Vegas and the three musketeers

Whoo hoo, Bellagio with my fellow Dukies, wow, I can’t believe its been 8 years . . . well, at least Darren’s still shorter than me :)

Hanover, NH to Tuba City, AZ

Some belated pics of our ridiculous 3000 mile drive out to Arizona from New Hampshire!

Cold Cold Cold West Virginia after a full night of driving through a blizzard in Pennsylvania, maybe it’ll get better after these mountains

After a good night’s sleep at Chateau le Roberts, off to Kentucky . . . Country ham anyone?

St. Louis, gateway to the west, yee ha, crossing the Mississippi

Largest cross in the Western Hemisphere, hmmm maybe this is where Karl Rove lives?

The Big Texan, home of the 72 oz steak in Amarillo TX, mmmm mmm here I come!

cow . . .

to steak . . .

yessirree, get ‘n ma belly . . . I’m gonna eatcha

Ma? I don’t think we’re in Kansas no mo . . .

Epilogue: Anyway, we got in at midnight on the third day after 3 days of driving . . . exhausting but definitely an adventure

More of Senor Clinton

Interestingly, according to the most recent Bill Clinton interview on CNN, he now says that he did NOT play the race card in South Carolina and that Iowa caused blacks to rally to Obama away from Hillary once people saw that he was electable and credible as a candidate.

He also made the point that the rules of the democratic election is to have a close race due to caucases etc compared to a republican race which he said if adopted the democratic rules would still have four candidates in the game.

One very interesting thing he said is that most democratic voters he talks to likes both candidates which actually goes against Hillary’s argument that she is more electable because she can win the traditionally blue states like New York, CA, etc. According to Bill, Hillary’s states would vote for Obama as the nominee anyway and his strength with independents and moderate republicans would ADD and not handicap his electability in the general election.

Anyway, it makes you wonder: What is this Clinton ‘charisma’ that allows him to convince, influence and suggest to you something that advantages his agenda even when you KNOW otherwise?

Tuba city ramblings and self career advice

Yá’át’ééh y’all! (hello in Navajo, you all in Texan)

Whhhheeeeeewwwwwww, Family medicine is just da bomb. 8-5 clinic, no call, fun patients, beautiful sunshine in Arizona, frybread, instant noodles and cable TV and maid service. Doesn’t get much better than this. Hey, and I actually have time to write on my blog which is always a good sign.

So what am I up to these days? Well, it looks like my summer is all set which is always good. I am going to be in SF May/June for internal medicine to finish out my 3rd year of med school. Then I take step 2 of the US Medical Licensing Exam (three steps total before becoming a physician) in June/July along with doing geriatric medicine. I also set up an away elective in Oakland for emergency medicine at Alameda Highland Hospital which is considered one of the best ER programs in the country which is exciting and daunting at the same time. Then its off to Tuck and possibly a return to the cold hearted business world.

So what’s the “differential diagnosis” for my career these days? A few thoughts that have come up
1) Emergency medicine + startup business – Finishing an ER residency in three years then working part time while starting up a business or helping Dan with one of his medical device ideas
Advantages: high cashflow, low risk, fun and exciting
Disadvantages: Something about just doing residency to work part time (even if it is for $250 bucks an hour) doesn’t seem quite right to me.

2) Organizational Psychoanalysis – I’ve always loved analyzing people and myself, this would allow me to do psychoanalysis and work with organizations, two of my favorite things
Advantages: Can travel, make lots of money, the time flies by when I am talking with or about people, can consult as a psychoanalyst to CEOs
Disadvantages: Long training process (4yrs psychiatry residency + 2 yrs of psychoanalysis) and need to build up credibility, very narrow also, would not feel like a physician w/o some physiology involved

3) Build an industry, help the poor and make money doing it – For profit health care interventions at the base of the pyramid (serving those making less than $1/d)
Advantages: I would be excited and motivated about my job every day
Disadvantages: Although the point of building an industry providing public health through private means requires that one generate profits, I feel like it would be easier to make money doing something where the primary motivation was profits. It would certainly be risky and I am afraid the risks do not balance the rewards.

