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22nd-Apr-2017 03:08 pm - [sticky post] Cross posting (starting and stopping)
Sword & Microscope 1
Haven't directly posted there for over a year; just cross-posting from here. About the only people reading it there are from Russia. Have nothing against Russian people, but if there are journal are in written in Russian (or at least Cyrillic alphabet), and not leaving any comments in any language, doubt have much in common, or reason to cross post. Eventually the account will auto-delete

NOTE TO SELF: Started cross-posting April 22, 2017. Ending cross-posting July 17, 2017.
<span style="font-size: 0.9em">Crossposted from %%https://warriorsavant.dreamwidth.org
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Henceforth, I can be found at warriorsavant.dreamwidth.org (Yeah, keeping the 'warriorsavant' moniker. Partly because that's me, even if haven't been a warrior lately (and questionably if a savant), and partly because too busy to think of another clever name.) For the meanwhile, will crosspost to LJ, but comments only on DW.

Why am I moving? Mostly (as we say in the vernacular) Imma follow my peeps.

Why is everyone moving? If I understand correctly, LJ is owned by a Russian company, and has been for a number of years. Last December they finally moved the last of the servers to Russia, which means they are now obligated to follow Russian censorship laws. Russia is cracking down on political blogs, but also have pretty restrictive laws on LGBTQ content, etc. Technically anyone using LJ is bound by those Russian laws. For the new TOS (terms of service), the English translation is not legally binding but the Russian one is, which means non-Russian speakers (eg me and most people I know) accepted a TOS that we cannot read, which was the last straw for many. Let me point out that it is not unreasonable for a Russian site to say that the Russian-language TOS (which is a contract) is the legally binding one. I'm in Quebec, where the French language version of a law is what is legally binding. That is, if I thought I was following the law because I read a bad English translation (even if it was the official governement translation), and the original French language version was different, well, that's my problem. Same for any country. The "World" Wide Web isn't. A site hosted in a country, even a repressive one, has to follow the laws of that country.

Would that really effect LGBTQ posting on LJ? Probably not. However people are moving because everyone on various websites are up in arms about LJ is now a tool of the evil, anti-LGBTQ Russian gov’t or something. No, I don’t support that, but (a) this is not verified, (b) I have larger reasons to detest the Russian govt (conquering part of Ukraine; fomenting armed rebellion in other parts of Ukraine; supporting Assad and Kim, the two current world chaps for massacring their own people, one of who is using chemical warfare on them), (c) if I got righteously and wrathfully indignant over everything that every website insists I should be righteously and wrathfully indignant over, I’d have to clone myself 100 times and still not have enough hours in the day. So why am I considering moving? Partly because might be true (and all the other reasons to detest the Czarist Govt), plus everyone I know on LJ seems to be moving, so I don’t want to lose my vast, dedicated cadre of followers (either of you).

See you on Dreamwidth.


Crossposted from %%https://warriorsavant.dreamwidth.org
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14th-Jul-2018 11:09 am - The Good: vacation and circuses
Sword &amp; Microscope 1
I'm on vacation. Had a jam-packed off Friday. I was expecting that, as there are always people I want to see before I shut down for 2 weeks, so the week before, and especially the day before, I shut down, are always packed with last minute issues. I'm not going anywhere, it's more of what we in these parts call as "staycation," a.k.a. "going to Kitchen Inn," or in French, "balconville."

Started off the vacation with a great show. Montreal is big on festivals. Trying to prove we're a first-ranked megacity. We ain't, but we have fun. All summer there are different festivals: jazz, comedy, movies, etc. This week is Montréal Complètement Cirque ("Montreal Completely Circus"), and last night there was a free show of Phénix (https://montrealcompletementcirque.com/en/program/shows/phenix/ ). Picnic in the park, and watch juggling, dance, acrobatics, and more. Most circuses in Montreal are inspired by Cirque du Soleil; maybe most around the world now. More fantasia, more choreography. I think needed in the modern world. A century ago, could watch someone juggle 3-4 balls and be totally fascinated. Now we've all seen better on television, so need more than the simple acts/actions. Children and adults (we met some friends there) all really enjoyed.

