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YOU ARE ON YOUR OWN…THIS IS THE NEW AMERICA

September 3, 2011

While waiting in a physician’s office, I heard a conversation between an elderly man and the receptionist about what Medicare covered.  It was obvious the man had difficulty understanding, and from his demeanor, I suspect he had difficulty understanding day-to-day matters, too.  The prevalence of dementia doubles every five years over 65.  An 85 year-old has an even money chance of dementia.  No, 90 is not the new 50; don’t plan on it.

That sad fact was emphasized by my later hearing a story from an acquaintance who helps an elderly woman with shopping.  She called the woman asking what she wanted.

“I won’t have money for food this week.  They are going to take away my Social Security.”

Of course, this has not yet happened, although many bullies, loud and unwilling to negotiate, want to kill the program.  Imagine being 85, a widow (a plurality of 85 year-olds are widowed women), no longer think clearly, have a failing body, and start hearing about Social Security being taken away.

We must couple spending for Irene’s damage with cuts–incredibly, both NOAA and the National Hurricane Center are on the chopping block.  I find that incredibly stupid and shortsighted.  Maybe we end Social Security and Medicare, too.  Suppose, given 32 C temperatures in the Gulf of Mexico, since the oceans are getting warmer, that a Cat 4 Hurricane enters, headed  northwesterly.  We can take Mr. Perry’s approach with Hurricane Rita in 2005, and pray that it stops and turns around, OR, we can be sensible and have scientific forecasts, which while imperfect, will save thousands of lives.  I am assuming, since Mr. Perry once considered secession, that he will not take federal money for the $30 billion that it would cost to rebuild Houston. Texans can pass the hat. We certainly won’t cut socialized defense or $2 trillion for wars that we could not afford and lied our way into.  No worries, however.  The climate is fine, since Congress passed a resolution saying there was no manmade problem. Maybe Congress will forbid hurricanes, too.  In the new America I see, you take care of yourself.  If you don’t have money, you don’t get medical care.  Vaccines are bad, public education is bad, and the private sector does everything right, from half finished jobs in Iraq that have wasted more than $60 billion to having the airlines regulate security through 10 September 2001, that indirectly cost more than a trillion in the past decade.  How many times do I have to say self-regulation does not work before I am believed?

My screening colonoscopy cost me $4000.  I have insurance.  Those over 50 without insurance will roll the dice.  When the current President finally put the money spent on the wars in the budget, I could hear the howling in Washington from Campbell and Skyline.  Mr. Bush did it, and not I did not hear one person outside my house who complained.

Many people barely make it.  In the new America, they will go bankrupt, medical costs the single biggest cause.  I wonder how much colon surgery for advanced cancer costs.  Oh well, that won’t be my problem, so why should I care?

But I do care.  Liberals care about those who aren’t as fortunate as they.  The current radicals were remarkably quiet when Mr. Cheney said “deficits don’t matter”  in 2005.   If Mr. Obama said that, he would be impeached.  If he kept emergency authorizations off budget, he would be impeached.  If he asked for a trillion to restore our infrastructure, providing jobs, I would need earplugs.  If he asked to raise the top marginal tax rate back to 39%, where we last ran a surplus (under Mr. Clinton), repealed the Bush tax cuts and put a 0.125% tax on stock transactions ($1.25 for every $1000, raising $600 billion by 2020 just on the NYSE alone), a progressive tax, we might get the deficit under control.  He could also put an 80% marginal tax rate on bonuses given to financiers, who have been shown by excellent research not to add value for what they are paid.

There is waste in medicine, too. But my neurosurgeon saved me from neck surgery, my dermatologist saved my face from disfigurement, my gastroenterologist saved me from colon cancer, and a Durango orthopedist’s quick actions on my right hip allow me to backpack today.  We should do better in medicine, but we add value.  I think the teachers who inspired me deserve better, too, and I fail to understand why if the free market is so good, teachers and others, who add clear value, are consistently undervalued.  Lack of oversight and self-regulation severely damaged the world’s economy.  Those who did it made billions.

The elderly lose their bodies, their minds or both.  The young need care, too. What do we do?  Do we remove their benefits and make them fend for themselves?  Do we decrease the surplus population?  Is this America? Where is the outcry demanding we will NOT allow our poor, elderly, disabled and those who did not get a break in life to live a better life?  This is one of the most religious countries in the world.  Where is organized religion?  Where are the voters to elect people who believe America tries to help those less fortunate?

I hear two sides of a story, as if both sides have equal validity.  They do not.  One side lied on Iraq, climate disruption, and vaccine safety, and dared say end of life discussion was “death panels”.  I will never forgive them that, any more than the physician who argued against evolution by saying “it debased man to the level of the animals,”  which is about as unscientific as it gets.  You are wrong, your data are flawed, you bully, and you pervert science.  Sadly, more believe you than I.

I’ve offered my solutions.  I’m ready for the usual attacks, the flawed reasoning, the rhetorical questions and lack of solid solutions from those in the majority. Maybe I need to live in Canada.  America has lost her way, and those of us who have been saying it for a decade are ignored.

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ON THE MEDICAL-SURGICAL FIRE LINES

August 14, 2011

In 1984, I had data about surgical outcomes by surgeon for carotid endarterectomy (CEA) in two Tucson hospitals.  There was a 14% major complication rate and a 23% overall complication rate, clearly worse than the results that we knew about medical management of the condition.  I referred my potential surgical cases to only one surgeon, whose outcomes were comparable to medical management; many patients, when told that the local outcomes, refused surgery altogether.  I took a great deal of heat from my colleagues for my stance.  So be it.  My patients mattered more.

I saw far too many complications post-operatively when I had not been involved pre-operatively.  In my view, many of these procedures, especially every asymptomatic CEA, were not indicated.  Some agreed with me.  Not many.  That of course, isn’t the only turf battle in medicine.  There are many. Patient care quality is often mentioned; I wonder today how much outcomes data is collected, how well it is collected, and whether decisions are made based upon it.  I would hope so.  However, as a physician with advanced training in statistics and quality, I never was called upon in this state to offer my opinion.

Before last summer’s fires, I wondered how many in Sierra Vista, a conservative city, had decried big government, only to realize that they needed the resources of the National Interagency Fire Center to save property, lives and indeed the city.

The National Interagency Fire Center was created by combining of three governmental agencies to cut duplication (waste)–the US Forest Service, the Bureau of Land Management and the National Weather Service.  Eight different federal agencies are now part of the NIFC, which has no single head. That isn’t to say that firefighting is done without an incident commander.  There is one.  But the organization itself has no CEO.

Aside from cutting waste, the NIFC did one other remarkable action: they coordinated nationwide firefighting.  Instead of each state having its own cadre of firefighters, on duty only for that state, the condition of the COUNTRY was looked at, so that wild land firefighters in Oregon might be called upon to fight a fire in Utah, because the latter was more severe than any fire burning in Oregon at that time.

This approach required that firefighting managers in a state give up local turf for the good of the country.  Incredibly, they did.  And we are better for it.  Congress would do well to follow that example.

