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Comments on medicine, neurology, science, and maybe some other things, too.

Updated: 2018-03-06T01:59:06.369-05:00




eReadings - Sailing

In the Track of the Trades - Lewis Freeman (1920)
Through the South Seas with Jack London - Martin Johnson (1907-1909)
Round Cape Horn. Voyage of the Passenger Ship James W Paige from Maine to Califormia in the Year 1852 - J Lamson (1878)

The first of these tells the story of a novelist cruising on a private yacht, starting out at Pasadena, California, then on to Hawaii, then southward to the Polynesian islands. There is never any explanation of how the author came to be on this ship. This was a ship well-captained and the sailing proceeded more or less as planned. Rough weather certainly occurs during the voyage, but is well-handled, with repairs as needed along the way. Even at this point in the early 20th century, there was some uncertainty of safety in Polynesia, still some evidence of piracy by local islanders, but nothing untoward occurs, and the inhabitants of the various islands generally treat them well.

The second book, while similar in its course across the South Pacific, is a very different tale. The author was a young man in his twenties in Independence, Kansas, who answered an announcement that the author Jack London was going to take a cruise, and was looking for a crew. In spite of no experience whatsoever, he was taken on by Mr. London, initially as a cook, which he had no experience with either. He travels to California and stays with Mr. London and his wife while their ship is being fitted for the cruise. The original idea was that they were going to make a trip around the world. It seemed that no one on the ship had any significant oceanic cruising experience, and consequently various problems occurred along the way, crew members were replaced at various ports, and they were lucky to survive some of the weather they saw. Mr. London was apparently corresponding with a San Francisco newspaper with articles about their trip, and at one point they were presumed lost at sea when they hadn't been heard of for quite a while. Various ailments are acquired along the way, and eventually infections with yaws causes an end to the expedition in Australia.

The last book is a different sort of harrowing tale, showing how bad a cruise on a passenger ship could be in the mid-1800s. Early in the story we begin to learn how irascible the captain is, and matters don't get any better. He short-changes the passengers in regard to food, presumably trying to save money on the voyage. He gets into fights with some of his crew, and arguments with some of the passengers, the author included. Since this was before the Panama Canal existed, the only way to California was around Cape Horn, a very risky thing at the time. They manage to make it to California intact, and it's hard to imagine any of those passengers traveling by ship again.

Challenging my brain


I was thinking about it for awhile, and finally schedules aligned in way I could do it, but I've started a course in Basic Conversational Arabic. (!)

Not that I have any plans to visit some Arabic-speaking country, or even pass through. I wanted a challenge, to see if my brain could do this. I don't expect to become fluent, even if I take the next course (so far, the place where I am taking it only has 2).

Challenging it is! It starts with the fact that the Arabic alphabet is quite different from our own, though some sounds are similar. Next is that it's written right-to-left. Then there is the way that letters change their appearance depending on whether they are standing alone, the initial letter of a word, or a medial letter, or the final letter.

There are a few vowels, but to a large extent vowel sounds are implied between two consonants.

On a practical level, we're on two separate tracks at this stage (I've only had 2 classes), one being the learning of the alphabet and how to write it depending on its place in a word, and the other hearing and speaking Arabic, which currently relies almost entirely on phonetic spellings to help recognize and remember the sounds. Later, we'll drop the phonetic spellings, once we've sufficiently covered the Arabic alphabet.



eReadings - James Fenimore CooperA Residence in France; with an excursion up the Rhine, and a second visit to Switzerland (1836)Recollections of Europe (1837)Homeward Bound, or, The Chase. (1871)Home as Found, Sequel to "Homeward Bound" (1871)All of these books are available on Project Gutenberg, my favorite place to find free books I can download to my tablets. By the way, my current ebook reader of choice is Aldiko. Aside from having a very nice layout, good choice of font (and therefore good readability), I can use Aldiko with my Magic Catalog of Project Gutenberg E-Books, and have Aldiko automatically download my selections into its library.The first two of these books I found to be very pleasant reading, since they represent narratives of Mr. Cooper's many years on the European continent. At this point he was obviously independently wealthy. I suppose that he may have done some writing during that time, but there is no mention of writing in his narratives, mainly his observations and various occurrences that happened during his travels.It's interesting to read almost 200 years later how one traveled in those times. It doesn't seem that railroads existed as a mode of travel then, so travel came about with variably-sized carriages, pulled by horses and/or oxen. Most often one traveled by postilions, so that in other words, you traveled some distance, then had to stop for a change of horses. Often these places of horse-changing had taverns or inns, so you would catch a meal while you waited, and late in the day perhaps stay overnight. There was also sightseeing to be done, so depending on the location of your stop, you might stay a day or two and do some looking about at cathedrals and various ruins, and indeed, much of the books consist of comments on various examples of architecture.He stayed with his family for some time in Paris, so there is much to learn about Paris of those days. This was, of course, a time not so long after the American Revolution and the subsequent war of 1812, but also after the French Revolution, its dissolution and reestablishment of the monarchy under King Louis Phillippe. Interestingly, Cooper found himself by various means able to attend various events of the upper classes, and even some which the King attended.There is little mention of money or expenses in these narratives, but the style of living is interesting if not astonishing. Not only was there Cooper's family, but also various servants accompanied him. Thus he would rent out suites of rooms for months at a time, typically including all the furniture and other needs, with meals early in the day at these same locations, then dining at various restaurants during the day, and then often some dinner party in the evenings.Something I particularly enjoyed while going through these books on his travels was Googling various cathedrals, or looking up locations on a Google Maps to follow their course as they traveled. In addition, one could look up historical events and personages of the time.Cooper obviously saw himself as well-educated, and in particular found himself in a position to defend the United States from various misapprehensions of Europeans of the time, as well as go off on variable-length digressions on the nature of America and the principles by which it stood. One gets the impression that politics was a common topic of conversations with him wherever he went. These digressions sometimes get preachy and therefore tedious, but overall I found the narratives fascinating to read, especially since I don't think we ever were taught much about this time.The NovelsHomeward Bound, and Home as Found turn out to be novels, centered around a fictitious family and other passengers making their way from England to the United States after a number of years spent in Europe. As I began these books I had thought they might be continuations of the narratives I had read, and considering their timing, we must presume that Cooper's experiences fed this fiction to a great extent.In particular,[...]

