in Paradisum

in Paradisum is an antiphon sung at the end of a Requiem mass as the departed is being removed from the church. It offers the wish that the departed will be welcomed to paradise by a chorus of angels. Through the centuries, composers have used this antiphon as a vehicle for tone paintings of their vision of Paradise. Some have produced pieces of surpassing beauty–I think, in particular of Fauré.

Of course, Paradise has a visual component as well as an auditory component. Over the last weekend I have been there and seen it. I didn’t have a near death experience. It was much simpler than that, but I can report that Paradise is sublimely beautiful.

Cumbres & Toltec Scenic RR

Cumbres & Toltec Scenic RR

My Muse and I went to Chama, NM to ride the train. We stayed in an RV park right on the Chama River close to the Chama Station. When we checked in, we were instructed that every morning we had to either  be on the train or down at the river  waving at the recently departed as it went by, so we did some of each. The C&TSRR is right on the New Mexico/Colorado border, and the route actually crosses the border 11 times in the run from Chama to Antonito, CO. The route was chosen by the Denver & Rio Grande RR in the 1870s, and completed as far as Durango in 1880. The track from Chama to Durango no longer exists.

Rocky Mountain High Country

Rocky Mountain High Country

This is high country. Chama and Antonito are both above 7800 feet and the track runs through Cumbres pass at over 10000 feet. The scene at the left is over 9000 feet. By this altitude, exercise is becoming difficult if you are not acclimated because the amount of oxygen in the air is less than 75% of sea level. But, if you are acclimated, this can be a wonderful life. Look at those beautiful yellow flowers. They are Dandelions. I don’t think there are that many even in your lawn.

 

Mountain ranch.

Mountain ranch.

Here is another view. I love these high mountain meadows; the broad, glaciated valleys; snow on the mountain tops and even at our level. The rivers, which seem to be everywhere, were running high. The snow pack was low last winter, but there have been several weeks of frequent rains. I like New York, too. But, that isn’t Paradise. This is.

Invasion

If someone breaks into your house or, worse, invades it while you are there, you will feel a variety of strong emotions including outrage, anger, and fear. It may be hard to feel safe there again. A few months ago, our neighborhood suffered a rash of mid-day burglaries–kick in the front door in the middle of the day while everyone is away and steal whatever you can that you can sell quickly, and generally trash the place as you are going through it. (The police told us that the front doors were heroin addicts. The rash of auto burglaries that we had at the same time were meth addicts.) One family across the street was broken into twice–once while the kids were at home. They moved to a gated community.

I haven’t personally had this experience. After years in security, I guess I know how to make my house look like a harder target than my neighbor’s house. But, I have a pretty good understanding of how they feel. In our current (over-) connected society, we can have the same feelings when our computers are invaded. I once had the experience of having my computer broken into while I was sitting in front of it. I didn’t really feel violated so much as insulted. “How could you. I’m using this now. How stupid do you think I am?” (“pretty stupid.”) In the end I felt pretty good about that incident. Using my superpowers, I removed the intruder, cleaned up his mess, and discovered and closed the hole he had used to get in, all within an hour.

Today things are different from those days long gone. Today I build and operate networks of computers “in the cloud,” somewhat freed from the computer under my desk (but not from a bunch of laptops). I get the computing horsepower I need from a large vendor of “Infrastructure as a Service” (IaaS in the industry jargon). If I need a new machine for an experiment, I ask for one and 5 minutes later, I have one. If after a couple of hours, I’m through with the new machine, I throw it away. There is some cost involved, but the machine I used for a couple of hours costs far less than my time, and way less than the cost of having a spare piece of hardware laying around. (If you want to learn a little bit more about how cloud computing works, you can look here.)

Last week, I had a strange experience. I received a notice that one of my cloud machines had been used in an attack on somebody else’s computers. Naturally they wanted to know what I was going to do about that. That part of the story is not unusual. The unusual part is how I felt about the incident. This was not a break-in at my house. It was not a break-in of my computer. But, there was a break-in, and I still felt angry and violated. I wanted to understand what had happened and make sure it could not happen again. I wanted to catch that hacker and step on their fingers (the tools of their trade). I wanted to make sure they would never again disrupt the flow of my well-ordered life.

