Dysfunction is a Kind Way of Describing a Broken System of Representative Government

In 2014, the US congress introduced 663 bills and passed 296 with a pass rate of 44.7%.  In 2024, 16,000 bills were introduced and 274 were passed at a rate of 1.7%. God only know how low the stats are for 2025 and 2026!  Does any reasonable human need any more evidence to proclaim our US congress is supremely dysfunctional?  Would any organization acknowledge a success rate of less than 2% as acceptable?  While taxes payers fund this circa 3-billion-dollar albatross of a government body, an obvious question is how much the legitimate public, which seems to be so poorly represented at so many levels, has in their arsenal to remedy this dire situation.  

Within this backdrop, legislators continue with their hysterically f-word loaded rants, infected with Trump Derangement Syndrome while lacking in anything cogent to say, bombarding the public with their trite, outraged soundbites that preclude any productive collaborative legislative meeting of the minds. The mainstream media is complicit in ensuring the that both red and blue will remain combative, resolute in their bombastic and affected positions that are immutably cemented.  Clearly, the only way anything gets done is along party lines, or when the tug of war that occurs when government shutdowns appear as the only legislative strategy for action favors one party or the other in terms of public opinion. Legislator malpractice seems rampant; campaign funds are routinely used for personal gain; behavior focuses on whatever will ensure reelection. Moreover, baring any concerns stemming from deep blue or deep red districts or states, it doesn’t seem that anything said or done by those representatives will shake the foundations of their bid for reelection. Legislators have long abandoned their regard for the public they were elected to serve, at least as far as I’m concerned as well as countless others who feel the same. 

Let me be clear, NEITHER red nor blue legislators are faultless is this behavior. I am not in favor of choosing sides or proclaiming a biased remedy for such dysfunction. Both sides are equally affected and deranged. And I realize my bias professes a global condemnation of congress, stemming emotionally by the relentless dysfunction and broken promises, that maybe be patently unfair. To be sure, there may be a few or even many sane legislators left that deserve to be excluded from this stark takeaway conclusion, but any constructive efforts have been neutered and swept away by the overall tsunami of the power grabbing, reckless, self-serving, opportunistic, ignorant, abandon of their majority. Its difficult to vere from the conclusion that members of congress represent only themselves, and not  the citizens of the US. They have long forgotten the hordes in middle America who expect their legislators to work for a better life for their constituents that voted for them and believed in the propaganda that they echoed during their bid for election or reelection.  In short, I am disgusted with the US congress.  In March 2026, 15% of Americans approved of the US Congress.  In my view that is 15 points too high.

If I had the power to fire the entire congress and start all over, I would. At the very least, when congress leaves the US high and dry without funding all or parts of federal workers, WE should demand that Congress should have to endure the same medicine as the rest of our government workers.  Secondly, I would encourage everyone who has an opportunity to vote, now and in the future, to vote OUT our present legislators in favor of new blood.  A strong message should be sent to the present stock that their words and actions have consequences, and so do their lack of words and action.  I’m looking forward to the day that congress will once again work together, blue with red, and red with blue including independents to act in the best interest of the American people. Too many decry “threats to democracy” as their calling card to criticize undesirable actions taken by those across the political aisle. Few can articulate and or defend these accusations.  It is truly an embarrassment to consider how many of our congressional representatives are so lacking in thought and knowledge, and ostensibly in intelligence, not to mention their disregard for the public that they have been elected to serve and protect. 

Airport Roadblocks and Fanatics

One or two incidents by fanatics and/or lunatics and the country reacts with formative roadblocks that are layered one on top of another.  Two days ago, I drove to the airport to pick up a friend.  I timed it perfectly, her text to me that her luggage was secured came moments prior to my arrival at the international arrivals area at the Honolulu International Airport.  I wasn’t really given a chance to adequately glance back and forth because I was immediately waylaid not by one, but three security guards who were only interested in waving me on, refusing to give me even a moment to search and locate my arriving friend. I have never been so rapidly bushwhacked by airport security guards, as it was evident that they had only one end game, the continuous movement of vehicles passing through the corridor of the arrivals terminal. They were not interested in giving me even a moment to search. Fortunately, she saw my car and with three pieces of heavy luggage pushed by a sleep deprived and exhausted 5-foot frame, she was able to run and almost catch and then run again and catch up to my car that was slowly rolling forward, resisting as much as possible the relentless directives pushing me beyond the most advantageous arrival exit while hoping for a miracle.  I could not see her beyond the hounding confusion and cacophony of the moment: I was in this instance lucky she was already out there, camouflaged somewhere in the emerging crowds, alert enough to notice my car passing through the area. She did all the work finding me, while I was treated like an unwelcomed interloper. 

