Friday, July 31, 2015

British Isles Cruise 2015 – Chapter 2: History of Slavery in Liverpool!

Three more days have passed and you must think I drank some bad tonic to enlist such an inappropriate subtitle! But please be patient.

Liverpool, Glasgow and Dublin have now been visited.  I’m happy to say that I have finally set foot on Scottish and Irish soil and it was truly a wonderful experience.   But I expected as much after so much chatter from friends about how beautiful Scotland and Ireland are - both in the cities and in the countryside, its kind and proud people, and its key role in local and world history.  Nevertheless, for now, I’ll leave these memories locked up inside, and dedicate the rest of this blog Chapter 2 to Liverpool. (I have one more day in Dublin and maybe I will be inspired to write something later).

Liverpool: I was prepared for Liverpool as an industrial wasteland, dirty, dreary and depressing!  It was the home of the Beatles, and that’s the only reason worth going there.

Nothing was further from the truth…really!  As for some examples, a few pictures, when posted, will showcase the beauty and majesty of the two cathedrals, one representing the Church of England and the other one Catholic.  But more broadly, the city was filled with old and well preserved buildings centuries old, but it also had its share of those in some disrepair.  Town squares, statutes of famous dignitaries, the hustle and bustle of a vibrant city and a very well done harbor area prepared perfectly to accommodate a growing number of visitors making Liverpool an easy and enjoyable city to visit and navigate.  Some lovely historical residential areas were in the process of revival and repair, not unlike other cities in England or elsewhere on the globe.  Liverpool was quite a nice city overall, nothing to be embarrassed about, as for example one truly in disrepair - Blackpool, which I have disparagingly written about previously.

Of course, memorabilia and historical landmarks about the Beatles dominate the city with places to go and things to see.  Nearly every street is dotted with reminders of the places and events that were crucial in the evolution of the Beatles.  The Beatles Museum was quite wonderful and entertaining…and brought back memories of when I first heard the Beatles play on the Ed Sullivan Show as a senior in High School, three months before graduating and going off to college.  And of course, everyone needs to go the Cavern, the underground venue that the Beatles became famous playing in.

Having squandered the better part of the morning at the Beatles Museum, in anticipation of our scheduled afternoon half-day city tour, we drifted back to the ship for lunch.  On the way, we visited several other museums without the time to fully invest in them, which was truly a shame.  They included the maritime museum that included displays and historical relics from the Lusitania as well as the Titanic.  The other museum that was located on the top floor of the complex was the Slavery Museum!!!!  What was that all about??????

It turns out that Liverpool was extremely engaged in slave trading of the 18th Century.  In fact, it was the European slave trading capital, responsible for over half of the three million slaves transported from Africa and then sold, including those sent to North America.  In its busiest period in the late 1700’s, hundreds of ships were working simultaneously to transport Africans around the globe. Of course, without the time to fully invest into the museum, I have very little insight into how this plays into the history of the city or its moral recompense.  I do know that slave trading made many folks very rich and bolstered the English economy until slavery was finally abolished in 1807.  To be honest, it makes me extremely uncomfortable to write about this without further explanation or context.  It becomes even more painful to admit that anything so offensive as slave trading had any positive impact on the health and wellbeing of a major British city; indeed, this is beyond repugnant!

Am I the only human on earth that didn’t know about Liverpool’s role in slave trading????  And so I am now completely embarrassed that my knowledge of Liverpool was heretofore limited to its portrayal as a boring industrial town, whose most important claim to fame was that it was the home of the Beatles.

Maybe I should not be so hard on myself.  Certainly, Liverpool does not want to dwell on its roll as a slave trading capital for the same reason it was a slave trading capital – because it created economic prosperity. Obviously, dwelling on this theme in the present would have the opposite effect.  The Beatles venues now sit as the major attractions for tourists and other visitors to spend their money on.  They will remain forever a major attraction and cash cow.  The city would like nothing more than to bury its dark history of the past and concentrate on the story of the most celebrated musical group in the history of the world! 