In the spirit of self-analysis and advice, I have gotten several snippets of truths around selecting a career that I have found very useful.
1) Dr. Coursin has always urged his kids to listen to their “quieter voices” in choosing a career in paths that may not lead to money or fame but could lead to happiness and personal expression.

2) Skip, Mark’s uncle said to me that he thought I was “creative”. Indeed I think I have always had a propensity for creativity whether it is in terms of business models, creative writing or creative analysis of a person or situation. Perhaps my quieter voice is one which resists conforming to a specialized career track and must look at all possibilities to accomplish a task before choosing one.

3) My dad told me that it is best to “widen the road you walk on” in terms of choosing a career such that you explore new possibilities even as you go down a career path and to maximize one’s flexibility. I have always naturally resisted the social pressure to specialize and become an “expert” preferring instead to be a generalist, translator, bridge between disparate groups and knowledge areas. Why not continue to find a career that increases my flexibility rather than diminishes it?

4) Finally my bro told me the importance of cash generation + smart investing in wealth accumulation. In other words its not about maximizing your income so much as having some income and investing it in cash generating activities.

Career Pearls to Ponder

I’ve been thinking a lot about some career pearls I’ve gleaned over the last couple of weeks from a few of my preceptors. Dr. C told me as we were talking about the advice he gave to his son and daughter about finding their paths that he always wanted them to listen to “quieter voices” that might otherwise be drowned out by family or social pressures. Dr. H told a patient yesterday how much she loved OB and how to be a doctor today, you really have to love it because otherwise it is not worth the amount of work you do for the pay you get. And of course, my assumption and realization that I have always had a lot of interests, enjoy having lots of interests, being spontaneous and curious. So what job can give me all of that? Jeez, its definitely gonna be a challenge figuring out what I can AND what I can’t do . . . can’t wait to take it on!

PAU GASOL YEEEEAAA BABY!!!!

Lakers got Pau Gasol for basically nothing aka Kwame Brown and Javaris Crittenton, yyyyyeeeeeeeaaaaaaaaaa . . . the championship days are back!

Billary and the politics of hope

So its official: Barack won South Carolina today. What’s interesting is a point that was brought up by Ian Lustick at the talk he gave here at Dartmouth last year entitled “Are we trapped in the War on Terror” in which I asked him if it was possible given the era of campaign finances and the American industrial-military complex he describes in his book for a candidate to win a presidency without “selling out” to special interests. He replied that in his view, it would not be possible. But yet this is exactly the choice that the Obama campaign claims Americans must make in this presidential campaign: the choice for change vs the “divisive politics of old”.

The British newspaper the Independent makes a very interesting analysis that by ceding South Carolina (in fact, Hillary was seldom there in the last week and Bill even gave the concession speech tonight while Hillary campaigned in Tennessee), the Clintons are taking a page out of the Republican playbook which Bill described when I heard him speak last month here at Dartmouth as “making the other guy look so ugly that people will have to vote for you” and “dividing people”. In essence, the article describes the Clinton’s political calculus that despite the importance of subsegments of the Democratic party: blacks, hispanics, women, they know that the majority of Democrats are still white and that by catering to blacks and being rejected by them, they can actually galvanize the white democratic base as well as hispanics into shifting away from Barack even while blacks flock to him. Indeed, early polling by MSNBC in the states with lots of hispanic voters show Hillary favored 4 to 1 and looking at exit polling only 25% of whites supported obama compared to 36% for hillary and 40% for edwards. With Edwards likely fading out of the race, I’d be willing to bet that most of that 40% votes for Hillary with Edwards out of the mix.

In contrary to my article about picking Bill Clinton, I am thinking now that it was probably a good thing I didn’t cast my vote the next day . . . he sure is one persuasive (and calculating) fella!

Wanna be like Bill . . .

No matter how hard he tries, Barack will never be like Bill

I just came back from a rally for Hillary that Bill Clinton did in the Dartmouth gymn. I did not get in (not at first anyway). Apparently due to some building fire code snafu, myself and another half or so of the 200+ people standing in line for half an hour in the cold to hear Clinton speak were not let in. Not only did Bill Clinton’s staff continue to let people in as the original 100 left but also arranged for Bill to speak at a separate session at the Thayer dining hall for the people who did not get in at all. This is in contrast to both the rally I attended with Barack Obama (more flashy complete with Dartmouth acapella but short and without such concessions to include the motivated but unpunctual) and the talk on healthcare that I heard from Hillary Clinton herself when she came to DHMC (invite only without so much as a hello to those without an invitation who had to watch a closed circuit broadcast in a separate conference room). As I remember from watching him on TV and reading about him in the newspaper he was eloquent, friendly and brilliant.

