Author: Ken Goetz

Would you like to live for, say, 110 years?

Posted on by Ken Goetz

     Would you like to live for, say, 110 years?  Does a long life appeal to you? Is it even possible to achieve? Seemingly so. Present-day science is oozing with promises to extend our lives.  How would I answer my opening question? That depends. If I were able to survive for well over 100 years feeling as healthy and happy as I am now, I’d shout “You betcha!”

     A quick disclaimer: I have not a shred of expertise on aging (other than reaching 90, which merely triggered my curiosity), so an authority I am not. But I’ve nosed around to see what’s going on with those who are devoted to studying our aging processes. A lot is going on! Facts jumped out at me from all directions. Those dedicated scientists, bless their hearts, have learned enough to fill a good scattering of scientific journals. And what they’ve discovered is good news for practically everyone.

     For one thing, the thousands of experts who study how we age seem to come together on one important point, namely this. Aging is a decidedly plastic process. It is influenced by a myriad of factors, a good number of which we can influence.

     Here’s one collaborating statement that comes from David Sinclair (1), professor of genetics and co-director of a center for aging research at Harvard medical school. What he said shocked me. I didn’t scribble it down as I heard it, so what follows is a paraphrase, but the gist of it was this: 80% of our rate of aging and our health when older is determined by “environmental” (lifestyle?) factors; only 20% is determined by our genome. Wow! Did that snap your eyes open? The evidence backing this statement appears to be solid, and it comes from many sources. What we do through the years is more important than what our genes control. In short, we can live better, and live longer, by adjusting our daily routines.

     Controlling our destiny isn’t all new stuff, of course. We’ve known for years that certain habits are bad for us. Smoking is a prime example. The smoke messes up lungs and hearts, among other organs. An article in the New England Journal of Medicine a few years ago ticked off more than a dozen disease processes set into play or aggravated by smoking.

     But here we’re talking about good habits. The more recent information concerning our aging, exciting as it is, has been derived largely by untangling rather complex intracellular biochemical pathways, and by digging into intricate genetic mechanisms, but luckily we don’t have to understand all of the complex details to realize what it all means, and to use it to our advantage.

     The basic message could not be clearer if it were announced in huge, glowing neon letters. And it is very simple. We have the power (ignoring accidents and bad luck) to slow our “aging,” and to remain healthier longer as we move through the years. This can be accomplished by adjusting our lifestyles (such as walking more, and weight lifting), by dietary alterations (so-called intermittent fasting), by taking certain oral supplements, and even by more experimental and less-available (and less generally accepted) genetic manipulations.

     I’ll focus on this theme for a couple of posts. Next time I’ll examine the varying methods of intermittent fasting, an accepted method for prolonging life and preserving health. I’ll even touch lightly on how that approach does the trick to slow down our aging process.

IMPORTANT HOUSEKEEPING NOTE REGARDING THE COLORS OF MEDICINE.

     For those of you reading my installments of The Colors of Medicine, I have news. Starting tomorrow (February 1),  you will be able to download the complete Kindle version of my novel from Amazon.com at no cost.  I’m giving it away free for the first five days in February. I must say it has been fun for me to provide little teasers at the beginning of each installment published here (number 13 was posted yesterday) and I plan to put out one final installment here tomorrow, along with a brief teaser indicating that the story is about to make a rather abrupt transition.  I’ll provide more details when I post installment 14.

Modern Medicine and the Magic 90

Posted on by Ken Goetz

            Having flown into my tenth decade with some speed, and finding I enjoy the altitude (1), I’ve begun ruminating about getting old. Why, I’ve wondered, have I beaten the odds? Today I’m going to retrace my tracks.  Next time I’ll look at the amazing process of aging itself.

            What was it that allowed me to survive longer than the average male born in 1932? The glib answer, of course, is luck. Dame Fortune has indeed smiled on me, at least in my later years. But what was it that actually kept my blood flowing, and my lungs going, for nine decades? Genetics and lifestyle likely entered in, but so did modern medicine, a big factor as I shall describe.

            In 2001, I noticed something new, a mild sensation beneath my collar bone as I walked up my favorite long hill. It wasn’t pain, just something odd. My medical training led me to suspect it was angina pectoris. A quick visit to a well-organized cardiac catheterization laboratory confirmed my suspicion. (One of my dye-filled coronary arteries was significantly narrowed.) I returned to the same laboratory on the next day, and stents were inserted and expanded in that narrowed segment (2). Presto! Normal blood flow to my heart was restored. No more odd feelings when I tramped up hills.

