Thursday, November 26, 2009

Giving Thanks

Today is the 27th anniversary of my mother's death. (In my best Debbie Downer voice, "wanh, wanh")  It is also Thanksgiving.  My mom had a massive stroke on Thanksgiving in 1982, which that year fell on November 25.  She passed away the next day.  For years I found Thanksgiving a difficult holiday but time does cause the pain of loss to dissipate.

In the past 27 years I have so much for which to be thankful.  I have a wonderful husband, two great children,  fantastic in-laws (daughter-in-law and mother-in-law) and most heart tuggingly, two wonderful grandchildren.  We live in a nice and safe community where the weather is lovely most of the time.  Today, for example, it is in the 70s, sunny and clear.  The beach was exceptionally pretty this morning with clear views of Palos Verdes and Catalina.

I am grateful to have my health.  I had a small scare about skin cancer in the past few weeks but learned yesterday that the mole I feared was harmless.  I also now know that I do have a few moles of concern which I have to watch but so far nothing that requires any other action but vigilance.

I am thankful for my friends and particularly for my friend Ann who continues to beat the odds of her life threatening cancer.

My work is stimulating and cutting edge in its own peculiar way.  Although I, like everyone else, complains about work and the work environment, particularly that of a large corporation, what I do on a day to day basis is about as good as it gets for work.  And I get paid pretty well for doing what I like.  Not too shabby.  (Please do not hold this against me, perfect masters, when I ask for a pay raise in the future since we all know I am paid below market value for what I do! :) )

I am grateful to be able to read and write as much as I do now that my children have grown up.  I am also grateful to be able to walk on the beach regularly which invigorates my body and my soul.

I am sure there are many more things for which I should be thankful.  But Chef William needs my help with the turkey and as usual we are missing some necessary ingredients so a trip to the store is required.
Happy Thanksgiving to all.

Sunday, November 22, 2009

By the Numbers

Ever since I studied psychology in college and later in graduate school, I have been enamored of the application of numbers and statistics to human behavior.  I even TAed an undergrad stats course in grad school (which I really had no business doing given how I  did not understand the underpinnings of Statistics) and later taught a methods course at KU, which included study design and basic statistics.  At one point I even applied for a post doc in economics foolishly thinking that my stats and psych background was perfect for analysing economic behavior.

With this history,  I find the new book SuperFreakonomics fascinating.  I was reading the chapter yesterday about large statistical analysis of the efficacy of medical treatment and thought how timely given this week's announcements of proposed changes to the screening for breast cancer and cervical cancer.  It made sense to me that if the risk of harm from false positives in ages 40-50 outweighs numerically the likelihood of finding true positives, as a society we may be better off not screening women from ages 40-50.   As Karen Kaplan wrote  yesterday in the LA Times:

After decades of focus on the upside of cancer screening, public health experts are increasingly reevaluating the wisdom of administering routine cancer screening tests to millions of asymptomatic people.
Though screening certainly saves lives, recent studies make it clear that it also leads to biopsies, surgeries, chemotherapy and radiation -- even some deaths -- that otherwise would not have occurred.
That screening has a downside is not easy to accept, as evidenced by the furor over this week's recommendation from the U.S. Preventive Services Task Force that most women wait until age 50 to start routine mammograms, and then get them only every other year.

One of the reasons people are in an uproar over the proposed changes  is the notion that we should be able to control our health by proactive measures such as visits to doctors and screening tests.  But again, SuperFreakonomics' analysis of data involving doctor strikes show that death rates are negatively correlated with doctor visits,  i.e. the death rates went down when the doctors were on strike.

And another reason for uproar is the notion that decisions about healthcare would be made taking into account the good for all as opposed the good for each individual. Interestingly, I do not have a problem with using this rationale to limit screenings for otherwise asymptomatic people.  I do however get the chills, as I did last night, when the rationale is extended to providing chemotherapy to stage 4 cancer victims.  SuperFreakonomics argues that the numbers show that outcomes for such cancer patients   on average are not positive but the cost is astronomical. They report that a treatment for non-small cell lung cancer costs $40,000 but only extends survival by two months on average.  Should society bear the cost of this treatment if it does not change length of survival in any significant amount?

