Tuesday, December 29, 2009


Language is the facile congress of intuitive thought. It is an expression of intent and emotion through sound modulation. Humans evolved into a society of doers through language. It is language that made the San Francisco Bridge,

 the Sistine Chapel,

Notre Dame cathedral,

the Leaning tower of Pisa

and all the wonderful architectural triumphs around the world.
It is also language that created the Mona Lisa,


or Christ in the Storm on the Lake of Galileo.

It is language again that has created the digital world we occupy through succession of 1s and 0s. And it is also language that gave us the Space Shuttle,

the Concorde

and the Joint Strike Fighter.

Language is at the heart of all that is accomplished and all that remains. All the music from Mozart to Beethoven to Stravinsky and Eminem there lies the common thread of language –an expression of hope, love, anger, fear, happiness and despondency It is through these communication of thought and expression of ideas that new worlds are born. We communicate via language, whether in written form, Braille, or sign language, our inner selves. Language thus creates a medium of expression. It tells others about our thoughts and us. It tells us through those pulses of vibrating air what the world is. Language is the determination of the nature of meaning.

Intent is the cloaked specter residing under the sounds of expression, yet through language even the hidden intent of our inner thoughts can be exposed. No matter how dark the veil, intent always oozes through in words and inflections. It is the emotions riding on the words that reflect feelings. We feel, therefore we express. Opinions are our release of inner thought and the cadence of the expression reflects the emotive mood. The slow undulating viscous smooth lilt of words of love, versus the harsh high-pitched staccato with the teeth chopping words as they fall out over the twisted tongue can only mean anger.

The written language has more thought prevailed upon it. It is disciplined and succinct to the projection of an idea. It also is an infant in the scheme of things, since the written word is youger by thousands of years to the spoken expression.

                                            Cuneiform the first known written language

How we communicate is how we think. How we think is riddled with our fears, happiness, and experiential references. Thus many a father has told his son to watch over the words before speaking, once spoken however these words enslave us.

                                          Werniecki and the Broca's Areas of the brain

2.4 million years ago the brain was half that of its present size. It achieved the current size around 1 million years ago. The Broca’s and Werniecke Areas in the brain seem to have evolved around 250,000 years ago yet language in all its glory did not occur till 40,000 years ago. The sudden adaptation from animalistic behavior to hunter-gatherer to the modern pin striped suited man with a Mohawk hair-do is what Chomsky proposed. No slow regulated evolution just boom there it is.

                                  Language is the determination of the nature of things

Current references to “mirror neurons,” the brain cells imitator extraordinaire are thought to allow learning through imitation. Ever seen a three month-old baby, sure you have, how she tries to express by imitating the adults till she is able to with time and experience. Akin to her arm and leg movements, the sounds that emanate from the infant are free staccato utterances, unformed and unguided until more control of the mouth, tongue and the vocal cords has occurred. Then one day “Mamma” rings out to the delight of her mother and all is well with the world.

“I can’t imagine someone saying that garbage!” He said with some anger and resolve. Something that was said had reverberated in him the wrong way, disassembling his structure of philosophy and nature.

“Who and what are you talking about?”

“That jerk. He is a quack at best. Doesn’t know a thing about anything and makes himself out to be an expert. That damned Joe.” Joe was the new fellow in the medical program. He was all bluster and blister. Spoke out when not spoken with, opined when no one asked and expressed when least desired. He was a one-man band of satire, uncouth and discourtesy.

“What happened?”

“I sent him a young woman for an opinion and he laid out the worst case scenario. Took the percentages and rolled them over to destroy any little hope she had. Left her crying in the room and then had the nerve to say, “Make the necessary adjustments in your life,” to her. He is the devil himself.”

“He can be a little opinionated at times.”

“Opinionated is not the word for him. It took me an hour to remove fear in her and even then the doubt he cast remained.”

“Maybe you should talk to him.”

“I do that about once a week. The tunnel between his ears is pretty wide. Everything flows through.” He said with his right hand sailing from left to right. “It would be one thing if he could empathize with the patients. I bet his ‘mirror neurons’ are dysfunctional.”

“That would make him…”

“Autistic. No. Just an imbecile with the devil’s tongue.” His exasperation was obvious. Stress rode the color on his face and sweat beads of anger formed over the temples. “I mean you can express the data with a positive bent. The response to treatment is over 85% in that woman’s case and he decides to ride the 15% barge of despair. 5-year survival after treatment is well over 50 percent and he says one of two women with this disease die in less than 5 years. Is that nuts? Or what? I understand false hope is as bad, but truth can be expressed in better ways than with a glass half-empty all the time. Wham, slap in the face and see you later attitude is not what a fragile mind can take. Take the hope away and you might as well ring the death knell.”


“Fighting a disease requires energies and super-human strengths. The fights against despair, frustration, hopelessness and plain depression are all too many, and then to present the worst case scenario is like walking someone to the guillotine.” His hand falls slicing through the air down on the table wham.

‘That is sad.”

“Sad but cruel too. I mean you can say the same thing better and with enough measure to allow the aggrieved understanding to sink in slowly yet with hope. Not only are his words chosen poorly but also his inflections are almost without empathy. There is no ‘me’ in the conversation. It is as if the book reads the words in a monosyllabic tone like the computer text to speech readers of the days past. Now even the computer text reader voices have inflections simulating reality for human comfort. None with that dufus.” He shakes his head disgustedly then gets up to leave.

“Don’t let him get to you.”

“Easier said.” He looks back after taking a few steps, “Empathy is being a human. To lose a fight before it is fought, to lay down your arms before the enemy is sighted or to accept defeat when the drums of battle have yet to be beaten and all because of mistimed, mistuned or misrepresented information is horrible! The decision must lie with the individual once the facts are properly assimilated.” He turned to leave and briefly looked back to say, “Always!”