Approach to Neurologic Problems - Neuropathies


There is a local and perhaps nationwide shortage of neurologists, so what this means is that it takes a long time to get an appointment to see one. What that means is that primary care doctors are sometimes doing what they can to initially evaluate and sometimes manage neurologic problems. There are anyway a number of neurologic conditions that are quite common, things like headaches, neuropathy (or neuropathic symptoms), and weakness, as well as particular sorts of pain syndromes. I would also add that not all of these patients need to see a neurologist, mainly because there is little to do and management is often quite simple.Let's start out in this series with the category of neuropathies, then focus on diabetic polyneuropathy. I would often see patients referred for electromyography (EMG) before they had seen a neurologist. A basic thing one could say about an EMG for neuropathy is that if you didn't know what was going on when you sent the patient for it, the test is unlikely to hand you the diagnosis on a platter. Given that situation, let's step back from this and go back to the patient.Neuropathic symptomsThe two main functions of peripheral nerves are for sensation and movement, in particular muscular strength. Loss of sensory function would cause numbness or loss of feeling in the skin, but there are other kinds of sensation which for example have to do with feedback from joints to inform about arm, leg, and body position, and also feedback from muscles which allow for a sense of how much effort is being made, as well as the results of that effort. Sensory nerve functions can be divided into two categories related to nerve fiber size. Very small and unmyelinated nerves carry signals related to pain and temperature. With loss of these functions, patients may say they injure themselves and don't realize it until they see they've cut themselves, or they have a hard time judging the temperature of bath water, especially with their feet. Myelinated nerve fibers carry signals related to some aspects of pain, but mainly light touch, vibration, and position sense. Loss in these areas may reduce fine motor manipulation such as is required for buttoning, or trying to pick out a particular object in a pocket based on feel. Loss of position sense impairs balance or coordinated activities, especially in the dark.There is another kind of sensory nerve symptom which we can think of as either a nerve signal that gets messed up, so that normal stimulation is perceived as strange, maybe painful (called dysesthesias), or where there is a nerve sensation in the absence of stimulation, like pain or tingling (paresthesias).Sensory nerve symptoms are quite common. We all have had at least brief episodes of tingling or numbness, maybe related to pressing on a nerve somewhere for too long.Loss of motor function leads to loss of strength, or early on may mainly cause reduced stamina. Almost universally, patients will not see the difference. Strength has to do with the maximal force that can be generated from a group of muscles. Stamina has to do with how long you can apply that strength. There is another confounding issue which is important to consider, and this is sudden weakness which relates to pain from activity or effort.Diabetic neuropathy as an exampleThis is probably the most common neuropathy most doctors will see. Diabetic patients are certainly aware of it, and at times I have had a hard time getting a patient to describe symptoms, since I keep getting responses like "I have [diabetic] neuropathy". What are your symptoms? "Neuropathy." Considering that diabetics can certainly have other kinds of neuropathy, this is important information. Start with the basic categories of location, kind of symptom, whether it occurs (mostly) at some time of day, any causative factors, any alleviating maneuvers. It actually turns out that there are several different kinds of neuropathy. The most common is the symmetrical, distal neuropathy, where there is a progr[...]

A Reminiscence


For some reason this memoir from a long time ago in a galaxy far away just occurred to me.

I grew up in a small town in Ohio, so small my graduating class was 25 persons. There was a special moment I had, back there in the pre-computer, pre-social media days. Our math teacher set up some advanced math classes for a few of us, maybe 6 people out of my senior class (or was it junior?), and we got exposed to things like different bases for numbers (our decimal system is "base 10", binary "base 2", but you can have whatever you want), some precalculus, some plane and spherical geometry. We just worked our way through the material, wherever it went.

In the latter part of the school year we took a test run by the GTCTM, the Greater Toledo Council of Teachers of Mathematics. I came in second out of that whole area. I never knew how many students took the test, but keep in mind this was advanced math, nerdville.

