Thursday, November 29, 2018

Day after New York

New York, NY.  So nice they named it twice.  And it really was a lot more pleasant than on any of my prior tourist attempts.  Bus ride from home 2.5 hours each way.  The Chinatown Bus driver passed everyone on the Jersey Turnpike but had to stop to replenish the diesel fuel on the way there.  The Macy's area, the drop-off location, may as well been the local mall.  While the flagship Macy's was a lot bigger than ours, the stores along 34th street included a KMart and mainly other chains found anywhere.  At the end of the day, the city bus took me along Fifth Avenue's more tony shops.  Lot's of Christmas shoppers on the sidewalks at dusk, not many shoppers in places that only need to sell a watch or two each day.  Lunch at Kosher deli a few blocks north, a treat to people who do not have kosher deli's and are deterred by the price of Kosher corned beef at Shop-Rite.

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Found my way to the Cloisters, my intended tourist target, via the A Train with a senior discount.  That left a half mile walk to the museum.  Having been to a number of Art Museums the last few months, this one given its reputation seemed a disappointment.  Since I had too much time left, I took the bus from the Cloisters to the bus pickup, a span of 160 blocks which took the MTA Driver 2.5 hours.  I had not been north of the George Washington Bridge in Manhattan.  Pretty nice place with clean buildings that have white brick, some architectural detail and neither litter or graffiti.  School letting out so a bunch of late grade school kids got on the bus, all nicely groomed, none boisterous.  Just south of the bridge appeared the Columbia Presbyterian Medical Center, a multiblock congested monument to health care, much of it aging, some new.  Made it past the less massive Mt. Sinai Hospital, first time I've ever seen it, about 70 blocks south.  As the street got the the 140's, the area appeared more Hispanic, a little shabbier but still without litter or graffiti.  Then I expected Harlem but that seemed largely gentrified with some theological seminaries, a large Barnard presence, more subtle Columbia University campus, and some vestiges of City College.  The shops along Broadway seemed similar to other college towns.  Cathedral Parkway at 110th Street, which I expected to be the southern limit of Harlem, also looked gentrified with a branch of Yeshiva University and some churches and some tasteful apartment buildings.  Then across the northern border of Central Park, turn down Fifth Avenue to the eastern border followed by the bus to the end.  Not a lot of people in the streets until the southern part of the Park.  Museums such as Guggenheim's spiral architecture, a music school, apartment buildings with increasing architectural decoration, signs for doctors who do not have ethnic names and do not say one way or the other if they accept Medicaid unlike the doctors farther north.  Made it eventually to the terminus, too dark by then to see much other than the storefronts with bright lights and the sidewalks, and the iconic lions that invite the scholarly or those terrorized by term paper due dates to partake of the massive New York Public Library.

Found my pickup stop, Boarded an early bus than originally intended and uneventful, restful ride back home.

When I did my semi-annual planning about six months ago, I had allocated three day trips among the twelve initiatives, all to places I had not been before.  Dickinson Plantation, Princeton Art Museum, Cloisters.  One very doable semi-annual project likely worthy of repeat when the next planning session begins next week.

Tuesday, November 27, 2018

Coffee by Percolator

Farberware Classic 8-Cup Stainless Steel Percolator 50124

Way back when, the night before major science exams, I would take out my orange electric percolator, contraband in the dorms, and brew a pot of real coffee after supper to enhance alertness.  It served its purpose.  I do not know where that percolator is now, but I have both an electric one kept in storage and a stovetop one that does not get used all that much kept in a corner of the kitchen.  Over the ensuing forty years, my fondness for coffee, both its taste and its effect, has never dwindled.  Sometimes it came from the school cafeteria, less frequently my percolator.  When visiting parents, they used mostly instant.  I could handle the freeze-dried, the powdered stuff which they tended to get my ooky.  I might still have a jar in a pantry recess, used to flavor mocha or some other similar purpose, but never as a beverage. 

