Notes on life, philosophy, and medicine

For years, you might have heard God or sermons on the goodness of all things, our sovereign God who can or uses everything for some greater purpose. I'm 36, I'm only seeing it now. As a physician, I hear peoples' stories daily - their losses, their suffering, their tragic past or current life - and in my own life - though pales in comparison - I also see the victories. AND there, I see God use the most tragic of stories. I see his hand working in my life and in those around me, curating the pain so that something so much more powerful happens.  The most amazing thing is, you start to see it. You don't have to question if it happens. So, in your darkest hour, I pray you remember this because it's true: There is a plan and purpose for your life and there is an open invitation for a goodness that surpasses our understanding especially in our lowest moments. 

It’s hard. My vote -I want to see a ban on high fructose corn syrup. Industry leaders, time to stand up, see what your foods are doing to us and change. Right?  #calltoaction

Search no more - why is the fight for healthy eating so difficult! Because so many things on supermarket shelves are high processed and it seems like everything has added sugar. This month, as part of whole 30, I attempted to eliminate among other things any added sugar to my diet. I'm not at an unhealthy weight but I hated the fatigue and the joint pain. This is one experiment I highly recommend doing because it's about getting to know yourself and knowing what foods do to your body so that you can make good decisions. So - I'm just going to start this list but plan to continue to add to it as I find products that are delicious without the added sugar. 1. essentially anything whole/unprocessed fruits, vegetables, meats, fish etc. 2. organic dried mango - I've found great bags of these at trader joes and Costco 3. organic peanut/almond butter from Costco 4. RAO's tomato sauce. YUMMY. 5. Mixed Nuts from Costco. 6. Traders Joe's Kale Gnocci 7. C

My patients struggle. I struggle. I don't have diabetes. I don't have a hurt back (at least not anywhere close to what my patients experience). I don't have some autoimmune disease. I am not obese. But sometimes I eat things and know that I'm eating it because it makes me feel good now but I may regret it later. I eat it out of spite for what I'm experiencing inside of me. I want to stuff my face and my gut so full of processed chemicals or sweet moist chocolate something or rather. I want to drive through McDonald's or Jack in the box and chase away tears and find memories of my past that maybe brought happiness. So, that struggle sucks. Rather than somehow face some nebulous emotional problem that has no immediate answers, I want to inhale food. So much so that I guess it makes it harder to find the answers and then maybe we hate ourselves a little. Maybe we ask of ourselves to be better. We find a way. We know what works. We try again, we feel good b

up again. i know i just wrote earlier today, but this is the first time i've been up at 1:25am in awhile... picking up where I left off, where I often leave off. I came downstairs to write and yet I found myself spending an easy 2 hours distracted with an online search for escape/with lofty plans and little to show for it. I could have probably written a novel by now. I love this. Love the feeling of letters into words beneath my fingers like I have something valuable to say like what I say may never have been said before but it all has. what makes up a great mind? is it simply the perfect storm of place/time that allows minds that wander to come to fruition? I can't imagine any mind being less than only limited by our own doing and not allowed the breath of life that is a God given to all who accept it. so, my life today: 22 days till Christmas 2019, some near 36 years has passed and I'm sitting between a 3 foot Christmas tree that we scored for free 5.5 years ago at s

For our 2nd annual memorial service Dear Friends, Today we come together to reflect on lives that have touched our own both in their living and in their passing. I cannot say what it means to another person but by sharing our memories today may be we are able to connect our individual story to a greater tale. In my own personal reflections, I wrote a poem that I would like to share with all of you. Perhaps you call it karma or simply the unknown I have named it faith - to believe in the unseen Yet still, I feared death. which of my parents would die first I pondered old wives tales about toes, my 2nd phalange was longer so surely no, I could not imagine but no matter, it happened shattered a future I had yet to even picture days lost to never return heart ache that could only be mended by the tincture of time something often on our side as the family physician oh how these moments mark us how sharpened and shaped we become destined to know hurts so deep and so

today my 16 month old son and I went to visit a potential sitter and she had a vietnamese show playing on tv, as soon as we walked into the house and he caught a glimpse of the television, he grinned from ear to ear, with a smile and joy that told me, "I remember." When he was 4-5 months old, his great grandmother came to Seattle to watch him while I had to go back to finish some schooling. We set her up with you tube and google chromecast so that she could watch her vietnamese shows. So my thought is that maybe we can recall with storybook accuracy about our lives in utero/maybe the heaven beforehand or the several years of childhood, but viscerally, we feel it and "we know." And when we recognize those things/the smells/the sounds/the tastes that gave us so much joy as a kid, we experience that joy again and that is just an awesome, beautiful thing. I'm thankful he will remember the good things and as for the bad or our mistakes along the way, I'm so g

dear big hospital institution, my question for you is are you a health (life) giving or a health (life) taking place? if you realize that you were the latter, would you change? how would you change? When does a hospital become just a place of employment? How can we maintain our ability to be a place that offers hope, life, and even perhaps peaceful place of death? How can we empower our patients to take care of their own health? how can we create an environment where health/life reigns supreme and death and dying are respected not an invasive part of society? how can we always recognize the human aspect of what we do in medicine?

