Thursday, May 31, 2007

Viagra: The Rise is in the Eye of the Pill-Holder

This week's photos aren't as gory as last week's Worm in the Eye, but they are fascinating nevertheless.

There is a retinal disorder called "Central Serous Retinopathy" (or simply CSR). In this disorder, the thin layer of nerves and blood vessels that coats the inside of the eye - the retina - forms a fluid-filled elevation -- a blister. It happens right in the area of the macula which is that specialized part of the retina that sees the clearest and is used for your straight ahead central vision. So, it's "Central" because it involves the central vision, it's "Serous" because it's a blister, and it's "Retinopathy" because it's a disorder of the retina.

In the photo, I've marked the outline of the blister with arrows, and on the cross sectional Ocular Coherence Tomography ("OCT") below, you can clearly see the elevation of the retina and the fluid in the blister, which shows up as black. The thickness chart below shows a green zone which would be the normal contour of the macula, and the black line which marks the actual elevation of this macula -- plenty elevation. (The OCT is amazing technology. It's been around for about 3 or 4 years, and we purchased one when the units became commercially available. It's revolutionized the practice of ophthalmology. We can see things that we simply could not see before. It's like a very high resolution CT scan of the eye, but uses light instead of X-rays, to capture the images. If you want to see it in action, stop by Marianas Eye Institute.)

Central Serous Retinopathy blurs the vision, sometimes causing objects to appear "morphed" (straight lines appear curved, people look like cartoons). It usually occurs in one eye, but can affect both eyes. It comes on for no apparent reason, usually in men in their 30's and 40's. It goes away without treatment over a 3-6 month period, and usually the vision returns to normal though sometimes it can remain slightly blurred. In rare circumstances when it doesn't resolve, we can find the area of leaking, blast it with a laser, and speed up the resolution of the blister.

Over the past year, we've been seeing a lot more of Central Serous Retinopathy. Recently an association between Viagra use and CSR has been reported. Take Viagra, and the elevation of the retina occurs. Stop Viagra and it goes away. Use Viagra again, and it comes back. There is no clear explanation, but now we ask everyone with CSR if they are using Viagra.

A weird bit of eye news worth sharing.

Tuesday, May 29, 2007

"Saipan This Week"

There's a new blog in town. I missed a bunch of events this weekend, in part because I found out about them too late, or because I knew about them so far in advance that by the time the events rolled around, I had forgotten about them. Now, "Saipan This Week" is here to solve the problem of missed events. There is so much that is going on in Saipan that's it's difficult to know it all. "Saipan This Week" will serve as a central information center for everything to do on Saipan in a given week.

We'll try to keep it to activities of general interest (or at least big interest) rather than meetings of various organizations and clubs. This is the place for the fun stuff.

The Saipan Blogger is already one of the team members, and I'd like to invite Marianas Life and The Reveler (and all the gang at Middle Road) to help out as contributors, and anyone else that wants to join in.

Here is how it works. Each new post will highlight some upcoming event or activity. Down at the bottom of the post will be a running list, by dates, of all the upcoming events. The list will have links to the previous posts for more detail. In this way, all the upcoming activities will be summarized in the most recent post, so you only have to look at the most recent post to see the list of everything that's coming up. Each contributor will just update the list, deleting the ones that have passed, and adding the new one. Pretty cool, huh?

I've put up a few events that I know about. Let's fill the calendar! If you want to just email information to me without having to bother with creating the post, that's fine too. (I'm still trying to figure out the whole "team member" thing). I think "Saipan This Week" will be a great resource for the island.

Edit: How could I have forgotten! And Brad. Anyone else?

Monday, May 28, 2007

Minimum Wage Increases

I'm posting this here, because I know that in the future I'll want to refer to it, and this makes it easy for me to find. At Marianas Eye Institute we pay our employees well enough that it will be a few years before the increase affects even our lowest paid employees. And they will have gotten raises by then anyway. The increase doesn't affect me directly, but I expect a gradual contraction of island businesses. At least the wait is over. Wall Street, and Main Street, hate uncertainty.

Sunday, May 27, 2007

Hike from Banzai Cliff to Beach

I've been delaying posting this hike because I didn't want to bump the "Old Man by the Sea" Hike to the dust bin of "Older Posts." But it must be done.

My friend Chris Fryling of N15 Architects, and I headed down this trail one morning last week. This hike starts at Banzai Cliff and is an easy 30 minute stroll down to the beach by the old Cowtown. The terrain is all flat, and the trail is well worn.

Banzai Cliff marks one of the spots on the island where hundreds of Japanese residents leaped to their deaths as the American warships were approaching the island. They feared a fate worse than death, and entire families perished in this way. There are lot's of memorials at Banzai Cliff, this being, in my estimation, the most striking, reflecting the Japanese sense of design: grace and simple beauty.

