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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.


Glenn Frey

This past week marked the deaths of two important figures in popular music, Glenn Frey and David Bowie. Of the two, David Bowie is likely the more important musician. Bowie was a chameleon of popular music; no two hits of his were ever alike, many startlingly different from each other. An endless innovator with an inimitable voice, Bowie was always distinct, always strange. An artist's artist.

Glenn Frey, best known as one of the founders of the Eagles, was the opposite. The Eagles were always consummate pop. In their time they sold records by the metric ton; their music was in every jukebox, back in the day when that meant something. But the Eagles weren't simply a popular group, they were a popular group of quality, whose albums were anticipated, who never recorded a bad song or an album not worth buying. Their "Greatest Hits" album, a phenomenon in music history, is 29x platinum, and the second best-selling record in music history. The Eagles rewarded loyalty, because their music was always listenable, always buoyant, even when it was trying to be dark.

Between Frey and Bowie, I find myself thinking about Frey more. Bowie was an innovator, and one never knew what he was going to come up with next. With Frey, one knew. But not in a bad way. Bowie was steak tartare and Frey was cupcake dessert, but there is certainly no shame in being the best cupcake chef in town; cupcakes, done right, are a marvelous thing.

In their day, the Eagles were mainline pop music. Not at all edge seekers, but good songwriters and musicians just the same. I for one do not demand that rock music always be avant-garde. Compared to classical and jazz music, rock is comparatively simple and musically safe -- one can listen to a rock station for quite some time and never hear a 13th chord, or change of key within the song, let alone a chromatic scale (music that does not conform to standard musical keys). These are regular features of jazz and classical music, which means that even rock songs that are considered innovative and sophisticated are, compared to classical and jazz, technically basic.

So I don't put sophisticated rock music much above the popular variety. Indie rock is just the Eagles with more distortion.

But sometimes straightforward turns out to be something more. The Eagles's style of music was a blend of country and pop music, long before country went big time. Many Eagles tunes used slide guitar accompaniments, and "Take it Easy" even features a good ol' fashioned, finger-pickin' banjo. The classic Eagles sound is the dubbed guitar -- a guitar backup that stacks guitar on guitar on guitar, giving the music a jangly, almost infinite depth. Some songs, like "Hotel California" seem to have at least 4 overdubbed guitars, an illusion complicated by the use of a 12 stringed guitar, which by itself sounds like two. Thus the Eagles, while sticking to standard country and blues accompaniment, sound much deeper and more complicated than they really are.

What is interesting about the Eagles is that, while their musical technique is not complex, their sound is never imitated. Even former Eagles, such as Glenn Frey in his solo efforts, sound nothing like the Eagles. It is a truism that talent makes the difficult seem easy, but whatever it was about the Eagles' sound, no one afterward attempted the deep overdubbed country polyguitar sound that characterized the Eagles. Rock went in another direction -- loud, throbbing, arena anthems and overproduced dance music -- but abandoned the open, placid, groovy style of the Eagles.

Perhaps no one imitated the Eagles because no one wanted to sound like Eagles imitators, but that is the hallmark of a good musical idea -- something that sounds so much like you that no one can approach it again without coming off as a cheap knockoff.

In that sense, the Eagles were innovators. Innovators in plain pop music sight.

As a guitarist, I find myself in a paradox that many musicians are familiar with -- I like to play music I don't like to listen to. Country music is a prime example. I like the bright, bluesy style of country guitar, the use of the blues pentatonic scale in broad, smooth strokes. I love to play it, that slinky, smooth, sliding sound. But I don't like to listen to it. Most country music is too simple and syrupy for my taste. But it is easy and enjoyable to play.

This is one of appeals the Eagles have for me -- they made country music listenable. The Eagles are country with the bounce of pop music, a clever blend of Country-Western, the folk rock of the 1960s, and the more progressive, polished studio rock of the late 70s and early 80s. This country-LA blend is a style of music that I liked to play when I was younger, and liked to listen to as well. This sets the Eagles apart from any other country music band I know.

One of the first serious attempts I made to learn a song on the radio was "Hotel California." My guitar teacher transcribed the whole song out for me in tablature on a yellow legal tablet, including the great Joe Walsh-Don Felder guitar solo in the coda that I learned by heart, every note, every bend, vibrato, and snap off. That solo was the piece I played as a teenager when people asked to see how good I was.

