Sunday, June 21, 2009

Favorite books

All-time favorite books I've read:

Zen and the Art of Motorcycle Maintenance: An Inquiry into Values
by Robert M. Pirsig



Godel, Escher, Bach: An Eternal Golden Braid
by Douglas R. Hofstadter



The Mind's I: Fantasies and Reflections on Self & Soul
by Douglas R. Hofstadter



The Chronicles of Narnia
by C.S. Lewis



The Hobbit
by J.R.R. Tolkien



The Hitchhiker's Guide to the Galaxy
by Douglas Adams



The Collected Dialogues of Plato



The Complete Pelican Shakespeare



Miles Davis, The Autobiography



Tao Te Ching
Translated by Man-Ho Kwok, Martin Palmer, and Jay Ramsay
Calligraphy by Kowk-Lap Chan



Brave New World
by Aldous Huxley



Fahrenheit 451
by Ray Bradbury



books to read / re-read in future:

Journey to the West
by Wu Cheng'en (Author), W.J.F. Jenner (Translator)



Atlas Shrugged
by Ayn Rand



The Analects of Confucius



The Book of Chuang Tzu
Translated by Martin Palmer with Elizabeth Breuilly



The Doors of Perception and Heaven and Hell
by Aldous Huxley



The Digital Photography Book volume 1
by Scott Kelby



The Digital Photography Book volume 2



Jean Christophe
by Romain Rolland



Stalking Microbes
by Richard P. Wenzel, M.D.

Wednesday, June 3, 2009

451 to Atlas



Song of the Day: Atlas Shrugged - Jeff Sipe

Quote of the Day: "The zipper displaces the button and a man lacks just that much time to think while dressing at dawn, a philosophical hour, and thus a melancholy hour." --Beatty, from Ray Bradbury's Farenheit 451

Thought of the Day: Just finished Ray Bradbury's Farenheit 451, what a wonderful book. The book that pumps you up about reading books. Set in the future, in a time and place where books are banned and government censorship rules. The firemen of the future, including main character Beatty, set fires instead of putting them out. Their most popular target: those curious thinking rebels who still keep books in their hidden home libraries contrary to the rule of the land. Solution: burn the books, the houses, and sometimes the book-readers themselves.

In this future dystopia, government censorship means no literature, no teachers, no creative individual thought. Its replacement is 'the family' which in actuality is more like mass entertainment. 'The family' is our current TV and youtube culture combined and on crack. The hapless populace assemble in their parlors, which are rooms with full-wall media screens where fast moving images of cartoons, soundbite sensationalist news, and cheap pulp fiction are offered like an all-you-can-eat buffet for convenient in-home standardized mass consumption.

The themes of the book, written over 50 years ago, still run quite true. How far are we from this picture today, where the population is more concerned with who will be the next American Idol than with the often destructive policies of our short-sighted politicians? The elected leaders love our pre-occupation with professional sports teams and mind-numbing reality television shows. No need for overt censorship in this age as the populace is content to ignore the goings on in Washington unless it is an election year and only if the complex news is filtered down to catchy slogans like 'Change' and 'Hope'.

After finishing 451 I immediately cracked open a new novel, Ayn Rand's Atlas Shrugged. In this sprawling work Rand details her own philosophy, dubbed Objectivism, and asks the question: "Who is John Galt?" The Song of the Day references the work it it's title. Not sure of the connection, but it's a pretty song. I'm already enjoying the book immensely and will likely post on it as I read more.

Cheers, Dr. Kowawa

Monday, June 1, 2009

Blog turns 1!

Song of the Day: There Is No Greater Love - Coleman Hawkins

Quote of the Day: "To love someone deeply gives you strength. Being loved by someone deeply gives you courage." --Lao Tzu

Thought of the Day: Dr. Kowawa the blog turned 1 yesterday. I've enjoyed this first year of posts and plan to continue on. This past weekend celebrated the marriage of my sister & Brad. Congratulations to them, may they have a happy lifetime together! The Song of the Day was part of the outdoor wedding ceremony, played by the great Charlottesville trumpeter John D'Earth with Pete Spaar on bass. The ceremony was beautiful and the weekend at Mont Fair farm was enchanting.

