Saturday, November 29, 2008

Race and Class

I like this short blurb from TIME magazine because it draws attention to the fact that racial tensions in America are increasingly gaining meaning as class tensions, and not merely as issues of color. Race still matters, but in this modern age of interracial offspring and the black middle-class, the conflict lies more in cultural and lifestyle differences than in differences of complexion. In the future, it would be prudent for the NAACP to pay attention to the growing rift between the haves and have-nots in the black community. At the same time, they would be wise to use this moment in history to integrate black disadvantages into the more generalized picture of American poverty. I don't deny that poor blacks face somewhat unique circumstances, but to continue to stand apart from Americans in general - that is, to insist that their economic history is fundamentally and permanently different - invites only division, and not useful discourse.

***
National Association for the Alleviation of Credit Pandemonium

Nov 19th 2008


At 100, the NAACP still has a mission

Corbis
Corbis

The struggle of the century


Barack Obama’s campaign for the White House raised many questions, for all Americans, about what it means to be black in America today—just in time for the centenary of the nation’s oldest civil-rights organisation, the National Association for the Advancement of Coloured People

The NAACP was formed on February 12th 1909 (itself a centenary, of Lincoln’s birth) by a bi-racial group of reformers. It promised to fight for equal rights and opportunities for black Americans. Primarily using litigation and legislation, it has been fighting the good fight, with varying degrees of success, ever since.

Does the election of the first African-American as president mean the battle has at last been won? NAACP members gathering in New York in July 2009 for its 100th annual convention could be forgiven for wondering how much their organisation still matters. Mr Obama and other young black leaders, such as the Massachusetts governor, Deval Patrick, embody the successful black middle class; and for many 20-something African-Americans the NAACP’s mission apparently means little when they feel overt discrimination is no longer an issue.

Hoping to make the NAACP relevant to that new generation is Benjamin Todd Jealous, a 36-year-old Californian who is the youngest chief executive in the NAACP’s history. Mr Jealous has plenty to do.

When he took over the helm in September 2008, the NAACP had been in turmoil for several years. Never a mass organisation, its membership now languishes at around 300,000, from a high of around 600,000, the association claims, just after the second world war.

Mr Jealous launched his tenure with an ambitious online voter-registration programme aimed at young blacks. As priorities for the coming year the NAACP is also targeting discrimination in the criminal-justice system, improving public schools, increasing black political and economic empowerment and boosting African-American representation, for example as surgeons, in the upper reaches of the health sector.

However, the credit crunch could prompt a shift in that strategy. African-Americans account for a disproportionate share of subprime loans, and tougher lending rules and tighter credit threaten to erode many of the gains made in recent years by black households.

The NAACP is suing 14 mortgage companies for discriminatory practices but it will need to do more, from expanding financial-literacy programmes to helping its constituents recover from financial crisis. In doing so, the NAACP might just find it matters once more.

How Georgia Stacks Up

(facts courtesy of the Guttmacher Institute for Sexual and Reproductive Health. Information is current as of Nov 1, 2008.)

Sexual Education and Family Planning

Issue: Sexual Education

  • Nation: Most states require that public schools teach some form of sex or STI/HIV education. Guidance on sexual activity is heavily weighted toward stressing abstinence; contraception, if it is covered, is not required to be stressed. Most states also have opt-out clauses so parents can remove their children from sex ed classes.
  • Georgia: Sexual education is mandatory in the state of GA, and abstinence must be covered whereas contraception does not. Information about STI/HIV must also be covered, with the emphasis on abstinence again. Parents can opt their children out of the curriculum.


Issue: Family Planning Funding

  • Nation: Beginning in the 1990s, a small number of states imposed abortion-related restrictions on state family planning funds. Some ban the use of state family planning funds to provide abortion counseling and referrals to women who have unintended pregnancies. Additionally, these restrictions often require strict separation between organizations providing state-funded family planning services and organizations providing abortion-related services. Currently, 4 states explicitly prohibit the use of state family planning funds for abortion counseling and referral.
  • Georgia: Guttmacher offers no information on Georgia legal restrictions on family planning funding, but as of Nov 11th, Georgia’s state budget for family planning clinics was cut by a whopping 34%. Governor Sonny Perdue had only specified that state programs be cut by 6%.