So I went to Toledo, received my recognition and a prize of a slide rule, a very fancy one (made by Keuffel & Esser as I recall). I had no idea what it was for, but when I went to college in those precalculator days had plenty of use for it later. I still have it somewhere.

I felt the honor of this, but it seems like it should have been a bigger deal to me, this small town guy besting out a lot of math students in the Toledo area (except one). At that time I suppose that there just wasn't such an interest in math (and maybe there still isn't).

A sad addendum
I found my slide rule, but it became immediately apparent that the case had gotten wet, since inside parts were rusted, and in particular, the slide with the hairline had become detached, and as far as I can tell can't be restored. 



It's an interesting and at times rather confusing process, this retiring from practice. I speak in my case of someone working for a health care corporation, so I didn't have to shut the practice down, just my own part of it.

As things went along, there was little in the way of spontaneous information coming my way, so I had to ask questions about my health insurance, my liability insurance, and so on. I found out quickly that everything stops at midnight on your last day. Since I'm over 65, I wasn't eligible for COBRA (except for dental care).

I already had Medicare Part A, since you must sign up for that, but struggled a bit to understand Part B. I registered on the Social Security website, but it takes a lot of fishing around to try to understand the process. I finally called the local SS office and received forms for my employer to fill out. This ensures I don't pay extra for signing up for Part B late.

One thing that working in rehab has taught me is that you need to have supplement insurance. You don't want a Medicare replacement policy, just a supplement. If you get a replacement policy, you hand over all the decision-making to these private companies. Here, our experience has been that Anthem and Humana can be a bit flaky with approvals, so I decided to go with a UnitedHealthcare supplement through AARP, which seems to behave pretty well. But you're not done yet, since there are standard Plan types that each company must offer. I chose Plan C, which has some additional bells and whistles like travel insurance. At this point you can sign up online, and there are links from the Social Security website for that.

I wasn't, and still am not, absolutely certain I won't go back and practice in some way, though an eye opener was learning that to pay for my current malpractice insurance would cost me $13,000 per year(!). There are some alternatives that might be more like $8-9,000, still a chunk of money, meaning I'd have to work that much just to break even. For now I just have a "volunteer" policy (costing $100), which says I can see patients as long as I don't charge them.

So now I have my coupon booklet for making my supplement premium payments, and Medicare tells me they will bill me for 3 months at a time. Once I sign up for Social Security, I understand they will take the premium for Part B out of that payment automatically.

The Social Security website is a pretty good one for finding out a lot of details, but still this was piecemeal work I had to do myself to fully understand what I needed to do when.

On to retirement!



The neurology of fireflies

Last year and this one, I've have a chance to sit out in the summer evenings in our sunroom and watch the day turn to dusk, then to dark. And then out come the fireflies this time of year.

What I've noticed is an interesting phenomenon, interesting to me anyway. We know that the male firefly is flashing its light to attract the female, but there is something in particular I've noticed about this. In the vast majority of cases, the firefly is on an upward flight while it flashes, and many times very close to a straight vertical flight. When you can see the firefly after the light goes out, there is an immediate downturn in the flight trajectory when the light goes off.

I suppose we might hypothesize that, well of course, the firefly "wants" to increase the likelihood of some female seeing him, and how better to do that than to fly upward? Or maybe flying upward is a sign of "male robustness" and therefore of a fitter male. Seems dubious to me, as if we're assigning a lot of cognitive activity to a firefly, or invoking Darwinism to explain this.

What I wonder about is whether there might be some more simple neural connection here. For example, does the neural activation of the lighting mechanism (release of the chemical) cause a spillover of neural activity that increases wing flapping and therefore upward flight? Or perhaps increasing wing activity is a necessary precursor to this. I know from experience of catching and putting fireflies in a bottle as a kid that they can light their lights without flying, but maybe when flying and lighting happen at the same time there is some neural synchrony...

I tried googling this, but not surprisingly this seems to be quite unmentioned or unnoticed.

This also reminds me of a former patient of mine who had ALS, and a very colorful man he was. One visit he told me he was sitting in his backyard one evening, and wondered if he should grab fireflies and eat them to try to counteract the disease. We laughed about it, but then a few days later he mailed me a copy of a newspaper report indicating that scientists were using fireflies in order to try to understand some things about the human nervous system.



The time has come, the walrus said...

As I was saying a couple of years ago, I was contemplating retirement, and now I've decided. It will be this year, a few months from now.

It wasn't exactly a difficult decision when I finally came to it. The main thing was that I was enjoying medical practice less and less, finding the relief of the weekends too short, and the dread of the coming week on a Sunday more and more.

For the short term, I'll have plenty to do, with various things around the house to catch up on. In the longer term, there is some uncertainty, but I look forward to being away from set schedules, all the various messages demanding answers, and so on.

People ask me if we'll be traveling a lot, but we've traveled quite a bit over the years, so nothing out of the ordinary is planned. Occasionally I have seen something about some trip that might last a couple of weeks that formerly I would never have considered, so maybe that will change.