            Since then, for over two decades, my cardiac pump has been a model of efficiency. It chugs merrily along without a hint of discomfort. Good timing on my part! Stents had been available for only about a decade (3) when I needed mine, those being much improved from earlier versions. Thankfully, those tiny gadgets have kept my important coronary artery nicely open. Without their silent and persistent help, I might well have suffered a heart attack years ago.

            Here’s more about my circulation. During my forties, fifties, and sixties, the electrical components of my heart were cranky. At times they fired off extra beats like a wild drummer. The wild beats by themselves weren’t especially worrisome, but occasionally the electrical noise turned completely rowdy and pitched my atria into brief bursts of fibrillation.

            You probably know this, but I’ll mention it anyway. The heart still can pump blood quite effectively when its two upper chambers are fibrillating, but with the atria just quivering during fibrillation, rather than contracting normally, blood sometimes clots in their appendages. Those clots may break loose and thumb a ride in arterial blood (as an embolus) to the brain, or other organs, thus plugging up a small artery and causing a stroke, or other damage.

            I had a couple of minor versions of a stroke, those called transient ischemic attacks, in which I lost partial sight in one eye for just a couple of minutes. Again, thanks to my earlier training, I was pretty sure what was going on, and the spots showing up in my brain in more recent CAT scans and MRI screens seem to bear that out.

            Even with my relatively small risk of going into atrial fibrillation, I now take an oral anticoagulant, a blood thinner if you prefer, to minimize clot formation should I happen to slip into fibrillation again. The drug I take is effective and has relatively few side effects. It was approved for use only a couple of years ago, another example of lucky timing on my part.

            I’ve also had a few skin cancers, basal cell types that almost never metastasize, and a squamous cell type that usually metastasize late, every one skillfully excised surgically, or frozen off, and all thus cured. I also developed a deeper cancer four years ago, a tumor treated with high-intensity radiation. From all indications that therapy, also quite new and even revolutionary, routed my cancer completely.

            Quick summary. Without the above medical care, my way to 90 would have been bumpier, or knocked entirely off track by one problem or another, reason enough for me to honor the many men and women who made those marvelous advances possible. Thanks to all of this progress, I seem to be ticking along just fine, and feeling great!

            Finally, I must give myself a bit of credit too. Keeping active surely was a plus. I’ve always enjoyed keeping my bones in motion. I played tennis until I had a knee replaced (another great intervention that has lifted my life tremendously, and one not available when I was younger). I still walk extra miles and mess with weights. It’s well established that physical exercise turns on good genes, so I’m confident my gene pool benefits from my activity.  A good reason for me to keep at it! And for you too!

            Next time I’ll nose into the science of aging. You’ll be amazed by all that’s going on.

Re-reading a Russian novel, after 65 years, Part 2

Posted on by Ken Goetz

            As I mentioned earlier (1), my first taste of The Brothers Karamazov came more than six decades ago. I swallowed that jumbo novel in big bites, dazzled by Dostoevsky’s grasp of psychology and religion, not to mention his way of dissecting the Russian soul of his time. And the multiple tendrils of his story kept me on high alert.

            It was a book that demanded to be read again. I skimmed through it a couple of years later when I was a first year medical student, but it was a cursory read, not fully satisfying. After that the years stretched out busily, keeping me otherwise engaged up to the time when I no longer received a regular pay check. As I eased into retirement, I picked up a newer translation of Dostoevsky’s finest, but that volume was outranked by other interests at the time, so it was wedged into a lower shelf where it languished for years. I discovered it a few months ago and finally promoted it to a place beside my reading chair.

            That hasn’t gone well. For some odd reason that I’m only now beginning to examine, I almost never schedule myself to read fiction during the day.  My to-do lists focus on other activities. I live alone, so much of my daily chores are routine. I prepare my meals. I keep house. I head out for errands and grocery shopping, I read newspapers, magazines. I socialize, I write, I walk, I even tussle with a weight machine at times, but with the rarest exception, I read novels only late in the evening, when the world is dark and fading, and my comprehension is short on fuel.

            You probably can see where this is going. This time I am sampling The Brothers Karamazov in microbites, dawdling along, swallowing only a few pages at a time, reading at a snail’s pace, and comprehending at a similar sluggish rate. Naturally I’ve forgotten much of that book after 65 years. The overall plot is still vaguely familiar, but it is a struggle for me to keep all members of the cast on stage, to remember each of their proper roles.