After "Hotel California," I learned "Try and Love Again," a filler song on the "Hotel California" album with a Joe Walsh guitar solo that remains one of my favorites even to this day. I love its cool, laid back style, complete with a couple of phrase inversions that for me is the epitome of tuneful, unpretentious pop music. Glenn Frey sung the lead.

This is why I will miss Glenn Frey. The Eagles's recording days are long gone and would have been even if its band members were all still living. But Frey's presence in the music scene always reminded me that there was a time when popular music wasn't trying to invent the next cool thing, create an internet viral sensation, or start the next dance craze. A time when the only goal of music recording was to sound good. And the Eagles always sounded good.

Photo courtesy of Steve Alexander.


The Case for Punctuation and Good Grammar.

When a writer sits down to compose a sentence, he has an idea in his head that he wishes to see reconstructed in the mind of another. This is the ultimate purpose of writing: to move an idea from one brain to another. Think of writing as a low tech version of the transporter machine on Star Trek -- a process that deconstructs an idea in one brain and reconstructs it in another.

People living the same time, place, and culture often think so much alike about some things that only a few words are required to pass an idea from one head to another. For example, all I have to do is say the words "Santa Claus" to efficiently transport a complex image complete with beard, red and white coat, and bag of toys from my mind to yours.

Unfortunately, the ease with which ideas like "Santa Claus" or "baseball" or "the Beatles" allow us to transfer concepts also tempts us into laziness. Ideas like these are the exception and not the rule. If I tell you that Xa inhibitors are the wave of the future for improving hospital length-of-stay for atrial fibrillation admissions, you probably need to know more. No one is a mindreader, and most complicated ideas require effort to convey.

Precision is what we want here. The reader wants to know exactly what the writer is thinking. The reader may not agree with the idea or find it pleasant, but she still wants to know what the original idea was, with as much clarity as possible. This is the point of communication.

Since a writer can't directly transport an idea from his head to another like an transporter beam flashing between two starships, the only way to exchange ideas is to have a set of agreed-upon tools that both the reader and writer understand well. When the writer makes proper use of these tools, the reader, understanding their meaning and purpose, can accurately reconstruct the idea in her own mind. The new idea in the reader's mind will be a mirror of the writer's idea, rather than an interpretation, or worse, a best-stab guess.

This process only works if there are strict conventions. When the writer capitalizes a word, the reader knows why. When the writer uses a comma or a semicolon or a period, the reader understands the need for it. The number of tools does not have be vast. Only a few will do, but the few that are used must be precise. The more precise the tools, the more exact the communication. More tools, such as a larger vocabulary or more sophisticated grammatical conventions (like the subjunctive voice or complex sentence structure), can be helpful because they provide more bandwidth, but what really matters is that the ones that are used are understood by both the writer and the reader. If I am trying to buy 10 pounds of apples from you and my pound is an ounce less than your pound, we will never reach an agreement on quantity or price or anything else. We may end up in a fight.

This is why picky readers are right to ignore writing with poor grammar, punctuation, or spelling. The picky -- or should I say discerning -- reader knows that if the writer cannot use his tools with precision and knowledge, he probably is not capable of fully transmitting an idea. What the writer intends and the reader receives could be different. The intent of the writing is defeated.

If I open a bottle of milk and it smells sour, I do not drink it. The foul smell indicates the milk will not provide the benefit intended, nutrition.

So it is with writing. If a piece of writing is full of grammatical and punctuation errors, this indicates that the writer is not in command of his tools and is probably not capable of providing the benefit intended, the recreation of an idea in the mind of another.

If that is being arrogant or picky, go drink your own sour milk. As for me, I don't touch the stuff.

What about the great writers, some may object -- the Joyces, the Faulkners, the Porters, the Woolfs -- who break the rules? Are they bad writers? Why do they get to break rules that ordinary folks can't?

The answer is, they cannot break the rules any more than we can. What they can do is play off the rules, which is an entirely different thing. I know James Joyce can write perfectly correct English; I know this by looking at more conventional writing he has done, and I know this because if I read his writing closely enough I can see that there is a convincing logical system present. Joyce doesn't break rules, he plays off of them, challenging our perceptions by writing in a way that contrasts what we expect with what is on the paper.

When Emily Dickinson ends a stanza without a period, we know she could have used one, and that she knew one belonged there. The absence of the period is Dickinson's statement -- we know it is supposed to be there and she does, too. That shared knowledge becomes the precise tool of communication.

The problem comes with a writer who has not yet earned that kind of trust from the reader. Does the writer know a period belongs here? Does he know the difference between there, their, and they're? If the reader cannot be certain, precision is lost, and along with it communication.