Tuesday, July 28, 2015

British Isles Cruise 2015 – Chapter 1

Dover Castle on the horizon
I’ve travelled to India and China but I have never been to the Grand Canyon.  In the same vein, I have been to almost every major eastern and western country in Europe but I have failed to visit Ireland and Scotland. I hope to correct the former deficiency sometime in the near future. For the now, this present outing will rectify the latter shortsighted failing. 
After a not too unpleasant two-legged flight from Honolulu to London, we found our way to Dover for the night. In the morning, we cabbed to the Dover Castle for a few hours of tourist gazing, which we found fascinating. To be sure, the massive Dover Castle was filled with history and intrigue. The historically accurate refurbished interior of the massive Keep, the underground tunnels including a fully equipped hospital, the strong fortifications and impermeable barriers that held a perfect record of withstanding foreign invaders, King Henry II contentious relationship with Thomas Becket (St Thomas of Canterbury) who he later had brutally killed fill pages of wonderful and interesting historical truths (assuming this possibility).

Finding our way back to the cruise ship harbor, our cruise ship eventually slipped into the sea revealing a long awaited extended view of the White Cliffs of Dover.  On close inspection, the cliffs needed a little whitewashing.  But to me they were spectacular less for their “off-white color” but rather from the spooned out appearance that formed the cliffs, with carved out drastically vertical cuts rudely interrupting the otherwise smooth and fluid rolling green horizontal terrain.   

DAY 3: We missed the first two ports of call due to inclement weather.  That was sad for us because we were looking forward to visiting Guernsey due to its significance in WWII being the only British land that was occupied by the Germans as beautifully described in the literary best seller – “The Guernsey Literary and Potato Peel Pie Society” book that almost everyone I know has read.  So the captain decided to divert the Crystal Serenity to Cork, Ireland in its stead.  We were then left with an additional day at sea (AKA sea day) to ponder our fate in a rough ocean spilling over with a treacherous blend of wind and rain that carelessly slapped the Crystal Serenity to-and-fro, fro-and-to, and to-and-fro. Indeed, it was the perfect storm set to do the most damage to the greatest number of cruisers as the ship rocked back and forth repeatedly like a toy in a bathtub occupied by a agitated toddler!

It was unsettling to walk down the ships corridors; thank God for the strategically placed guardrails.  Of course it was near hell for me to even attempt participating in social dancing at the Palm Court; everyone looked worse than a beginner trying to dance after inhaling a bottle of vodka.  But otherwise, life went on as usual in the world of the luxury cruise ship and people did what people do best in this or any other situation – they ate.  And ate they did!

Nor rain, nor wind, nor malfunctioning toilets, nor unexpected and unpredictable electrical problems, widespread nausea and seasickness, physical limitations and obvious chronic medical conditions, age, sex or body type, in short nothing in the world short of a titanic level disaster would stop the unrelenting procession of cruisers from one meal venue to the next.  To be sure, there was almost nowhere that you could venture on the cruise ship that you were not inundated by the sounds and sights and smells of more food than you could ever imagine being consumed. 

For lunch, there were at least five venues you could eat at or you could eat at all of them in sequence and not be noticed for overindulging.  Everything looked yummy, but not everything was tasty at all times. I focused on the fruit in the morning, one egg white from a boiled egg separated from its yolk, and ½ piece of an English muffin (OK, I admit that I also ate the other half!).  Most people ate some amount of meat like bacon or sausage.  Meat was the big item that was consumed at lunchtime as well as dinner. Beef, lamb, veal, pork, chicken, there was never a shortage.  The same could be said for shellfish; shrimp, lobster, clams, muscles, scallops, and crab.

And to be sure, for every one salmon burger that was prepared and served at lunchtime, a hundred meaty cheeseburgers and fries found their way into the GI track of an ostensible lot of ravaged cruisers that acted like they were eating their first meal in two months.  I can even visualize the burger grease melting into the blood and traveling to the descending coronary artery to settle in for a long stay by burrowing its tentacles into the vessel’s intimal wall, thereby limiting normal blood flow - by reducing the radius of the vessel caused by the glob of gunk glued permanently to the inner wall.