Issue: Physician and Pharmacist Refusal

  • Nation: Most states allow private physicians and individual institutions to refuse to perform abortions. The real issue here is the topic of referral. ACOG has more or less stated that it is a medical obligation to refer to a professional that will provide the services you refuse.
  • Georgia: Allows both individual physicians and institutions to refuse to provide abortions. 1 of 4 states that allows pharmacists to refuse to dispense contraception, although pharmacies themselves are not given explicit permission to refuse. As for the topic of referral, community sentiment decides whether Georgia healthcare providers will give meaningful referrals.


Issue: Emergency Contraception

  • Nation: On August 24, 2006, the FDA approved Plan B as an over-the-counter medication for those aged 18 and older; it remains a prescription-only drug for minors. 16 states require hospital emergency rooms to provide emergency contraception–related services to sexual assault victims. 15 states require emergency rooms to provide information about emergency contraception. 4 states explicitly allow pharmacists to refuse to dispense contraceptives, including emergency contraception.
  • Georgia: No laws mandating that ERs provide information on EC or dispense it upon request. No rules to allow pharmacists to dispense EC without physician prescription, even though the FDA has recommended it as OTC for individuals over 18 YO. No requirements that pharmacies stock or fill valid prescriptions for EC. Explicitly allows individual pharmacists to refuse to dispense EC (one of 4 states).


Issue: Insurance Coverage of Contraception

  • Nation: 27 states require insurers that cover prescription drugs in general to provide coverage of the full range of FDA-approved contraceptive drugs and devices; 18 of these states specifically require coverage of related outpatient services.
  • Georgia: Requires that insurance covers prescription drugs and devices, but not outpatient services. No provisions allowing for refusal to provide for employers, insurers, etc.

Abortion

Issue: Who can legally provide abortions?

  • Nation: Most states require that only licensed physicians (and hence not Physician Assistants or licensed nurses) perform abortions, and that a 2nd physician be involved after a certain point in fetal development (often after viability or 3rd trimester).
  • Georgia: Pretty much in line with the rest of the nation. Georgia prohibits abortions except in cases of mother’s health after the 3rd trimester (28 weeks GA).


Issue: Reporting Abortions

  • Nation: For the last three decades, the CDC has collected aggregate statistics on abortion in the US; states are not required to submit abortion data but the overwhelming majority of them do. Information gathered generally includes information about the facility, the patient’s demographic characteristics and medical history, and the abortion procedure itself, including the method used and gestational age.
  • Georgia: Required reporting with information on the procedure performed.


Issue: Funding

  • Nation: First implemented in 1977, the Hyde Amendment, which forbids the use of federal funds for abortions except in cases of life endangerment, rape or incest, has guided public funding for abortions under the joint federal-state Medicaid programs for low-income women. 32 states and the District of Columbia prohibit the use of state funds except in those cases where the woman’s life is in danger or the pregnancy is the result of rape or incest. In defiance of federal requirements, South Dakota limits funding to cases of life endangerment only. 4 states restrict coverage of abortion in private insurance plans to cases of life endangerment.
  • Georgia: Public funding of abortion limited to cases of rape/incest/endangerment. However, anecdotal stories support the idea that women rarely use state or federal monies for their abortions due to the burdensome requirements placed upon the women to acquire that money. Georgia has no limitations to coverage by private insurance.


Issue: Mandatory Counseling

  • Nation: 17 states mandate that women be given counseling before an abortion that includes information on at least one of the following: the purported link between abortion and breast cancer (6 states), the ability of a fetus to feel pain (8 states), long-term mental health consequences for the woman (7 states) or information on the availability of ultrasound (6 states).
  • Georgia: All women receive verbal counseling about the specific procedure they are getting, while receiving written information on all common abortion procedures. They are verbally told the gestational age of their fetus, while given written material on fetal development throughout pregnancy. Patients are given both verbal and written information on the ability of the fetus to perceive pain. According to Guttmacher, the written materials detailing the risks of abortion and the emotional responses thereafter are accurate, although some abortion clinics may still be using outdated (and inaccurate) state pamphlets on abortion.