Tonality, pitch and inflection lie at the heart of communication. The meaning of the word changes with variation of one or all three. Humanity’s gift is the ability to draw from these musical expressions an algorithm for communicating thoughts and feelings for sharing and building, for creating and developing and for softening the blows of nature upon nature’s grandest experiment – us.

If you can talk with crowds and keep your virtue, 

Or walk with kings - nor lose the common touch; 

If neither foes nor loving friends can hurt you; 

If all men count with you, but none too much; 

If you can fill the unforgiving minute 
With sixty seconds' worth of distance run - 

Yours is the Earth and everything that's in it, 

And - which is more - you'll be a Man my son. 
-Rudyard Kipling

Sunday, December 20, 2009

A Miracle on Christmas Street

December flows in fits and starts of cold winds and cloudy dreariness. The drama of change in the deep clutches of power and might. The whistling chimneys and the rattling of the windows overcome by the inconstant powering on and off of the heating system. But there is something in this cold air that makes humans alive with spirit and happiness. The last month of the year is also the month of Christmas. It is the joy of giving that supplants all other feelings.

Precisely in the herald of this month a cold and distant echo of misfortune was to strike claiming all virtues of joy and content of his spirit. He lived for this month. His “presents” for his family and friends started accumulating the day after the New Year. There were no resolutions to resolve past transgressions of life, for there were none. No bills of equanimity to pay for imbalance of ideas, or purge the colors of prejudice for he treated all the same. He lived a clean and decent life. He functioned on the beautiful hue of a mural of morality that claimed the blank fabric of his being. He was a giver of ideas and things. Nothing mattered but the joy and smiles he received in return. He was wealthy with contentment and ignorant of wants. His was a life lived in balance and selflessness. Not quite out-of-the-world-type of behavior, but in these days it seemed that way.

Sitting at his small wooden desk that barely covered the breadth of his own legs, with the conspired deliberations of thought and happiness he addressed the cards with words that would fill the hearts of all the lucky recipients, who took the time to read them. The elegance of his thought was expounded within the content of his words.

The pen had barely scratched the letter on the fortieth card when a sudden gallop of the heart and restlessness of his pulse made him pause. This was odd. He had never felt this before. He regained his composure after a moment. Poised to begin the exercise of love and comfort through the flowing ink of his pen, when a second wave of the sudden internal bodily riot made him stop. The concern was just being raised to the alarm level in his thoughts when the lights went out.

A crucial lever of continuity had become unhinged somewhere in his being. The wonderful machinery of his body of seventy-five years had through wear-and-tear lost the composure of the fluid function and form of being. Something had gone awry and there was no help around. He was alone in his modest home, a rustic ranch-style house perched near a pond of still clear water, ablaze with lights and sounds of Christmas.  And now with the passage of time the critical mass of the present was slowly dissolving the potential future. Life was oozing through the pores of his being. The clock ticked and tocked its mechanical hubris to allocate the next moment, heralding the future into the present and as it did so the colorful landscape of his life seemed to falter and fade in inches off the mural.

The shrill ring of the telephone claimed power over the room. It rang for a while and then it stopped and then it rang again for a while. Time was fleeing, in the darkness outside of the evening. He lay motionless. His head that had slowly fallen to the desk surface now ashen and his mouth open with his thick shock of curly salt and pepper locks of hair falling over his face covering his half opened eyes. The red conical Santa hat with the white plume of cotton on top lay on the floor.  His right leg twitched repeatedly and then all was quiet again. His facial color now drained like the parchment paper of the greeting card beneath it. The arrow of time kept its flight, the unmoving mover of events and lives, creeping in its steady pace overtaking the desires of this lonely habitant.

Ten days later the sun had just broken out after being held hostage to the dark gray clouds. The few spurts of snowflakes had come and gone. The wind was cold and shook the naked branches of the tall trees as they cowed to the whims of that force. The chimneys belched the dark sooty smoke of oil burning stoves. The homes were shuttered as fortresses to the bad weather, with curtains drawn and nary a pedestrian walked the icy sidewalks. Motion, was only exhibited by cars as they were driven to and fro to businesses.

He lay in the hospital bed with tubes exiting from all parts of his body. He was still distant to the present stuck somewhere in time where communication was measurable in being only. His eyes were partially opened, swollen and without recognition.

“So what do you think?’ The resident asked in his mild mannered baby-faced thirty-year-old questioning wisdom. He was sharp in critical thinking and had decided neurosurgical residency would help him decide his future.
“I haven’t the faintest idea.”
“We thought it was a tumor in the brain, but all the CT scans and the MRIs have been negative.”
“Well it has to be the critical cortical brain. I mean given that he has a good primitive brain activity but no cerebral functionality. His heart is ticking and he is breathing on his own but no perception, words or actions.”
“You see,” he bellowed, “any assumptions we have been wrong.”
“Waiting long enough something will show up.”
“Time is a delicate coefficient. Too little and wrong assumptions can mislead while too much and the wear and tear on his body will destroy his chances for recovery. What we need is a Christmas Miracle.”
“That’s a new one, coming from a neurosurgeon to be.”
“All tests have been negative and yet we have this impasse. I checked the books, journals and of course Google. All answers are fairly pat. There is no “House” moment. We cannot go and biopsy the brain and five minutes later have a diagnosis or for that matter do a craniotomy because a hunch has arrived and must be resolved quickly. I found out reality is a whole lot slower and more challenging,”
“Welcome to the real world.”
“That sounds eerily damning.”
“It is, because that is what real life is. It isn’t a TV show. It is life.”
“Okay enough of philosophy. What do we do next?”
“Done!” He slapped his fist into his hands.
“A small focus, the Neurologist feels it is some scar tissue from yester years.”
“Did you consider a SPECT scan?”
“What would that show?”
“Maybe able to isolate that area further. And while at it how about a Chest XRay?”
“The Chest was clear except for a small nodule in the left upper lobe. It is too small and deep for a biopsy. I’ll order the SPECT. This sounds like “House” now. Doesn’t it?”
“Lets get a PET scan while we are at it, since a malignancy has to be ruled out and it is the strongest of all arguments yet.”
“This could be the next House episode now.” He laughed as he walked away. Youth has a certain measure of flippancy that arguably is charming some of the times, and the TV is their measure for all things real and fictional.

