Nativity of St. John, St. James Anglican Church

I've been sick for weeks.  Dx'd skin cancer, bronchitis, pneumonia, resolving, waiting biopsy, legal threat from an pro abortion father when I supported the pro life mother condemned by the courts for the healthy child Monday morning quarterbacks always knowing better how the past should have been played. , unsuspected tax burden and failure of those who I'd loaned money to to repay their loans while continuing to party irresponsibly, and work, so much, with so little support from a government that promises but takes away.  I've been sick.  I wanted to stay in bed coughing up green phlegm, pounding headache, all joints anching.
But when patients tell me they were too sick to see a doctor or go to hospital, I confess, I consider it an oxymoron.
I'm a sinner and Kiekegaard described life as "sickness unto death'.   Being sick I needed to be in church more than in bed.  An evangelical minister friend says there should be neon signs up on churches shouting 'sinner emergency' and  'soul sick' wards manned 24 hours a day.  .
So I went.  I was glad I did.  The incense had me hacking but probably it's healing power helped get the chunks of evil out of my lungs.  I had to leave to get some cough syrup from the car before coming back to join Laura and Gilbert.  The congregation at St. James is a delight, so many loving people.  From all walks of life, all ages.  A fascinating collection of humans who I'm so thankful I'm able to be a member with.
Father Mark Greenaway-Robbins sermon was especially good. He challenged us all to think of the threats to Christianity that are present today, listing  secularism, individualism, the rise of radical Muslims, the wishy washy watered down lotus land Buddhism and more. But he said he thought the most important one was Christian Hypocricy.  He then took us through the Lord's prayer and asked us each to consider how well we were doing this week individually.  As usual I feel extreme guilt when it gets to the part of forgiving, being the most unforgiving person in the world.  I could see though that those around me were snagging on other parts of the Lord's Prayer.  Like do we really want "thy kingdom come' when it means the first shall be last etc.
So there I was arrogant about dragging myself to church only to see that my sin of pride remains strong despite my own best efforts.  Then Father Mark Greenaway-Robbins talked about authenticity and used as a very odd analogy a 'stick of rock' candy from his childhood in England.  Given the neighbourhood he had to clarify that his comparison of that rock to God was not as the neighborhood 'rock' comparison might be.  Indeed even through the discussion of hypocricy he had us all laughing though when he got into the description of this candy cane candy without the hook and how it was good through and through he had the kid in us all wanting the candy more than the analogy.  The message was made though.
It was good to laugh and we all sang hymns and joined in responsive readings.  We shared the peace and by the end of the service felt no longer alone.  Communion had brought us together again.  Gilbert even met a friend, a puppy who was new to the church but as happy to see Gilbert as Gilbert was to see him.
As a child I remembered most the martydom of St. John's, his  head on a platter  as the request of a girl..  Today his importance as the bridge between Old and New Testament was emphasized.
 I was thankful to be at St. James Anglican today. I'll start another week now working on being a good Christian and maybe even becoming more forgiving with supreme effort.  Alternatively, I'm thankful for the Grace of God which can heal even a sinner such as me.

