Saturday, April 21, 2007

An American duality

Let’s say you want to invent a killing machine. You have anything and everything at your disposal: toxins, germs, drugs, explosives, radiation, lasers, sharps, gears, and gadgets. If brought forth and marketed in the U.S., you can expect your invention to be highly scrutinized, its use heavily controlled and limited to a military or police setting. Unless, of course, it involves firing a projectile through a cylinder (one projectile per pull of the finger), in which case instead it will receive near immunity from regulation and instant approval for distribution to American homes.

Now let’s say you want to invent a new medicine, one that will cure a human disease. On average, you can expect laboratory and animal studies to take 3.5 years, your phase 1 clinical trial to establish basic safety one year, your phase 2 clinical trial to establish dosing and efficacy 2 years, your phase 3 clinical trial for further assessment of safety and efficacy 3 years, and your FDA review another 2.5 years. You will be lucky if your medicine can be sold on the market in less than 12 years.

It's the difference, I suppose, between protecting life and destroying it.

Saturday, April 14, 2007

Silent Night

Finally, a moment to lie down.
The tasks of the night are complete
and the ward is still and quiet.
If their illnesses will allow,
the patients too now may sleep
and take a short respite from the
symptoms that ail them.

A rare luxury it is
to remove the white coat
and sleep with one’s patients,
letting the lines of distinction blur
between carer of and cared for.
A sweet slumber it will be,
restorative to body and mind.

Sweet, yet cautious.
The shepherd too knows sleep like this,
one eye shut in rest
and the other partially open,
scanning the field for shadows
that may flick and flitter across it
and threaten his flock.

Interruptions are begrudged,
but most feared is the completely silent night,
which suggests that the sleep was too deep
and that luxury may have turned into negligence.
The sleep of call is usually devoid of dreams,
but a recurrent nightmare does exist:
that upon awakening the flock will be one fewer,
a cloud of oblivion having obscured
the helpless calls of a patient who lay dying.

Tuesday, April 10, 2007


This blog has and always will be foremost about the writing, but even I had to admit, it was time for a makeover. Although “dots dark” served me well as a template throughout my blogging infancy, wearing it was starting to feel like going to the prom in a display dress from Neiman Marcus: not only do you see plenty of others wearing your dress, but everybody knows where you got yours. The intrigue in that I'm afraid was limited. Every time I would come across one of my evil doppelgangers of the internet, that same feeling of anxiety would strike me as upon encountering a namesake in real life. Was this other blogger representing the template well? Were readers associating their feelings about the other “dots dark” blogs out there with mine?

These were troubling questions, and most troubling of all was that I didn’t feel as if I had my own unique identity. So, I went to the knife – purely cosmetic surgery, mind you, but transforming and utterly satisfying nevertheless. After two days of tinkering and experimentation, Foggy Bottom Lantern has been reborn. What do you think? Don’t grow too attached to the new format, though, because the tinkering is likely to continue for the next few days and weeks – we all know how addictive plastic surgery can be.

Tuesday, April 03, 2007

Of sirs and noodles

[Two residents meet in a busy afternoon clinic.]
Resident 1: Hey Noodle, how are you?
Resident 2: Sir, very good, Sir. How, are you, Sir?
Resident 1: Great, Noodle, just great, it's good to see you Noodle.
Resident 2: Hey, I had something I wanted to show you. [Pulls ekg out of pocket.] What do you think of this, Sir?
Resident 1: Interesting, Noodle, interesting. Look at the morphology of that QRS. [Points to squiggle on ekg.] That's pretty! What do you think, Noodle, are those fusion complexes?
Resident 2: Sir, that's what I thought at first, but when I calculated the derivative of the curve I was able to map the impulse to a specific location on the anterior right ventricle. Those are PVC's from an ectopic ventricular focus firing at a rate of 13 beats per minute.
Resident 1: Well done, Noodle, you're a genius!
Resident 2: Not at all, Sir, not at all.
Resident 1: So how's your wife, Noodle?
Resident 2: Very good, Sir, in fact, she's better than ever. And your wife, Sir?
Resident 1: Oh, she's doing just great. You know, Noodle, we should all get together again some time soon.
Resident 2: Sir, it would be my pleasure.
Resident 1: Noodle, the pleasure would be all mine. I'll give you a call.
Resident 2: Very well, Sir. See you later.
Resident 1: See you later, Noodle.
[Residents depart.]

To my regular readers: I apologize for this piece of esoterica. I simply could not resist.