That isn’t to say that the NIFC always gets it right.  The Fire of 1910 colored our wild land firefighting thinking for decades as sure as a missed diagnosis often colors a physician’s thinking for the rest of their practice.   Sometimes fire fighters, in spite of their training, do the wrong thing, as in Colorado’s Storm King fire in 1994 or the Thirty Mile Fire in Washington in 2001.  But there were no calls to dissolve the NIFC, to hand it over to the states, or worse, to local people, to handle matters themselves.  The fire deaths were investigated thoroughly, and the mistakes publicized, in hopes that they would not be repeated, although the Storm King fire deaths unfortunately paralleled those of the Mann Gulch fire in Montana in August 1949.

Without the NIFC, Sierra Vista, Alpine, Greer, Springerville, Pinetop/Show Low would not exist as we know them.   To me, that smacks as government doing something right, something that government should do, that individuals on their own, no matter how motivated, simply cannot do.   It is quite easy to set government up to fail.  I see that today.  It is far more difficult, but far more rewarding, to set government up to do good, to step in where individuals simply cannot deal with circumstances that are overwhelming, like severe poverty, catastrophic medical emergencies, education, or natural disasters.  Katrina was bad; the gutting of FEMA prior to that put the US on world-wide display as an incompetent country.  How many died because of that?

How much government we should have is a matter of opinion.  Frankly, I am willing to pay taxes, and a lot of them, to ensure we have a country that properly helps lead the world.

Like the NIFC, government won’t always get it right. But I am incapable of defending myself from wild land fires or knowing if my food, water or an aircraft are safe.  I depend upon somebody in government to have firefighters in place, mandatory food safety inspections, oversight of the financial system, and an aircraft control system, so that the results of unpreventable disasters are minimized and we prevent what can be prevented.

I want to know which physicians are best for me, should I need a bronchoscopy, colonoscopy, back surgery, or have a carotid event.  I hope my colleagues have sorted this problem out by now, but I don’t know, despite bringing a wealth of skills to the table.  Perhaps we need a National Interagency Medical Quality System, assuming we can find enough people to give up some turf and do what is right for the patient.  Like the NIFC, they wouldn’t get it right all the time, but it would be a step in the right direction.  Heck, I might come out of retirement to serve, should anybody ask.

 

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EUROPEAN ODYSSEY, LANGUAGE ODYSSEY

July 27, 2011

I am a lucky person, but I think I make my luck, too.

I started learning German about a year ago.  I didn’t plan to, but on an eclipse trip in Argentina I met two young astrophysicists from Munich, both fluent in English.  We corresponded after the eclipse, and because there is a ring (annular) eclipse in the US in 2012, I invited them over.  I promised I would learn a little German.  Well…a little turned into a full time 5-6 hours a day for 9 months.  I did most of it alone, until I found a couple of language learning websites.  These allow people to correct each other, and through that I met people on line in several countries.  I don’t like to use the word “friend” for somebody I have never met, but on the other hand these people have been available for me to bounce things off more than many of my friends over here.  I regularly correspond with people in Europe and Brazil.

Originally I planned on a short visit to Europe to see the two women I met.  I figured 4-5 days was enough, trying to heed the adage that guests are like fish, after 3 days they begin to smell.  But two of my online “friends” invited me to stay with them when I went over, one in Switzerland, the other in Austria. They were serious, so I changed my plans.  Now 62, my 4 days in Munich turned out to be 26 days abroad in 3 countries.  I spent 8 days in Munich, another 4 in Switzerland, and 14 in Austria, in a small town where people speak dialect and don’t lock their doors.  Yeah, those places still exist.

The first thing I realized was how difficult German is to learn, and that what I spoke was not at all as good as I hoped, nor was my comprehension anywhere near what I hoped.  But the people around me were astounded at my progress, and they were pleased that I was speaking their language.  Not one person said anything derogatory.  Not one.  Oh, I made some funny mistakes, but we all laughed….and moved on.  I asked questions and more questions.  Some things I picked up right away, others just didn’t stick for the longest time.

One of my hosts, Niki, met me in Munich.  He spoke German immediately and I later learned that was his plan–to be “grausam” or cruel–as he put it.  I responded in German, and within 2 days, I decided that in public, I would speak German, no English at all.  There was a lot I would not say, much of which I wanted to, and a great deal I would not understand, but I decided I had to go with the flow, knowing I would do some stupid things and ask a lot of dumb questions.  But I spoke German in Europe almost exclusively.  In Austria, I explained the US financial crisis to Elisabeth in English, both because it was easier, and because I am so angry at what happened that the anger affected my ability to speak German.

As I got more comfortable with Europe, I noted things to compare with here.  Europe sure isn’t perfect, any more than we are.  There are things people on both sides of the Atlantic could learn from one another.  There is too much smoking in Europe, although they are making progress eliminating places where people may smoke.  While many bicycle, there are far too few with helmets, although motorcyclists do wear them.  Yes, I am in favor of helmet laws; as a retired neurologist, I think my credentials to say that are  solid.

Europeans have good public transportation.  With gas $8 a gallon, they need to move a lot of people efficiently.  No, it isn’t perfect.  I missed a train in Salzburg.  But there was another one two hours later.  I was able to get all around Munich using the S and U-Bahns.  They work.  Not knowing the system, I still got around.  Speaking some German helped, but it wasn’t necessary; people were just happier with me when I did speak it.  We need the same public transportation system here.  It can be done, and Portland, Oregon is a good example of how a city can work.  I doubt it will in Tucson.    I have stopped listening to my detractors and those who confuse average with “world class.”  Tucson has major climate problems, educational problems, and an immense number of far right wing people living here.  They are old people, regardless of their age, and they have damaged the state perhaps irreparably.  We need good public transportation, and if it is good, people will use it.  Yes, it will cost money, but it will pay for itself in many ways, not all of them monetary.

The food was great in Europe, and I must have walked most of the calories off, because I did not gain weight, and I ate cheese and pastries by the kilogram.  Oh yes, we need the metric system here, too.  There is no excuse for not using it.  None.  I have for decades, and most Americans don’t know the English system well.  Think you do?  Answer these without looking them up:  How much does a gallon of water weigh?  How many ounces in a gallon?  How many yards in a mile?  How many acres in a square mile?  How many square feet in an acre?  To the nearest hundredth, what is 7/16ths in decimal form?  What is the scale in inches to a mile of a map that is 1:100,000?  What is the approximate conversion for nautical to statute miles?  If you can’t answer most of those questions quickly without looking them up, I rest my case.

Restaurants in Europe open later than I am used to, and you have to get the waiter or waitress to give you the bill.  What that does is allow you to stay longer with your friends, and generally order more food and drink.  I can’t say how many times an American waitress has lost money for the restaurant by shoving the bill under my plate without asking if I wanted anything more.  I would have ordered dessert, but decided it wasn’t worth it.

Internet service fails in Europe, as it does here.  But I had cable high speed Internet in homes, even if I didn’t have wi-fi.  Phone service had its problems, but my National Geographic phone was a nightmare that I finally stopped using.  Customer Service was a long wait, and if you didn’t have minutes you couldn’t call to order them. One has to have a toll free line to the service center, and this telephone did not have that.  Nor did it fill 80% of my request for minutes.  Is that stupid or just American?

In truth, despite National Geographic, I really didn’t spend a lot of time comparing Europe and America.  I simply saw parts of the world I had never seen before with people I had never met until recently.

