Growing up I had a great fascination with computers. I spent most of my time programming, which meant that pretty much every other facet of my life suffered. Anything not tangentially related to programming took a back seat at best. I got by in school with the absolute minimum to get decent grades that would assuage my parents. It is therefore unsurprising that having taken 2 years of electronics as part of a computer science degree, I probably couldn’t unhook a car battery without seriously injuring myself and the car in the process. That is… until a lack of basic electronics kept me from properly enjoying a vacation. How hard could it be to hot wire a motorcycle? In the movies, thugs do it in 15 seconds flat, after having sprinted half way across town while dodging cars and cops.

I did what every computer savvy person would do. I spent a few hours googling everything from “Yamaha electrical diagram” and “how to hot wire a motorcycle”, to “how to steal a motorcycle”. Luckily I found the entire electrical diagram for one of the bikes. Unfortunately, I still couldn’t tell the difference between a resistor and a transistor. But I’d be damned if I couldn’t figure it out.

While Alejo slept, I came up to speed on ignition systems, starters, and spark plugs. Thankfully it wasn’t hard to figure out. All I needed was a short cable to bypass the key locking mechanism. When Alejo woke up, I brought him along for a short trek around town, asking for a “short wire to hot wire OUR motorcycles”. In retrospect, that probably wasn’t the best opener. No matter how we spun it, no one believed two homeless looking guys had brought two motorcycles across the state while leaving the keys behind. The local mechanic suspiciously agreed to give us a few short wires, with no advice or help whatsoever.

After only a morning of fiddling around (I never said I was a good thief!), I was able to find the right set of cables to bypass. Short cable in place, and voila– lights on, and the bike starts cranking. Unfortunately, Yano’s bike (which always gets experimented on first) takes a while to crank. While I’m cranking, I’m doing the dance of joy, which got quickly interrupted by Alejo screaming over the noise “hey smartass, if you ever get the bike to turn over, how the hell are you going to fill it up with gas without a key?”. Uhhhh… hmmm… “And if you manage to fuck up the ignition, I’ll kill you when the keys do arrive. I only get one week of vacation, unlike you nerds which work from home and seem to be in a permanent holiday every day.” Fair enough… I put the bike back together, and we drove around the park in the 4×4 pickup.

At this point I must add that Big Bend National Park is absolutely breathtaking, and is sadly one of the least visited parks in the US park system. The restaurant has been revamped to cater to a more gastronomically demanding crowd, and they’ve done away with the traditional hamburgers and chilli that plague campgrounds the world over. The food, though pricey for a state park ($10-$18/plate), is wonderfully succulent. The entrees are varied and are hands down better than most restaurants. There’s everything from fillet mignon, and smoked salmon, to grilled portabella mushrooms and peppers for the vegetarian crowd. The home-made soups are delicious, and the desserts leave you feeling as decadent as you’re used to.

So all in all, bikes or not, we’ve been having a blast. The views are spectacular and the food is great. Below is a link to the pictures so far, which may spoil the rest of the story, but are well worth seeing. We’re both pleasantly surprised. Big Bend has not left us wanting.

And as you can see, we eventually get our keys!

A doctor and an engineer go on vacation…  While this is most likely the beginning of cruel joke, so far it hasn’t disappointed.

When you live in the southern most part of Texas, there are a limited amount of places you can visit if you can’t convince your fellow vacationers to visit Mexico.  I’m in the unfortunate dilemma of having a few more weeks of vacation than Yano this year, and my friend Alejo is in a similar predicament, having vacation but being restricted by his US visa status to stay within the country.

We originally planned to go on a road trip with our motorbikes, but being limited to a week, we quickly realized that Texas was far too big to get out without inflicting permanent damage to our buttocks.  Instead, we wussed out, and decided to take the bikes on the back of the pickup truck where we could drive in the comfort of a/c for longer distances.  Unfortunately, we ran into the cruel reality that is Texas geography, and realized that a day an a half would only get us to El Paso which is just like McAllen, but with less things to do (if you can imagine such a place).  So, the only logical vacation not involving airplanes, involved driving as far out within a day or two, and that turned out to be Big Bend National Park in the middle of nowhere Texas (as everything in Texas is, with the notable exceptions of Houston, Dallas, Austin, and some say San Antonio).  We’d drive with the bikes on the bed of the pickup, stay in the park, and ride on and off-road all day for a week.  Meanwhile, the women would stay behind– tending the children, or in my case, the dogs and the operating rooms of McAllen.

