Quick post-first-day-in-the-PICU update: it was a good day. Despite always feeling that someone was going to suddenly jump up, point their finger at me, and expose me as a total impostor, I picked up my six patients this morning (ugh, 6:45 AM!) and had a great time taking care of them for the whole day. Things work so smoothly in the PICU; it’s nice to see a place that’s pretty insulated from the politics and bickering that can take place most other places in the hospital. And I’m finding more and more that I like acute care… you really have a chance to feel like you’re making a difference, and you can actually see that difference a lot of the time.

Now, for the bigger step — I’m on call tomorrow night. Wish me luck…

Oh my god, if I had a car, I’d be all over this: two McDonalds on Long Island are testing allowing drive-through customers to pay for their meals with E-ZPass.

There’s just no other way to say it — Lance Armstrong is just frickin’ amazing. Going from testicular cancer — scratch that, metastatic testicular cancer — to three straight Tour de France wins is just completely, overwhelmingly, totally amazing.

Eeeek — and I was on an Amtrak train yesterday!

In spite of all the bad reviews, I saw America’s Sweethearts over the weekend and loved it. Billy Crystal is hilarious, Catherine Zeta Jones is vicious, Julia Roberts is understated, Stanley Tucci is nefarious, and the whole thing just worked for me.

I really have nothing more to add to this.

I start the pediatric ICU tomorrow, and I’d be lying to you if I said that I’m not pretty terrified. Combine the sickest of the sick kids with the clearest need for excellent acute management skills, and my head starts to hurt a little. Needless to say, I’m going to be shellshocked for a few days, so forgive me if I’m a bit terse here.


I spent a nice early weekend in D.C. (hence the lack of updates for a few days there); it let me indulge in my love of trains, spend some great time with SLC and her awesome friends, and I got to get out of the city before starting what could be my hardest rotation yet. The result of the trip was a realization that things don’t move nearly as fast as my impatient soul wants them to, though, and I’m now left with a lot to think about and a lot to explore within the caverns of my own brain. (Brief addendum: you rock. Yes, you.)

sts-104 night landing

The Shuttle’s back from its latest trip up to the space station; NASA has put a bunch of pretty cool videos up from the mission.

I mean, come on — how can I not giggle when, perusing the Yahoo news headline site, I see an article entitled “Survey: Cybersex Takes Less Time Than Expected”? Of course, there’s great quotage: “While men might be looking for stimulation, women often seem to be looking for education.” (To which I said, “It’s because men know what they’re doing.” To which SLC said, “No, it’s because men think they know what they’re doing!”)

If you want to understand why it is that I love my pediatrics work so damn much, you really only need to take a look at the following two pictures (click on them to get bigger versions):

twins sleeping   me and the twins

I really don’t know how to reconcile the news from a few days ago with this news — so rates of sex-related HIV infection among teenage girls are on the rise, but rates of childbirth among teenage girls are falling? The first sorta necessitates sex without protection, but the second points away from that altogether. (Or, teenage girls are availing themselves of the various post-coital contraception and abortion options more, or that teenage boys are less fertile.)

Bummer — I was all excited to start using, and to point to, Matt Webb’s Googlematic (an AOL Instant Messenger-to-Google interface), but then, it fell over and went boom. Hopefully, Matt will work out the issue (or Google will clarify that they don’t want him doing what he’s doing, or whatever); in the mean time, awesome idea, Matt.

No matter how you feel about Microsoft and their market behavior, you sorta have to admit that the very definition of lunacy is letting a U.S. Senator design software. I mean, these guys can barely design legislation worth a damn. Every bill that comes out of Congress has about fourteen quintillion amendments tacked on that have nothing to do with the original intent of the bill; if you think that Microsoft’s guilty of constantly adding features that don’t need to be there, you just wait until Chuckie Schumer starts designing Windows.

I hate the way the dhtml stuff above grab the tab key events instead of jumping down to this textarea. Maybe a “tabindex” setting could fix that?


Last week’s issue of Sports Illustrated has an insert section called SI Adventure, and in it, Austin Murphy has a great column about the lunacy and selfishness of people who engage in risky extreme and adventure sports. Most of his examples revolve around people who hike or climb way above their skill level and end up putting the lives of rescuers in danger who are sent in to rescue them; one such group that he missed is the Ohio church group who had to be rescued a second time after failing to complete an Alaskan hike.

I want pictures!

As a pediatrician, numbers like this depress the hell out of me: from 1994 to 1998, the rate of heterosexual sex-related HIV infection in teenage girls rose 117%; over the same period, IV drug-related HIV infection rose 90%. Somewhere, we — society as a whole — aren’t doing enough to prevent the spread of HIV.