            It has taken me over 600 pages to fully realize this, but I think I have it now, and a resolution is finally forming. Before this month is out, I have decided, I shall sit down in full sun light and finish the final 150 pages of this fabulous book on that one day.

            Now, having exposed the futility of my reading thus far, I must add that it was not all bleak. This time I spotted passages in the book that surely flew high over my head on my first reading. To give a single example, below is Dmitri, the oldest Karamazov brother, talking to the youngest, Alexei (this translation by Pevear and Valokhonsky [2]).

            “Alexei, I’m lost, you man of God! I love you more than anything. My heart trembles at you, that’s what. Who is this Carl Bernard?”

            “Carl Bernard?” Again Alyosha was surprised.

            “No, not Carl, wait, I’ve got it wrong: Claude Bernard. What is it? Chemistry or something?”

            “He must be a scientist,” Alyosha replied, “only I confess I’m not able to say much about him either. I’ve just heard he’s a scientist, but what kind I don’t know.”

            “Well, devil take him, I don’t know him either,” Mitya swore. “Some scoundrel, most likely. They’re all scoundrels.”

            That made me chuckle. Claude Bernard was a groundbreaking French physiologist with extraordinary skills. The likelihood that I knew of him on my first reading is exactly zero, but now, after having in times past actually referred to myself as a physiologist, I ‘m quite familiar with that famed man. In fact, I have on one of my bookshelves a rare translated copy of his Cahier Rouge, the red laboratory notebook in which Bernard wrote his innovative ideas from about 1850 to 1860. Was Bernard a scoundrel? Hardly. But in this brief segment, Dostoevsky tells us a bit more about Dmitri’s mind and the manner in which it functions, simple evidence of a remarkable novelist at work.

 

Re-reading a Russian novel, after 65 years

Posted on by Ken Goetz

I read The Brothers Karamazov (here) a long time ago, when I was an undergraduate. By that time I had learned (finally!) that rounding up a cluster of neurons and throwing them into action (with purpose) could be exhilarating.

I plowed through that prodigious novel over a three-day weekend. A marathon event! One so dramatic that to this day I can conjure up the chair in which I sat enthralled for most of those hours. Occasionally, to ease creeping stiffness, I read with the book between elbows on my desk, or while stretched prone on my bed, a pillow under my middle, all of this in my small upstairs room on North Brook Street in Madison, Wisconsin.

Like many English speakers immersed in Russian literature, I initially had trouble sorting out the huge cast of characters. Their multiple names also confused me, but my brain was fresh enough to see that the youngest brother, Alexei Fyodorovich Karamazov, (for example) might be referred to as Alyosha, Alyoshka, Alyoshenka, or Alyoshechka, or even Lyosha or Lyoshenka.

Never had I read such a book! Dostoevsky’s insight awed me. I remember thinking his psychological acumen had anticipated Sigmund Freud, and probably even inspired him. Two years later, during my rebellious first year of medical school, I stupidly shunned textbooks and immersed myself in fiction, diving deep and making my way through a good number of Russian classics. I even skimmed through The Brothers again that year.

As I’ve said elsewhere, that bone-headed year of medical school produced oodles of painful regret (here). Finally, to exorcise all remaining demons, I wrote The Colors of Medicine and forced my protagonist to repeat much of my intractable behavior from that year. Relief at last!

I’ll talk more thoughts about my favorite Dostoevsky novel next time, describing my turtle’s pace of lumbering through it this time (not three days but three months!) along with other musings about the book. I won’t put that up for a few days. I’ve averaged about a post per week on this blog, and I think that’s a good pace for me. (An old guy, like an old forest, surely is more susceptible to burnout.)

Post Birthday Bliss

Posted on by Ken Goetz

My 90th was like no other. Thanks to clever innovations by younger members of my family, readership exploded here yesterday. The blast unleashed a flood of good wishes and made my sweet day even sweeter.

As most newcomers may have discovered, this blog is unfocused and hard to classify. I don’t stick to classic medical experiments, or travel, or world affairs, or politics, or literature, but I’ve toyed with all of these topics here, and I plan to follow that undisciplined path as we move forward. My rationale? If it interests me, it may interest you. One extraordinary essayist expressed this notion with exquisite clarity.

