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Neophron's Senescence
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Below are the 20 most recent journal entries recorded in tinkll1's LiveJournal:

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Saturday, May 23rd, 2015
6:58 am
2 Years to the Day!
Another Memorial Day Weekend, and some time to think and write, and return to an old medium, where I can reflect and where my thoughts don't pop up on the screens of "friends" from the Facebook universe…. not that I don't like Facebook, but it doesn't usually encourage me to the kind of introspection that I like to treat myself to, and share, on an irregular basis.

I guess the first question is how many of my old friends are still on LJ? And how many have moved on to Facebook or other social media sites?

I owe, whoever's still there, an update, and, with the understanding that I may be largely talking to myself, at least I'll have the chance to summarize what's happening.

Sort of working my way backwards…. Yesterday, Lin and I, in her new Tesla P85D, went to the Keck School of Medicine of U.S.C. Annual Luncheon at the California Club on Flower Street in downtown Los Angeles. The Tesla is a wonderful stealth vehicle that is both a luxury limousine and a dragster, and you can guess what aspect of its personality appeals to which of its occupants. We arrived safely and were shepherded to the same table as 3 other classmates (about 72 didn't show up, some with very good reasons, as we're just about all octogenarians, or nearly so, and too many have hung up their stethoscopes forever. Passed on, in a better place, decomposing… depends just how existential you want to be. I miss them. Like old army buddies, I guess, as we were in many of the same trenches together. Ed Bloom, almost retired ENT who still works part time at Kaiser, Joe DeFrancisco who retired from OB/Gyn 19 years ago, and Willa O'Day, a retired pediatrician who remains very active in fund raising and in a fraternal organization that is tied to the Catholic Church, and myself, were the class representatives, and there was the recounting of who we were in touch with, and how they were doing, and the roll of the missing. It's funny how much I now appreciate the socializing that I had so little appreciation of in my younger years. Phil Manning, 94, looking like he was in his 70's, our former teacher, introduced the speaker, a third year student, who gave a speech that was not particularly memorable, but our medical school dean, Carmen P., a Harvard man, and a fund raiser extraordinaire, brought me to near tears by thanking the doctors present on behalf of the patient they served, many of whom had no idea what sacrifices and considerations had been extended. The Trojan Band marched in and played "Conquest," and "Fight On!" and I thought about my undergraduate days at the Coliseum booing those rich kids, and cheering on the Bruins, never imagining that USC would offer me a very safe harbor and a future doing what I love, while UCLA thought there were better candidates for their medical school. So I raised my right hand in the Winston Churchill "V for Victory," that USC has adopted as their own, and applauded my alma mater. The salmon was healthy and wonderful The chocolate, peanut butter cream dessert was… wonderful! My diet, again, was held in check for another day, and we 4, were the last to leave, vowing to come back next year.

Current Mood: Contemplative
Sunday, May 26th, 2013
1:59 pm
4 Hours 10 Minutes to Zero Hour
We're celebrating Memorial Day weekend with the Bjurstens in Corte Madera. Peter, my son-in-law, has always had a special interest in the B-17, and we've visited one together at the Chino Air Museum. My fantasies were always more in the direction of fighter planes, the Spitfire, in particular. A month or so ago, while perusing the AAA magazine, Lin showed me an advertisement for the Collings Foundation, and their Wings of Freedom Tour. It seems that a private foundation that maintains flying aircraft of historical interest was coming to Livermore, 55 minutes away, to offer B-17, B-24 and P-51 rides. The price for the B-17 was $425 of which $300 is a deductible charitable contribution. 22 years ago, or so, Lin had surprised me with a Spitfire flight, out of Aspen, CO, with Bill Greenwood's Spitfire TR9, which is the highpoint of my fantasies, actualized. Knowing Peter's love of history and the B-17, I purchased a copy of "Mission to Berlin," by Robert F. Dorr for him and one for me and I'm 2/3 finished and enjoying every moment. I called Becky and told her about the flight, and she thought it would be a great birthday surprise. I will join Peter in the flight, hoping they have a ladder or a winch to haul me on board. I've assured Becky that it should be safe, and compared 4 Wright Cyclones holding the plane in the air to the one Rolls Royce Merlin that powered the Spitfire. The Flying Fortress will fly on 2 engines, and if the Spitfire loses its single engine, it becomes a very ungainly glider. It will be a surprise for Peter, as only Becky, Lin and I know where we're headed. We'll have our books along and our cameras.

This is the plane as captured on YouTube and linked to the Collings Foundation website. Hope it's a "piece of cake."