Now, you know I’m prone to exaggerating this eating craze on Crystal Cruises because of my own obsessive and pitiful bias against those gluttonous individuals who lack the wisdom and willpower to moderate their fuel intake.  These folks eat with abandon and do not give a shit whether their waistline expands weekly like they would wish their stock portfolio would do.  In fact, most people on the ship displayed a modicum of restraint.

But still it has becomes more difficult with every days’ passing to maintain any hope that I can continue indefinitely to watch my diet and care one iota about my waste line and all that!  Most days it takes the most strength to pass up the temptation to just let it all hang out – grab for food like everyone else and enjoy the tastes that I have sworn to avoid for the sake of some distant benefit that will translate itself to a few days more on earth sans disability…….

DAY 4: Well, even if kissing the Blarney Stone at the Blarney Castle in Cork didn’t make me more eloquent, it hasn’t changed my overly verbose writing style and my propensity for writing long winded and difficult to follow run on sentences.  I will continue to work on this.

But in Cork, the Blarney Castle and its grounds were filled quite lovely, interesting and very peaceful, including the Poison Garden, the eye ball garden fronting the castle, and the beautiful and expanded landscape filled with mature trees perfectly situated to pose on. If you are interested, Cork is Ireland’s second largest city. 

DAY 5: The seas are better on the next day, as it feels like we’re on nearly solid ground.  Viva la difference!  Arriving in Holyhead, Wales.

The light of the Lighthouse

In Holyhead, our excursion took us to visit the South Stack Lighthouse.  To get there, we took a bus and then had to trek more than 1000 steps (down and up to get back and forth).  It was blustery day but the jaunt was still doable, well worth the effort.  And the effort that was taken ended up atoning for the big lunch that I have just consumed which I shall not describe, one I am not proud of, or want to experience again!!!  The majestic beauty of the surrounding area, not to mention the commotion made by thousands of birds nestled into the side of the adjoining cliffs and flying about was a special and spectacular treat.  A few pictures are indeed worth a thousand words.

And so ends Chapter 1 of my travel adventure.  Now I need to ready myself for Liverpool and the home of the Beatles.

Friday, July 24, 2015

Tuesday, July 21, 2015

John A. Burns School of Medicine 50th Anniversary Gala

Dr. Keawe Kaholokula during his amazing Hawaiian Chant - Oli
July 19th, 2015: Last night the Sheraton Waikiki Hotel was filled to the gills with more than 1300 physicians, scientists, professors, administrators and staff, students, families, patrons and benefactors, as well as other University of Hawaii dignitaries to celebrate the 50th year anniversary of the birth of the John A Burns School of Medicine.  They were all stuffed into the massive second floor Hawaii Ballroom, which typically is subdivided into four smaller ballrooms, usually accommodating to a smattering of events attended by hundreds, not thousands of participants.  Last night was indeed special, not only for the size of the production, but also for its celebratory purpose.

A production it was.  From the moment you stepped foot onto Sheraton Waikiki real-estate, you were funneled into a procession of greeters, hosts to identify your proper tables, and guests chatting and laughing, I knew that this was indeed a well organized celebration that would be easy to endure and even enjoy.  The Program Chair, the honorable James S. Burns, and the two co-chairs, Drs. Tom Kosasa and Carla Nip Sakamoto were there at the front line of the greeting procession to shake everyone’s hand and greet everyone like you were their long lost relative coming back home for a visit.  Up the escalator and to the ballroom foyer, Hawaiian music infused the air with melodious sounds creating a lovely ambiance, produced live from a foursome – Na Leo Kauka (two of whom are JABSOM graduates).  The band was situated at the back window of the foyer playing to hoards of guests that were happily mingling in the crowd.  Several bars lined the escalator perimeter insuring that everyone was sporting at least a partially filled glass of wine and no one was left wanting.  Drinks were served in record time. I can’t remember the last time that I went to a hosted booze affair (actually the wine was donated by two individuals – John Zelko and John Lederer).  Indeed, it was clear that when you take the time for paying for the booze out of the equation, the liquor flowed quickly and efficiently and whatever long lines there were dissolved swiftly right in front of your eyes.  But, maybe it would have been better to have a no-host bar; I certainly would have had fewer glasses of wine and be up this morning writing this blog with a clearer head.
Na Leo Kauka