Europeans usually can speak another language, but I learned that their English was often like my German, passable but not fluent.  That was fine by me.  They spoke English to me, and I spoke German back.  We communicated, and we had fun doing it.  Many have been to America and have a good opinion of the country, especially Mr. Obama.  They wonder why we don’t have national health insurance and why we don’t do something about guns.  I have wondered both of those for years.  I bet my career on improving medicine and lost, and I have long since not bothered trying to fight the National Gun Association (it really is about guns, not rifles, but ‘rifle’ sounds so much better than ‘handgun’).  I don’t interpret the 2nd amendment the way the Supreme Court does, and most of those who tote guns are not US Veterans.  Am I sure of that?  Yes I am, since only 7% of Americans served this country in uniform and a lot more than 21 million people (minus me) have guns.  So much for a militia, unless the Tea Party forms one, in which case I am off to Canada.

Here is a list of what I saw that I doubt I would have on my own or with a tour:

  1. Two visits to a family on a farm outside of Munich.  On my own, I had to deal with Bayern dialect, not understanding a lot of it, but learning a few words and realizing a man my age was calling me “du”, which is something one has to be careful about in Germany.  On the second visit, there was a party of 20 young people, half my age.  Three times, for a protracted period, one of the people engaged me in a conversation in German.  They spoke slowly enough, but still at reasonable speed, that I could ask about them and tell them about myself.
  2. A tour of Munich with one of my friends from the Argentina trip and her husband.  The weather was terrible, but it did not matter a bit.  We had a lot of fun. 
  3. A trip to Chiemsee, a large lake in southern Bayern (Bavaria).  Got out to Herreninsel, and walked around the island, seeing King Ludwig’s Castle.                                4. A visit to the Max Planck Institute for Extraterrestial Physics, and a look at the work going into EROSITA, an X-Ray telescope to be launched in early 2013 to L5, the LaGrangian Point (where Earth and Sun’s gravity are equal, so the orbit is stable), beyond the Earth’s orbit.  5.  A visit to Poing, a lovely wild animal park with room for the animals.

Yes, I walked around Erding, a suburb, and I had dinner and coffee with and without others.  I talked German with complete strangers, but these would have been normal parts of a visit. 

In Switzerland, the German is more difficult to understand, and I was with a family where English was spoken only by one son.  I stayed 4 nights in their house in Kerzers, a suburb of Bern.  I got off the beaten track.

  1. I was met at the Bahnhof and immediately taken to Enrico’s workplace (the husband of Teresa, whom I met online).  It was a clear Sunday afternoon, and we had unfettered access to the rooftop, where the view of the Alps above the powerlines and houses.  The views were stunning.2.  That night, I was shown a book about the first 26 hour flight with a plane whose wings were completely covered with solar panels.  The propeller driven plane used no fuel, only batteries at night, and flew as high as 8700 meters.  I also saw a DVD of the flight.  There were no American firms in the consortium.  I never heard about this flight.  If we can power an airplane with solar panels, why not a car, an air conditioner,  hot water heaters, and automobile accessories?   3.I was on the tourist track when Teresa took me through the three lakes and two canals on a boat ride.  We saw Merton through her experience, climbing high up into an old church above the old town.  We took the train to the boats, and we walked to the train again.  No cars.4.  One night, the family cleared the table quickly and I noted everybody dressing up.  I was still in shorts, so I decided I ought to put on decent clothes, really not knowing what was going to happen.  Teresa’s look, after I had changed, told me I had done the right thing.  We drove with a son to a school.  I saw a piano and drums on the stage and figured this was a concert.  I could have asked, but wasn’t sure I needed to or should to.  Sure enough, three young women appeared and played two numbers, one on the piano, one on a sax, and the third on a violin.  

But then things changed.  A man started talking, and from a few words, I realized this was their son’s graduation from school!  I was asked to take pictures, which I did, and later there was a reception, where I took the family’s picture.  There might have been other Americans there, but somehow I doubt it.  I was really deep into another country’s culture.

5.  On my second day, Teresa had to work, so I went into Bern, where I met the sons of my only cousin.  Peter lives in Bern, is the oldest, and I met him in Tucson in 2006.  He speaks four languages.  I had never met Richard, who looks like my late uncle.  Both spoke English and German to me, I spoke German back.  They were amazed, pleased, and we had a lot of fun.  They had lived in Bern for years when they were children, so we had a lot of fun together and I saw Bern through their eyes.  I have no parents living, only one cousin, and so to meet anybody in my family was truly special.6.The last day, Teresa took me to Freiburg, where there is an old church and a tower where one can walk to.  We climbed up to the tower, where really quite by surprise, a nearby lightning strike caused me to yell for Teresa to get off the tower.  She said, all in German, that everything was OK.  I screamed at her, again in German, that all was indeed NOT OK, and we needed to get out of there.  We did.

One has to be prepared for changes.  Teresa had mentioned nothing about the last morning, and I had a 0745 train to catch from Bern, meaning I needed to catch the 0650   train from Kerzers.  I was up at 5, and at 6 the house was still quiet.  I ate, expecting to take a walk to the Bahnhof.  At 0615, Teresa appeared in a bathrobe, so I assumed I would still be walking.  About as I got ready to leave, Enrico appeared at 0625, sleepy eyed and saying he would take me.  So I did get a ride, although I didn’t know it until the last minute.

I had no problem getting the train from Bern to Zurich, but I had to ask for directions for the train to Salzburg.  That was no problem, as it turned out, although the train itself was slow, frequently stopped too long, and I realized I would not make my connection in Salzburg for the trip to Oberösterreich, where Lambach was located.  I texted Elisabeth, who told me to take another train that left later, going to a different stop, which would be easier for her.

I have learned that the posted schedules at Bahnhofs are not always accurate, so I went to information to confirm my trip.  I found the train and got off at Wels, where Elisabeth met me.  People don’t use signs very often, but we had chatted on the Internet, and there were not many departing the train at Wels.  She took me to her house, where we had dinner.  I would stay there for two weeks.

Lambach is small, on the Traun River, but has good transportation.  The stores are all closed on Sundays, which is a throwback to many years ago here in the US.  

