Sunday, November 4, 2012

My Dad Finally Gets His Birth Certificate

My father was born in Codington County, South Dakota, December 12, 1923. He was born at home. The physician who delivered him was not very good at keeping records, so no birth certificate was ever filed at the county office. He was baptized a few weeks later in a local Church. He grew up in Watertown, went off to college at the University of California, was drafted into World War II, served in the war, finished college, returned to South Dakota, started his own business, raised a family, and paid taxes every year, all the while continuing to live about an hour from where he was born.

A week ago he went to renew driver's license. According to recent state regulation passed by a largely Republican legislature, my father, now an 88-year-old man, was required by law to show two pieces of proof that he indeed lived at the home that he has been living for nearly 50 years. He showed two envelopes addressed to his home.

He was also required to show his birth certificate, the one he never had.

They say this was to limit voter fraud. To be fair, South Dakota was involved in such a case in 2002, where thousands of phantom votes were cast, all in the same handwriting.  But now the pendulum has swung in the other direction, About a year ago, the NAACP petitioned the United Nations, claiming that efforts to stop voter fraud are really schemes to prevent minorities from voting; in the case of South Dakota, Native Americans off the Reservations.  Some suspect that there will be voter suppression activities among conservative groups. The United Nations plans to send affiliated election monitors from Europe and central Asia to polling places around South Dakota, as well as North Dakota, Missouri, and New Mexico.

If you think that there was some random coincidence regarding my father's birth certificate, he has been driving for over 60 years. Not once has he been asked to produce his birth certificate. Meanwhile, my mother also had show proof that her married name for the past 50 years, was, in fact, her married name. We're not talking about a police state here. We're talking about a part of the United States. Since my father had no birth certificate, he went to the state office to get one, a Delayed Birth Certificate.

He just showed them his old Driver's License.

Thursday, February 9, 2012

I Ate a Jack-In-The-Box Bacon Shake, and I Survived to Tell The Story

I ate a Bacon Shake at a Jack-In-The-Box restaurant, and I survived. To be honest, I’m still enjoying it. But I decided to put the rest of it in the freezer and write about my experience while the smoky flavor was still fresh on my palate.

Before I discuss the nutritional content of this product, let me say this: it’s ice cream, people!! It’s a dessert item. Stop prattling about the nutritional content and start living. It’s got a buttload of fat and enough Calories to power a small city, so get over yourselves and go out there and drive your crazy car to the nearest franchise. I don’t want to hear any more references to an artery-clogging-heart-attack-in-a-plastic cup. You people need to get off your fat ass and start exercising. Stop reading the side panels of Girl Scout cookies in the hope that you’re going to get over the guilt of shoveling Samoas into your esophagus.  You don’t have to eat the whole thing.  Oh my, you just had one cookie and not three cartons? Good for you.

This is an important catastrophic corporate failure, and we all need to go out there and bathe ourselves in the gastronomic foolishness of this mega-stupid decision. Jack-In-The-Box, no doubt, skipped right over about three tiers of focus groups and brought out this menu item straight to the public. This is not failure like getting drunk and having your 9-year-old kid drive the van home.  This is not failure like getting a metal stud driven through your frontal sinus to make yourself look more attractive. This is corporate failure. This is failure on purpose. This is one giant fucking Fountainhead of failure. This is big company meetings and charts and graphs and PowerPoint presentations, and they’re all making hand-wringing decisions about a bacon-flavored shake. When big corporations stick out their collective necks like this, I’m jumping right into the middle of it because I celebrate risk.

Of course, Jack-In-The-Box relies on social media and word-of-mouth to sell their product. I’m playing that pipe. I’m here to tell you that it’s good. It’s not made with real bacon. It doesn’t have a bacon swizzle stick. It’s all artificial goodness that tastes like breakfast made with pancakes, bacon and maple syrup, and everything runs together and tastes a bit smoky, but sweet. It reminds me of a Saturday morning breakfast at Grammy’s house.

Jack-In-The-Box restaurant is a fast food restaurant chain based out of San Diego, California that features the typical hamburger fare.  The bacon shake is a secret menu item for a limited time. It’s not anywhere on the menu, on a poster board at the counter, or on a sign at the door. It’s secret. You have to suck-it-up and ask the pimply-faced kid at the counter. Maybe they won’t have it, but you’ll never know unless you ask.