We went via Metro, which was a first for the kids. They handled it well. Good. They're urban kids, they should be comfortable on the Metro. More comfortable in Montreal than NYC, because Metro here is rubber tired and therefore doesn't hurt the ears. (That's one of the things I no longer appreciate about NYC. I don't mind the bigness and crowds, I don't like noise to the level of phyically painful. Put dang rubber tires on the subways, or otherwise engineer them better.) Not all the Montreal Metro stations are stroller friendly, but I find strollers do fine on the wide escalators. For the stations that only had stairs, we just looked around for some young man looking friendly and reasonable strong to help me carry it up or down the stairs while Nom herded the kids. Crossposted from %%https://warriorsavant.dreamwidth.org Please comment there.
14th-Jul-2018 11:09 am - The Bad: customer lack of service
Sword &amp; Microscope 1
I think they are getting these things solved, but spent far too much time on the phone the past few days. Don't want to go into details, but some generalities apply. First, I really, really hate voice menus. I'm feeling negative if I have to call them, because I'm calling because I have a problem. By the time I've gotten to speak to an actual person, I'm in a worse mood. Then half the time, they person on the other end of the phone doesn't know what they are doing, or can't solve the problem. This is besides when they decide that they will try to sell me up on another service. Hey, you can't even handle the existing work, why should I give you more? The worst is when this is not the first call I've made about the issue. *Growl*

Crossposted from %%https://warriorsavant.dreamwidth.org
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14th-Jul-2018 11:08 am - The Good, The Bad, and the Ugly
Sword &amp; Microscope 1
Well, the Bad and the Good. Separate post for each follow

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12th-Jul-2018 07:52 pm - Sainte Anne's: Hard to Stay Motivated
This was my second-to-last day doing consults at SAH, the former (and still partial) veterans hospital. As mentionned before, will be ceasing to do my monthly clinic there soon, partly because don't want to do the drive anymore, and partly because fewer and fewer veterans still there. I'd recruited a replacement for myself, but the administration hasn't followed through to bring her on board. I can only do so much; am tired of doing other people's jobs for them. Regardless, next month is my last day. It will be sad, but only a little. In my mind, I'm already detached, so it's hard to keep motivated today. Basic professionalism kept me going on the straight and narrow, but my heart not in it. I told the nurse for the clinic that if possible, I don't want any new patients for next month, just finish taking care of/disposing of the existing ones.

Crossposted from %%https://warriorsavant.dreamwidth.org
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Between military and civilian, I spent 7 years in primary care: general medicine, walk-in clinics, and small emergency rooms. Even after qualifying as a Derm, I did random bits of primary care, mostly while deployed. It's really about 10% specific training, 40% generalizing the knowledge you were trained in (eg if you understand muscle sprains, doesn't matter that much which muscle was sprained), and 50% common sense.

Got a somewhat flustered call from Nom today. Seems her mom had called an ambulance for her dad, then he was told "wasn't permitted to enter the ER." He was suffering from a sore foot. Or maybe severe pain somewhere. Or maybe couldn't breathe. Realize that this was from her dad, to her mom, then to Nom by telephone, then to me mostly by telephone. In-and-around this, I was (a) at my office, then (b) met Nom and the kids at the wading pool, then (c) had to go to one of the hospitals for a meeting about a research project (which got cancelled, as the other person had the date wrong). Eventually got myself over to JGH, where I clipped on my staff ID badge and strolled into the ER.

Dad, mom, and mom's brother were sitting in the waiting area. Dad in a wheelchair with a look of pain on his face (and he's not a wimp), but clearly was breathing. ER's do tend to rush you right in when that isn't happening. On the other hand, it was dinner time, and the worst times to go to Emerg is between after-work, and before-bedtime, when everyone else goes also. If you are still breathing and/or not bleeding copiously on their floor, there will be a long wait. Couldn't do much of an exam there, but asked a few careful questions, did some very limited exam, and realized he had sciatic nerve pain ("sciatica"). Although at the time he denied any trauma or straining, later came out that he had been lifting stuff too heavy for him earlier that day. Anyhow, since he was breathing, and was not bleeding on the floor, if he waited to get seen (allowing for appropriate triage), he'd likely be in the waiting room until the next morning (and in pain the whole time). I told them (both in French and via Nom's uncle translating into Vietnamese), to go home, gave them some basic instructions (mostly to ice it down), and I called in some pain and anti-inflammatory medications to their pharmacy, and told him to see his regular doctor in the next day or two.