This is the difference between bad writers who break rules and good writers who play off them. A good writer demonstrates through her writing that she can be trusted, that when she seems to ignore the rules, she is really playing off of them. A bad writer cannot do that because the reader can't trust this is going on.

How do you become a trusted writer who can play off the rules? By writing correctly and intelligently. Once you establish credibility with your readers, then you are allowed to make grammatical and punctuational mistakes


Christmas Eve

 What I most enjoy about Christmas is watching the overheated consumerist bullet train come to a halt. The signs begin Christmas Eve morning, when the crowds in the stores are not quite as intense as they have been. Inside, everything is picked over, most of the sales are past. The elusive empty parking space makes its appearance here and there. The merchants, having have already locked in most of their profits for the season, are contentedly winding down.

People get out of work early on Christmas Eve, and the roads at noon are jammed like rush hour. But by the time the normal rush hour comes, most people are home and the roads are open, almost lonely.

Even TV falls in step. Most of the Christmas specials have already aired, and except for the zombies that are news reporters most of the programming is reruns. I contentedly picture an empty broadcast room, with a lone computer queued up with hours of Yule Log videos and movies from the Spirit of Christmas past, although I know this image is a slight exaggeration.

One welcome change: the Christmas commercials taper off. (There are still Christmas themed commericals, but no more commercials for Christmas gifts.) By Christmas Eve the shopping season is over -- a Christmas ad on December 24 is like a political ad the afternoon of election day.

Somehow, a celestial finger touches the switch of our enormous buying-and-selling machine, and turns the sucker off.

Politicians follow suit. The presidential candidates go home for the holidays, taking their egotistical mania with them, and we need to pause over our Christmas dinners and give thanks to the families of the politicians for taking them off our hands for a few days.

Of course the machine never quite stops. My email box never ceases to fill up with offers, and there is always background noise. Somebody still has a buck left and somebody is chasing after it in the noisiest possible way. But Christmas Eve and Christmas day are as quiet as it ever gets.

Quiet, if not from the desire to stop, then at least from exhaustion. One respite can be just as welcome as the other.

If Christmas is about anything, it is about peace. Peace on earth. Many people these days brush aside the teachings of Jesus, but if Jesus' teachings were about anything they are about peace. Among his last teachings to his disciples was, "Peace be with you."

Peace is not just outer peace but inner as well. Inner peace, in fact, is far more important than outer peace. What does it mean? Its meaning is probably different for every person, but for me inner peace means acceptance of things as they are. Thankfulness for what I have, and no desire for more. Absence of greed. Absence of pride and arrogance. Desire only to love others and care for them.

This is a hard place to find. Almost impossible in a din. That is why it is so important that we have quiet days, days to rest, to be thankful, days to sip the stillness.

Silent night. Holy Night.

Image courtesy of Digidreamgrafx at FreeDigitalPhotos.net



Trump and the Ban On Muslim Immigration

It pains me to mar my pristine web page with the name Donald Trump, but I feel I have no choice. Trump has made any number of vile, bigoted comments over the last year, but proposing to ban all Muslims from entering the United States is not something I can leave unaddressed.

I have lived in the South for all of my life. I heard every shade of bigoted comment, from the very mild and deeply camouflaged to the naked and bald. Most are idle, empty protests that do nothing to affect the world at large, and thus are better off ignored. But not this. Not the sacrifice of the first amendment to a ridiculous claim of national security.

Thomas Jefferson, before he died, requested that the following words be inscribed on his tombstone:

Here was buried
Thomas Jefferson
Author of the Declaration of American Independence
of the Statute of Virginia for religious freedom
& Father of the University of Virginia

Each time I take the tour at Monticello (which I have done at least 15 times), the tour guide has pointed out that the words Jefferson chose to put on his own tombstone omit his service as the President of the United States. This is because Jefferson thought the establishment of religious freedom was a more important legacy than being the elected President.

Wouldn't it be nice if Donald Trump felt the same way.

In America, religious freedom is a big deal. The Pilgrims came here for religious freedom. The Declaration of Independence calls liberty "self-evident" and "inalienable." And not just for American citizens: the Declaration states that "all men are created equal." All means everyone, no matter what country you are from.

It is a conveniently overlooked fact that our Founders considered freedom and equality to be something all humans have a right to, not just those with the proper birth certificates. People in other countries have just as much of a right to freedom of worship as Americans do. The whole point of the American Revolution was that rights belong to citizens naturally. We are not given our rights by the government. They belong to us, whether the government acknowledges this truth or not.