Perhaps I'll find more time for this blog.

eReadings 20 -- World War I


No, I didn't stop reading since the last eReadings post. I've actually read a LOT of things since then. Of course, I'm talking about on my Kindle, not other reading, of which I do a lot also.What I fell or drifted into in the last year or so was a series of books about World War I, written at the time. What follows is a somewhat ordered list of what I have read so far.My Four Years in GermanyJames W GerardMr. Gerard was appointed the US ambassador to Germany in 2013, before there was any inkling of war breaking out. To be sure, there was a lot of militarism in the world, especially in Germany.This is a personal account of his time there, which of course ended when the US declared war on Germany. He describes in great detail the structure and operation of the Kaiser's court, and of Germany in general. Once war was finally underway, he became the representative for Britain and several other countries.This was very interesting to get this insider's view of the prelude and beginning of the war.From October to Brest-LetovskLeon TrotskyThis is Trotsky's account of the Russian revolution, going on of course as Russia was involved in World War I. As the communists come to power, they have more pressing things to do, and sue the Germans for peace.What I found interesting was how rapidly Lenin and his followers adopted totalitarianism, control of the press, and created a ruling group. There was never any plan to give any real power to the proletariat, who were supposedly those for whom the revolution was carried out. An interesting item in the negotiations with Germany was that both sides formally agreed there would be no independent Ukraine.What is Coming? A Forecast of Things After the WarH. G. WellsWells describes himself as a futurist, and aside from the various novels we are more commonly aware of, he also published works describing things as they were and trying to predict where they were going. This book was written as WWI was being waged, and as such contains some interesting insights.He anticipated that Germany would lose the war, though how confident he was at the time is hard to gauge. He nonetheless expected that Germany would not be seriously damaged by this war, and would be able to wage war again, and thus felt an important outcome should be removing the Kaiser from power. He was a strong advocate of a world government and saw that England needed to reach out to learn more about other important countries. At a time before the Russian revolution, he was suggesting that England should become closer to Russia, even teaching Russian in English schools.There is therefore a lot of his predictions which were quite off base, but considering they were written in 1914, very interesting in that context.Mille et un jours en prison à BerlinHenri Severin BelandOk, showing off a bit. This book is in French (1001 Days in Prison in Berlin). I've spent some time with my Kindle working on my French (e.g., simultaneously going through Candide by Voltaire in French along with its English translation), and a couple of years ago translated a French book on Scribus to English at the site. Somehow I was able to read this book pretty comfortably (with the occasional help from Google Translate), perhaps because this is a chronicle rather than a novel.This is the story of a French Canadian physician, who was travelling through Belgium as WWI broke out. Initially he offered his services to a local hospital as it began to treat war casualties. As conditions worsened with the German occupation he tried to be allowed to travel to Holland so that he could go back home. The Germans initially sounded like they might acquiesce, but eventually higher ups had him sent to detention in Berlin, in a former prison, which by then had a number of people from various countries.Repeated petitions for release to return home were [...]

Exit Strategy


It wasn't that long ago that I honestly told people that I had no idea when I might retire.

Somehow things have changed. In some future posts I would like to explain this a bit, but let's just for the time being say that I'm in the process of finding a way to stop doing what I'm doing as a physician.

My "Uncle Doc", my grandmother's brother, some years ago told me that he "retired too soon." This coming from a man who retired from family practice at 84yo. But what he meant was that he had no exit strategy. He didn't take the time, take the bother to develop some outside interests, some idea of what he was going to do when he retired. So when he retired, he spent his days, first of all stopping by the office where he used to practice to chat to his former staff, then he'd swing over to the hospital he used to attend at and sit in the doctors lounge and chat with colleagues.

I can't see myself doing that. Sure, I may stop and visit at times, but that's not going to define my days, and from his experience it's just as well.  He died not long after that visit I had with him.

I don't find medicine as envigorating as it once was. Yes, I enjoy my time in the hospital, facing some unknown issue, getting a history, doing an exam, putting together some hypothesis about what's going on, what to do about it. But I am more bothered by episodic interruptions, by getting the names of new consultations in the mornings. Not that I see things I don't know what to do. I've seen so much it all just happens now, the differential diagnosis, testing, empiric and other treatments. And it's not boring.

But still this dread of having to go in every day, not knowing when the next new thing is coming. I think it's time to look for the exit from this.

Getting back to my uncle, what's next? I have a lot of interests. Many of them involve computers. I have this blog, but the time since my last post says a lot about how invested I am in this. I help with the development of Scribus, an open source software program. My job is mostly documentation.

I'm thinking I need to carve something else out. Maybe something I haven't done before, or maybe only dabbled in. I have some interest in, but not necessarily a lot of faith in the various things you find out there for "preventing dementia." Do these things work or just identify people who were low risk in the first place?

But I like learning new things anyway, so this will probably be part of my strategy. I like to travel, and no doubt will continue that to some degree, but I also know that travel is irritating in various ways, so I don't see spending a lot of time on that. Maybe I can now take some trip that might last a couple of weeks or more, something I haven't ever considered in the past. You take two weeks off work and the mountain that piled up while you were gone is amazing.

There are any one of a number of charitable things I could do in some way related to medicine, but right now I just don't see these as options. Maybe I just need some time away to see their appeal.