It is in the subtle axioms of wayward thoughts that a germ of truth is beheld, waiting for the implied assumptions to reach the desired conclusions. So it is with small miracles that are born in the fragment of a sentence within the emptiness of ideas. Yet that emptiness beholds the richest of all experiences and knowledge. Sometimes in the sanctuary of a quiet reflection the expressed thought can weigh in and proclaim Eureka. It is like the discordant string tuning of the violin, the obo, the isolated bleat from the Saxophone or the semi-fluid tone of the flute, with an occasional echoed cough from the audience, that, suddenly with the raised arms of the conductor, in a flash of genius, all converge into a pure tone of rhythm and beauty to surround you with a symphony. Perfect harmony! Order from chaos! Convergence!

            William-Adolphe Bouguereau (1825-1905) - Song of the Angels (1881

And so it was that December 14th evening when two minds wrestled with the airy substance of exhaustive communication, an idea was hatched that would grow to lead to a miraculous recovery.
He, our gifted and talented lover of Christmas, the man with the wit and wisdom of contentment and balance, the writer of a hundred Christmas cards with a cast of thousand words, had visited upon him the Angels of Truth and Grace that evening via the ramblings of two men of science.

                                                 MRI result of a solitary metastasis (spread)

He was diagnosed with a Lung Cancer with a solitary metastasis to the brain. It was the non-small cell type. Both the lesions were removed and he was considered disease-free. His stupor, it appears was from the brain overcome with the poisonous material of the wayward cancer cell. The apothecary of poisonous hormones circulated into his brain and shut it down. It was euphemistically termed “Para-neoplastic Syndrome.” Only when the tumors had been independently removed, did the threatening humors dissipate and the brain was able once again to muse in its musings.
This was the Christmas Miracle.

A year later, surrounded by his favorite colors and lights, listening to the rich sounds of Bing Crosby, he sits once again inking in blue, the pure thought of the joyous season. He is once again reunited with the love of the Season and the breadth of the human Spirit.
The doorbell rings. He opens the door.

“Package for owner of 30th Christmas Street.” It is the mailman.
“Thank you. And I have something for you.” He returns with a gift package, “Merry Christmas!” He exclaims with the lyrics, “Have yourself a Merry Little Christmas,” playing in the background.

Life has begun again to forge new acquaintances. It is all in the giving that true happiness resides. The rest is the mist of ignorance that clouds our reason.

Wednesday, December 16, 2009

Soul Mates

The river bends at a most inopportune moment transecting a beautiful garden of trees, flowering bushes and flowers of all colors and beauty. It is a quiet place made haven to the birds that fly by to visit and some to feed, for there is always a bird feed full of content and promise. The lazy branches of the birch trees swagger under the tug and push of the breeze and the rustling leaves fill the sounds of heaven on this lovely paradise.

The grass is always neatly cut, for from time to time a thin tall man can be seen mowing it with great care. He seems to pause to catch his breath and then filled with the desire to accomplish he continues undeterred by the body’s desires of rest.  He can see the riverbed from where he mows and his glance moves from place to place taking in all the life this Eden has to offer. His rituals are weekly and Wednesdays are what he looks forward to most when he can sit in this haven on the back of a modest century old home and watch the birds at play.

This Wednesday however he is noticeably absent. The birds still fly in but the chatter is different. The sounds of communication have a different cadence. There is hurried chatter and coos and twitters but little harmony. They must miss the human.

It is 2.O Clock in the afternoon and he sits besides his wife who is lying quietly in the hospital bed. He holds her hand in between both his. There is a communication between them. A lot said but no words uttered. All emotions encompassed within the loving grasp of hands. She looks up at him and smiles. He leans forward and caresses the hair out of place and hovering over her face and gently places it back over the pillow. Her face is calm and content. No frowns of whys and whats and hows lurk on her weathered face. She is at peace.

“You wouldn’t know it, that she was sick. She looks so normal?”
“Yes she does. Unfortunately she has this leukemia and now it is taking its toll on her after 12 years. The bad cells are occupying most of her organs and even congesting the lymph glands. Her immune system is unable to mount a defense against the infection she has but the antibiotics should help with that.”
“Will she be okay?”
“I don’t know jus yet. Her vital signs are steady but until we get ahead of the infection this could be serious. She has been having more and more sweats and chills. She has lost a considerable amount of weight and her appetite is poor.”
“I noticed that and asked her about the appetite and weight loss but she would shush me every time, saying she was okay. I know you are all working hard to help her. I appreciate that very much.”
He goes back to the room to join his mate and picks up her hand gently to caresses it once again in both his. The circuit of energy is once again established and she smiles.

The nightfall is slow and comes easily but within the fluorescent white walls of sterility it is fire walled to an outside realm, deciphered only by the clocks that register the passage of time. Muted echoes of emergent calls overhead stream through the hallways and scurried steps emerge and follow to whence the demands came. The pace is slower a little. The clatter of the dinner plates being collected by the Food Service creates a limited banter between employees but this too is brief and quickly ceases once the tasks are completed.