The trail starts at the very north end of the parking lot, by the edge of the boonies. Nothing marks the trail, except for the trail itself.

For much of the hike, the trail is covered by a canopy of tagan tagan trees, so even at high noon, there is some shade. Early on there is this patch that I call, "the Coral Gardens", these large 4-6 feet high spikes of old coral dotting the trail.

Soon after the Coral Garden's there is a complex of caves. It's not marked and it takes a little bit of hunting to find the opening. This is the opening, which is really just a hole in the ground. The caves are in a ring around this hole, so the entrance was probably the roof of one of the caves that collapsed.

The view out of the cave back towards the opening.

Here's Chris exploring a bit. There are active stalagmites and stalactites forming. If you manage to find this cave and go in, please tread carefully and leave these alone.

On this rock, previous explorers have left some of the artifacts they have found -- bullets and bottles and an old salt shaker in this case. Many of the caves on Saipan were used WWII as hiding places for pretty much everyone -- Japanese soldiers and civilians, and indigenous civilians.

Farther down the trail is this old boat. For years, I've heard that this boat belonged to Larry Hillblom, who lived on Saipan and died young in a plane crash on a trip to the Northern Islands during the 1990's. He's the "H" in DHL, and was a multimillionaire who gained some notoriety in this part of the world. The Hillblom Foundation gives away hundreds of millions of dollars to medical research and education.

This building was supposedly part of the offices and barracks for his investment companies. He was a major shareholder in UMDA.

Of all the times I've walked by this building, I never bothered to go inside until today. Some of the stuff lying around seemed to confirm that this was associated with UMDA.

The walking trail eventually hits a grassy road. Just turn left (west) and walk about 3 minutes down to the ocean.

The grassy road turns off to the left (south) but keep going straight down this sandy path.

The water can be really rough here, depending on the winds and the tide. I usually take a swim near the shore if things look calm enough. The edge of the reef is close by as you can see. Right at this beach there is also an old Japanese bunker which is easy to miss, but is right there behind where I'm standing.

We headed south on the rocky coral, because we thought we saw a glass ball floating inside the reef. It turned out to be a rubber buoy. Oh, well.

It's very slightly uphill walking back up the grass road to the trail head. If you get to the stone wall, you've gone too far. Turn around and walk back to find the trail head going back to Banzai Cliff. Enjoy!

Saturday, May 26, 2007

Taste of the Marianas

Tonight is the last night of one of Saipan's greatest annual events -- the Taste of the Marianas Food Festival that runs each Saturday night during the month of May. For the folks in Japan who have recently been visiting my blog, here is the description from the Marianas Visitor's Authority.

The smell of scrumptious and delectable food is in the air at The 9th Annual Taste of the Marianas International Food Festival and Beer Garden. One of Saipan’s most popular of events will take place on May 5, 12, 19 & 26, 2007 at the American Memorial Park. This event is complete with live entertainment, food, beverages and numerous competitions in the tropical Saipan weather making this outdoor evening event a favorite of visitors in the region who swarm for a "Taste of the Marianas".

There is no fee to join in on the fun and festivities, but you will need to purchase tokens for food and beverages. Saipan’s very best restaurants and hotels participate in this event making it a delectable culinary and cultural experience extravaganza not to be missed.

Locals show the Hafa Adai spirit to visitors of our tropical island of Saipan, sharing in the culture and enjoying all that the festival has to offer. So come and enjoy!!

Our family has been every Saturday night this month. It's great for the kids, and it always strikes me that we (and all the other parents) just let them run around and have a good time -- something you wouldn't do in a larger place.

Young Dancers
(Photo courtesy of Dave Hodges - visit his site for more great shots of Saipan)

Photo opportunity with the Carolinian dancers
(Photo courtesy of David Hodges)

The main stage

Artwork at the Taste of the Marianas

The ubiquitous roasting pig

Food huts on the grassy lawn at American Memorial Park, the usual venue.
Come join us next year!

Friday, May 25, 2007

Revolution on Little Cat's Feet

This is a long post. I probably will not post anything more personal or more important than this (so if it makes you queasy, avert your gaze now). It's been bubbling in my head for most of this week. My friend Don Bader and I were on another hike this Tuesday morning, and he was asking me about one of my Seven Random Facts. There I had written:

I’m a practical idealist. I believe the paradigms that govern society and human relations have worked well for a long time, but are proving themselves woefully inadequate for an emerging global civilization. I see the accelerating turbulence in human society as the death pangs of the current defective order. Instead of trying to fix these dying paradigms, I work to help establish the foundations of the systems that I’m convinced will rise up and redefine our world over the next century. That's why I don't complain much or criticize the way things are. I'm a builder.
So here goes explaining that.


