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Tuesday, July 25, 2006

Going down


OK so this blog has never really gotten off to what we'd call a rolling start, much less a steady hum. I'm finding that a lot of what I want to post is rather personal, so I'm going to switch over to blogging using my .Mac account (makes it easier to manage pictures, etc.)
Also, I'm taking an interest in starting a blog to discuss professional issues or patient cases, and I'd like to start with a certain degree of anonymity.
Thanks to those who took the time to read.

Thursday, July 06, 2006

Mandate




Congratulations to Felipe Calderón (pictured above with my daughter) on a preliminary victory in México's Presidential election. This morning on NPR they mentioned that it is going to be a tough road ahead for Mr. Calderón, since the election was so close and thus there is no clear mandate. This took me back to the US election in 2000, when I was similarly struck by how the notion of a "mandate" is a frighteningly artificial construct.
From wikipedia: "Elections are often said to give the newly elected government or elected official a mandate to implement certain policies."


I suppose that if you have a huge majority voting for something (say environmental conservation, as in the 2000 US election if you add up Gore+Nader) then you have a clear "mandate" from your electorate that you need to pursue a certain agenda. To me the highly contested Mexican election signifies a mandate for healing the growing divisions between rich and poor. Lopez Obrador seems to have captured a large portion of the disaffected poor by essentially promising handouts (hmm... I'll give you money if you vote for me - where have I heard that before?), but the message to me is one of increasing discord. So even if there is not a clear majority of the electorate showing support for a particular set of policies, I think that the message they send is still clear enough to constitute a mandate.

Wednesday, May 31, 2006

Curandero, curate


Sick today, so trying to boost myself with a classic family remedy: chamomile tea. My abuelita used to give this to me whenever I had a stomach bug. Would you believe that was a common occurence in Mexico? Well, there are some studies showing that there are significant anti-inflammatory effects of tea, and there was even one study supporting its use for infantile colic. I sometimes recommend camomile tea for colicky infants, though always with the caution to use small amounts (1-2 oz per day) to avoid water intoxication.
At any rate chamomile tea is a good way to try staying hydrated while I let my body do its healing thing. And of course there is always the placebo effect, which is perhaps stronger for me due to fond memories of my grandmother's TLC.
Let's hear it for a natural monocyclic sesquiterpene alcohol!

ALARA, not Alarm


Nice post over at Scan Man's Notes. He has an excerpt from an editorial in Applied Radiology by the Chief of Rads at Maryland, Dr. Mezrich.
The editorial comes as a response to recent fears that diagnostic tests such as CT scans may increase the likelihood of cancer. This can be of particular concern for tests performed in children, who will presumably have a longer time to accumulate radiation doses from subsequent radiological studies. At our institution we recently had a discussion regarding the doses of radiation used for tests such as CT scans and others that involve radiation exposure. ALARA is an acronym for "as low as reasonably achievable," in reference to the amount of radiation used for a particular diagnostic test. There are some excellent standards available that take into account a patient's weight (mass) and adjust the doses of radiation accordingly.
The crux of the editorial speaks to the way cells repair damage due to radiation. There are excellent mechanisms for this, as we have evolved in an environment with a substantial amount of radiation. The real question is determining the level of radiation in both time and intensity that will overwhelm our ability to repair damage. Dr. Mezrich makes a good argument for thinking that our bodies can deal with the level of radiation from most tests rather well, and that total radiation dose stretched out over a lifespan does not necessarily increase the risk of cancer. The excerpt concludes by mentioning the need for research to find this specific level of harmful radiation. I suspect that there isn't a single dosage point, but rather as with most other functions of our complex physiology, we will narrow it down to a range of radiation that, in most people, would be sufficient to increase the risk of cancer.
A good read on the subject, for those interested.

Monday, May 29, 2006

Garden & Cooking update


Here's what our garden looks like now:


From the top, the giant, medium and dwarf sunflowers have grown the most. The milk jug is there to act as a hot house for the tomatoes, which have just started poking through the ground. On the right are the beets, which are growing very well. The various carrots are also growing well, and if you squint you might see the Walla Walla onions growing to the right of the carrots. At the bottom left are the peppers and basil, still not growing much. The right lower corner is our cilantro, which is also doing well.