My very close friend was diagnosed with stage 4 lung cancer in early January 2008.  The average  survival time after such a diagnosis is 8 months.   My friend has beaten that average and then some.   In the past two years she has had, she told me at lunch the other day, seven protocol of chemotherapy and her last scan showed shrinkage of the tumors.  Every additional month she has lived over the average expectancy is a blessing to her family and friends, like me.  Every day that we get to be in her presence is special.   She has pain but it appears to be manageable.  She is now in a wheelchair all the time due to the tumors' effect on her left leg and the possibility that it has destroyed bone in other places.  She needs to be hypervigilant about getting sick. But she still is able to go out to restaurants and other people's houses.  She is living her life one day at a time and I feel privileged whenever I can share time with her.

When the numbers are pushed aside by the personal experience, we all drop our scientific viewpoints and become advocates for the good of the one over the good of the many.  I think the strong history of individualism in this country makes us so susceptible to this type of reaction.  The push to bring our system of medical care in line with the rest of the developed nations in the world must always butt heads with this very powerful desire to put the needs of the individual close to us over the needs of the group.  I could try to distinguish between applying the numbers to screening vs. applying the numbers to treatment but in the final analysis, when it becomes personal, the numbers do not matter.  After all, like average survival expectancies, they do apply only to the population and do not predict any particular individual.  And who is to say that the value of those extra months and years are not worth the cost?

Palin' by Comparison

There is a wonderful article  about Hillary Clinton by Jonathan Van Meter in the December Vogue and a frightening article  about Sarah Palin by Frank Rich in today's NYT.  The Rich article discusses Palin's book, Going Rogue, as instructive about why we cannot count out Palin in the public arena even though in a recent CNN poll , 71% say she is unqualified to be president.  That same poll, however, shows that 42% see Palin in a favorable light, with 51 % viewing her unfavorably.  That second set of numbers is what is frightening and reflected in the Rich article.  Notwithstanding all the hoopla over her resignation as Alaska governor, her frequent inability to get out a coherent statement and her poor performance with Katie Couric during the election, (or maybe as Rich suggests, because of it) a large number of people like Palin, and her infatuation with the limelight and celebrity.  They think she is plain spoken and like the average American, although most average American women do not run for VP with a new Downs Syndrome baby and other children at home, including a pregnant teenager.  Why are people so willing to overlook Palin's lack of even the most rudimentary knowledge about world affairs?

Contrast Hillary Clinton who, according to the Vogue article, blew away Katie Couric with her command of the facts in a recent interview about Afghanistan.  The Vogue article also shows how sociable and charming Hillary really is despite her characterization over the years as a "ballbuster" (remember the tasteless Hillary nutcrackers during the 2008 campaign?)  And she was overwhelmingly adored by the people of Africa  on her recent trip there, although as usual the most reported incident of that trip was her unflattering clash with a Congolese student over a question about what her husband thought about the issues.  

Hillary is not only smart but she is effective and creative as SOS.  Her approach in Africa and other developing countries is to look at the "soft issues"-- including the role of women in the countries (a subject also addressed by Kristof and WuDunn's Half the Sky).  As Van Meter says about Clinton's view:

[T]he micro-economies of the poor are deeply important, and when the so-called soft issues—violence against women, food safety and agriculture, sustainable development—are not tended to, the result is chaos, instability, conflict, and war. 
Why is such an intelligent approach not given more its due by MSM?  Why instead is the MSM so intrigued by the Sarah Palin phenomenon?  To me, it shows a view of the American public as fundamentally ignorant and uninterested in anything but flash.  I hope for all our sake that view is merely a cynical one and not true.

Occasional Chef Wannabe- First in a series

Yesterday my foray into cooking had me trying a Hungry Girl recipe for a low calorie pumpkin pie.   The assembly looked fairly easy so after a quick trip to the grocery store to pick up all the fake carcinogenic ingredients necessary for a low cal dish, e.g. artificial sweetener in granular and syrup form, egg substitute, I started my Occasional Chef Wannabe project.  I put one of my ipods into the docking speaker station in the kitchen and searched for some calming music given that cooking always makes me anxious.  The best I could find was John Rutter Christmas Album, a series of lovely English carols sung by the Cambridge Singers.  It was 5:00 p.m. so I figured I would have the kitchen to myself while I measured and mixed.

