poker

Poker can be a fun but extremely frustrating game. It does not comprise purely of chance of skill. An article from The Economist argues that it is primarily the latter. I'd say that you've gotta give lady luck more credit. On any given hand you can play it to a tee, but if the player across from you just happens to have the right combination and the flop is unforgiving, you can be SOL.

There are a lot of elements in poker you can control, but there will always be some you can't. You may have other player's tells down or can read their tendencies. The odds can be overwhelmingly in your favour. In the end though, there are some things that you can't control... including that excruciating last card. That's why it's called gambling.

In a way, life is kind of similar. I think back to when I was growing up, and countless books, TV shows and movies I read or saw had a pretty common message - do the right thing, and you'll reap the rewards. The protagonist will go through some pain and suffering, but by the end, the universe has corrected itself so that our hero wins. So when we're raised on these kinds of stories, it's a bit of a rude awakening when things don't go our way, often despite our best intentions. We can play life's cards perfectly, knowing most of the variables in front of us, or at least taking into account most factors. Every now and then, something just happens. And there's nothing that we can do about it. Worse yet, it's often undeserved or unfair. What then?

For a while, I never thought much of the phrase "when life gives you lemons, you make lemonade". I always took it to mean to be optimistic, or to make the most of a bad situation. Yeah, it's partly about that message but I feel like it relates more to what I said above. Sometimes we get dealt the worst cards, or something absurd happens to us that makes us feel wronged or treated unfairly. I've learned that life isn't just about choosing what direction to take when there's a fork in the road; arguably it's shaped more by how we deal with situations in which we had no control. We can't always say no to the lemons. Sometimes it's thrown in our face and we're stuck with them.

That's when you make lemonade.

Olafur Arnalds - Living Room Songs

Speaking of someone playing in your room... Olafur Arnalds basically did that... but in his room. Neat. Some more of that neo-classical genre.

Watch the videos here. The individual songs are also available for free download off the website. If you like what you hear, try to find his first album, Eulogy for Evolution. E is for excellent. Got me through a lot of long study sessions.

Oh yeah, he's from Iceland. I wonder what would happen if he backed up one of Jonsi/Sigur Ros's songs. If my ears could salivate, they would right nowwwww.

music by bulk, including a gem: Felt by Nils Frahm

In the past couple weeks, I've been doing my best trying to juggle a stack of recently released albums (amongst a bunch of singles I'm catching here and there):

Future Islands - On the Water
Justice - Audio, Disco, Video
Florence + the Machine - Ceremonials

I wouldn't say any of them are particularly bad albums, per se. On the Water was pretty solid album. Their lead singer sort of sounds like Modest Mouse's Isaac Brock. Despite that, you wouldn't mistake the two bands or sounds. I'll leave it up to you to sneak a listen.
Justice's latest release was kind of disappointing, unfortunately... if anything they took a step back from their previous work.
Florence + the Machine was excellent. That woman has a powerful voice and with the strong backup of a grand piano and the full band, most of the songs sound pretty epic. In fact, I'd say it's a lot more 'epic'-sounding than Lungs which was fit more into the pop genre.

However, I think one release that truly stands out is Felt by Nils Frahm. I liked his previous stuff (Wintermusik and The Bells), but had a hard time finding a means to listen to this one. Eventually, I bit the bullet and gambled buying his album on iTunes. Boy, that paid off. If you're big into music to help you study, relax or maybe even just lull you to sleep it can serve all three functions. The only instruments involved are his piano and a few percussion instruments. It sounds pretty simple (and is), but is also incredibly intimate. Feels like he's playing right there in your room... awesome.

Highly recommended.

Coldplay and Mylo Xyloto

Tonnes of new music has been released in recent weeks and I'm doing my best to get through all of it.

Of course, the big news is the release of Coldplay's newest album, Mylo Xyloto. I've listened to it solidly 3-4 times from top to bottom now, and if I could describe it in a nutshell, it'd be... not bad. For me though, with A Rush of Blood to the Head being one of the most influential albums in my adolescence and Parachutes being arguably even better as a whole, I've always had high standards for these guys when they come out with new stuff. In a way, I've been kind of sad their sound has gotten a lot more busy and cluttered over the years, but I understand it comes with the turf as they fill massive arenas for their (excellent) shows.
Anyways, a few great tracks including "Charlie Brown", "Hurts Like Heaven" and I'd even put "Every Tear is a Waterfall" in that category. Lots of fillers though. If I had to rank their albums to date from favourite to least favourite:

1. Parachutes - every. track. is. great. 
2. A Rush of Blood to the Head - The top two are more like 1a and 1b. I have more an emotional tie with this album than Parachutes, but just a shave below in quality, in my opinion. 
3. Viva La Vida or Death and All His Friends - a big drop-off from 2nd to 3rd place. This album actually took a while to grow on me. 
4. Mylo Xyloto - see above.
5. X&Y - A few really really good tracks on this album like "Fix You"and "Talk", but a lot of songs I just didn't like, especially in the last half of the album. 

shop talk

Obviously, work plays a large part in all our lives, and we often want a chance to debrief from stressful situations, future endeavours and career paths... especially in medicine and at this stage of our training.
However, I've gotten to the point where I'd much much much rather not to discuss it unless it's a few of my close friends who I genuinely care about.

