Favorite run of the year

Saturday set the mark for my favorite run of 2008 so far. A 3-4 miler along Salt Creek Beach with my Dad. We glided down the big hill right when the sun was brilliantly blazing a red sunset, big and round over the horizon. We ran down to the beach front, right along the waters edge where the sand is hard and firm and easy on the knees. Did about 2 miles along the sand. Perfect temperature, nice breeze, good company. Not just my Dad, but a small pod of 5 dolphins that swam along at the same speed we were running. It may sound cliche, but it was magical, everything coming together, running, being home, feeling good, the breeze and 5 dolphins frolicking along side of us for a good 15 minutes made it surreal and incredible. One of the younger dolphins caught a few ways, two of them jumped out of the water, they were just playing while we ran along. One of those moments you won't forget for a very long time!

The Health Care Crisis

Health Care can be dwindled down into 3 basic parts: Cost, Quality, and Access. It is almost impossible to improve all three parts at the same time.

So far the media has focused on Cost and Access. Republicans yell about cost, Democrats rant about access. I think they are both important to the average American. My question is, what can we do now to improve our health care system for the long term? So we can improve all 3 aspects over time?

It's a tough question, no easy answers. Can focusing on quality and access to care lead to reduced costs in the long term? Will focusing on cost and quality lead to improved access in the end? How will technology play a factor in this triangle? Right now most assume that technology is increasing costs, but what if our innovations in the future lead to reduced costs? We have MRIs now, like the mega-computers of the 80s. Who is to say we won't have improved imaging technology in 15 years at much lower costs? This I believe, we are destined for. So, with this belief in mind, that technology will lead to lower costs of care in the future, I saw we don't worry about increased costs for now. I say that all these projections of the Health Care Sector taking up 40% of the GDP are wrong. Yes we do have some startling problems with an aging population and a fattening population, but I am seeing technology being the key to this, reducing physician visits, ER visits, making care accessible and affordable.

With this in mind, the government should own up, and take more of the costs off American's back. But we shouldn't worry about cost in the big scheme of things. Right now we need to focus on improving quality of care and access to quality of care first and foremost. This means we need a larger physician and health care provider pool and we need to really tackle quality. I don't have the time to go into quality of care right now. But lets just say that continuity of care would make for so much less duplicate and extra care that I think that would be a good place to start.

LA Homicide Report

I read an article today about the LA Homicide Report. It's a blog of all the victims of killings in LA over the past year written by an LA Times reporter. There have been over 800 murders in the past year in LA, in streets, homes, stores, driveways, alleys, cars, and parks. I know there are a lot of people in LA, 9.9 million according to the 2006 CA consensus. Oakland CA, a large city also prone to gangs, guns, and violence, had 115 homicides in 2007 with a population of 1.2 million....598 homicides Chicago with a population of 9.7 million...

I'm not putting in the effort to do a thorough examination of these numbers or the variables that contribute to them, it would be very interesting to look into this further. My main point is there are too many homicides! Just from scrolling through the LA blog, I would guess that majority of these homicides are from gunshots. To me, this is a serious problem, it is wrong to let this continue. But then again, it's not something I think about every day, personally, I've never known someone who was murdered, and to my knowledge I've never known a murderer. I don't know anything about the culture within these killings occur, I don't know the circumstances, the outcomes, or the reason for killing this people. What I do know is that if we could have better control of the use of arms in this country, we could dramatically reduce the number of people who die from them. Given the complexity of understanding why these homicides continue, why don't we just put a plug in the bottleneck? I understand the perverse cyclical thinking some people have, "If I can't get a gun I can't protect myself from those that do not give their guns in".
This is true, and this is why America and other developed countries with soft gun restrictions are in a predictament. But I really think it's the only way.

Ireland trip

For the past few months I've been debating whether I will go to Ireland this summer. For the most part, I've brushed the idea aside for several reasons. First off, I was blessed to go on an 11-day tour of Ireland with Grandma, Grandpa, my mom, and my sister in August of 2005. We stayed at Nora's in County Mayo, Grandpa, my mom and I successfully reached the summit of Croagh Patrick together. We also saw Dublin and Killarney. It was an extremely memorable and wonderful trip, I will never forget pushing Grandpa up the Holy summit that symbolizes so much of his spirituality and faith, nor will I forget Grandma's ability to know the oral history of every every village and street we visited, and how could I forget Abbey's ability to "Baa" in the car for 4 hours straight on the windy roads strewn with sheep on both sides. It was a trip of a lifetime--really, it was.

Regarding the upcoming trip, I've been in the mindset of, "I've done this before", "it's expensive", and as a new member of the work force (the sooner I'm back in school the better!), I put a high value on the limited resource that is known as "vacation days". There are other things playing into it as well, applications for medical school are rolling through in August, the new batch of interns could really use my help at that time, etc.

Recently, I came to the realization that I have not been putting enough value on what this trip really is about. It's not about "Ireland" per se, it's not about Grandpa's 80th birthday (his birthday is not even in August!), and it's not even about Abbey climbing Croagh Patrick. It's about family.

Honestly, how many opportunities do we have in life to travel together? Let alone as one big family to the place of our heritage? Many of those going on this trip I only have the chance to see at either weddings and funerals, wouldn't it be nice to get to know them more outside of these rather formal contexts? How awesome is it to have a chance to gather for the pure enjoyment of being a family? How many chances will there be in life to do something like this? What wonderful memories we'll be able to share for years to come? For some, this may sound a bit cliche, but really, how awesome of a chance. Looking at the big picture, instead of focusing on the immediate logistics, helped me to realize how fortunate I am to have this opportunity and how I should take full advantage of it. The logistical realities are still true and valid, but are so small in the big scheme of things.

This past year I've worked very closely with women diagnosed with breast cancer, some of which has been very serious disease. While this experience has increased my passion for medicine, it's also made me think about other things as well. If there is anything I've learned from talking with these women, it's the importance of priorities in life. It shouldn't take a life-threatening disease to reevaluate our priorities, to realize how we've been swept up in logistics, burdens, and constraints instead of doing what we truly we want to do. I talk with women who are facing a cancer that can't be cured, that has spread to their brains, their lungs, their bones, and I see what they want, what they cherish, what's really important at the end of the day. At the end of the day, it's all about family. We have our ambitions, our goals and passions, but we're social animals, we want to be there to create memories and experiences with our family and those we love...From this experience, I think it's important that we are constantly evaluating our purpose, our roles, our actions and how they play into the bigger picture, of what brings us happiness and what brings those we love happiness and satisfaction. To me, it doesn't matter if we go to Ireland or Death Valley, Ireland is a nice perk, but just getting together with so many relatives is a wonderful opportunity that I do not want to miss out on.

And, truth be told, someone's got to be there to photograph Grandpa when he's tied to a rope between Pat and Mike climbing up Croagh Patrick... :)

In the spirit of all things Irish, I'll close with the old Irishman's Philosophy...

There are only two things to worry about:
Either you are well or you are sick.
If you are sick,
Then there are only two things to worry about:
Either you will get well or you will die.
If you get well,
Then there are only two things to worry about:
Either you will go to heaven or hell.
If you go to heaven, there is nothing to worry about.
But if you go to hell,
You'll be so damn busy shaking hands with friends
You won't have time to worry!