Thursday, January 31, 2008

Free Comedy Workshop Begins

I've put together this press release that will go out next week. Help me spread the word.


Have you thought about becoming a stand-up comedian? Do people tell you you’re funny? Do people tell you you’re not funny, but you want to be? Are you interested in writing comedy, or making a living through comedy? Then the Comedy Workshop is for you. This free course will start on Wednesday, February 6 and will meet weekly for four weeks.

The course will feature instruction based on Judy Carter’s famous LA Comedy Workshop. “A few weeks ago, a few friends gathered to explore the idea of putting together a stand-up comedy night,” explained David Khorram, the course organizer. “We realized that we needed some structure to help us move through the process of developing our acts, so we ordered Judy Carter’s instructional DVD series, called ‘Comedy Career in a Box.’ It’s a way to attend her Comedy Workshop, here on a remote island.” Judy Carter is the author of The Comedy Bible and Standup Comedy. She is a renowned comic, speaker and teacher. This unique DVD series takes you step-by-step through the creative process of joke writing and basic and advanced performance techniques.

The goal of the workshop is for each individual to ultimately develop thirty minutes of original comedy material. “Even if you don’t want to perform comedy, but just want to add more humor to your life, to your writing, or to your talks, this is a good way of doing it,” said Khorram. “Understanding comedy also helps you see more humor every day, and helps you appreciate the natural comedy around you. So, this comedy workshop isn’t just for people that want to perform comedy. It’s for anyone who wants to gain an appreciation for how comedy works.” For those interested in performing, the group has planned an evening of stand-up comedy towards the end of February.

Part 1 of the workshop is “Creating Killer Comedy Material.” According to the course materials, you’ll learn to use the same tools your favorite comedians use to write material from your own point of view. It covers how to jumpstart your creativity, fighting stage fright and other worries, joke writing made easy, finding your authentic material, and getting big laughs.

Part 2 focuses on “How Not to Bomb.” In this section you develop your material further and concentrate on performance. You’ll learn secrets to dealing with hecklers, avoiding hack material, the top five mistakes comics make, insider secrets of successful rewrites, how to make the audience love you in five seconds, and building a set that kills.

For those interested in making money, Part 3 is on “Making Money from Being Funny.” It shares secrets from managers, agents, executive producers, casting directors and club bookers on how to get noticed. It features interviews with 18 Hollywood heavy hitters.

The Comedy Workshop will begin on Wednesday, February 6 at 6:45 PM at Marianas Eye Institute on Beach Road Garapan. If you’re interested, contact David Khorram at 235-9090, or by email. There is no charge for the Comedy Workshop. Space is limited.

Monday, January 28, 2008

CNMI Investor Visa

I've gotten a few requests in the past few months from non-US citizens on whether or not it is possible to live in the CNMI. It is. Here is the response I sent to the last enquirer.


For “non-US” types, you can enter in one of three ways: as a contract worker, on an investor visa, or on a retirement visa. The first requires an employer, the latter two require money. Actually, there is a fourth option-- marry a US citizen.

I think the retirement visa is available if you are over 55 years old. I’m not sure of the financial requirements.

The investor visa requires an investment of $150K, but the investment can include the purchase/lease of property, i.e. a home. I have good friend who is Canadian, and living here by virtue of an investor visa. Here is his input:

The investor visa is obtained through the Dept of Commerce. Any questions you have should be directed to Lillian, she is very helpful and easy to work with. You can also download the application and its requirements, I believe it’s on the website.

There is a long list of requirements and its a lengthy process, but its easy to follow and goes smoothly. Briefly, the investor must set up an "investment" in the CN
MI, which is usually a corporation to do business, and a minimum of $150,000 in assets (real estate is acceptable). The assets must be in the CNMI, and they must all owned by the corporation.

My application has been almost an inch thick both times, but most of the info is the business plan, tax statements, etc. The application costs $1000 and the permit is good for two years.