Current Mood: happy
Sunday, April 14th, 2013
1:21 pm
Seat 15A Swallowed My Passport!
The events of April 12, 2013 ~ 2 PM, PDT

It happened most innocently enough. I was lying nearly flat on the wonderful business class seat. The contents of my trouser pockets were pressing into me and I emptied my wallet, credit card case, the Crystal Symphony key case and photo case into the little blue drawstring bag that ANA supplies to hold their toothbrush and toothpaste, eye cover and sleep promoting tea, or aroma… Lin’s and my passport were safe in my left breast pocket with my glasses and pen. I had slept for at least three hours and I was feeling a bit restless. I turned to my left from the horizontal position of this seat and I felt something begin to slide. Before I could arrest the slippage, I heard a two part thunk, as something left the pocket and slipped out into some space between the window seat and the fuselage’s internal plastic covering. I reached into the pocket and Lin’s passport was still there. Mine was gone.

The potential destination of the passport had to be between the fuselage and the chair, or between the various components of the chair’s left arm, the left side of the seat cushion, or the mechanical and electrical devices that permit the chair to go from vertica to horizontal. The spaces within that arm rest and the seat were just wide enough to permit the fairly dense passport to slip through, and its weight to carry the little book down into the recesses of the mechanism. Fingers could not slip into the space, and the penlights of the two lovely ANA flight attendants could not adequately illuminate the tiny space.

The attendants tore out seat cushions exposing the horizontal surface of my seat, but the vertical surfaces could not be moved. The passport had disappeared into thin air, its path marked only by the thump of its coming to rest against the bottom of the seat or the cabin floor.

There is a gentleman sleeping in Seat 16C, and no one in 16A, the window seat directly behind mine. When he wakes up, or we land, we still have the possibility of reaching under 15A from behind and retrieving the passport. If that fails, I am about to learn what happens to someone who takes off with a passport and lands without one. I have visions of “The Man Without A Country,” destined to travel forever aboard a ship and never to be permitted ashore, or taken into custody by Immigration, particularly since I have a Santa Ana address and connections at Clinica La Amistad, as well as a funky Castilian accent. Even my attempts at Hebrew reveal a sinister Ashkenazic accent, linking me to an Eastern European shtetl ancestral origin. The beard, the subscription to The Nation, an NPR supporter…. A believer in the Single Payer Health Care dream of Liberals…. A history of odd bumper stickers…. The charges are piling up.

What will immigration say when I say, “I don’t have my passport.” They will say, “You lost your passport?!!!” I will say, “No, I know where my passport is. It’s just not accessible until the plane is scrapped, or the seat is removed.” Then, I will be taken away and grilled. They can’t waterboard me… Can they? I have nothing to confess to except not safeguarding my passport, but who would suspect a business class seat of being the agent of my undoing. I can’t say it with a smirk, or even a smile, although I can see the humor before the consequences arrive.

It’s 3:15 PM, PDT, less than 3 hours.

It’s 4:33 PM, PDT, on Friday, April 12th. 8:33 AM, on Saturday, April 13th in Japan. We’ve just had a filet mignon, sake, miso, and a cheese plate. The gentleman in 16C enjoyed his dinner and our lovely flight attendant, Kimiko Ozaki, found my passport, apparently quite easily just under my seat, toward the back-left side. The passport is safely back in the left breast pocket and I will be ever vigilant. We’ve just passed over the Golden Gate Bridge, so Becky, we’re right over your house. Cheney, Woolfowitz, the FBI and the CIA have totally lost interest in this tubby, old nephrologist who is just bringing home some tee shirts, and purses, and tea cups, and a lot of wonderful memories. No extraordinary rendition, no visit to the security apparatus of a police state. The ANA staff and flight was a pleasure. Just don’t take one left turn, too many!

Current Mood: Relief
Saturday, January 5th, 2013
8:22 pm
Book Review: "Life's Too Short to Cry: The Compelling Memoir of a Battle of Britain Ace", Wing Comm
Life&quot;s Too Short to Cry: The Compelling Memoir of a Battle of Britain AceLife's Too Short to Cry: The Compelling Memoir of a Battle of Britain Ace by Tim Vigors

My rating: 4 of 5 stars

View all my reviews

The biographical entry in Wikipedia appears to barely brush the surface of a most interesting life.
I would love to know more about him and his career. I note that he was married four times and flew a Spitfire, placing him very close to my heart.
Saturday, December 22nd, 2012
10:24 am
Farewell to an Indomitable Spirit
He died on December 18, 2012, following a liver-kidney transplant several months ago. This was his second kidney transplant, the first, coming from his mother, was done in 1976, and functioned successfully until April 2010, when he was started on hemodialysis.
He was gainfully employed until very recently, despite 3 times weekly hemodialysis, which was done in the early evening, to allow him to continue working. The transplanted kidney worked for 34 years. He had been born with congenital abnormalities that caused urinary tract infections in very early childhood, and corrective urologic surgery was needed, but still a transplant was required, when he was 7 years of age.

He was short in stature, undoubtedly because of the early onset of kidney disease. The strain on his mother and his family were enormous, but they were there for him, and somehow, despite this enormous challenge, he received his education and assumed a very responsible position in a financial corporation. He was married and had an extremely supportive wife and son. His wife accompanied him to his dialysis treatments.