Cheers, Dr. Kowawa

Thursday, May 28, 2009

Porcelain Vase

Sweewawa & I have made several trips to Busch Gardens this spring, and as part of the trips have been making pottery at one of the shops. Below see the amazing flower vase Sweewawa painted, with a poem in calligraphy on reverse.



Friday, May 22, 2009

Memorial Day Weekend

Fun, fun, fun! Today Sweewawa and I head out for a half day at Busch Gardens before heading West to Crozet, VA for a BBQ with old friends. We're all packed up to for the camping trip to begin Saturday morning though Monday afternoon. Can't wait, will update the blog with some photos on our return. Cheers, Dr. Kowawa

Wednesday, May 20, 2009

Planning camping trip

Song of the Day: Dock Of The Bay - Otis Redding

Quote of the Day: "He who hath many friends hath none." --Aristotle

Thought of the Day: Today have spent much time planning a two-night, three-day camping trip for Memorial Day weekend with Sweewawa. Planned out our circuit hike, our menu (cooked solely by stove, no open fires allowed in Shenandoah National Park), and our gear. I expect it will be a fun time of tranquility, exercise, picture-taking, and philosophizing.

Cheers, Dr. Kowawa

Sunday, May 17, 2009

MCV Takeoffs

The following is a clip from MCV Takeoffs, which is a humorous film made by fourth year medical students at the Medical College of Virginia about the trials and tribulations of med school. In it my classmate Leslie Brown and I poke fun at the things we're taught in our "Foundations of Clinical Medicine" course. This particular scene was quite well received when the film was screened at the historic Byrd Theater in Richmond, VA last Wednesday. Hope you enjoy it too! Cheers, Dr. Kowawa

Saturday, May 16, 2009

Graduation from medical school



Songs of the Day:

Weird Fishes - Radiohead

My Way - Frank Sinatra



Quote of the Day: "The mind is not a vessel to be filled but a fire to be kindled." --Plutarch

Thought of the Day: Today completed the second day of graduation ceremonies from medical school. The songs of the day are two that are dear to me. Weird Fishes is a Radiohead tune I really like, and is one I have listened to again and again during my years of studying. For some reason it seems even more special to me now that I have graduated. The second song is a tune made most famous by Frank Sinatra, My Way. Dr. Collins, one of the founders of the Human Genome Project, was the commencement speaker at the VCU graduation. At the end of his commencement speech he did a brilliant modification of "My Way", shown above.

After four years of near-constant, hard work I am done! I matched at my first choice for my desired specialty, Radiology, and am feeling on top of the world. All my work has paid off, and I am humbled and deeply honored to have earned my M.D. degree. I look forward to the next years of providing excellent care to my patients and continuing my studies of Medicine and Radiology.

Cheers, Dr. Kowawa

Saturday, May 9, 2009

Ricercar

Song of the Day: The Musical Offering, BWV 1079 - Ricercar a 6 - Johann Sebastian Bach

Quote of the Day: "If there is any religion that would cope with modern scientific needs it would be Buddhism." Albert Einstein

Thought of the Day: Just finished reading Godel, Escher, Bach, An Eternal Golden Braid. What a brilliant book! Can't say I understood every concept in the 777 pages, but I definitely enjoyed the book immensely. This book is intellectual exercise, but Hofstadter has a wonderful sense of humor so it's fun. The last chapter ends with a 6 part dialogue that re-explains some of the author's methods and mirrors Bach's masterpiece 6 part fugue that concludes the Musical Offering. I would absolutely recommend this book to anyone interested in music, philosophy, mathematics, or religion who is looking for a challenging, intellectual read.