Thursday, January 24, 2008


These things are the greatest. Every time I watch an infomercial, I'm ready to buy whatever they're selling. I actually only bought an infomercial product once, but it lived up to its promises. I consider it one of the best purchases of my life. It was the Tony Robbins "Personal Power" program. Now I'm sitting here watching the P90X infomercial, and once again, I'm thinking, "this looks great." I think the things most infomercials sell really do work, with the caveat, if you use them, or follow the program, or whatever. I think most of us just fail when it comes to using the product as designed.

And so, I sit here wondering, "am I really going to take the time to do this?" That's the only real question.

The conference continues to have a lot of very valuable information, but we're all getting tired.

Wednesday, January 23, 2008 in Lava

Here's what we did for 45 minutes today after the conference.

Tuesday, January 22, 2008

Intraocular Telescope

It was a full day at the conference. One of the really nice things about the conference this year is that the organizers have set up wireless access in the main lecture hall. So, as new information is being given that I want to incorporate into Marianas Eye Institute, I just end off email to various people in my office to get things started -- check about pricing on this drug, send me a copy of that form to review, check the model number of this piece of equipment in the office. It's really nice to get things started while we're fresh.

The conference is being held at the Hilton Waikoloa Village, which is a huge property, with its own tram, and it's own boat taxi, and its own dolphins, and insanely, its own oversize air-conditioners that require you to wear a winter coat in the conference rooms.

Cool new technology currently under FDA trials: an intraocular telescope. This is a tiny telescope that is implanted into the eye for astronomy buffs. No, silly. Many people very poor vision due to macular degeneration and require lots of magnification to see anything. They often carry around a little telescope with them. This implants the telescope into the eye. Very few people will need them, but it can change their lives. About 20 have been implanted so far in the FDA trial.

Monday, January 21, 2008

Snow in Hawaii

I went running this evening. I looked up, and the clouds moved apart unveiling the summit of Mt. Manakea, dusted in snow. How cool is that! If you click on the picture and enlarge it, you can see the astronomical observatories, which are just to the left of the big fluffy cloud.

Chris Gardner Meets People from Saipan

Today's keynote speaker was Chris Gardner, whose life story was made famous by Will Smith in the movie, "The Pursuit of Happyness." He was a dynamic speaker and entertained the crowed with lots of humor and inspiration. I recorded his talk, and if anyone wants a copy, I can get it to you (or if someone can tell me how to post it here for downloading, I'll do that.)

The highlight of Chris' day was posing with us for this photo. He knew where Saipan is, so we said, "Okay, you can take a picture with us."

If you haven't seen the movie, it's a great one.

Floating Hotel

A couple of weeks ago, Arman asked me if a hotel could float. We talked about cruise ships, but he couldn't really picture it. This was anchored off the Kona coast. This is a cruise ship, Arman.

Sunday, January 20, 2008

Subspecialty Day at Hawaiian Eye

Today was the first day of the conference -- sort of. It officially starts tomorrow, but they've started having a one day specialty conference, so we all went to that today. Mel and Emilly did remarkably well following the talks. Russ, not so well. I'm kidding. Actually, Russ was thinking and making some good connections.

The first section was on Oculoplasitic and Aesthetic Surgery. It focused on Botox and Dermal Fillers. I've enjoyed this part of my practice since we started doing Botox two years ago. I'd like to be doing more, but we just don't have the demographics on Saipan -- people who are concerned about their appearance and who have disposable income. They included a live demonstration. Here, a patient is going to get injected with Botox and Juviderm filler. It was interesting to see Dr. Steve Yoelin's technique. Steve is the country's leading Botox injector and the person who taught me to inject Botox. He lives in Beverly Hills. Now that's the kind of demographic where you can thrive doing this.