The anemia that accompanies renal disease required transfusions. Somewhere, along the way, before Hepatitis C could be detected in blood, he received a contaminated transfusion. The disease was diagnosed years ago, but therapy requiring interferon would have caused rejection of the transplant, and in consultation with gastrointestinal specialists, a decision was made not to treat the hepatitis with the hope of arresting the progress of cirrhosis, at the loss of the kidney.

So he continued to work and to enjoy his family. By 2010, he was having episodes of confusion due to ammonia accumulation related to his liver disease. This was treatable, and even as the transplanted kidney failed and he started dialysis, he continued to work. He was a fighter…. an indomitable spirit.

On dialysis with kidney failure, he suffered encephalopathy from liver failure, controllable by diet and by unpleasant medication that caused a therapeutic diarrhea, that interfered with his life… his ability to work. He didn't always take all of his medications the way the doctor ordered, but bright as he was, he controlled the diarrhea and the encephalopathy, and he continued to work.

He needed a transplant of a kidney and a liver. Our hospital, with a superb kidney transplant program, could only offer him a kidney, and that wasn't enough. So off he went to UCLA, and then to UC San Francisco, and off to UC San Diego. Records and phone calls, and still he worked.

Finally, Cedars-Sinai put him on the list. Then there was staying on the list, and working your way to the top of the list, the MELD score. There were the ups and downs of chemistry changes, lab values going up and down, and intervening events that landed him in a hospital ER, and threatened his hold on the number one spot on the liver-kidney transplant list. There was a moment during an alumni event that I recorded previously that will give me a belly laugh whenever I think of it. We got over the obstacle and finally he got his liver-kidney transplant, but things did not go well, or smoothly.

Many of the events following the second transplant occurred at CSMC or at his new dialysis unit, closer to his home, where he was attended by another nephrologist. His course was complicated and the last week or two, he was at Cedars. He underwent a laparotomy, and as his wife describes to me, "They found a recurrence of his hepatitis and said they could do nothing more for him. He went onto hospice, but he continued to want to live."

Well, that was the man I knew and respected. It wasn't easy to be his doctor, but it was an honor to try to help this great little fighter, and a special kindness to me that I wasn't there when his battle finally ended.

I extend my respect to his memory and honor his existential battle. I admire the constant support of his wife, son, mother and all of his family, who understood the events that made him such a determined fighter, if, often, a challenge in their lives, but one they willingly assumed. Sometimes its the patient who are the heroes and heroines. Often, it is their loved ones.

I assure you that I will never forget him. He died on the same day my oldest daughter was born, December 18. that day will never pass without his memory surfacing in my thoughts.

Current Mood: sad, reverent
Friday, December 21st, 2012
11:46 am
A Rant on Free Offers and Internet Frustration
This was psychotherapy….. It really is a great espresso maker. Letter sent off today, before I visit the hospital. No, the regular hospital. Not the psychiatric hospital.

December 21, 2012

The Nespresso Year End Promotion
24-01 44th Road, 12th Floor
Long Island City, NY 11101


The Nespresso CitiZ & Milk is a beautifully designed and manufactured Espresso Maker which we first bought as a present for our daughter and loved, and then bought our own via Sur la Table, by the internet, and then I have spent the last 3 hours inputting information and revising that information to respond to error messages, appearing on 2 different computers. I have copied receipts, phoned for the receipts, changed formats from Excel to .jpg and then phoned in to your support, where I received the following message, “..We are experienced more than the usual delay….etc.” 30 minutes later, a most polite lady guided me through the process that I had just performed, using the serial number without spaces and with spaces, and then submitting. The internet site then erased all of my input and I started again! And again. And again.

Now I’m writing to you, because I love the design and appearance of your espresso maker, and I love the espresso it makes, and the froth, and its speed. And I love Nestle Crunch Bars…. A bit too much!

I don’t love your website! Stuff happens. I have a good sense of humor. I’m laughing as I scratch out this desperate note. I’m a nephrologist and I have had a long career, and need lots of espresso to keep myself going. My wife loves bargains. $100 worth of coffee credit, looked to her, like a great bargain, but she doesn’t enjoy reading instruction manuals, and she has no real facility with the internet and computers so I’m delegated to those chores.

Even with the very poor state of reimbursement for the medical services I render to Medicaid patients and indigent patients, my time is still worth $100/hr to the government and to the insurance company. I figure that should a $100 reward ever reach my wife, I will be about $200 behind in the time spent. I’m writing this because it is therapeutic to express one’s frustrations and not take them out on the family dog or the unfortunate motorist who commits some minor infraction in front of me.

Would you please note that your site requires some tuning and that you have a fan who still likes your products, if not your internet page.