Unbeknownst to most of the world’s 6.7 billion people, this week marked the anniversary of a rare occurrence in human history. It marked the birth of a religion. On May 24, 1844, Samuel Morse sat in a room in Washington DC, tapping out a message in the code he had invented. The successful receipt of this message in Baltimore marked the inception of the modern era of telecommunication.

On the eve of the prior day, May 23, a meeting was taking place in a room, on the second floor of a modest home, in a dusty corner of the city of Shiraz, in southern Persia. At two hours and eleven minutes after sunset, the protagonist, a young man of 25 (who six years later would die brutally before a firing squad of 750 soldiers) intimated to his guest, whom he had met a few hours earlier, that he was a manifestation of the Divine – one of those rare Beings, sent to revitalize the character of man and society.

The acceptance of this claim by his guest marked the birth of the Bahá’í Faith. From these obscure beginnings, the Bahá’í Faith has grown in the past 164 years to include some 5 million people of every nationality, race and ethnicity (even Chamorro & Carolinian). The Encyclopedia Britannica identifies it as the second most widespread religion after Christianity.

Revolutions come upon us quietly, like on “little cat’s feet” (as in Carl Sandburg’s Fog). This week, Bahá’ís around the world mark the anniversary of that intimate conversation that set in motion forces that have recreated the planet, a conversation that signaled the birth of a revolution in human affairs.


Now, I’ll admit, I’m a skeptic. I hear things like this and I raise my eyebrows, have my doubts. Religion, of any ilk, is not exactly a trustworthy institution these days. The existence of a divine being who intervenes in human affairs, in my affairs, in the affairs of anyone, is questionable. Yet, I count myself among one of those 5 million people. Why? How can a scientist, a thinker, a skeptic like me, come to accept that some person has some special access to some remote unseen source of knowledge, and that that knowledge is relevant enough to my life that I’m going to change what I do based upon it?

First, I think I have to ask myself, is it possible that such a being, a messenger or manifestation of the Divine exists? Is it possible? Might it be true? For the answers, I look to the pattern of history. Civilizations have been born in many ways. One of the most frequent and enduring is the civilization that is born because of an individual who proclaims “I am not an average human.” The pattern has been that these individuals proclaim that they are not expounding their own philosophy, but are relaying a message, or being a mouthpiece or manifesting the Divine. They state that they have come to revitalize humanity and that this task is not of their own volition. They gain nothing from it other than pain, suffering, exile, and often death.

History knows these individuals by the names of Krishna, Buddha, Zoroaster, Moses, Jesus, Mohammad and Bahá’u’lláh. In the case of all but the most recent of these, we have seen the full course of a recurring pattern: first, the manifestation of the divine appears, then

“...A community of believers forms around this focal centre of spiritual life and authority; a new system of values begins to reorder both consciousness and behavior; the arts and sciences respond; a restructuring of laws and of the administration of social affairs takes place. Slowly, but irresistibly, a new civilization emerges, one that so fulfils the ideals and so engages the capacities of millions of human beings that it does indeed constitute a new world, a world far more real to those who ‘live, move, and have their being’ in it than the earthly foundations on which it rests. Throughout the centuries that follow, society continues to depend for its cohesion and self-confidence primarily on the spiritual impulse that gave it birth.”

I cannot deny that this has occurred repeatedly. And it has occurred for each of these divine Manifestations. On this basis, I accept that there is validity to their messages, their teachings, their claims of the existence of something outside our ken. I accept that Manifestations of the Divine enter the world at rare intervals and release creative forces that revolutionize life.

But the question of God still remains in the mind of the skeptic. If you’ve noticed, I’ve been careful not to even use the word “God” until now. (I wanted to tell you that the content of Samuel Morse’s first message, but didn’t because it contained the word “God.”) I suppose I’ve been cautious because I assume I’m talking to other skeptics, scientists, and pragmatists. I don’t want to close minds by using a word that is fraught with so many assumptions and difficulties.

My best friend is what I call a "born again atheist.” He’s not an “anti-theist” that is, he’s not against God. He just doesn’t believe that “God” exists. What I’ve learned from him, and from others who claim that “God does not exist” or who are doubtful about the existence of God is that they are not rejecting the mystical or the divine or the transcendent. They rejecting a particular concept of God.