When did LexisOne pop up on the net? Between the free case law (between 1996 and now) and the legal news and commentary, this is a killer resource to have on the web.

For a completely moronic view of last week’s protests in Genoa (and last year’s protests in Seattle), just flip to today’s Wall Street Journal editorial page. According to the unsigned piece, what happened in Genoa is Bill Clinton’s fault, and standing in stark contrast, Bush has shown much better control over such situations. What a total load of crap — something that the second-to-last paragraph implicitly acknowledges by saying that those who caused the only real problems at the protests are unconvincable “hooligans” who aren’t even there to protest globalization or world trade. (The reader responses to the piece are pretty funny, though.)

Thanks to Lawrence for passing on a link to an explanation of how to find and punish bad webcrawlers and robots. I particularly like the first one — set up a directory only referenced by the file that robots are supposed to use to know what not to index, and then when something shows up there, you’ve caught it.

Thanks to Anil, I found Mena’s latest post, Radio, Radio, an NPR-type audio entry about finding an old audio cassette of a toddler Mena’s babbling, and surprisingly, a young Mena father singing. It’s definitely worth the 3 minutes and 19 seconds it takes to listen to. (And as an aside, why have I never known about her site?)

It’s nice to know that Microsoft has a sense of humor about the abysmal failure that was Clippy.

I rarely look at the search terms that people use to click through to Q, but yesterday, one caught my eye: cursing like a pro. Funny, damn funny.

I really don’t know what I could possibly say about this. (A not-terribly-translated page about the artist is here, thanks to Google.)

As part of a hospital project, I spent some serious time yesterday writing a new Manila plug-in that wrangles the webserver logs here. (If there’s any interest, I’ll think about cleaning it up and making the plug-in available for public consumption.) After I was done (or provisionally done, since I have a feeling I’ll spend a lot of time over the coming weeks tweaking and tweaking), I went searching for good resources to identify search engine spiders and crawlers; my next project is to get a decent idea of who’s crawling this site, and who abides by the rules for what’s permissible to crawl.

footprint on the moon

At 4:17:40 PM Eastern time today, it was the 32nd anniversary of the first manned landing on the Moon. At 10:56:15 PM Eastern time tonight, it will be the 32nd anniversary of the first human step onto an extraterrestrial body. The fact that we, as a species, managed to fly to the moon, putter around a bit, and then come back to Earth still amazes me every time I think about it.

Why do I have a feeling that there are a ton of scandals, of more consequence than Whitewater ever had a chance of being, lurking in the Bush Administration? You have Cheney denying all access to records of the people and companies who lobbied and met with the Administration while the current energy policy was being shaped; likewise, you have Karl Rove meeting with companies about policy decisions when he owns stock in those very same companies. How much is lurking under the surface?

What a great, great photo. (I actually wonder how the photographer got the shot.)

About the only way I can stomach writing about the violent protests and the death at the G8 summit in Genoa is by simply linking to the MetaFilter thread on it, and letting people form their own conclusions.

Come on, is there anyone who would think that I’d pass up the opportunity to link to a news story entitled “Wild asses struggle for life in Iran”?

Scott Shuger, normally the author of the Today’s Papers feature in Slate, has a column in the online mag talking about the irresponsibility of having septuplets in today’s world. There are a lot of good points in the column — like, for example, that the one family of septuplets born in Washington, D.C. will cost over $2 million before they even leave the hospital. Wow.

If you haven’t heard about it elsewhere, then hear it here: if you run IIS 4.0 or 5.0 on Windows NT or Windows 2000, there’s a security patch you should probably install.


Today, I covered the neonatal ICU for a friend, making it my first inpatient day in the hospital in over a month and a half. Not surprisingly, my body had gotten used to outpatient and shift work; I now feel like I’ve been run through a wringer. But on the flip side, I got to spend all day taking care of the smallest of the small, and the sickest of the small, which is a pretty damn good day. And, making my day that much better, I was able to do all my own blood drawing today — a pretty great feat when we’re talking about veins the size of strands of hair, and test tubes that, at times, seem like they’d take the baby’s entire blood volume and then some.

I mean, I work in an inner-city hospital and clinic system, so I assumed that I’ve heard most of the myths that adolescents harbor when it comes to contraception and pregnancy. Apparently, though, I was wrong.