“You should go home. You look tired.” She says awakening him from his nap. Her hand still in his and his body slumped to the side against the hospital bed.
“I am okay. I want to be here with you.”
“I know, but I don’t want you to be sick too. I couldn’t help you.”
“You get better then I will get as much sleep as I need.”
“There is little chance of my getting better. The doctor told me.”
“I think this is just a slight relapse. You will bounce back as you have done before.”
“No, darling. My time is over.” No tears flow from her eyes, just truths. She looks at him and a frown crosses over her forehead. “It is okay. We will meet on the other side. I couldn’t live without you anywhere.”
“I love you.” He says and continues holding her hand. Tears flow from his eyes readily with a sting of pain. He turns his head to avoid being seen. She knows.

The sun announces its arrival as a shaft of the golden hue breaks through the shutters and touches the opposing wall scattering the bright light in the room. The bright light falls on his face and he awakens to a silence. His hands still cover hers but the warmth has stolen away in the night. Her eyes are closed and her face is set in its quiet calm of peace and tranquility.

The tears don’t come. He wants them to, but his eyes are wrenched from all their moisture. The heart feels heavy and flutters inside his chest but continues to beat. His hands shake ever so slightly yet they continue to do his bidding. The past flows through his mind in torrents, bleeding the memories in its wake. Some sharp and vivid, others softened and blurred – all good and comforting and aching his insides.

“But she was in remission?”
“She was for almost two years. But she had been in remission several times before.” The disease always comes back. We have many tools now. Medications that thwart the mature lymphocytic leukemic cell from growing, but we still cannot get to the primitive mother cell or cells that start this whole process. “
“How long do others in her condition live?”
“Some much shorter and a few much longer. Remember that is from the time of diagnosis. Sometimes the diagnosis is not made and the disease has been in the body for many years.”
“Without any symptoms?”
“Yes, unfortunately. These lymphocytic white cells basically grow and survive raising the total white cell count. They subsequently overpower the normal functioning white cells by their sheer numbers and infection and organ dysfunction starts to create mischief in the body, which ultimately leads to illness and death. In her case the infection got her because she had no defense network of normal cells to help the antibiotics to rid of the bacteria.”
“I don’t now what to do?” He looks for answers and can find none.
“You can keep her alive in your memory, by staying healthy.”

It is a Wednesday afternoon and he is once again mowing the grass and the birds are chirping their normal chatter, unbeknownst to them of the heavy burden of loneliness he carries. His gait is slow and his once erect spine and straight shoulders are bent and slumped under the weight of his grief. He looks at the riverbed and the water appears to course around the bend a little quicker, sloshing ever so harshly at the turbulent turn. The light is bright but seems to fade a little. He wipes his brow and heads to the chair to catch his breath and drink from the glass of water sitting on the table. His hand never reaches the glass.

The Obituary Section of the newspaper mentions one J.U. Brown, 97 years old dead of natural causes. No relatives. His wife G.L. Brown predeceased him at age 99 years two months ago.

Years later the bend in the river is gone from the thrashing of the turbulent water and where once stood the majestic garden now courses an angry river. The boarded house has fallen in disrepair and uprooted trees form the river’s bank. Now the weeds rule the chaos that surrounds where order once ruled and the sound of the chirping birds is replaced by the burble and roar of nature’s fury from the angry river as it slowly inches its way to devour the once upon a time home of two beautiful soul mates. 

Monday, November 30, 2009

It was the best of times...

The Appalachians rising slowly covered with a forest full of trees and green overlooking the grassy meadows. From ancient calumnies of the Utica-lower Paleozoic in Upstate New York to the Devonian Shale in the Ohio valley to the Carboniferous Coal Bed near Western Virginia, the harbinger of momentous energy supply, a constant motion of grinding, crushing folding and molding beneath the surface catapulted the ground into a wavy horizon of the Appalachian range extending hundreds of miles beyond where the fabric of vision could perceive. The liquid blue of the yonder and the dark greenish-gray foreground merged to conspire the beauty of nature as autumn days slowly eclipsed the summer months. The low-lying grounds filled with pools of water reflecting the majesty of a tempered beast underneath.

No singing Finches here, just an occasional mourn of the dove with its rhythmic coo-ah-coo-coo and the staccato movement of the grouse strutting its gait with its neck jutting out on the defoliating branches of the autumnal season. Visitations from pigeons and ducks were also common as the coated banister of the balcony of a lone log cabin, with bird droppings, belied the remains of the departing visitors. The fall colors fading from memory and the gray dawn of desolate hours looming ahead made for a season to rethink philosophies.

He sat on the ledge of his humble abode. It was a small cabin, perfect for a single person, perched atop one of the hills. The quiet of his surroundings broken only by nature’s creatures was his solitude from the advocacy of interminable activity he had left behind. His days as the Boss in the Trading Pit with numbers flying in forms of outstretched hands gasping for air in the sea of arms. The riot of the human mind in full display as commerce drove the plentitude of a society. The science of action in this constant warfare of dog-eat-dog world to survive and thrive had given way to the art of loneliness and solitude for the desire to survive and thrive.

He looked around as the sun faded below the undulating mountainous horizon. The dark cast of twilight slowly enveloping the grandeur of visible reality. The chilled air seemed to find wings and leap at his neck. A dry cough erupted from his throat as he lifted the collars of his faded blue-checkered shirt. There was a wheeze from whence the cough had originated and that seemed mild but constant and then as quickly as it had arrived it left without a trace, but he still felt the chill inside of him. He got up from the bench walked the few steps of the balcony and went indoors to the shielded warmth. He glanced at the mirror over the mantle and the two-day stubble darkened his weathered face. The two-inch long dirty blonde hair in disarray from the breeze gave him a look of a hobo. From riches that inquired looks from walker-bys, to this – loneliness of thought and philosophy, it was a movement away from his original movement, a self-imposed immersion into solitude.