They (and I) accept that things exist that cannot be grasped, that the senses cannot contain, that are unfathomable, mystical, spiritual, infinite. Every time they (and I) look up at the night sky and contemplate that it doesn’t end -- that there is no edge (and if there is, what would be on the “outside” of it?) we accept the existence of the infinite even though we don’t understand it. It’s staring back at us with the eyes of all those galaxies we can’t even see. So it is not this concept of “God the mysterious” or “God the infinite” that people reject. Most doubters and skeptics reject the concept of anthropomorphizing God: God as dude, who behaves like most other dudes, only bigger and way more extreme.

Bahá’u’lláh explains God as an “unknowable essence.” My mind can accept this God – a source of creative energy. I can also accept that any attempt to describe this unknowable essence must of necessity fall short. The human mind cannot contain the infinite. Anything we say is speculative. This is not to say that the descriptions of God in ages past were incorrect. They were simply describing the abstract, the indescribable, in terms that could be grasped by minds of those times. As the child grows and becomes capable of grasping the abstract, so descriptions of God change and evolve from age to age. Thus the prior concepts of “God” are not intrinsically “wrong” or in conflict with one another. I can live with all of that.

God as “unknowable essence,” as a source of creative energy, is not something I have to blindly “believe in.” I can actually experience this God. Every day I see signs of the unknowable essence. From the unwinding of a double helix of DNA to the pulsating beauty of retinal blood vessels, to the sounds of my children laughing, I see traces of this unknowable essence, of transcendence that is God. I’m content to not try to understand it beyond that. God, the unknowable essence, I can believe in.

So, I accept that there is God, the unknowable essence. I accept, (because history seems to clearly prove), that this unknowable essence does intervene in human affairs from time to time in a very concentrated way through the agency of these Manifestations of the Divine. But am I saying that they are all the same? Am I saying that the religions they founded all are true? Am I saying that their source is the same and therefore that God and Allah and Yahweh and Jehovah are all the same? Yep.

Huh? If that’s the case, why am I a Bahá’í? Why choose a specific Faith above another? Why am I not a follower of Krishna or Buddha or Moses or Christ or Mohammad? Well, as a Baha'i, I am a follower of all of them. Not in some wishy-washy eclectic buffet sort of way. I am a follower of all of them in that I accept that, in their essence, they are all the same. Identical. They are all the Divine Manifestation returning from the same source from age to age. “This is the changeless faith of God, eternal in the past, eternal in the future.” The all have the same purpose. Their spiritual teachings remain fundamentally similar: develop your virtues -- love, kindness, justice, compassion.

However, their social teachings – those that guide the complexities of society -- are not the same. They change from time to time in accordance to the circumstances of humanity at the time of their appearance: one says you can divorce, another says you can’t. Eat pork; eat what you want. Have four wives; don’t have four wives. These differences exist not because of intrinsic differences between the Manifestations or of their source. The differences in the social teachings exist only because of the circumstances of humanity at a particular time and place in history. Math for one grade is different than math for a different grade, not because the teachers are in conflict, but because the students are different. The religions are not really different religions. They are manifestations of one common faith. We just haven't recognized that. Once humanity understands this, religious strife will fade.

The spiritual teachings of long ago are still valid today. This is the reason millions of people continue to find sustenance in faiths that are thousands of years old. However, people are increasingly disillusioned by their religions (or any religion) because they do not appear to address the needs of the age, they do not appear to be relevant to life in the 21st century.

This set of ideas on the progressive nature of religion is the fundamental essence of the teachings of the Divine Manifestation in this day: there is only one “God”; the same “God” has sent these Divine Manifestations from time to time to educate humanity. Bahá’u’lláh is the most recent of these Manifestations with guidance from the Divine to move humanity to its next level of development – to a global civilization based upon the fundamental principle of the oneness of humankind.

The spiritual laws today are the same as those of all the previous iterations of the Divine Manifestation. The social teachings are renewed for the emerging global society. Their mere enunciation over 150 years ago unleashed the forces which propelled them in the forefront of the standards of civil society. When they were place before humanity by Bahá’u’lláh at that time, they were unthinkable, punishable:

  • The independent search after truth, unfettered by superstition or tradition;
  • The oneness of the entire human race, the pivotal principle and fundamental doctrine of the Faith;
  • The basic unity of all religions;
  • The condemnation of all forms of prejudice, whether religious, racial, class or national;
  • The harmony which must exist between religion and science;
  • The equality of men and women, the two wings on which the bird of human kind is able to soar;
  • The introduction of compulsory education;
  • The adoption of a universal auxiliary language;
  • The abolition of the extremes of wealth and poverty;
  • The institution of a world tribunal for the adjudication of disputes between nations;
  • The exaltation of work, performed in the spirit of service, to the rank of worship;
  • The glorification of justice as the ruling principle in human society,
  • And the establishment of a permanent and universal peace as the supreme goal of all mankind
These are not just a few well thought out social principles. Many see them as the principles enunciated by the eternal voice, through the return of the Divine Manifestation. And that eternal voice of the Divine has given the sort of detailed guidance that will be used to build a global civilization in the centuries to come.