So here I am, still at the beginning or the middle of this. The reason I'm blogging about it is that I think it's true that one of the ways of working through a dilemma is to write down your thoughts about it. The process of turning a lot of competing, well- and ill-formed ideas into something you can understand yourself begins with making some coherent piece that lays it all out so you can create and reread it later.

Further notes on the Nexus 7


Battery Life
I've read some articles suggesting a battery life of about 11.5 hrs for the Nexus 7. This is of course with continuous usage, but this isn't how I need to or actually do use mine.

Typically I shut it down at night, since I don't use it then, and even during the day I am mostly leaving it in suspend, then periodically using it -- I turn it on about 7:30 in the morning, and then shut it down at about 8-9 pm. I'm not streaming video or music, not doing a lot of emailing. I find I can easily use it for 2 days without recharging, and even at the end of the second day there is still 30% or so of the charge left. So this means a typical day runs about 30-40% of the battery down.

The external keyboard I bought is mostly unused, but this doesn't mean I wish I hadn't bought it. When I got my new "black bag", I was carrying the keyboard in it, but space was a bit cramped, and after I noted that I rarely needed it, thanks to the TouchPal soft keyboard, I took it out, so my black bag is that much lighter -- not a lot, but clearly noticeable.

I was on the verge of buying the Pro upgrade of Jota+ (simple text editor), but then I saw that the ONLY benefit is being able to load more than 2 files. I'd rather fish around for more feature-full editors, but in the meantime, 2 files at a time is adequate.

Android vs Linux


On the surface, this might seem like a nonsequitur, since in a sense Android is Linux, but the ecosystems are different.

On Linux there are a host of utilities and applications, all full-featured, and FREE in all the senses of the term.

Yes, there are free apps for Android, but most are shadows of their incarnations on Linux, and beyond that, the free versions are typically crippled in one or more ways to encourage you to buy the PRO (or whatever) version. Example: the Jota app I mentioned only allows 2 files open at a time.

So Android wants to compete on the mercenary Apple playing field, and metrics are generated which measure Android's success by how much money is spent on apps.

But I can manage. The only app I've purchased was one that more time passed than the allowable 15 minutes for me to decide it wasn't going to work for me to decide I wanted a refund, since it was of no use to me. So in addition to my basic attitude,  I now also have a bad taste in my mouth from a purchase I did make. At this rate I may never use up my initial $25 credit at Google Play.

15 minutes?

(incidentally, this post is the first done with my Nexus 7)

Nexus 7 and Files


The Nexus 7 doesn't come with any built-in way to look at files, as in looking at the files in the various directories. I'm using File Manager HD, and this does what I need, such as getting a look at the directory structure, seeing what files are where, and so on. But what about transferring files to or from the tablet?

The presumption seems to be that you will use the internet, either by transferring them as email attachments or maybe using something up there in the cloud. But you may want to be a bit more private that either of these.

There is a capability of transferring via the USB socket, but the filesystem is an MTP format, not native to anything, so you have to go througn some steps to do this. I decided I didn't want to bother.

I've used ssh (secure shell) at home for years for transferring files, signing onto another computer remotely, and also the related sftp means of uploading files to my site. It took me a while to get the syntax right. Generally speaking I am using my desktop to interact with the tablet, so given that the wifi address of my tablet is, I can type

ssh -o Port=2222 root@

to remotely connect to the tablet, and

scp -P 2222 somefile.jpg root@

to send the picture somefile.jpg to the tablet.

sftp -o Port=2222 root@

sets up an sftp connection to the tablet, where you might serially send and receive a number files to/from the device. For example, after connecting with the sftp command above, I could type

put somefile.jpg

to accomplish the same thing I did with the scp command, but afterward, I'm still connected to the tablet, until I type 'bye'.

get anotherfile.jpg

would download anotherfile.jpg from the device.
Once I have the file there, then typically I may use File Manager HD to move it where I want to. It's helpful to know which directories your files are in, since some apps have minimal ability to search directories.

SSHDroid is only setting up your tablet to be a receiver from other computers, it's not loading an ssh binary on the tablet.