Friday, November 25, 2011

Another pumpkin soup recipe

We bought a pumpkin for Halloween that was left un-carved. Instead of throwing it out, I decided to carve the carcass into food. Here’s my version. 

5 cups water
1 ½ tablespoons vegetarian soup base (Better Than Bouillon™)
½ large pumpkin (approx. 20 pound pumpkin)
3 cloves garlic
1 white onion
½ cup heavy whipping cream
½ teaspoon chopped fresh thyme
½ tablespoon crushed red pepper flakes
4 tablespoons chopped fresh parsley (garnish)


1.    Cut the pumpkin into large sections and place face down onto a baking sheet. Place into an oven at 350ยบ F for one hour.
2.    Sautee the onions and garlic in olive oil until brown. Add spices.
3.    Slice the skin off the pumpkin sections and place into a food processor with some water, and puree with the onions, garlic and spices.
4.    Place contents into pot, and simmer contents in open container for 30 minutes. Add cream.
5.    Garnish with parsley.

Friday, September 30, 2011

My grandfather

Here is a photograph (circa 1955) of my grandfather I found on the internet. He is, by the way, holding a baton. Several years ago, I had found another photograph on the internet of him and my grandmother as young newlyweds outside of Chicago around 1925. There were several other Guderyahn's in the picture. They had children, and grandchildren and great-grandchildren. One of those people, distant from me, posted that photograph of the young couple with my grandmother in a summer flapper dress. She was a rather cute woman. That's funny, I can never imagine my grandmother as "cute." But there she was, standing in front of my grandfather, outside of a lake cabin somewhere near Chicago. A couple of years later, he got a job teaching at a small Lutheran College in South Dakota. From there he started a music program that created a local symphony.

My grandparents, second couple from left, along with the entire Guderyahn family, Chicago, circa 1925.

     I never met the man. He died a few years before I was born, collapsing at the podium. He had developed congestive heart failure related to rheumatic heart disease, a common disease of the time. Had he lived a few more years, he may have received an artificial valve, which hadn't been invented at the time. He was a violist. As a kid, I grew rather tired of hearing from people what a wonderful man he was. I never knew the man. I didn't know his personality, or what made him great. Most of the people that knew him have since passed, and I rarely hear about him any more. Nonetheless, here is a man from humble beginnings in Chicago, who moved to a small town in South Dakota, and started a music program that has since grown and matured and created several professional musicians who have gone off to have wonderful careers. It all started with this man. As I grow older, I see life as more of a continuum and less of how it starts and ends with me. My children have followed in my footsteps, forgetting about my aging parents as they have lives of their own. Maybe some day I will have grandchildren. I hope they will know me.

Sunday, September 11, 2011

More photographs from San Diego

In the event that you missed some of these photo-posts on Twitter, I'll show them again here. It's been a warm week in San Diego. On Thursday evening, the entire county lost power, affecting some 3 million people. I suspect that people on the East Coast didn't care, what with their silly rainstorm and all. And for the most part, it was no big deal. It gave us chance to appreciate life without television and computers, and get out and meet the neighbors. For some reason, all I could think about is drinking a cold beer. I mean, if you're gonna have a Blackout on a hot day, you gotta have a beer. Turns out, a lot of people I talked to thought the exact same thing. I was thinking, we should have one of these blackouts next week.

September 9, 2011 headline in the Union Tribune after the largest power outage in San Diego history.

Sunset looking West from our house. It was especially humid that evening this past week making the sky especially orange at sunset.

Another close-up photograph taken by my 13-year-old daughter of the tomato plant.

My 13-year-old daughter turned the camera onto her face.

Moonrise on Mt. Woodson, San Diego. This is looking east at sunset, August 11. It's a waxing moon: tomorrow is full.

Super close-up photo of Torey the cat. Serious cat is serious.