The second section of the day was on Controversies on Perioperative Pharmacological Therapy. Sounds fascinating, doesn't it. Actually, the information in this section resulted in me making a few changes to the regimen of drugs I use around the time of surgery (that's what the word "perioperative" means). I'm switching from Ocuflox to Zymar, using the Zymar for two weeks post-op instead of one week. I'm not patching the eye after surgery, but instead using Zymar every 15 minutes for the first hour, and every two hours thereafter for the first day. And I'll be checking the wound with fluorescein at the time of surgery. Finally, I'm going to develop a good method to automate the extended use of NSAID's in our diabetic cataract patients.

Anytime I end up doing something differently as a result of a conference, I consider it a good conference. Knowledge is useful, but clinical practicality is the key.

The final section was on the use of implanted intraocular lenses to correct presbyopia -- the loss of near vision that occurs in the early 40's. This is the new trend in ophthalmology, because unlike LASIK, it can correct both the near and distance vision simultaneously. I've tried introducing this to Saipan, but there seems to be very little interest, again due to demographics. The lenses and the extra work cost a lot more than regular lenticular surgery. (Note to self: this year, the best IOL combination is Crystalens in the dominant eye, and Restor in the non-dominant eye. Micro RK/ARK and CK can be useful for over/under corrections.)

Tomorrow is the start of the conference. It's the lifestyle day, and the keynote speaker is the guy upon which the movie "Pursuit of Happyness" is based.

Toto, I don't think we're in Kansas anymore.

And we're certainly not in Saipan. My apologies to all my friends in Saipan, who are sure to weep at this sight. If you listen carefully, you can hear angels singing. Aaaaaaaah!

Waikiki to the Big Island

Yesterday we headed from Waikiki to the Big Island where the Hawaiian Eye Conference is being held. We called up Benny, our friendly limo driver from the previous night, to pick us up and get us back to the airport. If you ever need a taxi in Oahu, give Benny a call. His rates are the same as a taxi, and you ride in style. His number is 808-721-5579. He requires 2 hours notice. It costs about $38 from the airport to Waikiki.

Waikiki is the group of buildings just to the right of the wing. The Diamond Head crater is on the peninsula in the center of the photo.

We flew into the Kona side of the Big Island. This side of the island is a wasteland. It's all black lava fields, and looks like the surface of the moon. In places, grass has sprouted among the lava rocks, but even then, it has the feel of a desert, and not a tropical island. The Hilo side of the island has rainforest. And of course, Mount Manakea has snow this time of year, and the northern part of the island has real desert with cacti. Mara and I came here in 1995 when we were living in Oahu. We went up to the active volcano at that time. This is an amazing island with its diversity.

When we lived in Waikiki

During the first year or our marriage, Mara had to return to Hawaii to finish her Masters in Public Health. She was here for 13 weeks, and I spent 8 of them with her, in a tiny studio apartment we had right on Kalakaua Avenue on the Waikiki strip. Our apartment building is the five-story one just behind the bus. Were were in the one on the top floor, left corner.

I loved it and every time I come here, I like to walk by that building. We celebrated our first wedding anniversary living there. The apartment was tiny with no kitchen. We bought a mini-fridge and a hotplate. While Mara was in classes, I'd watch TV. I'd work out at the gym in Waikiki. We'd go for walks. We'd eat at the little noodle shop across the street. We'd take the bus together to the grocery store or to Queen's Medical Library. We'd lay in the park. In the evening's we'd stroll amongst the tourists on the Kalakaua strip, basking in the vibrancy.

Living here is one of the fondest memories of our early years of marriage, and it's one of the reasons I love coming back to Waikiki.

Saturday, January 19, 2008

Arrival in Waikiki

We made it to Hawaii, on the way to the Hawaiian Eye Conference on the Big Island. I love this place. We got in last night and walked out of the airport to catcha taxi to our Waikiki hotel, and were greeted by a limo. Did you know the meter is the same rate as a regular taxi? Nice.

Melonie and Emilly, with driver behind Mel.