Everything went according to plan until mile 500, when Yano calls and asks “do you have an extra pair of keys for the bikes?”.  Alejo and I look at each other with eyes wide open, and slam on the breaks.  The bikes almost ended up in the cabin and I nervously responded “huhhh… why do you ask?”.  “Cause there are two pairs of keys on the dinner table here.”  My fault entirely, I couldn’t blame the doctor for anything more than the sad state of medicine in the south of Texas. There were various insults, mostly flowing in my direction, and numerous threats of taking my bicycle wheels (which I’d brought too), to make sure I would be under the same inflicted boredom as he would be starting tomorrow.

There was no sense driving further, so we stopped at Marathon, Texas (see previous comment about nowhere Texas, and multiply it by 500).  It turns out FedEx drops by every other day, and most popular carriers will sporadically deliver this far out.  Luckily, the Gage Hotel and Spa is a quaint hotel not unlike what you’ve seen in popular westerns: cantina, guns, and pretty girls.  I’m not really sure, but I think we are the only visitors here tonight.

12 Gage Hotel

We’ve arranged with Yano (who hasn’t stopped laughing), to ship the keys overnight. “Overnight” being an euphemism for “if you’re lucky in three days”, but hey– at least we’re not in McAllen– and there are mountains [I’m not allowed to ride on the bicycle].

p.s. Oh yeah, stay tuned for a week’s worth of insults (hopefully involving running bikes).

Hay algunos que son estilistas del lenguaje.  Son aquellos que tienen un contrato como representantes de la Real Academia Espa~nola.  Cuya mision en esta vida es preservar la lengua castellana.  Yo a cambio, bastante dificil que se me hace escribir con letras mayusculas, y mucho mas tildar cada dos palabras con acentos.

Para mi el lenguaje esta en las equivocaciones, en cada expresion que diverge del estandar y se amolda a la cultura o sub-cultura en la region donde reside.

Para mi el lenguaje del puertorrique~no documenta la cultura y nos cuenta un par de cuentos que se han perdido a lo largo de una historia de centurias.  Nos cuenta de las  hechizante Islas Canarias de donde nos trajeron cuatro locos y siete medio lenguas que nos pegaron aquel acento sin las eSes y las eRres, pero que al menos nos trajeron un amor a las playas, a los rios y cascadas.  Nos cuenta de un Taino y su Yunque, y hasta del dios aquel, El Huracan.  Nos traen palabras que sin las cuales, ni hasta el gringo pudiera describir un verano en una “hammock” o la venida de un “hurricane”.

Nos ultrajan a los indios y los trabajan a morir, pero no sin antes heredar un par de ocurrencias.  Ya no decimos molesto, ahora estamos enFOGONaos.  Tan calientes como el  fogon de una mujer taina.  Ya no te invitamos a la casa, si no al bohio de la esquina.  Y rara vez estamos sudados, ahora estamos adobaos.

Despues nos traen al africano con su vudu y su danza, y otro par de palabritas.  Que si vudu, tun-tun, y hasta a veces griferia.  Y como siempre, un giro de palabras, y otro giro en una historia que se cuenta con palabras y ademanes al cantar.  Ya no te invitamos a la fiesta de Pepito, sino al bayu en casa ‘e Pepo.  Y si en el patio de su casa te caes en el lodo,  ahora te chavaste’ porque te caistes en el bache.

Despues vienen los gringos queriendo suplantar a Cervantes con aquel loco Chaquespior.  Pero no hay problema, porque ahora nos robamos mas palabras.  Extraviamos el bote  de basura, en favor en un “safacon”, que algunos dicen se asemeja al “Save-A-Can” inscrito en los envases que nos traen para botar su apreciado “bobol gom”.  Los chicos del barrio, ya no se reunen para hablar, sino se sientan a jangear (“hang out”).  Ya no te relajan, ahora te tripean (tripping).

Con el tiempo nos cansamos de cambiar tanto de gobierno y nos conformamos con pelear entre nosotros por la utopia del estatus.  Nos pusimos a mirar telenovelas y adoptar un  par de frases.  Ya no son mujeres lindas sino un par de mamices alli.  Ya no estoy sin dinero sino “no tengo un chavo prieto”.  No heredamos un problema; lo que hay es una chavienda.  El borracho de la esquina ya no es borracho, sino un atomico.  Y Pablo con A.D.D, no es mas que un chapucero.

Y hasta los 80 y los 90 nos traen mas enredos, pues reflejan a Nirvana, a Guns ‘n Roses, y Arjona.  El sobrino de Do~na Estevez ya no es mas que un roquero malo, que se la pasa “de pary en pary”.  Y las papitas de McDonalds estan como tu cuando molesto: un poco crispi.

De era en era, de a~no en a~no, robando y asimilando palabras para adornar un lenguaje y contar una historia.  Asi que cuando te manden pal carajo o te manden a buscar a Do~na Juana con sus pollos, recuerda que hay historia que se pierde atraves de los papeles.  No es que somos medio lenguas, si no que contamos una historia de 2500 a~nos, y estamos apurados.  No es que nos faltan letras, si no que nos falta tiempo.  Hay tanto que contar y el espa~nol no nos da a basto.

