Tuesday, April 28, 2015


In the children’s picture book Captain Small by Lois Lenski, a storm comes up as our ubiquitous hero (see also, Cowboy Small, The Little Farm, The Little Train, etc.) navigates his sailboat home. “Water washes over the bow. The boat heels and nearly upsets. But brave Captain Small brings it about and safely sails into the harbor.”

Upset. To turn upside down, to, as defined by my 1966 Reader’s Digest Great Encyclopedic Dictionary, “overturn, throw into confusion or disorder…” Even as an adjective: “1. Tipped or turned over. 2. Mentally or physically disturbed or ill. 3. Confused; disordered; messy.” Though it’s been diluted over time to mean mostly “unhappy” or “to make unhappy”, it was helpful for me to be reminded of the original and more full intention. A sailboat in rough seas, overturned.

I am not faring as well as Captain Small right now. Nor is the small town of Omak, which I left behind only two weeks ago, and for which, upon departure, I had words that may have left some people leaving unhappy. I would rather that they were upset.

Explanations, shorter sentences, plain English for God’s sake lad! Let me try:

A year ago, LL and hadn’t planned to leave Omak this year. We have a just-turned-3-year-old and (as of a couple days ago) a 10-month-old. Moving away from a familiar home, friends, work, the walk up Ross Canyon, the scooter ride to the market, is upsetting. Our boat has turned over. We are extremely lucky to have excellent flotation devices in the form of loved ones and some time. But we’re definitely swimming. We moved into a rental with a clothes washer that doesn’t drain, a dishwasher that doesn’t exist, and a ceiling we keep bonking our heads on. Disrupted sleep routines for our boys has translated into minimal sleep for us. Felix has announced that he’s moving back to Omak. My car battery’s dead, the back door handle fell off, and the dog ran away…oh wait, we don’t have a dog. It’s hard to keep track sometimes. I can’t say we would recommend a similar move to anyone with young ones.

At the same time, as our feet begin to find solid ground, we are reminded of all the things we’re grateful for. We’re an hour away from Nana and Papa. We’re two from my sister and her family. Previously both were five. We have an Asian (and yes, it is Asian, which really means more American than were it Thai, or Japanese, or Korean, but still!) bistro, within takeout range. Curbside recycling. For that matter, we have curbsides, and sidewalks, and even a bus line that takes us right downtown to the Asian bistro.

Most importantly, we have work that we are excited to begin. Though we loved the people we worked with, we ultimately felt unsafe in our hospital. A lack of vision, leadership, and collaboration added up to accidents waiting to happen—or already happening. In a remote and rural community, people can’t afford to not work together. Upon leaving Omak, LL and I submitted a letter to the editor of the local paper, who ran it as a guest column:
(sorry you have to cut and paste!)

Our new jobs are also in a rural area. We think they will be an outstanding fit in terms of our colleagues, opportunities for personal development, the mission of the clinic, and so on. The first and fundamental requirement is that it feels safe here. A huge part of that feeling of safety is that there really seems to be, both in the healthcare community and at large, a spirit of working together for the common good.

To expound on this: America has some of the worst health outcomes on the planet, especially in light of our healthcare expenditures. This fact is not surprising when one also considers that we are one of the world’s most unequal countries in terms of wealth. Not just poverty, but inequality itself, is strongly linked to poor health. Our tax structure often serves to exacerbate these inequalities, especially in rural areas. For example, schools being funded by local property taxes creates better educational opportunities in areas that are already rich. Omak is not only poor, it is also rural, so there is not the buffer of nearby pockets of wealth that cities tend to have. As is the case for education, funding for public healthcare facilities is similarly bereft. In such a setting, what one long-time resident of the area called “the stark fist of poverty”, it is essential that people work together. This is what was lacking, and correcting it is, I believe, where opportunity lies. When things are getting by—when there are small errors in safety or quality of care but no big events—when there is perhaps imperfection but not crisis—such a situation can carry on. Now there is crisis. There is upset, and sometimes upset is what it takes to change.