The next morning the piercing sun from the East window awakened him. He felt feverish and had a mild headache. A cold maybe, he thought from the chilled air last night? He thought. He could not muster the strength to get up from the comforts of his bed. The weakness surrounded him completely. He was alone. Hours ticked by and yet the strength eluded him. Finally into the waning hours of the afternoon sun - now leaking through the southern windowpane, he managed to lift himself to the tiny cove of his dining room. With his head swimming in unholy circles of confusion and the wooden floors coming up to meet him in waves, he reached for the phone and dialed a number to his friend.

“Good Morning Sir!”
“What the hell?”
“Expected emotions, from an ex-trader and traitor to friendship.”
“What happened?”
“You had a serious infection called psittacosis.”
“What the hell is that?”
“It is a bacterial infection from birds.”
“Do I have bird flu?”
“Not exactly. This is a bacterium that lodges in the birds.”
“So in layman’s terms, how did I get this psychosis. Or whatever?”

“Okay, here it goes. You inhaled some bird poop. The poop had a bug. It went into your lungs. It multiplied and made its way into other organs. Your body created a fever response to circumvent the infection via the white cells but to no avail. It took us almost two days to make the diagnosis and then with the right antibiotic cocktail and some prayer the rest is easy.”
“How did I get here?”
“You called, buddy, and then like other times all you said was, I don’t feel that good,”
“That’s all I said.”
“Not unlike other times. You know you could be more social.”
“Anything else?”
“You must have passed out. The EMS found you half sprawled in the kitchen your mountain hideout in your PJs.”
“Then what?” He was looking for more information.
“You had a faint pulse, a low blood pressure, a florid pneumonia and signs of meningitis – which was misleading but we had to make sure that was addressed immediately. I have n XRay in my hand since I knew you would ask. Prioritize as you used to say. Remember, the whole investment world can be going to hell but if one prioritizes one can make money. I never understood that, but I can use it too in medicine. Oh and by the way all that whited out area on the left hand side is the pneumonia from the Chlamydial bacterium. Nasty.”
"That what my inside looks like?"
"It did. But like you say don't look at the past. Cut your losses and move on."

“Clever. Using my words against me.”
“Anyway. The bird poop caused a disease called Psittacosis. You might have inhaled the dry poop or carried it in your hands accidentally or found a new meal riddled with bird poop in that forsaken land of yours.”
“Very funny. What about the enlarged spleen business?”
“A retico-endothelial reaction to the infecting agent. The spleen is a collection of these cells. Nothing of consequence.”

“Good!” He said with his fingers clutching and pulling the blanket to smooth the wrinkles and folds, exhibiting the quiet self-sustained drama of perfection played out in his inner sanctums of the mind.
“Seriously you should come back to earth now. There are a lot of very friendly women who want to meet with you. Maybe one of them might even be perfect!”

“Right! Here we go again.” He snarled. “Always against peace and quiet.”
“Never, peace and quiet are my middle names. I believe in companionship with the right person. A soul mate of sorts.”
“Just because you found the right person doesn’t mean everyone else can or will.”
“The heart can be impusive at 16 years or even at 24 but not where you are peering at the world. If you give yourself a chance to meet you will know.”
“Uh huh.” He almost looked ready for a fight but stopped short..
“We are going to celebrate this recovery at my house and I’ll enlist some help for your cause.”
“My cause, as you put it is self inflicted. I like my company.”
“Maybe. But if there were a girlfriend or wife, this calamity would have been prevented and we would be enjoying holidays together more often rather than ministering potions to cure and being ministered to for illness. Besides wouldn’t it be great to share that wilderness with someone else?”
“We’ll see.”

He made a full recovery after a long treatment with an antibiotics called, Levofloxin, Clarithromycin and Chloramphenicol. With the bacterium destroyed and the infected, inflamed and inflicted upon, tissues healed to full function, as only this masterpiece of invention called the human body, will wont to do, he was back to his wise old self again. His philosophy however did change.

During the after life of the winter months when the shadows started to shrink and the once gray cloudy days broke to new color, he started to search for meaning.

He had realized that there were more things, wonderful reaches and inexplicable startles of beauty in humanity much like that of nature. And as like nature humanity speaks to the warmth of companionship. And as with a distempered reality humanity creates comfort. There is always another soul that yearns to meet its mate. He found his in the most unexpected of places – dinner at a friend’s place.
It may not be in the clashes of outspoken words nor distill of a chaotic dance, it may, sometimes lie in the most unlikely of places of quiet solitude, silent togetherness and smiling eyes.

There are more things in heaven and earth, Horatio.
Than are dreamt of in your philosophy. Hamlet 1.1

Sunday, November 22, 2009

Tonal Dissonance

There creeps in, at a steady pace, a comical antagonism that on its outstretched arms reveals little of its banality but the disarming smile of congeniality. It is within its substrate of slow disarmament and constant ridicule that the manner of its conspired gains are brazenly achieved. Sometimes these ridicules are innocent and sometimes they have far reaching quills that prick the essence of a firmament established in society. Humans will forgo the truth but become so involved with the political will that musters and eggs them on that they in their own benign innocence will yield to the temptation of self-righteousness. One such story is that of the age To Be!

We as a society having achieved of things once thought impossible like viewing the Titanic wreck on the dark depths of the Atlantic Ocean floor or stepping on the moon to hit a golf ball with a 9-iron club to the images of the rugged Martian surface, now consider no task unreachable and rightly so. It is manifest in our destiny that realizing one’s dream is the gateway to success. It is also manifest in our present the successes of the past that make the future so bold and yet easy. We have succumbed many times and will many more to the riches of varying degrees of truth that sometimes we have fallen victims to the very lies we try to avoid. Sometimes this is for expediency of our political desires and other times to the material desires of our self.

It is always in the rewards of truth that life unfolds its most beauteous of flowers. There is no controversy of thought or action. No blame or victimization and no lies to be told. It is the essence of reality. Of what it is and what it will become. No revisions of history to speak for the present and no obscuration of the peaks and valleys of the lessons learned from the past, just the truth.