Despite the noise and annoying passengers, being a train conductor must have its moments:

Gil Murtagh’s train from Hoboken, N.J., stops at Paterson. One day recently, a pretty girl got off and ran into the arms of a young man holding flowers. From his seat, Mr. Murtagh smiled nostalgically at the lingering embrace, mood uplifted. As the train pulled out, the conductor smiled, too. “She was smooching with some guy in Hoboken also,” he said.

Let the northeastern summer begin.

Muchas felicitaciones to Matt and Kiehl-o-rama, both of whom are back in the world of the employed. And an immense, overwhelming, awe-inspiring thanks to Matt, who sent me one of the best birthday presents I could imagine getting.

I don’t know what it is, but Bryan Garner, a Texas lawyer, has managed to get himself noticed twice in the media over the past two weeks for his contributions to making legal writing more readable by the lay public. First, the New York Times pointed to the pressure he’s put on judges and lawyers to move legal citations to footnotes, rather than placing them inline in the text. Then, the Dallas Observer published a piece about his general contributions to more accessible legal prose. The funniest part of it all is the story recounted in the Observer piece about how one of the Texas Supreme Court justices offered to will Garner his entire law library if he’d just go to law school; he declined, but then later (after the books were gone), he reconsidered and ended up getting his law degree.


Crabbiness was the word of the day, but then, the most unexpected end to the chat — “can i call you?” — led to the most open and honest conversation that I could ever hope for. Yeah, sure, I’m exhausted, all my cards are lying face-up on the table (ack!), and the little molecules of panic may be starting to stir up their comrades in revolution, but damn if I don’t feel a lot better today.

All banged up, maybe; remember, though, I’m a doctor. smiley:

I loooove auto Winer. This is the greatest web page ever.



I spent a good part of today moving my mail server (being that sendmail on Windows 2000 doesn’t seem to be ready for prime time, at least not with other processor-intensive services running on the same machine); everything seems to be working well now. If anyone has any suggestions for good, integrated web-based admin tools for sendmail on Linux, I’d be happy to hear ‘em — maintaining sendmail via all the different text files is going to get old fast.

Maybe tonight, I’ll bring my tripod out to the Great Lawn and get some firework shots that are actually worth a damn.

From Victor Stone comes one of the funnier automatic-page-generators I’ve seen in a while: the Auto-Winer. Keep this bookmark around, to prevent symptoms of withdrawal in case Dave Winer goes without updating for a few days. (For those who don’t recognize the name, Victor was the author of Stone’s Way, one of the Microsoft Developer Network columns.)

The National Security Agency security papers on Windows 2000 that I talked about a month ago have moved — the old server couldn’t handle the load, so they’re now mirrored at Conxion.

Yes, ladies and gents, we have a new nominee for funniest MetaFilter thread of all time. (And seriously, aren’t the Chandra Levy police composites the most ridiculous pictures you’ve seen, ever?)

tomb of the lord of sipan, peru

After taking a leisurely trip through the Washington Post’s slideshow of the Pam-Am Highway, I realized that I may have found my next big vacation trip. What beautiful countries and cultures… I feel like I wasted my time in San Antonio, being so much closer to all this and yet never venturing southward.

As always, a “quick trip” to Barnes & Noble for a single book turned into an hour-long affair that ended with three different books (House of Sand and Fog, by Andre Dubus III, Motherless Brooklyn, by Jonathan Lethem, and Fierce Invalids Home From Hot Climates, by Tom Robbins). It really is impossible to get out of there without spending serious money. Fortunately, it wasn’t one of the stores with a music section, or else there would have been a couple other purchases, as well.

The New York Times has a pretty great article on the growing use of maternal-fetal surgery, and the recent shift towards performing the risky procedure not to correct potentially fatal intrauterine problems, but to improve the life of a baby with a non-life-threatening diagnosis. There are some good ethical questions embedded in this one.

Talk about usability problems: the most recent RISKS Digest has a pretty funny story about a bunch of motorized shopping carts going haywire during a power outage. It turns out that the interface for charging the chairs involves plugging them in but then turning them on and placing the handle in the “forward” position — and then, when the power goes out to the outlet they’re plugged into, they surge forward and have to be chased down.

The space dork in me has tracked down yet another cool picture of the Space Shuttle launch from Thursday, although I suspect that this one will disappear in a week, when the Washington Post turns its daily photo archives into a single weekly best-of disaster of a Flash presentation.

Happy Friday the 13th!

The Public Citizen’s Health Research Group has released a report that confirms that patient dumping — refusing to treat patients without insurance or with other “objectionable” conditions — is still very much a feature of emergency room management in America. Thankfully, my hospital isn’t represented in the list of confirmed violations of the law; then again, being an incredibly urban hospital, we’re the ones that usually are dumped upon rather than the other way around.