Issue: Ultrasound

  • Nation: Some laws and policies require that a woman seeking an abortion receive information on accessing ultrasound services, while others require that a woman undergo an ultrasound before an abortion. Since routine ultrasound is not considered medically necessary as a component of first-trimester abortion, the requirements appear to be a veiled attempt to personify the fetus and dissuade a woman from obtaining an abortion. Moreover, an ultrasound can add significantly to the cost of the procedure. Only a few states (6) require verbal counseling or written materials to include information on accessing ultrasound services.
  • Georgia: Providers must give verbal information on how to access ultrasound services. If an ultrasound is performed as part of the procedural workup, the patient must be offered an opportunity to view it.


Issue: Waiting Periods

  • Nation: 24 states require a woman seeking an abortion to wait a specified period of time, usually 24 hours, between when she receives counseling and the procedure is performed. 6 of these states have laws that effectively require the woman make two separate trips to the clinic to obtain the procedure.
  • Georgia: Mandatory 24 hour waiting period, but no mandatory trips to the clinic for counseling (can be done over phone prior to procedure).


Issue: If Roe v. Wade were Overturned

  • Nation: 20 states have laws that could be used to restrict the legal status of abortion.
    • 4 states have laws that automatically ban abortion if Roe were to be overturned
    • 13 states retain their un-enforced, pre-Roe abortion bans.
    • 7 states have laws that express their intent to restrict the right to legal abortion to the maximum extent permitted by the U.S. Supreme Court in the absence of Roe.
  • Georgia: Has not passed any explicit resolutions in this matter recently, but there is good reason to believe that Georgia legislators would attempt to impose restrictions on abortions should Roe v. Wade be overturned (see recent legislation proposed in Georgia: NARAL ProChoice BillTracker and Planned Parenthood Legislative Update )


Issue: Choose Life License Plates

  • Nation: 17 states allow production of “Choose Life” license plates. 7 states donate the monies to anti-choice organizations, 13 states donate the money to agencies or organizations that provide adoption assistance, and 8 states specifically prohibit using the funds raised from aiding organizations that provide abortion services, counseling, referrals or advertising.
  • Georgia: Choose Life plates are allowed, although Choose Choice plates are not allowed. Funds go explicitly to maternity/adoption services agencies. Unclear which these agencies are (for example, Crisis Pregnancy Centers, which are notoriously anti-choice in their operations).

Parenthood and Minors Access

Issue: Minor’s Access to Prenatal Care

  • Nation: 35 states allow minors to access confidential prenatal care. Of those, 12 allow physicians to inform parents that their minor daughter is seeking or receiving services when they deem it in the best interests of the minor.
  • Georgia: Explicitly allows minors to consent for prenatal care, without any rules allowing the physician to notify parents.


Issue: Minor’s Access to Contraception

  • Nation: Most states have adopted laws supporting Supreme Court rulings that extend the constitutional right to privacy to a minor’s decision to obtain contraceptives.
  • Georgia: Explicitly allows all minors to consent to contraceptive services


Issue: Parental Involvement in Minors’ Abortions

  • Nation: 22 states require one or both parents to consent to the procedure, while 11 require that one or both parents be notified and 2 states require both parental consent and notification. All of these states also provide for an alternate way of obtaining the procedure in the absence of parental consent, usually via judicial bypass. Some states even allow grandparents or other adult relatives to be involved instead of the minor’s parents, and some states waive the consent altogether in cases of rape or incest
  • Georgia: Georgia has a parental notification law, as opposed to a parental consent. There is an option for a judicial bypass if parental notification is not done. There is an exception to this rule in cases of a medical emergency, but not in cases of abuse/assault/incest/neglect.


Issue: Minor’s Rights as Parents

  • Nation: Though most states require parental involvement in a minor’s decision to terminate a pregnancy, they overwhelmingly consider minors who are parents to be capable of making critical decisions affecting the health and welfare of their children without their own parents’ knowledge or consent. Nearly every state permits minor parents to place a child for adoption. Moreover, most states authorize minor parents to make health decisions for their children, and some allow minor parents to authorize surgery.
  • Georgia: Minors can consent to placing their children up for adoption without 3rd party involvement, and minors can consent for medical procedures/services for their child.