Friday, May 8, 2009

Ceci n'est pas un message



Song of the Day: Dream - John Cage

Quote of the Day: "How can you tell if your own logic is 'peculiar' or not, given that you have only your own logic to judge itself?" --Douglas R. Hofstadter, from Godel, Escher, Bach

Thought of the Day:

My thoughts these last couple of days have been with the people of Santa Barbara, CA as the wildfires continue to blaze. Fortunately there have been no deaths but some firefighters have been injured and there has been substantial loss of property. May the blaze be contained soon with minimal further damage.

Of late have been continuing reading Godel, Escher and Bach, and am on the final chapter. This has been an extremely rewarding, though quite challenging, read. The quote of the day is a really interesting one from Hofstadter. Love this loop of questioning. The Song of the Day is from John Cage, whose work is frequently mentioned also in the book. The pic at the top is from Magritte, who challenges viewers of his works to question the reality of representations or symbols. In this piece he highlights that the reality seen through the window is represented on the painting, and the viewer takes another step back to see that this representation is itself a painting on a canvas. Which is itself also a further two-dimensional reality-representing symbol, the one the viewer is witnessing. Take it back a step further by interpreting the whole visual concept a la the philosophy of Descartes . . . Here is a quote from Magritte on this work:

"I placed in front of a window, seen from a room, a painting representing exactly that part of the landscape which was hidden from view by the painting. Therefore, the tree represented in the painting hid from view the tree situated behind it, outside the room. It existed for the spectator, as it were, simultaneously in his mind, as both inside the room in the painting, and outside in the real landscape. Which is how we see the world: we see it as being outside ourselves even though it is only a mental representation of it that we experience inside ourselves."

Tuesday, May 5, 2009

Tao Te Ching

This weekend decided to do a 56-hour fast (apples & tea allowed) and to re-read / study the great classic Tao Te Ching. First, wanted to share a link to the actual edition that I am using, which I think is excellent for several reasons. First, it is a beautiful hard-cover book with very tasteful illustrations. Second, according to Sweewawa the translation to English is favorable to some of the other versions currently in print. I would strongly recommend this version to anyone who is interested in purchasing the book or checking it out from the library. You can get it from this link to Amazon, or at the time of writing this version is available at Barnes & Noble, believe it or not in their Bargain books section!

Tao Te Ching
Translated by Man-Ho Kwok, Martin Palmer, and Jay Ramsay
Calligraphy by Kwok-Lap Chan



Here is a brief outline of the timeline of Chinese philosophy:

•The Classical Age (6th century BC-2d century AD)

–Confucianism (Confucius, 551-479 BC)
–Daoism (Lao Tzu, 6th century BC)
–Mohism (Mo Tzu, 468-376 BC)
–The Yin-Yang School (founder unknown)
–The School of Names (Logic) (Hui Shih, c. 380-305 BC)
–Legalism (Han Fei Tzu, d. 23 BC)

•The Medieval Age (2d-10th centuries BC)

–relations & conflicts between Confucianism, Daoism, & Buddhism

•The Modern Age (11th century AD-Present)

–Neo-Confucianism (incorporation of Daoist & Buddhist elements in an overall Confucian perspective) (Chu Hsi, 1130-1200 AD & many others)
–20th century impact of Western philosophies such as Pragmatism & Marxism

I would like to highlight some of my favorite passages of the work and offer some comments.

Introduction

    The translators / editors emphasize that the Tao Te Ching was not written solely by its supposed author, Lao Tzu. Rather it encompasses texts which probably cover 800 years. This is a crucial point in my view. Another interesting point made in the introduction is that in many ways the Tao Te Ching represents an opposite view from K'ung Fu-tzu (Confucius) philosophy but in some ways Taoism and Confucianism are very similar.

    The book is made up of 3 sections. The first consists of Chapters 1-37 and is the Tao, or "the Way". According to the translators this section contains the core of Tao Te Ching's message. The second part consists of Chapters 38-70 and is the Te, or "the Virtue". This part plays a supportive role to the original message of "the Way". The third part the translators interpret as a "Coda", Chapters 71-80. In this section a lot of the themes presented in the rest of the book are reiterated. It is arguable that the quality of the text declines for this last section.

Chapter one



"The Tao that can be talked about is not the true Tao."

