My boss came into my office at the end of the day, sat down, and told me his idea for how the Department of Medicine can address the issues of burnout and resiliency that the health system is focused on these days. Dr. Rogers wants to relieve the various stresses on our faculty, clinicians, and health care providers. We can do this. I told Dr. Rogers how, the day before, I'd been annoyed by the painful screech that a highly-trafficked automated door made every time it opened, and how a call to Engineering and Operations got it addressed the same day. That's the kind of availability and responsiveness that can help reduce frustrations throughout the medical center.

I'm on a few committees exploring these issues and the innovative solutions - simple or systematic - that we can implement. I'm not quite sure how best I can be involved, so I'm thinking about how I can evolve to be a park ranger, or a community builder and culture creator.

Over my morning cappuccino, I reread Duke's recent academic strategic plan, Together Duke. It's clear, ambitious, inspiring.

Oliver was to have a friend spend the night, and he was brimming with excitement because it was to be the first sleepover. Alas, the friend wasn't able to come over, and Oliver was quite bummed. So Erin decided we needed a family movie night, and off to the theater we went, to see Jumanji: Welcome to the Jungle.

I wasn't sure I was going to like this update of the 1995 movie with Robin Williams. But this new film, with Dwayne Johnson and Kevin Hart and Jack Black and Karen Gillan, was hilarious. I laughed so much that I was crying. Through my tears, I heard Oliver busting up, too.

Fun night.

On the Football Show on Sirius XM yesterday, Charlie asked Ray to name the best soccer books.

"The Miracle of Castel di Sangro, by the late, great Joe McGinniss," Ray said, launching into a long answer about why McGinniss, who'd written a bestseller about Nixon's 1968 presidential campaign, had gone to Italy to write about a small team newly elevated to Serie A.

The book sounded interesting, so I requested it from the Duke Library, and picked it up today.

I'm a few pages in, and wanted to note this passage on page 30:

The sidewalks, in fact, were filled with walkers spilling out into the street. "This is the time of the passeggiata," Barbara said. "Everywhere in Italy, in early evening, almost everyone turns out for a walk. No destination. No purpose. Just to walk slowly and to look and to talk occasionally with one's friends. Maybe to shop, but that is usually an afterthought, not the purpose. The charm of the passeggiata is that it has no purpose beyond itself.

What a great idea. A daily walk, to be outside, with people without purpose.

I see from the McGinniss entry on Wikipedia that Hudson spoke at McGinniss's funeral.

Duke Health is building a new bed tower, and the construction crane is in the process of being installed, the pieces lifted and lowered into place by another, mobile crane. This morning, men are walking up there, guiding the heavy counterweights into place.

This is fascinating to watch, engineering in the open, and it made me think about all the amazing medical procedures that happen in the operating rooms and intensive care units above my desk (my office is on the ground floor of one of the older bed towers of Duke University Hospital). I wonder if we made more of medicine visible, would we inspire more wonder in ourselves and those we serve?

Last week, I attended a Duke Health resiliency ambassadors workshop, with excellent presentations, activities, and tools to help managers infuse wellness into our teams.

Bryan Sexton leads the workshop, and opened the second morning with a presentation about awe -- he showed stunning, inspiring photos from around the world. These were great examples of visual awe.

That got me thinking about the awe I feel from music, and smell, and even the touch of a breeze or sun's ray on my skin.

Today the Health Arts Network Duke had a jazz duo playing in the hospital concourse. As I walked by, they were singing Louis Armstrong's What a Wonderful World.


That reminded me, yet again, of my brush with the angel Israel Kamakawiwo'ole.

When I got back to my desk, I found (via Kottke) this awesome video of a choir singing Toto's Africa.



It was a day of uplifting sounds. I feel good.


The new Ed Sheeran and Andrea Bocelli 'Perfect Symphony' duet is beautiful listening, and there's a new movie about Bocelli, The Music of Silence.

This brings back a great memory: During my Peace Corps service in Vanautu, I was in the capital, Port Vila, sitting outside, eating a hamburger, and Boccelli's Time to Say Goodbye was playing on the cafe speakers.

Erin and I have planned our return to Vanuatu, and we're excited to get back to Vila, and Paama, and to hear the sounds of village life again.

Last Sunday, too cold to venture out to Durham for the weekly soccer game, I sat around with a mug of coffee and a pile of magazines.

A few of the engrossing articles I read:

That article in Saveur had me thinking the food magazine was regaining some of its previous heft. Even though I previously decided to discard my many-years' collection of Saveur issues, I still have the boxes (more procrastination from Anton). Now that I see Saveur is cutting back – half the staff laid off, and moving to quarterly publishing – I may just save these back issues for their history.