  1. I went to a school, where I was asked to speak English at Elisabeth’s English class.  She is fluent in English and is the school’s English teacher.  I soon realized that those teachers who spoke English with me were less fluent than I was in German.  I answered in German, they spoke English.  This was a recurring theme in Europe.  The students loved having me there, had many questions, surrounded me afterwards, peppering me with questions.  Later, we had a computer class where I showed them pictures of the US, solar eclipses, and explained the latter phenomenon in German.  I had a blast.2.The next day, we hiked to a Laudachsee, a small lake east of Traunsee in the mountains.  It rained, but not hard, and we walked around the small lake and then had lunch in a restaurant.  The inside was taken up by a wedding party, so we ate outside.  It was cold, but we were given blankets and stayed dry.    We walked back down the mountain and took a visit to Traunsee and a church on a small island accessible from shore.  I almost died on the walk over.  One of my big fears is riding in a car, the other is being a pedestrian.  Most cars will stop for people in a crosswalk.  Fortunately, in this crosswalk, I looked.  A black Mercedes sped through at 80 kph (50 mph), never once stopping.  Illegal, yes.  That would not have saved my life.
  1. The following day, we took the train to Salzburg.  Elisabeth had lived there 3 years, so I had a tour guide.  We saw the city, the Feststellung, high on the hill, had lunch in a lovely old place dating at least 300 years, and at the end of the day had drinks with her sister and brother in law, who lived nearby.  Again, it was a chance to work on my German with strangers, and again I was told I was understandable.  This had been my biggest concern, and I was greatly relieved to know I was able to speak correctly.  Elisabeth and I took the train back and walked back to the house from the station.
  2. I was invited to go to Linz, for a program where schools in the surrounding area (Linz is the capital of Öberosterreich, one of the nine states in the country) put on a show.  Unfortunately, the dancing, athletics, and the fair atmosphere was considerably dampened by the rain.  Still, I got to see the Danube, Brown, not Blue.
  3. On my own, I visited the farmer’s market, several bakeries, and had conversations with people in town.  I had to see a doctor about a small infection that wasn’t healing, and it was interesting to see medicine from a patient’s side abroad.  The visit was 15 euros, the medicine about 7.5.  All drugs are 5 euros for residents, regardless of what the drug is.
  4. Elisabeth and I went to a concert with a Russian pianist, held in a local church.  I figured with a town of 4000, there would be few attendees.  There were 400, and the pianist was superb.  So was the church.
  5. We visited Epps, the oldest city in Austria (800 years next year), and then went to Mauthausen, the main concentration camp in the area.  It took in just about anybody the Third Reich didn’t want, which in this instance led to 122,000 deaths.  It was perhaps the cruelest of all the camps.  Prisoners had to haul 55 kg blocks of granite (120 lb) up an incline which today has about 200 stairs and had me puffing.  Many were lined up at the top of the quarry and told to push the person in front of them over or to jump themselves.  The guards laughed as they called these people “parachutists without parachutes”.  Several thousand were shot as they tried to escape; at least 1500 committed suicide by touching the electric fence.  When liberated by the Americans in 1945, a day before V-E day, they buried 1200 the first day and 300 a day thereafter.  The surrounding countryside is so beautiful, but one cannot not escape the memorials by more than 40 countries, with words almost all in languages other than English. The words struck me deep to my core, as did the place called “Gaskammer”, and a beam where hundreds of Russian prisoners died painful deaths.  These places existed.  I had never been to one.  It is said Austrians won’t take people there, but Elisabeth takes her school children there to show them what their country was capable of.  America has MyLai and Iraq.  No country is immune to evil.  The evil at Mauthausen, however, was beyond compare.
  6. The next afternoon, we had dinner at a house of a friend–fellow teacher–and again, I had to speak German at length.  The way people opened their houses was deeply appreciated by me.
  7. We spent two days in Hallstättsee, spending the night in Obertraun.  The first day, we went up the Dachstein on the Gondola where we saw two caves, the latter the Ice Caves, where there are stalactites and stalagmites, made of ice.  The backlighting was superb, and the caves remarkable.  We spent time on the summit, over the 5 Fingers, which are projections built out over the cliffs.  It became foggy, but we were up there and again beat the rain down.  The next day we explored the town and the gondola up to where the salt mines were.
  8. That night, we had dinner at a local pizza restaurant in Lambach.  Perhaps America has better pizza, perhaps, but if we do, that is the only food I ate over there where our’s was better.  I have never just savored the taste of bread, pastries, and other food the way I did in Europe.  We were part of a group of 8, and again, many were curious about me and my life.  I spent some time talking about German grammar with a man, again, all in German.
  9. Elisabeth and I rafted the Traun, with a friend driving us upstream.  There is a 10 mile stretch with no houses, only clear water and lovely woods on either side.  It is a gentle river and with a raft, no problem.  There are plenty of places to swim or to camp.

I was not allowed to clean the house or the yard, although I did take it upon myself to empty the dishwasher, take out the trash, and feed her two cats.  We split up expenses, although I paid for dinner one night and gas one time as well.  There were just too many things she was doing for me that I needed to repay somehow.

I brought gifts for Teresa, Enrico and Elisabeth.  I had no idea and still don’t, how they will work, although the SW jewelry bracelet Elisabeth received has been worn several times.

I spoke English with Elisabeth twice, as mentioned earlier.  A third time was at the train station the day I left.  I wanted to be certain I could express myself clearly.

I then had to return to Munich, where the schedule changed, and I went from the Bahnhof to the S-Bahn and then the U-Bahn, taking that to MPE.  I met Maria and Anita and had a snack at MPE.  Maria, Niki and Maria’s uncle had dinner with me in Erding, my last night before flying home.

I was pleased that my German was understood, but I was disappointed that I still could not understand completely the news, although I knew the drift.  Nor could I read the newspaper well, although I read it daily.  I have two German books I am reading, I am spending sometime every day listening to German, and I decided to join the University of Arizona German club so I can meet with them on Thursday nights and both speak and hear German.

I do want my life back, where I am not spending every day learning German.  But I do not want to lose what came at great expense of time and effort, and is really appreciated by the German speakers whom I met.

I’ve seen the ads “Learn German in 20 minutes a day,” or “you will be nearly fluent using Rosetta Stone.”  Do not believe these.  Learning a language is hard work.  It requires mastery of vocabulary, and in German, the noun gender and plural.  It requires knowledge of grammar, which in German requires knowledge of cases and verbs/prepositions that take certain cases (in some instances two different cases for a preposition, depending upon how it is used).  I spent 5-6 hours a day for 9 months. I wrote, I listened, I practiced, I had lists of words, file cards of nouns, whose gender I needed to learn.  But it was worth it.  I could talk in sentences, and I could do more than just order things in a restaurant.  I could speak correctly, and my grammar was good.  There is just so much more I need to learn.  LiveMocha.com defines fluency as being able to carry on a simple conversation with somebody.  I don’t agree.  Fluency is speaking the language clearly with anybody, about anything, at any speed.  I am not fluent.  But I am conversational.  I can talk about any topic I want to.  Sometimes it is slow, and sometimes, I need help for verbs or nouns.  But I can make myself understood.  I just want to do better.  And that will take years.  Being “in country” was essential for the nuances that every language has.  This is a journey that won’t end, but on this particular journey, I not only spoke German, but I got to see a side of Europe that tourists just don’t see.  And I am a different and I hope a better person for it.

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SWIMMING WITH THE ORCAS

July 17, 2011

“In nature, there is no right or wrong, only consequences.”

An Alaskan cruise ship happened upon several deer swimming across an inlet.  Suddenly, several Orcas appeared, attacking the deer, killing the whole group.  The passengers screamed, begging the captain to “do something.”  There was, of course, nothing the captain could do.  Or should have done.  This is how nature works, predator and prey, survival of the fittest.  It is terrible to see it, but deer feed other animals as well as to breed and make more deer.  It is the way of the world.

Unfortunately, I didn’t like the way of the world when lightning caused Minnesota’s Pagami Creek Fire,  It was monitored, because wilderness fires are beneficial phenomena to the ecosystem. Jack pine seeds can only open after a fire, and I’ve seen large forests of young jack pines 10 years after a major burn. Unfortunately, one day the fire exploded, running 12 miles, ultimately burning 92,000 acres.  Regrowth has already begun, but I will never again travel my favorite route to Lake Insula.  It is the way of the world.