My horizons expanded as a resident.  A place near my apartment specialized in coffee, introducing me to the French Press.  I bought my first coffee cone after a fellow resident introduced me to hers in the residents lounge.  Shortly thereafter, multicup drip machines captured the market followed by the emergence of Starbucks which popularized what the Coffee Connection at Harvard Square had already been doing.  And ultimately the K-cup which allows variety and ease with only a small sacrifice to taste.  That's my morning go, though I still use the cone and the French Press when not deterred by the need to clean the devices.  The French Press definitely makes the best coffee, as it did when first introduced to it.

But my origins remain the percolator, which I took out this morning for the first time in forever.  I had trouble finding the round paper filters which had fallen to the wrong closet shelf, but once in my possession, it's a go.  Opened a new package of New England Donut Shop Blend Coffee, put in four coffee measures, or actually slightly less, filled to the 4 cup mark and let it perk for seven minutes.  Then some Oreo flavored whitener and shake of pumpkin spice in a cup and poured myself liquid to the top.  While other brewing methods have predictable results, the percolator has vagaries of measurement and duration.  This pot came out a little weaker than I might have preferred.  There is a slight bitterness, which I like much as what attracts people to beer.  Maybe the next cup will be with milk or some heavy cream that I have left over.  Too much cookie influence.

But it's good to return to a special treat, one set in personal history, even if there are now better ways to brew that morning coffee.

Monday, November 26, 2018

My New Instant Pot

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It's still in the box on the back seat of my Honda where it has been since purchase about a week ago.  I had $48 dollars to spend, having harvested every five dollar bill that I received in change the previous six months, accumulating $130 of Me Money that way.  Some went for a No Soap Radio, some for an electric shiatsu back massager and the remainder for the Instant Pot which was on sale at Shop-Rite for $50.  So now my culinary skills have moved to the modern age.

First item, milchig or fleishig?  I tried to get some feedback from users on but their interactive site faltered so I signed onto Facebook which had a community of kosher instant pot users.  As expected, fleishig uses dominated, particularly chicken preparation.  There was advice to start with pareve, advice to get a second one at the bargain price.  People even get an extra for Pesach, which seems like an extravagance to me but they write that it simplifies preparation for that holiday.  My own meat consumption has not been much and preparation largely limited to shabbos and special events these days, so I'll start milchig.  Got some mahi mahi which should be a suitable introduction.

While I look forward to using it, the real horizon for me might be the common connection to other kosher users.  As I open their profiles, they are mostly young women with young children, scattered around North America mostly but not exclusively, a few men.  Not many bubbes who probably still use the oven or have adapted to the microwave.  We'll see how the fish goes and I'll let my new electronic friends know.

Sunday, November 25, 2018

Weekly Planning

It's been some 25 years since I first read Stephen Covey's 7 Habits of Highly Effective People.  The type of goal setting that he described came fairly naturally to me, though my lists were too long and not categorized well enough.  One piece of advice that permanently changed was time perspectives.  While I always had what I should do today and what I need to do this semester and what am I pursuing toward graduation, my planning had always been day to day.  His guidance changed the perspective to a week.  So now I have a semi-annual list of projects in categories compiled every June and December.  But instead of the Franklin Planner approach of day to day, the perspective has been to incorporate parts of six months into each week.  I think that is a much better goal breakdown.  Seven day blocks have been the norm since Biblical times, probably for a reason.  Each Sunday morning, excepted only for yontiff, I look at the six month projects and determine what I should be able to do this week.  Activities for the week that are part of that six month effort get a colored highlight.  Each night I take the weekly list and select a daily array of stuff that I need to select from, as the list always exceeds what I can do, but urgencies get done and non-urgent priorities get pursued. 

So this week I should be able to complete my third day trip, either to New York or the Harley Factory in plain old York.  There is a meeting with my financial advisor who helped me computerize my assets.  I need to review my Medicare Part D program.  Clearing my upstairs study has not gone as well as some of the other initiatives because the weekly projects seem to lack the task specificity of the others.  My weight has gone nowhere though I have done reasonably well on the intermediate steps to lose those ten pounds.  I keep weekly records and while I have not lost any, my weight and waist circumference have remained static for two years. 