This 50th year anniversary was much more interesting and festive than what I remember of the one held 25 years prior, which was more somber and subdued.  But maybe that was due to the fact that I had been at JABSOM for only 13 years instead of 38.  Moreover, in these last 25 years, the number of students graduating JABSOM has more than doubled – using simple mathematics.  And, if we consider that 50 years is not that prohibitively long in relation to a person’s life expectancy, most of the students and many of the faculty members would be expected to be alive with many still in practice and/or still affiliated with UH. With Hawaii’s insular community and the fact that a good number of students graduating JABSOM either settle instantly in Hawaii, or somehow find a way to return sometime in the future, the stage was set for an outstanding turnout of former and present students.  A similar argument can be fashioned for the JABSOM faculty.  And voila! 1300 people found their way to the Sheraton Waikiki on Saturday, July 18th.  Truly, this felt more like a reunion than a 50 yr. anniversary celebration of the medical school. 

Dr. Jerris Hedges
To be sure, this was more than an anniversary celebration and/or a reunion.  It was an opportunity to fund student scholarships for JABSOM using the bulk of the evening ticket proceeds, a venture that was successful beyond expectation with 750K being announced as the finally tally.  In that respect, the evening was an overwhelming success, which I think made everyone very happy to contribute to such a worthy cause - considering the rising tuition costs and the outrageously high general cost of medical education.  A few more scholarships will make a big difference in recruiting the best students to JABSOM.  That can’t do me any harm as a potential patient for some of them as I see my years swiftly sliding by, recalling that I’m about to turn 69y/o in a few months.

OK, back to the evening. Physicians and friends that I have known for nearly 40 years, some that I have not seen for decades were there to chat with and hug.  Some like the group from our Okinawa Chubu Hospital affiliated JABSOM program travelled thousands of miles from Japan to attend.  Yikes, I got to say hello to my friend Kaoru Ashimine, Director of the University of Hawaii Postgraduate Medical Education Program at Okinawa who I have not seen in 30 years (I did two stints at Chubu Hospital in my younger JABSOM days that shaped my philosophy of patient care!).  I got a chance to talk to two of my favorite pediatricians Ryan Sumida and Steve Yano; I got to say hello to Keijiro Yazawa, I got to shake the hand of Martin Rayner, Greg Dever, Jerris Hedges, John Lederer, Marian Melish, Santosh Sharma, and countless others.  There were too many people to talk to, what you ended up doing was pure serendipity.  
Dr. Kaoru Ashimine
Dr. Robert Nichols, Dr. Martin Rayner
Dr. Keijiro Yazawa

People looked generally good, not what I expected, despite that fact that not everyone paints their scalp and facial hair with shoe polish like I do.  Most people at the celebration looked health and happy and not too far from being in decent shape.  Very few lay people understand how hard physicians work and how the burden of patient care cannot be shed after the last patient is seen at the end of the day.  Physicians in Hawaii work exceeding hard and their work is an all consuming commitment, so I was happy that not all of them have sacrificed their health for the profession…...or maybe their appearance was colored by the wine that filled my veins. 

Still one of the oddities of Hawaii prevailed at the event.  While the dress of the ladies attending was varied and appropriate with some a bit more formal than others (as much as I can remember), the men presented the greatest contrast in dress.  Some wore aloha shirts and pressed trousers like me, others wore tidy sport coats, ties and shirts, some sported dark suites and ties, and finally a bunch of outliers included those with long sleeve shirts sans ties, or the local Hawaii favorite, the aloha shirt covered with a sports coat.  Anyway it was a mishmash of dress, which in a way took away from the unique celebratory significance of the event, while at the same time making it less formal and more relaxing.  

Mahealani Richardson
 The extended ballroom was warm, spacious and nicely adorned.  As well, the evening presentations were tastefully done and not too long.  The MC was the talented and beautiful Mahealani Richardson, who introduced the speakers; Jerris Hedges, James Burns, Carla Nip-Sakamoto, Thomas Kosasa, and Governor David Ige.  I can’t remember everything that was said, but at least I was quiet and respectful during the presentations.  A wonderful video “50 Years of Healing in Hawaii” was shown, followed by the rapid firing hands and fingers of the master ukulele player, Jake Shimabukuro (I remember first seeing him play in awe when he was 14years old).  Throughout the evening, slides were being shown on several large screens including class pictures, presumably from the first class at JABSOM to the present. 