So on Saturday, which is "gourmet night" at our house, I made a Pollo a la Romana and a variant of the spectacular Sweet Potato and Corn Southwestern soup (Moosewood Cookbook), using carrots instead of sweet potatoes. One of the garnishes for the soup is a lime wedge, the other is a bit of cilantro. I picked some of the cilantro from our garden as I plated the soup. The bite with the cilantro leaf had the single most intense flavor from this herb that I have ever experienced (and I grew up in Mexico, so I know cilantro). Ever. The meal was well received all around, but the star of the evening was the little cilantro leaf in each of our soups.

This made me contemplate further the new California cuisine which focuses on presenting the natural flavors of each ingredient as genuinely as possible. The idea is to take local ingredients, which will be presumably the freshest available, and pair them to attain the most "truthful" flavors. One of the Seattle restaurants, the Herb Farm, takes this approach to a logical extreme by serving mostly what they grow, and not much else. I have to say that I am a convert to this philosophy of cooking after having experienced my little cilantro leaf. Now if only I had planted sweet potatoes and corn, and lived somewhere where I could grow a lime tree...

Friday, May 12, 2006

Driving Green


We are replacing one of our cars this fall. It all started with the idea that, since we're going to Germany we might as well do the European delivery thing and pick up a new BMW while we're there. That way we can avoid having to rent a car, and I'd get a sweet new set of wheels in the process.
Then I started to think more about the Prius that we had hoped to get 2 years ago when my wife's car suddenly died. Unfortunately at the time we needed a car pronto, so waiting for a Prius was simply not an option. We've been very happy with her Mazda 6 sport wagon, which is an awesome car, versatile, does everything we need for our family. Still, I've had the desire to drive a much more environmentally friendly vehicle ever since and thought that I could do this when we replaced my car.

The Biodiesel Promise
At first I thought that I had stumbled on a perfect solution - a diesel 3 series BMW wagon, fueled by biodiesel. Unfortunately it did not take too long to establish that, as of 2006, no new diesel passenger cars are being sold in the US! VW used to sell the Jetta and Golf TDI, but have stopped as of this year. Unfortunately for the environment and consumers who would like the choice, the diesel regulations in the US are far behind those of the EU. Whereas most of the BMWs, Mercedes, Audis, and VWs sold in Germany are diesel, here in the US we have yet to come up with smarter pollution controls allowing for improved diesel fuel and the more efficient engines that can use it.
I agree wholeheartedly with Senator Obama that Energy Security is one of our most crucial issues. I used to think that Healthcare was more important and just as broken, but now I feel that I may have been biased by my personal involvement as a physician. I tend to think of our Energy Security now more akin to the issue of Slavery in the lead up to the US Civil War.

The Elephant in the Room
There is much blathering these days about the price of oil, energy company price gouging, pain at the pump, etc. But the real issue is that our dependence on oil makes us far more vulnerable than leaky borders, inadequate port security, or bioterror agents. Though I also tend to agree with Ray Kurzweil on issues of technology, and I also agree with the Kurzweil and Joy editorial calling for a huge investment in countering biotechnology, I disagree that it is our most crucial need at the moment. What we need most right now is the national will to enable us to become energy self-sufficient. There are numerous obstacles in place, just as there were with the abolition of Slavery. The economic drivers for an oil-based economy are certainly responsible for much of the political pressure that has kept us from innovating new energy sources, just as a slave-based economy was also a key political driver.
What we really need is an Abe Lincoln who will lead the country away from oil dependence and into a secure future of energy self-sufficiency.

New Wheels
So despite my feelings above, I'm really looking forward to my new set of wheels. I am getting over my disappointment at not being able to have my cake and eat it too. It would have been boss to have a diesel BMW that I could fill up with biodiesel. Alas, not this year. Hopefully our next car will be much greener. And in the meantime, I plan on putting as few miles on my new car and as many miles on my bike as possible. Right now my commute to work is 14 miles each way, which makes for a great 40-min workout in the mornings, plus it is zero emissions!