Paparazzi shots

We got to our Waikiki hotel. Russ took off to meet up with an old friend for dinner. Mel and Emilly and I went down to Wolfgang Puck's and had pizza. One of Mel's cousins who works for medical referral came by and surprised her and the three of them headed out to see Honolulu, getting in after midnight.

I walked down the Waikiki strip, which I love. It's a place of everything. Every few feet there is some street "performer" (and I use the word loosely) trying to make some money. Here is a guy dressed in a monkey suit, standing on a crate, with his buddy playing the ukulele. Hey, you know this is America.

In the morning we walked around Waikiki in the daylight, picking up some souvenirs. Waikiki has to be the most famous beach in the world and one of the greatest tourist strips on the planet.

View from my hotel room

Statue of Duke

Saipanese Tourists in Waikiki

At the International Marketplace in Waikiki

Thursday, January 17, 2008

Born-Again Blogger Recants Faith

This title just came to me. It sounds intriguing and I bet there's an interesting story behind it. So, let's write the story together... right here on this blog, right here in the comments section. Just write a couple of sentences, and the next person will pick up where you leave off. Anonymous sentences are welcome. I'll start.
Devout blogger, Jeremy Finklemeister, recently shocked his friends and family by renouncing blogging while attending the Fundamentalist Blogger Revival in Maynard, Tennessee. When interviewed, he gazed skyward and said, "I just...
Okay, click on comments and run with it. Yes, I'm talking to YOU.

Watch Your Mouth!

Now I know many of you visit this blog just for the gory eye pictures, and that I've been remiss in posting them lately, so here is one. This is a picture of a young woman who visited our office last week with severe diabetic eye disease. This is the retina. The white round thing in the middle is the optic nerve head (or "disc"). The 1.2 milliion nerve fibers of the retina leave the eye through the optic nerve and go to the brain (the eye is technically part of the brain -- an extension -- so yes, I'm a brain surgeon). The arteries and veins also enter and leave the retina through the center of the optic nerve. The darker spot is called the macula (which means "spot" in Greek or Latin or something). It's the specialized part of the retina that's involved with the sharpest clearest vision.

Diabetes affects blood vessels, and you can see all the massive intra-retinal hemorrhages from the diabetic damage. The retina is the one place in the body we can look directly at the blood vessels, but this same damage is taking place all over the body -- brain, heart, kidneys, feet, everywhere. Bummer.

Diabetes is a bad disease, and if I've said it once, I've said it a million times, it's a lifestyle disease. You get it by eating too much, eating fat, eating simple carbs, eating animal prodcuts, eating, eating, eating. It's prevented by keeping less than one inch of fat around your middle. It can be cured by losing the extra weight and exercising. The stage is set when you're young. So pay attention. You're not invincible. This is the reason the life expecancy for the indigenous population is 54 years. That makes 28 "middle age."

Hawaiian Eye

Now if I were as savvy as Angelo, I would change the name of my blog to "Hawaiian Eye" for the next week. I leave for Hawaii early Friday morning to attend a conference, aptly named, "The Hawaiian Eye." It's the one professional conference I attend every year, and it rotates among Maui, Kauai and the Big Island. It's a great conference, bringing together about a thousand participants from around the world for a week of updates in all areas of ophthalmology. There is a concurrent Retina conference, which I attend, and an administrator's conference, which Russ, our CEO attends, and also a Nursing/Tech conference, which this year for the first time, two of our ophthalmic technicians are attending. They're scared to death -- island girls in the big city (actually, island girls on a bigger island. Mel and Emilly, you guys will be fine. If you get lost, just follow the setting sun back to Saipan.)

I like this conference for a few reasons. First, it's only four time zones away. I'm useless at the conferences in the mainland because of the jet-lag. I just don't bother going any more. Second, it's a relatively small conference. Some of the eye conferences have 15,000 participants and are just unwieldy. Third, it's laid back and relaxed. No one wears a suit. It's shorts, flip-flops, casual fare. You gotta love that, coming from Saipan. And finally, the folks from the Mainland are like so happy to just be out of the snow for a week, there is a jubilant air to the conference. Everyone is smiling. You don't see that much at medical conferences.