I don't know whether it was my being in the kitchen or the music that beckoned, but suddenly my husband and mother in law decided they too had to make food in the kitchen.  Our kitchen is not that big and does not have that much counter space so having others take up counter space and get in my way looking for their own utensils got my heart racing so much that I suddenly stopped and left the room in the middle of the recipe to calm down.  Deep breathing does work--for a moment.  When I returned to make the filling, having finished the crust, my mother in law was heating up already cooked salmon in the microwave.  I heard the "pop" (she didn't) but hoped it was nothing much.  Unfortunately, when she opened the microwave we discovered the salmon had exploded everywhere and had filled the ceiling and crevices of the microwave with smelly salmon pieces.

My mother in law, uncharacteristically, cursed and then changed the curse to a more ladylike "shoot" while she spent a few minutes cleaning up.  After she finished, I went to check the damage and continued cleaning for a few more minutes.  Man, that salmon was everywhere!  I took the innards of the microwave apart (a revolving tray assembly) and scrubbed it top and bottom.  My mother in law felt bad but these things happen--and apparently must happen during my occasional forays into baking.  Hmmm pumpkin and salmon. Yum.

So back I went to finishing the pie.  I got it into the oven while hearing only twice the story of how the music reminded my mother in law of her aunt who taught piano when she was a child in England.  After the prescribed cooking time I checked the pie which did not seem done enough to me so I made an executive decision to cook it 15 minutes more and then hope for the best.  I let it cool and refrigerated it as instructed.  It smelled good and gave the house that holiday air in conjunction with the holiday music.

This morning I tried a slice for breakfast.  The first bite tasted good but as I proceeded I got a bit of an aftertaste not typical for pumpkin pie.  I do not know if it had too much pumpkin pie spice or it was the artificial sweeteners.  Typically artificial sweeteners do not bother me so I am thinking I may have put in more spice than I should have.  Hopefully someone else will try it and let me know how it is.  Calling something low cal in front of my beefy boys is a sure fire way to keep them from eating it!

Wednesday, November 18, 2009

Memories--Misty Memories

Yesterday a friend of mine from high school and elementary school contacted me via Facebook.  I recognized her from the picture even though her last name had changed.  We exchanged a few emails in past few days and she told me that she had found our high school chemistry teacher online and that lead her to search for others from that time period.

I do not have any memory of my high school chemistry teacher or any other high school teacher, except for  my Trig and Calculus teacher who I had for 2 years.  And I do not remember her name.  I did not even remember that the high school chemistry teacher was a man (unusual at my Catholic girls' school) and that he was very young when he taught us--same age as my next older sister.  I learned all these facts by doing some research on him.  He became a renowned neuroscientist  with major finds in the area of adult stem cell and Alzheimer's research.  He was chair of the medical faculty and neuroscience faculty at UCI, which means he has lived 50 miles away from me while doing all these amazing things in science for the past almost 40 years. (I took hs chemistry in 1969-70).  And he is going to be playing himself (!) on Criminal Minds tonight for what I understand is a theory he developed about violence running in families that have experienced extreme trauma .  I set my Tivo to record the show, in part because I am wondering if I will recognize his voice and that will bring back memories of his teaching me.

This matter of memory is fascinating and frightening at the same time.  I live with a parent whose memory is clearly deteriorating, much to her own sadness as well as ours.  I have talked to others about their experiences with their parents' memories declining.   Everyone talks about the problems of what I call the "loops" which are a sign of working memory problems.  The loop is the person asking a question, getting an answer and then a few minutes later asking the same question again--rinse and repeat many times.   My problem is not a working memory issue.  It is a complete loss of memory of certain aspects of certain periods of my life.  I remember my friends and classmates for the most part from high school.  Why do I not remember the teachers?  I vaguely recall the social science teacher with whom I took history for a few years and did an independent study my senior year.  No name, just an image.  As I said, I also recall my math teacher--but again no name.  Oddly enough I remember two nuns-- my 8th grade teacher who I rudely called (privately of course) "Bowser" and the infamous Sister Charles at my high school who taught latin and typing, neither of which I took.  I cannot recall the real name of the 8th grade nun.  But then I remember my kindergarten and first grade teachers,  Sr. Irene and Sr. Eileen as well as my 4th grade teacher Mrs. Gavigan.

