Notes on life, philosophy, and medicine

"Her Private Life" - Korean Drama on Netflix  "What Alice Forgot" - Novel by Liane Moriarty  And this poem that plays in pieces in my head about becoming a woman but always the ages before you -  Our life is made up of yesterdays, stretches of memories that can't necessarily be replayed minute by minute or relived. Within these sometimes distant memories are the makings of who we are today, perhaps not defined by but certainly defining moments, whether they were marked by laughter or tear stained and broken, they are yours and it's collection is yours alone. A masterpiece that can only be claimed by one person. Unique.  That story doesn't dictate our future and it cannot dictate our next step in life. It is not a blank slate but we can control the next brush stroke. Like a large mural on museum walls, see it for all it is and still call it beautiful. May we find inspiration to keep painting. May we share it with the ones who love us most and have them sa

 Well almost, but not entirely...   I was clearly not the only one captured by this book. I heard of it, saw that it made some headlines as a major motion picture but had no idea what I was getting into when I clicked download from my local public library. I figured it was some fictional adventure, but instead met with brutal honesty, historical facts, a picture of America's truest economy through the last century plus.  I'm about a third of the way through this book after taking my own little adventure in an RV unbeknownst to me that there is an entire community making their own way all the while I'm working a well paid job, living out what could be casted as an American dream yet I feel like I'm missing a key ingredient - of love and people - having wandered somewhat to achieve this career and so at a lost on how to set out roots, how to find my tribe and keep it going while 100s if not 1000s of miles away from presumably my closest family and friends.  Strewn about b

One of my big takeaways from this trip we took was how much the material world has stripped us of our connection to earth and in essence, to one another. I came away from exploring this small massive part of the world - The Colorado Plateau - with such wonder and realization that we need to spend time outside, that I WANTED to spend time outside all the time. Sure I talk about 30-60 minutes of physical activity, I tell kids and adolescents, spend time outside, but I had no idea it is so much more than making sure all our kids don't need glasses from too much screen time, it's about being and connecting with nature, it's about the cleansing air of trees and the dirt under your feet. It is about climbing mountain peaks and having your eyes wander around bends along the Colorado River and seeing beauty beyond measure.  We are sharing this little journey with you, hopefully to make it easier for you to have your own. Here's our first day of the trip.  https://youtu.be/TqgW9

 Day 8  Where I most want to be  hearing the sound of a chicken crow as daylight breaks  walking around the Coral Sands RV site  in the presence of a few shanties  I was immediately displaced back to those mornings in Vietnam  with only less humidity and before the heat of the day  as I was drawn to such a time and place I wondered  is that where I most want to be  traveling with unrestrained awe  limits set by no one  If I cannot go back  how do I go forward and reach out of my past  to make a part of my present?  The 3/4 glow of the moon lies directly overhead  the mesa tops of bluff, utah in front  the sweet chill of early summer breeze whooshes through the trees and  in between by uncombed hair the anachronistic computer in which I use to type  hoping my words will guide me  because I'm searching for something  perhaps just the present - enjoyment of the sun rising to my left shining against the towering rocks that appear erected but is more likely eroded  no, not quite, my anx

No answers. No judgement. Just silence, whispering breeze, chirping birds, floating moon and sunrises. Here. 

Just waking up, the buzzing sound of the river behind us, the dawn before us, and the still of the night still among us. This is my favorite time. Alone. Peacefully taking in the newness of a day, breathing my first conscious breath that can only be done in present. Then just as quickly, swept away by the worries of later. May we all spend a little more time in the now. Till later.  

Day 4 - we are here at Somerset, Co in our third ever RV park on the same trip. I am wondering what brings me out here and why we still have 6 nights and 7 days left. A part of me wishes for time to fly by so that I can back in the comfort of my own home, another very real part of me recognizes that moments like this, with my now 7 year old, will be a distant memory but one I hope he can cherish and remember; I hope I can remember it.  We have had far too many smores and have added at least 1000 miles to the treads of this Cruise America rental. James is now fondly acquainted with his aunts Jennifer and Nancy but perhaps for him, more critically, time is being spent in the company of a gentle Doberman named Billet. While for me, other than a dwindling fitness level from too much time spent mostly in the seated driver position, I want to set an intention for this trip, I want to reflect on the questions I first posed to myself as I planned on making this excursion happen - was I trying

what do they represent, these sad ugly tears? the unforgiving history, the beautiful life, the loving future that is unlikely to be? Wow truly wishing for a world without such pain, where goodbyes that feel like forever, where our own mortality is not so in your face and you have to LIVE - but how?  ...

Living 37 years, it's only in hindsight that I am able to reflect on the choices I've made... and watching my 7 year old grow up, seeing the pain that I can put him through... how to be adult about THINGS when you are still figuring out what it looks like to be an adult, to make wise decisions and to not REACT.  I tell him all I can about what I know about love and goodness hoping and praying that he can do what I say and not what I do...  I pray for a tomorrow when I can do better.  All I can try to do is leave the world a better place than when I came into it for him and his friends.  So I'm rambling, what am I really wanting to say? I'm hurting all the time about the choices I've made, I've played out my past 100 times over and lived and relived it - yet seeing no different outcome - because here I am, and nothing can change that, but what's next? what can be changed? what choices do I make next that alter the course of my path and those around me? In all

We want to change the world, when the world we need to change is right here in front of us. As a nation, I feel that I can safely say we have had our issues and that we have tried to have these dynamic conversations about our core values and deepest held beliefs on the national stage but its been frustrating. Right/Left, somewhere in between... What felt easy was losing sight of each others' humanity  as if somehow we can just talk however we wanted about our principles and values and ignoring the personhood in front of us.  My hope is that we boil down our frustrations and we redirect our energy to where it counts the most, amongst our friends, families, neighbors and local community. Right here, right next to us, there is much work to do be done.  May we take the gains and lessons from this years' conversation and do what counts for the people that live right around us.  Because it is right there that I think we will see and feel change for the better. 

I’m a little bummed I didn’t do a proper reintroduction- but I have discovered a few things that may generally be true for people - of course you don’t know until you do your own whole 30 experiment so try it!  Here’s some of my random discoveries - peanuts interrupt my sleep - twice I added it back and both times I woke up at 2 or 3 and had trouble going back to sleep. I don’t think I’ll try it again; not sure why I would- I like my mixed nut butter from Trader Joe’s or almond butter from Costco. Corn makes my joints sore. Flour/gluten rich foods gives me a headache. Dairy, particularly cheese, I knew before whole 30, but after the onset of my runny nose was instant. Bizarre!  Sugar? I’m not sure but one of these food groups makes me tired and does not help me get up for some morning exercise. That’s it for tonight. But coming soon, I’m really excited to delve into what we are planning/doing with our medical practice. For now I’d like to share a few photos I’ve taken lately of some of

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.