The essayist is a self-liberated man, sustained by the childish belief that everything he thinks about, everything that happens to him, is of general interest. He is a fellow who thoroughly enjoys his work, just as people who take bird walks enjoy theirs. Each new excursion of the essayist, each new “attempt,” differs from the last one and takes him into new country. This delights him. Only a person who is congenitally self-centered has the effrontery and the stamina to write essays. E. B. White (see here)

Perhaps I’ve exposed myself here most openly in my two-part series titled, My First Year of Blogging, and My Books (see those here, and here). Those reveal a bit of my background, not always exemplary, and also explain why I’ve chosen to post installments of my novel, The Colors of Medicine, on this site.  (Hmmm, is it really partly autobiographical?)  Overall, more than 50 essays have been posted here. Feel free to browse.

To come back to my 90th birthday, last night’s celebration was highlighted by the astonishing appearance at dinner, just before we ordered, of my daughter, Anne, who had secretly flown down from Chicago to surprise me. Another great moment brought about merely by sliding safely into the Big Nine-O. I recommend the process to all. A photo was of course taken.  In order to gather all, the celebration with my son, Greg, and his family was delayed until tonight, so more frolicking is on tap for me. How lucky is that?

 

90 Years Old!!!

Posted on by Ken Goetz

Today, I proudly announce, I’ve landed upon an elevated plateau, the one labeled Age 90, the Big NINE O. I saw it coming, of course, but even that advanced warning didn’t diminish the grin-producing pleasure streaking through me as I awakened this morning. I’ve actually arrived! I know of no prizes given to those who hang around this planet for nine decades. Nevertheless, I consider it to be a minor accomplishment (not to mention a lucky one), something like back-flipping into a pool without a splash. I’m aging happily!

In the accompanying photo (taken in this morning’s sunshine), I’m seated in front of my version of one of Frank Stella’s works, one I painted some 30 years ago.

Aging, by its very nature, demands changes, and the latter half of life is lived on a downward slope. I’m okay with that. In fact, I’m still sliding downward with glee. To report that I’ve lost a lot during my advancing years is like reporting that leaves drop from trees as the days shorten. Nevertheless, I remain reasonably mobile. Nearly every day I set off for walks ranging from 30 to 60 minutes, The longer jaunts, over mildly uneven terrain, cover more than three miles, all this with minimal increases in my heart rate and little puffing.

I own no hearing aids and peer into most of each day with eyes uncovered by lenses. I do, however, don glasses at times while driving, or watching a movie, or when settling down with book or newspaper.

My good balance continues to keep me from stumbling, a fact that reminds me of my favorite contemporary essayist, Joseph Epstein (1). He, upon reaching 70, reported that he had begun to use the handrail when descending stairs. I’m a second-floor guy, and I usually head downward straight in the middle of the stairway, arms swinging. Admittedly, caution creeps in when I step down a staircase while packed together with others, say in a crowd surging out from a symphony concert. At those times, I skim a hand along a rail, just in case.

I haven’t, of course, escaped the inevitable decay. Examples are abundant and obvious. My joints show signs of rust. My memory has more holes than all the golf courses in Phoenix (even simple facts often refuse to come out of hiding when summoned), and my analytic skills, such as they once were, now lurk behind impenetrable barriers. All of this I’ve accepted with what I believe is the proper spirit.

In short, I’m extremely grateful for all that remains in working order, and most days I’m pleased as punch to be alive. Reasons abound. I’m fortunate to have a son and a daughter, both with families I love and admire. I have a small nucleus of friends, fewer than I would prefer, but nevertheless they too add color to my life. Existence continues to amaze me.

Even puttering with this blog gives me a sense of  – I search for a word – fulfillment!  Admittedly it takes more effort than my antiquated brain had imagined, but I find satisfaction while writing the little essays I serve up here. Writing actually does seem to stimulate my diminishing population of neurons, to keep them from dozing when I’m so engaged. For that reason, I shall continue essaying, and opining. I’ve revealed a selection of my adventures, along with some misadventures, (see one here). More are on the way. Stay tuned!

 

This photo was taken last summer. On the wall beyond the Stella painting is my version of one of Edvard Munch’s works.

I don’t intend to make this a photo gallery, but I just received the shot below. It was taken yesterday by my granddaughter, Megan, as we had breakfast together.