Netflix TV

I've just watched the first season of Jericho on Netflix tv. I've been sick so I've had time lying about and enjoyed immensely the ability to program my entertainment with this brilliant series.  No commercials.  Easy download. I love Netflix.  Cheap at $8 a month.  I've loved tv series I bought in DVD but the cost of $40 or more a season was relatively prohibitive.  That said, Sons of Anarchy was well worth the price when we got it at Sturges North and watched it in the RV rainy nights after a Harley run.
When I first got Netflix a few years back the selection of movies was limitted and I only watched a couple before dropping out.   I've seen a lot of movies over the years being somewhat of a movie buff.  Tuesday 1/2 price movie at the theatre was a regular event some years.  Now it's only the movie that's a must see big screen event like the recent Men in Black that gets me out to the theatre. Some movies are cultural events and seeing them early in the first week at the theatre allowed one to be able to talk about them. Woody Allen films were like that a few years back.  Then there's Kidman's Australia which really needs a truly big screen to appreciate it.  Australia is that big a country.  Otherwise we like to stay at home with the dog and watch DVD.
I'd watched an episode of Jericho on tv and never watched it again. The commercials disrupted the 'flow'.  However, watching the series over a week has been like reading a great book .  The characterization, the sub plots and sub stories have all been so alive this way.  I realized too that commercials have caused television story telling to have to be 'dumbed down'.  Jericho has alot more happening than alot of the mainstream tv. Ironically lack of commercials can kill a tv series but equally commercials can kill a great tv show.
Thanks to netflix I'm reviewing tv series I've not 'caught on' too because without the commercials complex character stories like Jericho are really extremely intriguing. The fast pace thriller aspect is maintained without the interruption too.
I'm hoping that tv series and movie series find a better way to 'make money' to make the money they deserve.  The acting and writing of these has never been better.  Other venues seems to have sorted this out.  I don't mind paying the monthly rent for this sort of quality. I imagine however all manner of things that could of gone the 'commercial' route like 'educational lectures' at Univeristy interrupted every 5 to 10 minutes by a jingo.  Maybe with the health care crisis surgery can interrupted for a 'word from the sponsor'.  I recently had the experience of a video commercial board over a urinal and thought while I missed the opportunity for my own thoughts I preferred commercial in the washroom to commercials in my livingroom.
Just as Frank Lloyd Wright asked that architecture consider the environment it was in  an ahead of his time ecological consideration,  high quality marketting really needs to get on board with better ways of selling without abusing the potential 'customer' the way commercial disruptions of entertainment have.
Netflix  is a  great antidote.
I don't have much time in my schedule for tv or movies as is.  I suspect though I watch at least a couple of hours a day of some sort of entertainment making me one of those roughly 20 hour a week sorts.  Perhaps that's a lot by some standards, less by others.  Whenever I'm sick though or recovering from an injury or overworked tv series and movies are a favourite distraction and entertainment.
Thanks to Netflix though I can better program the content - indeed I could watch more 'discovery' channel easily if I was so enclined. Frankly I do watch a lot of history and science material but nothing beats a good tv series for 'comfort food enjoyment'.  Jericho did that like Friends and Tudors did it, like some of the HBO mini series have too.
Probably having watched so much Jericho this last week I'm a little post apocalyptic and more attentive to the BBC news about world terrorism.  Certainly Sons of Anarchy didn't affect my desire to do crime, if anything it made me more against it, but it did affect my desire to ride my Harley.  Just seeing the bikes on the open road was invigorating. "Friends" always takes me back to medical school days,  nostalgia of student friendships that is always enjoyable. I appreciate the friends I have today more as a result of the relationships depicted in the Friends series and in Seinfeld too.
Netflix lets me choose the tv I want to view.  I confess, if I'm eating alone at home, I prefer to watch tv , a half hour, rather than watching a movie which can have me infront of the screen for an hour and a half limitting the available choices for the evening after that.
I like that it's on my laptop too.  My Mac Air is just fine for viewing.  The Apple cube and tv seemed over priced and didn't have what Netflix has in comparison.