That is why I hope anyone who reads our article in The Omak Chronicle, and might be unhappy, is also upset. At least a little bit. Maybe upset enough to ask questions. As we stated, our intention is not to make anyone feel bad. It’s to rock and perhaps help tip over a sinking ship, so that a better one can begin to be constructed.

Monday, March 30, 2015


things I am grateful for:
my 9-month-old
my almost-3-year-old
the love of my whole life, LL
my friend Randall for putting up with me while teaching me guitar
all the people I've worked with here in the Okanogan
rivers especially the Salmon which is the longest un-dammed river in the lower 48 states
coconut shells which can be made into fun things
my friend LDawg who travelled all the way out here from Michigan
orcas, which are not whales but rather members of the dolphin family
coconut oil
fresh coconut water
fresh coconut meat
the joy that my almost-3-year-old takes in opening a coconut with me, and the satisfying "pop" it makes when we first break the seal
the joy that my 9-month-old takes in almost everything
hair, of which, when I was younger and would cut it myself sometimes with patchy results to say the least, I would tell my mother, "It's ok, it will always grow back" (now I know better)
color vision
the color blue, especially the color of the sky between Cornucopia and Red Mountains when viewed from Pine Lakes
sunlight, snow, rain
Catalpa trees, mangrove trees, giant sequoias
my parents, my siblings
igloos, which are one of the many things my older brother is amazing at
having a partner who's the smartest physician I know
my hands which still have 5 fingers apiece despite the abuse I've put them through, and their ability to do things as varied as type these words, play a guitar sort of, and make forts which are almost as much fun for my boys as for me
red-tailed hawks
mangoes, raspberries, avocados, chocolate, kale, butternut squash, kabocha squash, not necessarily in that order
food in general
the amazing abundance of food that arrives daily even to far-off corners of the world like the Okanogan
the knowledge that all of this is transient, that in under a billion years the increasingly toasty sun will make the Earth completely inhospitable for life as we know it, that in fact we may do the the same to the Earth in the very near future, yet that we have hands and minds and imaginations that can still try to make things as beautiful and as sustainable as possible
the songs "Valedictorian", "I will do the breathing", and "Little Hands" by Matt the Electrician
the existence of dance
my dance teacher Chery from my first year at Wesleyan
more people than I can possibly name in a poem
waterfalls especially the one in South Africa that Paul, Richard and Miriam hiked around with me
my family in South Africa
sailing ships
the past existence of pterodactyls
sleep, time for that

Friday, March 27, 2015

I want that hour back

I realize that the hour lost to Daylight Savings can't serve as as excuse for not posting in February. That change occurred on March 8th. This brief posting isn't meant to replace the one I didn't do then, nor to serve as this month's.

Instead I'll use it to share a few links--there are a ton out there--about why DST should be done away with. Fascinating that, for instance, the main reason DST was extended to the 1st of November was to profit convenience stores, who sell more candy when trick-or-treaters have an extra hour of light in the evening. From my perspective as a family physician, one thing that is clear is that children would do better to have that extra hour of light in the morning (e.g., there are numerous studies citing better school performance with a later morning start time). It looks like a good book on the subject, as these are all just short blogs, would be Michael Downing's "Spring Forward: The Annual Madness of Daylight Saving Time." If anyone's read it I'd be curious to know what you thought. Cheers!

Hmmm…links not appearing to show…here they are for copying and pasting:





Saturday, January 31, 2015

The Deep End

It is Saturday night and I’ve just finished up at a meeting of family physicians. It takes a while to wrap up some final paperwork and goodbyes, then I wend my way through the snarl of traffic I used to call Seattle and pick up my friend Neville for dinner. Neville says that when we lived here the traffic was the 18th worst in the country. “Now it’s the 3rd,” he says.