 

Happy New Year, 2022 Version

Posted on by Ken Goetz

May this year fill you with cheer and gratitude. May you have fewer Covid worries and more mask-free days. May you enjoy warm, gratifying moments with friends and relatives. May you endure fewer chilling travel restrictions. May you soak up 365 days of simple pleasures. Happy New Year, 2022!

I’ve now steadied my blogging legs with more than a full year of experience.  Last year I posted a new essay about once a week. I plan to increase my output this year, as I’ll mention below. This site has gradually added more readers and subscribers, so I’m optimistic about the year ahead.

Most of my posts focus on travel, medical experimentation, literature, or politics. All earlier posts are still available on this site, so if you missed reading about the first human heart catheterization, this accomplished in 1929 by a young German doctor (the heart he catheterized was his own), you can find that story by clicking (here). I’ve also described my personal experience with cardiac catheterization (here).

I’ve traveled through much of Europe by train, plane, bus, and automobile. Many of these trips are described in my Travel category. Luckily, in all my wanderings I’ve only been tossed into the clink once, that being in Madrid, as I describe in the fourth installment of my account of traveling through the Iberian Peninsula (here). Please feel free to browse through my earlier postings. And please tell me which ones piqued your interest.

This year I’ll begin posting serial installments of my novel, The Colors of Medicine (here), this beginning on January 3rd and continuing daily unless I’m diverted by other obligations. I would love to hear your comments as the story develops. Every opinion, critical or otherwise, will be appreciated.

See you soon!

 

‘Tis the Season of Joy

Posted on by Ken Goetz

Do you get charged up over holidays? For most of them I don’t, but the pair now approaching always key me up in the right way, sharpening my focus on family and friends, and intensifying a feeling of – there’s no better word for it – JOY. I can’t explain what triggers it, but genuine joy pops up every year. I’m on the upslope right now, feeling great.

I grew up saying “Merry Christmas and Happy New Year!” so I now wish the same to all of you. If that phrase doesn’t ring your bell, please have the happiest of holidays.

This year I’m also looking forward to the new year with mixed emotions, a combination of excitement, trepidation, and considerable anxiety, all because of the enterprise I mentioned earlier. In short, beginning in January, I’m going to serialize my novel, The Colors of Medicine on this website (See here for details).

I’ll keep each installment short, probably no more than a thousand words each time, so you can occasionally savor the beauty of my words, and cringe as I expose my missteps. My anxiety, of course, stems from fear that I’ll at times be running in public dressed only in my underwear.

So spread the word, PLEASE, to your family, neighbors, and even distant cousins, and tell them the show is about to begin (I wear Jockey briefs). Encourage them to subscribe to my blog, and if you haven’t signed up yourself, please do so now.

I know a number of you have tried to subscribe and failed. Unfortunately this is not a rare phenomenon with the platform I’m using. It fails at times. So if that has happened to you, I apologize and offer Plan B. If you, or others you know, are unable to subscribe by using the Subscribe to Blog via Email box on my site, simply email me at kengoetz4@gmail.com and I will personally notify you each time a new post is up.

P.S.

The images are of the Country Club Plaza in Kansas City, Missouri, a shopping center that has been decorated with Christmas lights annually for over 90 years (See here). ‘Tis the Season of Joy!

 

A Harvard Professor and Wuhan

Posted on by Ken Goetz

The Wuhan Institute of Virology (See here) has earned its badge of notoriety. Now a prominent Harvard professor is likely to draw attention to another Wuhan establishment, The Wuhan University of Technology (See here).

Professor Charles Lieber, a renowned authority on nanotechnology, had a decade-long academic partnership with that Wuhan Technical University. Today a federal court in Boston found Professor Lieber guilty of accepting payments from a Chinese government talent program, one designed to advance China to the top of the scientific world.

The professor was convicted of receiving hundreds of thousands of dollars, these amounts paid in cash or in funds deposited into a Chinese bank account, monies that the professor apparently did not report on his income tax forms. There is more to the story, but those are the key elements.

The take home message? The connection between China and professor Lieber is another example of a foreign government dangling money to recruit world-renowned scientists for purposes, one might assume, not exactly focused on the good of all mankind.

My First Year of Blogging, and My Books (Part 2)

Posted on by Ken Goetz

Below is the second installment from the beginning of my revised memoir. This part is newly added and does not appear in the original Bending the Twig (See here). As I explained in my previous post, the revised manuscript is as yet unpublished.