Todo esta cool.

Aldy el de Puejlto Jico

1997

Birthday girl is 30 something today, so I decided I would make my own presents this year.  Unsurprisingly, this turned out to be a bit harder than envisioned.

The reason I’m always inclined to self-made presents, crayon painted birthday cards, and homemade pies is not only because I’m cheap, but because it takes a lot more effort to make something, than it does to go online and click “buy now”.

Ancient Japanese legend promises that anyone who folds a thousand origami cranes will be granted a wish such as long life, or an eternal marriage.  There is even a wedding tradition among the truly bored known as sembazuru, where a couple will fold 1000 origami cranes in order to be granted a happy and prosperous marriage.  It is thought that the time and energy put into folding a thousand orgami cranes symbolizes the patience and trust necessary to sustain a happy marriage.

My goal today was to learn how to fold the paper creatures, and give Yanory a 100 of them.  Throughout the next 10 years I could give her 100 cranes at either birthdays or anniversaries, and I’d be up to 1000 cranes in no time.  Yeah, well… easier said than done.

I started my day at 6am, shortly after Yanory left for work.  Papers in hand, and the determination of a young samurai, I typed y-o-u-t-u-b-e-.-c-o-m.

What the frik?  How do they get from step 3 all the way to a flapping paper crane is beyond me.  I looked for step by step instructions… same thing: the easy steps are shown and you’re somehow supposed to divine how to get from a folded square to a flying bird.

After 2 reams of papers, Aldy-scissor-hands was up to a mildly decapitated and mostly unrecognizable crane.  I was beginning to panic.  No amount of “tailoring” with actual scissors could make my cranes looked like the cranes from the small handed Japanese anime instructors on-line.  Luckily, after about 3 hours, I managed to make a recognizable crane that could actually flap its wings like the instructor’s.  Quickly, I pulled out the stop watch and folded 3 more.  Average time per crane?  5 minutes.

Now, you don’t have to be a math geek to realize that to finish 100 cranes, I would fold the remaining cranes in 480 minutes (8 hours).  And that’s assuming I make no mistakes, don’t get any paper cuts, and Yanory doesn’t come home commonly early (did I mention anesthesia was the residency to get into?).  Realizing this is an impossible task, I am hoping she’ll be impressed with 4 beautiful origami cranes, a long blog entry in her honor, and a mountain bike ride through trails this afternoon.

Meanwhile… I’m heading out to the super market to buy ingredients to bake a key lime pie from scratch.  Provided no distractions, I’m sure I can pull this off with no scorching before she gets home!

Here’s to a thousand more years with the same beautiful wife.

With few exceptions, I have found that those who think we have a great medical system know very little about medicine, billing, and how the whole process works.  It’s not that I finished a residency in neurosurgery, but in the past 5 years, I have been around enough surgeons, internists, radiologists, residents and even medical plan owners, to have a fairly good idea on how it all works, economically speaking.

For the money, I think we have the worst medical system in the world.  When you balance how much things costs, versus what you get in return, it’s not hard to see this.  Sure, if I suffer from a rare disease with experimental treatment in the US requiring expensive equipment, then by all means, this is the place to get treated.  But routine procedures not involving rocket science?  Please…

A recent example.

My mom convinced Yanory to get an endoscopy to make sure her frequent indigestions and heartburn, weren’t something more serious.  Since we’ve already paid our yearly deductible earlier this year with Yano’s “minor” head-on collision with a bike (don’t ask), I said– screw the plan, let them pick up the entire tab.  Get every surgical procedure on the book!

For those of you in the dark, an endoscopy is a simple procedure.  They put you to sleep.  They stick a, ahem, stick with a camera down your throat, take pictures, and analyze.  Again, not rocket science, but not something for the untrained to perform.

Today I looked at the explanation of benefits from our insurance.

The gastroenterologist who did the work billed $792, however the plan decided they should only get paid $165.  This is the man who spent 4 years in medical school, 3 years in an internal medicine residency, and 2 years for a fellowship in gastro.  This is the poor schmuck with $250,000 of debt at 6% (because not all school debt is finance at 3% by the Federal government).  This is the man with a god complex paying a yearly $15,000 in debt interest alone, and possibly $20,000 in malpractice insurance, all while trying to keep up with his friend the radiologist who billed $184 for a tangentially related ultrasound, and got paid $147.

Let’s review.  MD who did all the work and stands to get sued, $165.  Radiologist who was in the office for a few minutes and pays hardly any malpractice insurance, $147.  Note to Braulio– you got suckered going into surgery.  Radiology was the residency to get into!