I realize this may have been an extreme case of airport security’s insensitivity to the primary mission of the arrivals areas to safely match the arriving passenger with their ride to secure their passage out of the airport to their destination.  But I get tired of the constant harassment of these humorless, rude and emboldened  security guards focused entirely on the movement of traffic through their area. 

An inconsequential Day

Well, approaching 80 years of life is scary.  I could have only a few years of life left, at best I could have a decade or more and if I’m really lucky, I could reach what my father and maternal grandmother experienced – life after 100 (he 102, she 105).  I’m doing mostly the right things, but I could do better.  I exercise but I’m not moving around all day like I should. 

Sitting in the afternoon watching sports, the news and or Netflix dulls the brain, the reason I am trying to write - hopefully a column a day for my blog.  I wrote one piece on “the qualities of a good teacher” that will be published sometime this year in the local medical journal in Hawaii.  When that happens, it will have given me a publication record spanning 50 years.  I never aspired to publish all that much.  While I will never reach 100 pubs, having the 50-year span means something to me.  

Well, I’m off to the weight room at the Yacht Club to pump some iron.  God has planned for some major rainstorm the next few days.  Not looking forward to the downpour, worried about water intrusion under my house, and other heretofore unknown leaks rearing their ugly drops.  

But staying fit and mentally alert is what its all about.  Very happy to have another PSA level that will keep me out of the MR suite and biopsy room for another six months….whew……. Lots to do around the house to keep me busy. Writing a bit each day - even this paltry stream of consciousness is the least I can do to keep my fingers moving on the keyboard and my mind free associating inconsequential nonsense.  And Gerri just returned from boyfriend #3 in Taipei.  Happy to have her back home to harass me about cleaning the house.  Ok, off to the gym. 

Green Tea and Me

Well, this writing lacks originality and/or style.  But it describes a simple way of improving your health by avoiding sugary drinks at zero cost.  And it assumes that you will be drinking at least one cup of green tea, preferably in the morning. Now, instead of tossing the tea bag after your 3-minute steeping session, transfer it into another cup/container/bottle containing about the same volume of heated water – that was initially heated to prepare the primary cup of tea - and let it sit, while going about your business drinking your hot tea and reading the depressing news of the day. Come back in a few hours, discard the t-bag and refrigerate the diluted tea. After a few hours of chilling, you have some safe and healthy hydrating fluid to drink at any time for any purpose. 

I have been making this chilled, diluted tea now for a good 5 years. It took a bit of time to look forward to the taste. But if you stick with it, you will prefer it to drinking plain water although sipping both at various times of the day in also a cogent strategy. 

Green tea usually contains some caffeine, although much less than coffee.  Maybe enough to keep you alert without increasing your heart rate or getting you agitated. The truth is that I follow up my one cup of hot tea with one cup of coffee as the morning progresses. 

Introducing green tea into my feeding schedule was not an easy task. As a westerner, my tea preferences gravitated to black tea, i.e., English Breakfast, Earl Grey, and the taste of green tea was not only different but initially distasteful. The stronger green teas from China and Japan were particularly objectionable. I settled on Tazo green tea that contained a dash of spearmint. That was a few years ago. Now I drink any green tea that I am served or can squirrel away from airport lounges around the globe.  Truth is that green tea from Japan possesses the most spunk to color that second glass of tea that is crafted from the tea bag discard from your primary cup.  My favorite is the Yamamotoyama brand. 

Green tea is presumably good for you on a number of fronts. Mostly through its anti-oxidant properties, it mitigates the effect of oxidant stress your heart, lung, brain, GI tract, and even your prostate gland - for those of you who are lucky enough to have one. It also has been found to reduce your chances of some cancers including prostate cancer. While this short essay is not meant to provide evidence for such medicinal virtues, it certainly argues that not only does this green tea concoction provide an alternative to canned or bottled drinks that contains calories, artificial ingredients, and an addicting sugar component, it is also good for you, and also saves you money that can be spent on buying more green tea and other healthy fruits and vegetables.  

Retirement: A Period of Reflection and Continued Engagement

Introduction

At the age of 79 and having entered retirement, I observe that much of the available personal literature on this subject offers only limited engagement, with an extensive emphasis placed on financial aspects. The commercial sector tends to focus heavily on products and services related to retirement—ranging from financial planning to health supplements and specialized housing options. Existing narratives frequently convey highly individualized experiences, which may not be universally applicable or relatable. Recognizing that my own perspective carries similar limitations, I believe it nonetheless valuable to share these insights.