Sincerely yours,

Current Mood: frustrated
Tuesday, December 18th, 2012
7:21 am
A Dinner with Lin and Sylvia
Lin, my wife, has done incredibly well over the years despite her multiple sclerosis. Much of this is the slow progression of the disease process, but an awful lot of that is her positive attitude. She simply does not focus on the limitations, but concentrates on what is not limited, and keeping her ability to walk and her strength maximized. In this vein, for greater than a year, she has been regularly going to a gym, with an exercise program that has built up her strength in a very positive way. Her trainer, Sylvia, has become her friend. Actually, anyone who Lin interacts with for any length of time, including lines at the bank or the super market, is likely to become a friend. When Sylvia got married last summer, we were invited, but we were in Chicago with our grandsons. So last night, we got together with Sylvia at our favorite Vietnamese restaurant, Long Hai, in Tustin. Her husband, who aspires to be an occupational therapist, was out for a football watching evening with his buddies, but Sylvia had committed to this dinner.

Over egg rolls, spring rolls, crab wontons, bun, teriyaki salmon and orange chicken, I got to know a very interesting young lady who had attended college with a major in religious studies, wanting to be a missionary, but especially, wanting to travel. She worked as an au pair in New Zealand and Fiji, her last job being with an Italian furniture manufacturer and his Iraqi wife, caring for their 2 year old. Our conversation ranged from the challenge to pay for an education to be an occupational therapist, to the limitations of being raised in a society where entitlements go unrecognized, and where one's station limits the development of empathy. Sylvia is empathic. It was a lovely evening, and I did not greatly miss the Titans vs Jets game, or even the PBS Evening News. Sometimes, its nice to be social. I must remember that.

Oh, and Lin (and I) loved to recount how we had met and fallen in love. On second thought, perhaps the very best part of the evening was the action that I toss in so casually at the end. The retelling of a love story that remains so fresh and so vibrant. Isn't love what makes the world go round, and the antidote to existential anxiety?
Sunday, December 16th, 2012
5:57 pm
Newtown, Connecticut and Tucson, Aurora and Oak Creek - Gun Violence
So sad to see the president speaking from Newton, CT in an effort to console the grieving loved ones of those slain in the insane shooting of school children and their teachers, on a pre-Christmas Friday, by a madman, whose mother had a fascination for guns, and an apparent denial or a functional paralysis in coping with the mental illness of her son. I looked at a few pictures of innocent children, of brave school teachers, and I'm sad that the majority of our society that opposes gun violence, has been powerless to confront the NRA and those in its pay, and under its influence. We need leadership, and I hope that President Obama rises to the leadership challenge that this tragedy demands.

The President acknowledges that this is the fourth time that he has come to an area to console the victimized families. "Are we prepared to say that we are powerless in the face of such carnage...."

It was more sermon than plan. Hopefully, the plan will come later. It better!

Current Mood: Sad
Monday, November 19th, 2012
10:13 am
Congressman Raul Ruiz, M.D., Democrat, Bruin

He defeated the incumbent, Mary Bono, in a bigger upset than the Bruins delivered last Saturday. I wrote him the following message:

I can't tell you how thrilled I am to see that you, a Democrat, a Physician, a Latino, a Bruin (and a Harvard Graduate..... maybe you couldn't get into UCLA's medical school, as I couldn't in 1958, but you chose a considerably more prestigious alternative, than I {USC, Class of 1962}) are now Congressman Raul Ruiz, congressman elect. I once dreamed of running against "Bomber Bob" Dornan, in Garden Grove, a seat now held by Loretta Sanchez.

This message is just to tell you how much hope and inspiration you infused into this old warrior. I'm Orange County's longest serving nephrologist, and I've focused on the Hispanic community since 1967, when I was deferred from the Viet Nam War to start dialysis in Orange County. I was a Eugene McCarthy Liberal in John Birch country, an early advocate for Single Payer Health Care and PNHP, and even managed to make it as far as the Board of Directors of the Orange County Medical Association. I searched and searched for a bilingual nephrologist coming out of the Mexican community for a partnership and would still welcome the opportunity to pass my practice along to someone with the sensitivities to care for the people that I serve. I volunteer at Share Ourselves Clinic (Costa Mesa), Clinica La Amistad de San Jose (Orange) and Lestonnac Free Clinic (Orange), where my Chicago secondary school Castillian Spanish draws peels of friendly laughter.

I'd love to meet you sometime, and I have no hidden agenda or favors to ask. I'm simply proud to have you as a professional colleague, a fellow alumnus, and a Latino physician Democrat! Buena suerte y felicidades!
Saturday, October 20th, 2012
7:48 pm
Best Date of My Life (BDML)
It was on a Saturday night, October 20, 1984, that my life began. I was 48 years, 8 months and 7 days old. I had 5 children with 3 wives. I was separated from my third wife, and I had an infant daughter, a week shy of 4 months old. I was a three time loser with a proven record of relationships doomed to failure. The love and inspiration that I sought seemed beyond realization.

On that night, on Happy Sparrow Lane, in Laguna Niguel, I walked up to a doorway and there she was. Beautiful. Breathtakingly, beautiful. She kissed me, lightly, on the cheek. I was awestruck! I couldn't believe the green carpet and the white paint, and the princess of my dreams…. and shekissed me!

I met her lovely daughter who was a contestant in the homecoming princess competition, that evening, and then we got into my car, a 1984 Dodge Colt GTS Turbo, with a sticker on the back, Don't Step on the Gas Unless You Really Mean It!"

