Now Reading

Shelby Foote, The Civil War

Herman Melville, Moby-Dick, or the Whale

Michael Punke, The Revenant

Bill Bryson, Notes from a Small Island



The contents of this website are for contemplative purposes only. No medical advice will be given, and emails asking for medical advice will be ignored.

Although patient vignettes are based on my experiences with real individuals, I liberally change details to maintain patient confidentiality.

I also reserve the right to change old postings to correct errors, and to delete comments that include obscene language or that I deem abusive to me or other commentators.  If you are looking for a open mind, I suggest you consult a neurosurgeon.

Katrina Blog Project

...And a Comment about DACA

Yes, it is true that Dreamers are here "illegally," and that we are a nation of laws. And yes, it is true that a nation that cannot defend its laws is a nation without order. And yes, we need order.

But laws are man-made. People are gifts from God. When you ask me where our hearts should be, and where our laws should be, I say they should be in the service of gifts from God.

A country without people in it will never have a lawbreaker. People are an inconvenience for law -- people have needs, they are complicated, they demand exceptions to the rules, mercy, leniency. The simple answer is to get rid of the people, and then there will be no problems.

But what is a country without people worth?


The President and “His” Stock Market

Fewer and fewer people defend the President these days, but when they do, their main defense of his antics is that is that, cad as he may be, the stock market went up 25% last year. This notion of crediting the president for what the economy does always struck me as odd. While there is no doubt that a badly run nation can lead to a poor economy, it does not follow that a president exerts any control over the day-to-day movements of the economy at large, let alone the Dow Jones Industrial Average.

My own view, for what it is worth, is that presidential actions take years to impact the economy in a meaningful way. Businesses base hiring plans and expansion on revenue over the long run; only a complete idiot would say, “Hey, Congress cut taxes, let’s open 200 new stores and build a billion dollar manufacturing plant in Ohio.” It takes months, if not years, of proven growth before most businesses will make the decision to invest more money in expansion. That means most companies needed several years of growth under Obama before they would consider hiring new people under Trump. Businesspeople are conservative for a reason — they don’t like losing money on random movements in the economic numbers. They sit, they wait. They don’t gamble on who sits in the White House. It’s common sense.

But I also wonder, why do people think credit for economic growth goes to the president and not to the people who run the companies? I just bought an Instant Pot, a product that has been selling like hotcakes lately. I am pretty sure the company that makes Instant Pots deserves a lot more credit for building their business than any of the elected squatters in Washington, DC. If I were a businessman, I would be insulted that a politician would think to take credit for my business success. It would be no different than if the CEO of my hospital pranced into the room of one of my patients and tried to take credit for my good medicine. But I guess that’s just me. Seems that at least some business people these days are happy to let a politician who has been on the job for a year claim the credit for something they worked hard to accomplish.

Imagine that you have a bad knee and go to see an orthopedist. The orthopedist tells you that you are a fat lazy slob and you need to lose weight to make the knee pain go away. So you go home, get on a diet, lose 50 pounds and start running 10K races. Then you tell all your friends your orthopedist is the best doctor in the world.

You can do that if you want, but you’re a fool if you do. All the doctor did is insult you. You did everything else. Stop letting politicians take credit for the economy; they don’t do anything but stand on the sidelines. You are the one playing the game.


On Immigration Reform (More to Come)

I find it hilarious that the Trumpites, who hold Harvard University in the lowest esteem, want to run our immigration system the same way Harvard runs its admissions department.