    I love the humble way the book begins. Right from the start the author acknowledges that one cannot truly represent the purity of Tao via finite words with their inherent limitations.

"Everything in the universe comes out of Nothing."

    It is interesting how this statement has parallels in the modern science of Big Bang Cosmology. According to the Big Bang theory, all the mass contained in the universe now, trees mountains moons stars and all, originated from a single point of miniscule (or no) volume containing infinite (or all) the mass.

Chapter two



"Beauty and mercy are only recognized by people
  Because they know the opposite, which is ugly and mean."

    This is such a powerful concept. Lao Tzu has a special appreciation for the slip side of the coin -- the "bad and ugly" -- and sees their value, in a way, as on par with "the good". This is a tough concept for Westerners to get, as we in religion and culture often hold "the good" on a pedestal while sweeping "the bad" under the rug or dismissing it solely as the realm of the devil. One of the challenges I hope to meet in studying Taoism, Confucianism, and Buddhism is to learn how to acknowledge the good and bad present in all things while still striving to accomplish what I perceive as "good" in my actions.

Chapter four



The Tao " . . . smooths round sharpness
                      and untangles the knots."

    Such a beautiful quote. In physics and science there is the concept of entropy, or disorder. The second law of thermodynamics is an expression of the universal law of increasing entropy, stating that the entropy of an isolated system which is not in equilibrium will tend to increase over time, approaching a maximum value at equilibrium. This means that the universe is not unlike the room of a child, which gets messier with each passing day. I see this concept of increasing entropy present in the rounding of sharpness and the untangling of knots. But note though that often smooth jewelry is considered more "perfect" and desirable, and that hair without knots is actually considered neater or more ordered, though it may in fact have a higher entropy value. I love it that this quote can be interpreted in opposite but equally profound ways. Another really neat concept is that of planets. It is thought that all planets and moons probably started out as quite irregular shapes but the forces of air resistance and gravity over great periods of time caused them to become basically spherical.

Chapter five

"Heaven and earth are like a pair of bellows:
  they are empty, and yet they can never be exhausted."



    How can something come from nothing? What is so meaningful about emptiness and nothingness? The Tao Te Ching explores these questions again and again. I love the choice of words to end the quote -- note the dual meaning of "exhausted" as tired out but also contributing to the image of bellows "exhausting" or emitting puffs of air to fan the flames.

Chapter seven

"The sage guides his people
  by putting himself last.

  Desiring nothing for himself,
  he knows how to channel desires.

  And is it not because he wants nothing
  that he is able to achieve everything?"

    I really appreciate the last lines of this passage from a utilitarian perspective. One of the nagging thoughts that has in the past drawn me away from continuing studies in Tao and Buddhism is the sense that while it is beautiful and profound it lacks utility in everday life. In my life I don't really just "go with the flow" but rather I am always actively working and struggling to carve out a straight path towards my goals -- for example becoming a great Radiologist. This is a little different from the free spirit who wanders the earth and experiences that which comes his way. I love talking about vague concepts such as "Nothing" and "the Way" but do sometimes appreciate a tip of the hat towards the practical value of studying a particular philosophy.

Chapter eight



"Water, you know, never fights
  

  it flows around
                               without harm."

    I find this to be a beautiful way of describing the concept of pacifism without suggesting that it is a weakness. Note the photo is one I took at Lushan mountain, near Sweewawa's hometown in Jiangxi province of China.

Chapter nine

"You may amass gold and jade in plenty
  but then the more you have, the less safety . . . "

    This is sage advice on the dangers of gluttony and greed. Note also that this is an example of good and bad being equally contained in all things. Newton's third law is that "for every action there is an equal and opposite reaction." This is yet another example of how Tao concepts are often mirrored in science!



Chapter eleven

This is one of my favorite chapters so far, and I think this particular translation is excellent! Here's the whole of the chapter:

                                Thirty spokes on a cartwheel

              Go towards the hub that is the centre

- but look, there is nothing at the centre
and that is precisely why it works!

