I saw a gay cowboy movie the other day..... the mancard holding guy's guide to Brokeback.

Actually I didn't. I saw Brokeback Mountain. And if you haven't seen it, or are afraid to see it, you should. It is easily one of the best movies I have ever seen. Hands down. The sorrowful honesty of the simple lines. The complex physicality of the acting. The perfect pacing and timing by Ang lee. The focus on love and relationships - not homosexuality. And the tragedy of dreams unfulfilled pressured by inward and external obstacles. I wasn't prepared to like this movie - but I admit it. I do.

That said, there's a ton of guys who refuse to watch this movie. In a sense, I can't blame them. The thought of watching two guys pitchin tents (literally) and gettin their gay on is not really on the level of say.... watching Jessica Alba in bikinis all day. Frankly, the thought of having feelings for another man doesn't repulse me per se, I'd just rather not go that route. I like my wife the way she is.

So I came up with some good reasons for the hetero, ballscratchin, pee territory markin', and porn watchin (in the AM no less) male to watch BBM. Please tell me you know waht BBM stands for.

Reason 1: There is boobage in this movie.
I must say, the boobage is quite good. Anne Hathaway's boobage is surprisingly nice. I didn't know she had a set like that! But then again, any thought of that while watching the Princess Diaries' movies would be akin to child porn - but she's grown up now, so its okay to talk about it. (Either way, I feel as if I'm stepping on the catwalk of trepidation - I can't believe I admitted that I've seen the Princess Diary no 1. No plans to see the sequel.)

Not only that, but there is boobage with Michelle Williams too - although her boobage is flat on her back boobage - which by any measure is a difficult predictor of normal standup boobage. I think she has good mammaries - and I'm glad I saw it.

Reason 2: You look better to your date.
Let's face it. Women are much more accepting of gay men that guys are. Why? Well, guys offer sex like they offer cash to the bartender - It doesn't matter who accepts the offer a lot of times - there's no shame in offering because the reward is so good. So women get tired of the constant offers disguised as ignorant psuedorecognition (Hey, don't I know you from somewhere), arrogant chest pounding, and/or cheesy (and often greasy) suave-itude (I make up words as I go along to suit me - my linguisticality is simply amazing)

Guys - well guys would love to have it the other way. If women threw themselves at me all the time - hell I'd enjoy it. But we would enjoy simply because it doesn't happen that way. In part, this is due to a guy's introverted self esteem deficits. They won't say it, but many guys lack it. If they say it, they're bitches. Like snitches. Fo shizzle my dizzoggy dizzle double oh pizzle. Fucking butter popcorn high's got me saying crazy shit. So men with lo self esteem need that women attention and crave it.

So what happens with the gay male who lavishes attention on the straight guy? The lo self esteem guy takes it as a shock to his manhood. Like somebody just poured cold water right to his testicles - shrinking them to freeze dried peas. They look at it like they're a bitch being sought out for some behind the alley dropping the soap bar action. The reality is this. Most gay guys are impeccably fashionable. They also know style when they see it (at least not the bonfire flamingly gay ones) - so if you get a compliment from them - you better know that you're on the level, if you know what I mean.

So how does BBM relate to this? Let's just look at it like this. You can sit through a gay sex scene without flinching (eating popcorn furiously fast and staring at teh upper left corner of the screen and counting the number of white dots is not flinching - perfectly normal movie viewing). You can feel the sorrow and pain of a man who loves another man. You can stand up proud and hold your SO's hand. All this means that your self esteem is in check. Your'e comfortable with your own manhood. You know where your penis is pointed. And you are NOT afraid to be comfortable with gaydom. You're gonna get laid.

Reason 3:.... ummm.... uhhh....... Its seriously a great movie.
If Heath Leger doesn't win Best actor, if Ang Lee doesn't win best director, and if the movie isn't the best movie fo the year - something is entirely wrong with the Academy. It's that good. And it has some of the most memorable scenes and lines:
"If you can't fix, you gotta stand it."
"I wish I could quit you."
"Jack Twist. Jack NASTY." (Jack, its TWIST IF YOU'RE NASTY - yes that's right brining it old school with the Janet Jackson reference - gyeah!)

Okay, there's only 2 good reasons for mancard carrying guys to actually try this movie out. But I bet, that more than half of you mancard carrying men will actually like it. The other half - well you're probably already on mancard probation - having already done something that is smolderingly gay - not flamingly - and are now trying to front like you're King Kong or something.