Wasn't high level medicine, but they were most appreciative, and at least I remembered how to do this stuff.

Crossposted from %%https://warriorsavant.dreamwidth.org
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9th-Jul-2018 04:37 pm - China
Signpost Ft. Benning
Am reading a history called The Devil Soldier by Caleb Carr. Carr is best known for his excellent novel The Alienist, but he writes history too. The book is about Frederick Townsend Ward, who was an American mercenary commander in the Taiping Rebellion in China in the 1850-1864. It’s a period of time and a history that I knew nothing about. The Taiping were sort-of Christian converts (really had their own religion that was a mix of Christianity and their own thing) fighting the Imperial Manchu government. Seems the Manchus, although we think of them as the ancient line of Chinese Emperors, were essentially new-comers, being Tartars who conquered the place in 1600-something. For the Chinese, they were the interloping new-comers, since 200 years in China is like 15 years here. The Manchus were also corrupt, oppressive, and incompetent. Unfortunately, the Taipings weren’t any better. Ward was a soldier of fortunate who ended up forming a western-style organized and equipped, mercenary combat force that was apparently decisive in that civil war. The Imperial Government, since they had the Mandate of Heaven, were reluctant to hire lowly foreign barbarians to do their fighting for them. They also, despite having gotten their butts kicked in the Opium War (and repeatedly afterwards), saw no reason to change how they did business, organized, fought, or in any way changed their views that they were the center of the earth and everything they did was right. They would rather suffer 100 defeats than admit that any other way could be right, regarded any backing down as massive and unthinkable humiliation, and were masters of bureaucratic obfuscation. Much like their view that China was the center of the universe, it is a mindset I think the Chinese government still has, something to remember for anyone dealing with China today. Crossposted from %%https://warriorsavant.dreamwidth.org Please comment there.
8th-Jul-2018 02:35 pm - For this we went to university…
Sword &amp; Microscope 1
Many will tell you that education is the key to getting a good job, good life, and avoiding manual drudgery. For much of human history, that meant being able to avoid laboring in the fields. So, for the first relatively cool day in a while, we two university-educated parents took our young kids to pick berries. The irony is not lost on me that what is considered horrid grinding work if you have to do it, can be the epitome of leisure if doing it for a lark.

Quinn Farms is about 35 minute drive from where we are. I've always been amazed that for a city of it's size, from Montreal you can be in farm country in 30-45 minutes. I think because Canada has such a relatively small population for its size, the cities are not as widely surrounded by suburban sprawl as in the US or Europe. Quinn Farms is large, clean, and well-run. We got there early before it was too hot or too crowded. First we went to look at the animals. The kids, urban-raised that they are, were fascinated by the future chops, wings, steaks, and bacon animals. Some you could pet (eg sheep), and some you couldn't (eg pigs), which I imagine depends on how likely they are to bite you if annoyed. In with the chickens was one larger, bald-headed bird, which I think was a turkey. Or possibly a vulture (or turkey vulture?). Naw, turkey.

After that, took a ride on a wagon behind a tractor out to the fields. (WS loves tractors, and they had several old ones he got to climb on.) HF was very into picking strawberries, and quickly filled her basket. WS mostly waited for mom to pick some, then ate them. I noticed they had different fields with different crops, which ripened at different times, cleverly allowing them to have tourist custom at all times during the spring, summer, and fall. As part of it's being a working farm, there was an area you couldn't go into: dusty tracks connecting buildings made of sheet metal or of old shipping containers. Reminded me of my Army days.