That’s what excites me. That’s what makes this week and the anniversary of that conversation so profound. That’s why I’m optimistic about the future of humanity, despite the darkness on the immediate horizon. That’s why I don’t scratch my head and wonder, “What in the world happened in the middle of the 19th century that has caused humanity to progress further in the past 150 years than it had in thousands of years? What’s the source of the revolution and upheaval in human affairs that is taking place?” This guidance is what gives me the tools to help build systems that will redefine our world over the coming centuries. It is the basis for the new paradigm I refer to. Samuel Morse's devise, without the wires and the keys and the clicking is the cell phone in my pocket. The revolution is visible. I, the skeptic, the scientist, the thinker, have heard little cat’s feet upon which the revolution arrived. The paradigm makes sense, both to my mind and to my heart.

Tuesday, May 22, 2007

"New Pill Promises No More Periods"

That's the headline. Here's the story. It's hot off the press from one of the medical news story services I subscribe to (or for those who speak and write proper English, "to which I subscribe.")
The Food and Drug Administration is expected to announce approval of a new birth control pill, called Lybrel, which would be the first to be taken continuously and suppress menstrual periods indefinitely. Gynecologist say they have seen a steady increase in the number of women seeking to limit and even stop monthly bleeding. Surveys have found up to half of women would prefer not to have any periods at all, and most would prefer to have periods less frequently. (Reported by ABC News)
And this, referring to a story in the Wall Street Journal:
"The reason most traditional oral contraceptives have [placebo-pill] periods during which bleeding occurs was to increase women's comfort levels with taking something they might otherwise view as an unnatural disturbance of menstrual cycles," according to the Journal. But, "[t]here's no real medical need to have the withdrawal bleed at all," Paula Amato, a gynecologist and professor at Baylor College of Medicine in Houston, said, adding that there are advantages to eliminating the withdrawal bleed, such as reducing pain, headaches, moodiness and bloating. Women without periods also could improve their productivity at work and would not have to purchase feminine products, which could save them money, she said. Women's perceptions of Lybrel still could pose challenges to Wyeth, according to the company. Some women might think that not having a period is "unnatural," be concerned that daily doses of hormones could harm their health or worry that they will not be able to menstruate normally or become pregnant after taking the drug, according to the Journal. "There are some women who feel they need to have a period," Ginger Constantine, vice president of Wyeth's pharmaceutical unit of women's health care and bone repair, said. However, Lybrel is no less "natural" than other oral contraceptive pills and has similar risks, including blood clot, stroke and heart attack, she added.
I'm sure we'll be hearing more about this in the weeks ahead.

Monday, May 21, 2007

The people I admire most

I was recently asked to name the people I admire most. It took me a while to come up with a few. It's not something I go around thinking about, or a list I have in my head. (I won't share the whole list here, but Yoda is on it.) As I went through the names, I tried to identify the common features, and then I hit upon it. All of the people on my list have successfully let go and soared, in some way or another. Maybe that's what I admire because that's what I seek.

It reminded me of one of my favorite stories, and I realized the story embodies this principle that I admire:

Once there lived a village of creatures along the bottom of a great crystal river.

The current of the river swept silently over them all – young and old, rich and poor, good and evil, the current going its own way, knowing only its own crystal self.

Each creature in its own manner clung tightly to the twigs and rocks of the river bottom, for clinging was their way of life, and resisting the current what each had learned from birth.

But one creature said at last, “I am tired of clinging. Though I cannot see it with my eyes, I trust that the current knows where it is going. I shall let go, and let it take me where it will. Clinging, I shall die of boredom.”

The other creatures laughed and said, “Fool! Let go, and that current you worship will throw you tumbled and smashed across the rocks, and you will die quicker than boredom!”

But the one heeded them not, and taking a breath did let go, and at once was tumbled and smashed by the current across the rocks.

Yet in time, as the creature refused to cling again, the current lifted him free from the bottom, and he was bruised and hurt no more.

And the creatures downstream, to whom he was a stranger, cried, “See a miracle! A creature like ourselves, yet he flies! See the Messiah, come to save us all!”

And the one carried in the current said, “I am no more Messiah than you. The river delights to lift us free, if only we dare let go. Our true work is this voyage, this adventure.”

But they cried the more, “Savior!” all the while clinging to the rocks, and when they looked again he was gone, and they were left alone making legends of a Savior.

Richard Bach, Illusions: The Adventures of a Reluctant Messiah

I love this story. Every extraordinary person was once ordinary. You just have to have the courage to let go.