Now, there are still the hospital charges.  The hospital bills $6,615.  The plan, who is sometimes partially owned by the hospital, gets paid a whopping $5,300.  But wait you say, the hospital must have provided all sorts of other services.  A bed? Nope, out-patient procedure.  A meal?  Nope, that’s what the vending machines are for.  An anesthesiologist doctor?  Nope.  A nurse anesthesist making a comfortable 6 figure income instead?  Nope.  The hospital had regular nurses trained to give anesthesia.  Oh wait, that was my mom, and I know her entire wing did not make that much that day.

I have a friend who’s making a surgery clinic so he can take a bigger piece of the pie.  But while he will take in more, the insurance will estimate down his charges because he’s not an actual hospital, but a clinic– so he can’t take the $5,300 for a brief procedure.  Meanwhile, the clinic may cost millions of dollars.

You may think I’m exaggerating, that medical plans don’t make that much, but I have a (street) smarter friend, who along with other doctors, pooled in a few million dollars and bought a failing medical plan.  The result?  He said in a year, he made more money than he had in his whole career as a doctor.  And doctors don’t exactly make minimum wage.

Another example.

The gastroenterologist thought it would be a good idea to do an ultrasound of all the poop in Yano’s belly, just in case.  As we know, the radiologist made $147 for this analysis.  However, the hospital who owns the ultrasound machine made $1,200.  Wanna know how much an ultrasound machine costs?  Anywhere from 15-50 grand.  So even if it costs $50,000, the investment pays for itself in just 40 uses.  And you don’t need to go to med school to own one!  Great investment!

The reason we pay doctors so well is not because they’re so much better than in other countries (a lot of US doctors studied abroad), but because they have such high med school loans, and because we’re a lawsuit happy country.  That, and they think they should live a half a million dollar lifestyle to keep up with the dermatologists and radiologists with their high pay, low work residencies :).  Of course, it doesn’t turn out that way, because they have the high overhead of an office downtown, 2 nurses on staff, a secretary, 4 cars, two boats, a summer home, and a wife who’s a professional shopper.

I have another friend who, after he finished his residency, went to work for a hospital making a pretty penny.  No malpractice, no office overhead, no nurses’ salary out of his bottom line, virtually no overhead.  However, he was forced to work 12-14 hour days, seeing so many patients, he was only able to provide a cursory exam.  He felt bad that he couldn’t give the level of analysis and medical care he was trained for, but the hospital has strict quotas for their doctors (read, paid slaves).  Who owns the hospital in question?  You got it… an investment group who also owns a medical plan.

You may think these are hospital and doctors in Argentina, where my brother-in-law is finishing his surgical residency?  Nope.  You may even think they’re in Puerto Rico, where even though the doctors are all US certified, they’re nothing but a glorified third world country, right?  Nope.  This is all right here in the mainland, where we bitch at any attempt to throttle the medical system.

If someone comes up with an alternate health plan for the US, we poop on it, accusing it of socialism, communism, or some other ism.  But no one ever bothers to see how much the pharmaceutical and medical plans pay for lobbiers in congress, or how much they fund the different candidates’ campaigns.  I have not a clue if this Obamacare is any good, because I tuned out of the debate a long time ago, but I can tell you this much– anything is better than the alternative.  It doesn’t take nobel prize winning economists to design ANYTHING that’s better than the raping we call a medical system.

As an aside, wanna know how much an endoscopy costs in Panama, where I *know* the private medical system is not that bad?  $670.  Compare to the $6,000 bill here.  How about in Peru where $400 can pay for an endoscopy in a private hospital with a private room, and your own private nurse?  Of course, nothing can beat a friend who’s a gastroenterologist, but unfortunately my friends decided surgery and internal medicine were better residencies, so unless Yano needs her stomach taken out, I’m much better paying out of pocket for a vacation in Machu Pichu.

Sorry for the somber post.  I don’t even have any solutions.  But this system definitely sucks for anything but the most advanced, expensive procedures– and maybe not even that…

In the past 10 years, I calculate that between my employer and myself, we have paid at least $60,000 in insurance premiums.  How much have they actually paid back?  You got it… the inflated $6,000 for this endoscopy, and only because we had already paid the deductible this year.  So that’s it, I’m done with insurance.  Next year I’m signing up for Red Hat’s high deductible plan with a health savings account.  I don’t want coverage for anything more than a catastrophe (car accident or cancer).  It’ll cost me $1800 less a year, and the IRS allows me to deduct travel for health care tax free from the health savings account.  For $1800, I’m sure we can visit Braulio in Argentina for an appendicitis, or wait until my friend finishes his clinic.