Large fires have burned huge swaths of Minnesota, the last big one in 1918.  That fact has not stopped many on the Iron Range from blaming the fire on the Forest Service or “radical environmentalists” like me. Scientists know fire belongs; if there is anything “radical”, it is the idea that forests, like life itself, are immutable.

Often, those who decry big government are first to ask where government is when there is a disaster.  FEMA was decimated in the name of smaller government, until Katrina, proving the adage to some that government can’t do anything right. I might counter with “Lehman Brothers.”  Wildland firefighters, who save so much property and risk their lives, are part of “big government”.  A PCMS member once made a pejorative remark to me about “government doctors.”  I think those of us who were medical officers, including the VA physicians who trained all of us, might feel differently. The previous Vice-President, who never wore a uniform, referred to those 16% of us against the Iraq invasion as traitors.  I want every president to succeed, because if they fail, we are in big trouble. If being against a war is treason, wishing a president to fail is the same, unless there is a double standard.

Big government cleaned the air (under Nixon) and the rivers, because corporations would not do it voluntarily. Accountants do not factor environmental costs in the bottom line.  When free markets fail because of greed or poor planning, big government must step in. If government is bad, then it must not interfere in the bedroom, marriage, and how I should decide to die. Drowning government in a bathtub would appear, in my world, to drown national defense. I don’t want that.

We did canoe in Minnesota, just not where we had hoped. While the fire was beneficial, we are likely to see more of these as boreal rainfall patterns are changing to a savannah-like ones with floods and droughts, rather than even, a phenomenon ascribed to climate change.  The oceans are more acid, the Ksp (solubility product) of calcium and phosphate will now, with 30% more hydrogen ions, cause deterioration in shell formation.  This is a major concern, since the oceans are acidifying at a rate 100 times faster than ever recorded during the past 20 million years.  Carbon dioxide + water=carbonic acid.  Nearly every glacier is retreating, and the volume of cubic kilometers of fresh water entering the ocean will further change the climate.  This isn’t bad, it just is, unless you are human, live on a coast, eat seafood, or get your water from a glacier, as do Peruvians and Indians, in which case it is a huge concern.

Every prediction of the future must quantify uncertainty; to do otherwise is unscientific. Not one argument I have heard against climate change has stated a p-value, confidence interval or margin of error. The late Sen. Moynihan said “you can choose your opinions but not your facts.” The IPCC is 95% confident, which we statisticians consider high. Using a cold week or a record low as a counterexample shows an inability to distinguish between local weather and global climate, which is basic to understanding climate change. For the record, in Tucson there have been 6.5 times as many record highs than lows since 2001 (142/22). This is a fact.

Not one argument I have heard against climate change has been free of personal attacks.  These attacks, having nothing to do with science, obscure the issue, ironically diluting and degrading the writer’s thesis. The subject is climate change, not what hikers wear.  I have discussed the science using statistics, which may be confirmed.  To clarify, I have been to ANWR twice, hiked 120 miles in three of its major river valleys, including 1002, and I find it and Antarctica among the most beautiful places on Earth.  I strongly disagree with those who disparage ANWR or climate change without having ever seen or understanding each respectively, and I have considerable knowledge of both topics.

Of course, some scientists, ever fewer, do not agree, but the vast majority of reputable scientists believe manmade climate change has occurred. Per cent occupancy of the globe is statistical misuse: 70% of the planet is water, and vast stretches are desert.  Fukushima is 0.0003% of Japan’s area, but radioactive Cesium contaminated 10% of the country. It is the way of the world that as a statistician, I frequently see statistics misused (99.999996% of aircraft flights in the US were not hijacked in 2001).  Mankind has never encountered CO2 levels this high.  We are running an uncontrolled experiment; worse, models are under-predicting the consequences. The average temperature has risen, overall weather patterns have changed and the higher sea level has already caused problems. These are facts.  It is the current way of this world.

When I was a neurologist, I often delivered bad news.  I do so again as a scientist and writer.  As a physician, I changed my patient management in the face of convincing evidence.  I believe I have convincing evidence about the world’s climate. I believe if nobody speaks out against those who disagree, and I continue to be polite with my word choice, misinformation will continue. I am calling them out; I will not be silent.  It is the way of my world.

The voters who elected this Congress believe that they will benefit from smaller government.  Ironically, many of these voters will need SSI and Medicare, which may be cut.  They are deer, and they actually want to swim with the Orcas.  It is, sadly, the way of their world.

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NO MORE

May 26, 2011

We don’t learn enough from our mistakes.

Back in 1949, eight months to the day after I was born, 14 smokejumpers died in the Mann Gulch fire in Montana, when the fire suddenly exploded and beat them up a hill.  Fire always wins races uphill. It was a small fire when the jumpers dropped, but it got out of control.

Act of God? I don’t buy it. Study accidents, as I have, and you soon learn that it is seldom one failure but a concatenation of them, as happened here. We fix flawed systems by redesign, not by telling people to be careful.

The famous 1910 fire that killed 86 people brought a change fire management systems. But not enough. Or the lessons learnt were soon forgotten. Proof? About 700 wildland firefighters have died since. Consider this:

* 1994, Colorado: Storm King Fire, Prineville. Ring any bells? Same thing as in 1948. Fourteen dead, caught on a hillside, when a predicted dry cold front caused the wind to shift. A few outran the fire, 14 Prineville hotshots did not. For what? To keep land from being “scorched”, “destroyed” or other jargon which denies that fire changes, not destroys. It is necessary for nature to clear out old growth to allow new. Many trees need fire, either to open seeds or to allow competing species to die.

Both fires were extensively investigated and books were written, one the father of the other. One hoped the mistakes wouldn’t be repeated.  But they were:

* July 2001, Washington State: The smoldering Thirty Mile Fire on a lazy summer day killed four young people, who even a couple of hours before, had no inkling of death. This fire was unimportant, burning where nothing mattered, with plenty of chances to be extinguished. But a pump failed, there were communication breakdowns, the weather changed, safety shelters were deployed wrong….

We talk about firefighting costs in the millions. As a statistician, I count stuff. I learned years ago what is important and countable must be counted. What is important and not countable must be honored. And we need to know the difference.

Deaths in fires can be counted. Not the potential and pain of the lives lost. But we end up counting the money spent and give it the most attention.

“Acts of God” are due to insufficient knowledge or poorly designed systems. We no longer have “Acts of God” deaths from smallpox, measles, polio, rheumatic heart disease, puerperal fever, or infected hangnails. We no longer have commercial aircraft crashes every month.

Deaths from fire are preventable. The firefighters know the rules. We have excellent weather forecasting, every firefighter knows that property destruction is not worth one human life.

The National Interagency Firefighting Center was founded to coordinate firefighting efforts among states, so high priority fires got the most resources. Many gave up turf and power for the greater good. This is almost unheard of in my experience, and those who created the NIFC were remarkable people.

But their job isn’t complete so long as there are purple ribbons.

