Sunday, November 4, 2007


Micky H and I are expecting 1 of 12 coming up this May. I am thinking that it is going to a little Micky H rather than a little David III, which means I have until May to learn to shoot, apply for a concealed weapons permit, and buy my first Glock. The thought is that we are going to call her Lily and that she is going to be pretty cute. The waiting list to get a date with Lily is already growing with our man Tyler having reserved the first spot. Take a number, get in line.

Mountains Beyond Mountains

Quotes from the book:

"Never underestimate the ability of a small group of committed individuals to change the world. Indeed, they are the only ones who ever have." - Margaret Mear (Jim Kim)

"Intelligence plus character--that is the true goal of education." - Martin Luther King, Jr.

Excerpts from the book:

I am aware of other voices that would praise a trip like this for its good intentions, and yet describe it as an example of what is wrong with Farmer's approach. Here's an influential anthropologist, medical diplomat, public health administrator, epidemiologist, who has helped to bring new resolve and hope to some of the world's most dreadful problems, and he's just spent seven hours making house calls. How many desperate families live in Haiti? He's made the trip to visit two.

I think of the wealthy friend of Howard Hiatt's who balked at contributing to PIH (Partners in Health) because, while he knew about Farmer's work in Haiti and considered it impressive, he doubted anyone could reproduce it. I've heard variations on that theme. (Paul) Farmer and Kim do things that no one else can do. Zamni Lasante won't survive Farmer. Partner in Health is an organization that relies too much on a genius. All the serious, sympathetic critiques come down to the two arguments: Hiking into the hills to see just one patient or two is a dumb way for Farmer to spend his time, and even if it weren't, not many other people will follow his example, not enough to make much difference in the world.

But standard notions of efficiency, notions about cost-effectiveness, about big people performing big jobs, haven't worked so well themselves. Long ago in North Carolina, Farmer watched the nuns doing menial chores on behalf of migrant laborers, and in the years since he's come to think that a willingness to do what he calls, "unglamorous scut work" is the secret to successful projects in places like Cange and Carabayllo. "And," he says, "another secret: a reluctance to do scut work is why a lot of my peers don't stick with this kind of work." In public health projects in difficult locales, theory often outruns practice. Individual patients get forgotten, and what seems like a small problem gets ignored, until it grows large, like MDR (multiple drug resistant TB). "If you focus on individual patients," Jim Kim says, "you can't get sloppy."

That approach has worked for PIH. And I can imagine Farmer saying he doesn't care if no one else is willing to follow their example. He's still going to make these hikes, he's insist, because if you say that seven hours is too long to walk for two families of patients, you're saying that their lives matter less them some others', and the idea that some lives matter less is the root of all that's wrong with the world. I think he undertakes what, earlier today, he called, "journeys to the sick" in part because he has to, in order to keep going. "That's when I feel the most alive," he told me once on an airplane, "when I'm helping people." He makes these house calls regularly and usually without blan [non-native] witnesses, at times when no one from Harvard of WHO [World Health Org] can see him kneeling on mud floors with his stethoscope plugged in. This matters to him, I think--to feel, at least occasionally, that he doctors in obscurity, so that he knows he doctors first of all because he believes it's the right thing to do.

If you do the right thing well, you avoid futility. His patients tend to get better. They all get comforted. And he carries off, among other things, images of them and their medieval huts. These refresh his passion and authority, so that he can travel a quarter of a million miles a year and scheme and write about the health of populations. Doctoring is the ultimate source of his power, I think. His basic message is simple: This person is sick, and I am a doctor. Everyone, potentially, can understand and sympathize, since everyone knows or imagines sickness personally. And it can't be hard for most people to imagine what it would be like to have no doctor, no hope of medicine. I think Farmer taps into a universal anxiety and also into a fundamental place in some troubled consciences, into what he calls "ambivalence," the often unacknowledged uneasiness that some of the fortunate feel about their place in the world, the thing he once told me he designed his life to avoid.

"The best thing about Paul is those hikes," Ophelia says. "You have to believe that small gestures matter, that they do add up." Earlier today Farmer said that he'd brought on others to fight "the long defeat." The numbers are impressive. They include priests and nuns and professors and secretaries and businessmen and church ladies and peasants like Ti Jean and also dozens of medical students and doctors, who have enlisted to work in places such as Cange and Siberia and the slums of Lima. Some of the students and doctors work for nothing, some earn much less than they could elsewhere, some raise their own salaries through grants. I once heard Farmer say that he hoped a day would come when he could do a good job just by showing up. It seems to me that time has already arrived. A great deal of what he's started goes on without him now, in Roxbury and Tomsk and Peru and, some of the year, in Haiti. Meanwhile, other definitions than the usual, of what can be done and what is reasonable to do in medicine and public health, have spread from him. They're still spreading, like ripples in a pond.

