For the record, I fully expect to be disappointed in some things I really feel strongly about not moving forward the way I thought or that he originally promised. Part of being a good leader is adapting to new situations and information; being a better leader is conveying why things have changed for those who were expecting otherwise. We’ve had enough of this “stay the course” because “I’m the decider” bullshit for a lifetime.  I think everyone on both sides of the aisle should be in a position of compromise on domestic affairs in this time of financial crisis.

Having gotten “current events” out of the way, I want to return and remain on the inauguration itself. I saw it partially live, but since I was caring for my daughter that morning, I was unable to see Obama’s swearing in, speech, and after coverage until later from the DVR. Fortunately, one item I did see live just before having to switch off was when Sen. Feinstein announced the names of Itzhak Perlman, Yo-Yo Ma, Gabriella Montero, and Anthony McGill to play the commissioned inaugural work by John Williams, “Air and Simple Gifts.”  I about fell out of my chair when I heard Perlman and Ma’s names. Mind you, we had just heard Aretha Franklin in the broadcast which was already over the top awesome (not to mention that gem-studded bow hat!), but to have Perlman and Ma on the same stage LIVE as a surprise (I hadn’t done any prior scouting or reading of events) was incredible.  Wind instruments aren’t my thing, so I didn’t know the clarinetist, but Gabriella Montero is a phenomenal pianist and gifted collaborator on several cross-over projects; she’s also certainly Venezuela’s most popular export to the classical music world along with Gustavo Dudamel.

The point is, before the music even began the tremendous surge of pride at how serious music and the arts had been given here was overwhelming.  This was no “filler” cocktail quartet music–this was the unquestionable musical “main event.  It also instantly occurred to me that 3 of the 4 musicians were not originally of this country (Perlman and Ma however are both naturalized citizens), and the fourth was African-American. What incredible symbolism of unification and diversity in just the musicians themselves!

Then the music started.  Once they started playing, the realization hit me like a brick across the head: “OH. MY. GOD. It’s 20-something degrees and Perlman and Ma have their multi-million dollar Stradivarius instruments warping in the cold?!”  Just as my heart recoved from throwing a PVC it then hit me: “Wait…the piano!!!!  How is it being kept in tune?!”  You have to understand–it takes HOURS to tune a piano; there are 88 keys but over 200 strings/pegs to adjust since most keys have more than one string (most have 3)–all of which need to be in unison among themselves and in proper relative pitch with every other key.  I think, “So instrument valuation aside, adjusting the four strings of a cello or violin, or pushing in/pulling out the segments of a clarinet would be comparatively simple, yes, but….”

And suddenly I hear that familiar tune, used so gloriously by Aaron Copland in “Appalachian Spring” that’s become part of the very fabric of  American musical existence.  And then it continued. And continued.  “Aw hell no….” I thought to myself, realizing that this was the focal point for Williams’ work.  I was so disappointed, feeling the event was cheated, wondering how Williams could have not come up with something more personal, more evocative of this special moment in history.

The whole point of a commission is to write something new, not re-work a tune that elementary school children could recognize that was already popularized and made iconic by yet another American composer.  GOOD LORD!

I even tweeted the fact that I thought the composition was less-than-desirable in real-time, so this is not a revisionist point of view, but I did look up what people thought afterwards and I’m comforted to know I’m not alone. In the process, I also discovered what probably everyone now knows about the “live” performance and that what we heard on TV and what was broadcast locally over the speakers was in fact a pre-recorded performance from the previous day for the very technical reasons I was thinking as I was watching.  I didn’t feel bad when I found out, because obviously I know why and also that they were in fact playing in real-time; the honor to the event was still maintained if you could hear any of them acoustically. There were just too many damning technical factors to consider outside the players’ control to do the event justice for everyone while still have them on stage in that weather which Yo-Yo Ma himself described as “wicked cold.”

Regardless though, I’m happy to see that classical music got a prominent moment to shine, even though it was via Williams channeling Aaron Copland cheered on by Wolf Blitzer’s voiceover in the middle of the performance–but I won’t go there lest I get upset all over again…

I’ve been robbed–ROBBED–I say! Celeste, a long time commenter and reader of this blog, pointed out to me that National Public Radio (NPR) has taken one of my old posts and stolen it, without reference, without a “hat tip,” without anything, in their feature entitled “Playing Five Beats To The Measure.”  My post entitled “5/4″ obviously is the victim of an NPR five-finger discount. Now it stands to reason with NPR you’re going to get a much more polished product than with lil’ ol’ me, but the spirit of my post clearly comes through, and with the added literary/dramatic touch of a second, autobiographical voice feeling an “odd” kinship with this asymmetric time signature.