And the long and the short of it includes my moving in with my wife to be, the following Tuesday, and marrying her, less than 4 months later.

I am more in love with my wonderful wife today, than I was when the shine and glitter fed fantasy. The reality of spending as much of my life with her so outweighs what I could imagine. My respect for her is enormous.

Rather than detail our life together, at least at this time, I want to say how our weekend began.

On the 18th, Thursday, I brought her flowers and this card.

She has served me breakfast in bed the last 2 days. Today, she gave me this card.
2012_10_20 LELtoLL_BDMLa
2012_10_20 LELtoLL_BDMLb
Two days ago, with the help of Trader Joe and Conchita, she made me a fresh peach pie that caused the stockholders of Polly's Pies and Marie Callender's to panic in fear of new competition. She had gotten me sunflowers, my favorites, and baked chicken that simulates fried chicken without the calories.

Here she is, returning from shopping, while I spent a tough day watching football!
Tomorrow, we're going to 2 movies: Moonrise Kingdom and The Perks of Being Wallflower. Yesterday, we saw Argo.

Tomorrow night, I'm taking her to Yelp's pick of the Best Sushi Restaurant in Orange County.

I'm a very, very lucky man!

Current Mood: lucky
Friday, September 28th, 2012
10:45 am
The Good Life, Ackworth, Comcast and Good Friends
A cup of Kuerig's Breakfast Blend, a good night's sleep in a beautiful, modern Georgia mansion, a Portugese water dog named Pepper, as a friendly companion, low calorie lime yogurt, and can you believe this, here in Georgia, outside Atlanta, SEC country, Bulldog Country, Georgia Tech Country, I have Comcast, and the Pac12 Network. And that means, I get to watch the thrilling match of the 1-3 Colorado Buffaloes and the 3-1 UCLA Bruins on television, live…. if I don't have to go out to dinner, Saturday night at 6 PM. If so, theres DVR potential. I can't see the Pac12 network on Direct TV at home, or even in the sports bars who all have Direct TV, but out here, in Georgia, I can watch the game, and stay in touch by internet, and listen to my favorite radio station, and see lots of alien sentiment, like pick up trucks with "Impeach Obama" bumper stickers…. so, it's not quite perfect, but it's awfully, awfully good. There's hope for Georgia, too. We had sushi with our matron of honor, Jayne, at Yellowtail in Kennesaw, GA. We are being treated like royalty, and they have Bruin TV!

Current Mood: Happy
Saturday, July 28th, 2012
8:30 am
The Museum of Science & Industry - Day 2
This was my return to the Disneyland of my youth, and the place where I was introduced to the Supermarine Spitfire and the Junker Ju-87 Stuka, and there they were waiting for us. As I lined up to take a picture, a friendly docent provided me with information that included its original participation in 74 Squadron during the Battle of Britain. We were wearing our John Freeborn t-shirts. The HO model railroad brought me right back to 1945. The boys had a great time and we still have lots to explore.
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Current Mood: happy
Thursday, July 26th, 2012
8:10 am
A Vacation with Grandsons to Chicago
We arrived on Tuesday and took a stretch Lincoln limousine from O'Hare to the downtown area to check into the Hampton Inn, on Illinois Street, one block from State Street and in the River North area of restaurants and hotels, just north of the Chicago River. It's a great location and we have a wonderful corner room with a bedroom door that closes and a nice sofa bed and separate television for the kids. The first night we walked a block and a half to Weber's Grill and after a 40 minute wait, we had the best burgers I'd eaten in a long, long time, and the kids were free with special cards that we got from Tracee, basketball player (UCLA) and Hill Street Blue's Mike Warren's second cousin. Mike Warren's son, Cash, is married to Jessica Alba. Mike was a great point guard on one of John Wooden's NCAA Championship Bruin teams. The conversation began with Tracee's comment to Lin that are boys were very cute and she could see we were from California.... where she had a cousin.... Mike Warren, who happens to be one of my very favorite people. I know of him as a basketball fan and really didn't see him on HSB.

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Current Mood: happy
Sunday, May 20th, 2012
7:05 am
Oliver Hardy, a 50 Year Keck Fellow?
It was like any other day. As I was urging Lin to finish the process of applying the ritual chemicals and festive adornments that prepare her to assume her proper role in the forthcoming celebration, and packing in our clothes for the dinner and the next day, the phone rang and it was a patient to whom I had given my home phone number. It was getting late. I had already used up the built in fudge factor that allows us to leave in plenty of time, for any event, to consider unexpected traffic, restroom stops, etc. I had arranged for coverage from the nephrologists who make my social life, whatever that is, possible. They would cover admissions, my secretary knowing that I would take care of non-emergent phone calls and it looked like I was going to get away with peace of mind, relatively, of course.