The annual Turkey Bowl is a football game played by the Duke internal medicine residents since 1973. My friend Scott Huler stopped by this year to watch, and he produced this  audio postcard for Duke Magazine:

Another nugget from McPhee's Draft No. 4:

The worst fact checking error is calling people dead who are not dead. In the words of Joshua Hersh, "It really annoys them."

I gave dukeriver.co a new river icon.

Today's Eno River Run was fun, though challenging. The trails present many rocks and holes and roots. The morning was chilly, but once we were running, the air was perfect. I ran the 6-mile race, finished in 1:12, 10th for my age group.

Have been trying to get another instance of 1999 working on my Webfaction server space, for the Duke Narrative Medicine Colloquium blog. I can log in and write a post, but when I try to view the blog, 1999 crashes. Don't know if Webfaction doesn't like competing instances of 1999, or whether I've got a bad setting somewhere in the colloquium 1999.

Here's a fun TEDx talk by Tess Walraven about the joys of speaking Bislama:

It's time to review my blogging habits:

I also write daily, for myself, in my Baron Fig Confidant notebook with a Muji capped gel-ink pen, and am constantly scribbling in a Field Notes notebook.

Today, on a walk across the Duke University campus, I saw my friend Mark Schreiner standing in front of the engineering school where he works, and I asked him to accompany me to the coffee shop. Mark and I have been friends for nearly 30 years, since our days at John Carroll University.

From work, over to watch Anna's final volleyball game. The team won, a few points after Anna had a block and a tip over in quick succession.

Then, to the home of my friend Russ Campbell to chat and join his family at the dinner table.

Earlier this week

A conversation with Jeffrey Baker, MD, PhD, director of the Trent Center for Bioethics, Humanities & History of Medicine, about his recent presentation on the history of Duke Hospital and Durham (watch here) and the many activities across Duke Health relating to health disparities and helping our trainees and students understand the history of Durham.

Lunch with John Rose, PhD, associate director at the Kenan Institute for Ethics, about the Arete Initiative exploring ‘characteristics of a life well lived’ and Rose's expertise in Aristotle's philosophy of a virtuous life.

Following on the heels of the successful Narrative Medicine Colloquium plan, I  have submitted a proposal to the Duke Institute for Health Innovation pilot projects program, for a Voices of Duke Health listening booth and podcast.

I want people - staff and visitor alike- to leave Duke Health thinking, "They listened to me."

Erin read my proposal, and had me listen to Really Long Distance, a segment from This American Life, about a "phone booth in Japan that attracts thousands of people who lost loved ones in the 2011 tsunami and earthquake."

In the Harvard Business Review, former U.S. Surgeon General Vivek Murthy writes about the loneliness epidemic and the workplace.

At work, loneliness reduces task performance, limits creativity, and impairs other aspects of executive function such as reasoning and decision making. For our health and our work, it is imperative that we address the loneliness epidemic quickly.

I finished reading that article, which urges companies to  "create opportunities to learn about your colleagues's personal lives," after I submitted my Voices proposal. I think I'm onto something.

Our proposal for a Narrative Medicine Colloquium at Duke University has been approved.

The Narrative Medicine Colloquium will be a year-long exploration of the activities and programs already in place at Duke that give faculty, caregivers, students, and others the opportunity to reflect on their lives through stories. The colloquium is also a focused effort to look for new ways to build narrative into the research, medical education, clinical care, and employee health at Duke. It's especially a chance to ask how narrative can strengthen the resiliency of us all.

This colloquium will be one of many interdisciplinary activities funded by the School of Medicine that bring together basic science, translational and clinical faculty members with common interests in a biomedical problem or area.

Blogging where?

Now, where to put our narrative medicine blog to keep track of our discussions and explorations and events?

For example, the David M. Rubinstein Rare Book & Manuscript Library will present an Oral History Workshop with Craig Breaden on October 20.

Maybe we'll use the MedicineNews blog, or maybe we'll use 1999.

Over there

I bought the domain dukenarrative.blog.

Yesterday, drove through the rain to work with Guns N' Roses playing on the radio. Today, on my way in through the fog, played Resphighi's Ancient Airs and Dances. Glanced up to see a cyclist, sitting up on his seat, silhouetted against the mist.

I know I'm living in the Matrix because each fall the algorithm provides more and more roadside goldenrod and tickseed sunflower for me to enjoy.

Went with my daughters last night to see Wonder Woman. Enjoyed the film very much.

