Dr. Sour Puss

How on Earth did I miss this? 1972 recording by Italian pop star Adriano Celentano with the unwieldy title Prisencolinensinainciusol .

7/2/03-11/30/09 Shireesha and I both commented that we'd never lost anyone as close to us as her. Leela Lou. Little Lou. The littlest little. Little Scoop. Leela-pants. Little Fluff. She played the foil to Kali's straight man. She was the playful one, carrying her favorite ribbons up and down the stairs all day long. No twist tie or string was safe with her around, and no empty box left unsat in. Little tufts of fur could be found all over our house, left over from some sudden pounce on something, often on her sister Kali. There was just no end to the fur. I'd said before that you could construct a new Leela from what we would vacuum up on a weekly basis. Sometimes we'd catch her munching on giant ball of it after cleaning herself. I could be traveling in some far off place and pull out a sweatshirt and find it covered in traces of her hair. Now there are bits of her everywhere in places like India. She was the most interactive, personality-filled, friendliest little ki...

Last night, as many of my high school friends whom I hadn't seen in years gathered to celebrate Kevin's 40th birthday, I was stuck in the hospital, sitting at the foot of the bed of one of my favorite patients. I was on call, attending for the residency, and trying to figure out how to deliver this patient's baby who'd arrested at 8 centimeters dilation. Her temperature was rising and the fetal heart rate was showing signs of distress. For 40 weeks, this patient had greeted me with a huge smile at each prenatal visit. She was so excited to be pregnant again, having miscarried her last pregnancy at 13 weeks the year before. She had no insurance, and most of her family was in Mexico, so for her the care and support she received from the clinic each week was literally a lifeline. Each visit, I'd work so hard to reassure her that things looked normal, diffusing her anxiety with humor. I knew she and her husband had wanted a boy and so early on, long before her ultrasou...

Matt Haughey , founder of Metafilter and user #1, is in the hospital and twitter is probably going to crash with the flood of well wishing. -->: #mathowielove Guy tweeted his own seizure. That's hardcore geekery. Get well soon, Matt. Metafilter is the only website that matters.

I love Wonkette's headline this morning: "House Votes to Kill Your Grandmother & All Christians, 220-215." The House bill, which has to go through further watering down in the Senate and is a *long* way from becoming law , is a step in the right direction. Problem is, I think we are *far* past the point where "steps in the right direction" are going to take us where we want to be: quality, accessible, evidence based health care. I honestly think that, with the exception of health care providers and people with serious medical problems, very few Americans understand how far we are from that goal and how entrenched the institutions are that are trying to keep us from this goal. I am all for market based approaches that improve quality and drive down costs. The problem is that quality and cost aren't where insurance companies are competing. They compete with strong arm negotiations with hospitals, denials of coverage, and lobbying money. This bill, while s...

There are a number of successful health-care systems, at least as measured by pretty good care much cheaper than here, and they are quite different from each other. There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence. Paul Krugman, New York Times Op-Ed, July 25, 2009

Last year I wrote about what an amazing time I had riding the Cascade Bicycle Club's Seattle to Portland Ride and how I just knew I'd be doing it every year for the rest of my life. This year, things went a little differently. It started well enough. Clear skies, 80 degrees. Greg finally got a new bike. Things seemed all set. It's no surprise I'm not as fit as I was this time last year, but I had a few long training rides and I was ready. Filmore left early to ride with the Major Taylor Project but got a flat almost immediately after the race began. After replacing his inner tube, as he went to pump it up, his tire stem snapped off in his pump and he had to wait 30 minutes for someone to stop and help him out. I lost Greg and Matt in a pack of cyclists somewhere around Auburn. About 10 miles later when I still hadn't caught up to them, I thought to myself: "Those assholes, they can find their own damn ride home." I met up with Fil in at the lunch stop in ...

Holy shit. Just wow. *Borrowed without permission just to underscore Tom Tomorrow's point.

Bouefcake has 9 or 10 proper original songs by now. It's pretty hard to share songs that you've lovingly crafted with a skeptical public. Songs can be very personal and it's easy to be self critical about even the smallest recording mistakes. Usually we'll work out various parts for weeks, trying out different ideas and someone will spend days coming up with lyrics. That's not the case with these two songs. These ones basically came out as is, with Kevin improvising the lyrics. In fact, with The In Security Song, we literally made it up about twenty minutes before this recording was made; what you're hearing is exactly the third time we played it through. Somehow, it is so much easier letting go of things that you didn't try hard to create. Sewerage The In Security Song

Ok, my new favorite hobby: bouncing Ravi to sleep watching VH-1 Classic late at night with the Wikipedia open, reading about where these bands are now. For instance, did you know that the bassist for the Red Rockers is Paul Westerberg's manager? Or that one of the guys from Musical Youth died at age 24 of a congenital heart condition? Or that The Stranglers are still touring, and that their drummer is now seventy years old ?

"Your infected cyst is ready in room 1. It looks bad, are you gonna drain it?" It was bad, probably six inches across. These things can get pretty nasty. Imagine the ugliest pimple you've ever seen and then think of the pint of foul smelling cottage cheese mixed with pus inside. Why do these always get scheduled right before lunch? "Yeah, we need to drain it. This is a good procedure for the nurse practitioner to learn how to do, can you call her in?" So with the cyst all prepped and numbed, I was explaining to K, my nurse practitioner, how you have to push down hard right after you make your incision, when the pressure is the greatest, in order to extrude the thing all at once and...BLAMMO! Cheesy, rotting pus all over the walls, the table, and the ceiling. Miraculously, K and I were unscathed. When it was all done, we came out of the room to talk to the medical assistant. "Um, we're not going to want to use that room for the rest of the day."