After dinner I drive by the Central Cinema. I love the Central Cinema! Dinner, drinks and dessert—a fabulous crème Brule, if I recall—while you watch a movie. It’s here that LL and I first saw “Best Worst Movie”, a charming documentary about what truly is the best worst movie ever made, “Troll II,” and then stayed up for the namesake midnight movie. Right now they’re showing “Groundhog Day” and I’m tempted enough that I park the car to check show times. Right in the middle. Too bad. I get back in the car and drive back up 23rd, then take Boyer to cut back west again. I drive past the church where I crashed a wedding in order to meet the band that LL and I ended up asking to play at our own reception.

Everything feels eerily normal.

Everything has felt too normal, ever since reading the introductory chapter to Naomi Klein’s latest work.

In language brilliant for its clarity, Klein lays out a thesis captured by her title. “This Changes Everything: Capitalism vs The Climate”. I haven’t yet read beyond the 30-page introduction. Now at LL’s parent’s house, I can see the book out of the corner of my eye. It crouches on the desk, a fire-breathing dragon cloaked under a sky-blue cover. An ocean-blue cover. A tropical ocean blue, swallowing islands, cities, and the sky.

“The International Energy Agency warns that if we do not get our emissions under control by a rather terrifying 2017,” Klein writes, “our fossil fuel economy will ‘lock-in’ extremely dangerous warming. “ ‘The energy-related infracture then in place will generate all the CO2 emissions allowed’ in our carbon budget for limiting warming to 2 degrees Celsius…As Fatih Birol, the IEA’s chief economist, bluntly put it: ‘The door to reach two degrees is about to close. In 2017 it will be closed forever.’ “

2017 is 23 months away. Suddenly lower gas prices don’t seem so great. Seattle’s traffic mess, even as it buries a few billion dollars in a car-only tunnel that’s already way over-budget and way under current sea level, is one piece of a rapidly sinking planet. We are headed for deep water. And that’s if we were to stop, for all intents and purposes, now.

If we instead achieve the more-likely (without drastic action) prediction of 4+ degrees Celsius by centuries end, “even the best-case scenario is likely to be calamitous. …This would drown some island nations such as the Maldives and Tuvalu, and inundate many coastal areas from Ecuador and Brazil to the Netherlands to much of California and the northeastern United States, as well as huge swaths of South and Southeast Asia. Major cities likely in jeopardy include Boston, New York, greater Los Angeles, Vancouver, London, Mumbai, Hong Kong, and Shanghai.”

A chime. I look up. A text. My phone is pulling me back to the surface, back to the present, the normal, to a beautiful family 5 hours’ drive away on the other side of the Cascades, two beautiful boys who are asleep and a beautiful wife wanting to check in before sleep. I must go. “This Changes Everything” will have to wait. But not for long. Not for very long at all.

Wednesday, December 31, 2014

what I want

I’ve watched Keanu stop bullets with kung fu
too many times to not want to be famous.
Too often I’ve watched the out-takes
at the end of a Jackie Chan movie
that shit is for real y’all
to not know that amazing things
are, indeed, possible.
With enough practice.
Most recently I’ve related
to Mark Ruffalo in The Avengers, right before
he turns green and huge and tears apart bad guys,
he says (when asked how he can become angry so quickly)
“I’m always angry. It’s keeping it down that’s the hard part.”
Some days I wish I could skip the Jackie Chan discipline,
dedication, dislocated joints,
and just let my anger turn me huge and green
and tear things apart.
Tear apart things like the Grand Coulee Dam
and in the process restore the salmon run,
the Colville confederated tribes whose culture was that salmon run,
the broken lives that show up in our ER because it’s gone.
Tear apart things like Monsanto
and in the process bring back farming that isn’t actively destroying the planet
things like Coca Cola
and bring back clean water as public property and a human right
things like Walmart, Shell, the empires of the Koch brothers and Kemper Freeman,
and restore representative democracy and community and some last vestige of hope
for our planet.
I wonder if this poem will get the attention of the FBI.
Some days I want to be famous for channeling my anger to destroy bad things.
I want people to look past the mild-mannered family doctor
and see a simmering pot of rage just waiting to tear things apart.
But today
today I am angry over trivial things
little things
petty and avoidable things like wasting time online trying to decide
which superhero movie to watch in the precious time that LL’s parents watch the boys.
And so I walk down 45th and instead of reading the movie marquee
I walk into Open Books
and buy, for LL the love of my life,
a book of poetry by Mary Oliver.
Next year Mary Oliver will turn 80.
I open the book and read a poem called “What We Want.”
Then I don’t want so much to be famous.
I don’t want to stop bullets with kung fu.
I don’t want to be angry.
I just want to listen.
To observe nature, such as it is, such as is left of it, such as we are a part of it.
I just want to be a good husband and a good father
and as much as possible
to inspire my two little boys to make the world a better place
by doing so myself.
And if Monsanto and Coke and all the dams and prisons and jetski manufacturers
go by the wayside
in the process
well, that will be okay too.