Is there a common thread among the people you admire most? Write about it on your blog and leave a comment here so we can come read.

Sunday, May 20, 2007

Seven Random Facts

Bonnie and The Reveler "tagged" me, so here I am, offering seven random facts about myself. Here are the rules of the game for those I tagged.

Each player starts with 7 random facts/habits about themselves. People who are tagged need to write on their own blog about their seven things, as well as these rules. You need to choose four people to get tagged and list their names. Don’t forget to leave them a comment telling them they have been tagged and to read your blog!

I tag Angie, Walt, Sean, and everyone at Shazam Saipan. Here are my Seven Random Facts.

1. My goal this year is to have no goals. I’ve been working so hard for so long, one thing after another. It's been satisfying, but pretty arduous. This year is a conscious decision to get off the treadmill, to do things purely for fun, to spend time on friendships, and to play. Yipeeeee!

2. I consider myself one of the best (and humblest) eye surgeons in the world. But if I’d had the musical talent, I would have preferred to rock the world, Bruce Springsteen style. Last month I had my performing debut. I played the blues on stage, solo (yikes!), at Discotheque GIG. I totally sucked, but I was happy. So, I consider “Rock the World from a Stage” checked off my list. Next… Rock the World from a Coliseum.

3. When I was in high school at Lake Forest Academy, my best friend and I shattered a 150 year-old school tradition by stealing a chariot.

4. Mara and I met and fell in love in Pago Pago.

5. I grew up in a coal-mining town in the Appalachian mountains of Kentucky. There, before the era of “political correctness,” no one wanted to make the effort to learn the name of some foreign kid, so in the first grade the principal called the immigrant family into his office and told us that my name, the one my parents had given me when I was born, “just wouldn’t do in these parts. Pick another.” David is the name I picked.

6. I’m a practical idealist. I believe the paradigms that govern society and human relations have worked well for a long time, but are proving themselves woefully inadequate for an emerging global civilization. I see the accelerating turbulence in human society as the death pangs of the current defective order. Instead of trying to fix these dying paradigms, I work to help establish the foundations of the systems that I’m convinced will rise up and redefine our world over the next century. That's why I don't complain much or criticize the way things are. I'm a builder.

7. When I was finishing my training in ophthalmology, and was trying to decide what to do next, I walked into a bookshop next to the El station in the Old Town neighborhood of Chicago. I saw a dusty book on the shelf called something like The Answer to Life’s Questions. “Perfect,” I thought. “That’s exactly what I need.” I opened it up and the page read, “Be bold and courageous. When you look back on your life you will regret the things you did not do more than the things you did.” That was the deciding moment for me. That night I bought a plane ticket to the Pacific. That quote continues to run through my life.

There you have it. Seven random facts about me. It was a fun exercise.

Saturday, May 19, 2007

Picasa Rocks!

I just downloaded Picasa this week, the free photo organizing, editing and sharing software that's owned by Google. And I'm impressed.

I've never really done much with photo editing, but this has some amazing features for free software. First, when you download it, Picasa goes through your computer and finds all the photos and organizes them by date. You can see them all without opening separate folders, which is really nice. I spent an hour or so just looking at pictures that I didn't remember taking because they were buried in a folder somewhere.

Second, it has great editing features that are very easy to use. Picasa can turn a mediocre photo into a nice one. Now, I will first hit "sharpen", which really does make the picture sharper. I can't begin to imagine how this works. Then I adjust the warmth of the photo and the shadow, and finally may adjust the saturation.

The crop feature is the best I've seen in any free program.

I'm sure it doesn't compare to something like Photoshop, but for a basic organizing and editing program, Picasa is a great find. You can take a tour and download it free, by clicking here.

Hike to Old Man by the Sea

Once a month, the kids at Brilliant Star School (which is one of the greatest schools in the WORLD, right here on Saipan!), go on a Junior Hikers' Trek. Today, we headed off to Old Man by the Sea. While we were there, my friend Xavier told the story that his father told him. There is a legend that an old man was fishing at this beach, and cursed the ocean for not giving him any fish. The ocean reached up and plucked the man away, but left his image on this rock on the beach for all to see and remember to respect the sea.

The trail has some small ups and downs and can be muddy and slippery if it rains. Take water, snacks, sunscreen, a hat and clothes to get wet in if you want to wade in the water at the beach. It's not a good snorkling beach, so don't bother lugging snorkle or mask along. It's a kid friendly hike. A few toddlers under two made it, albeit they were carried most of the way. It takes about 30-45 minutes each way, from the road to the beach.

Down at the bottom of this post, there are directions (complete with satellite photos) of how to get to this hike.

The Lamar's going down the steep part. A rope is always there to help.