Come next week, we return to December, that semiannual review of what has gone well, what fell short, what merits continuation, and what directions should get revised.  But overall, it's been a useful system.

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Wednesday, November 21, 2018

PM Minyan

Our shul has been the full service congregation for most of its existence.  Two minyanim daily except Sunday night, control of the Vaad HaKashrut for the state, full kryat HaTorah at each scheduled time.  We need people to do these things.  For the Vaad the Conservative congregation now has some representation but Chabad does not.  Our minyanim, though have become insecure.  On Wednesday and Friday shacharit we have a combined service with the USCJ affiliate with a hybrid liturgy that is mostly from the Conservative siddur.  As people retire, the 7AM starting time gets less realistic but I am told the quorum usually materializes. 

PM has been more problematic.  I went yesterday, just the Rabbi and me and two men observing shiva.  Attending three a month had been one of the twelve initiatives for this half year.  Since I do not want to go to the Rabbi's classes that follow on Wednesday and Thursday, I selected Monday and Tuesday.  Rabbi has Monday off so for all practical purposes there is no service.  Tuesday never gets more than half a minyan when I am there.  I asked the Rabbi if there is ever a PM minyan.  Sometimes if enough men attend the evening classes and sometimes for Shabbos afternoon.  That would mean kabbalat Shabbat is no more, which is why I observe Kaddish at the Reform congregation that starts later of Friday nights and secures ten Jewish men, or at least within my system of counting ten men wearing kippot in a sanctuary where they are optional.  And I get some wonderful music and a thoughtful sermon thrown in.

We are running out of people. 

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Monday, November 19, 2018

Donating Platelets

Retired people become less useful.  Invitations to offer an opinion on new treatments still come my  way but clicking the Retired Box results in an automatic exclusion.  What I have been able to do more, something highly valuable to anonymous recipients in great need, has been to share my CMV negative platelets to assist some of the chemotherapy patients who often develop thrombocytopenia.  While we now have Granulocyte Colony Stimulating Factor for low leukocyte counts and Epogen to restore red cells, a means of stimulating platelet restoration chemically has been elusive.  Selective transfusion remains a core intervention for recovery. 

While I had been a periodic whole blood donor for many years, prompted mainly by the transfusion insurance a single blood donation once a year would offer my family, once notified that my CMV negative platelets had special value, I made a point of donating four times a year, receiving a 50 donation pin within the past year.  It meant scheduling  this first thing Saturday morning each quarter, for which I would then reward myself with a ride to Lancaster or some other mini-afternoon journey an hour or so away.  This past year, the blood bank expanded to Sunday hours, and with retirement I could go any day.  Rules limit donations to biweekly but so far I've just gone to monthly for the first time. 

Technology has changed.  Traditionally they made the donor into a temporary quadriplegic, tethering me to a recliner with metallic IV's in both antecubial fossae.  I once asked the hematologist in charge, who I knew from my practice, why they needed both arms and metallic access.  Eventually it became a single site for both extraction and return, though the failure rate was much higher and my left hand was a lot more sore that way.  It also seemed to take longer, so after three misadventures I returned to one access to take the blood and the other to return the red cells.  This has worked well.

Incentives have come and gone.  The emergence of Mad Cow Disease and AIDS excluded many potential donors who had potential exposures from living in England to using animal derived insulin for their diabetes.  More people are anticoagulated these days and people take cruises that innocently allow them to stop at a port where the inhabitants might have malaria or Chagas disease.  We also have more people with cancer surviving longer but at the price of toxic treatments.  Thus more need for blood products as the donor pool contracts.  But as long as it is safe for people to get what they need from me, I'm on the list.