So please put you're squirminess aside and see the damn movie. It's a classic. One I'll remember for the rest of my life (then again, I remember Breakdancin' as a classic movie as well). Even if you end up hating it, you can at least say you saw it and its still memorable either way.

Is Luxury a Sin?

I feel guilty often. Due to my wife's hard work, talent, and ambition, we have a good income which allows me to indulge myself in finer pleasures. There's nothing but happiness in this. No complaints at all. Where it becomes a difficult issue is when my tastes in luxury somehow become the topic of conversation amongst other people. I feel incredibly guilty even conversing about any of my less miserly hobbies. And often, I can't explain it. I can't explain why its worth it to spend so and so amount of dollars on something, when the person I'm talking to is staring at me like I'm the poster child for materialism and excess.

So a question comes to fruitiion almost every day - is luxury wrong?

What is luxury? What is materialism? When does it become wrong?

Some quick searches for the definition of the word luxury reveals various opinions in itself. ONe states that it is anything in excess of necessity. Which then leads to the question, what is necessity? Technically, basic physiologic function is only what is necessary to humans. So really all we need is food, water, and some excercise. So does this mean that clothing is a luxury?

Another definition states that luxury describes anything that carries with it high value and uniqueness, such that it is considered the finest example of a class of activity, good, etc. I tend to think this is the more correct definition. This means that the appreciation of luxury is not an appreciation of excess per se, but rather an acknowledgement of the pinnacle of that class of acitvity, good, etc. This definition lends itself to a slightly more focused and friendly view of luxury, but it also requires examination of how each characteristic of luxury is correct - how do we know that Picasso's art is near the pinnacle of painted art? How do we know that Bentley's are the pinnacle of automotive transportation? Who determines this?

My thought is that luxury is okay. There's nothing wrong with luxury even when defined by BOTH of the above definitions. Desiring a Porsche is in excess of what is necessary, while acknowledging its superiority and high quality in the automotive world. Desiring this luxury on 4 wheels is not at all a sin.

What of materialism then? Materialism can be loosely defined as the desire for possession of wealth and material things. Note that the definition does not mention appreciation of the finer points of welath and material things. It just says that a person desires things.

Is this wrong? If I suddenly become a hip-hop mogul with 20s on my whip with monstrous mansions with recording studios and hos hanging off me like I'm a reincarnation of a Vietnamese pimp - am I being materialistic? And if I am, am I wrong?

I say materialism is both right and wrong. By definition, it contains encompasses those that desire luxury and the pursuit of finer things (and unfortunately, in our capitalistic society - we place a price on finer things - even nature costs money these days). It also encompasses those that, for lack of a better word, flaunt.

I hold no ill will towards those who wish to pursue finer things for their own sake. For example, I love hi end audio. I spend too much money on amplifiers, speakers, wires, etc to eek out the best reproduction of music possible. But this stuff is in my house. No one knows its there unless they come over and discover it by accident. Its only for my own happiness. Purusing luxury for one's own happiness tends to pervade every aspect of one's life. For example, I seek the best in my cars, my audio, my literature, my clothes, etc. It's a distinct perfectionism that seperates a person from the type of people I describe in the next paragraph.

Where I have issues is those who flaunt luxury for purposes of reputation and show. They simply want to portray an image of luxury and an image of understanding of luxury. They really don't know, but they think that flaunting it will automatically make them luxurious. You know who I'm talking about. They think that one thing that costs a lot will give them an air of money. For example, the FOB driving the lexus in his tshirt and pajamas trying to look hard. The loud and obnoxious patron of an expensive restaurant who forgot that it was a jacket and slacks restaurant. The prada toting female wearing only juicy coutre sweatpants to the night on the opera.

Even worse, there are those who have no idea why what they buy costs so much. The Porsche driver who has no idea why a Porsche is so much better than most othe rsports cars. The purchaser of automatic chornographs who have no idea what makes expensive watches so expensive. The lists go on and on.

To them, luxury is the action of flaunting money, and in the process luxury defines their self-esteem. I don't get that.

I have no need to flaunt my luxury (even though I am at the entry level of luxury in my hobbies and interests). I know what I like and I know why I like it. I research it thoroughly. I read about it every week in magazines and online. I embrace the enjoyment of luxurious things, because I appreciate the quality that it represents. Do I care if you notice it? Not really. Will I be happy if you ask about it? Of course. LIke anybody, I love to talk about my interests and what drives me. Does this mean I'm a materialistic, uncaring blowhard? No - I just like fine things.

I know, this particular blog will sound horribly elitist. And some will read into it that I'm spoiled and that I'm not acknowledging the fortunate situation I'm in.