Basal Cell Carcinoma - a doctor's self report

I squeezed the 'pimple' on my face a couple of times and just blood came out. I picked the scab. It was hard not to pick at it.  For a couple of weeks I used antibiotic cream but nothing changed.  It seemed a mm or two bigger.  A month went by.  I was going for dinner with  a friend who is a great family physician. I did the thing doctors hate people to do.  I'm a doctor. I know how rude this is.  But I did it anyway. I'd made my own diagnosis.  I wouldn't want anyone to know I was scared but I was 'uneasy'.
"What do you think this is?" I asked.  He was concerned.  Only the coffee and bread had arrived at our table.  Chez Michel, the fashionable Parisian West Vancouver restaurant.  Only a couple of tables taken this early in the evening. No one close by.  Beautiful view of English Bay.  Daylight savings. The sun still bright outside.
"Stand up and let me look at that  in the light." Skin is best viewed in bright sunlight.  I moved so he could position my head. He's taller than me.  A big man.  A doctor who served the far north for years in his youth.  A doctor's doctor. His practice as full of the rich and famous as well as the common man.  He doesn't differentiate when it comes to people. "All God's children'.  he says.
"It looks like basal cell cancer." he said finally as we sat down to eat our rolls.
"That's what I thought." I answered.
"It's hard to be certain." he said.  "It's raised with the typical edge."  We talked some more about what to do. Matter of fact.  We're friends. Both doctors. He could see I was concerned.  I could see he was concerned. I didn't want to worry him more than necessary.
"Aldara" is a new antineoplastic cream. You could try that.  Can cure basal cell carcinoma by enhancing your own immune response."  he told me. I'd not heard of this.  But that night on the way home from the meeting we'd attended together I drove to an all night pharmacy and got some. $400 for 23 treatments. I've not got extra health care coverage.  Self employed I pay for everything myself.  If I'm sick no money is coming in.  Worse these days, there's  no one  left to cover my practice.   I know the constant daily stress is getting to me.  My fingers were shaking when I put the first dab of cream on my face.
The first appointment with a Canadian dermatologist was given as 3 months away.  I thought the cancer could have entered my brain by then or I'd be psychotic.  Without the cream I'd not have slept thinking about this foreign alien thing gnawing up my face.  Basal Cell is also called 'rodent cancer'. That day I asked a couple of doctors I worked with what they thought.  As doctors we all like looking at physical disease. Improves our skills of recognition. Besides they'd been looking at me already discretely wondering what that thing was on my face.  They too thought it was basal cell carcinoma too. Can't be sure. Need to see a dermatologist. I'm clinging to a thread now that it's just a bad blemish.  My friend phones a good old boy and he'll see me the next week. There's a cancellation.  We phone back the first dermatologist and cancel the original appointment.
I suspect I'll survive. But I'm prone as anyone to catastrophise. Sometimes looking in the mirror I consider fascial mutilation of the cancer itself or the possible surgery. Surgery is usually the answer. . Other times I think of the rare case of metastases. They're not supposed to but I imagine myself the exception that proves the rule.  
Mostly I hope it's not that but now I'm sick with the flu like symptons the Aldara can cause.  It's a minor concern but I don't feel well. I go to work and care for others but I don't have a whole lot of hope myself.  It seems too that in the Canadian culture the sick are brutalized and  marginalized. Show weakness and this society hits you harder where it hurts. Canada is a culture that caters to the rich. I'm thankful that I can afford Aldara.
"Have you had that looked at? Doctor?" a patient points at my face.  "Oh yes, it's taken care of .  Just a little infection,  I'm putting cream on it."   I can't say Cancer. It's not Cancer. It's not the big "C" word.   It's not the modern leprosy.  People still back away from people with cancer despite all the education and science we know today.
I think how I used to work on television. I have to confront my own vanity.  I think what's important about a face. I wonder how much money my fairly okay face till today has made me.  I've felt sorry for those born with deformity.  Genetic deformity diseases and now I'm going to have an Acquired deformity disease.I think of Leonard Cohen's song,  with the words, "I want a new face, one not covered up in shame and pain".  Something like that.
 I imagine a hole in my face. I don't want anyone to know but then I tell my patients its best to share.  We live in walls here frightened of the advantage people take of the sick and suffering. Only the psychopaths and sociopaths seem to thrive. It's all about corporate economics today.  The sick are less valuable. The beaurocratic "in" words are abortion and euthanasia.  Doctors committed to healing are marginalized.   I'm becoming cynical with fear.  I have to pray more. As the Third Day song goes, "There's a light at the end of the tunnel."
"Did you not wear sunscreen?" a friend asks.  I tell him yes.  I'm fair skinned , a sailor and an out doors man.  And I've always worn sunscreen. But the question is like one that Job in the Bible was  asked by his friends.   I reply  " Personally I think I've got cancer because I masturbated."   We both laugh.  He's Catholic so he knows that is the root of all evil.  
My nurse friend says I should look on the bright side, "Maybe you can get a face lift thrown in."  I imagine myself with half a face lift, all the Canadian health care would provide. I'm the old geaser then in the nursing home with half a turkey neck.
It's silly. I'm not thinking very sanely.  I wall the thoughts off during the day enjoying the distraction of routine but at night I'm alone with my fears.  I wake from sleep seeing the pictures I've seen in textbooks and the faces of patients I've seen working overseas.  The time moves slowly.  I am a patient. Patients must have patience.
It's nothing really.  Just a little lesion.  I'll be okay.  I'm thankful for Aldara.  Even if it were just a placebo I apply it religiously and think it's working. It's keeping me sane at least till I see the dermatologist.
In Bellingham USA a dermatologist will see you next day for $150.  It's a small price to pay but then if I cross the border as a patient I couldn't return here as a doctor in good faith.
I pray more.   Anxiety is a measure of one's distance from God. Cancer is that which you can say in no other way.  My family physician friend is a poet. Maybe his dermatologist friend will have a way with words.

