skiing, healthcare reform, & birthdays

It’s been over 6 months since my last blog post, so I’m about on schedule for another one. I went skiing last week at Whistler and had a great time. I’ll post some pictures on my website after I steal them from Alan’s facebook page. This was my first trip to Canada and it completely shattered my stereotypes. I was under the impression that Canada was completely covered in snow, whereas in reality it is only partially covered in snow. Furthermore, not everyone in Canada says “eh”. Some of them play hockey. The Mini made the trip up and back without any problems and I definitely want to go back and spend some time in Vancouver which looks like a really cool city. I also have two days left on my Edge card if anyone wants to join me on another weekend trip up there sometime before ski season ends.

Since I was gone last week I missed a session of an elective class I’ve been taking called “healthcare in underserved communities”. As a makeup assignment I wrote a paper on healthcare reform. It was written in a few hours before class this evening, so it’s kind of half-baked and not very developed, but if you want to read it click here. Overall the class was kind of interesting, but also kind of disappointing. The class was more focused on introducing you to the concept/existence of underserved communities than on discussing how to actually improve health in underserved communities. One thing I did really enjoy about the class though was the practical requirement to work an afternoon clinic at the Aloha Inn, a transitional housing program here in Seattle. I got to meet two patients, one a young person about my age who had recently learned that they were HIV+. I usually think about HIV/AIDS in the context of Africa, Bono, PEPFAR, etc. and have met older patients in the US who were HIV+, but this was the first young, recently infected person I have met. It is depressing to realize that despite all the public health messages and over ten years of access to antiretrovirals, HIV continues to spread in the richest country in the world. The other patient was an older person complaining of hearing loss. They had a “bad” right ear (bone conduction>air) and a worse left ear (recent tympanic membrane rupture). They also had some crackles in the left lung and clubbing from chronic smoking. Overall it was cool to see so many interesting physical exam findings in a patient since I hadn’t done an exam in about a year. On the other hand it’s not so cool for the patient. That’s a challenge that’s hard to figure out what to do with- balancing the fact that you find the pathophysiology interesting, but depressing that understanding the pathophysiology doesn’t always correlate with being able to offer a treatment to make things better.

This past weekend was close to perfect. I got to listen to some live music, hang out with my roommates, have breakfast with really cool people, be a wannabe hipster shopping the record store and trendy clothes stores in Ballard, enjoy the sunshine, picnic at Greenlake, go out to dinner downtown with old friends, watch a movie, sleep in, get a little lab work done, go to church, go to a birthday party, work on the kayak… I wish it was the weekend everyday! More on the birthday party- This was Darwin’s birthday party/fundraiser. This is a cool idea for a birthday party. You get to hang out with friends and support a cause you care about. In this case Darwin was selling his photography to benefit the Filipino Youth Project.It’s a pretty sweet deal- I got some cool art for my wall and got to help send a kid in the Philippines to school for a year. I think I might have to steal the idea and organize some kind of party/fundraiser for my birthday in June (except I don’t have any cool photography)!

Seattle, one month on

Ok, I haven't been keeping up the blog, so here's a post to try to get back into the habit. Here's a little bit about what's been going on lately: I moved to Seattle (pics from the trip and my new place here). The lab is up and running, doing experiments and getting ready to go to ASV next week. Trying to get into the Seattle spirit by growing a vegetable garden, recycling, reusing (RE Store, free stuff, chemicals), riding bike to work, getting involved in community (Quest church and running club), taking part in water sports- sailing and building a kayak (more to come on this subject). The weather is beautiful. There's daylight from 4:30am to 9:30pm (not looking forward to the converse of this in wintertime). Roomates are cool people- they write code for Adobe, build buildings, respond to emergencies, take care of sick people, teach English abroad, and other generally productive things like that.

Since this blog is supposed to be occasionally about science and medicine, check out this article on a new model for primary care. It seems like a good idea if it works out. It makes sense to me from a sustainability standpoint to cut the for-profit insurance middleman out of the picture for primary care. People will still need insurance for emergency and specialty care, but we could save a ton of money on specialty care if people had good acess to primary care so we could catch and manage disease processes in the early stages, spend more time on patient education and primary prevention. If you have a chance, read the Healthy Dallas task force report. Here is one amazing conclusion from the report concerning the potential impact of primary prevention:

"Fifty percent of health outcomes are a result of poor health conditions caused by habits and behaviors, such as poor nutrition, lack of physical activity, tobacco use and alcohol abuse. Specifically, it is estimated that these four behaviors drive over 40% of deaths in the United States."