Went today with my daughters to the mall, then to Gray Squirrel for coffee and chai. Enjoyed spending time with them very much.

With Erin, my wife, we are doing our best to raise our daughters to be strong, energetic, and kind-hearted. Our world needs saving, and I believe they can be part of the answer. 

After a series of good conversations at work, I'm really itching to have a place to blog more of activities as a Duke park ranger. Should it be the MedicineNews site? The Threedot Duke Health blog? Zuiker Chronicles? Or right here in 1999?

Dave, always digging, is developing Electric Outliner, and the Old School node app, to take his blogging back to pre-Twitter and pre-Google Reader days. Exciting.

Sure, there are plenty of others documenting the insanity of the new administration in Washington, but here's my contribution:

From Presidential Memorandum Regarding the Hiring Freeze (1/23/2017):

By the authority vested in me as President by the Constitution and the laws of the United States of America, I hereby order a freeze on the hiring of Federal civilian employees to be applied across the board in the executive branch.

From Executive Order: Border Security and Immigration Enforcement Improvements (1/25/2017):

Sec. 16. Hiring. The Office of Personnel Management shall take appropriate action as may be necessary to facilitate hiring personnel to implement this order.

Earlier this week, I updated the outline with my list feeds of the sites I regularly read. I'd previously set up my reading-list river, at my.zuiker.com, to watch for changes to that opml list, but the river stopped working once I had changed the outline. I guess I was expecting River5 to work in a way it's not meant to, though I think the Duke River is doing what I wanted my personal river to do.

Anyway, I tried to restart the river, getting an error every time, so then recreated the river on my webhost trying to remember the steps I'd previously taken, and finally figuring out that I needed River5 to use the opml list directly and not via an include.

All this, by the way, as I prepare my short presentation about the "river of news" concept for the AAMC GIA17 professional development conference I'll attend this spring.

UPDATE the next morning

I've borked it again:

  • I added a new feed to my Little Outliner opml file.
  • I stopped river5.js.
  • I replaced the list.
  • I started river5.js using forever, and briefly saw the river page at river.zuiker.com. Then it went to a 502 bad gateway message. Forever list shows the process is stopped.
  • Trying to start river5.js with node reports an error. I suspect there is a problem feeds in my list. So I take out the 2 feeds I changed this morning, and reloaded the list. Still errors. 
  • This is frustrating. I don't know what I'm doing, or doing wrong.

Restarting the 1999 server, which seemed to have been down.

1. Commander: Fight To Retake Mosul Progressing Faster Than Expected
Major General Gary Volesky, who is leading U.S. forces in Iraq, gave clear, direct and reasoned answers on what's happening in the fight against ISIL.

2. Just In Time For The Election, It's Time For Some Family Political Therapy
This week's StoryCorps segment featured a father and daughter honestly addressing the way politics has divided them, but also how respect and love keeps them connected. Brought tears to my eyes.

3. 'Loving' Tells Story Of Supreme Court Ruling Legalizing Interracial Marriage
Jeff Nichols, writer and director of the new film Loving, talks about the amazing, down-to-earth couple at the heart of the constitutional case against miscegenation.

I'm cheering for the Cleveland Indians this World Series.

It was a tough choice. My family has a long history with the Cubs (and other Chicago teams). My father and uncles, and my grandfather, worked thousands of games selling popcorn and soda and beer. I watched a lot of Cubs games on WGN with my other grandparents, hoping Ron Cey and Larry Bowa and Ryne Sandberg and Shawon Dunston and Leon Durham might break the curse. I walked on the Wrigley infield one spring day along with other Illinois high school honor roll students.

But then I moved to Cleveland for college, and that city became my home for the next 10 years or so. My first Indians game was a $5 upper-deck ticket that actually let me sit anywhere in the massive Cleveland Stadium. I met and married Erin, who worked Indians and Browns games as an usher. Since moving to North Carolina in 2001, I've visited Cleveland at least twice each year. I consider Cleveland my home.

So, I'm cheering for the Cleveland Indians this World Series. 

Race day was cold, but clear. The Twin Cities Marathon course was beautiful, through downtown Minneapolis and around a few lakes and into neighborhood streets lined with thousands of cheering spectators. Quite a few were holding out boxes of tissues, a rarity at other races I've run.

Mike and I ran the first half fast, but then I faded, and struggled through the rest of the miles. I approached the finish line with a painful cramp in my left calf, but I came in at 4:21:10, a personal record (by 5 minutes). Mike beat me by 10 minutes.