            I was twenty-six when I enrolled in medical school, older than most of my classmates, but not necessarily more mature. I spent four years in the Air Force before completing my undergraduate degree at the University of Wisconsin, studying diligently for the first time in my life and graduating with high honors, and high hopes.

            I expected medical school to be more inspiring than my undergraduate courses, more interesting, more challenging. How could it not be? I sprinted off from the opening bell, racing through every course in the head of the pack. Everything was new and exciting, everything was different. I galloped happily along for some weeks until I suddenly realized what had become obvious. This different wasn’t what I had expected. This different was dull memorization. This different numbed my brain. This different meant we students were to salt away every name of the tiniest branches of ordinary arteries and recall them by rote for one single purpose, to provide answers to questions on anatomy examinations, even though we knew with certainty that such minutia would not inform the diagnosis or treatment of one single patient during our entire lifetimes. To be fair, parts of our curriculum were valuable for fledgling physicians, but I discounted those and bemoaned the dreary memorization. My classmates grumbled, yet nearly all of them adapted to the program, shrugging off its obvious weaknesses and dutifully shoveling micro-facts into their heads. But it was too much for me. I belly-flopped into rebellion.

            While my classmates continued to pull doggedly on their oars, I splashed behind, trying not to take on too much water. Disaffected and disappointed, I cut lectures and avoided laboratory sessions. I read novels, short stories, and poetry rather than textbooks. I played the perfect fool. I was embarrassed by my untoward behavior, miserable day and night, but too stubborn to hit the brakes. For most of that dismal year, I was a frazzled mess, my fuel gauge bumping against zero, my digestive tract in painful overdrive. Finally, after an eternity, the school term ended, and I, fool to the end, capped off my most annoying course with one final defiant act, one so unruly and recalcitrant that I expected to be drummed out of medical school on that very day. But rather than getting the boot, I received a stunning gift, one that eased me into summer and propelled me, triumphantly I thought, into the second year of medical school. I’ll come to that story, but even now that dark year pains me. I have no explanation for why I behaved so badly, why my life at times has gone off track, but others have suggested that my formative years, those unrolled in these pages, may have planted fertile seeds of rebellion.

As I confessed in my previous post, I have ulterior motives for introducing these paragraphs (see that here). First of all, I’d like to whet your appetite to read my revised book (assuming it ever becomes one).

Another motive is a bit more twisted. I’ll try to explain. The published version of Bending the Twig, is basically the story of my first nineteen years. Little of my life after my less-than-perfect start is mentioned in that book. A number of readers have suggested that I cap my childhood memoir off with one describing my later life.

I’ve always brushed that suggestion aside, saying my early years were much more interesting than anything that went on since. Truthfully, I have had a string of uncommon escapades throughout my lifetime, but I doubt I’ll ever squeeze my adult years into a book.

Why? Certain blemishes in my adulthood would be embarrassing to reveal. Case in point. My first year of medical school, sketched briefly in those three paragraphs above, stuck painfully in my memory for decades. Finally, a few years ago, I eased my ache by writing about that nasty year, but stealthily disguising it as fiction. I wrote a novel, calling it The Colors of Medicine, and revealing in it how I botched that disastrous year.

Writing about that ugly time was an adventure! I had no inkling how much work it would require, and I made more wrong turns than a mouse in a maze. I wrote entire scenes, many of them in excruciating detail, and then decided to dump them, many hours of effort down the drain.

Still, in the end, it was all worthwhile, for I managed to create my version of the world and to send my protagonist, Martin Cromlech, to medical school at the University of Wisconsin. In four long chapters I fiendishly forced Martin, as a first year medical student, to follow a course much like mine. That set me on fire!  I actually grinned at times while striving to make Martin stumble almost as badly as I once had stumbled.

Remembering this, recalling how I bumbled along while writing the novel, made me wonder whether others might enjoy learning how I, an obvious tyro, tripped over every obstacle known to writers. So I’ve decided to serialize my novel here, posting brief installments of The Colors of Medicine, probably daily, and often adding what I was thinking, rightly or wrongly, while I wrote that part.

But I’ll hold off until after the holidays. Starting early in January, I’ll begin posting small installments of The Colors of Medicine here, often accompanied by comments describing what I was thinking as I wrote, and continue until I’ve gone through the entire novel. If you know of anyone who might enjoy this sort of thing, please pass the word along.

I will of course continue to post other essays as I have done over the past year. Stay tuned!