The patient, a remarkable man who has maintained his employment despite end-stage kidney disease, and end stage liver disease, had finally reached the number two position on the liver-kidney transplant list, and with grit and determination, was waiting for the phone call. He was calling me to tell me that he had been hospitalized, not at his regular hospital, but at one closer to his house, and had been released and that the transplant coordinator at the renowned center in Los Angeles on which he was listed, wanted to speak to me about his condition. With a hepatic encephalopathy on his side, and an "are we going to be late for this 50 year event on my side," communication was sub-optimal. I did get a phone number and with blue tooth I resolved to call en route, and we left, the Turbo packed with our overnighters.

The instructions were very clear and very simple, and very wrong, on the invitation. The I10 East does not run into the I5 North, but GPS fixed that. Unfortunately, it could not fix the traffic, however, only give me detailed information of how I would be traveling in my 198 mph rocket, at 10 mph for 5 or 8 miles, watching the arrival time gradually extend toward the beginning of the reception.

And there was the phone number at the large institution, the courteous operator, the switching to the department of transplantation, the liver office, or whatever with each step accompanied by what seemed like 20 recorded options ranging from language selection, to call 911 if I really was in trouble, and, always lastly, or number 19 on the list, "if you're a doctor, press 7." Eventually, I got to Vesta, coordinator, who was very loquacious, and very concerned about stopping Zovirax for Bell's Palsy, his recent encephalopathy, and his treatment at the hospital which she knew more about than I did, as I had no record from the hospital. As the Porsche turtled forth, and the clock ticked, a series of phone calls established that a blood culture done at the other hospital had been treated with oral levaquin and the patient released. More was certainly needed.

The exact order of the phone calls and the traffic progress is not entirely clear to me, but with GPS assistance, and miraculous clearing of traffic as we reached I10 East, I found the State Street off-ramp and, like time travel in the movies, the Porsche propelled me into the same route, more or less, that my 1957 Volkswagen had followed, day after day, in the 4 years of medical school, to the looming temple, the Los Angeles County Hospital. It is a magnificent building and it is no longer used as the hospital because of earthquake requirements. It remains a historic monument, and its forecourt was the site of the reception and luncheon. We arrived to valet parking only 5 minutes late and well within the time frame of respectability. The valets placed the Turbo last in line, directly in front of the event, the Obama-Beiden sticker announcing that I was some kind of bizarre outlier at a University of Southern California event, a gathering of aged physicians, no less. But we were there.

My pager had an unrecognizable phone number that was definitely Orange County, and I had asked to be paged only for emergencies, so after I shook a few hands and said hello to a former professor who had retired in his eighties, Phil Manning, youthful and vigorous as ever, I excused myself from the line, left Lin at table 5, talking with classmate Colin Hubbard and wife Jackie, whom Lin knows through a good friend, and I called the number in the quietest place I could find. It was the hospitalist who had paced the patient on levaquin and he assured me that the patient had no symptoms, but it was, so far, a gram negative rod, almost never a contaminant, and thus in need of urgent treatment. The sensitivities had not been identified, but we exchanged numbers and he said he would call me. I felt I needed to report this to the transplant coordinator as this would put the transplant on hold. Thus, between handshakes and bites of chicken and salad, I tried to get through the recording maze, dropping opportunities to get directions in Spanish, to the ER, etc.

The ceremonies wore on, as the hospital operator attempted to track down Zesta from the lunchroom to the powder room. In the midst of this desperate search, a lovely young lady, from the dean's office, pressed into service by my anxious wife, found me and pulled me off into the direction of the podium, where one after another, my variously decrepit classmates were being adorned with the crimson and gold, engraved medal that marked us as 50 year survivors, just that much closer to allocating a significant part of our estates to our alma mater.

The distinguished Dean, Carmen A Puliafito, a Harvard man, who has presided over the rapid growth and increasing prestige of the Keck School of Medicine, was the man who slipped the ribbon and medal onto my head, as I related the necessity of holding the transplant until the identity of the organism and its successful treatment could make the use of immunosuppressives, a reasonably safe process. Of course, the reception line had no other roly-poly Santa Claus like figure, carrying on a phone conversation.... remember it takes 5 minutes to find Zesta through the maze of "press 4 to hear the instructions in Swahili....etc" I was not going to let go. So the distinguished dean, through peals of laughter form my classmates and the distinguished assemblage, greeted me, a long lost alum, a potential donor, with "Is this some kind of a joke?" It really was an Oliver Hardy moment. If only the desert had been a whipped cream pie!

But it wasn't! So I said that I was in the middle of a liver kidney transplant and looking after a patient's best interests, and wasn't that what this was really about. Well, actually, I didn't say that, because this was happening in real life and it was an unscripted moment. I had my picture taken with the dean by the official photographer and I can't wait to see where the telephone was.

The luncheon was memorable for this huge distraction, and we sat with Richard Teller and Bob and Audrey Pedrin, heard a recent graduate explain how she would return to serve the Mexican community in family practice, coming from an immigrant, and if I heard correctly, undocumented status. While I was on the phone, my beautiful wife who knows me so well, made a bee line to the young Latina physician, bypassing the distinguished dean, and on my busy behalf, congratulated her for her achievement and intent.