How does one person with great talents come to exert a force on the world? I think in Farmer's case the answer lies somewhere in the apparent craziness, the sheer impracticality, of half of everything he does, including the hike to Casse.

My goal personal goal, the end to which I seek, is to be to education in America what Farmer is to public health in Haiti.

Tuesday, May 22, 2007

Hot Soup, Cold Soup

Donna B Nielsen describes in her book Beloved Bridegroom the ancient biblical imagery of Christ as the Bridegroom. In reading her book I have gained an appreciation for both Christ's intimate love for each of us as well as the historical importance of marriage as an institution and eternal covenant.

Anciently, Jewish marriages were the pinnacle of their culture and society. Marriages were not arranged per-se, but a young man often made proposals of marriage to a girl he may have never have spoken to and only seen a few times during city wide festivals or otherwise.

Marriages were a solemn legal and spiritual covenant. The betrothal period often lasted a year while the young man built a house for the couple to live in. The proposal was accompanied by a dowry for both the family as well as the bride. The bride received this dowry much as we would an engagement ring today, and wore some of the money around her neck as a symbol of her promise of marriage.

Marriages were protected and emphasized by the families, society, the church, and the law. Such support leads to strong families. But is there not one thing missing? What about love? Is that not the foundation for a strong marriage and family?

To quote from the book, pg. 13, "It was not that love was thought to be unimportant, it was just that to them, love was an emotion to be cultivated after marriage rather than before. Much more emphasis was placed on the principle that marriage meant honoring a sacred commitment to a pledge. A person's word of honor to be loyal and to make the marriage work was considered more significant that passionate attraction."

To help sum up this difference between ancient and modern marriages, contemporary minister and religious psychologist, Walter Trobisch says, "[They] put cold soup on the fire and it becomes slowly warm. [We] put hot soup into a cold plate and it slowly becomes cold."

I found this quote very interesting. I think that to a large degree that this is true. That in our society we focus on finding love, on the initial attraction, then assume the story is a happily ever after as long as the couple makes it to the alter. While the marriage institution of old was firmly and effectively established, I don't believe we have to let our hot soup turn cold.

In fact, possibly surprising to some, the divorce rate in the US has declined over the last decade:

Per capita divorce rates 1990-2002:
1991, 0.47%
1992, 0.48%
1993, 0.46%
1994, 0.46%
1995, 0.46%
1995, 0.43%
1997, 0.43%,
1998, 0.42%,
1999, 0.41%,
2000, 0.41%,
2001, 0.40%,
2002, 0.38%

In my own life, I would like to have steamy hot soup that only grows warmer with time. President Faust, in his recent conference talk asks, "How can a marriage be constantly enriched?”

He goes on to answer, "We build our marriages with endless friendship, confidence, and integrity and also by ministering to and sustaining each other in our difficulties. Adam, speaking of Eve, said, 'This is now bone of my bones, and flesh of my flesh' (Genesis 2:23). There are a few simple, relevant questions that each person, whether married or contemplating marriage, should honestly ask in an effort to become 'one flesh.' They are:

"First, am I able to think of the interest of my marriage and spouse first before I think of my own desires?

"Second, how deep is my commitment to my companion, aside from any other interests?

"Third, is he or she my best friend?

"Fourth, do I have respect for the dignity of my spouse as a person of worth and value?

"Fifth, do we quarrel over money? Money itself seems neither to make a couple happy, nor the lack of it, necessarily, to make them unhappy. A quarrel over money is often a symbol of selfishness.

"Sixth, is there a spiritually sanctifying bond between us?"

I believe that we can have our cake and eat it to. I am grateful to have had the opportunity to date and find my wife and fall madly in love. I am also grateful for our eternal marriage covenants and all that marriage has taught me. I am grateful to have hot soup and to have the examples of my parents, as well as David & Lindsey, to show me all a marriage can be. I am grateful for Pres. Faust's words of direction as well as Pres. Hinckley and the other leaders of the church to help show us the way--show us how to have warm soup in warm bowls.

Monday, May 7, 2007

The Dreamer's Freshest Dream

I have been reading a lot about the rising difficulties for today's youth to (1) get into the increasingly demanding college entrance (BYU's ACT acceptance cutoff has risen 4 points in 5 years), and (2) the increase difficulties today's generation of college students have paying for higher education (A full Pell Grant in the 1970's would pay for 75% of Harvard vs. 25% of a state school today).

Are the doors of oppurtunity still available to all? The America Dream has long been questioned and seems increasingly jeopordized. Seemingly, in today's world, the American Dream seems more sustained by reality television giving the occasional average joe a crack at a million dollars, a dreamy bachelor/bachelorette, or a chance a pop stardom, than it does by American industry, education, or policy.

Here is some proof that the American Dream is still hanging in there. Today, it seems, the American Dream just takes a little extra dreaming.

Newseek Reports a decade ago, Jesuit Father John Foley decided to tackle problem of the low graduation rates for inner city minorities, and even lower accpetance rates into college.