Issue: Drug Use During Pregnancy

  • Nation: No state specifically criminalizes drug use during pregnancy. However, several states had expanded their child-welfare requirements so that prenatal drug exposure can provide grounds for terminating parental rights on an individual basis (DFACS involvement, usually). Further, some states authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant women who use drugs. A number of states also place a priority on making drug treatment more readily available to pregnant women.
  • Georgia: Legally, in GA, substance abuse during pregnancy is neither considered grounds for child abuse or for civil commitment. There is no state required reporting or testing. There are no targeted programs for pregnant women, but they are given priority in general treatment programs.


Issue: Safe Haven Laws

  • Nation: Every state, beginning with Texas in 1999, has enacted a provision intended to provide a safe and confidential means of relinquishing an unwanted infant. These infant abandonment measures—also referred to as “safe haven” or “safe surrender” provisions—typically allow a parent or other specified party to relinquish an infant under certain circumstances without threat of prosecution for child abandonment.
  • Georgia: Parents may abandon their children up to age 7 days to any health care provider. There is no specific law protecting anonymity. The acceptor does not need to provide ID bracelets, ask for health information, or investigate “missing child” status.

Thursday, November 27, 2008

I wonder...


- Why the kids on the Tifton peds wards just stay in their rooms all day? They should really get out more, and play in the open spaces. It sucks just being in your own stinky room all day, and unfortunately, there is no coordinated system for getting the kids outside (reading hour, crafts time, etc).

- "If a wound heals and you don't notice when or how, is that good or bad"? (courtesy of Ozge Samanci at ordinarycomics.com)

- Why emotions are always so much stronger at night?

Thanksgiving


Rachel Maddow of MSNBC says that 1 in 10 Americans will be on food stamps this holiday season. And AP News reports that soup kitchens and food banks are expecting an all-time high in needy this year. Here are two links to organizations in Augusta and Atlanta that can help feed the needy this season. Please get involved - I know I will.

Tuesday, November 25, 2008

Sunday, November 23, 2008

Some Great Fails

because I don't feel like thinking too much tonight, and because these amuse me...
(courtesy of FailBlog.org)
















Thursday, November 20, 2008

The 1st step may not be the noblest...


... but it should prompt you to take more.

Today, walking out of pediatrics to head home for the day, I saw a Hispanic lady in the waiting area outside the ward weeping into a towel. I had seen her earlier on the floor; she was presumbly the parent of one of the kids on the ward (not one of my patients). She had expressed to the nurses in her broken English that she was stepping out to get some air, and her demeanor then had been cheerful and pleasant. Imagine my dumbfounded surprise when I saw her crying.

I wish I had done more than just ask "Are you OK?" and accepted her hasty nod yes. Not that I believed her, but because at the moment, I was scared and felt inadequate and didn't know if I could help her. But that last bit is a sympathetic lie to myself - of course I could have done something to help her, and I should have. Even walking out, I knew that at any moment I could turn back, call the translator, and try to assuage what worries she probably had about her child. I would not have been overstepping my boundaries, or if I truly felt that I was, I could have called her physician to talk to her. But the fear of doing something unfamiliar stopped me, so there I was, sitting in my car, justifying my inaction on the grounds that she would feel better soon, maybe she just needed to cry, the translator might be out... name an excuse, and I thought of it. And then I drove home.

Not long ago, Lydia and I discussed how the 21st century, despite all its progress, is an era that has cultivated fear. I'm not referring so much to 9/11 and the subsequent actions of the Bush administration (although that certainly changed my experience of America more than I would like), but to the caution that was drilled into us even as young children. We are the generation of throwing away unwrapped Halloween candy, of never picking up hitchhikers, of not looking the homeless in the eye. So is it any surprise that as adults, our mindset is insular, hesitant even when our sense tells us we won't die if we help a random stranger who does not dress like us or talk like us? The world is our oyster, but we crack it open with only a select few.