(Read, edited and improved by Anindita Sanyal of the Hindustan Times, New Delhi, India)

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HUNTER’S MOON

May 7, 2011

Muddy and wet, I reached the end of the portage to Little Saganaga Lake an hour before sunset on a dreary October day.  I pushed the canoe off my shoulders, flipped it over, caught it on my knees and gently lowered it to the ground, pushing the bow into the water.  Wearily, I removed my pack and dropped it in the bow compartment, the sound echoing from the woods across the small bay.  I picked up the wooden paddle, grasped both gunwales, and carefully stepped in, pushing off from the rocky landing.

The rain had finally stopped, but once clear of a nearby point, the cold northwest wind caught me full force, as if to say winter had nearly arrived in northern Minnesota and canoeists were no longer welcome.  For perhaps the tenth time that day, I asked myself aloud why I was out here instead of back in town.  The previous day I had spent in the tent, rain-bound.  After eighteen grueling miles of solo travel through a dozen lakes and as many portages, I was back on schedule but needed to find camp soon, pitch the tent, put on some warm clothes and eat.

The lake, dotted with islands, was undoubtedly pretty in summer, but my mood matched the dark water and low nimbus clouds.  Only with difficulty was I able to keep the canoe on course as I crossed the quartering waves, the splash further chilling my mitten-covered hands.  I was therefore satisfied to land in the lee of a half acre rocky island containing a few groves of cedar and scraggly jack pine.  The campsite would have to do; it was too late and I too tired to continue looking for another one.

I carried the pack thirty feet uphill from the shore to a flat spot, then pulled the canoe up and turned it over, tying the bow to a nearby root.  I unpacked, placing food, tent and personal gear into three piles.  Grabbing a pot, I slid down the gravel bank to the lake to scoop up some water.

I lit the stove and started heating the water as I erected the tent under a small group of cedars.  With a half hour, I had changed into dry clothes, stowed my gear and had a few handfuls of trail mix with hot chocolate.  Marginally warmer, I obtained more water and started preparing my usual macaroni and rice dinner.  As I worked, a change in light heralded sunset, but clouds were too thick to show either color or detail.  The night would again be cold, but I hoped to sleep warm.  Eleven lakes and fifteen miles awaited me the next day.

Eating my rapidly cooling meal, I looked at the gray and rapidly darkening scene, wondering yet again why I had come out here.  At least I was dry and my tent sheltered from the persistent wind.  Had anyone been near to ask, I would have said there was a Hunter’s Moon that evening.  But I hadn’t seen anybody in four days, and seeing the Moon was far from my mind.  Under skies that threatened snow, I retired early, quickly falling asleep in my cedar hollow.

The geese awoke me.

I didn’t know the time, but I immediately recognized the sound.  I hadn’t heard geese since my childhood in upstate New York.  Their honking triggered fond memories when I was a young boy, looking up, fascinated by the formations, wondering how and why they did it and where they were going.  Realizing I still didn’t know those answers made me smile, as I listened to the different calls high over the island, heading south, away from the frozen waters of Ontario and Manitoba.  From the light on the roof of the tent, I realized something else as well.  It was clear.

I unzipped the tent door and slowly crawled outside, stiffly standing, barefoot, on the hard soil.  It was cold, but I was barely aware of the temperature.  I saw a brilliant Hunter’s Moon above the darkly forested south shore, its light rippling towards me across the nearly calm water of a wilderness lake.  Overhead, heading towards the Moon, were scores of geese, honking.  It was magical.  Knowing at last why I had come out here, I watched and listened, silent, until the geese were no longer visible and their calls blended with the light wind that just stirred the trees.

This appeared in the first edition of Firegrate Reviews, put out in 2010 by The Friends of the Boundary Waters

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TRYING TO BE CIVIL DURING A CIVIL WAR

March 10, 2011

Twenty-five years ago, I went to trial for alleged malpractice.  During the trial, the plaintiff’s lawyer kept quoting a neurology book, trying to make it appear that I practiced below the standard.  Each time, I asked to see the passage, and each time, I read the paragraph before and after the lawyer’s quotation.  He was quoting out of context.  He was lying, to make a point.  The third time I asked for the book, he literally threw it at me, on the stand.  Several jurors actually gasped.  For the first time, I thought I might not lose.  I didn’t, but of course in a malpractice trial, a physician never wins: it is lose or not lose.

I question whether the U of A’s new to promote civility will be successful.  I will try to be civil in my comments.

I find it difficult to be civil to those who did not serve this country in uniform, but are quick to support our military in our many misadventures that have cost hundreds of thousands of lives and trillions of dollars.  I was among the 16% of Americans in 2003 who thought invading Iraq was a bad idea.  I was right.  I am often right on the big issues, not that it matters much.  The bullies and the jerks usually win.

I find it difficult to be civil to bullies who use ideology, rather than facts, to call those who disagree with them unpatriotic, and sold a war that has been so costly.  These bullies polarized the country.  Worse, the media supported them in the name of “balance.”  We allowed the debate on health care to be uncivil, allowing words like “death panels” into the national discourse.  My opinion piece was entirely civil, factual, and appropriate, since I have dealt with death and dying many times when my colleagues were quite happy that I, and not they, would.

During the last total lunar eclipse, CNN interviewed two astrologers, no astronomers, because the eclipse happened to occur near the solstice.  Is this what America has come to?  I will ask:  what does a total lunar eclipse require, and why does it occur?  Can you tell me why we have seasons?  Can you tell me how you would determine the number of square feet in an acre and how many square kilometers equal a square mile?  Can you tell me what case follows the word “between”?  Do you know where Guadalcanal is, why it was important and what Marine Division has it on their emblem?

I find myself difficult to be civil to those who disparage science, want to take us back several centuries, at the same time enjoying their cell phones, cars, food and water so safe we don’t think about it.  I find it difficult to be civil when I am in a minority of Americans who believe global climate disruption is occurring and man caused.  And I will not argue this with anybody, unless they (1) avoid all use of pejorative language, (2) use statistical terminology and (3) state the consequences if they should be wrong.  I have yet to find anybody who can do this. I find it difficult to disagree so without being disagreeable, for I see these people and others destroying a country that I served as an officer in uniform, and at least 98% of Americans have not.

I find it difficult to be civil, when 10 years ago I proposed a reporting and counting system for medical errors, which failed.   And do we know the scope of the problem in 2011, and have we improved our care?

I find it difficult to be civil to those who received complete data on 6th grader obesity–from 5 middle schools–promised to help, and didn’t.  Tucson has a grant to deal with this problem, when with a few volunteers from PCMS and the school of nursing, we could have obtained data from every middle school in the county–free, since I would not have charged for my data analysis.

Do we have any data this year?  None that I know.  The principal at one of those middle schools yelled at me, uncivil, although we were helping him meet his mandate.  What is happening in his school?  Is the median BMI still at the 89th percentile, rather than the 50th?  Are 14% of his students still above the 95th percentile and 7% above the 99th percentile, 3 and 7 times the expected values, respectively?  Is his school representative of the county?  Does anybody care?

What we need in America are volunteers, service, ideas, hard data, willingness to say “I was wrong,” and polite, respectful discussions with willingness to listen.   It is time we say “no more” to those who deliberately lie to push an agenda.  It is time that we and the media gasp, like the jurors did in January 1986, call these bullies out on their lies, because equal time requires equal facts.  Bullies must be stopped, whether high school students, lawyers or fat old non-veterans who deliberately lie on the public airwaves.