Check Out the article, but the long and short of it that the church did not have the funds to support the school, and the low income families couldn't afford the tuition.

Dreams take money. Money or big dreams and fresh ideas.

Foley, threatened to see his dream fall apart before ever getting a sinlge student enrolled turned to management consultant, Richard Murray, for help. Murray came up with the idea to have the students pay for their own tution by holding entry level jobs with local Chicago firms. If they could work 1 day a week and work the cirriculum into the other 4 days it could work.

Now a decade later, he has over a 100 Chicago firms involved and nearly a 100% acceptance rate into college. What a model.

Two great things from this: (1) look at what results came from rethinking the education model, and (2) the privatization of education.

Tuesday, May 1, 2007

Harvard to kick the bill for <$60k families reports that Harvard is kicking the bill for the children of families that earn less than $60K/yr. The students will continue to be required to pay some amount based off of a payment schedule that is tied to their campus employment.

What a great step. Harvard has the means to be a major influence in changing the educational landscape and I am glad to see them take such a meaningful step.

A tiered payment program could be implemented so as to not leave the $61K families out to dry.

Also, while I feel this is an incredible step, I would be interested to learn about the requirements with the payment schedule and the campus jobs.

I just graduated with my BS a week ago. I worked multiple jobs through school both for experience and to keep the bills paid, but found that those who had really high financial demands were at a considerable disadvantage when they had to sacrifice extracurricular activities and career promoting opportunities.

At this point is the $6,000- $8,000 a year that a campus job will earn really worth the sacrifice to the individual when that amount is of such little significance to Harvard?

A great step... there is still a better way.

Wednesday, April 18, 2007

Virginia Tech & Kurt Vonnegut

16 Apr. 2007, Cho Seung-Hui decided he had had enough of this world. Cho Seung-Hui, opened fire in a dormitory and classroom building on the Virginia Tech campus, killing 32 people before committing suicide. It is a tragic event for everyone involved. Here is Utah, this comes in the wake of a recent, and much closer, shooting at Trolley Square. Life is tragic.

The recently deceased Kurt Vonnegut put it well: "It appears to me that most highly evolved Earthling creatures find being alive embarrassing or much worse. Never mind cases of extreme discomfort, such as idealists' being crucified. Two important women in my life, my mother and my sister, Alice, or Allie, in Heaven now, hated life and said so. Allie would cry out, "I give up! I give up!"

"The funniest American of his time, Mark Twain, found life for himself and everybody else so stressful when he was in his seventies, like me, that he wrote as follows: "I have never wanted any released friend of mine restored to life since I reached manhood." That is in an essay on the sudden death of his daughter Jean a few days earlier. Among those he wouldn't have resurrected were Jean, and another daughter, Susy, and his beloved wife, and his best friend, Henry Rogers."

"Twain didn't live to see World War I, but still he felt that way."

"Jesus said how awful life was, in the Sermon on the Mount: "Blessed are they that mourn," and "Blessed are the meek," and "Blessed are they which do hunger and thirst after righteousness.""

"Henry David Thoreau said most famously, "The mass of men lead lives of quiet desperation."

"So it is not one whit mysterious that we poison the water and air and topsoil, and construct ever more cunning doomsday devices, both industrial and military. Let us be perfectly frank for a change. For practically everybody, the end of the world can't come soon enough."

What would Mark Twain have to say if he could see the world today?

Cho's roomate, Joe Aust, a 19-year-old sophmore, was interviewed by the New York Times' Marc Sontora about Cho:

"[Cho Seung-Hui] was my roommate. I didn’t know him that well, though.”

Aust said that he never saw Cho with a girl or any friends for that matter.

“He was always really, really quiet and kind of weird, keeping to himself all the time,” he said. “Just kind of anti-social, didn’t talk to anybody. I tried to make conversation with him in August or so and he would just give one word answers and not try and carry on the conversation.”

“I would notice a lot of times, I would come in the room and he would kind of be sitting at his desk, just staring at nothing,”

The police were surprised that even his roommate knew so little about him. Not that this situation is Aust's fault in any way, but isn't it sad that a person could reach such an emotional state that they would flip out like this, and the closest person in Cho's life, for better or worse, tried making conversation "once" 8 months ago.

So, when we try talking to someone once and when they make it apparent that they are shy, distraught, withdrawn, possibly hurting in such a way that it is hard to interact at a casual level that we let them continue to bump along their way.

It just serves as one more reminder that, "For practically everybody, the end of the world can't come soon enough."

If only people were like tea pots. When the steam and pressure begins to build a whistle would sound.

But people aren't tea pots.

I suppose the key is to take both Thoreau's and Christ's words--combine them--and live by them. Assume everyone's life is as dark and desperate as Cho's and determine to mourn with all those who mourn, comfort those that stand in need of comfort, and we will find that we are not far off in assuming everyone needs someone to help them through this life.