I'd just like to remind those people that my father slaugtered cows to feed and clothe myself and 12 other members of my family who slept and lived in a trailer house in Wisconsin. Oh yeah, and in the meanwhile leaving behind a life of prosperity in a war-torn country. I'd also like to remind people that its not like I've been sitting on my ass enjoying luxury. I actually work, and work hard my whole life to be where I am.

So, am I materialistic? In the fact that I like luxury and that luxury requires money in this day and age - yes. IN the sense that I flaunt materialism - no. But I'll let you decide and see where the chips may fall.

Shout out to my real friends....

You know who you are. You're the one who doesn't forget. The one who remembers to email me even if we haven't talked for months. The one who sticks by even when I'm far from perfect, or even satisfactory. The one who gives me the benefit of the doubt, because you know that deep down I didn't mean to make that mistake. The one who actually wants to hear what I have to say, not just feign conversation for your own sake.

These are friends I'm lucky to have. I'm often negative on my blog, but once in awhile, the thought of a true friend emailing, the reading of an email from a friend from afar but still close in my mind, and the recognition of how lucky I am to even have them as friends... reminds me that I'm far richer in friendships than anything else.

Thanks for understanding... I'll be the same old me at some point... just give me some time.

The underappreciation of the surgery resident

One of my personal new years resolutions was to start blogging more. Not really for any particular audience, but to at least keep personal tabs on my thoughts, emotions, and ideas at the time. Well, I already am starting behind on this resolution (let's not even start about the running everyday resolution) - I guess I'm always playing catch up.

These past few wees I've been rotating through a SF hospital to get some training in Transplant Surgery. Now I wanted to do transplant surgery when I started residency, but my relative wishes to be there for my wife and future chi clones (yes she refuses to let my genes be any part of it) have made it less probable. I now know why I can't do Transplant for long. To give a clue as to how my week starting last wednesday goes... I'll document it here.

Wednesday
Get called at 3AM to be in the OR by 430am for kidney/pancreas recipient operation (kidney transplanted INTO patient). Wake up, shower quickly drive 30 mins to hospital and go to OR where I'm told we have a second kidney/pancreas recipient operation. 16 hours later (yes each operation takes 8 hours), with no water or food, and completely tired legs, I stagger out of the hospital. OF course during the whole 16 hours I get berated by the head surgeons, whose idea of education comes from an Army Drill Sergeant's Basic Training manual I think. Its not that its inappropriate - I need to learn, but dammit do they need to yell at full volume and demean us surgical residents? For Christ sake's I'm 30 (which is young for surgery standards but still old compared to my friends).

Thursday
Luckily its a day off so to speak. I go to educational meetings/conferences in Oakland that start at 7am and last till Noon. But I need to read the rest of the night to prepare for our annual in training exam that lets us go on to the next year.

Friday
I get called 1AM in the morning - 4AM start time for a kidney transplant. Another 7 hours of an operation and more of that Officer and a Gentleman type of yelling (I need to make sure they get Louis Gossett Jr's kin for my life story). Again, no lunch, just a splash of water and I'm in a pancreatic tumor removal for the next 6 hours. I stagger home again, tired.

Saturday
I get called AGAIN at 1am int eh morning for a 7am start on a kidney transplant. I get there, and of course, noone tells me that it got delayed to 11am. So I go back home and come back later. I don't get out of the hospital till 5pm. I'm officially a little tired by now.

Sunday
Day off... but I get these horrific fevers and chills when I wake up... not a good sign at all. Of course at 1245AM (mind you, my wife wakes up everytime my crazy ass pager or cell phone goes off) I get a call to come by at 8am at the ambulance entrance to go on a donor run (meaning we get the organ's from the patient who is now brain dead and is an organ donor).

Monday
I wake up in horrible condition. My nose is stuffy, I have a horrible dry cough, and I have muscle aches all over. Not to mention that headache that feels like somebody stuck my head next to a Harley Davidson exhaust all night. I drug myself up with heavy prescription doeses of Ibuprofen. 8am I'm at the ambulance entrance and they pick me up. Oh yeah, did I mention, we're flying to Redding CA to pick these organs up? This doesn't bode well for my now climbing temperature which I last recorded at 100. We fly there and we need to wait for the lung team from Canada to come (organs go to different places depending on which patients need them - we're here to harvest the liver and kidney/pancreas, Stanford came to get the heart).