OK, I have no idea how I didn’t know that PBS was showing a new special on Air Force One earlier this week. It may just be me, but I think that TiVo needs to be a little more aware of my viewing desires…

Cool picture alert — it’s an extended-exposure image of the Space Shuttle’s launch yesterday, with the plume arching brightly into the distance.

Wow — a group of Caltech engineers successfully used a kite to stand a 6,900-pound obelisk upright, demonstrating the possibility that the Egyptians may have pulled off the building of the pyramids and monuments without quite as much manpower as has been believed to be needed.

Recent Mirror Project submissions by yours truly: with SLC, in the lobby, and with the boys.

Combining the concepts of Dubya’s irregular mentation and Cheney’s irregular heartbeat, Tom McNichols has a pretty funny satire up over at Salon.

In one of the sillier moves I’ve seen lately, Los Angeles is looking to impose a property tax the orbiting satellites of companies based in LA, classifying them as “movable personal property.” My question: how much will the city of LA spend on court cousts fighting to be able to impose this tax?

Hey, I think I know this guy! (CNNdotCOM, tomorrow, on CNNfn, 12:30 PM Eastern.)


“In the eyes of the residency program, you had an exceptionally good year, and we look forward to the next two years of your work with us.” My meeting with the chairman of my residency program went well, needless to say; I even got up the nerve to ask him about the entire selection process for the chief residents. All in all, a happy morning.

the nexus of the universe

There’s a new photo slideshow up: Just A Random Week.

While I’m a sucker for stories like Harrison Ford helping find a lost Boy Scout hiker, it disappoints me a little bit that if it were just a hired state trooper doing the flying and searching, he wouldn’t get any of the public noteriety for helping track down and return a 13 year-old kid to safety.

After chatting last night with a bunch of other people who maintain sites, I’m more intrigued with PHP — what it does, what it can do, and whether it is able to do everything that I can do here with my own Frontier server. So it seems fitting that, this morning, my brief pre-work surfing randomly brought me to monaural jerk; maybe I should take it as a sign, and download it to play a bit.

Go go Gadget Space Shuttle! This trip up features a new type of main engine on the shuttle, more than doubling its reliability; of course, the real goodness in this press release is the information that the engines perform at the unbelievable temperature extremes of negative 423 degrees Farenheit (the fuel) and 6,000 degrees Farenheit (the combustion). Cooooool.


I don’t know when the last time was that I felt this tired. It’s strange — I’m on an easy month in the hospital, but it seems that my body is refusing to recognize that. And then add on top of it a few weeks of into-the-night phone calls, laying out in the sun yesterday (albeit enjoying reading and watching kids play in the surf), and then a late last night, and I feel downright pooped today. I think it’s naptime!

How did I not know that Alan Dershowitz and Richard Posner have been having a verbal duel about the Supreme Court’s involvement in the 2000 election over on Slate?

I don’t know what it is, but I like when MetaFilter threads get totally hijacked; this morning, I spent a good five minutes laughing at this series of posts.

Now here’s some good news: six medical publishers are going to provide free access to all their journals to medical schools and researchers in the poor nations of the world. The companies (Elsevier, Wolters Kluwer, Blackwell, Harcourt General, Springer-Verlag, and John Wiley & Sons) are responsible for over 1,000 medical journals, and are offering the content as part of the World Health Organization’s push to spread primary research and evidence-based medicine to the Third World.

Anil is a rockstar for pointing out c.walker eggpants (“the ongoing story of an egg and his favorite pair of pants”). I wish I were half as creative as some of the people that I run across on the web.

I’m not quite sure where I inherited the bookmark from, but I had a pretty damn great time paging through forget magazine this past weekend. Good representative examples of what’s in store for you there: Fact and Opinion (all about accordions, including the statement that National Accordion Awareness Month is “kind of like Black History Month for white people”), and Ask a Stupid Question…, a piece ruminating on the changes in newspaper sports coverage since the advent of major television sports broadcasting. The whole thing’s worth a weekly visit.

I also like Joyce Millman’s take on the resurgence of Paul Reubens (once known to you and me as Pee-Wee Herman), if only for the line: “He was childlike in the sense that children can be naughty little devils with richly creative inner lives all their own, from which grown-ups are barred.”

2001 birthday weekend

There’s a new photo slideshow up — it’s all pictures taken over last weekend, when I bought myself a digital camera. (In addition, I spent some time redoing the scripts that generate the slideshows, mainly because I was sick of how they looked before.)