2017: My Year in Books

Any year you can read a lot of books is a good one. In 2017 I read a little of everything, good and bad, old and new, fiction and nonfiction. Even the bad ones were good, although some were better than others. 
Here is the basic list, roughly in the order that I read them.
  1. The Turn of the Screw, Henry James
  2. Debt: the First 5000 Years , David Graeber
  3. Hillbilly Elegy, J. W. Vance
  4. Foundation, Issac Asimov
  5. Moonbeam,  Michael Chabon
  6. The Merchant from Venice, William Shakespeare
  7. Will of the World, Stephen Greenblatt
  8. The Introvert Advantage,  Marti Olsen Laney 
  9. Colorless Tsukuru Tazaki and His Years of Pilgrimage, Harkins Marukami
  10. Hit Makers: The Science Of Popularity in an Age of Distraction, Derek Thompson
  11. The Science of Mindfulness:  A Research-Based Path to Well-Being, Ronald Siegel
  12. One Flew Over the Cuckoo’s Nest, Ken Kesey
  13. On Tyranny, Timothy Snyder
  14. Nine Stories,J.D. Salinger
  15. Thank You For Being Late, Thomas Friedman
  16. The Handmaid’s Tale, Margaret Atwood
  17. Middlesex, Jeffrey Eugenides 
  18. Immunity, Eula Biss
  19. Oedipus Rex, Sophocles
  20. An American Sickness, Elizabeth Rosenthal
  21. The Death of Expertise, Tom Nichols
  22. Mariette in Ecstasy, Ron Hansen
  23. How to Read and Understand Shakespeare, Marc Conner
  24. So You’ve Been Publicly Shamed,  Jon Ronson
  25. Oedipus at Colonus, Sophocles
  26. Richard II, William Shakespeare
  27. Strangers in Their Own Land, Arlie, Russel Hochschild
  28. The Aeneid,  Publius Virgilus Maro
  29. A Visit From the Goon Squad, Jennifer Egan
  30. Stein on Writing,  Sol Stein
  31. A Moveable Feast, Ernest Hemingway
  32. Private Empire: Exxon/Mobile and American Power, Steve Coll
  33. Salvage the Bones, Jesmyn Ward
  34. State of Affairs, Esther Perelli
  35. Loving, Henry Green
  36. A Colony in a Nation, Chris Hayes
  37. When in French: Love in a Second Language, Lauren Collins
  38. The Making of Donald Trump, David Kay Johnston


Among the nominees for the best books of the year were Richard II, The Aeneid, Loving, Immunity, and Moonbeam. There are no winners here. To be nominated is to be honored.

I especially want to recommend Mariette in Ecstasy, the story of a Catholic postulate whose divine visions upend the quiet life in a turn-of-the-twentieth-century convent in upstate New York. Roughly based on the life of St. Therese of Lisieux, it is in many ways more a long poem than a novel, and is very beautifully written.


Also Loving, a fine book by an almost completely forgotten British writer named Henry Green. Green might be the finest writer of dialogue I have ever found. His ability to produce a conversation between two people that appears to be about one thing but is actually about something else unsaid is nothing short of amazing.


There were a few disappointments. Hillbilly Elegy, a bestseller, was supposed to be an insider’s account of Trump’s America, but was nothing of the sort. I found it banal and it contained nothing I didn’t know already. Its answer to poverty in America? Let the Army make you a real man, then go to Yale Law School and work the alumni network. Wow. Never would have thought of that myself.


Surprisingly, I was also disappointed by A Moveable Feast. Although one of the best book titles of all time, this book was very uneven. At times it was a very interesting view into Ernest Hemingway’s inner life. Other times it was arrogant drivel. I wished for more.

A final special word goes to the standout Colorless Tsukuru Tazaki and His Years of Pilgrimage. Although this book had a rather bleak ending, it was the first Japanese contemporary fiction work I think I have read, and was well-told. It is a fascinating look into the Japanese life, doing what fiction does best — taking me to a distant place, into the mind of someone in a very different culture, living an existence that I never would have dreamed up myself. Hard to do better than that.

I am looking forward to 2018. May it bring many reading pleasures to you.



Quote on the Year’s Penultimate Day

I do not feel any pity for Gollum. He deserves death.

Deserves death! I daresay he does. Many that live deserve death. And some die that deserve life. Can you give that to them? Then be not too eager to deal out death in the name of justice, fearing for your own safety. Even the wise cannot see all ends.

J.R.R Tolkien, The Two Towers