Google Nexus 7


After a considerable delay in getting any tablet at all, reading a lot of reviews, picking up various tablets at stores, I finally decided to get a Nexus 7. The specs and various reviews sounded good. Without saying anything more about it, I do not expect to ever own an iPad or an iPhone, just as a personal choice.The idea with the Nexus 7 was to find a replacement for the laptop I carry on my medical rounds. I still have the laptop, still use it daily for generating EMG reports, but I wanted something smaller and lighter for rounds. The key thing was that I needed to have access to the hospital charts via the free wifi the hospital has.Getting to the ChartSome time ago, the hospital switched from a Windows-only means of hooking up (and required IE 6 and XP), but they began using Citrix for connection, and Citrix has receivers not only for Windows, but also MacOS, Linux, and Android. I knew the Android works because I have it on my phone. The screen size of the Samsung Galaxy S is not conducive to navigating and reading hospital charts, however, let alone trying to see a CT or MRI scan.I thought I was going to have to use a browser to connect, since I didn't know all the settings for the standalone receiver, so at first I connected through Firefox, since Chrome didn't work. Later, I found out what to enter in the domain setting, so now just use the receiver. It takes a little while to get all the usability issues resolved. While the Nexus 7's screen is much bigger than my phone, there is still limited real estate. Except for some of the larger targets, many of the clickable things on the hospital chart UI are quite small, and yes, you can zoom in, zoom out, but it's annoying to be doing that constantly.I'm guessing it comes from the Citrix receiver, but it turns out there is a small tab to click on at the top of the screen, and tapping this slides down a number of choices, including a soft keyboard and a mouse pointer. You use the pointer by sliding it around the screen over a target, then tapping anywhere on the screen is like clicking where the cursor is, so this is what most navigating is done with. You can also simultaneously activate the keyboard with this pointer active.The biggest problem with the keyboard is that it shoves the screen contents aside, so you tap out something, then slide the keyboard away. Fortunately, there isn't so much data entry involved with the UI, and sometimes holding the tablet in portrait orientation works Ok.A Real KeyboardAfter a couple of days I bought a bluetooth keyboard (Targus), and this is handy for doing something more than tap-tap-tap. Even with the predictive nature of keyboard entry guessing words, typing is slow. The Targus keyboard works fine right out of the container. At first I seemed to have some trouble with something like keybounce, where tapping a key enters the character twice, but I believe it was because I was hitting the keys too hard, so it seems less a problem now.A Better Soft KeyboardI thought maybe I would try out a Swype keyboard like I use on my phone, where you just wipe your finger over the keys to enter words. I works surprisingly well even with pretty sloppy swiping, since it also is looking for words, and gives choices if it isn't sure. What I found at the App store was actually something better, called TouchPal. TouchPal has the swiping down pretty well, and also briefly shows a blue trail where you have swiped. It has more available keyboards, even one which has arrow keys, an ability to select, copy, cut, and paste text, plus Home and End keys. You can also download and use keyboards for other languages. I'm still working on my technique, but another cool feature, aside from a dedicated keyboard with [...]

eReadings 19


The Sea-Hawk
Rafael Sabatini
When I started reading this I didn't know anything about it. Later I found that the author was English, in spite of his name suggesting otherwise, and that he was a somewhat prolific writer of swashbuckling tales. Another of his works is Captain Blood.

We can assume that he was fascinated by the early days of sailing, and must have spent some time learning about the history of the time. This isn't a history book, but a novel about a privateer turned gentleman, after having been given a title by Queen Elizabeth for his help in defeating the Spanish Armada. It so happened that I had read, though perhaps scanned might be more accurate, a nonfiction book, How Britannia Came to Rule the Waves, by WHG Kingston, and in it he credits the various privateers for their help in building the Royal Navy and in defeating the Spanish.

But The Sea-Hawk is of course a novel, about Sir Oliver Tressilian, who has amassed some wealth through piracy to go along with his title. It is full of dialog, both between people and the various characters with themselves, and rather verbose dialog it seemed to me.

Nonetheless, this is compelling storytelling, perhaps getting off to a slow start as we read what seems like it's going to be a book about the interfamily goings on revolving around Sir Oliver's plan to marry Rosamund Godolphin, then taking some quite amazing turns, so that we abruptly leave England and head off to the Mediterranean, quite active with Arab corsairs raiding Spanish and other ships. both for the riches, but also for the slave market. Suddenly we are introduced to Sakr-el-Bahr, an infamous corsair with the interesting past.

The story here is interesting, riveting at times, but seemed to bog down with the ever-heavy dialog.

eReadings 18


Common Sense
Thomas Paine

Yes, this is that famous book, a pamphlet really, published in 1776 as the Revolution was taking shape. You know a book is small when you click to the next page and each Kindle page is 1% of the book.

I'll be honest, it's not such an easy read. The language is a little thick, with some unusual words to be sure, but the sentence structure very heavy with clauses and loaded with commas. One might think that this was the English language of the time, which in some respect may be true, but one can read works by Samuel Johnson or Boswell's Life of Johnson and find a very different readability of 18th century English literature. I read Life of Johnson some time ago and found it quite easy reading.

Look at this passage from early on in the book:

Society in every state is a blessing, but government even in its best state is but a necessary evil; in its worst state an intolerable one; for when we suffer, or are exposed to the same miseries BY A GOVERNMENT, which we might expect in a country WITHOUT GOVERNMENT, our calamity is heightened by reflecting that we furnish the means by which we suffer. Government, like dress, is the badge of lost innocence; the palaces of kings are built on the ruins of the bowers of paradise. For were the impulses of conscience clear, uniform, and irresistibly obeyed, man would need no other lawgiver; but that not being the case, he finds it necessary to surrender up a part of his property to furnish means for the protection of the rest; and this he is induced to do by the same prudence which in every other case advises him out of two evils to choose the least. WHEREFORE, security being the true design and end of government, it unanswerably follows, that whatever FORM thereof appears most likely to ensure it to us, with the least expense and greatest benefit, is preferable to all others.
It's not that this isn't understandable, but reading page after page like this is certainly tiring. We have a way of getting to a point much quicker these days.