We toured the very impressive campus in a bus, next to a classmate, Bill Arterbury, who was a pathologist who retired to became the leading avocado grower in southern California, and had traded histology for the more profitable agriculture. I did come to the conclusion that I would leave some money to USC, but not to the research that appears to be so well funded, but to training more physicians like the Latina, perhaps UCLA rejects like myself, who wanted to become physicians just to help people, however unfashionable that has become. I really did enjoy the day and the many friends, and this bit of recognition by the medical community.

Current Mood: happy
Friday, May 18th, 2012
9:29 am
50 Year Medical School Reunion
It's a day for reminiscence and contemplation. It was June 14, 1962 that I became a physician, and added M.D. to my name. It was a very happy and proud day for me and for my parents. Today, U.S.C., now, U.S.C. Keck School of Medicine, celebrates the 50th anniversary of our class' graduation. I will be going back to Los Angeles County Hospital, now adorned with the description, "Historic." Of our class of 68, about 35 are expected, but that may mean to include spouses and significant others. My dear friends Vic Medrano and Don Knapp wont be coming. We'll tour the Health Sciences Campus, check into the Westin Pasadena, then attend a Reunion Dinner at McCormick & Schmick's Restaurat. Phil Manning will emcee the afternoon events, after a long and distinguished career in medical education. He put together the annual CME program at the Mauna Kea Beach Hotel that has been a March event for me since around 1980. I hear that it is to be discontinued, and this is a surprise as it seemed to have an increase in attendance with half the attendees from Canada.

I tripped across my old transcripts which I had received in connection with my 1965 application for a renal fellowship (Cedars-Sinai Medical Center, and the NIH.) I was remarkably consistent for all 4 years. 34th of 68. Top half of the class. Last man, in the top half of the class. Well, I made it, and by a lot more than the skin of my teeth.

It wasn't easy. I wanted to be a fighter pilot. No matter that the Nazis were gone, and the Spitfires were gone. John Wayne, Dana Andrews, David Niven, Tyrone Power, and the ladies that idolized them, blazed the way, and I wanted to follow in their footsteps. Arrested development, of course, and fantasy.

With the intervention of myopia, I was forced into a more realistic evaluation, and by age 12, I was convinced that I wasn't going to be a cog in a wheel, but sought some imagined level of autonomy and respect. This best fit with the professions, and I had an example on each side of the family. My mother's brother, Uncle Rudy, was a graduate of the University of Chicago, and he had started off to be a psychiatrist, when the war intervened and he enlisted, overcoming asthma, and spending a good part of the war aboard hospital ships transporting cases of battle fatigue. Apparently that was enough to re-evaluate the specialty, and he went on to become an anesthesiologist, settling in San Pedro, where he was inaccessible, geographically, and with his introversion, not really very helpful to me in encouragement, discouragement, or merely providing an understanding of what this profession that I was thinking about, would really entail.

On the other hand, Uncle Herb, my dad's youngest brother, was in Chicago where I was facing this dilemma, and he was very helpful, giving me a summer job in his law office, surrounded by paper, files, secretaries, banging typewriter and cigar smoking colleagues. there were lunches in dark, wood paneled restaurants where chefs carved meat and cheese into sandwiches, and lawyers sat and talked shop while I tried to see something interesting in the process. I never did get into court, as Herb seemed to spend most of his time in the office and talking on the telephone. Didn't seem very interesting, at all, and even with The Defenders, on television, adding glamor and righteous indignation as they sought to do good, help the falsely accused and seek justice, I leaned toward the unknown, toward a profession that was an association of people who wanted to help other people. Noble! Sounded just right. I wanted to help people, and I loved science, and my mother had subtly molded me into an empathetic liberal, a New Deal Democrat, and my father had demonstrated what goodness there could be in character and unselfishness.

To be continued.
Saturday, April 21st, 2012
4:02 pm
Spitfire Revisited
A few weeks back, Becky visited us and surprised me with a book, "Spitfire - Icon of a Nation," 2008, by Ivan Rendall, and I'm 146/288 through it, and enjoying it immensely, less so for any new knowledge or information on the airplane, but for the author's focus on the symbolism and the iconic nature of this airplane. It was so much more than a fighter aircraft, and Rendall divides his chapters into Introduction, Speed, Air Power, Science and Art, War, Battle, Fighting Machine, Flying Legend and Star and Celebrity. I am going through "Battle," and enjoying the observations and summary. The author has synthesized so many of the thoughts wandering through my mind over the years, explaining the appeal of this aircraft on so many levels.

The timing is such that I will be going with 2 ten year old grandsons and Lin in July to Chicago's Museum of Science and Industry where "my" Spitfire hangs from the ceiling. This was where I fell in love, although movies paved the way, like "A Yank in the RAF" and "Eagle Squadron." I've introduced the Spitfire to my grandsons but this is the first time they will see my first love. We'll also go to Wrigley Field and the Chicago Cubs, and the Field Museum.