Memories are a funny thing.  I think my working memory is still pretty good but these gaps in longer term memory are mystifying.  I see my mother in law also not remembering longer term events but then at times she had very good memories, or so she claims, of events from her childhood.  Maybe my old chemistry teacher--now famous neuroscientist-- can explain it to me.  Hopefully I will remember the explanation.

Sunday, November 15, 2009

Santa Cruzing - The Fall Edition

Autumn in Santa Cruz surprised me.  I expected crowds given that the colleges are back in session. UC Santa Cruz has 15,000 students and Cabrillo College has 13,000 so I thought the streets would be teaming with young people.  As it turned out, Santa Cruz was much quieter and mellower than in the summer.  The Holiday Inn  was half the price of the summer rates and we had no problem getting into any of the restaurants that were so busy this summer (with one exception as I will describe below).

We arrived Thursday night and immediately went to meet our daughter and her beau at the Santa Cruz Diner where I was able for the first time in my life to order from the senior menu!  I had a typical senior type meal--french toast and scrambled eggs-- nice and soft for those old teeth!  I enjoyed tucking my napkin in at my collar and tucking into a dinner special for a measly $3.49!

Friday we ran some errands--car repair, book return etc. with our college students and then headed out with g-ma to see the UCSC campus.  UCSC has a residential college system similar to but a little different from the one at Yale.  Students join a college upon matriculation and stay with that college through graduation.  The college is mostly for housing and dining but it also has faculty members who are affiliated with it (and thus have offices in the college) and offers a core course for freshmen.  I gather there are themes to the colleges.  I was told, for example, that Porter College is a liberal arts college.  See here for more information about the college system at UCSC.

UCSC also has a beautiful hilly campus with fabulous views at times of the Pacific Ocean.  Students have historically been more counterculture at this UC than other campuses (except Berkeley, of course).  Looking around at the throngs of students going to class I felt transported a bit to my own college experience in the early 70s.

We also drove to Cabrillo College which has its own fantastic views of the ocean.  However, Cabrillo was empty on that Friday.  Apparently few students take classes on Friday.  Classes are offered on MW and TTh with the Friday classes consisting of the dreaded 3 hour challenges to attention and sanity so most Cabrillo students show their smarts by avoiding Friday classes.  It was also the Friday before a holiday Monday which may have decreased the already small group of people who attend on Friday.  I had a parking lot almost all to myself which apparently is in stark contrast to parking problems at the school during the rest of the week. (Although nowhere as bad as the parking at Santa Monica College which "drove" both of my children to seek other education options when they could not attend class because they could never find any parking, not even in the satellite lots).

Community colleges in California are experiencing huge enrollments and significant budget cuts right now, making it difficult to attend a public college in CA.  The UC and Cal State universities have raised tuition and cut budgets forcing more students into the community college system.    Most of the schools have wait lists a full month before the classes starts and lines of students out around the building to get into courses on from a wait list.  At CCSF someone put up signs saying a course was closed, even though it wasn't, to get an advantage of getting in from the wait list.  CCSF reportedly now has over 100,000 students, up from 70,000 last year and making it by far the largest college in the state.  Hats off to the students who navigate the CA community college system.

But I digress.  Back to the Santa Cruz trip.  Friday night we had dinner at Kianti's ,  a pizza/pasta place in downtown Cruz.  Last time I tried to go there on a weekend evening, the wait was over an hour, but this time we walked right in.  The fun part of that dinner was the show put on by the wait staff.   It turned out our  waiter was the star of the show,  twirling rubber pizzas while dancing to "Footloose" and jumping on a ledge between tables.  The rest of the staff had choreographed steps to three or four songs--  e.g. "Dancing Queen" and something from Grease.

Santa Cruz has a very nice independent bookstore,  Bookshop Santa Cruz .  We went there twice although I spent most of my time there on my iPhone reading an e-book.  We also went to Walnut Avenue Cafe twice because g-ma loved the blueberry pancakes beyond measure and the rest of us thought our food was good too.  This restaurant was the only one where we had to wait.  On Sunday morning we had a 40 minute wait but luckily there was a Starbucks around the corner where we drank coffee outside with a screaming female schizophrenic ("What are you looking at you rich dick!!" insert more unmentionable invective)  while waiting for our table.  Santa Cruz downtown is a showcase for the state of mental health care in our state.  Many of the homeless seem to be schizophrenic and paranoid, which raises the age old question of how to deal with the homeless mentally ill.  Like the subject of the Soloist,  these people do not always want to come inside where it can get crowded with the presence of all their demons.  I leave that subject for another day.