The quiet pandemonium of muffled voices, clanking of silverware on the ceramic plates and murmur of hurried movements lays the scene in an enclosed space with some 80 people seated or in the process of sitting in an auditorium.  Some happily munching on the green salad while others sampling the large brownies with chocolate icing on top encrusted with colorful sprinkles right of the bat. There is a sense of urgency amongst all to get seated before the speaker begins. Most of the seats are taken in the rear of the room while the first row is virtually empty.  Between quick glances and mouthfuls the crowd assembles into a uniform audience. The lights are dimmed and the speaker who has been checking his computer screen for the presentation slides, shifts his weight on his right leg, clears his throat and welcomes the crowd.

He is an authority in his field of medicine. He is well traveled and distinguished in his field of expertise. He knows his subject. His sharp focused eyes, an aquiline nose and chiseled features define him.

“Ladies and gentlemen, I am going to discuss the ramification of the screening processes that we as humans have to endure for the single defined purpose of living healthy lives. I encourage any questions during this discourse. We will start with knowing about the types of Risks encountered in medicine.” He turns to the projector and presses the navigation button and the screen fills in.

“The Absolute Risk is defined on the bases of real numbers such as 1 in 10. Or for instance as in Breast cancer 1 in 7 during the lifetime of a woman. But it is as low as 1 in 25,000 in a 25 year old and as high as 1 in 3 for a woman aged 85 years.” He waits for the impact on the crowd and witnessing a few nodding heads he moves on, "The relative Risk issue is based on percentages and does not reflect true value. This is strictly based on a relationship with some other findings. I will digress to make a point between the two risks and use a slide on Pravastatin a Cholesterol lowering medication versus placebo in 1000 patients.”

Now compare that to the fact that the Relative Risk reduction which was computed as 32/(32+41) = 43%. In other words the promotional discourse is the calculated relative risk reduction but the truth is different and a little unsettling like the dust particles in this room.” There were a few coughs around the auditorium followed by muffled laughter.

“Now lets turn our attention to the value of mammograms in women.”

“The answer to the question is in the following slides and will become apparent to you shortly. But in the meantime keep thinking the answer to the posed question about the probability of a woman with a positive mammogram to have breast cancer on your own.”

The answer is 8 out of 1000 women screened with a 0.07% probability of disease in the population.” He waits again for a question but none is uttered.

“Lets deal with the risks of radiation from the screening process. It is established that the older machines before 1970s exposed the breasts to higher Rems then the current ones. The current exposure is well within the annually expected exposure.”

A hand shoots up from the audience, “ And who determines the annualized risks?”
“Good question. The linear hypothesis of radiation exposure and death is 2500 Rem. A value of 100 Rem is considered safe with less than 2% probability of disease. With mammography we are talking of millirems only.”
“But how do you know the breast tissue will sustain that amount of radiation without changing to cancer?”
“Here is a slide that answers to that question and I will expound on that.”

“You notice that there is a peak and fall out as a result of radiation exposure. So the cumulative effects are important and one has to balance out the benefits to the population in terms of early detection. Here is information from the JNCI about the suspected risks. You may have to squint to see the material clearly but it is worth it. I will give you ample time to review this slide.”

(Click on this slide to enlarge for full review)

“But if we are inducing cancers in the screening then isn’t that a self-fulfilling prophecy of ultimately finding the cancer after many years of testing?”
“Tough question and true in its premise. The real answer is the number of lives saved to the number of lives at risk from the procedure. Refining the breast imaging procedure and limiting exposure are tow important methodologies. Mind you and this is important to know; that we are all sustaining carbon 14 nuclear decays at a rate of 120,000 per second. Each decay yields gamma rays that disrupt cells and mutate their DNA. We are also exposed to the solar flares with trillions of neutrinos cascading through our bodies and of course the Radon decay in the soil that permeates through the soil and moves upwards into the atmosphere all yield radiation exposure to us. Our bodies have this mechanism called Mismatch Repair Gene. This governs the DNA replication process so that any error in recording of information to the dividing cell results in apoptosis or cell death. So the body rids itself of all these bad genetics. However if the mechanism is overwhelmed with the onslaught of bad genetic cells it can be over powered and the body can lose the battle. Another important factor is in women with dense breasts the mammogram yield is 62.2% while the norm in a non-dense breast is 88.2% and the detection rate of cancer in women with dense breasts is 9.7% compared to 4.7% in the normal breast. The denser the breast the more radiation is required for optimal viewing.”  He looks around the auditorium with his sharp focused eyes for any further questions. There is quiet and a few people shifting in their seats. The dark auditorium is under his spell.

“Now let me talk about the costs of screening.”

“Look at the facts. For 10 abnormal mammograms only one is truly positive for cancer or a10% probability. Repeat mammograms causes an enormous resource depletion and early detection if DCIS is really of no benefit since almost 99% of these will sit there and can be detected later without spread. It is the false positives that create anxiety and the false negatives that lead to potential problems. Here is one of the proposed algorithm for screening and interpretation and the potential complications that ensue from it." He waits a moment and then in a clearer and more forceful voice says, "every false positive has a potential for extra testing and intervention and every false negative has the risk of potential delayed diagnosis!"

“Now let us talk about real and perceived costs.” He flips the slide with a certain amount of flair. Almost maestro-like performance and immediately regrets it when a few snickers and suppressed laughter breaks out into a muted chorus.