If you mould a cup      you have to make a hollow:
it is the emptiness within it that makes it useful.

In a house or room      it is the empty spaces
- the doors, the windows - that make it usable.

They all use what they are made of
to do what they do,

but without their nothingness they would be nothing.

**************************************************

    I love the concept that it is the emptiness, and space that makes things useful. Empty space is also a really important concept in music. Often it's the notes you leave out that truly make a piece of music beautiful. This concept is exemplified masterfully in the Miles Davis composition "In a Silent Way". Miles is really good at creating space in his music, and the space is what makes the tune "something".


Interestingly, Miles once was quoted as saying: "Don't play what's there, play what's not there" which I feel to be the perfect yang to the empty space's yin.

Chapter twelve

"The five coulours
                                 blind the eye -

The five notes
                             deafen the ear . . .
The five tastes
                            deaden the mouth

[ . . . ]

The sage [ . . . ] is guided
                                       by his instinct

and not by what his eyes want."



    Reading this I'm drawn back to my readings of Descartes, who believed that true sense perception was more dependent on the mind than the body. He argues that sense can fool, as in the case of watching a candle melt. Is "candle" a liquid, solid, or a fire? The only true understanding of its nature is arrived at by realizing the senses are just hints or clues about what is true . . . and using the mind to connect the dots. Descartes says "[P]erception . . . is neither a seeing, nor a touching, nor an imagining . . . [r]ather it is an inspection on the part of the mind alone."

Chapter thirteen

"If you can put yourself aside -
  then you can do things for the whole of the world.
  And if you love the world, like this
  then you are ready to serve it."

Sage advice especially for ultra-competitive and ambitious me.

Chapters fifteen - nineteen

These chapters talk about what it takes to be a good ruler. An interesting concept described is that the best government is one that is not seen at all:

       "The highest form of government
  Is what people hardly even realize is there

[ . . . ]

  And the people stay happy
  Believing that what happens
                                                     happens, naturally."

  
    First, I definitely don't take this to mean that the people are being deceived or that the details of governing are being hidden from public view. Rather, the Tao Te Ching in my view suggests that good governing should be more like the laws of nature, mysteriously and silently telling the trees which way to grow and the rivers how to flow to the sea.
    How does this concept relate to modern politics? It's my view that free market capitalism with wise & minimal regulation fits well into this picture. A mountain spring will trickle down via tributaries to the river and then the sea, provided you let it. The forced welfare state, in contrast, oppresses people by taking them out of their natural state. The "benevolent" ruler in a welfare state is very visible, and those receiving aid are felt drawn to leave their own natural forces of survival and self-betterment to fly like moths towards the new artificial light.

Chapter twenty

"Is there really much of a difference
  Between being angry and pretending not to be?"

As Shakespeare would put it "be true to thineself." I believe it to be one of the most important lessons there is in life.

Chapter twenty-one

(Note the accompanying photos are ones I took at Lushan Mountain in China (near Sweewawa's hometown) of a shrine to Buddha.)

  This edition / translation of the Tao Te Ching is one Sweewawa and I picked partly due to the fact that it overall depicts very well in English the original intent and beauty of the Chinese text.  However, the translation is by no means perfect.  This chapter is, in my view, one example of the imperfection of the translation.  To illustrate my claim I quote first the translation of the chapter in its entirety followed by an alternate translation by Sweewawa.

  From these two versions you can catch a glimpse of how radically different translations of the Tao Te Ching can be.  The difficulty lies in the fact that a very literal translation of the text will be clumsy and much of the desired meaning would be lost due to the fact that the English-speaking reader will lose subtle cultural references and other subtleties of the language.  So for a great translation a certain amount of creativity is required.  But there also is a danger in being creative of straying away from the intended meaning.

  The ninth line of the book's translation is "I say so, and I can prove it!"  This line when I first read it caused my hair to stand on end and I read on with great interest.  This is quite a bold claim contained within a book with groundings in religion and philosophy  . . . but after finishing the chapter I was disappointed.  "How do I know the Tao is the root of all being? . . . Because I know this."  I never would have asked for such a thing as a proof that the Tao is the origin of all things, as this is, I think, such a undefinable and unprovable concept that if one believes one must only hold based on faith.

