June 2000

The first questions that need to be asked about this are: "Where did the trainee selection process go wrong?" and "Where did the training process go wrong?" I believe that nobody is untrainable for any job. Having said that, some people have a greater aptitude for certain jobs than others.

Pathology has never been the most popular medical specialty. I am the only member of my medical school graduating class of 113 who became a pathologist. That was almost fifteen years ago, and the appeal of pathology as a career has only diminished since then, what with hospital budget cutbacks and regionalization of laboratory services leading to increased workloads and static or decreasing pay.

Pathology residency programs in North America have a difficult time filling their training positions with North American medical school graduates -- they opt for higher-profile and better-remunerated specialties like radiology, surgery, and internal medicine. As a result, in order to continue operating, pathology residency programs are forced to accept whoever applies -- people whose first (or second, third or even fourth) choice is not pathology, and, increasingly, international medical school graduates who are unable to get into any other specialty program.

That a well-regarded program like the one at UW had to consider, let alone accept such a marginal candidate speaks volumes about this situation. (OHSU's residency training program director tells me the shooter also applied to our program last year, but was rejected.)

Though this has been the state of affairs for some time, pathology training programs have been slow to respond to the change in the nature of their trainees. In the past, motivated North American medical school graduates were able to complete their pathology residency successfully despite suboptimal training systems. Today, those with weak English skills, people unaccustomed to North American health care systems, and those with less aptitude for and/or interest in pathology need a different way of training, perhaps more explicit and defined, with more checkpoints. Work processes can also be changed to minimize the chances for error. Medical informatics can be used to provide decision support.

Pathology training programs should either make adjustments in their education methods for these people, or not accept them in the first place and close down the position and, if necessary, the program until truly interested and qualified trainees come along.

This was a tragic, unnecessary loss of life. The conditions that led to it are not isolated -- there have been situations in every place I have worked where the same thing could have happened. I had a premonition about something like this earlier this month, except I envisioned it happening to me! Unfortunately, I doubt if yesterday's events will change the way pathology recruitment and training are done.

• 2 die in UW medical school shooting
• Shooter was angry after losing medical residency, police say
• Signposts that led to UW bloodshed
• UW couldn't stop troubled doctor from buying gun
• Residents face high pressure to succeed
• Foreign medical residents face added barriers
• Rodger Haggitt, MD: Profile
• Dr. Haggitt's passion for pathology developed as a teenager

Kikujiro no natsu (Kikujiro) (Japan 1998; Dir: Takeshi Kitano) 1/2
An ex-yakuza befriends a little boy who is looking for his mother. People who only know Kitano from his violent yakuza films Sonatine and Hanabi might be surprised by this sentimental story and its goofy second half. But this is nothing new for those who watch Japanese television, where the seemingly ubiquitous Kitano assumes Kikujiro's gruff, verbally abusive persona nightly as the host of various shows. Watch for the cameo by Kitano's former comedy partner Beat Kiyoshi.

Cultural elements:

• Hanko - name stamp used to sign documents in Japan; the boy goes looking for his grandmother's when a delivery man comes to the door, and comes across his parents' wedding photo, which inspires him to go on his search.
• Counting - review your Japanese numbers as Kikujiro goes to the racetrack and gets the boy to pick the winning cyclists.
• Yakitori-ya - a restaurant/bar where you can buy chicken-on-a-stick
• Hotel Yukata - light cotton kimono provided to guests, usually in white and indigo.
• Matsuri - summer festival with various events, like catching kingyo (goldfish) with a net made of paper
• Tengu - winged goblins of folklore with long noses and various magical powers

• A half-Native American woman is interviewing her 70-year-old mother, who was the unofficial historian for her family and tribe.
• A woman is using oral histories to identify factors that led to the success of a women's higher education mentorship program at a local college.
• Oregon Uniting, an organization working for greater racial harmony, will be recording the oral histories of people, mostly African Americans, who were displaced when Portland tore down their neighbourhood to build the Memorial Coliseum, former home court of the NBA Portland Trailblazers.
• I am doing a miniproject for the OHSU Oral History Project: a look at a few of the Japanese American graduates of the OHSU School of Medicine.

Staff members of the Oregon Historical Society offered helpful hints on interviewing technique and recording equipment.

• About.com: Genealogy: Oral History Links
• About.com: Genealogy: Oral History Resources

Afterwards, I went around to see the exhibits. Most impressive was Historic Vehicles in Miniature, models of horsedrawn wagons by Ivan Collins. On trips to the countryside, he would find the wagons of Oregon's pioneers abandoned in the fields, then carefully measured them and built painstakingly detailed replicas in 1:8 scale. This collection is a reminder of a time when horses were needed for everything in daily life, from delivering milk to hauling logs. Instead of gas stations, there were roadside feed stations!

I also liked the Maritime Gallery, which showed paintings and artifacts of maritime exploration in the Pacific Northwest. The first explorers like Captain Vancouver faced great danger, but the traders who followed had their own problems. The OHS Bookstore had copies of Katherine Plummer's book The Shogun's Reluctant Ambassadors: Japanese Sea Drifters in the North Pacific, about Japanese sailors who ended up in Oregon by accident in the 1700s. (She has written another book called A Japanese Glimpse at the Outside World, 1839-1843: The Travels of Jirokichi in Hawaii, Siberia and Alaska)

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(24 June 2000)

• A young couple goes about getting married: meeting the parents, buying a ring, having photos done, and celebrating with a reception.
• A schoolboy obsessed with sound recordings becomes enamoured with the voice of a girl in his class. His taped love letter gets into the wrong hands.
• A middle-aged widow re-enters the dating pool with a television personal ad, only to be overwhelmed with responses. Her daughter helps to narrow down her choices by arranging a mahjong game. While the tiles are flying, the suitors show their true selves. This was the most heartwarming segment.
• A young couple revives their stale marriage by playing with children's toys.
• A young boy tries to keep his parents from divorcing by preparing a family meal using a magic potion given to him by a sidewalk fortuneteller. (3 hankys)
• A couple recounts through flashbacks how their relationship was a matter of chance. I thought this was the weakest segment, little more than a music video. Furthermore, the ending is copied from the "Home" story in La Ciudad (The City).