I would have probably stopped reading early on, but then I realized that July 4th was coming up so I persisted. One of the things which struck me in the early pages was that, if one translated to a more modern English, this was basically a rant such as one might read on the internet these days, or perhaps see on some news report. It becomes quite clear that Paine has no good words for monarchy, and in particular King George.

I did appreciate reading first hand some of the concepts that formed our country and its subsequent government, where he talks about creating a land governed by the rule of law rather than the rule of a man. It becomes a bit repetitious, but he sets out to bring up the many objections to the current state of affairs, the possible remedies, with the only sensible one being secession from England and formation of a new country with its own government, and finally that the time was NOW to do these things.

As a reminder of the history of the time, the thoughts of people at the time, this is a very enlightening book. Be prepared for slow reading of this formal 18th century English.

eReadings 17


The Innocents Abroad
Mark Twain

Having previously read A Tramp Abroad, I was reluctant enough to read this one that I read a bit first with a browser before downloading to my Kindle.

This book predated A Tramp Abroad, being published in 1869, after a chartered excursion to Europe, sailing around the Mediterranean. It differed quite a bit from the cruises popular now, since one might be let off somewhere in Italy and then go travelling for a month to Paris and other inland sites.

One certainly gets quite a bit of commentary of the mercenary nature of travel at the time. Everywhere you go, there is someone to pay some fee to, some guide to hire, and many a beggar along the way.

Not so different from sightseeing now is the pressure one feels and the ease of being shuttled around from sight to sight, and we hear Mr. Twain railing against the fatigue that sets in as you visit yet another church, with its collection of relics, with so many churches professing to have pieces of the Holy Cross or the Crown of Thorns. The artwork, the sculpture, at least for him, became numbing.

It's necessary to remember that this was the world before World War I, so a very different sort of place from today. He lost his passport somewhere in the middle of the journey, but that never appeared to be an impediment to travel. A number of ports were closed due to fears of cholera.

One could no longer travel as he did from Turkey to Syria to Palestine on horseback, camping out in tents as they went. He certainly appreciated the depth of history in Palestine and especially in Egypt, but the terrain and climate were awful. In addition, beggars were everywhere in the Middle East.

In the end, this is a very enjoyable book, full of insights into a time we think we know but have never heard about what it was like from a first-person perspective, hearing not only about the history and famous architecture and art, but the lives of the people in the lands he visited.

eReadings 16


The Lost World
Arthur Conan Doyle

This is a book initially serialized in 1912. It introduces the character Professor Challenger, a man of great intellectual and physical strength, who is something of an outcast in the scientific community. Challenger also figures in the subsequent story "The Poison Belt" (eReadings 11).

Professor Challenger has already made the outlandish proclamation that so-called prehistoric beasts remain alive in an isolated part of the Amazonian basin, though since various proofs of his personal expedition were lost or ruined on his way back to civilization, he is generally considered a charlatan, and therefore has isolated himself from the scientific and public community, and has been known to physically assault various members of the press who have tried to interview him.

Edward Malone, a young athletic Irish journalist, is sent to attempt an interview, already knowing about the fate of others. He is indeed assaulted, but in the process somehow manages to break the ice with the professor, who confides his experiences, and invites Malone to a public presentation where he will expound his experiences before a scientific audience.

Once again, things go badly for Professor Challenger, and another man, Professor Summerlee, steps out as his chief antagonist. In the end, Professor Challenger proposes an expedition back to South America to settle the issues, consisting of himself, Professor Summerlee, and with a couple of other volunteers, one being Lord John Roxton, an accomplished explorer and game hunter, and on an impulse, Malone.

Eventually the group, along with a number of guides and native helpers, make their way to a high plateau, somehow isolated from the surrounding jungle ages ago, and indeed, an abundance of life seen nowhere else in the world for ages is found there. The science of it seems more than a bit distorted, with a curious mixture of dinosaurs, mammals, and even "anthropoid ape-men" being found there. Challenger is vindicated, yet he and Summerlee continue to have many things to argue about as they explore the plateau.

At the time this book was written, just coming out of an era of exploring and plundering various parts of the world, it probably seemed sensible to consider how things went on the plateau. To the modern mind, it seems odd to read about how readily the group falls into killing so much of the life there, including the ape-men, who are depicted as quite savage. I suppose at the time there was thought to be little difference between studying a dead specimen and a live one.

But Conan Doyle is a good story teller, and this makes for good reading, with some well-developed characters.

I thought that I recalled that this story had probably been made into a movie, but even so was astonished on finding that not just one, but numerous movies have been made, the first a silent film in 1927! There have also been a number of radio adaptations, and other tangents, such as Michael Crichton's borrowing of the title for "The Lost World: Jurassic Park". Seemingly without exception, these movie adaptations take a number of liberties with the original story, for example finding a way for a woman to accompany the men on their expedition.

eReadings 15


A Tramp Abroad
Mark Twain

There most likely is a double-entendre in this title word tramp, but this is not the tale of a hobo roaming around Europe, but rather the travels of a well-heeled American making his way through Germany, Switzerland, and Italy.

It's entertaining to a point, especially getting something of the gist of these areas as they were in the 1870s. There is a lot of great satire here, and I found myself laughing from time to time.