I took my skills out of medicine to other fields.  I now wonder whether I take myself and my skills out of this country, which I see as in major decline, because of lack of MY “family values”:  education, politeness, population control, caring for the Earth and all its living beings.

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MESSING WITH THE MIND

March 10, 2011

How many people do you need in a room before any two are more likely than not to have the same birthday?

Twenty-three.

I’m sure there are those who disbelieve, saying “I know that can’t be right.”  What is disturbing is that even when a simple proof is delivered, many continue not to believe it.  That is stupid, but these days disbelief of reality by people in power is beginning to destroy this country.  The proof looks at the probability that two people don’t have the same birthday.   Here are the probabilities:

 

Number of People Prob (2 have same Bday) Probability (2 don’t)
2 0.003 0.997
5 0.027 0.973
10 0.117 0.883
15 0.253 0.747
20 0.411 0.589
22 0.476 0.524
23 0.507 0.493
25 0.569 0.431
30 0.706 0.294
35 0.814 0.196

 

A disease has a prevalence of 1 in 200 (0.5%), a sensitivity of 98% and specificity of 99%, meaning if you have the disease you test positive 98% of the time and if you don’t you test negative 99% of the time.  Not knowing if you have the disease, you test positive.  What is the probability you will have the disease?   The issue here is that having the disease and testing positive is very different from testing positive and wondering if one has the disease.  If the disease is rare, the likelihood of a positive test’s being a false positive is significant.  Here’s why, using 10,000 people and the above percentages:

 

  Test Positive Test Negative Total
Disease Positive 49 1 50
Disease Negative 99 9851 9950
Total 148 9852 10000

 

If you test positive (148), a third of the time (49) you will have the disease.  The others are false positives.  That’s why we don’t do routine HIV blood tests for marriage.  In a randomly selected individual, and that is important, a positive test for something rare has a significant likelihood of being a false positive.

Many mountaineers defend the safety of their sport by saying one can get killed in a car accident.   We all know someone who died in a motor vehicle accident, but relative to the denominator, it is small, 1 in about 7000 Americans each year.  Mountaineering is a small community, and number of climbs is a small denominator.  Every serious mountaineer has lost several friends in the mountains.  Mountaineering is far more dangerous.

The lottery is a tax on those who don’t understand probability.  The chances of winning the Powerball jackpot are approximately those of randomly picking a minute chosen since the Declaration of Independence was signed, 1 to 110 million.  Yet people continue to tax themselves because “if you don’t play, you can’t win.”

Too many Americans play “I’m sick do I see a doctor?” lottery:  I have abdominal pain, and I don’t have insurance. I hope it goes away.  But it doesn’t; instead, the pain worsens.  I call an ambulance, go to an ED and am admitted with a ruptured appendix.  The costs have increased and are well in five figures.  I’m bankrupted by the illness, nobody gets paid, and my productivity is zero for a long time.  I’ll probably never get out of debt.  If I get sick again, I’ll bet again it goes away.  I will have no other choice. I’m betting that my body’s natural healing ability will bail me out.  Maybe it will.  Or maybe it won’t.

We were once the richest country in the world.  Our annual medical costs are far more than a trillion dollars.  A trillion is roughly the number of days since the Earth formed.  How many these costs could have been avoided by timely prevention?  How many could have been avoided by universal coverage?  I don’t know.  But I do know that our system makes it impossible for at least a sixth of Americans, not Zimbabweans, to get decent, timely care and not be bankrupted by it.  If you don’t want my solution, you fix it.   Here are my metrics:  your fix has to show an increase in productivity, a decrease in emergency department overcrowding, a decrease in bankruptcies that are primarily due to medical reasons and a decrease in late diagnosis of disorders like appendicitis, that should all be picked up early–in America, not Tajikistan.

If that requires I pay more taxes, I’ll pay them.  I’d rather pay taxes for education and health care than for fighting,  foreign aid to countries who despise us and bailouts to car makers who built monstrous SUVs, when it was obvious decades ago we needed to retool.  The selfish say, “I got mine, and the hell with you.”  Liberals like me say, “I got mine, and I want to help you get yours.”

I’m a patient, and I’m tired of waiting weeks to see a physician (I thought only Canadians waited), worrying about medical errors that affected me and three family members and really tired of the bickering and the lies that stalled any meaningful reform.  It is disgusting and un-American.

The above birthday problem was solved by looking at what we didn’t want to find what we did want.  I don’t want a huge national debt.  Here are 2 thoughts:  end our wars, and enact a 90% marginal tax rate on those with incomes over $3 million.

I can live with 70%.

 

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WINNING THE JACKPOT AT AN AUCTION

November 26, 2010

I was recently auctioned off for a charitable event.  No, nobody was buying me, but they bought a dinner with me at a friend’s house with a star party to follow.  My job was to show up for the dinner then show the stars afterwards.

For 20 years, I wrote 750 astronomy columns for the local paper.  I don’t do much observing any more, other than chasing the next solar eclipse, which I’ve done 20 times, successful on 17.  I was once an avid observer of variable stars, sometimes getting up at 2 a.m. to make visual observations on one that the AAVSO (American Association of Variable Star Observers) needed.  I was so good, my eyes could detect a 0.1 change in magnitude.  I’ve seen about 400 galaxies, 2000 double/multiple stars, all the planets and once followed about 25 variable stars without using star charts.

The night sky is predictable enough to be reassuring but changeable enough to be interesting.  In 1999,  I saw 300 Leonids meteors in an hour.  I saw a red glow over the Catalinas in ’89, realized there was no fire but in fact an aurora.  I’ve seen one grazing occultation, where the Moon’s limb was tangent to a star, so that the star blinked in and out of view as the valleys and mountains of the lunar edge passed by.  That was really cool.  For many years, I did photoelectric photometry, then having to reduce the data by hand.  Other than a total solar eclipse or a total lunar eclipse, the occultation of 28 Sgr by Saturn in 1989 might have been the most striking thing I ever saw.  As Saturn covered the star, I could define every ring layer by the star’s passage.  I still have my notes for that one; the star disappeared from view 38 times in 45 minutes!  That was beyond cool.  I stayed out half the night looking, and I had an office full of patients to see the next day.  I’m sure more than a few of those patients noted the doctor was tired, but finally seeing the star in between the globe of Saturn and the inner ring was an image I will never forget.

I wrote an article for Sky and Telescope several years ago how astronomy and dark skies freed me from my shyness.  After I was auctioned, I didn’t know what would happen; the person who “bought me” was a minister, and I had some trepidation about the evening.  After all, some ministers believe the Earth is 4000 years old and don’t realize that we are made of star stuff; our Sun is at least a second generation star.  I am not religious, but I am intensely spiritual, the idea of the elements coming from stars strikes me to my core.  The iron in my hemoglobin, the calcium in my bones, and the carbon in the fat surrounding the myelin sheaths in the corticospinal tract leading from my brain to my lower spinal cord are just a few examples.

I wore my Argentinian eclipse T-shirt that two delightful women, brilliant German astrophysicists, gave me after the event.    I arrived at John’s house early, set up my ‘scope (20 cm reflector), then had a beer with John  and his wife.  John and I go back a decade as bike riders.  I quit the sport in 2006 after breaking my 6th, 7th, 8th and 9th bones, but we stay in touch.  Just as I finished my drink, the other guests arrived.