After that, went back to the main area, had BBQ lunch, then hit the shop (toys, souvenirs, fresh eggs, etc). It was a great day for the kids, and for us. Nom is thinking of going back with her parents. I think her dad might enjoy the new experience, but her mom is more likely of the "we went to university to avoid this kind of work" philosophy. I'm thinking we could create a VN version. Instead of BBQ for lunch, could have pho; instead of sheep, could have water buffalo; and instead of berries, could pick rice. Crossposted from %%https://warriorsavant.dreamwidth.org Please comment there.
5th-Jul-2018 08:15 pm - A brief anecdote about patch testing
Dunno what brought this to mind, but about 12 years ago, I mobilized to back-fill Walter Reed, the Army's premier medical center.*

Some key background:

- "Patch testing" is used to test for allergic contact dermatitis (eg allergy to something that touches the skin, not food or animals, unless you are rubbing the kitty cat on your face). The antigens (test agents that you might be allergic to) are usually organized into "trays" by functional area. There is a Standard Tray that everyone gets tested to, then specialized trays such as Hair Dressers, Dental, etc.

- Dermatopathologists examine biopsy specimens from skin. Contrary to what you might have "learned" from TV, Pathologists spend very little time on autopsies, and very much time trying to diagnose disease from biopsy specimens. About 25-30% of biopsies are from skin (much easier to biopsy than, say, brain). In bigger hospitals, Pathologists are subspecialized by type of tissue/organ system. Some of these are officially-recognized subspecialties, some are de facto. Derm Path is the oldest such subspecialty, and in the US, you can come to it either from being a Dermatologist or a Pathologist, but you have to spend half your fellowship (eg subspecialty training) in whatever field you did notcome from (eg a Pathologist has to spend half his time on Dermatology, and half on Derm Path).

While I was there, the Derm Path trainee who was doing his rotations on Dermatology was someone I had known from being deployed to Iraqi Freedom 2-3 years earlier. He had already been a Pathologist, who was then deployed with the Theater Medical Lab (I forget the official bureaucratic Army-speak name). Very nice guy, very sharp.

It came up that his patient had to be patch tested for hand eczema. I told him to organize it, to use the Standard Tray, and also the Glove Tray.

- He gave me a "what the heck are you talking about?" look.

- I gave him the "why the heck are you giving me the what the heck am I talking about?" look.

- Then he asked in a puzzled tone, genuinely confused, "the LoveTray?"

After we sorted out the miscommunication, and got over laughing, we spent some time figuring out what should go on a hypothetical Love Tray: latex and lambskin, lubricants, spermicidal agents like nonoxynol-9, massage oils, leather and PVC, etc.

*Now combined with Bethesda, the Navy's premier medical center, to form the Walter Reed National Medical Center at Bethesda - no one wanted to give up any part of their names. The Air Force didn't play well with others so they're not there, but all military hospitals take care of all military as needed, with some political nonsense sometimes interferring.

Crossposted from %%https://warriorsavant.dreamwidth.org Please comment there.
3rd-Jul-2018 03:06 pm - Conference (CDA).
Sword &amp; Microscope 1
The CDA (Canadian Dermatology Association) annual meeting was in Montreal this year. I've gotten less and less interested in attending meetings, but felt I needed to support the home time. Why less interested in conferences? Firstly, if they are out of town, I don't really want to be out of town/away from family these days. Secondly, even if local, I get less out of them than I used to. My first AAD (American Academy of Dermatology) meeting as a first year Resident, every day, I scheduled a breakfast session, morning session, lunch session, afternoon session. After 3-4 days, I couldn't see straight, but everything was new and interesting. By now, I've been doing this for a day or two. The speakers are mostly invited because they have published in the leading journals, and I read those journals, so I likely already know what they have to say. Further, either they are saying things I agree with, in which case I am already doing them; or they are saying things I disagree with, in which case I'm not going to do them.

Many people attend for the social side of things, but I'm not that sociable, nor am I much of a networker, nor do I want to be attending dinners away from my family, so again, not that much incentive to go.

All that having been said, there were some good sessions, and I did learn a few things, and make a few contacts that might prove useful as I try to move more into the research side of things. Well have to see how that part plays out.

Crossposted from %%https://warriorsavant.dreamwidth.org
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