Miracle Cure - the book

Harlan Coben has done it again. This intriguing  thriller is an extraordinary story of gay killings aimed to stop research into a new cure for AIDs.  Sara the beautiful television news reporter and her celebrity model sister Cassandra team up with Mike a basketabll hero in helping Harv their researcher doctor friend find out whose behind the rash of gory deaths.  The motive at first seems plain to Max Bernstein the pencil chewing New York detective  but as doctors and nurses die and healthy people go missing there's much more at stake.  Especially when the sleazy televangelist is raising money saying Aids is todays plague of Egypt.  Chemistry and sociology mix with Coben's endearing characterizations.  I couldn't put it down. But then I've read all of Coben's books.  He's a heavy hitter against anti semitism and any kind of discrimination that makes a person miss seeing the truly entertaining human in all of us.

Angel - obituary

Angel died last night.  Laura, Gilbert and I were watching tv. She was lying on the couch beside me. Suddenly she shot up and fell down quivering. A minute passed while I  ran my hands over her, her eyes glassy, tongue lolling to the side. I felt her heart beat stopping as I held her.  Then I got on pants to go to the Vet but picked her up again and realized it was over. . She was definitely dead.  Suddenly.  Sadly. Tragically.
I was numb.  Laura suggested we put her in a blanket. I did.  Then cleaned up the feces and pee.  14 years old and apparently a cat 'stroke' or cerebral bleed. It was like she'd been electrocuted but there was no electricity.  There was no life in her either. We set her in the blanket gentle on the couch at the back of thesail boat. That's where we'd laid together in storms crossing the Pacific Ocean
In the night about 3 am I checked her. She was stiff. This morning I put her outside  in the cockpit under the bimini out of the rain.  Gilbert my dog came up with me.  He sniffed her nostrils for the longest time.  They always greeted with rubbing noses.  Now he nudged her with his snout.  He was anxious. He'd never known a friend to die.
 I'm an old timer at that.  Heavy with death.
But he's a little dog and she was like a big sister or mother to him.  I called him back in.   I can see he's confused by death.
They would chase each other up and down the dock together. He'd chase her, little paws pounding after her quick clawed lightening flight till she'd suddenly turn and hiss, the two stopping in a dramatic stand off. Then he'd run away with her chasing along beside him till she'd pass him and stop. Suddenly she 'd be sitting there licking herself, nonchalantly,  acting like she'd not even been racing. She'd however be just a little smug.  He'd want to have another match but she'd won and she'd ignore him as he'd put out his fore paws arse in the air and bark at her to go again.  When he'd least expect it she'd take off and the whole caper would replay.  He could do it all day.  But she'd bore easily, suffer cat ennui, and leave him to return to her academic study of  the nearby birds.
I always knew she'd liked to kill a seagull or better still one of the Canada Geese that climbed up on her dock and sunned themself. She'd tried to not let on that was her dream especially when she could sneak up close to them as they stood on the dock.
When I'd had the boat (ship)  over by Stanley park she'd escape the dock and take to the trees. Later she'd come back in the wee hours with song bird feathers caught in her fur.  She was a great birder. She brought me mice home too at times. Little treats to remind me how clever she was.  Gilbert adored her.  He was so amazed at how fast she'd go up a tree or climb the fence in Laura's backyard.
But mostly she'd like to lie on the bed or couch and preen herself.  The minute I lay down anywhere though she was there lying on my belly.  This beautiful half calico half siamese majestic feline who would purr constantly telling me all manner of things  about her day.
I remember her as a kitten in the Vancouver Pet Store on Broadway at Laurel.  I was living in a studio apartment near Oak and walked by the pet store on my way to my Broadway and Granville medical office.  She was there in the cage rolling around tumbling with her siblings.  I think it was a day or two I stood watching her in the window before I went in and stood watching her inside.
"Is that the one you like?" the animal loving owner said.  'You can hold her. you know"
She picked this little bitty bit of fur and personality  put her in my palm.  Game over. I was in love immediately. I lifted her up and she snuggled my neck, purred and purred as she looked me in the eyes and said very distinctly, "You're going to be my human, now."  And I was.
I called her Angel forgetting that Satan had been one. She was certainly angelic most of the time but could be terribly mischievous especially with paper around .She never knew that some of the papers she scratched and spread about were most important in a human sense.
I'd missed my last cat, Moon for so many years.  Now here was another making a mess of my well ordered sterile bachelor life.
