Thursday, May 31, 2007
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
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
Sunday, May 27, 2007
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.
Saturday, May 26, 2007
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!!
(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
Come join us next year!
Friday, May 25, 2007
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.
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
The acceptance of this claim by his guest
Revolutions come upon us quietly, like on “little cat’s feet” (as in Carl Sandburg’s Fog). This week, Bahá’ís around the world
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
“...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
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
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
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
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.
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
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
The crop feature is the best I've seen in any free program.
Friday, May 18, 2007
Wednesday, May 16, 2007
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.
Tuesday, May 15, 2007
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
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
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.)
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
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.