We start at 11am and finish by 5pm. We then get transported back to the learjet that took us there (which I'd never flew on before but damn those private jets are tiny) and now I'm in full shivering/feverish/coldish/achish mode. Not looking good for the home team at all.

Get home at 830pm and eat (I love my wife - she got me anything I wanted and took care of me all through this). And dive under a million blankets but can't warm up. I didn't get into bed until 10pm.... which sets me up for another call at ... you guessed it 2am in the morning. "Rich we have a kidney transplant starting at 3am...." My reply, "Hello, no speaka english? No really, I'm going to make it, but I feel horrible... I had a temp of 102 last night." No sympathy from the other end other than, "Well maybe you should just stay home." But I'm a stubborn son of a bitch, so I go anyways.

Tuesday
After answering the phone, I nearly fall over, completely sick, fatigued, and dizzy. I probably didn't drink enough fluids the night before. I get in the shower to wake me up and it just doesn't seem hot enough no matter how high I turn it. I get out, throw on some scrubs and head to the hospital. I think I only had enough energy to drive at theat point and the Butterfinger I always keep on hand for a quick boost of energy didn't do anything for me. I was nauseous. The entrance to the hospital is up a two story hill and I actually had to stop and rest halfway I couldn't make it up. Once I entered the hospital the security guard actually said that I looked sick and the ER was straight ahead... I told him no, I'm here to operate. To which he laughed. Thanks.

I struggle up to the OR and the attending and the PA are there, who immediately look at me and say nothing. Its like some unspoken rule that as a senior person, you can't tell someone to go home, you have to leave it up to them to stay or not. Because of my valor or stupidity, I wont' leave. I love operating. I scrub in and I proceed with the 6 hour operation, which I do well during simply running on pure adrenalin. Operating is an adrenalin rush that I can't compare with anything else. But when we're done, I nearly collapse. My knees are weak, my arms fall listless by my sides.

I get home and collapse on teh floor. I wake up 30 mintes later shivering and proceed to have a fever of 102-103 the rest of the day an night. Luckily no cases occurred ove rthe next few days and I've been able to stay at home and rest with what is now the flu.


In retrospect, I probably should have just stayed home. But in surgery, that's seen as weakness. Seriously. I've gotten IV fluids in the hospital before while I was sick just so I could do the work. Nobody will tell you, "You look and sound horrible you should go home." Well maybe a select few would - but they are few and far between. Moreover, the senior surgeons are so cynical, some actually think that residents would fake illness to not come in. Which, in my case, is entirely not true. I feel absolutely HORRIBLE about not being at the hospital and taking care of patients. Its my duty to be there for them and to learn from the senior surgeons.

But at some point, the senior surgeons should balance that innate desire of surgery residents with common sense. If they are a danger to themseleves (driving while being dizzy, nauseous, and lightheaded is not good) then no good can come of them being there and the senior surgeons should step in and tell them no.


I sometimes think that people don't realize the hardships surgeons face and overcome. They don't realize the work we put in, the pain we endure, and the sacrifices we make to provide the community with care. All they see is Dr. 90210 and a few documentaries here and there and stereotype that to all surgeons. They think that surgeons all live the glamorous life and that we roll in the dough. That's not true at all.

Surgeons are slowly losing pay in the bay area. Not to mention malpractice and loan repayment, their pay is woefully inadequate for what they do. Of course, someone will say, why should you complain, you'll be making 6 figures. Surprisingly some surgeons dont' anymore, for one. Second, who else trains for 13 years after college, making less than minimum wage for half that time, works 80-120 hours a week with no break, and endures the life or death stress that we do? Third, shouldn't society as a whole attract better doctors/surgeons by raising their wages? Or will we have what we have with schoolteachers, who perform an incredible societal function but get paid nothing? Finally, do you really want to underpay the person who may be your only option for savior down the line?

It strikes me as funny that some will completely revel in real estate agents' bankroll during the boom and yet look at doctors with disdain when they complain about money. Why is that? Will a real estate agent save your life? Isnt' what they do resolutely selfish? It sounds arrogant, but I save lives weekly - sometimes emergently sometimes over a longer time period. Yet, outside of my medicine friends, my wife, and Jimmy, no one expresses any appreciation for what I do or feels proud to know someone like me.

I just wish there was more support for doctors in this country. Not that we need it, but we're human too and we'd like just a little notice that someone out there is supporting us instead of looking to sue us for a quick buck. If not, we're going to lose the good talent and truly good people to other fields, and our healthcare will regress. Ugh, I need to get off my soapbox now... and go call the hospital to see if I need to come in.