“Interesting how our perceptions dictate our lives. We are fearful for the wrong reasons and fearless when caution should be the order of the day. Initially the advocacy was to use screening in women at age 40 every other year. But that is counter-intuitive since breast cancer in the young is more aggressive then in the old, so you would want to screen them more frequently. Now the issue is to screen women over the age of 50 years and once every two years. I think governmental interference over physician based intellectually designed scientifically considered options are a recipe for disaster. The politicians have no business in the profession of life saving. It is heretical in a communist society to question where the government knows best but in a society where diverse opinions and logical understanding based on verifiable scientific data exist, the decision must be evidence based and left to the physician. There are some women who need closer monitoring with higher risk factors and they have to know the risks of screening and then there are others that do not. A clinical examination performed by a competent practitioner and any findings can be confirmed by diagnostic testing may yield better results. To date the reduction in breast cancer has been attributed to cessation of Hormone Replacement Therapy and early detection to screening and therefore by implication more cures although the latter confirmation still remains elusive. The time for Medicine which is Tailor Based to the individual as other methodologies become available will yield better outcomes, limit risks and diminish fiscal pressures.” He stopped and took a quick swallow of water from the glass on the podium.

“I am going to leave you with these thoughtful questions?”

The thunderous applause drowns out silence. Many people walk up to shake his hands and words like “iconoclast” are heard and repeated around the room. The disbanded group walks out with a new understanding of the facts. The culture has to be refined one individual at a time and he is changing them by the scores.

“Omni Verum Vero Consonat.” (All truth accords with truth)

Wednesday, November 18, 2009

A Little Inconvenient Truth

It is early morning and the first light of dawn is stretching westward slowly pushing as it does the dark blanket of night. The brilliant dewdrops shimmering perched delicately on the spider’s web hold court to the spikes of golden rich hue of the rising sun. The stillness of the air, the coolness of the surroundings and the glory of nature all encompassing delight to behold. These vistas proclaim the wonders of the planet. Like the Snoqualmie falls in the northwest spilling their content into a fine mist and the rugged mountains of the affably known Rockies covered with the fairy snow dust of grandeur to the cascading waves rollicking over the sandy beaches of the Eastern Sea Board all enchant us, call us to vacation, remind us of times spent and hold us in their locket, forever yearning for more. It is another beautiful day for a walk through the woods and muse upon the wonders of this elegant planet.

The planet is a wonder a huge collective of stardust that made its elliptical circuit just far enough from the sun not to get scorched and just near enough for the warmth to grow an intelligence that lives and breeds and breathes and lives. This intelligence sometimes arrogant, and sometimes humble, sometimes cautious and sometimes reckless continues to enjoy the vast beauty.

Man is in equal parts lonely in thought and collective in spirit. He is enjoined by the fears of his limited knowledge and grazes at the outskirts of understanding. He is forever employing the world as it appears to him through his eyes and ears. His arrogance of self-worth seems prodigious and can easily surmount the greatest of all obstacles. His delight in his limited conquests gives him the rigor to question the health and well being of the beautifully self-sufficient planet called Earth.

Reductionism to the point of closeted intelligence that deciphers the meaning of little may not encompass the meaning of the large. Man nor his adjunct mechanical mind of computers cannot correlate the varying forces that conspire, cajole, breed, breathe, broil, boil and bubble the wealth of the daily day.

The dark clouds that form in the afternoon and then dissipate may very well climb to thirty-thousand feet and create a nasty thunder cell if but for the lift, the heat, the terrain, the surroundings, the mountains or hills or the adjoining lakes. It is indeed the butterfly wings that flutter and move the air that may initiate the cascade that would be a pleasant breeze or the sudden emergence of a rollicking tempestuous thunderstorm. In the winter the gliding fronts may conspire to reach an accord of whether the day would open its eyes with a beauteous covering of snow or the cold soggy rain drenched earth. This little understood cat and mouse drives the meteorologists crazy to the point of them looking out side their window and predicting the weather. This is the earth in its entire splendor and we humans are a small part of it. We are a species that have survived thus far through the raw innate civility of limited knowledge-based intelligence that we in our daily dialog fathom to decipher. It is this intelligence combined with that arrogance that brought us to the present and may lead us to extinction as the earth loses 3 species every hour based on fossil data. The vast landscape of 1.5 billion species lost through the intergalactic flight of mother earth.

It was one of these crisp cloudless, motionless mornings when it is good to be alive. A chance meeting as he sat on the recumbent log straddling the sides. His right leg in a cast from his recent fall and his left leg in a brace from his affliction with poliomyelitis, never one to complain about his health’s misadventures he quietly but rhythmically hit the log with a stone eliciting the echo within. Looking at him one would not know that the head that was covered with the fur-lined hat of a hunter covering his ears had received an MD, a double PhD in biology and atmospheric physics. He was the recipient of many awards from the scientific community, but sitting there, knocking on the wooden log for some answers that would never come, he looked like a forty-something homeless person.

                                               Beautiful and Rugged Antarctica

“I love this time of the year and day. It is rejuvenating.”
“Uh huh.”
“This earth is a living breathing being like us. It burps, and shakes and stills itself to survive as we do. What a magnificent collection of star-dust!” His eyes wide with wonder.
“So you don’t think we are all going to die because of hurricanes and floods and greenhouse gases we are creating as they all say on television?”
“The unlucky ones might get trapped in a hurricane or the tornado or a flood but that has nothing to do with us.”
“What about Global Warming?”
“What about it?”
“Aren’t we creating the warming with our barbequing, our SUVs, our jet planes?”
“What about the rhetoric?”
“It is exactly that.”
“But they say they have the proof.”

                                          Global Warmth and the known sources

“There are several reasons for earth's warmth and there are beautiful and elegant theories but the little ugly truth gets in the way. They use facts but lend a little distortion to them, they exaggerate the findings to suit their cause and then use selective data to bind the same book.” He stopped the knocking on the wooden log and after a brief moment he resumed, “I am not denying that the world is not hotter by 0.6 degrees Fahrenheit in the past 100 years. No, I am not. But did we cause it? The answer is probably not. That is the truth. However and here is where it gets a little testy for the rest of the cubicle scientists. When you stretch the observation to thousands of years before that time period of 100 years, from ancillary ice data the real fluctuations of the temperature becomes normalized. In fact if you saw the pictures from 1950 you would see a frozen River Thames in London and in 1973 you would see virtually no ice cap on the Mt. Kilimanjaro.”