We were the first nation in the history of the world to guarantee religious freedom. Once upon a time, we thought so much of it that we wrote it into the Constitution, the highest law of the land.

The irony is that the miserable people who support the Muslim ban are the same people who fret the about big government and government tyranny. Isn't restricting the travel of people based on religious beliefs the worst kind of government control?

In 1988, Ronald Reagan said: "The first amendment of the Constitution was not written to protect the people of this country from religious values; it was written to protect religious values from government tyranny." This gets it exactly right. When religious freedom is made secondary to public safety concerns, it puts religion in the service of the government. If the government can limit religious liberty to keep citizens safe, then it can limit religious freedom anytime the people feel threatened. And that is almost always.

This argument, that the universal freedom of religious belief should be subservient to national concerns, is appalling. What country dares call itself free if the people who cross its borders have to fear being asked about their religious convictions?

But there is something else.

There is a such thing as human decency. As ethics. Integrity. Core personal values. When I think of a core personal value, I think of something that does not need to be explained. Something that is so deeply embedded in my being that I cannot fully give voice to it, any more than I can say who I am and what I am like. Core values shouldn't be explained, they should just be. We shouldn't have to explain the logical reason why murder is wrong. Why rape is wrong. Why owning human beings is wrong. It should be obvious.

If it isn't obvious to you, the problem is with you, not with the values themselves.

In the same way, it should be obvious that no decent nation would use a religious test to decide who can and cannot cross the borders. We don't do that. Because decency dictates that we don't discriminate against people because of their religious beliefs. Anyone who wants to think of himself or herself as decent has to be on board with this.

There are practical arguments, of course. In practice, banning a religion from crossing our borders is not going to decrease terrorism. Doesn't anyone see that someone who wants to commit an act of terrorism would have no problem lying to customs officials? The only people effectively banned would be the ones willing to tell the truth. In other words, the honest Muslims. We have nothing to fear from honest Muslims.

How much stupider could an idea be, that we can keep dishonest people out of America by asking them to tell the truth? We are going to keep terrorists out with the honor system?

But as silly as the reason is, it isn't bad reasoning that is important here. There is something much more profound. There are some things decent people don't do, and this is one of them.

Is there a price to be paid for letting Muslims into America? Because this is what the bigots always say. They say if we are "soft" on this issue, we will be taken advantage of. We will be sorry.

To which I say: Sorrier than if we abandon our core beliefs? Sorrier than if we betray ourselves?

As Shakespeare said in Julius Caesar:

Cowards die many times before their deaths;
The valiant taste of death but once.
It seems to me most strange that men should fear;
Seeing that death, a necessary end,
Will come when it will come.

We can't prevent tragedies from happening. One way or another, there will always be evil in the world. If it isn't terrorism, it will be something else. Because there is always something else. The real question is this: Do we want to face evil with or without our core values?

You either understand this or you don't. If you don't, you stand against everything America ever stood for, all the way back to the beginning. Before the beginning, in fact: Jefferson wrote the Virginia Statute of Religious Freedom in 1777, ten years before the Constitution.

The one thing America should never do, not ever, ever, ever, ever, is protect bigotry by refusing to admit people who have religious beliefs that conservative extremists consider politically incorrect.


Quote of the Week

'Tis the season, and time for holiday stories.

A few light taps upon the pane made him turn to the window. It had begun to snow again. He watched sleepily the flakes, silver and dark, falling obliquely against the lamplight. The time had come for him to set out on his journey westward. Yes, the newspapers were right: snow was general all over Ireland. It was falling on every part of the dark central plain, on the treeless hills, falling softly upon the Bog of Allen and, farther westward, softly falling into the dark mutinous Shannon waves.... It lay thickly drifted on the crooked crosses and headstones, on the spears of the little gate, on the barren thorns. His soul swooned slowly as he heard the snow falling faintly through the universe and faintly falling, like the descent of their last end, upon all the living and the dead.

      -- James Joyce's "The Dead," 1914

"The Dead," a novella about a party preceding Feast of the Epiphany ("Little Christmas") around 1910, is the greatest holiday story I know. Its beauty lies in misdirection. Most of the story takes place around an annual holiday party in Dublin, Ireland. At first, the plot seems to be about social conflict among the partygoers, but it takes an astonishing turn when the main character, Gabriel Conroy, makes a discovery about his marriage. What is remarkable is the way Gabriel comes to terms with this discovery, overcoming his initial shock and anger, and instead finding understanding and compassion.

Read and be jolly.

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