Though filmed in modern-day Beijing, these stories are universal. This film shows that Asian people aren't so different from the rest of the world. Beijing today looks very much like a Japanese city. Some clues that this was China: fewer signs are in English, bicycles in the main streets, and the food.
Western influences: The walls of one boy's room are plastered with NBA posters, kids hang out at a video game center, women work, Jeep SUVs, the apartments are Western style, everybody sleeps on beds and has lots of consumer goods.
Customs?: Marriage and divorce alike are accomplished with a bureaucrat's stamp at a government office. "Let your hair get white together!" the reception guests shout at the newlyweds, to wish them a long marriage. The bride and groom oblige by blowing a white powder (flour?) at each other off of a plate.
Neat stuff: Yin & Yang 2-chambered hot pot. Where can I get one?

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(23 June 2000)

I recently came across a revisionist history website which alleges that, by tradition and expectation, Japanese nationals living in other countries and their descendants still owe first allegiance to Japan and Emperor Akihito; that Japanese nationals in America and Japanese Americans are part of a conspiracy to promote pro-Japan U.S. domestic policy as well as foreign and trade policy. There are people who actually believe this!

Having been raised in the Canadian democratic tradition, my interest in royalty is more on a celebrity level than reverence. I know more about Britain's and Monaco's royals and America's Kennedys because they get the most attention from the English-language media. Now that I have access to Japanese news through the Internet, I can see that Japan's treatment of its imperial family is not too different: witness the sensationalist coverage of Princess Masako's miscarriage at the end of last year.

In 1918, the 14-year-old then-Princess Nagako was betrothed to then-Crown Prince Hirohito. She married at age 21, and proceeded to bear four girls in a row, prompting the media to write, "(She) may have a constitution that makes it impossible for her to give birth to boys." Today we know from genetics that a baby's sex is determined by the father's chromosomal contribution. Then came the current emperor Akihito and two more children -- seven in all! Though they lived through some of the most momentous times in Japanese and world history, the Showa imperial couple in some ways were like any other happily married husband and wife. When they celebrated their 60th wedding anniversary, Emperor Hirohito said, "The Empress is always cheerful. (She) has made our family cheerful, and she has supported me."

• A Chronology of the Empress Dowager's Life
• Empress Dowager known for her warm smile
• Imperial couple esteemed each other
• Nation Mourns Empress Dowager
• Empress Dowager's Funeral Set For 25 July 2000
• Japan and the Imperial Household
• About.com: Royalty: Japan

• An Organization With Memory
  Learning from adverse events in the National Health Service

• Walt & Stanley's Excellent Adventure
  The Keeper of the Cup tells how people from different countries have different reactions to Lord Stanley's Mug

I taught Stefan some French hockey terminology, learned from La Soirée du Hockey on Société Radio-Canada, like "Séries Eliminatoires de la Coupe Stanley", "un très belle arrêt par le guardien de but Martin Brodeur", "le disque est hors jeu", "mise-au-jeu en territoire des Devils", "le plaquage sévere par Derian 'atcher", "Sykora est blessé", "Carbonneau à son adverse", "deux minutes pour rudesse", "l'accrochement", "l'avantage numérique", "le tir ... ET LE BUT!!!"

During the third period, a woman walking by asked us what the score was. We replied enthusiastically, "C'est un-à-un!" She looked stunned for a few seconds, then figured it out. "Oh, one-to-one, right?"

I pointed out all the people with 'Chuck connections: Coach Hitchcock, and players Manson, Thornton, Sydor, Matvichuk for the Dallas Stars, and Daneyko, Niedermayer, Sutton and Arnott for the New Jersey Devils. Stefan finally asked, "What, is Edmonton some kind of hockey mecca?" (Well, yes, actually.)

I was expecting ABC Sports to show a highlight reel of overtime Cup-winning goals during le troisième entracte, mais they didn't. If I had wireless Web access, I could have downloaded the following list from SportsLine.com:

Stanley Cup Series-Winning Goals In Overtime
1999 Brett Hull - Dallas Stars
1996 Uwe Krupp - Colorado Avalanche
1980 Bob Nystrom - New York Islanders
1977 Jacques Lemaire - Montréal Canadiens
1970 Bobby Orr - Boston Bruins ("The Goal")
1966 Henri Richard - Montréal Canadiens
1954 ??? Leswick - Detroit Red Wings
1953 Elmer Lach - Montréal Canadiens
1951 Bill Barilko - Toronto Maple Leafs
(mentioned in The Tragically Hip's song 50 Misson Cap)
1950 ??? Babando - Toronto Maple Leafs
1944 ??? Blake - Montréal Canadiens
1940 ??? Hextall - New York Rangers
1934 ??? March - Chicago Blackhawks
1933 ??? Cook - New York Rangers

Jason Arnott can be added to this list, as the Devils prevailed 2-1 with his beautiful one-timer in la deuxième période de prolongation. Almost every prediction I made this year was wrong, except guessing the type of injuries the players got. I should stick to what I know!

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(10 June 2000)