I'm always a fascinoma at these conferences. "You live WHERE?!" "Wow, I always dreamed of working internationally, but never did." "How did you do it?" "Can I touch the hem of your garment?" Those of us that are here, all know, that you just gotta let go of the rocks on the bottom of the river (vide infra... and if you don't know what that means, look it up. I've been wanting to use some Latin in my blog for a while and here's my chance.)

So, for the next week, I'll be reporting live from the Big Island.

We All Have the Power to Fly

This is one of my favorite stories off all time, and pops into my head at various times of my life. It's just another along the line of "use the Force" images. It's all there for us. It is we who resist out of fear. Conquer fear, use the Force, and you become the rarest of creatures, a Savior, a Jedi.


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 Savoir.

Richard Bach, “Illusions: The Adventures of a Reluctant Messiah”

What do you think? Meaningful, or just a bunch of hooey?

Wednesday, January 16, 2008

Saipan, Nigeria

There is a restaurant in Lagos, Nigeria, named after our famed island. Here is the blurb from their website.

SAIPAN is a contemporary Chinese restaurant and wine bar situated on the 3rd & 4th Floors of Dream Plaza, Bishop Aboyade Cole Street, Victoria Island, Lagos.

The restaurant name ‘Saipan’ is derived from a beautiful, unspoiled tropical paradise island situated in the pacific ocean where tourists go to relax and enjoy themselves, thus Saipan is the restaurant for people who have a taste for class and good food.

We have a taste for class and good food! Go figure.

Their website is

Year in Review 4 & 5: Happiness and Bad Stuff

Well, I better finish this up, since the year is moving on.

One of my key lessons this year was realizing that happiness is a skill. I think that for so long I was trying to make certain things happen that would make me happy. I think this is pretty common -- thinking that some new material possession or some new and improved relationship or a new job or whatever will "make" us happy. But this year I really took to heart that happiness has more to do with internal circumstances than external ones.

The other major life lesson for me this year is this. Bad stuff happens to all of us all the time. Maybe we get out of bed late, or our wife/husband/other-relationship-person yells at us, or the kids don't listen, or our employees or bosses or co-workers are jerks -- it all raises a level of anxiety that we seek to escape. Most of us work very hard to try to prevent the bad thing from happening again. We say, "Hey, don't yell at me. Why did you yell at me? You're a jerk for yelling at me. Don't ever yell at me again." In effect, we react. I've come to see that there is a certain intrinsic futility to this approach -- trying to get the bad things to stop. The real key is figuring out how to respond to the bad thing with grace and dignity. You can't make it stop, but you can choose how to respond. That's the one thing you can control -- yourself (sort of). When bad things happen now, I try to stay focused on how I respond rather on trying to get to to go away.

Okay, so there is a number 6 also. Anxiety/fear triggers the reptilian brain in our heads that yells either "fight" or "flight". This happens like a million times a day -- anxiety wells up from all kinds of little things. Some of us respond to the anxiety with some form of aggression (harsh words, anger, a fist) and some respond with some form of passive escape (stay quite, leave the room, avoid the situation, etc.). We're programmed to respond to anxiety with either passiveness or aggression -- these are survival mechanisms that work for all kinds of species. But being human has to do with staying in the middle. Neither running away, nor fighting, but staying present, calm and firm. This is a tough one, but it's major cool when you can do it. Don't fight back, don't run away. Just stay with it, stay with the person or the situation that is evoking your anxiety. Be present.

It was a great year for me because of these collective insights and skills.

Tuesday, January 15, 2008

Turning 35

Here are a few pictures from my birthday. Mara planned a "surprise" party for me at Oleai's, where I hadn't been in at least ten years! It's great to be that close to the water. The staff got me a "vegetarian" cake. Unfortunately, we didn't take many pictures.