This was my third marathon this year, fifth in all (previously Tobacco Road 2016, Austin 2016, Honolulu 2014 and 1993). I'd still like to finish in under four hours, but I'm not sure how I'll fit in more training over the next six months, as I have plenty to focus on at home and work. Still, I'd run the Twin Cities Marathon again.

I'm in St. Paul, Minnesota this weekend with my brother-in-law, Michael Shaughnessy, MD. We're here to run the Twin Cities Marathon

Mike was here last year as an honoree of the Medtronic Global Heroes program, which each year brings two dozen runners from around the world to run in the 10-mile race or the marathon here. Each of the runners has a Medtronic implantable device or part: pacemaker, insulin pump, urologic device, or other. Each of the runners has a heartwarming, inspiring story.

In 2011, Mike discovered he had a life-threatening aortic aneurysm. He had open-heart surgery and received a new valve, and got a new perspective on living.

Here's Mike's story:


And here's Mike's Heart Beat Report, where he blogged his surgery and recovery and headlong dive into running and triathalons and living life to its fullest.

Mike decided he wanted to return for the marathon this year, and I offered to run with him. It's an honor to do so.

Here's another good video about the Global Voices group last year.

More troubles with the Duke River, so I'm taking this opportunity to update the main opml file in Little Outliner for a combined listing of all the Duke feeds I've collected.

Hope to have the Duke River home page, dukeriver.co, back to normal sometime in the next couple of days.

A postcard in the mail informs me that my number for the Medtronic Twin Cities Marathon on Oct. 9 will be 6182.

I've updated Zuiker Chronicles to Textpattern v 4.6.0, which was released earlier this month. As expected, upgrading went smoothly. The new admin layout is much more intuitive and conducive to writing. I like this CMS, and am supremely grateful to the volunteer developers who have nurtured it all these years.

I tried to add a couple of newsfeeds from the new Duke Today to the Duke River, but one of the feeds is not quite right, and so I attempted to backtrack. Not sure I did it right, or thoroughly, but the display of Duke River seems to be coming back, albeit slowly.

If you want to see all of the rivers with Duke River, see river5.dukeriver.co.

Follow up

Looks like it's all back to normal, and the Duke River is reflecting all the interesting news from around campus.

The house smells of hickory and vinegar this morning, with a pork shoulder slowly roasting in the oven, after searing and smoking on the small Weber grill in the backyard. Thanks to the instructions from Michael Ruhlman, making Eastern North Carolina barbecue at home is simple.

Once the meat was in the oven, I sat on the front porch to read more of the Sunday NYTimes. The Travel pages, my go-to section, included a Q&A on shopping the markets of Provence — Erin and I did that in June — and also a long essay about Amtrak's California Zephyr train that goes between Chicago and the San Francisco area.

Riding the Zephyr

When I was 11 or 12, living in Idaho, my family drove south to Winnemucca, Nevada, where we parked the station wagon on a side street, and boarded the Zephyr for a trip west. I spent much of that ride in the observation car, watching the desert and mountains and valleys roll by. I fondly remembered that train trip when Erin and I were whizzing through France on the TGV this summer. I love trains.

On that earlier trip, my family visited relatives in San Jose. They lived in a geodesic dome. We went to San Francisco one day, and I enjoyed the waterfront but was frightened by the homeless veteran ranting in the middle of the street.

We took the train back east, and disembarked at the Winnemmucca station in the middle of the night, to find that someone had siphoned the gas from the station wagon. I helped my dad push the car down the hill, while my mother steered and my four brothers slept in the back. We eventually found a gas station, filled up, and drove four hours to our home in Caldwell.

Following the How to customize the editor docs, I was just able to update my 1999 server so that the template displays BlogTogether in the menubar. This should be the default menubar product name across any blogs on my 1999 server. You'll see it when logged into the editor.

The icon at right is part of the BlogTogether logo.

I walked into Flyleaf Books, in Chapel Hill, to buy a box of Blackwing pencils, and I walked out with just two pencils — a grey Blackwing 602 and a white Blackwing Pearl — but also a copy of Between You & Me: Confessions of a Comma Queen, by Mary Norris.

Norris is a query proofreader at the New Yorker, and I've been enjoying her short videos on grammar and style here's a video of her at the C.W. Pencil Enterprise (a pencil boutique New York City!), talking about reflexive pronouns.

I'm testing the Blackwings, and liking how they write, so will probably be back to Flyleaf to stock up soon.

Department of Handy Haystacks

By the way, see the cool Search page at newyorker.com.

I like to search for the writings of Joseph Mitchell.