Rethinking Retirement

The term "retirement" itself is one I approach with some reservation, as it commonly implies a withdrawal from professional life and an inclination toward leisure activities. For many, retirement suggests a reduction in activity and an increased focus on pursuits that may not always support optimal well-being. In essence, retirement signifies a distinct transition in both lifestyle and daily routine. Typical depictions include repeated leisure activities such as golfing, television viewing, unrestricted dining, travel, relaxation, pursuit of hobbies, or relocation to retirement communities. My intent is not to critique individual choices or propose alternative ideals, but rather to reconceptualize the meaning of retirement, placing emphasis on its relevance for those who transition into senior citizenship at retirement, as opposed to individuals who exit the workforce earlier in life.

The Quartiles of Life

Life, in my view, can be segmented into four quarters, analogous to the phases of a sine wave. The initial quarter—from birth to age 25—is characterized by rapid growth and resilience. The second quarter, spanning ages 25 to 50, presents stability, maturity, and peak productivity. The third quarter, between 50 and 75, marks a gradual decline from previous levels, as physical and cognitive faculties begin to diminish. The final quarter represents the ultimate stage, culminating in the end of life. Statistical data indicates that by age 75, most individuals have a reasonable expectation of reaching 85, though far fewer attain a centenarian milestone. While mortality is inevitable, the specific circumstances surrounding death vary considerably—ranging from unexpected events to chronic health conditions and progressive decline.

Confronting Decline

It is unrealistic to assert complete control over the factors influencing mortality. The essential challenge lies in determining whether efforts to slow the aging process are justified in order to maximize quality of life in retirement. From my perspective, such endeavors are warranted. Subsequent consideration must be given to selecting strategies that most effectively mitigate age-related deterioration, bearing in mind the finite nature of time.

A Personal Strategy

My own strategy is straightforward and tailored to individual preferences. At present, I am gratified to report that my functional capacity remains comparable to that of previous decades. I am unwilling to acquiesce to the anticipated declines typically associated with aging; thus, I endeavor to continue engaging in activities such as walking, swimming, dancing, weightlifting, reading, writing, social interaction, and travel—with the possible exception of skiing, which has become increasingly challenging.

Maintaining an active lifestyle requires dedication yet does not monopolize all available time. My daily routines also encompass medical appointments, grocery shopping at retailers like Sam’s Club and Costco, scheduled periods of rest, consumption of a primary meal, and the planning of future travel—nine trips are already arranged for 2026 to destinations including Japan, Korea, Thailand, and Norway. Although time constraints persist, my central priority is the sustained preservation of health and well-being.

Summary

This essay examines the realities of aging and retirement, challenging common ideas of leisure and decline. Instead, it emphasizes strategies for maintaining health, vitality, and a sense of purpose into advanced age. Drawing from my personal experience and the insights of Dr. Peter Attia, I advocate for resisting the physical and mental decline that so often accompanies later life, and for adopting an engaged, proactive approach to living well beyond 75.

Perspectives on Longevity

This discussion is not about those with terminal illnesses or untreatable conditions. Rather, it addresses the experience of everyday people who are fortunate enough to have lived for about three-quarters of a century. In a recent podcast, Dr. Peter Attia, author of Outlive, described the period beyond age 75 as facing a universal physical decline. He suggests strategies for optimizing both lifespan and healthspan by delaying or even preventing the inevitable deterioration that comes with aging. This approach closely matches the mindset I have adopted as I approach my 80th year.

Postscript This essay represents an initial draft that was doctored by an AI edit.  While it polishes my writing and helps smooth out the edges, it also replaces much of my quirky style and hyperbole. I decided to publish this essay as an experiment.  In the future, i will note in the text if AI has injected any influence on the final product.  The fact is that, at least in this article, it took away some of the points of emphasis and I don't feel it conveys all of what i was trying to explore and emphasise.  Nevertheless, I wanted to experience what I believe is the common practice of using AI to embellish and polish original essays into something that feels wrong and cheating!

Sept 2016 to Jan 2026! Hoan Kiem Lake, Hanoi, Vietnam HAPPY NEW YEAR!

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January 2026

What are the Qualities of a Good Teacher?