Thursday, May 11, 2006

Latest Dinner Hit


Last night I made Chicken Achiote with Tangerine Sauce to great acclaim from kids and my wife alike. I found the recipe at epicurious.com and modified it slightly by using just a bit more tangerine juice than called for (I used 3 large tangerines for the zest and juice) and by using my trusty cast iron skillet instead of a nonstick pan.
My friend and fellow cooking enthusiast Matt was caught not long ago with a dreamy look in his eye. "What are you thinking about" his wife asked. "My pan [meaning his cast iron skillet]." "It loves you too." was his wife's reply. Well, we've adopted that phrase in our household as well. As I was pulling out my pan and caressingly applying olive oil I heard my wife behind me say "it loves you too." And as proof of that love, we had a delicious chicken achiote with a superb caramelized tangerine sauce with a complicated flavor. Next time I make this, though, I will add large slices of onion and serve it with rice + cilantro + veggie (I'm thinking carrots, though squash would be good too).

Thursday, May 04, 2006

The Other Prophecy


Harry Potter is a great series - SPOILER WARNING: I discuss Book 6 events!
In the “high” literature reviews Jo Rowling has not received outstanding marks, probably due to many factors (among them the fact that this is viewed as children’s literature). However, the stories and most especially the characters are so compelling that I’ve been hooked since the first chapter of the first book.
Couldn’t we have educated the general public a little about alchemical history and kept the original title, Philosopher’s Stone?
One of the most compeling characters is Albus Dumbledore, and so it was a great shock to have him die at the end of Half-Blood Prince (HBP), a shock that still has me going through the grieving process. As some of the websites out there attest, some people still haven’t moved beyond the denial phase.
So I was listening to the most recent book not too long ago and developed a theory for another prophecy that Dumbledore might be aware of.
The setup:
* We know that Dumbledore trusts Severus Snape for reasons known only to him.
* We have hints that Dumbledore might know that Snape made the unbreakable vow to help Draco Malfoy kill Dumbledore.
* In the chapter I’m about to discuss, Dumbledore has just summoned Harry to go with him to recover one of the Horcruxes, as he has just discovered the location of the cave where it is presumed to be hidden.

Harry is highly agitated when he first bursts into Dumbledore’s office, because he’s just found out that Snape was the one who revealed the partial Prophecy that led Voldemort to kill Harry’s parents and attempt to kill Harry (I’m using the capital “P” here to denote “the Chosen One” Prophecy, as opposed to my hypothetical prophecy that this post is all about). Dumbledore is at this very moment highly excited - he’s just discovered the location of a Cave that he’s been looking for for some time, and it is less than one year since he’s discovered and destroyed another of Voldemort’s Horcruxes (the ring). He’s clearly ready to go get the Horcrux and is about to leave with Harry, when he notices that Harry is in an altered emotional state.

Here’s my hypothesis: Dumbledore knows of a prophecy that says that Severus Snape will not go over to the dark side, but that he will kill Dumbledore. This prophecy also says that will not happen until Severus is revealed to the Chosen one as (for lack of a better term) the snitch that led to the Chosen one’s marking by the Dark Lord.

Here’s the quote that made me come up with this theory:
(HBP, Chapter 25, The Seer Overheard, page 548 of the American Hardcover version) “Dumbledore's expression did not change, but Harry thought his face whitened under the bloody tinge cast by the setting sun. For a long moment, Dumbledore said nothing. 'When did you find out about this?' he asked at last.”
Immediately after this, Dumbledore insists that Harry has to swear to obey him immediately if he is to go along to retrieve the Horcrux. It is not until Harry reveals that he just found out that Snape was the snitch that Dumbledore requests this of Harry. His very words are: “If I tell you to leave me and save yourself, you will do as I tell you?” This all speaks to Dumbledore somehow knowing that his life would end that night.

I’m still torn, though, on where this puts Snape: irrevocably on the side of Voldemort, or still playing both sides? My hypothetical prophecy would be one of the only ways that I can think of that those in the Order of the Phoenix would ever trust Snape again, and even that might not be enough. I suppose a memory, left by Dumbledore, saying “Snape killed me on my orders” might do it. On the other hand, such a memory would place Snape in mortal danger with Voldemort should it ever be discovered, and I don’t think that Dumbledore or Snape would take that risk. I wonder if the portraits in the Headmistress’ Office retain all the memories of their living subjects, or do they merely serve as advisors?

Feel free to poke holes in my theory in the comments.