“Really and how does a stretching time change result?”

        Evaluating time from a 1000 years and Tens of Thousands of years

“Take the data from the American Icebreaker vessel RV/1B in the Antarctica Ice Sheet for example. Some 14 thousand years ago, when the Holocene age began, the ice layered sediments varied from 0.7mm to 30mm per year. Followed by a glacial retreat some 10 thousand to 7 thousand years ago with warmth over the globe and little glacial cover some 5 thousand years ago. Interestingly this cooling and warming did not happen universally over the entire globe but was geographically desynchronized. Most climatologist believe that the earth was 8-15 degrees Fahrenheit   warmer than today. And then there were times when the glaciation spread all the way almost to the equator some 2 million years ago, and that was the Pleistocene Ice age period and then it retreated. Even as recent as 1500AD the temperatures cooled by 2 degrees F. So this is not a complex argument.”

                                              Ice Core Data from Antarctica

“The obvious question is what makes the variation in temps?”

                                                        Earth's Precession

“Several factors. Start with the earth’s rotation. It wiggles and tilts and goes from the elliptical route to the circular route. Then there is the Sun’s thermal activity which varies with the fuel being used for fission.” Seeing the quizzical eyes staring at him, he continued, “remember the sun spots those are indicators of variability. However there is more to the sun than solar flares. If you just consider the earth itself, it has a wide array of excuses for these variations such as, the volcanic activity which can shield the sun from its volcanic ash and lower the temps or the insidious tectonic activity with minor and major earthquakes that release sealed carbon dioxide in the atmosphere that creates the greenhouse effect by reflecting back the infrared warmth to the earth’s surface.”

                                                      Greenhouse Effect

“ So I can drive my SUV and barbeque on Sundays without feeling wretchedly guilty?”

“Go right ahead. And plant a tree here and there too so that the carbon dioxide can be scrubbed up a little. Deforestation may also have colluded to increase the CO2 in the atmosphere.” He reached over and pulled his weakened leg across the log and wiggled his feet for circulation. “When you fly in a commercial aircraft do you see cars below let alone humans?”

“So you see for all our shenanigans we are unable to change the earth. One big Mt. Pinatubo eruption or Mt. St. Helen eruption and the weather is affected for days if not for months.”

 View of the Gulf Stream from Space

“Oh and I forgot. The cold ocean temps absorb the CO2 and warm waters release it. This is a cyclical event. If anything that is going to raise the ocean temp is the particulate matter from soot from the newly industrial forces called China and India, not the US.  Coal is plentiful and is the driving force for the electricity in both those countries. Burning coal leads to CO2 increase in the atmosphere while the soot sedimentation can disrupt the gradient flow of the Atlantic Ocean water - the cold waters that migrate south via the Mariana Trench and the warm waters flow northerly on the surface back to the Artic to cool down. This constant migration of waters leads to global temperature stability. This is called the Gulf Stream. That is why the Kyoto Treaty was never ratified in the US. It restricts the US but allows developing countries to continue polluting. 2% increase from them will require us to decrease our emissions by more than 20%. That will shut down all industry here. Good for them and bad for us. In fact if coal burning continues in China at its current pace then CO2 will increase instead of the current 36% to 100% in this century alone, which will increase the greenhouse effect. But along that thread, warming of the earth surface will lead to water vapor loss and more cloud formation which will hinder solar heating and by the same consequence the snowfall over the Antarctica and the Arctic will increase the ice sheet. This paradoxical effect was suggested by the IPCC back in 2001. According to IPCC then, current loss of 36 cubic miles of ice sheet per year in the Antarctica is a reflection more of the cooler climate than otherwise stated. So you see there are inbred mechanisms that shield, mollify and modify earth’s temperature just as the human body increases sweating to rid of the high fevers.”

“But all these agencies keep harping about that we are the culprits.”

“That is political expediency. The Intergovernmental Agency on Climate Control (IPCC) itself states that there is 10% probability that the humans have nothing to do with it and a 66% chance that there might be a slight possibility. So there highest probability is predicated on a 66% Confidence Interval. Now equate that to medicine where strict methodology uses 95% Confidence Interval and there too a 5% probability of missing the target exists!”

                          Intergovernmental Agency on Climate Control Data

“Wow, I didn’t know that.”

“Interestingly enough some of  these experts review weather phenomena from months to millions of years and consider 30 years evaluation the norm. Pretty short term thinking in the scheme of long term history. Put that number in your head and consider that the earth is 3.9 billion years old and humans have existed only the past 150,000 years and the Industrial age is about 100 years old. Through that time there have been many meteor strikes. The recent historic one in 1908 in Tunguska province in Russia that purportedly destroyed more than 80 miles of vegetation flattening trees with an impact force of 10-15 Megatons of TNT and changing the weather patterns of that area for years. The more dramatic and devastating one was the meteor creating the Chicxulub Crater in the Yucatan Peninsula that eliminated most life on planet including the dinosaurs millions of years ago and committed it to lightless days for decades causing a bigger havoc on the weather pattern and life than your SUV. The IPCC itself states “Because of the uncertainties involved a probabilistic approach is required” in other words make up with statistics to tie any loose ends.”

  Tunguska Meteor Strike (top)                              Chicxulub Crater (bottom)

This was not a man shy about his strong convictions. Later in his small office lined with books and papers a small path created between piles of journals he dragged the copies of charts onto the small wooden table and gazed at the information confirming his statements.

“A Little Inconvenient Truth!” he said and winked.