I had thought about all this before, yet I still hesitated today. I am certainly not proud of that.

I guess if one good thing came out of that experience, it's that I will absolutely loathe myself if I allow it to happen again. The next time I see a scared patient or family member, I will get involved, even if it means I feel stupid doing so. Even if the fear is not gone. After all, what is the worst that can happen?

Tuesday, November 18, 2008

In Psychiatry, Can a Punchline be a Lifeline?

A friend posted this on facebook, and I thought it was a charming little article. I remember feeling the same way during my psych rotation: Can I crack a joke? Are the paranoid schizophrenics going to go crazy if I smile at them? Will the demented people take what I say the wrong way and tell my attending I harassed them? In the end, it's a matter of discretion, but it's nice to know that there ARE times to loosen up, and be able to address your patients - even the ones who are supposedly "not all there" - with some semblance of humanity. After all, whoever said that WE were the ones who should control the show?
****

In Psychiatry, Can a Punch Line Be a Lifeline?

“Has anything changed since the treatments began?” I ask the patient, as he lies down on a stretcher in the ECT suite. The anesthesiologist places an IV line in his arm and checks his vital signs. My attending psychiatrist adjusts the machine that delivers the electric stimulus. I’m a psychiatry intern, and this is my electroconvulsive therapy rotation. I’m here to watch and learn.

“My cellphone always has a great charge,” the patient deadpans.

If this were a friend or colleague, I would laugh easily. But this is a patient I barely know. He has bipolar disorder, a previous suicide attempt and a history of bizarre, impulsive behavior. In that context, his joke just feels inappropriate and overly familiar.

I’m taken aback. Is it O.K. to laugh, I wonder? An intern, with years of experience being inexperienced, I quickly glance around to take stock of the room.

The nursing assistant laughs and the anesthesiologist grins broadly. The attending psychiatrist remains stone-faced, and says, “Clearly he’s improving.” As the anesthesiologist injects a sedative, a telephone rings. Everyone’s hands are occupied; the ringing continues. Just as the patient starts to drift off, he looks over at me and says: “Can you get that? It might be the governor calling to stay my execution.”

A moment later, he’s out. The attending hands me the leads, and I feel slightly uncomfortable as I bring them to the patient’s head. The nurses are still laughing as he begins to convulse.

When I was an intern on the medical service, I often joked with my patients. It’s how I naturally relate, and carefully joking with a frightened patient is a powerful way to establish rapport.

But when I left the internal medicine floors for psychiatry, the humor stopped. On the advice of the attending doctors, I tried to be more concrete and matter of fact with psychotic patients, more empathetic with depressed patients and more authoritarian while working in a volatile emergency room. Not since adolescence had I spent so much time worrying about how I come across.

I had a vague sense that prompting a patient to laugh could sometimes be therapeutic. But when is it safe — let alone useful — to joke with a psychiatric patient? At least in the hospital, the patients seemed to have enough trouble relating to me without having to decode the nuance of humor. It seemed too risky, too ripe for misunderstanding.

Still, there were patients who insisted on joking with me.

Leading a community meeting on the inpatient unit, I asked the patients and staff members to introduce themselves and say something about who they are. “I’m a social work intern!” a staff member said brightly, followed by a patient, who declared, “I’m a chronic bipolar patient.”

This wasn’t what I had in mind; I’d imagined some type of biographical detail, not a recitation of titles and diagnostic labels. I grew uneasy as the patients started describing their personal pathology to the group.

Just as I was getting uncomfortable, one of the patients acknowledged the tension. “I’m a nursing student,” he said, with mock authority. The next patient, someone who had trouble relating to others and often missed social cues, said, “I’m the nursing manager.”

The entire group, myself included, erupted with laughter. The moment was a striking contrast to the unit’s usual sober atmosphere. Not for the first time, I wondered whether it might ever be appropriate for me to lighten up and initiate a joke.

At the end of my internship, I got my answer. I was on call at 1 a.m. on a Thursday, admitting my last patient of the evening. She was a woman in her 60s, brought in by the police for disruptive behavior in her apartment building. After being involuntarily admitted, she hid in her room and refused to talk to the nurses.