what's wrong with a hospital that is too big? does it take away the individual responsibility of caring for their own health. the same way big government takes away the intimate knowledge and responsibility one feels toward their community?  So we might have clean streets, but is it sustainable when the community is only paying for it to some form of taxation 10 steps far removed? Or rather, what is lost - so we have clean streets but we don't know our neighbors?  Has the hospital become a place where people go not only for emergencies, but is the easiest option for someone to go when they don't have a community that knows their name or cares about their health?  Can their hospitals do better? Are there better hospitals?  What about teaching hospitals? highly stratified systems with no one truly invested in your education?  who is teaching who?  who is learning what?  I suppose for now, I will learn what I can, see what's out there through green eyes. Will someone

Medicine note: for me, the care of a patient, a neighbor, a friend...is not in the one time heroic measures of surgery but the persistent, long term, empowered, and effort that goes into building a community: a safe haven, a place to practice peace, to change lifestyles that makes the lasting difference in the health of the individual and for the future community. To teach a man to fish, rather than to give him fish. This is the heart of medicine and healing.

youtube video on education is a must watch. I think I've subscribed to it; look into ROWE (objectives and outcomes based, but autonomous schedule), post exam learning, have other students teach, truly pass/fail, study tips, interactive orientation week.

Imma gonna keep learning.

not a great topic the mortuary business? my first cremation are you buying a casket for your loved one? will you witness the cremation? ask the crematory if he will be cremated with the coffin you purchased police escorts are great feathergill mortuary in sd was on point having a social worker there that day (i'm not sure who called, but it was very cool) having a viewing on a weekday and the funeral service on a weekend know ahead of time when all this is happening so you can tell everyone in advance be sure to meet and talk with friends and family of your loved one during the viewing find out stories ask and encourage stories that make you laugh and bring you joy accept god's grace and his PERFECT timing. traveling a lot can be a pain once between the funeral home/service to the site of cremation is not terrible. perhaps having both service and cremation on location is not bad, but traveling by police escort (a short distance) is peaceful. celebrating life after funeral servi

it's been a super long time...but here's my two sense 1) i think its silly to say "i don't know why the body chooses to do this .i.e. recurrent laryngeal nerve coming off your vagus nerve and coming around to wrap around your aorta, it's so stupid. - would i really trust YOU (who said it was stupid) to design my body? just a thought. 2) it's probably better to question why the body is the way it is and discover how it helps/works for you. 3) most cross sections/body books are from someone else's body so your R. is their left./why not have it so that their R is your R...less confusion? can you just do surgery over someone's head vs. from below? --> cool art project.

integrity of heart, protecting heart... hmm (i think i just wanted a distraction). love over guilt. ceaseless passion and desire. wake up content (somehow).

it's not about our plans, it's about attuning ourselves to god's already great plan so that we can live out a great life for His glory. a life that is unsurpassable, unimaginable by any human standard.

i just spent one week in guatemala and four of those days creating and supporting the smooth running of a medical clinic with a team of dedicated god fearing people and a 7 year-old. and now that i'm back home sick from some uri (upper respiratory infection) most likely caused by a guatemalan virus (if there is such a thing), i think that i'm blessed despite some very loud complaints. i don't think i've been this sick for quite some time if ever. i'm experiencing all flu like symptoms including awful sore throat (hurts to swallow), burning eyes, throbbing headache(that's improved), fever, chills, rapid heart rate, muscle ache. i'm pretty sure it's not more serious than a virus that my body, god's temple, can conquer. my point is being ill connects me to the people i tried to help heal in guatemala. it is a nice reminder that a sore throat feels this crappy. although i think i gave some sound advice (warm wash cloth in case of a fever, warm salt water

So here's the problem: how long does it take a leg to heal naturally from a fracture or a twisted ankle. Say, 7 - 14 days. How long would it take for that same leg to heal when a doctor puts a cast on that leg? ooh gotta help my daddy shave but let me finish this thought. it might take 4-5 weeks for that leg to heal after the cast and then that leg would need to go through some therapy because of atrophy. That's not always the case, but I think medicine needs to be more considerate of our body's natural healing processes before putting us on medications and other forms of "therapies." I am convinced that the switch back to vancomycin (an antibiotic for gram + bacteria) is a part of the reason why my dad is still in the hospital with a low grade fever and why he continued to have fever spikes. Live and learn. We are still alive.

because doctors and healthcare professionals have the trust of the general public, they should not lie (i.e. not even to say that you can move into a different room without clarifying that it will most likely not happen for another five hours) and we should be able to provide the best standard of care despite a possible lack of monies for technology etc. Simple procedures (that do not have added costs) such as not using a trach during surgery and "bathing" a patient a day post surgery should be standard to not cause unnecessary pain to the patient and to maximize comfort. hospitals should not be a breeding ground for disease.

We are not limited by space and time. We are only as incapable as our beliefs.