Sunday, November 30, 2014

4644 square inches

(99% written on November 9th on my so-called smartphone; last 1% written right now)--

I am standing at the kitchen sink with our four month old baby asleep on my chest in the baby carrier. Straight ahead of me the window looks out onto fall. To my left is the oven, from which I have just removed roasted red peppers, tomatoes and carrots. To my right, cupboards and countertops form an "L" punctuated by the refrigerator. I walk between a 5 by 4 and a 3 1/2 by 3 1/2 foot shock-absorbing wellness mat, and these 4644 square inches define my current existence.

In the crook of the "L", Israel Kamakawiwo plays Ka Huila Wai on the ukulele; Sam often tolerates much more mellow music once he's actually asleep. This arrangement allows for remarkable accomplishments. Together we can remove roasted vegetables from the oven. We can core and slice pineapples. With a bit of a stretch we can even wash dishes. There are a few things that are hard to do. I cannot, for instance, go to the gym. It's pretty hard to go through the mail. Email is difficult, not because it's impossible to respond to things using voice recognition software to type, as I'm doing now, but more because it's hard to occupy the mental space needed to confront things such as Medicare payment reform, global warming, job interviews. Those things exist in a world far outside of these 4644 square inches.

At the very time when outside forces seem to have conspired to make our lives busier than ever, Sam, even more so than Felix before him, has forced us as parents to slow down and examine what is important to us.

More important than anything is our family. Felix. Sam. Mama. Dada. When I say these names aloud to Sam, the world’s biggest smile lights up his face. We cannot get this time back later. I can’t go back in 4 years and spent more time with my 4-mo-old. As our outside world spins into ever greater dezord—the Creole word for disorder, and the other word besides baggai (stuff) that I retained from my Haitian birthplace—these few square inches of soft, bouncy, supportive floormat seem ever more comforting. The most important job for me to be doing right now is to hold my sleeping baby.

Friday, October 31, 2014

White Walls and French Hiphop

I wanna be free
I just wanna live
inside my Cadillac
that is my sh*t
and I throw it up (throw it up)
that's what it is (what it is)
in my C A D I L L A C b*tch (b*yaaach)
Can't see me through my tints (nuh uh)
I'm riding real slow (slow motion)
got my paint wet dripping shorty
like my 24's (umbrella)
I don't got 24's (no oh)
that's those big white walls
r-r-round those hundred spokes…

These, it turns out, are the words that our now-4-mo-old will fall asleep to. And even, sometimes (praise be!) take a bottle to. He likes Macklemore, one of the very few rap artists I can listen to. Oh, yes, and he also loves French hip-hop. Diam's "Peter Pan." Amylie's "Mes Oreilles". Youssoupha. Plastic Bertrand from the movie "Ruby Sparks".

We discovered this first in the car, when LL would be driving and marimba (the favorite CD of our 2-yr-old) would fail to put our newborn to sleep. So she put on Macklemore. This had been given to us by her sister, an amazing dancer and choreographer who among other jobs teaches a high school dance team. And guess what? It worked. Not the slower, melodic songs. The hard-hitting, beat-driven numbers like "I just wanna dance with you" and "White Walls".

So who knows. Our first is on track to be a construction worker. Or a Wild Thing. Or a chef. And this little one? A French rapper. We're just thrilled that he sometimes now will eat independent of Mama.