They used to offer to screen donors for diabetes with a random glucose taken from the donor plasma or serum.  Rules require eating within three hours so a random glucose in the intermediate range is of limited utility.  RBC collection would allow a hemoglobin A1c which can be drawn randomly but the test is a lot more expensive.  The program stopped a few months back.  For a while my house started to look a little like a Blood Bank Museum with some t-shirt, tote bag, umbrella, or baseball cap either following the donation or by redeeming accumulated points.  That program comes to an end soon.  More disruptive to the blood bank than it's value in enticing donors who usually have a better justification for participating than receiving some kewpie doll with blood bank logo. 

I'm sore, being recently comforted by naproxen once or twice a day for lumbar pain.  In order to donate, this needs to be set aside for three days, and to be sure I usually stop five days in advance.  But the recipient would be in jeopardy without the platelet supply so I can use some icy hot lotion or stretch for a few days.  There's naproxen in the car, first pill resumed on the way home.  And I got my outing and perhaps a small recurrent mitzvah, though it would be unthinkable not to provide this to somebody in need.

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Sunday, November 18, 2018

Hanukkah Gifts

It has always been my desire to complete gift buying before the Christmas rush.  After marrying into my family, I quickly adopted my in-law's tradition of one small gift for each member of the household with each Hanukkah candle and a single gift, also of relatively nominal value. for each first degree relative.  That left me with a short list, father, later step-mother, two siblings and I absorbed an edible for my wife's aunt.  As a newlywed, the only one living a distance from home turf, I would putter around Harvard Square and downtown Boston, for just the right book or kitchen gadget from the small stores that lined either Massachusetts Avenue in Cambridge or the very large but suitable Woolworth's, z"l where I could always count on something with my wife's first name.  My last year, Massachusetts, or at least Boston, allowed the stores to stay open on Sundays between Thanksgiving and Christmas, but the hospital of my residency allowed all employees, including the residents to designate a floating holiday as "Christmas Shopping Day." which all of did.  That meant I could not beat Black Friday and Hanukkah usually falls a couple of weeks before Christmas leaving some scramble.  Yet even though I had only a few individuals, it may have been my best time during the year to think about multiple people and diverse interests at the same time.  Birthday's seemed a little easier, one person at a time and a more liberal budget.  Later some relocation on my part and my father's part, a couple of children, then attrition of the list which is now my own household and far-off offspring.  Fewer people to tease out interests and personalities but the principles have endured.  I could shop on-line but not at that budget.  The small stores, even along Harvard Square, have given way to mega-chains that give a huge variety and a favorable price, but it is not as easy to find something that shouts that's the essence of my son or daughter. 

Still, I reached my quota, eight for wife, four for each child, before Thanksgiving this year, hastened slightly by wanting my daughter to carry her gifts across the country when she visits us.  Restrained by budget as always, but also now restrained by the TSA to avoid anything sharp or liquid. 

Black Friday and beyond will soon arrive, Hanukkah itself ten days or so later.  Gift wrapping has its own challenge, as does shipping, but even there, firms like Staples or MailBoxes Etc have made that easy enough.  Concentrate on being festive.

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Friday, November 16, 2018


Had been planning the third of my three day trips for a while, a round trip bus ride to NYC where I would take the subway to the Cloisters, where I had never been.  It was tentatively scheduled for yesterday but snow squalls here and there made a later time more suitable.  I can deal with cold, walking a half mile from the subway stop to the museum and back as well as the Chinatown bus to the subway makes precipitation justification not to travel.  Instead, I got my car serviced, loafed, read, took a hot shower, worked on Thanksgiving menu for fewer people than originally anticipated and made a little pest of myself commenting on  I did not watch television, after scrolling through a hundred channels and finding none worthy of my attention.  One less screen.  Work on less computer screen too.

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Thursday, November 15, 2018

Thanksgiving Dinner

Since Thanksgiving has been protected for me my entire career, in exchange for taking medical call every Christmas, until recently  as a long weekend, some personal expression has gone into this.  I have always been the food preparer, bringing the rather elaborate meal to my in-laws during my mother-in-law's lifetime, then more recently asking the remaining in-laws and my children to come to our house, as the logistics are much easier for me that way.  Like others we have our political strains, jokes not well received, concessions to people who cannot easily travel to us that we need to pick up and return, and a self-imposed obligation to have our place far neater than its usual appearance.  My mother-in-law served as the family glue that gave us our reason to assemble periodically at her house
but with her passing at age 97, we are left with First Seder and Thanksgiving as the reliable family gatherings.  For Seder, I make the dinner and still transport it.  For Thanksgiving, though, I am the designated balabusta.