I invite you to read mine first, then see the NPR feature. Afterwards, tell me whether or not mine gives those thieves a run for their money!  heh

Story short, the Soviets decided they were to host a grand competition for the world’s finest pianists, violinists and cellists, all in honor of the famous Russian composer Tchaikovsky. Premier Khrushchev was certain that the Soviets would illuminate the musical world as Soviet musicians would compete and emerge victorious on an open stage for the world to see. I’m sure the Soviet Ministry of Culture had their “hand picked” winner, but the crowds were chanting Cliburn’s name. He was the obvious choice among the jury, and the shock wave was enormous. The soft-spoken Cliburn literally had women screaming as if it were a rock concert, yet Cliburn’s stage presence then and now has always been one of austere sincerity.

So powerful was the “note heard ’round the world,” that the jury had to ask Khrushchev personally to approve naming Cliburn the competition winner. And lets examine some of the luminaries on that jury: Emil Gilels, jury chairman (photo w/Cliburn), Dmitri Shostakovich, Sviatoslav Richter, to name a few: to have won over these geniuses, regardless of nationality or politics, was a feat unto itself. Imagine it! The gold medal of the inaugural Soviet competition in honor of the grandfather of Russian classical music–going to a practically unknown American at a time when the USSR was spilling over with national communist pride. So powerful was this weaponless and honest victory, that Cliburn received a ticker-tape parade in New York upon his return. Usually reserved for sports champions, military heroes, or pop-culture icons, no other classical artist before or since has ever received that honor. Cliburn’s live recording of the Tchaikovsky First Piano Concerto made upon returning back to the USA (with the Soviet conductor and orchestra from the competition no less) was the first classical album to go platinum, selling over a million copies. A classical album!!

No longer making recordings but still playing limited engagements, he is more known now for the international piano competition that bears his name. It shows his character that Cliburn stayed true to his roots and had the competition held in Fort Worth (ie, not neighboring Dallas or any other “big” city) where this small, humble city becomes the musical capital of the world for two weeks every four years. The Cliburn Foundation also hosts a competition for amateur pianists on off-years, something I have always had on my “Have to do before I die” list–just to participate.

Below is a video clip of Cliburn playing the last movement of Tchaikovsky’s Concerto No. 1 in 1962 during one of Cliburn’s numerous tours of the Soviet Union. This one happens to be in Moscow, with the same conductor and orchestra, and in the same hall as when he won the competition four years earlier. You can even see Khrushchev himself applauding during the last few seconds of the video. Understand that this was the same year as when the world was on the brink of nuclear holocaust from the Cuban missile crisis, yet there Cliburn was on Russian soil, wowing Soviet audiences with their own national composers. Seeing the video, it’s not hard to understand how Cliburn was and is a true musical ambassador of peace in the name of great music and art. Enjoy!

(For more, go to the Van Cliburn Foundation page and follow “50th Anniversary” links for more videos and interviews of Van Cliburn then and now)

Prelude:
Thanksgiving is two days away in the USA. This will mark the 3rd Thanksgiving in a row that I am not home to spend with the rest of my family. Perhaps I’m just a little nostalgic for home right now, but I really wanted to incorporate the holiday here in a way besides references to turkey, pie, and football (Go Packers!). Victor Hugo said (translated), “Music expresses that which cannot be put into words and that which cannot remain silent,” and like the last time I hosted, it is to music I turn once again to express myself.

In the Thanksgiving spirit, all of today’s selections will highlight American composers. Since all links here are set to open in new windows (or tabs), you can read articles while leaving this window playing in the background. In all but one shorter case, the selections are about 8 minutes each; I hope you indulge my desire to share. Enjoy!

When Aaron Copland burst onto the musical scene in the 1920s, American music would never be the same. While there were several important composers before him–McDowell, Herbert, Sousa–Copland was arguably the first to truly musical codify what it was to be “American,” by drawing from folk songs, cowboy music and other “popular” sources. Everyone knows Rodeo (the last part used in the “Beef: It’s What’s For Dinner” campaign in the States), but there was far more to Copland than catchy tunes. Here is the 2nd movement of his third symphony. The expansive, colorful harmonies and driving rhythms are so distinctly American, one just feels it.

Editor’s Choice:
Sid Schwab at Surgeonsblog has a great piece about people’s need for magical thinking, particularly as it relates to “alternative medicine” and new discoveries. The post builds up steam (both momentum and ire) and finally culminates in a challenge bordering on the ridiculous (the whole point) to those who want to cherry-pick common sense. In a similar vein, Dr. Val comments on an infuriating decision by Medicare to no longer cover expensive, necessary treatments to lymphoma patients while at the same time, government dollars are wasted trying to legitimize the spurious benefits of homeopathy with more research studies. Craziness.