Honorable James Burns at the Podium
I must admit that it was a little rude of folks, and also a little surprising that so many guests were busy chattering, conversing and visiting during the presentations. I felt that this undermined the message that was being delivered.  It appeared that so many people were caught up in the moment by the buoyant festivities of the evening to really care about who was up at the podium or what was being delivered.  It really caught me off guard; I was even embarrassed for the speakers.  But maybe it was only me, and a few others that noticed the surrounding cloud of background noise that competed for attention during the formal presentations. 

Nevertheless, this 50 yr JABSOM celebration was a wonderful experience in almost everyway.  I think the organizers deserve recognition and congratulations for a job well done.  And 750k is not a trivial amount to add to our JABSOM scholarship fund, which will insure that the legacy of this night will live on for decades to come. 

JABSOM has undoubtedly contributed greatly to the health and wellbeing of our Hawaii community, and it has given abundant opportunities for careers in medicine and medical research as witnessed by the numerous grateful guests that offered their attendance and dollars.  I did feel a strong bond with those attending this celebration understanding how JABSOM has contributed to their lives in individual ways as it has to my life and career.

Indeed, JABSOM has been my home for 38 years.  Attending this 50th celebration has served as a reminder of the importance of JABSOM in my life and career.  Once thing that is apparent, I will not likely be able to attend JABSOM’s 75th (I would be 93y/o). But don’t count me out just yet.  Still, calculating my 38 years at JABSOM in relation to JABSOM’s 50-year history equates to more than 75% of its history.  It also represents more than half of my life. 

UH has been my only academic home and it has given me all of the opportunities I have had to grow and prosper (I do not diminish the role of HPH in this regard).  This includes the Director of the Division of Neonatology, my role in the Perinatal Regional Center (KMC) and many of the community hospitals in Hawaii, as Director of the NIH Clinical Research Center (13 years), as PI for several individual, and other large infrastructure grants, as Director of Clinical Research (pseudo Associate Dean) at JABSOM, as the father of the Grants Development Office along with Tammy Ho (resulting in 100+ million dollars being award to JABSOM), as special advisor to the Vice Chancellor for Research and Education at UH Manoa, and now as Professor Emeritus.  I owe my career to JABSOM and UH!

One last item.  I did not attend all of the daytime events on the day of the celebration.  I just want to make sure that we do not forget the individual contribution of my most revered mentor, Fred Greenwood PhD to the evolution of JABSOM and the Cancer Center at UH.  Many folks like Fred, who pride themselves on their ability to motivate, unselfishly prompting others to take ownership of projects under their creation, in the end get forgotten for their contributions.  Make no mistake; Fred was the brilliant architect of JABSOM and the Cancer Center.  So it’s sad that Fred was not here on earth with us to share in the festivities of this special occasion. 

The late Dr. Fred Greenwood

Monday, July 6, 2015

July 4th, 2015 – Happy 4th of July in the Nations Capital

I’m really not sure why, but I believe that everyone should go to the nations capital at least once in their life for July 4th fireworks.  But I wasn’t sure what to expect two days ago when we finally made it happen, other than hoards of Americans converging magnetically toward the Capital Mall from every direction as the clock neared 9pm to witness the annual 20-minute firework display.  Actually, they looked like zombies marching in unison like from the Night of the Living Dead.  Only they were wearing red, white and blue fanciful shirts and blouses and pants and skirts and some were carrying flags while others were dressed casually, appropriate for the warm mid summer’s night temperature.  And there were flocks of people of all ages, colors, sizes, including sadly, many infants and small children who were mostly startled and bedazzled, while others were outright spooked into frightful crying fits from the thunderous earth shattering sounds and lights of the neighboring fireworks shooting into the sky.  Some were speaking English, but many were speaking Spanish and other foreign tongues.  Regardless, many, indeed many others were ostensibly there to film the event with their iphones, hands in the air aiming their phones at the fireworks display, less interested in enjoying them for whatever they are worth and perhaps what they represent, and living thus for the moment.