  Sweewawa's translation speaks to me much more.  "God" or "Tao" are words and concepts that have been around for eons.  Just that is in a way a "proof" that there is something real behind the words . . . "From the Ancient time until now, its name has never perished."  But this is not a proof in the sense that you can say "I can prove it!"  Sweewawa offers the translation "At the bottom of the dark abyss, there is an essence.  The essence is so real, you can rely on it."  I do believe or "rely" on the idea that there is a "God", "Tao", or "Creator" who exists outside the universe and is the source of all things we know.  This concept is in a sense obvious to me, but yet I realize it is absolutely unprovable.  This is the beauty and difficulty of the "faith" concept present in many religions.   You cannot prove it, but you rely on it.      

Book translation:

The Body of The Tao
                                       is a mist beyond your eyes.

Tao of No Body,
                              and yet within it is All Creation.

Like a seed in the dark, and a dim light
     And from it, comes everything.

Root, stem, leaf . . . its essence is in everything.

Everything is born from this Tao

                                  I say so, and I can prove it!

From the beginning of time until now
the Tao is eternal because it is Creation.

How do I know the Tao is the root of all being?

Because

                 I know this.

Sweewawa's translation:

The biggest virtue obeys nothing else but Tao.
  Yet Tao reveals itself in an obscure way.

Behind the fleeting sceneries, there is an image.
  Behind the vague phenomenons, there is an object.
    At the bottom of the dark abyss, there is an essence.
      The essence is so real, you can rely on it.

From the ancient time until now, its name has never perished.
  It is the origin of all things.

How do I observe the beginning and development of all things?

    Because I know Tao.

Chapter twenty-four

"The kind of person who always insists
  on his way of seeing things
  can never learn anything from anyone."

This is great advice about the benefits of keeping your eyes, ears, and mind open.

Chapter twenty-five

  This chapter contains language which paints "Tao" as a very "God"-like being.  In it the Tao is described as "Mother of Everything", "greater than everything", "Tao is Great", "It is greater than Heaven, Greater than the Earth, Greater than the king."  I found it incredibly interesting (and satisfying) to see that Lao Tzu (and the other authors) took this stance on describing the Tao.  The Tao, according to them, is not just everything itself but is the source and master of everything.  This hierarchy is one that resonates with me personally and jives with the basis of the Christian faith to which I am accustomed.

To be continued . . .

Tuesday, April 21, 2009

First Music



Song of the Day: Fanfare for the Common Man - Aaron Copland

Quote of the Day: "What the superior man seeks is in himself; what the small man seeks is in others." --K'ung Fu-Tzu (aka Confucius)

Thought of the Day: To keep a semblance of political balance I like to mix up my news sources a bit. When I'm driving I'm almost always listening to NPR, which offers a fairly in depth, albeit extremely left-slanted, account of many news and general interest stories of the world. My conservative news sources are drudgereport.com, townhall.com, and boortz.com. To round out the two ends of the spectrum I enjoy reading google.com's News section. I skip television news entirely as Sweewawa and I very very rarely watch television. Anyway, when driving back from the hospital last week I heard on NPR this delightful general interest piece on Music for Newborns. In it was discussed what choices various public figures had made as far as what music to play for their newborns or young kids. The Song of the Day is Aaron Copeland's Fanfare for the Common Man, which one of my favorite jazz vocalists, Rene Marie, would often play for her young boys. I look forward to the day when Sweewawa and I will choose the music our kids will be exposed to early in life.