When I tried to interview her, she buried her head under a pillow, exclaiming, “I refuse all psychiatric care!” But beneath her refusal, I noticed something playful in her tone.

“That’s O.K.,” I said. “We’re good at treating people who refuse psychiatric care.”

That got a little laugh.

“Can you tell me how you got here?” No response.

Maybe I should try something more concrete? Given her age and the story I got from the senior resident in the E.R., it dawned on me that she might be cognitively impaired. “Who’s running for president right now?” I asked.

That got a response. Three people, she replied, using an epithet I can’t repeat here.

What are their names? I shot back, using the same epithet.

“Clinton, Obama and McCain,” she said. She was looking at me now.

“O.K., so what’s a nice lady like you doing in a place like this?” I asked.

Suddenly, I was in. She started telling me about her paranoid delusions about her landlord and neighbors. I sat down and started writing.

“Tell me more,” I said.

Friday, November 14, 2008

I'm just curious...

Why isn't Condeleeza Rice being re-considered for the position of Secretary of State? I thought she was doing a pretty good job, and the world leaders are used to working with her already. Is that not allowed to serve 2 terms in a row under different administrations as SOS? Has she stated that she is not interested??

Wednesday, November 12, 2008

"the slow fade of love"

Hmmm.... is Rilo Kiley ever going to play near me? At a time I can actually go to? Because if so, I'm THERE.



"If livin' is the problem, well that's just baffling."

Tuesday, November 11, 2008

strange sad song



Tell me one more time
Why you went away
It makes a little sense
In the light of day
When evening comes around
All my senses fly away

Pediatrics

I really like the way my current peds rotation assigns responsibilities to the med student. As I've mentioned earlier, I really think med students could do a lot more, and their personalities are generally those that like to rise to the occasion. Thus, there is no better way to teach and cultivate a med student than to have them perform tasks that are just a little bit above their comfort level (with supervision, of course).

Anyways, I'm on call tonight (in fact, I'm on call all week), but I'm FIRST call. So if a patient needs something, or if they're getting admitted, the nurses call ME first. Totally sweet! I really feel like I'm learning a lot better this way. I wish all rotations were like this. I like peds just fine so far, but I don't think there's anything intrinsic about the field that calls to me. But the way this rotation is being run, peds is going to be much higher up on my list of possibles than if it were being run the way, say, L&D was run.

I'm very excited about these next 6 weeks :-)

Sunday, November 9, 2008

life is good

I'm sitting outside at my parent's house, enjoying the fall colors and breeze, and getting in some of my Vitamin D. Yes, I am doing some USMLE World questions, but Pandora is on playing some kick-ass songs, and the neighborhood is content and calm. Life is good.

Now for some music videos from one of my favorite bands from the 90s.





Saturday, November 8, 2008

random thought

I think it would be very ironic to make paper cranes to M.I.A's "Paper Planes."

On a related note, I finally learned how to make a paper crane today. I'll be trying the origami on this website next.

Friday, November 7, 2008

I just want to...


I finished up ob-gyn today. I really liked the rotation, and I can see myself doing it for a career. But I haven't discovered an area of it that I really really love yet, and that worries me. Perhaps I just need more exposure to the field. I find that I tend to like things better if I'm more involved with them. So let's hope my REI elective next semester goes well, and if not, I'll try something else in gyn-onc.

There's a lot I need to figure out right now, and I gotta admit, I feel a bit confused and flustered in just about every aspect of my life. Maybe I will recharge this weekend with the fam.

Right now, I just want to listen to music with my headphones on, lying on rooftops.