I never got to the Mall to witness the true extent of the invasion of people.  I was nestled up against a very old and beautifully crafted building a block away, feeling a false sense of protection from the inexorable intrusion of people fighting their way to the closest location for viewing this July 4th spectacle, while also feeling artificially protected from one likely target location for a terror attack.  Of course the news media filled its pages forecasting one, and God knows how many were averted this July 4th by the FBI, CIA, Secret Service and other street police.  Security was truly visible everywhere especially with tall young men with secret service written visibly on their shirts patrolling everywhere and looking at everyone, targets themselves for the next fanatic crazy wanting to gain instant stardom.

The fireworks were still magic to the masses as they revealed their remarkable presence; everyone was fixated on the sky just west of the Washington Monument.  The sky shimmered with light, which flickered, sparkled, spiked and rained as each firework torpedoed from earth into the sky, shedding its contents in order to construct a programmed assortment of patterns, some that disappeared instantly, while others that seemed to linger forever until yet another boom was heard and felt vibrating the ground, forecasting the next show that was about to start.

The last and most dramatic fireworks display always seems anticlimactic, the crowd disappointed with the end of the show, yearning for a few more displays for the road.  But, when it was all said and done, inexorably, the crowd dispersed as quickly as it has formed, with the masses heading for the metro as we competed for space on the street, down stairs toward the Metro, to and on the escalators, through the turnstiles, and to a safe and comfortable seat on the red line train taking us back to Bethesda where we were staying.

The truth is that I didn’t come to DC for the 4th of July.  I came to visit a friend before the 4th of July and so we thought it would be a good idea to attend the firework display at the capital.  And as it turns out, the fireworks was a no greater spectacle than the display in Honolulu either on Kailua beach as I remember going to in my early family years or in Honolulu where I have resided at for the past 18 years.

My friend (who shall go unnamed) and I came early to DC from Bethesda and had dinner at the Occidental Grill, a famous landmark bordering the Mall and adjacent to (and owned by the same entity that owns) the very famous Willard Hotel.  Before we left after dinner, I remembered to take a picture of our recent presidents that were on display in the foyer of the restaurant.  Obama was flanked by the two Bush presidents on either side – to be sure, he was truly bushwhacked!!! 

Obama is Bushwhacked!!!!!

Dinner was so so but the Italian wine selection was quite good.  I broke down and ordered a hamburger from the otherwise boring menu (there were no 4th of July hotdogs on the menu – see last years blog).  When it came, I undressed it from the juicy bacon overlay, split it in half and only ate the slightly larger of sections. 

 I felt guilty that the pulverized partially cooked meat would somehow contaminate and pollute my otherwise meat restricted and protected intestine and cause me a host of unwelcomed complications like a heart attack, or maybe food poisoning, or some cancer.  Even so, it still tasted good!!! But I was satisfied that if I only ate half, that my intestinal microbiome would only be affected transiently and it would revert to the mainly green colored foods environment that it was mainly accustomed to.  And thank God for Lipitor, and Green Tea and dark fruits and a failing memory of what I had for dinner the night before!!!

In the past, 4th of July had little patriotic significance and the day was just a welcomed day off of work (not always true) to do something fun with my growing family.  The fireworks occurred at the end of the long day, and by the time the children were put to sleep, the day was over. 

But the last few years, despite yearning for meaning in my later years, I have avoided asking myself on this day of American independence, how I truly feel about America, the country of my birth and life over 68 ½ years.

This probably reflects a nagging sense that my answer would not please me.  And I’m good at obsessing on the negative, and if I started, this writing would never end.  I will say that I am generally unhappy with how my country has evolved over the last few decades, not only in politics, but many other aspects.  And I hope that I will never find the time to do that kind of reflection, and if I do, I can count on anyone reading such drivel falling quickly to sleep in boredom like grandson DJ-2, son of DJ-1, who is the son of me, who is also a D, and even their mighty dog, Jackson.