Through the thicket.

Arriving at Old Man by the Sea beach.

Michael looking like MacArthur wading ashore.

Cool water and great waves crashing on the reef. I love this island!

Today Nava learned that it's not a good idea to run in the rocky water without reef shoes. She got a pretty deep gash on her heel. She was a trooper hiking back out. But it was deep enough that we went straight to my office where I put three stitches into the wound (after cleaning out all the bits of rock and coral.) We managed to get it sewn together in about 15 minutes, with enough time left to get home and shower and run off to see Shrek the Third.

Beautiful rock formations at the beach.

Preparing to leave.

Rob leads the way out for the last ones to leave.

Arman takes home a piece of Styrofoam -- a prized souvenir for any six year-old boy.

Directions to Old Man by the Sea

I think this is one of the coolest maps of the trail to Old Man by the Sea. I left the file "full size" so if you click on the image, you can get a nice detailed view of the map and satellite photo.

The trailhead for Old Man by the Sea is on Talafofo Road (the road to Kingfisher Gold Course from Capital Hill which starts next to Esco’s). The trail begins just after the Egigi Road intersection (misspelled on the map as Igigi) , and before the San Igancio Road intersection (not labeled on the map). The road widens a bit and there is room to park on the side.

As you get close, you'll see this "winding road" sign, which goes downhill.

Then as you start to come back uphill you'll see this telephone pole. The trailhead is past the telephone pole, near the farthest car.

Here is what the trail head looks like. It's an oft used trail, so it's usually pretty well worn and rarely gets overgrown. As is typical on Saipan, someone has left some markers hanging in the tree on the right, in this case, a water bottle and a pink shoe. If you're ever driving around Saipan and see something hanging from a tree by the side of the road, it is usually the start of a trail.

Friday, May 18, 2007

Worm in the Eye

Sometimes a little redness is just a little redness, and sometimes it's a worm.

Click on the photo for an enlarged view. (You know you want to).

DISCLAIMER: Gross content. Viewer discretion advised.

(Photo courtesy of Simon Robarts.)

Wednesday, May 16, 2007

Hike to Lao Lao Bay

This was a great Wednesday morning. I was off from work, so my friend, Don Bader (who used to live on Saipan and is now here on a six month sabbatical from his job as an Emergency Room physician in Durango, Colorado) and I headed into the jungle.

This trail to Lao Lao Bay starts on Railroad Drive in San Vicente. The entire hike is down a gully that is usually dry, but fills with water when the rains are heavy. Today it was dry. The hike involves a fair bit of climbing over rocks and under fallen trees, so it can be a bit slow. The hike down is lush and shaded. Some of the most massive Banyan trees on Saipan are on this trail.

It is moderately kid friendly. I've taken my kids on it a couple of times. The ones under four usually need to be carried (mostly for speed), but the older ones do great.

To get to the starting point, turn down Railroad Drive, which is near the San Vicente post office on Isa Drive. The trail starts near the second telephone pole. If you get to the first set of houses on the left, you went just a little too far. There really isn't a trail head per se. At the lowest point in the road, just dive down into the overgrown gully and start walking.

You'll pop out, about an hour or so later, on the road to Lao Lao Bay. Walk left on this road, and you'll soon be at the beach. The fastest way to get back is to not go back up the gully, but rather to walk up the Lao Lao Bay road to Isa Drive, then turn right and walk along the main road (Isa Drive) to Railroad Drive.

It's a great hike, and can easily be done in a couple of hours.

One of the Banyan Trees on the way down.

Lush, "old growth" vegetation at Lao Lao Bay

Lao Lao Bay waters at the bottom of the hike.

Tuesday, May 15, 2007

You heard it here!

Okay, guys, here is the scoop on these famous people (and things) I know nothing about.

Ron Paul is one of the 2008 Republican presidential candidates who has come out strong against the Iraq war.

Galilea Montijo is a Mexican celebrity whose uncensored sex tape video just surfaced.

Michael Buble is a music guy -- sings, writes songs, performs, stuff like that.

Eurovision seems to be the European version of "American Idol" -- a singing contest.

Joost is a way to use the internet to watch TV "where you want it, when you want it". It hasn't gone live yet, but apparently there is a lot of anticipation.

Ubuntu is a Linux based operating system.

Mario Lopez is a "hot Hollywood star" (according to his website), and one of the stars of ABC's Dancing with the Stars, which pairs Hollywood stars with professional dancers. (I'd never heard of that either).

Bebo is a MySpace alternative.

Did you guys know this stuff?

Sunday, May 13, 2007

"The Excited States of America"

I heard this phrase on a tape of an eye conference. The meeting was held in Canada and the speaker said something like, "Well, up here, we'd watch this growth, but they'd biopsy it in a second down there in the Excited States of America." The audience chuckled knowingly.