Much thought goes into the menu, scans of my cookbooks, surveys of ideas on line.  Looks like:

Motzi-- French Bread
Appetizer--Vegetarian mushroom and barley stuffed cabbage
Salad--Israeli variant, a salad of many colors which should go well with the Torah reading.
Stuffing made in crock pot.
Cranberry sauce, homemade
Sweet potatoes with other vegetables

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Acorn squash with pomegranate glaze in deference to my son who cannot join us.
Banana-bundt cake
Iced mulled cider with pomegranite.

Mixture of book recipes and online recipes and some taken from this month's magazines reviewed at our local library the last few weeks.

A challenge,. a hobby, an effort, and most of the time an accomplishment.

Wednesday, November 14, 2018

Check Engine Light

Check engine light came on.  That keeps me mostly immobilized for the day until I can take the car, 189K miles of it to the shop tomorrow for something that in the last year or two has always turned out expensive.

Not that I have a shortage of things to do at home today and tomorrow, I don't, but my car from the time I got one as a third year medical student has been my freedom to roam.  I can go to parks and supermarkets and the library almost at will.  With some planning I can go afar.  And I could take what was a rather good job 45 minutes away. 

We'll see what the computerized diagnostics shows and how much it costs to restore mobility.

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Tuesday, November 13, 2018

Lumbar Pain

My grandfather at about my age used to experience what in those days was called lumbago.  I do not think this is an inherited trait but I've acquired it as well, on and off for a few months, fully disrupting what had been a very successful exercise schedule.  It will endure a while, response to non-prescription anti-inflammatory agents, cause no neurologic disruption, but leave me rather sedentary.  I've tried to tease out the anatomy.  Flexing knees and hips gives relief.  Worst pain occurs at about the halfway point moving from sitting to upright.  It's more noticeable when sitting than standing or walking, which may be a hint for keeping myself upright and moving.  Car seat seems more comfortable than kitchen chair.  I have a Howmedics back massager whose input has been disappointing but worth another try.  It will soon pass.

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Monday, November 12, 2018

Shabbos as Spectator

Made it to Beth Tfiloh for shabbos.  Understudy Rabbi this time, with a D'var Torah on the disappearing derech eretz in politics, one that can get quite a few cards & letters, perhaps even mine.  Yet going there, despite the substantial round trip has its allure that I find hard to duplicate.

The drive is quiet time.  No radio.  One stop for either breakfast or coffee, subsidized by the State of Delaware, since the route to the WaWa takes me around the toll.  Once there, I take my seat, having staked out two places, one on each side of an aisle which affords me a few seats of personal space and a good view.  I do not know anyone and nobody knows me, until the end when I typically encounter somebody from my home shul who now lives in Baltimore and attends there.  The Torah reader usually comes over to greet me, but I might as well be a spectator in a theater, which adds to the attraction if once a quarter but would end the attaction if I went every shabbos and remained alone amid a crowd of hundreds.

Lately I've been arriving a little earlier, typically at the Amidah repetition.  Their sequence of prayers is a little variation of AKSE's.  The Torah processional is limited to the return.  Women do the Government and Soldier's prayers in English.  Prayer for Israel is part of the Torah processional.  Torah reading is expert in accuracy and fluency.  There are no Aliyah Sound Bites, which is worth the drive in itself.  I've been there enough now and read additional sermons online to suspect they are written de novo without recycling AIPAC or other organizational FAX broadcasts to American rabbis to adapt to their weekly shabbos message.  Those messages are OK, but I think I can tell that the rabbis function as an organizational conduit and not people of personal insight when they do that.

No Bar Mitzvah this shabbos.  Musaf zips along, services conclude and we go to kiddush, not very different in content than ours but on a larger scale.