I was recently asked to help a medical school faculty member with dossier preparation for a prestigious teaching award at the University of Hawaii at Manoa. I had previously helped with her promotion to Associate Professor and so I was happy to assist. After some thought, I contemplated a strategy to provide the most compelling argument for her to compete effectually for the award. Along the way, this commitment allowed me to broaden my appreciation for what constitutes an exceptional teacher.

Good teachers come in many colors, styles and a variety of disciplines. I always thought myself a good teacher, especially in my prime. Moreover, many of my mentors and colleagues were respected and effective teachers that I admired throughout my career. Accordingly, I believed that over my circa 50-year academic career in the Department of Pediatrics, Dean’s office, Office of the Vice Chancellor for Research and Graduate Education followed by a return to the Department of Pediatrics as a Professor Emeritus, I possessed a decent grasp of the attributes of a “good” teacher. To be sure, the diversity of positions that I occupied throughout my career allowed me to see/interact with an assortment of different teachers inside and outside my discipline. Surprisingly, as I considered the qualities of the faculty member I agreed to assist, I realized that my prior ingrained understanding of the attributes of an exceptional teacher was insular and incomplete. 

What I realized was that evaluation of clinical faculty’s teaching ability is particularly challenging. Formal classroom instruction typically consumes a minority of teaching commitment. Instead, teaching occurs at scheduled and unscheduled times and in diverse settings; on the wards, at the bedside, in the cafeteria, the parking lot, and even in social settings that clinical faculty members interact with learners at all levels. Teaching in this context is an extension of the daily communication between teacher and student. Teaching moments emerge fluidly from discussions of patient care, queries from students and families, and or programmed into the day’s activities. Sadly, it has been my experience that too many faculty members lack the patience to provide a safe, interactive, and meaningful teaching experience. Too many answer questions they ask without giving enough time for their learners to chime in. This tendency is amplified when teaching is held in any intensive care unit where patience is at its limit, when making timely decisions is critical to providing the best and most responsive care for patients. Faculty members tend to overlook the educational needs of students in this setting.

Considering these significant challenges, the exceptional faculty member I agreed to assist possesses most if not all of the qualities of my expanded view.  While most clinical faculty members gravitate to one or two groups of learners to focus their teaching on, she sets no limit to the audience in her midst. She not only teaches medical students, pediatric residents, neonatal fellows, but also undergraduate students, community members, colleagues from Pediatrics and other disciplines, nurses, the media, etc. When it does not conflict with her on-call duties, she graciously accepts invitations to speak or participate in educational activities without hesitation. 

Moreover, during her carefully prepared, polished delivery of lectures, seminars, informal discussions, and other interactions with learners, she exudes a gentile humanity and an ever-present, inviting warm smile, while attentively educating her learners as well as patiently listening and responding to their queries and concerns. Her motivation stems from her sincere long-term goal of paying back for the educational opportunities that she had as a Native Hawaiian. She genuinely cares for the learners in her sphere; she is not just spewing out knowledge as an academic obligation of her university. 

Due to her character, performance and productivity, she is increasingly recognized and inspired by learners and colleagues as an outstanding role model for students of medicine and academics. She does not whine or complain about her wide-ranging work load. She finds time to get her work done, prepare for lectures, finalize her research manuscripts, work on assignments in her Dean’s Office role, and reading the latest journals after her three children go to bed at night.  Most of her interactions occur through email communications sent around midnight or later. She is truly an unselfish workhorse who is naturally driven to fulfill her passion in all of her roles; at home, in the classroom, at the bedside, and in the community. 

She frequently attends lectures, educational and social events with one or more of her children, maximizing the time she spends with them. Not surprisingly, people are drawn naturally to her both professionally and in her role as a mother, a wife, and as a local born and raised in Hawaii. She has a natural flair for fitting into any conversation or social setting. 

What I realized when I was pondering how I would counsel this faculty member on how to frame this teaching award application, was the distinct difference between giving a brilliant lecture and being a brilliant teacher.  I have witnessed many brilliant lectures throughout my career, many from well-known dignitaries and renowned academics without knowing the person behind the accolades. They may or may not be considered good teachers or inspiring role models. A good teacher is more than the sum of what or how well they teach. A good teacher cares for their learners. A good teacher is patient and sensitive to their learner’s concerns and challenges. A good teacher is a good person, a good role model, a balanced individual who is able to somehow manage the multifaceted challenges of life with dignity and a positive spirit. Burgeoning learners gravitate to and often mimic those who inspire them in life, to validate their own quest, to give them courage for their future endeavors and often to receive long-term career advice as they encounter crucial cross-roads in their life’s journey.