The pet store owner was a mensch. She got me everything I needed.  The old Jewish landlord in my little building had already told me he loved cats.  He oohed and ahhed when I showed him Angel too.  "She's a talker, " he said.
Cats Only, her special vets, took the best care of her and even kept her for a week at a time when I'd fly back to Winnipeg to see my parents. They told me how everyone loved her and as everyone knows Cats Are Us know their stuff when it comes to cats.  Angel was special.
It's hard to believe that was 14 years ago.  A year or so later I'd get my sailboat back. Angel and I would move aboard. That became more her home than mine.
Winter was bad one year . She was short haired and didn't like the cold. I'd leave her in the boat with the heaters on but when I came home at night the boat would be ice cold and I'd find her quivering in my open sock drawer, her favourite little cave.  This happened repeatedly before a neighbour told me the boat owner across from me was a psychopath who'd wait for me to leave and then steal my electricity unplugging my high power cable and plugging his boat in instead.  I spoke to him softly later that day and he never did it again.  Thereafter Angel was warm.  And I always thought it Christian of me to let this bottom feeding inhuman scumbag live another day.
Some years later I'd get the white scotty.  Angel didn't take to him immediately but a day later when she woke up she seemed to think he must be hers.  I watched her little eyes seem to say she was going to give up catnip and Toms forever if this was what that wild life landed her with. After that she was like his mother and tolerated all manner of abuse from Stuart as he grew up. His favourite past time on the boat was to drag her about with her head in his mouth while she'd retaliate by sitting on the table where he couldn't get at him but she could claw his little white butt whenever he went by.  At sea they'd chase each other around the boat, her long gliding leaps matched by his pounding short leg dashes.  I had netting to keep them both from falling over the side.
Those were my two companions through all the preparations I was making for off shore sailing again. Those two were with me too when I headed out from Victoria in November on my way to Saipan where I had a job waiting.  Everyone knows you don't sail to Hawaii in winter.  Summer sailing is a breeze but winter sailing is a horror. I was knocked down three times in high winds and 40 foot seas off the mouth of the Juan de Fuca when a surprise hurricane hit the coast.  It was supposed to pass by but obviously didn't.  Angel was down below in her sock drawer while Stuart was inconsolable below so stayed leashed beside me in his yellow life jacket.  I remember when we were knocked down the second time and the sail was in the water and great waves were crossing over the boat his leash broke and he was going away from the boat, his little feet paddling frantically. I was harnassed in myself and holding onto the steering wheel when I lunged and grabbed his jacket hauling him to me as the keel went back down and the boat righted itself again in a mighty swirl.  I tied him in again  but could tell he was as frightened as I was after that.
When I got back to land and made it into the protected harbour of Neah Bay I dropped an anchor in the bay, exhausted. Angel appeared then coming above deck to see where we were, tweaking noses with Stuart then telling us at great length about her discomfort in the sock drawer below.  As long as she had her sock drawer thought to go to she was fine in any inclement weather.  Let the boys take care of matters above and she'd make an appearance after all the fuzz was over.
When at night we were sailing in storms and the boat was like living in a washing machine she'd venture out to cuddle beside me in the stern berth I'd made where I could keep an eye on the GPS and radar dozing and getting up every hour to check the horizon.  She'd lie on one side of me with little Stuart on the other side.  I had pillows all around to protect us from the chaffing and bashing that went with the rough seas.  The autopilot kept me on course with only the storm sails up.
When it was sunny and we were sailing along in the glorious trade winds Angel would  be an arial gymnast trapezing along the boom or climbing up to sit on the radar post high above the passing ocean water.
She smelt Hawaii before all of us.  She and Stuart went to the bow sticking their heads out on either side sniffing the winds  a day or more out from the islands.  It would be a half day at least before I'd pick up the scent of the island fragrance.  How rich and earthy and sensual an experience that was after 20 some days at sea, including Christmas. It would be 25 days at sea before we'd drop an anchor off the Big Island.
I was late for work and left the boat in Hawaii flying on with Angel and Stuart first to Japan then to the Northern Marianas Island.  She was allowed in the cabin with me and was a favourite with the girls sitting in the seat behind me.  She lay on her side and purred as the stewardess stroked her belly.  A jet setter cat indeed.   Stuart was quarantined in Saipan so I had to visit him daily for a month or so before he joined us in the new apartment.