At the same time, because of the satire, one would need to know more specifics about Europe of those times to understand the depth of various jokes. To say the least, there is a great deal of exaggeration for entertainment purposes, and I found that this became silly and tiresome with the recounting of hiking stories about Switzerland.

eReadings 14


The Seven Poor Travellers
Charles Dickens

This is an odd little story, about a charitable inn in Rochester, set up to allow poor travellers a free night's stay and a meal, with the narrator venturing in as a seventh poor traveller, adding his assistance with meals and company.

For the entertainment of the travellers he tells an extended story within a story on a completely different topic.

As a whole, it is enjoyable, yet still remains an oddity.

eReadings 13


In Defense of Women
H L Mencken

The title interested me here, knowing that this was written in the very early 20th century. It took some time to finally decide that this book is a satire. It is written in an intellectual style, ostensibly by someone who has figured out women, and men, and a good number of other things.

There are aspects, which if serious, would offend many, since there is a lot of negativity in all directions. Women are held up to be more highly intelligent than men, yet in more than one part of the book prostitutes are noted to be an example of the high intelligence of women.

There is a good deal of entertaining wit here, but for the topic and content, I found it got quite tedious, and could have easily been half its length or shorter.

eReadings 12


The Black Tulip
Alexandre Dumas - père

This book begins with the description of a historical event, the gruesome murder of the brothers DeWitt in The Hague, in the Netherlands. This was a time of great antagonisms, between religions, between countries, and the DeWitts were in the middle of one of these moments when power changed hands, and were mercilessly slaughtered (literally) by a mob. The descriptions are graphic.

After this, the scene now shifts to a nephew of the DeWitts, Mynheer Van Baerle, living a simple life in the town of Dort, and very much a tulip fancier. Thus we find our way to knowledge of the great challenge of the time, growing a black tulip, for which a prize and great prestige is promised.

Van Baerle isn't alone in his quest, with the Netherlands full of tulip mania, but one in particular is a neighbor, Isaac Boxtel, who envies his skills at creating new varieties of tulip. So, with the machinations of Boxtel, Van Baerle becomes entrapped in the public antagonism for the DeWitts, and ends up in prison, but not before he has managed to create a true black tulip.

The bulk of the story, then, is about the intertwining of these events, these characters and others, and the eventual presentation of the black tulip. A very enjoyable story.

eReadings 11


The Poison Belt
Sir Arthur Conan Doyle

This book was published in 1913, and has nothing to do with Sherlock Holmes. It figures another of Doyle's characters, Professor Challenger, a large and boisterous man who is able to see phenomena and make some startling deductions, such as the impending demise of all life on earth, which he communicates to the London Times at the beginning of this story.

The story relies on a holdover from prior generations of scientific thought that there is some ill-defined "ether" that permeates the universe, which somehow plays a role in the maintenance of life.

Professor Challenger, noting reports of some aberrations in Fraunhofer's lines – these are the gaps in the visual spectra of light which depend on the light's source – attributes this to some disruption of the ether, and anticipates this will be lethal to the human race, this being accompanied by some coincidental epidemics being reported in faraway parts of the world.

Indeed, there is something spreading over the world, from south to north, with everyone falling lifeless as it comes upon them invisibly.

The story is a relatively short one. Although I can't imagine someone making a movie from the concept, something like an episode of The Twilight Zone could have been made.

eReadings 10


South Sea Tales
Jack London

This is a collection of short stories by this famous author. While there is some range to the territory this covers in these tales, there is an emphasis on the area around the Solomon Islands.

As depicted by Mr. London, these people were savages, untrustworthy, and liable to cannibalism and head hunting. I'm not sure how true this was at the time he wrote these stories. To the modern eye, the various white people who travel the South Seas are hardly less barbaric, capturing the natives into virtual slavery for use on plantations and as crew on ships.

There is a gruesomeness which all this lends to the stories as a whole, and one could not say these are uplifting stories in any way. It also seems likely that there is more than a little exaggeration for effect.

eReadings 9


Selected Prose of Oscar Wilde

This collection of essays, articles, and stories by Oscar Wilde was put together by an admirer, seemingly to counteract the various negative public opinions of him which came about and preceded his premature death. There is no explanation of any of that in this work, so consult Wikipedia or other sources for the details.

He was an infamous character in late 19th century Britain, with a flamboyant lifestyle and sharp tongue. He had been a top student at Oxford, and made a name for himself there, and later, with his most famous work being for plays such as "The Importance of Being Earnest".

As you begin this collection, you quickly get a sense of his wit and the sharpness of his tongue as he derides one person after another. As you read along, you see in contrast his exuberance about things he holds in high esteem, one being the supremacy of literature over all kinds of other artistic media, such as painting or music.

Some of the included material are his own attempts at prosaic stories, so there is a mix of critical commentary and his own creative output.

Mr. Wilde was by reputation a very entertaining person to be with or even just observe, based on what one can read about him, and one certainly gets a sense of his wit in this collection. At the same time, while he certainly was skilled at turning a phrase, there seems to me a shallowness to his own works, so that they lack the depth of character and story development that he admires in others.