Looking around, they probably can assemble a minyan of men under age 50, but it won't be a very large minyan.  To be fair, they have parallel services elsewhere in the building and the people at kiddush seem younger than the men in the main sanctuary so that may be where the younger men worship.  The women on their side of the mechitza seemed younger than the men in the main  sanctuary.  Children come up to the bimah for kiddush.  There were about 30 of them, so generational attrition will likely happen though at a much smaller pace than at AKSE. 

So if I want to watch something done well, I go there.  If I want to be more of a participant, even a sometimes irritated one, my home base supplies that need.

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Friday, November 9, 2018

Due Dates

Shabbos approaches.  I've scheduled my roughly quarterly shabbos morning at Beth Tfiloh tomorrow.  Easy dinner to make today, defrost the previously made chicken and make Hasidic Noodle Kugel.  Will try to use a water bath this time to promote more even cooking in the loaf pan. 

I don't have a sense of urgency to get everything done in time that I once had, even with the return to Standard Time this week bringing sunset much earlier on the clock.  Dinner will get done.  Everything else on  a long daily task list really has no deadline other than paying my Medicare premium and renewing my state medical license where the deadlines are not imminent.  Our motivation and ultimately our success, though, depends on how we handle the things we want to do without the external impositions, whether the natural sunset or the legal due dates.

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Thursday, November 8, 2018

Voted Out

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My home state has voters that run mostly blue.  Being a small state geographically, access by voters to those the majority has elected comes much more easily than in places with millions of people but the same number of senators that we have.  Little nobody me has seen virtually all my elected representatives from county coucil to US Senator.  I've spoken to most, written to some, worship with one, and heard all live.  Like everyplace else in America we had our 2018 mass political participation in the form of voting.  I voted a straight ticket, only the second time I have ever done that, knowing that I will be voting against the more personally capable incumbent candidate and knowing that I would be casting my preference against the one candidate that I know best.  By late night, the results were known, Democrats swept statewide and in pretty much in my county, unseating my friend who had been in place for twenty years and a very professional state official who is a pro at the role the previous voters had elected him to do.  Had they worked for me in a company or in a non-profit, their jobs would have been in no danger.  No boss would accuse them of underperformance or undermining company goals or bringing discredit to the firm in any way.  More likely they would have gotten performance bonuses.  But they are not employees of my company.  They are more like contractors sent to fill a position by the Republican Party.  If I do not wish to maintain relations with their sponsor, their fortunes follow.  So two very good public officials of significant tenure and achievement fell victim to their standard bearer in the White House who does his best to create victims, most intended, a few like these men and two people in other districts of long tenure become his victims unwittingly and probably undeserved, though the intentional victims are also mostly undeserved.

This has come up in a different form.  I do not buy Papa John's Pizza, haven't for a while.   I found their pizza inferior the two times I bought some.  The standard bearer's presence favorable or not would not make me a customer and the amount of pizza that I buy would not move the fortunes of any company in any direction.  But I did find some of his public positions offensive and superimposed that on his company.  I do like Barilla pasta.  It always comes out better than Ronzoni or Shop-Rite brand but costs more, so when it went on sale for a comparable price I would get a box or two.  No more.  The spokesman takes a public stance that I find offensive, the gradient between his brand and the other brands is small, and my life and those who eat at my table will be no different whichever brand of pasta goes into the meal.  Barilla is gone.  I do not clip the coupons for it from the weekly circular.  There is never an incentive to divert my money to his pocket to demean groups of people he doesn't like.  I won't knowingly be an accomplice in that.  But my purchases do not change a stock price so if my mutual funds want to own some of the stock, they can buy it for my portfolio.

Who represents you matters.  It is not just a matter of personal competence, which is widely distributed among both parties and among companies with stellar reputations and among companies you choose to shun.  As a physician, my reputation depended on my employers and on the other people within the upper tiers of the organization who create policy.  The political parties are no different, even at the sacrifice of at least two men of real talent and professionalism.