Angel however moved into my beautiful 2 bedroom condo with me .I'd was so lucky to get this fabulous suite  above the Commonwealth of Northern Marianas Hospital.  Angel made this our home spending hours chasing geckos that loved to hang out on the wall just above her highest leap.  When Stuart joined us there was a whole lot more chase and even further for him to drag her about by the head.  Not something strangers thought funny but I'd come to take as normal since he never hurt her and she seemed to bounce right back with a swat to his nose and more chasing around the hard wood floors with fur sliding turns more entertaining to watch than the Nascars. It did mean that her head was often wet though.  This however was her world. She loved Saipan. She loved the heat.  I was fatigued like the Scotty who had to be kept shaved but she was in her siamese element .  I felt sorry when I had to bring her home. She'd so enjoyed it and loved more when Laura visitted having another human to boss about.
When Stuart was poisoned by the stoners whose urine I refused to pass as clean in their bid for government jobs, she was bereft for days having lost her child and best buddy.  We were both sad at Stuart's loss.  The South American doctors dog was killed for the same reason.  A new corrupt government was taking over and my friends said our lives were being threatened because of our integrity.  Mom was ill in Canada.  I'd come to work in Saipan when the ruling party were the friends of high integrity I'd come to cherish and admire.  Dog dead. Mother sick in Canada. Politics.  I came home though I'd loved to have stayed with Angel. It was hard leaving friends and paradise but I was so glad to be back in Canada and closer to my parents.
Back in Vancouver Angel  became the Lady of the high rise apartment I had in the West End overlooking English Bay.  There she'd stop my heart a couple of times getting out on the balcony only to do a high wire act over to the neighbours balcony where she'd lay in wait for a pigeon.  I could just see her taking a triumphant leap followed by a 15 floor "oops' purr while claws clung to equally disappointed pigeon. I got her back and put up netting to stop her from bolting over there if she outsmarted me getting out the sliding door.  Despite her inability to get at the pigeons who nested on the deck she was very happy here.
But when a couple of years later I sailed the boat back with my friend Tom she was again in her element,  mistress of the GIRI, sea cat extraordinary.
When ever work was being done on the boat she'd visit Laura and her cat Tiffany. These two now old ladies, Tiffany and Angel,  would hiss at each other.  When Laura and I would return from a jaunt with Gilbert we'd find them sitting across the room from each other on high ground daring the other to try to get the mouse that never crossed between them.  With Gilbert back they'd join forces and sometimes both would swat his butt at the same time when he got between the two of them on the bed trying to get closest to Laura or me.
Chicken night was Angel's favourite.  She slummed on Whiskas and always had to have her special Fancy Feast can. She didn't like turkey and she didn't like tuna unless I'd caught it fresh when she was more than happy to join in on the barbecued feast.  But Chicken night was when I'd bring home a barbecued chicken from Safeway or Save on.  It started with just her, then it was her and Stuart and finally Angel with Gilbert. I'd be sitting on the boat with one little furry body one one side and the other on the other side. I'd be watching some video movie while together we'd all make our way through this incredible feast. A piece for you, a piece for you and a piece for me. Naturally Stuart and Gilbert just the same,would try to get Angel's piece after wolfing their's but she'd stand her ground nibbling daintily then hissing at the dog before finishing up and looking at me for more.  So whenever I came home with chicken I'd have a cat around my legs and a dog jumping up and down and there'd be no peace till the movie was on and the chicken was being partitioned about.
She was a singer too.  Whenever I'd bring out my guitar and sing a sea shanty or hymn I'd immediately have this little furry body sitting beside me belting out Siamese cat harmonies with little concern for human concepts of melody. She just loved to sing and it was always a joy for me to have my sad solo become a robust duet.
Angel had been back on the boat this last month.  She was happy as I've ever seen her.  The boat was her home.  We were all here that night.  Gilbert her child and best friend, Laura and me.  I'm crying now. But then I cry easily sometimes. Silly really. I'm tough as nails about alot of things.  Not this though.
I'm going to miss her. Angel, Cat of cats. The little house cat with the heart of a lioness and soul of a cheetah.  Singing Sea faring cat extraordinaire!