Saturday we left the Cruz and spent a lovely day in San Francisco.  We lunched in Sausalito and enjoyed a perfect sunny view of the city and the water.  Pelicans entertained.  During the evening we went to a reception at a Peruvian restaurant where Paul was honored for his work in settling the Wiwa case in NY.
The CHP gave us a parting gift on the way back to Santa Cruz that evening-- a fix it ticket for not having a current registration sticker on the car.  Santa Cruz police also noticed that problem and gave us a ticket the next day for parking without a current registration sticker.  What cities will do for money!

Sunday we headed home on El Camino Real for most of the way.  I found a wonderful Lebanese restaurant on Yelp in Santa Barbara called Cafe Zaytoon.  I had chicken shwarma of magnificent taste and quantities.  The atmosphere was quite lovely too with firepit tables throughout the courtyard.  My friend David told me zaytoon is a variant of the arabic word "zaytun" which means olive.  Interestingly in the trivia contest of the night I bested my husband who believed Lebanese spoke Arabic when in fact as I said they spoke Lebanese, which is derived from Arabic and Aramaic but its own separate language.

Eventually we got home after being in gridlock on the 405 as the result of a 5 car pileup.  Although the delay was annoying, I was grateful we were in the gridlock and not in the cars that were part of the pileup.

Monday, November 9, 2009

At the River

I attended my friend Paul's funeral three weeks ago and was reminded today of it while listening to an account of Justice Scalia crying openly and publicly at the funeral service of  Chief Justice Rehnquist.  I admire people who are secure enough in themselves to cry in public.  I am so uncomfortable crying in public that I was embarassed when I started to weep at the funeral during a performance of Aaron Copland's arrangement of "Shall We Gather At the River".  Part of the problem may be that I have always cried easily when emotionally hurt and that has happened too often in the work setting.  Like Tom Hanks said in  A League of Their Own, "There's no crying in baseball" --or in the workplace if you are a woman.  So I get upset when the tears start to flow as if it were such a bad thing to cry anywhere.  I hate to be viewed as an "emotional woman" or "hysterical". But sometimes it is ok to cry, such as at the funerals of friends.

"At the River" is a wonderful hymn which I had the pleasure of learning a few years ago when I sang with the LMU Community Chorus, although the version we did combined that hymn with another song, "Deep River."  At the funeral, the hymn was sung by a baritone with tenor overtones.  Here is a young baritone  I found on Youtube singing the Aaron Copland version.  It gives me the chills.

Tuesday, November 3, 2009

Election Day and die Deutschen

I spent the day with the German copyright lawyers today at the American German Copyright Summit held at Villa Aurora just above PCH off Sunset.  It is the second year in a row I have attended and I am scheduled to speak again this year.  Last year we were all abuzz about the presidential election and the Germans enjoyed partying into the wee hours in Century City after Obama was elected.   I left the Summit early that day to go watch the returns with my family.  This year I left early with a vague intention of voting in the local elections but never made it to the polls.  I tried to go this morning to my normal polling place but, although it was still a polling place, it had my address listed at a different location for this election. The peripatetic polling place.  I was already late for the Summit and the correct polling place was out of the way so I decided to forego voting at that time.  I must say that I was not particularly educated about the choices.  My only desire was to vote against a former neighbor who, in my opinion, would not make a good city councilman.  In particular I was offended by his telephone marketing campaign which smeared another member of the city counsel.  My son said there was a similar smear in poster form out on the main drag in our town.  But I did not do my civic duty and vote against the candidate not of my choice.

I always feel a bit bad when I do not vote.  I can only count a few times over the years when I have not.  One time I voted with almost no information about a local candidate and helped elect someone who I later discovered had very different views of the world than I.  Luckily there is not much harm that can come from what these local council people can do, as far as I can tell.  Conservative or liberal council members- the city seems to run about the same . . .until the next construction project to beautify Pier Avenue, which I understand starts in January.