Along the same iconic path, J. C. Freeborn's 74 Squadron Spitfire not only flies over my bed but over my left shoulder in Torshia II's left rear window (My 911 Porsche Turbo S.) Perhaps the iconic 911 Porsche is today's standard bearer, beauty, speed, power, grace.
Tuesday, December 6th, 2011
5:09 pm
Book Review: “Without Hesitation; The Odyssey of an American Warrior,” by General Hugh Shelton
“Without Hesitation; The Odyssey of an American Warrior,” by General (Ret.) Hugh Shelton, with Ronald Levinson and Malcolm McConnell; St. Martin’s Griffin Edition: September 2011

This is the autobiography of the 14th Chairman, Joint Chiefs of Staff, who rose from a farm in North Carolina to be the chief military advisor of President Clinton, and briefly, and not nearly long enough, President Bush, through October 2011. The book incorporates three interwoven themes.

The first is the biography of a career army officer who set off to become an aeronautical engineer, discovered an interest and a proficiency in the military, and rose rapidly through the officer cadre, learning lesson after lesson in leadership, how to, and, most importantly, how not to, lead and inspire men to perform the role of defending our nation, working within the constraints of our democratic institutions. In every situation, Shelton analyzes how the goal of an effective, cost efficient military can be achieved while the interests of enlisted men and their families are preserved. This often requires standing up to special interests, and courage of a different order than that which is recognized in medals and citations.

The second is the history of the evolution of the army of the Viet Nam era to the all-volunteer army that first contracted, and then expanded to undertake an ever-expanding agenda in Kosovo, Iraq and Afghanistan. What experiences does it take to mold an officer to effectively embrace greater and greater responsibility, and what are the lessons learned at each stage that enable him to persevere and not lose sight of the goal, nor adopt expediency at the cost of integrity. Shelton has an infallible moral compass, and the courage to stand up to the volleys of egotistical politicians, bent on making a reputation over the sacrifices of others. He is a warrior who looks to the most efficient plan to prevail at the least cost in human lives. His presence in the cabinet room and the Oval Office allows the reader an insight into how and why decisions were made, and who deserves the credit and the blame. He tells it like it is and allows you to draw your own conclusions.

Finally, it is an inspiring story of an active man, an athlete who ran every morning and never spent a day in the hospital until a fall off a ladder led to paraplegia, a confrontation with death, and a truly remarkable recovery that demonstrates what willpower and the very best in medical care can accomplish.

Our country was admirably served by this great American, and the reader will be entertained by his stories, and inspired by his courage, and feel great satisfaction in the triumph of a man of integrity over one obstacle after another. On a scale of 1 to 10 = 12!
Wednesday, April 20th, 2011
9:33 am
Table Top Aviation - 1970 - Orange County Medical Association
I had been in practice in Orange County for 3 years when I was asked to write an article about my hobby as a feature in the journal of the local medical association. I was then married to my first wife, Sally, and had two sons, John and Geoff. I had a solo practice in Anaheim, initially, and lived on Broadview, in a rented home. I was driving my second Porsche, a 1969 911 S, a car that is now owned by my son, John. There were few dialysis units and I was a year away from opening my own unit. John was 6 and Geoff was 4, and I was renting an office at 1701 S. Euclid in Anaheim, and covering Joe Leonard Orange County's first nephrologist.

I still had time for aviation and fantasy.
Sunday, March 20th, 2011
7:27 am
Mohammed Nabbous, a Face of the Battle for Freedom in Libya, Killed in Action
A brave journalist, Mohammed Nabbous, died while working to keep the world informed of the situation in Libya. He leaves a pregnant wife behind, and the admiration of many people around the world. He gave his life in pursuit of press freedom. May his dream come true for the long suffering Libyans, and for oppressed people around the world.
Friday, March 11th, 2011
3:33 pm
Tsunami Dodged - We're Safe
The Prince Hotel, where the auditorium is located is an evacuation site. The Civil Defense team evacuated some people from lower lying areas and put them up at night in the auditorium where the classes are held, so they started 2 hours late. Also, this luxury hotel has taken in a bunch of folks from a couple of other hotels situated lower down toward sea level, and there are a bunch of haggard looking people who must have been evacuated in the middle of the night.

Apparently at about 2 AM, word came that the 4 lowest floors were being evacuated to higher ground. We are on the 8th floor(827). Our warning system didn't work, so it was a phone call from Becky at about 5 AM that alerted us to the tsunami. We checked CNN and saw the photos of Japan and the news of an 8.9 earthquake.

The beach was closed today and the beach level Hau Tree bar and restaurant was said to be covered with sand. The beach was closed today. Linda's planned kayaking lesson, foregone. We're completely safe, and so very sorry for the terrible catastrophe that befell Japan. That was the very place that the ship, Gentle Leader, was bound and set to arrive today. I will check its destined port relative to the devastation. We leave tomorrow at 2 PM and are confirmed on a flight to arrive LAX at 9:20. We feel very, very fortunate.

Current Mood: thankful
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