A few days later, I see how strange this was. It’s not like some real possession was broken into or attacked. There is no physical machine anywhere in sight. There was nothing that was “mine” there except for some work 5 years ago. And yet, I have this feeling of violation. Why? I don’t really understand this. But, I do better understand the feelings op people who have actually been violated. It’s not a small issue, and could have lasting repercussions.

I also felt curiosity. My first instinct was to get on the machine and look around to see how they had gotten in. But, there was a problem with that. I built this machine almost 5 years ago and really hadn’t been back to it since then, and I couldn’t remember how to get on (which only convinced me even more that someone had taken it over). There really is a right way to deal with these incidents, and I had the luxury of being able to use it; I notified the right people, shut the machine down, and went to dinner.

I did get on the machine the next day and looked around. I found that the machine was under attack almost continuously, but from people who really need to get a life. I’m happy with attacks from the terminally stupid (the attackers who try the same thing over and over again, sometimes for hours or even days, in the hope that something will be different the next time). But, I didn’t find the attacker who succeeded, and I’m not happy about that. That means I would never know if I had successfully cleaned up the machine.

In the end, I chose the path of no resistance–preserve the data I’m trying to serve from the machine and throw everything else away. Rebuild the machine from the ground up on a new, more secure platform and move on. This is a cloud computing path I could not have chosen with a non-cloud machine. The attacks are inevitable and continuous, and some are bound to succeed. The cloud infrastructure has given me a new, less stressful way to respond, and I am happy about that.

Prostate Cancer

ColdHandBoyack posted a Public Service Announcement (pun) about his elevated PSA and prostate cancer biopsy. Fortunately, he did not have prostate cancer—congratulations to him.

Been there. Done that. Results not as good. As you pointed out, I had no concept of modesty left after the biopsy. The nurse did the ultrasound, the doc the biopsy. When the ultrasound was done, the doc was busy with something else, so I had to wait with the probe in place until he finished his coffee and danish. Of course, the nurse waited with me—she wouldn’t have wanted me to pull the damn thing out.

If you have cancer, the next step is figuring out what to do about it. There are 3 main treatments: surgery, radiation, and seeds. The problem is that the treatment outcomes don’t diverge until after 10 years. In practical terms, that means there is no objective way to choose. I had the good fortune (for me) to know a man who had had prostate cancer 10 years earlier and had chosen radiation. Then 10 years later, it had returned. Because the radiation causes collateral damage in the vicinity of the prostate, he could no longer have surgery. There was nothing to be done for him, and he died. I chose surgery. That was almost 8 years ago, and I am still here, and my PSA is still 0.0—woohoo.

I’m convinced that prostate cancer is something that every male who lives long enough will get. It’s a matter of when, not if. If you are over 50 or so, get a PSA along with your other blood work. All you have to do is ask for it. If the biopsy shows cancer find someone else in the club to talk to while you are deciding what to do. Despite the intimate nature of the problem, I have found others who have been through prostate cancer surprisingly willing to talk.

Entertaining Stories

I’m going to invite everyone to re-blog, tweet, and otherwise share this post today. We all wish our posts got that much love, but this one is important. If you are a man, love a man, or maybe both, this post is important.

I debated long and hard about sharing this at all. It involves personal information, and I like to keep a bit of privacy. I had to weigh the fact that my mother reads this blog, along with at least two co-workers, against the possibility of helping someone else. Someone else won.