Salon continues to be the place to read about Memento — this time, with a whole bunch of viewer theories. In addition, there’s a link to the Esquire reprint of Memento Mori, the short story that inspired the movie.

I’m glad that even non-medical people have caught onto the fact that the medical care Dick Cheney would be pretty much impossible for any average citizen to get. HMO approval for a major invasive procedure that is acknowledged by his own doctors as not being a medical necessity? Unlikely, for you and me at least.

It’s so nice to see that I’m not the only person who is driven insane by the stupid phone menu tree systems that it’s impossible to avoid these days. If every individual who developed the systems was required to read this article, the world would be a much better place.


I swear, I think that there will be a time when I feel comfortable being in the position of waiting for someone else to make a decision. But right now, it still feels like there’s a hell of a lot that I can’t control, like there are a slew of variables that may or may not work out in my favor, like there are things that are a lot closer than I ever gave them credit for. Not so strangely, all of that just puts me on edge. And then I realize that it’s not like I haven’t made a decision, too — on the contrary, I’ve decided that it feels just fine right now to wait.

These are the photo pages that I’ve put together over time, documenting things that have happened in my life, or nothing at all.


Washington D.C., March 2002: Shannon and I went down to see friends and check out the cherry blossoms.

South by Southwest, 2002: the pictures from my trip to Austin in March 2002, to finally meet all the people that I’ve been reading (and virtually communicating with) over the years.

Ground Zero, 1/1/2002: a set of images from my trip down to the site of the World Trade Center attacks on New Year’s Day 2002.

Seattle 2001: a photo log of my vacation to visit my brother in Seattle in August and September of 2001. Includes my visit to the Experience Music Project, and a hike on the Hoh River Trail to see the Blue Glacier.

Just A Random Week: a week of walking around with my camera, taking pictures whenever it fit my fancy. Features a trip to the beach, dinner with a bunch of other people with sites, and even the corner of First and First.

2001 Birthday Weekend: Random pictures taken during the weekend of my birthday in 2001.

Super Bowl 2001: Our trip to Tampa, Florida, for the 2001 Super Bowl between the Baltimore Ravens and the New York Giants.

Morrill’s Party: Michelle’s party for our graduation from med school, replete with both protodoctors and ruggers.

Super Bowl 2000: Our week-long trip to transmit back images from the Super Bowl in Atlanta, Georgia.

New Year’s Eve 1999-2000: A night in New Orleans at Emeril’s, enjoying food, wine, and the transition into 2000.

[Macro error: Can’t evaluate the expression because the name “discussionGroup” hasn’t been defined.]

the original star spangled banner

Happy 225th, America.

Why is it that the only things worth having are those that you have to work your ass off to get? The lazy man in me doesn’t like that one bit. Of course, it doesn’t help that he and the self-protective man in me are fighting it out to see who can best author the “con” column of my evolving pro/con list. But last night’s newfound ability to say what you’re thinking — and say those little things that I need to hear every now and then — was a welcome (and sorely needed) addition to our conversations. And despite the fact that four weeks is a long time, if you don’t think that I went to bed feeling at least a little better (read: less pathetic), then I’m sorry for not being clearer — 4:30 AM can do that to a man’s ability to explain himself.

really, really greasy cheese with Mexican sausage

Thank you to all the birthday well-wishers, including those of you who were here to wish me well in person (and, specifically, those who treated me to margaritas and queso fundido con chorizo). Usually, birthdays after the big number 21 are pretty anticlimactic; this year, I had a great one, and I’m finding it pretty damn hard to wipe the satisfied smile off my face. Same time, next year?

(I just noticed that Mozilla, or at least Mozilla 0.91, doesn’t show you the images when you click on the above links; instead, it asks you which application you want to use to handle the image/jpeg that you are trying to download. I can’t, for the life of me, fathom why it’s doing this. Of course, I also just noticed that Mozilla 0.92 is out… maybe I should give that a run around the block.)

New toys rule.

For those who are still struggling with Andrea Yates’ killing of her five children, Sally Satel has a pretty good column on the current layman’s understanding of postpartum depression and psychosis.

With an implantation in Louisville, Kentucky yesterday, clinical trials officially started on the next completely-implantable artificial heart. The device, an AbioCor, has only two chambers (instead of the normal four-chambered human heart); importantly, it also has a special plastic coating that helps avoid both the destruction of blood cells and the formation of clots around the edges of the device. It’ll be interesting to see how these trials go.

Seen this weekend, on West 80th Street in New York City:

no baby carriages???

How did I manage to miss Dahlia Lithwick’s wrap-up of the D.C. Circuit Court’s Microsoft decision? As always, it’s terrific.