Monday, September 5, 2011

My daughter's backyard camera adventure

My 13 year-old daughter grabbed the camera and ran around the backyard taking very close-up pictures with the macro lens attachment. It rained today, now a very common Summer event in San Diego. Here is the result of today's work:

Saturday, August 6, 2011

Atrial flutter in the human heart

The cardiologist view of the human heart is often reported as a structural entity with valves that pumps blood around. It has these arteries that run along the outside of the heart that when they get plugged up, can cause a heart attack, or lead to a catheter intervention or bypass surgery. Essentially it is a pump with fuel lines. I see it in a slightly different way, looking at it also from its electrical standpoint. This is often under-appreciated by the medical community, as cardiac electrophysiologists are looked at as the nerds and geeks of the cardiac world. For years, no one, except for the electrophysiologists themselves, really understood what the hell they did. Many of the pioneers of the EP world were locked up in academic centers for 12 to 24 hours at time studying a single patient without much to offer as a cure. That changed in the late 1980s and early 1990s as ablation of cardiac arrhythmic pathways became the new treatment paradigm. In other words, the nerds actually did something that could make money. Here's a case I worked on today. Three or four years ago, I could create something like this in a matter of a couple of hours (see figure below). Today, this electroanatomical map of a cardiac arrhythmia was created in a matter of minutes. Pretty amazing.

Here is a model of the heart showing atrial flutter in the right atrium of the heart. In our patient today, the rhythm actually rotated in an opposite (or clockwise) direction.

Atrial flutter map in a clockwise direction shown in the right atrium of the human heart. In this view, we are looking down on heart. The entire heart is not shown, only the right atrium (seen as H in the figure below). The round structure is the superior vena cava (seen as G in the figure below).

Here's how it works. This is the CARTO system that is sold by a company called Biosense-Webster. There is another company called ESI-Navx that produces a similar product. Patches are placed on the outside of the body: this is essentially a GPS system, where the heart is the planet, and the platinum-tipped catheter is the body on (in) the planet. The catheters have a magnetic location tip. The catheter is a very long wire inserted through the femoral vein inside the right (and left) groins, and run up the vein into the heart, much like a very long intravenous line. However, this line is connected to a recording and pacing device that is also run through the CARTO system.

When the catheter tip touches the inside wall of the heart, the impedance changes, and the computer is told to make a point. As the catheter is drawn across the inside of the heart, the point becomes a line, which becomes a plane, which becomes a shell, which becomes a chamber of the heart.

In this case the catheter(s) were contained within the right atrium. The patient arrived to the lab with an underlying cardiac arrhythmia called atrial flutter. We were pretty sure it was well-contained within the right atrium, but we wanted to make certain. The total time of the procedure to terminate the arrhythmia took approximately 15 minutes, but we liked playing around with the arrhythmia just to make sure we ablated in the right spot.

Here is another view from our case today. This is an anterior view with the superior vena cava being that structure on top. This is just the right atrium. The arrhythmia is moving from the anterior-lateral part of the heart across the top in a clockwise manner and down along the posterior-medial part of the heart across the cavo-tricuspid isthmus (CTI in figure above). Ablation from the CTI to the inferior vena cava terminated the arrhythmia.

Atrial flutter is the electrical energy of the heart that is caught in a closed loop, much like when your computer does the spinning hourglass (Windows) or spinning pinwheel (Mac). This is a re-entrant arrhythmia, meaning that it goes round and round inside of the heart. In the 1970s, scientists didn't have clue on how this worked, until somebody one day opened up a dog or a pig or a human and actually measured the timing cycles of this electrical energy moving around and around in a circle. Fortunately with computers, this can be easily demonstrated. This patient was in the arrhythmia for nearly a year. The top figure is that of the right atrium looking down from the superior vena cava. The colors are assigned to time, so that red is early and purple is late. As you look down on the heart you can see the energy spinning in a clockwise fashion. Think of it has a millions of cells performing the 'wave' inside the right atrium. 

Fortunately this arrhythmia has to travel across a bridge. This bridge is the cavo-tricuspid isthmus. Get rid of the bridge, and you break the circuit. You don't have to cut the heart open, just apply radiofrequency energy (or heat) to this ridge to lightly scar this tiny area. Ablation is accomplished by drawing a line of RF energy from the cavo-tricuspid isthmus (CTI in figure below) to the inferior vena cava. Magically the cardiac rhythm was restored, and the patient went home without complication.