Popular rumor holds that a man should have certain things checked medically once he turns 50. In typical male fashion, I waited until I was 53 and 8 months to schedule my colonoscopy. This is a degrading procedure that involves shoving a camera into places that aren’t visible by design. I thought it was degrading, but…

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ACEs

A few days ago, Victo Dolore posted a piece titled Quagmire in which she discussed being at a loss in dealing with an obese patient. No approach that she had tried seemed to connect with the patient about the need to lose weight. This communication problem sent her on a quest for other possible approaches that might work, a quest that eventually led to a post on another blog, ACEsTooHigh, titled The Adverse Childhood Experiences Study — the largest, most important public health study you never heard of — began in an obesity clinic. The ACES post reports on work carried out by Dr. Vincent Felitti and Dr. Robert Anda. Dr. Felitti noticed that patients in his obesity clinic would lose 100 pounds or more and then drop out just when they were making real progress, and he wondered why.

Studying 250 of his own patients he uncovered a strong connection between obesity and what have since been called Adverse Childhood Experiences, ACEs. ACEs include events such as abuse and neglect, violence in the home—abuse of mother or siblings, violence in the neighborhood that a child has witnessed, alcoholic of drug-addicted parents, or a parent that has been in jail. And, obesity wasn’t the only problem connected with ACEs. Other adult problems, such as alcohol or drug abuse, depression, criminal activity, and even diseases such as COPD, IBS, and fibromyalgia are much more likely in adults with non-zero ACE scores, and increasingly likely as the ACE score increases. After having some surprising difficulty getting his peers to believe his results, Dr. Felitti, together with Dr. Anda and others, conducted a much larger study involving over 17,000 patients.

The article has some stunning stats in it (you should read it). Perhaps the most surprising to me was the possibility of long delayed effects (decades in some cases) of childhood trauma and of ongoing trauma having the effect of permanent changes in brain structure as a result of toxic changes in brain chemistry. I’m not in any health care field, so I’m sure that I think I know more than I really do, but I found those effects surprising.

I also found stunning the quotation from a rape victim ‘Overweight is overlooked, and that’s the way I need to be.’ According to the article, she had gained over 100 pounds in the year after she was raped, and the weight gain appeared to be a (semi-)conscious protective measure against being raped again.

I was led to read more from the ACEsTooHigh blog and followed some links to other sites. One that was particularly interesting dealt with Trauma-Informed Care (TIC). It was a power-point presentation by Tim Turner from the Substance Abuse and Mental Health Services Administration (view it here) that had a list of what is TIC and what isn’t. My first impression was “that sounds pretty good—what do I have to do to be treated that way?”

So, what about the treatment of adults? Not knowing anything about toxic stress, I went looking for more information on the network–not the best way to search for scientific results, I realize, but a good place to find an overview or pointers to more scientific results. What are the effects of toxic stress on adults, and can what has been learned about treating children be applied to adults. I thought I would find information about how adults are being treated to alleviate the effects of stress, or at least find information on PTSD as a result of stress. Nada. Maybe I gave up too easily or was guilty of Google Incorrectness, but I found only one site, and that was about how to deal with a micromanager. Good stuff, I suppose, but “watch funny movies and get some exercise” wasn’t what I was after.

There doesn’t seem to be much to read, so we’ll have to resort to MSU (making stuff up). Let’s do a little thought experiment. Suppose that we applied the general principals of TIC (which distill down to things such as basic respect, asking what the patient wants, trying to be collaborative instead of authoritarian, involving patients in their care) to residents in nursing homes. Could that do something to lessen or even reverse what seems to be an almost universal revulsion for nursing homes? Could it make them feel less like warehouses or places of incarceration? (The only thing my mother ever said about the way we cared for her was “Don’t put me in a nursing home.” She lived in an Assisted Living Facility at the time, and her experience was that people had a medical event of some kind, were trucked off to the hospital, sent to a nursing home, and never heard of again. To her, a nursing home was a death sentence.) Do your own thought experiment and tell us what you learned.

Let’s try one more thought experiment. What if we had Trauma-Informed Policing? (I know you haven’t looked at that power-point yet. You better go do that before trying this one.) For this experiment, suppose that we have already reversed the current fad of militarizing police departments and gotten that toxic idea out of our systems.

If you have gotten this far, you should go back and read those other posts now. Then report the results of your thought experiments. Happy experimentation.