Among the other things I learned are that economies with renewable energy are actually doing well Denmark along with 5 other countries that have met the Kyoto protocols. He argues that going green will not only help the planet but will be the most effective investment in jobs and industry creation that we could make as a nation. For example, we could reopen a mill in Berlin, NH making biofuels. Another interesting idea is that electric/hybrid cars may be the best intermediate green solution while we develop a hydrogen option. On international development, Bill Clinton pointed out that the world population is rising from today 6.5 billion to 9 billion in the next generation which will further the impending energy crisis and that educating the world’s poor girls especially will reap dividends in the decreasing birth rate, increasing rate of contraception, delaying the age at which young girls marry etc.

On healthcare, Bill pointed out that the most effective healthcare systems in terms of outcomes are actually places like Japan, a mixed payor system rather than Canada which is a single payor system. He believes that healthcare reform has the backing of a majority of major corporations, physicians, labor unions as well as the public and that it has a reasonable chance of being passed because of this aligning of the stars.

On politics, Bill showed off again his uncanny ability to simplify, summarize and frame the issue: the Karl Rove game plan is to divide and paint the other guy as so ugly that no one will vote for him and that for the Democrats to win, it will have to unite the people whereas for the Republicans to win all it has to do is to divide the people.

Also, that Barack’s platform of running as a candidate with 1 year of experience in the senate (which is a weakness spin-doctored into a strength which he calls “change”) and a candidate with “good judgement” having supposedly been against Iraq from the start but who said in 2004 that he “agrees with the Bush position on Iraq”

(I couldn’t find the exact quote but there is a good article from the Boston Globe analyzing his voting record on Iraq:
http://www.boston.com/news/nation/washington/articles/2007/03/20/obamas_record_shows_caution_nuance_on_iraq/
)

To the claim that Hillary is old news, Bill argues that Hillary is endorsed by the greatest number of both Republican and Democratic senators (10) and commands a great deal of respect in the Senate. He also used an effective anecdote that Magic Johnson said that the older he got, the less his vertical became and the slower he got but that he got better taking the pressure shots and that he believes the same is true in politics.

To the claim that the Clintons are a dynasty, Bill shared an anecdote that he actually tried to convince Hillary to leave him just after law school because he thought she was such a capable person and politician and didn’t want to hold her back to which she replied “I won’t ever run for political office, I’m interested in a bunch of other things”

And as always, he added a personal touch, something only he can do with that signature lowering and softening of his voice, somber glint of the eye conveying sincerity, genuineness and warmth. He told a story of a golf caddie he had who took him by the arm during a round of golf and told him that he was really not a caddie but the Captain of a NY regional fire department and that Hillary must win because of what she had done for all of the firefighters of NY. These brave men and women had breathed in the asbestos and benzenes produced by the demolished buildings and even as the federal government refused to pay for medical bills, even sending the EPA in to declare that this would not cause any health problems, Hillary as Senator proposed and passed legislation that ensured that these firefighters who subsequently developed health problems would have their hospital bills paid for. As he finished the story and described the tears streaming down his face, you could almost see his eyes glisten and hear his voice crack.

I think I’ve made up my mind . . . I’m voting for Bill Clinton for President

Xmas pictures!

Mom doing what she does best . . . mother

Mom’s famous lion’s head meatballs . . . mmmmm . . . I think I ate about 15 of em

Mom, Dad, bro and the new addition: Poki Hsu! :)

Mom and Poki: hey get back here and put on this hat

Sit still Poki!

“I said look at the camera dog!”

Cheers Mom and Dad!

Ulys and me trying to double team Poki into a good shot

Ulys and Kate, aren’t they cute?

The Hsu men

MERRY XMAS EVERY ONE!

Merry Xmas everyone!

In SF with my parents, my brother, his gfriend Kate and Poki (my bro’s mini schnauser). Hope everyone is well and have a safe and wonderful Xmas