I have heard it's a struggle for a lot of my friends not in medicine to stand by in these situations where it keeps coming back to the shop talk, and honestly I get that. Let's talk about something else in you life, ok folks?

I had this really well-thought out before but right now I'm exhausted and can't remember what I was thinking.

the art of medicine

^ I used to think that phrase used to be a steaming pile of an eye-roller cliche. It would be in essays, medical school admission interviews, etc. and I grew sick of the phrase before I even got into medical school. Sure, we all used to say it was about talking to the patient, listening, being a decent human being, and all that jazz. Strangely enough, I think it's a bit more than that.

I used to think that if you knew your shit, you'd be set when it came to medicine. In a way, I couldn't give a good reason why the computers wouldn't eventually replace physicians (think: Watson from Jeopardy). I know I'm only had about a year and a half of solid clinical experience but I'm already seeing why it takes so @#*%ing long to get trained properly - it's so much more than knowing the facts.

Even at this stage, an orangutan that knows how to memorize things could tell you why a patient is vomiting after eating two-day old burgers sitting at room temperature, or why a toddler at this time of year  is developing a barking cough that is worse at night. Classic presentations of diseases or infections don't require much thinking, and even if it's of a relatively rare condition, it doesn't take long for it to be picked up.

The "art" I'm talking about is when there is a patient in the emergency department who is a 55 year old diabetic male, obese, a 30-pack year smoker, having chest pain and all their tests for a heart attack come back negative. Do you really let them go?

How about when that same patient comes in with pretty severe flank pain that's not resolving? Their kidney function and urine are fine. What next?

Each day, I'm learning it's not about the facts. Well, it sort of is. If you're a dumbass physician that doesn't really help... but that's not the point. I never realized that so much of medicine is about clinical gestalt. There were a couple of times early in my clerkship where I saw a patient, examined him or her, ran bloodwork which came back normal and reported that they should be OK. The physician would walk in and simply say, "Hmm, they just seem sick." And eventually we'd find out there was something seriously wrong with them.

Those were always humbling experiences. I used to think geniuses could get so far in life and move up whatever ladder they were a part of much faster than the rest of us. They'd be the ones who didn't have to practice or train as much, and would therefore be a step ahead.

Coupling what I read in Malcolm Gladwell's "The Tipping Point", and what I'm seeing every day in medicine, it's more about exposure, repetition and practice.

One way or another, most people appreciate or gain the science of medicine pretty easily. It's the art of medicine though, that remains elusive.

Steve Jobs tribute song (Mac sounds) by AzRmusic

Everyone has their opinion about Mr Jobs' death, but that's not the point of this post. Here is a very well done tribute song to Steve comprised of only his voice (from the infamous Stanford speech) and sounds from Macs.

Reminds me of that "Wear Sunscreen" song. Spoken word songs often give me the chills. This one was no exception.

Props.

can't keep up

maybe I'm just listening to too much music and procrastinating on #indecision2012 but there's too much fun stuff for me to keep up with...

The Asteroids Galaxy Tour - Major

Childish Gambino vs Chiddy Bang - Put It In Your Manners (DJ 12azy remix)

Oh Land - Bloodbuzz Ohio (The National cover)
The National - Bloodbuzz Ohio (Oh Land Cover) by Hypetrak

Keep in mind, the new Justice album Audio, Video, Disco drops October 25.

my shortlist for favourite album of 2011

Photo credit: The New Yorker

I will add more as I think of them and/or other albums get released...

Bon Iver - Bon Iver
Cults - Cults
Danger Mouse & Daniele Luppi - Rome
Explosions in the Sky - Take Care, Take Care
Feist - Metals

Foster the People - Houdini

Jay-Z and Kanye West - Watch the Throne

The Strokes - Angles

The Weeknd - House of Balloons

some call it a telephone booth

Taalbi Brothers - Freestyle (as seen on Breaking Bad)

Ridiculous guitarists... and they're teenagers.
This was the song that played after Walt said "We've got work to do."

Brilliant.

music feast

The number of albums I've been enjoying recently is kind of absurd. Just as I'm getting into one, another comes along and beckons my attention.

Take note, folks:

Future Islands - On the Water
M83 - Hurry Up, We're Dreaming
Feist - Metals
Alex Clare - The Lateness of the Hour


And some particular songs:

The Rapture - How Deep Is Your Love?
James Blake - A Case of You


Not... enough... time...