Boni has designated this CNMI De-Lurk week. I heard the rule is that if you visit a Saipan blog, you have to leave a comment (i.e. stop just lurking). So, go ahead, leave a comment. I'd like to know what brings you to my blog, and what keeps you coming back. Tell me what you like and what you don't like. I'm going to allow anonymous comments so you don't have to do anything special, other than just leave a comment.

Monday, January 14, 2008

How to Eat Watermelon Better

Swallow the seeds. There's no reason not to. They won't grow inside you, despite what I used to tell my little sister. Just swallow them, and experience carefree watermelon eating. It will change your life.

Saturday, January 12, 2008

Center for Advanced Diabetic Eye Care Opens

(From Today's Saipan Tribune. The story is generally accurate.)

Marianas Eye Institute's Dr. David Khorram, MD, chief executive officer Russ Quinn, Saipan Mayor Juan B. Tudela, Public Health Secretary Joseph Kevin P. Villagomez and Deputy Secretary for Public Health Administration Lynn Tenorio lead the ribbon-cutting ceremony for the Center for Advanced Diabetic Eye Care on Beach Road, Garapan Friday. (Jacqueline Hernandez)

The Marianas Eye Institute held a grand ceremony yesterday for the opening of its new $200,000 Center for Advanced Diabetic Eye Care, which features the latest technology in eye care.

According to Marianas Eye Care chief executive officer Ross Quinn, the center was built specifically to address the ocular needs of the islands' diabetic population. The CNMI has one of the highest rates for diabetes in the world, third only to Nauru and the Pima Indians.

The expansion project includes the Ocular Coherence Tomography, a breakthrough eye scan technology that provides detailed color CAT-scan like images of the structures of the eye.

OCT helps guide a doctor's evaluation and treatment of a patient's diabetic eye diseases, particularly glaucoma and retinal disease.

According to Marianas Eye Institute owner and ophthalmologist Dr. David Khorram, the OCT is used at least five times a week. “It really is a huge necessity. We wish we can use it less,” he said.

The center also features a digital retinal photography and flourscein angiography. Marianas Eye Institute is one of the first two centers in the United States to acquire the specially designed high-resolution digital camera.

“With this camera, we are able to document the level of diabetic eye disease and its response to treatment. Digital photography allows you to instantly see what is happening inside your eye and to better understand your diabetes and our recommendations,” Khorram said.

The advanced cataract removal system is another one of the advanced technologies the Marianas Eye Institute implemented. It is one of the world's most sophisticated pieces of surgical equipment for restoring vision. It uses digitally modulated ultrasound to remove cataracts and provides for a gentle procedure with enhanced safety and rapid recovery time.

Another equipment is the biological modulator. It is used to treat diabetic eye disease at a molecular level.

According to John Garland of the Advanced Medical Optics in California, “Dr. Khorram uses the latest extraction techniques that are being used at U.S. mainland facilities. Your patients in the CNMI are truly getting a world-class cataract operation.”

Public Health Secretary Kevin Joseph Villagomez said the new center will lessen the need to send people to off-island referrals.

“When we send people off island for eye care, it is really for severe cases. It usually requires us to send that person there in less than a day because of needed surgery that cannot be done here.”

But with the installment of the new center for advanced diabetic eye, “that will lessen the need for travel and the need to wait for visiting specialists who are here one week and gone the next,” said Khorram.

He added he understands the financial burden that diabetes can bring to individuals and families. “For this reason, we established the Eye Foundation Fund. We want to make sure that you get the care you need, even if you cannot afford to pay for it. It is our commitment to the community.”

“What is more important here, I think, is that we are improving the livelihood of the people of the Commonwealth-and we can never put a price to that,” said Villagomez.

The two ophthalmologist of the Marianas Eye Institute includes Dr. Mark Robertson, OD and Khorram. Both doctors have received national recognition in eye care. [Mark is an optometrist, not an ophthalmologist.]

For more information, visit Marianas Eye Institute.