John Rauls and Academic Fame

My friend is a philosopher who lectures college students.  She gave me a copy of John Rauls decades back. I duly read it, mostly because she is extremely beautiful and worried she'd quizz me about it at sometime in the future.  When I'm not reading about neurochemistry and Higgin's particles I'm more often than not reading theology.  I liked that Rauls said to paraphrase, justice is to social institutions what truth is to the individual.'  I've always liked the 'as above, so below' connection between macrocosm and microcosom. I just didn't realize that John Rauls, Theory of Social Justice would become so important. It was written in the 70's and I read it in the 90's and today I learned it's one of the most cited of social philosophers.
I've had this experience with individuals before. I read Harvard's, George Vaillant's book on the Grant Study, wrote to him a very appreciative letter in the 70's long before I knew he was one of the 'grand men' of our age.  I was just delighted that he corresponded with me and later I had the opportunity to meet him, a truly wise and remarkable man, a few years ago.  I read Thomas Kuhn's, "The Structure of Scientific Revolutions' a few years after it was published in the early 60's .  Today paradigm is a garden variety word thanks mostly to his book.  I read Turing early in my interest in computer programming when I was writing in Basic and MS Dos long before I cursed program language realizing I could speak swahili, punjabi, mandarin and spanish if I had devoted my attention to learning living rather than techno language. I still enjoy learning spanish but will likely die before I ever  learn swahili. There is simply not enough time for learning all one wants to and so much interference in the study of what really matters.  
Recently I read Jared Diamond's first books and happened to share the tastes of the world as that great genius has also gone on to acclaim he deserves.
When I travelled I used to carry a copy of the Bible and I also had a copy of Plato. I enjoyed in my 20's  reading the discussions  of Socrates.  Over the years I'd routinely read three texts, one about some aspect of sociocultural world, from the  arts , a scientific text, which might be from any aspect of science, medicine or psychiatry, and finally a novel which commonly discussed matters of importance in the other fields.  I've loved the writings of physician writers like Michael Creighton and recently Daniel Kalla.
I loved Love in the Ruins and the Joshua Tree.  I've loved those books that spoke to our times and culture, like Robertson Davies trilogy.  Obviously reading Thomas Mann's Magic Mountain was an insight into asylums, tuberculosis and the human spirit just as that other nobel prize winner Magister Ludi caused consideration of meaning as much as Victor Frankl's writing does.  Recently I was reading an economics text, a physics text and an evangelical theology text side by side getting relief from them by reading the antics of Flashman by Macdonald as he boisterously raced through the hot spots of history.  Most of the ideas of science fiction a hundred years ago and even only 50 have come to pass.  I laughed because several of my patients were called insane for thinking exactly the same way as  characters out of a William Gibson's novel.  I thought meeting these exotic creatures some of my colleagues should get out more.  Not at all insane by global standards but definitely beyond the mindset of Georgia and Howe.  
An old friend, the father of my dear friend, before he died told us how he'd supported himself in the latter years. He'd had very little or modest returns from all the best stocks and investments. However he chose to invest in an obscure company because he thought what they were up to was rather brilliant. This man was a scientist in chemistry himself but chose to buy stock in this obscure little start up.  "It was called IBM. It's provided more returns than all the other blue stocking stocks put together and allowed us to live as we did after retirement." he told his son.
I feel like I've invested well intellectually.  There's a kind of 'social justice' in that.  It's the truth.  John Rauls was a good read even if my brilliant and beautiful friend never asked me about it later.  But today as his name has achieved an even greater popularity I am thankful to her too for recognising gold in the dross.

