we'll not be married in heaven, he was denigrating the bond of marriage. Rather, I think Jesus was reinforcing the bond that we all will have in heaven. Marriage on earth was designed by God to imitate the bond that Christ has with his bride, the body of believers. In heaven, because of our communion in God's presence, we will all be bonded through Christ.

Please don't flame me because of my theology - I spent my education studying about less important things, like the human spleen. Really, I'm just a guy trying to come to grips with a difficult situation, and reconciling the importance of a pretty difficult day.

Mom (and Dad) - Happy anniversary. If my marriage is anywhere close to yours in commitment to God, each other, or your children, I'll consider my life a success. I love you very much.

A Celebration of Life - Steve Dyar

2007-08-26T14:19:00.000-04:00

For those of you who were at Dad's funeral, you may remember the beginning of this slide show; it was playing behind his brothers while they sang. Unfortunately, we only saw about half of the pictures because of some timing issues. So, Sterling and I made some modifications and converted it to video. I hope you enjoy watching - many of these pictures capture my memories perfectly.

A Totally Boring and Nerdy First (or Second) Post

2007-08-19T18:49:00.000-04:00

Rest in peace, Merv Griffin.

For those of you who don't know, Merv Griffin died earlier this week. He was a pioneer in game shows, and was the man behind Jeopardy and Wheel of Fortune, among other things. It makes me sad that "reality TV" is so popular now, when the two kinds of original "reality" programming - live sports and game shows - are much more interesting. So, in case you're not familiar with this classic genre, I give you my top 10 game shows of all time:

10. Bumper Stumpers - An old, short-lived game show which made phrases into license plates. Fun for anyone who's ever almost rear-ended someone trying to decipher their license plate.

9. Win Ben Stein's Money - It makes the top 10 just because of the witty category names (i.e., Keep Your Hands Off My Balzac) and Jimmy Kimmel as co-host.

8. (Classic) Concentration - Originally came out in 1958, but I grew up on Alex Trebek's "Classic Concentration". This is the one with the rebuses (rebi?) that are revealed after you match different prizes.

7. Tic Tac Dough - winner of the "best 80s theme music" award. Tic Tac Dough still occasionally comes on GSN; the premise is simply answering trivia questions in categories appearing on a tic tac toe board - first to get three in a row wins. Hosted by Wink Martindale, whose career has since degenerated into a job as spokesman for orbitz.com.

6. $10/25/100,000 Pyramid - The best endgame in game shows (try and give someone a list of "things that are transplanted"), and Dick Clark as host. Also, Joey Tribbiani made a guest appearance on the new Pyramid.

5. Scrabble - seriously underrated. Chuck Woolery hosted, and the primary objective was to guess a word on the Scrabble board after letters are placed one by one. The clues were always a play on words, and so it took a good deal of thought to come up with the answer. I really wish GSN would buy the rights to this one.

4. Press Your Luck - not the "all new" Press Your Luck, the original 1980s version. One homecoming at Furman when the float theme was game shows, someone traced out a giant whammy onto a sheet of plywood, and Dad cut it out with a sawzall. The thing was six foot tall, was a huge hit at the float, and stayed in our apartment for two years after that, just staring at people.

3. Jeopardy - Classic. Has been around for years, got totally revitalized by the Ken Jennings winning streak, and hasn't given into the pressure to add gimmicks (like Wheel of Fortune). Also, fun to yell out answers at the TV before your significant other can answer.

2. Family Feud - Unlike number 1, has had to withstand multiple hosts and upgrades through the years, and the Ray Combs story is about the saddest thing I've ever heard. And yet, has managed to stay popular and interesting. Also gives prime material to Game Show Blooper videos (like this guy).

1. The Price Is Right - what can I say? Even people who hate game shows know the Price is Right. Bob Barker is a cultural icon (he was in Happy Gilmore, for crying out loud!), and I'm actually dreading Drew Carey's first show. I suspect the staying power of the Price is Right will be gone along with Bob, but we'll see.

Incidentally, I could probably do a top 10 of the best games on the Price is Right, but I'll just leave you with these:

Most overrated - Plinko

Most underrated - One Away

Game you have to be an idiot to lose - Clock Game

Best sound effect - the yodeler in "Cliff Hangers"

Post Numero Uno

2007-08-19T18:24:00.000-04:00

Well, here it is. My first attempt at a blog, or some semblance of one. I’m not really delusional enough to think that anyone is dying to get inside my head. Honestly, I think this may be more of an outlet for my ramblings than anything else. I’ll probably talk a lot about sports, some about medicine, a fair amount about my family and my emotions about recent events, and maybe some randomness as well. Feel free to comment, argue, agree, or otherwise let me know you’re listening.