We went outside, as the brightest stars appeared.  This is navigational twilight, when the Sun is 6-12 degrees below the horizon, light enough to see both bright stars and the horizon.  I pointed out the Summer Triangle and Jupiter, and described star magic.  In Tucson, the mountains allow a rising star to suddenly pop into view, so if one can determine the exact time of its rising, she can go out 4 minutes earlier the next night and count down 4, 3, 2, 1 RISE!  And the star will rise.  It is like magic, except of course, it is entirely predictable.  I also spoke of “Earthmove” rather than “Moonrise,” for I have learned that if one changes perspective, it is possible to see the Earth rotate, which in fact is what Moonrise is.  I do it many times a year.  Seeing the Earth rotate is primal.

The minister thought all this fascinating.  His wife sat next to me at dinner and is, like me, is a teacher.  Before we finished dinner, she had invited me to her advanced junior high math class next February to talk to them about math in the outdoors, a subject I am particularly interested in.  American kids need to get out more, and this is one way.

After dinner, we went outside, and looked above us.  Even in the suburbs of Tucson, we can see the Milky Way.  I pointed out the beautiful curve of Andromeda, found the Galaxy, showed the star clusters around Mirfak in Perseus, the Pleiades and the Hyades.  I taught them how to use their fist to show that the elevation of Polaris was our latitude, and that Kochab, in Ursa Minor, is Arabic for “Pole Star.” which it was 3000 years ago.

As we turned to look at the southern sky, a minus 8 magnitude fireball, a meteor, shot across right in front of us.  Everybody saw it.  I’m not one into “signs”, but I had to be a bit impressed that we happened to turn at just the right time.  The minister and his wife were fascinated by the Moon.  I pointed out Alpenglow, where the tops of the mountains were lit up away from the terminator.  His wife loved seeing that.  I spoke of nuclear fusion in the center of stars, walking over to the sand nearby, pointing out that the silicon was made inside a star.  Heady stuff.  I showed them Albireo, a gorgeous blue and gold double star at the end of the Northern Cross, which seemed appropriate for a group of Christians.

I spoke so much that once again I forgot that I was a shy person.  I was bubbling over with knowledge about the sky.  I consider myself a profound introvert.  But it is all relative, for once I get talking about astronomy under a dark sky,  a solar eclipse, the wilderness I have seen, or the Sandhill Crane migration in March, I’m a different person.  For a long time, I thought it was the wilderness and the night sky that changed me.  But it’s more than that.  The next day I thoroughly enjoyed myself as a substitute math teacher.  What brings me out of my shell is teaching.  I am a natural teacher.  The minister and his wife learned a great deal about the sky that night, but I was luckier; I learned something about myself I had never realized before.  When I teach, I am a completely different person.  And I like that person a great deal.

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IF YOU WANT TO LEARN, TALK TO THOSE WHO SAY LITTLE

November 26, 2010

In November, I went to the Bosque del Apache National Wildlife Refuge for the Festival of the Cranes.  I got to see fellow volunteer crane guides and took a course in Sandhill Crane behavior, with on site examples.  I also visited the VLA, the Very Large Array of 27 large parabolic radio telescope dishes on movable tracks.

Lesser Sandhill Cranes are remarkable birds, some migrating as far as Siberia.  I now can identify juveniles, males and females by voice.  I can identify their unison calls, see the aggressive behavior they may display afterwards, and describe their dancing.  I was a decent guide last spring; I will be a far better one next year.

I stayed at a house in Socorro while the owners were temporarily living at the Refuge, volunteering.  Erv and Sandra are a remarkable couple; both well into their 60s, they are “professional volunteers,” known in the Fish and Wildlife Service as a couple who will go to a place for a few months, make a big impact, then move to another area.  In 2008, when I first met them, they “followed” the Sandhill Cranes north from their wintering spot in New Mexico, to the magnificent staging of 600,000 on the Platte, to Homer, Alaska, finally ending in Fairbanks.  While I was in New Mexico, they received an offer to go to Coldfoot, Alaska next summer.  They are either going there or to the Columbia River.  They are in demand.  Sandra can do it because she has two artificial joints.  Bravo for science, bravo for Medicare, bravo for Social Security.

My first evening, I went with both to watch the evening fly in of the cranes to a wetland.  Unfortunately, there weren’t many when I was there.  The cranes migrate south later every year, because the Arctic has warmed so much.  Indeed, the dates of the Festival will likely have to change.  One can argue about climate change, but cranes don’t argue; they sense warmth, not politics; 65% of bird species in the Christmas bird count, which I help out in, have moved significantly further north.  Erv and Sandra introduced me to several of their friends in a nearby RV park, and I was invited for dinner.  I was going to drive back to Socorro, grab a sandwich and sleep.  Fortunately, I didn’t.

That evening, I spent time with 6 other couples, all of whom older than I.  The food was good, the conversation better.  They were fascinated with my eclipse chasing and experiences.  Politics stayed out of the discussion, and mostly medical issues, too, a rarity among the elderly.   These people had worked for decades and were enjoying their retirement.  I wonder if they would be if it were not for the science so many disparage or the liberal programs of Social Security or Medicare.  I just wondered, but I kept my mouth shut.

I did open it later, however, to speak to the man who owned the RV and had been quiet most of the evening.  Quiet people often have a lot to say, if one can draw them out.  This man was no exception.  He was a physicist who worked at JPL and was surprised that I knew of it.  Are we so “educationally challenged” these days that we don’t know of the JPL, the place that allowed Americans get to the moon and do all sorts of other wonderful things?

The man was a pioneer in fiber optics.  He told me about silica (SiO2), the stretching and strength properties of the pure substance, which is the best spring we know of.  He told me that he thought it was better than satellite transmission, since it was faster and had fewer delays, so long as it was protected.  Satellites, as we all know, are far from safe, given solar radiation and space junk.  Bouncing signals off satellites leads to longer delays.  They are also more difficult to repair.  Fiber optics have revolutionized society, including medicine, although I learned fiber optics were most helpful was in transatlantic cables.

This man disparaged himself by saying that he was out of date.  But his explanation of fiber optics was by far the best I had ever heard.  Perhaps that is because he mentioned one of his teachers in quantum mechanics:  Richard Feynman, arguably the most brilliant physicist in the 20th century, and who single handedly figured out what happened to Challenger using simple science that even most Americans could understand.

I’ve come full circle.  In July, I met a young physicist from Germany, a woman who is working on an X-Ray telescope that will allow us to learn a great deal about X-Ray radiation sources in the universe.  She represents where we are going–brilliant, part of a large team, well educated, well traveled and articulate.

In November, I met an 80 year-old retired physicist who worked on fiber optic cables and studied under Feynman.  He represents the past and helped me understand how we got to where we are today.   Twice now, I’ve gone to see something and discovered far more.  In July, I went to see an eclipse; in November the Sandhill Cranes.  But my memories of both will be of two different people I met on each trip, young and old, German and American, woman and man, same field, different eras.  Both had a great deal to teach me.  All I had to do was draw them out.  For some reason I really don’t know, I did and was better for it.

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