Thursday, November 6, 2008

30 random songs off my iPod

I'm bored. This takes up time. Guess the song - I've given the 1st line. And yeah, some of these songs might be embarrassing, but it sure is a good foray into nostalgia! Email me with the most correct songs without having to look them up, and get a prize :-)

1. In the day, in the night, say it right, say it all
2. If you ain't got no money, take yo broke ass home
3. If you had my love and I gave you all my trust, would you comfort me?
4. All I wanted was to feel the way you feel, all I wanted was a chance to make it real
5. Love love is a verb, love is a doing word
6. It's not worth anything more than this at all, I'll live as I choose or I'll not live at all
7. I've been had and I've been held with the ghosts at bay
8. Driven through the canyons, I was dazzled by the mountains, and we didn't go very far
9. What to say, what to say...
10. Come to me, stay the night, you say the words, but boy, it don't feel right
11. Today is gonna be the day they're gonna give it back to you
12. And we're not going back into rags or in the hole
13. I gotta be honest, I think you know, I'm covered in lies and it's ok
14. There was a game we used to play: we would hit the town on Friday night, stay in bed until Sunday
15. You gotta a fast car, I wanna a ticket to anywhere
16. Blackbird singing in the dead of night
17. Anyway now, it don't seem right, he's in there and you're on the outside
18. Ecstasy is all you need living in the big machine
19. When there's nowhere else to run, is there room for one more song?
20. I look at you all, see the love there that's sleeping
21. I'm tryin' to tell you something 'bout my life
22. On the way to your brother's house in the valley, dear
23. How many special people change?
24. What I want from you is empty your head...
25. Sometimes I find myself sittin' back and reminiscing, especially when I have to watch other people kissin'
26. What's wrong with the world, mama? People living like they ain't got no mamas.
27. I am a little bit of loneliness, a little bit of disregard
28. Life, it's ever so strange, it's so full of change
29. Squint your eyes and look closer...
30. You say, I only hear what I want to

Tuesday, November 4, 2008

A Historical Moment



I am so glad we can finally strike one line from this amazing song. America has shown its desire to move forward in the 21st century. I'm ready and hopeful :-)

Monday, November 3, 2008

10 Favorite Quotes

"Fairy tales do not tell children that dragons exist. Children already know that dragons exist. Fairy tales tell children that dragons can be killed."
- G.K. Chesterton

"Make no judgments where you have no compassion."
- Anne McCaffrey

"There are no events but thoughts and the heart’s hard turning, the heart’s slow learning where to love and whom. The rest is merely gossip, and tales for other times."
- Annie Dillard, Holy the Firm

“I think the way we are as we get older is a result of what we knew when we were children.”
- PJ Harvey

"All God’s children are not beautiful. Most of God’s children are, in fact, barely presentable."
- Fran Lebowitz

"Kindness is in our power, even when fondness is not."
- Samuel Johnson

"Everyone is entitled to his own opinion, but not his own facts."
- Daniel Patrick Moynihan

"They always say that time changes things, but you actually have to change them yourself."
- Andy Warhol

"Earth's the right place for love; I don't know where it's likely to go better"
- Robert Frost, “Birches”

"To grow up would be an awfully big adventure."
- Peter Pan, movie version

Taste


She places the leaf on her tongue. She relishes the gritty feel of dirt. It tastes like a boy she once knew. A boy she once knew reminded her of the earth that she loves. All is solid, all is good. She smiles: a sweet memory perfectly contained in the cave of her mouth.

Random Thoughts I Had Today

After seeing a cancer patient in a pain crisis: Why don't we use pain-perception altering drugs like pregabalin instead of typical narcotics for cancer pain?

After seeing a really bad cervical tumor: Oh god, I can't handle smells.

After Dr. Barnum's lecture on PMS: Maybe it would be good to micro-track my life for a while. What I'm eating, what I'm thinking, who I miss, when I wake and sleep, etc...

After getting home: Why didn't I make small talk with my roommate?? And why am I still not?

After getting onto my internet homepage: Could Obama really be assassinated? How bittersweet it would feel to win the presidency after your most cherished role model passes.

After logging onto Tastespotting.com: Ugh, I can't handle food today. I might have the VRE.

After sitting in bed for a while: God, I really want to leave the country for a while. I still don't feel like I've really lived yet.

After listening to "Transatlanticism": How odd and touching it is that we miss even those things/people that we chose to let go of.

Saturday, November 1, 2008

normal aging

My emotions change. Feelings seem stronger in the past, but I feel smarter and more confident in what I feel today. Is this normal aging? It seems good, but then why do I sometimes feel so bad?