Notes on life, philosophy, and medicine

I have never done any sort of "diet" before, and though I don't count Whole 30 as a diet, I am certainin some ways it is...but I love it and if you're interested and want to find out more check out  Whole30 Downloads - The Whole30® Program . This is where I print out the basic information for my patients for free! A few things that helped me:  1) it's easier to do along with at least one other friend. Along with Melissa's text messaging service which I did pay for (not sure it's totally worth it for me but it did keep me on track and helped with the day count), I texted with two other friends doing the program with me.  2) announce your intentions with your family and let them be there to encourage and celebrate each day with you, "what day are you on?" "...how great you have completed another day". I much prefer this than holding you accountable which might sound like this "you can't eat..." or "why are you eating...

One of my patients came to me recently, she just a got a new job and said she's learning things in her job she wished she had learned in school. While I don't think school will teach us everything we need to know, it has certainly done us a major disservice. Yes, a major part surely is a significant lack of funding but I tell you we can usually do things with little funding if we are creative and are actually given the space to do it.  So my major gripe today, I never really learned to cook from my mom; and I am not blaming her because surely I can learn now. It's just why did schools take away home economics classes and shop classes? We tossed it aside for what? If we don't have the basics? Were we all going to become engineers or whatever else that we didn't need to learn the basics of home economics and all this time as the family as we knew it has changed and altered some for the better and others for the worse.  I hope we are on our way to recovery but if nothi

If I accomplish this, it will not have come from me.  If you are still near, may you hear my tears  all this wishing you back to life  at 38, somehow not secure enough to be without you let alone now near 11 years since you have left I do have a son who speaks of his ancestors  this life I have been given was at no small cost to you  or to ong noi you sacrificed comfort of that which was known to you you traveled to a far away land  that may not have completely opened their arms wide for you  and you built a home, a family  you kept us together  your sadness and weight in this life I'll never truly understand  I pray my heart continues to speak to yours  so that even in death, I may know you deeper still.  I hope I'm making you proud. 

This last weekend, from what I can piece together, one of my patients went to bed early and didn't wake up. The community I serve is reeling from the lost of a strong, courageous, vocal, and beyond compassionate woman. I wonder if I could have done something, offered an intervention beyond what I did. I know at the end of this day, like all other days, I can only carry that knowledge with me to my next encounter. No amount of self battering or guilt will bring her back but I can honor the process by asking myself these questions as a way forward. We have to learn - from our past, we have an opportunity to grow and better ourselves and our understanding, and we must use it to create a brighter future.  I do not believe the community in which I work in an exception, but I have been struggling to understand how horrific pain can be encountered and brushed under the rug to only be encountered again. Is it the compounding nature of tragedies that has befallen on this collective communit

It's not everyday you lose a patient, but when it happens, it hits you like a wave, carrying along with it, all past losses. It's really hard. You wonder if you missed something, if you could have done more to turn the tide, to give them more time...  you wonder if you are worth the trust they gave you.  All I know, is I won't forget, that your life mattered  and if no one else recalls your story, I will.  That through your life and death, you shared it with me.  You entrusted me and forever I will be honored.  May I carry on what you have given to me.  May I share your story and your hope.  May the tears that shed turn to the most powerful of waterfalls  and your legacy, what you were here to do, live on in the lives you have touched  like mine  our stories tied  thank you. 

I spent many encounters this last year reminding patients to focus on their close relationships rather than be moved (or more bluntly put stressed/anxious) by the national and international "battle" over ideas. The reality is in part these battles are "created" and spurred on by a much deeper/darker frenzy to "sell" and "self promote."  More so, when we spend our time positioning our ideas to be heard globally or at least the abyss that is social media, we are missing a fundamental reality that the lives we most impact are those around us.  This idea is not entirely my own, most of it comes from my church and our pastor Jim at Evergreen PNW. He furthers the idea that our greatest impact occurs among our "oikos" - the 8-15 people that we genuinely share and do life with eg friends/family/coworkers/neighbors etc.  As the national debate may have torn apart that close fabric, I hope and pray, we can look more closely and what is important

We are in the middle of reforming healthcare in our own little way, we are starting a cash pay service for medicine consults.  I cannot wait to see how it evolves, whether is flounders or flourishes. At the end of the day, I hope the message is clear, that medicine belongs to everyone. Our ability to heal one another with 1000 year old traditions or through a smile or through the latest innovations is not sustainable unless we empower one another or remind people of all they can learn from the generations before them... I'm not good with anecdotes or story telling but I would like to share a brief story and how to this day, I wish I had asked... It was well over 20 years ago, by then my grandfather had probably been in this country for about 15 years or so. I don't know much about his story except for he was a police officer in southern Vietnam and a photographer if not by trade, than certainly a passionate pursuit. Early on after their move to the US, from the wreckage left by

these words, written and spoken by one man  that is reflected in the generations and ideas of many before him  to be still  feel the presence  to relive memories  of quiet heroes  of big sacrifice  the not famous  but makes the world spin  of doing the right thing  all of this, through such ugly times  2 more mass shootings  how do we stand  together những lời này, thuộc về một người đàn ông ý tưởng của nhiều người đi trước vẫn còn cảm thấy sự hiện diện hồi tưởng lại những kỷ niệm của những anh hùng thầm lặng của sự hy sinh lớn không nổi tiếng nhưng làm cho thế giới quay làm điều đúng đắn tất cả những điều này, qua những khoảng thời gian tồi tệ như vậy 2 vụ xả súng hàng loạt nữa chúng ta đứng như thế nào cùng với nhau

If there’s one question I think every political decision or affirmation of agreement with should do to align with the spirit of our God - it is to ask - what does this policy I support do or how does it impact the “lowest of these” That’s not an easy question to answer from up above - best to ask those it impacts. 

This last year, what happened to our connections?  I suppose because I've always felt mine with others were tenuous, so although I smiled on zoom, I can't help but feel that I lost something. Maybe that's human nature, to feel the grass in greener. In the sermon today, I'm pretty sure one of the our pastors quoted Justin Bieber - that the grass is not greener on the other side, it's greener where you water it.  So, did I water the garden I was standing it or did I let it dry out as I struggled my way toward some other better side?  It's near midnight, I'm watching clips of tonight's Grammy's...and it settles me. I imagine the millions who tuned in, who have heard these songs and felt connected. I'm not terribly keen on the amount of money that goes into "entertainment" - I feel some righteous anger that music artists can make so much when our teachers who are raising up our nation and the next generous are making a basic living.  I envi

If I tell you what I did then I no longer get to collect my reward in heaven and how I long for that - how I desire to serve our God to such a degree that one day he will say "well done my good and faithful servant."  This was a huge struggle, I grew up being adorned with the praises of my family, so I continued to crave it; seeking approval from others and feeling lost when I didn't get it. I also did not understand what my identity in Christ meant. Until I connected the two. By doing the will of God on earth in kindness and love (e.g. not reacting in outrage, saying hurtful things out of hurt, seeking self satisfaction or the approval of others) - I would purse treasures in heaven and therefore not rely on the whims of others for peace, joy, and approval. I have it all, in God, my identity is in Christ.  May we serve one another in Christ. 

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