I mentioned in a previous post that breast feeding is extremely difficult. Well, after watching my baby-mama torture herself over the past two weeks, I can no longer stand idly by: That's right, male breastfeeding. Not only is it possible, but it's healthy, and it's my paternal right. Discover magazine did a fairly serious take on this in 1995: There are numerous conditions under which injected or topically applied hormones have produced inappropriate breast development and milk secretion in humans, both in men and in nonpregnant or non-nursing women. In one study, male and female cancer patients who were being treated with estrogen proceeded to secrete milk when injected with prolactin . Lactation has likewise been observed in people taking tranquilizers that influence the hypothalamus (which controls the pituitary gland, the source of prolactin ), in people recovering from surgery that somehow stimulated the nerves related to the suckling reflex, and in women on prolong...

I promise not to turn this into yet another daddy-blog, but it's true that I have done very little in the last week outside of child care. Some observations: The level of exhaustion is nowhere near residency training. Newborn care is incessant, there is no time where you are free from responsibility, but I haven't had to do much thinking and there have been regular nap periods. I have lost my ability to do simple math problems such as figuring out the tip on take-out food. It's amazing how much laundry one tiny little six pound human being can generate. Breast feeding is difficult. Extremely difficult. The ergonomic design of baby gear is incredible. I'm consistently impressed at the attention to tiny details that make your life easier. The way the car seat clicks in and out of the base. The handles on the laundry hamper are exactly where you want them. The way the baby bjorn holds Ravi exactly where he wants to be, without any back strain whatsoever. The lithium batter...

As the dawn broke over a clear sunny spring day in Seattle, Ravi John Sourpuss was delivered on April 20, 2009 at 5:13 AM to his previously ambivalent parents who now understand the true meaning of love. Namesake Meaning

I am so friggin happy right now. I am totally, completely, blissfully in love. More later...

We are at Baby-Con 5...this is not a drill. Shireesha is resting comfortably, contemplating the wonder of epidural anesthesia.

Well, I'm at home still waiting for the Babu, but it gives me a moment to write about my latest musical obsession. With Konono No.1's Congotronics in 2004 and Jupiter's Dance in 2006 it seems like the most interesting music I've heard in recent years is being made in Kinshasa, Democratic Republic of Congo. But far and away the most astonishing of the bunch is made by a group of polio-stricken paraplegics and abandoned street kids living on the grounds of the Kinshasa zoo who call themselves Staff Benda Bilili. This clip comes from Jupiter's Dance: In 2006, the United Nations Development Programme helped them produce a song called "Let's Go and Vote" which became wildly popular in the run up to the Congolese elections and was reportedly responsible for a 70% increase in voter turnout. The track became one of the most recognizably popular songs in the history of central Africa. For all this, the musicians were paid about $50 each. Well they finally hav...

The other day I had my first dream about the baby, due any day now. I never dream, or at least remember my dreams, but this one was so vivid, the kind of polysensory experience where you hear, touch, and smell what's happening and when you wake up and you aren't sure it wasn't real. In the dream, I was holding little Babu in my hands just after he'd been born. He was crying and squirming, still glistening with amniotic fluid, his rubbery white umbilical cord still hanging from his tummy with a steel surgical clamp attached to the end. I found myself completely overcome with emotion, sobbing uncontrollably. Looking down, I saw in this one brief moment the limitless potential, a clean empty canvas upon which I would paint the world. Pretty powerful stuff for someone whose attitude thus far in the pregnancy would best be described as "mixed ambivalence tempered by hesitant anxiety." Appearing elsewhere in the dream was a more sinister figure, a patient I had seen...

I just came across this video I took a couple years ago and I think it's pretty funny. This was taken at Xian's birthday party. He survived a bad scooter crash earlier that year and had just been discharged home so we threw him a surprise medical-themed party. Brian showed up as Dr Pepper and danced his booty off.

Isn't this like the cutest photo in the world? I love you so much, Shireesha.

I never understand why people want to share their baby's ultrasound pictures with the world, but isn't this one creepy? Our little Babu is 34 weeks now. He reminds me of Jack Skellington.

Kali gets on the internet. Leela flames out on Metafilter. Kali updates her Facebook page.

Shiree and I just attended our 37th (!) opera, The Seattle Opera's production of Bluebeard's Castle, a wholly engrossing twisted and dark psychological production. Every aspect of the performance, the music, the story, the set, the singing, and acting contributed to one of the most memorable evenings of opera I've had and was a perfect example of why we keep going back. Seattle, for being a pretty small city, is lucky to have such a world class opera. The music, written by Bela Bartok 90 years ago is surprisingly modern with its loud-quiet-loud repeating pattern and quietly looping background melodies which perfectly suit the narrative, a series of dark revelations about a woman's new groom, a mysterious man with whom she fell in love and eloped before knowing him perhaps as well as she should have. The story begins with a narrator appearing in front of the stage who tells us that the story exists as much in our minds as it does on the stage, setting us up for the power...

Well, it's been about a month in the new job and I'm still finding my feet a bit. New hospital, new patients, new computer system, new staff. It's about as disorienting as moving to a foreign country where you don't speak the language. You know what you've got to get done, you just have no idea how to do it. But people have been very helpful, and it's coming along faster than I thought. Today was my first day rounding at the hospital with the residents, which introduces a whole other dimension of complexity to the job, but it was fine. So far, it's really lived up to my hopes and the contrast with the "normal," insurance-funded system of health care has been stark. I have no idea why I stayed away from community health for so long. Every day when I make the seven block walk home, it gives me pause to reflect upon all the things I'm loving about this job. 1. The patients. It's a community health center; its mission is to see people who o...

Yes, I just threw away an Ipod. What an age we live in.