One of the greatest things about living on a far away Pacific island like Saipan is that you can be as "out of the loop" as you want to be (like a Nova Scotian), and not be considered weird (unlike a Montanan).

I was back in mainland America this past December for the first time in seven years. The thing that struck me the most was the level of hype that permeated the air. You couldn't help breath it in. There was no escaping the gases of insignificant events being made grand to excite the state of the nation.

There, you can't get away from it. Here, you have to work to find it.

I just came across a list of the most searched names on the internet, and I've never heard of any of them! They are at this very instant (but probably not for much longer) pumping up the adrenaline of much of the Western world. It's not like I'm living under a rock. My homepage is set to CNN International. I know the broad trends of society and civilization, the important stuff.

Here's the list: Ron Paul. Never heard of him. Galilea Montijo. Who? Michael Buble? (Is there an uncensored video or photos involved? I dunno.) Eurovision? (Presumably a band of some sort.) Joost? (Good name for a drink). Ubuntu? (I'll go with tribe in Africa). Paris Hilton? (Okay, I've heard of her, but why is she still on anyone's radar screen?) Mario Lopez? Bebo? Sorry guys, you haven't yet reached these sandy palm-lined shores.

Can anyone tell me in two sentences why any of these names are significant beyond a week? They may be. I just don't know. And send me their links so I can enhance this post and enlighten others.

I'm thankful to be unplugged from the ephemeral details that lead to those artificially excited states. The important will endure a week or more and make it to my attention. All the rest, I'm really thankful to not know about.

Saturday, May 12, 2007

Moonrise over Lao Lao Bay

This is taken from our house in San Vicente, which is for sale or rent. It's one of the most beautiful spots on Saipan. Click here for more information and pictures of the house.

(We're not leaving Saipan. We moved to Navy Hill so the four kids can walk to school. We traded beauty for simplification. It's been worth it, but we do miss the Lao Lao Bay view.)

Happy Anniversary

Yesterday was the 9th anniversary of the opening of Marianas Eye Institute. It's hard to believe it's been nine years! Mara and I were both working for the CNMI Department of Public Health at the time, and decided to quit our jobs and undertake building a world-class eye clinic on Saipan. We took our life savings, borrowed money, and entered the world of private health care. Having given away our government jobs, we had no place to live, so we just put a door in the hallway of the clinic, and lived in half the building. Mara was six months pregnant with our first child.

We would be over there until midnight every night trying to sort through all the business stuff -- accounts receivable, billing, chart of accounts, all the details of running a medical practice that no one teaches you. But we did it! It's been an amazing journey.

Over the years we've had visiting medical people from Australia, Hawaii, Japan, and the mainland US who have universally been struck that such advanced technologies and systems have been put in place on this remote island. Very few practices in the mainland US have the broad combination of advance technologies that we have at Marianas Eye Institute. I'm a tech freak, and I like to keep up on things, but I think the main driving force has been the fact that there is nowhere close to send patients for specialized testing. We purchase the new technologies simply to give our patients the highest standards of care available.

I'm proud of what we've accomplished. We have a team of really talented people, starting with Mark Robertson, who sees most of the patients and Russ Quinn, who serves as CEO, and great locally trained eye care team, technicians and administrative staff. I feel lucky to work with them all.

Yesterday was an opportunity to pause and think about where we started and how far we've come. And because new stuff is always in the pipeline, we are in the midst of adding even more advanced technologies over the next few weeks. I'll keep you posted.

Friday, May 11, 2007

Beware the paper clip

I've been remiss in posting the ever-popular gory eye picture. So here's a good one.

Sometimes the littlest things can cause the biggest problems. This woman was pulling apart two pieces of paper that were held together with a paper clip. The paper clip flew off, and hit her left eyelid. You can see the results. Massive bleeding and swelling. Look at the CT scan. See the massive swelling on the whole left side of her head (your right on the scan)? Have you ever seen a worse "black eye"? We call it a hematoma.

How in the world could a simple paper clip at normal "office velocity" cause such a problem? She's on Coumadin (or warfarin), a blood thinner. Because of an artificial heart valve, she's on a blood thinner. When we put hardware into your body, we don't want the blood to form clots on it which can then break loose and go to your brain (causing stroke) or your heart (causing heart attack) or your lung (causing pulmonary embolism), or anywhere else. So we put you on a blood thinner. But if you take too much of the stuff, and don't get the levels checked regularly, the blood can get too thin and like this woman, your risk of serious bleeding from a minor injury is very high. If she got hit on the head with an acorn, she would die of a brain hemorrhage.