So despite being a 4th year med student I have been quite busy of late. I recently spent quite a lot of time filling out all the forms and completing other tasks required to begin my internship year. I also have been busy exercising daily and contributing to an online bulletin board Ethics course. Today I would like to share one short essay I wrote for this course, on the case of Jesica Santilan. Here is a brief synopsis of the case (offered by a classmate):

Jesica Santillan was a 17 year old girl originally from Mexico who died from a botched heart/lung transplant. Jesica and her family originally came to the United States as illegal immigrants in order for Jesica, suffering from restricitive cardiomyopathy with secondary pulmonary hypertension, to get life-saving medical treatment. After entering the U.S., the family moved to Louisburg, NC near Duke University Hospital in order for Jesica to get the best treatment. Her medical care was paid for by private donors in her community.

On February 7, 2003 Jesica received a heart-lung transplant. As the surgery was ending and the doctors were closing up, they received a phone call that made them realize they had made a fatal mistake. Jesica and the donor did not share the same blood type and no one had thought to check. The organs were originally made available from Boston to another one of the transplant doctor's patients at Duke. Once the transplant surgeon realized the organs would be no good for the other candidate, he asked about giving them to Jesica. A few hours later, the transplant surgeon was given the go ahead for Jesica's transplant. He assumed the blood type matched and no one checked until the surgery was almost over.

On February 20, 2003 another set of lungs/heart were found for Jesica and were transplanted, but the damage had been done. She was pronounced brain dead a couple of days later. Her family did not donate any of her organs.

**********************

While there are a number of fascinating ethical questions regarding the case, one aspect I chose to write about is the debate about to what extent illegal immigrants should be given access to the public health system in the US. Here are my thoughts:

I think one of the most interesting aspects of this case is the question of whether and to what extent illegal immigrants should be allowed access to the US health care system. This issue has been a big one in California, where a steady flow of illegal immigrants has led to dramatic increases in costs for hospitals (and all social services) and the government. In 1994 the CA voters passed Proposition 187, which required publicly funded health care facilities to deny care to illegal immigrants and to report them to government officials. The proponents of the proposition declared "While our own citizens and legal residents go wanting, those who choose to enter our country illegally get royal treatment at the expense of the California taxpayer." The proposition was in 1997 found in federal court to be unconstitutional, in part because it was out of the scope of the state of California to pass legislation that encroached on the federal domain of immigration law.

Speaking as a citizen and not as a physician, I am a nationalist when it comes to this debate. I often get irate when I hear or read news stories where the rights of illegal immigrants are discussed. These people broke the law by evading detection on entrance into our country or overstaying visas. I have always wondered what the debate is when the entire premise of their being present in the US is an illegality. According to our law these people have no right to reside in the country, let alone to request public services. If you want to reside in the US then use the legal process of immigration. Side note: it also bugs me that the politically correct media have shifted away from using the term "illegal immigrants" to the less offensive (and less accurate) term "undocumented workers".

So the nationalist part of me wishes we didn't even have to have this debate. But the reality is that the problem of illegal immigration is not going to go away. This is a debate that we must address as citizens and as physicians. And when you look past the pure nationalist gun-toting border enforcer view of it this is a debate that has considerable gray area.

First there's the notion mentioned by others in previous posts that barring illegals from receiving medical care may result in a forced breach of professional ethics for us physicians. As physicians our job is to help to improve the health of those who walk in the doors of the hospital or medical office. We abide by the Hippocratic oath first and foremost. I like how David S. separated his opinion on the subject in terms of whether or not he was wearing his physician's or citizen's hat. I do think it's actually comforting to think that when we are in the hospital or medical office setting we just wear the physician's hat, we just follow the Hippocratic oath, and we just help people to improve their health. Proposition 187 would have required physicians in California to occasionally toss off that hat and call the INS.

Interestingly there are arguments to be made FOR providing the public-funded medical care to illegals from a public health or even from an economic standpoint. For example, if we refuse to treat illegals but many remain in the country anyway, one projected outcome is that the rates of Tuberculosis will rise dramatically. Thus, by trying to save the funds appropriated towards the handful of illegals you actually can end up with a national crisis affecting many people if the incidence of tuberculosis increased dramatically. Another interesting argument is that even from a purely economic standpoint -- it is arguable that illegals are actually providing near-equal benefit to society even if they are not legal residents paying income taxes. They pay sales taxes, they do jobs citizens don't want for very low wages, and in general they can be a driving force to keep companies and the economic engine running along smoothly.