Brain - Behaviour Relationships

Depression and Cognitive Complaints Following Mild Traumatic Brain Injury, by Jonathan M. Silver, MD, Thomas McAllister, MD, and David B. Arciniegas,MD (Am. J. Psychiatry 2009 :166:653-661 is a truly elegant paper discussing this subject from experience with detail. It's an essential read for anyone treating pateints with depression and mTBI.
What I am essentially copying here is from Table 1 in this paper. I have seen this information elsewhere and it's standard in neuropsychiatry and behavioural neurology texts.  Like everything else in this paper it was presented here in a readable and easy to comprehend and clinically useful way.


Structure                     Function                           Consequence of Injury                                      


ROSTRAL and VENTRAL  BRAINSTEM, THALAMUS

Reticulothalamic system    Arousal                    Impairment of Counsciousness

Reticulocortical system       Arousal, facilitating cortical activity         Hypoarousal,  inattention, impaired information processing
                                                                         Attention

Hypothalamus        Autonomic,, neuroendocrine,                   Dysautonomous, thermoregulation problems, altered feeding behaviours,
                                                    Circadian, some lower level social           endocrine dysfunction, sleep wave cycle disturbances, pathological affect
                              functions                                                        (laughter and anger)

Ventral forebrain             Cholingeric supply to medial and             Impaired information processing in multiple cognitive domains, neo cortical areas                                         particularly attention, memory, and executive functions

TEMPORAL LOBES

Entrorhinal-hippocampal Complex        Multimodal informationa filtering                Impaired sensory gating, attention, working memory and
                                                                      Declarative memory, some aspects of        declarative memory
                                                                      Attention and working memory

Amygdala          Generation of contextually relevant           Affective placidity, Kluver-Bucy-like presentations, alternatively
                                                                       emotional and social behaviour                   anxiety

Anterior/Polar cortex              Semantic memory, semantic aspects        Disturbances in semantic memory, functional communication
                                                                        of language, sensory limbic integration    impairments, impaired sensory-limbic, facial, social and emotional
                                                                        face recognition, social and emotional      processing, impaired social/empathic function
                                                                        processing, "theory of mind"

FRONTAL LOBES

Ventral frontal cortices       Comportment, control of primitive              Disinhibition, irritability, emotional dysregulation, agitation, aggression
                                                                        ("limbic") behaviours

Anterior Cingulate cortex         Motivation                             Apathy

Inferolateral prefrontal cortex          Working memory                                          Working memory impairments

Dorsolateral prefrontal cortex             Executive function                                         Impairments in complex cognition, including executive control of attention,
                                                                                                                                                    memory, language, motor planning, as well as sequencing, set shifting
                                                                                                                                                     abstraction, judgment, insight

White Matter                                                 Connections between cortical areas         Impaired cognitive, emotional and behavioural functions, supported by
                                                                           particularly in frontal and temporal           affected white matter, slow, inefficient information processing.
                                                                           areas, facilitation of information
                                                                           processing

My columns got smunched by the editor so it's best to go to the paper. The rest of it is an excellent and must see read.  I've just listed these areas to show where the lesions are being deliniated in a beyond Broca way that's clinically relevant.

This is geographical presentation but then there are the neurochemical transmissions with both facilitating and dampening process.  Coupled to this is the endocrine modulating effects and the fluid these systems sit in, a kind of 'soup' which is affected by quite a variety of spices in addition to sometimes being affected by heat or cold.