So I do see there are arguments for and against providing publicly-funded health resources for illegal immigrants. If I had to pick one side for this case I would side with the nationalist viewpoint and state that I don't believe this patient who was here illegally should have been given a higher place than citizens or legal residents on the organ transplant list. This, however, is just my personal opinion and I respect the complexity of the issue and differing opinions.

Cheers, Dr. Kowawa

The Fan

Sweewawa's latest brush painting, beautiful!

Monday, April 13, 2009

Hamlet



Song of the Day: Roads - Portishead

Quote of the Day: "This above all: to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man." --Shakespeare, from Hamlet

Thought of the Day: Sweewawa and I had a wonderful time over the weekend re-reading Shakespeare's Hamlet and then going (with my folks) to see the play at the Blackfriar's Theatre in Staunton, VA (http://www.americanshakespearecenter.com). It is a timeless and superb masterpiece, and was brilliantly performed by the players of Blackfriar's.

Sunday, April 5, 2009

Wednesday, April 1, 2009

Day and Night



Song of the Day: Castles Made Of Sand - Jimi Hendrix

Quote of the Day: "Knowledge speaks, but wisdom listens." --Jimi Hendrix

Thought of the Day: I have been really enjoying reading more of Hofstadter's Godel, Escher, and Bach book. I am now approaching half way through. Now am continuing to learn a little more about Zen through the book. Was struck by this neat concept presented in the book: that an ultra-concise summary of "enlightenment" would be . . . transcending dualism. The world is made up of night/day, happy/sad, self/non-self, life/death . . . or is it? I love how in the M.C. Escher woodcut shown above Escher blurs the distinction between duality. To mentally accept this painting one has to abandon the idea that it is night OR day. It is both. Similarly perhaps there is good and bad contained in all things, and in fact even "all things" are just one.

One of the really weird concepts to get around in studying Zen is that it's not meant to be studied. To commit the Zen concepts to words is challenging the duality. It's really interesting that perhaps one of the reasons Zen didn't become a powerful movement like Christianity is that its "preachers" actually resisted putting words about Zen on paper to spread to others. One Zen student once asked, if Zen eschews intellectualizing it, then how am I to study and learn it? The student was given the response that any path towards understanding Zen is equal. If the student wished to use intellectual study as his path towards Zen, then part of the process of reaching enlightenment would be to fall away from this chosen path. Quite a concept.

One of the modalities used in "teaching" zen and helping students reach enlightenment is the koan, which are stories like the one I presented in my last post. These stories do not have self-evident "morals" at the end but rather bring the audience to a state at which they can appreciate reality from a new perspective, perhaps by abandoning previously held views. I have always been struck by the lyrics of Castles Made of Sand by Jimi Hendrix, shown below. Was he a modern-day Zen practicer? These lyrics feel to me like a koan.

Down the street you can hear her scream you're a disgrace
As she slams the door in his drunken face
And now he stands outside
And all the neighbors start to gossip and drool
He cries oh, girl you must be mad,
What happened to the sweet love you and me had?
Against the door he leans and starts a scene,
And his tears fall and burn the garden green

And so castles made of sand fall in the sea, eventually

A little indian brave who before he was ten,
Played wargames in the woods with his indian friends
And he built up a dream that when he grew up
He would be a fearless warrior indian chief
Many moons past and more the dream grew strong until
Tomorrow he would sing his first war song and fight his first battle
But something went wrong, surprise attack killed him in his sleep that night

And so castles made of sand melts into the sea, eventually

There was a young girl, whos heart was a frown
cause she was crippled for life,
And she couldn't speak a sound
And she wished and prayed she could stop living,
So she decided to die
She drew her wheelchair to the edge of the shore
And to her legs she smiled you won't hurt me no more
But then a sight she'd never seen made her jump and say
Look a golden winged ship is passing my way

And it really didn't have to stop, it just kept on going...

And so castles made of sand slips into the sea, eventually