Coming back from the Twilight Zone to the ER (some would say that’s just a few steps away ), the truth always comes out eventually, as Bongi at Other things Amazni shares. It may not come via the patient nor the patient’s family or friends–it may require surveillance cameras to finally shed light on what’s going on. The delay, however, could be deadly.

And on the lighter side, Zac at Agraphia has a story about a particularly reptilian surgeon which had me belly laughing from a similar experience.

Mark O’Connor is of a newer breed of contemporary American composers. O’Connor draws his inspiration from the country and bluegrass aural traditions (handed down through playing, not written) and brings his formal training to transform it into something completely unique. O’Connor’s most famous piece is Appalachia Waltz, and O’Connor has arranged several versions, this one for solo cello. This is a slow, easy waltz, just like sitting on a porch looking at the mountains…

Clinical Perspectives:
Here are two selections about burnout and emotional balance. Keith at Digital Doorway talks about having been all compassioned out. Third-year medical student Nick Gavin at NY Emergency Medicine has a post entitled Traumatic Disconnect where he explores the fact that empathy and connecting with patients don’t come automatically with the white coat.

Straight Talk from the Stanford ER’s Sean Donahue writes a good summary of how an ideal stroke response plays out, from EMS to thrombolytic treatment.

Nancy Brown at Teen Health 411 writes with suggestions on how to ensure an inclusive, positive holiday season for the whole family. With so many families being “go-go-go,” just pausing long enough to communicate openly is probably more than half the solution.

Ever wonder why your psychiatrist doesn’t take your insurance assignment (especially if talk therapy is involved)? Dinah from Shrink Rap explains why.

Terry from Counting Sheep tells a touching story about how a frail, blind nonagenarian had the power to halt activity in a busy OR staging area–in a good way.

Clinical Cases and Images Blog comments on the Perioperative Ischemic Evaluation (POISE) trial and how it might affect perioperative beta-blocker usage.

Some patients just “get to you,” and some do so without you realizing it before they’re gone. About a Nurse talks about one such patient and her struggle to find balance when you can’t even grieve because there’s still work to be done.

In Emergiblog’s first-ever guest blogger post, an anonymous Army nurse writes a letter of thanks to her fellow military nurses who serve our country by helping manage the healthcare of detainees. It’s another world entirely when one is faced with a potential moral dilemma for every medication/intervention, every patient, every day.

Tara Gidus at The Diet Dish shares why she’s especially thankful this year.

How can one talk about American music and not include jazz? Well, 1) Ken Burns already covered that history at length, and 2) I am focusing on classical music. Nevertheless, jazz’ universal appeal influenced many composers from around the world, none more so than American composers. George Gershwin is probably most recognized for this, evidenced most popularly with his Rhapsody in Blue. However, the work I’m featuring is the Piano Concerto in F, an unmistakably American work but rooted in a more traditional form. In spite of feeling a distinct “swing” at times, it’s completely written out and is very strictly timed (as evidenced by the orchestra’s accompaniment–there are no free-form solos as in Rhapsody) Here is about 1/3 into the first movement to the end:

Patient Perspectives:
November is Diabetes Awareness Month. In a special feature, Amy Tenderich at Diabetes Mine interviews musician Elliot Yamin, former American Idol finalist and Type I diabetic, on World Diabetes Day. Stories such as Elliot’s are clearly inspiring for any diabetic feeling imprisoned by their illness. However, this can have an unintended counter-effect, as Kerry Morrone shares at Six Until Me. Just because a person appears healthy doesn’t mean they are disease-free.

In The Power of the Flower, Own Your Own Health talks about how physicians who tailor their communications individually to their patients win them over in more ways than one.

In Sickness and in Health, a chronic pain sufferer, has a nice, short post about appreciating the small moments of being pain free.

Of all the many incredible pieces Samuel Barber wrote, his “Adagio” is far and away the most known. The “Adagio” was first penned as the slow movement for his first string quartet, but was arranged by Barber once for string orchestra (which is most played by far), and again for a capella 8-part choir. It is this infrequently performed second arrangement that I present here. The music is set to the words of Agnus Dei:

Agnus Dei, qui tollis peccata mundi, miserere nobis.
Agnus Dei, qui tollis peccata mundi, dona nobis pacem.

Lamb of God, who taketh away the sins of the world, have mercy upon us.
Lamb of God, who taketh away the sins of the world, grant us peace.

The seemingly endless, ever reaching melody passes among all the vocal parts, finally culminating in a climactic chord and sighing quietly to the end. The tonality is never really settled until the final major chord, making one feel that after all of the yearning, peace is found at last.

Healthcare Business and Policy:
The Executive Physician gives his thoughts and concerns on the concept of “cultural competence” as mandated by Washington and New Jersey and offers a more generalized solution.

Regarding hospitals and their attempt to maintain an edge–or at least financial viability–two stories are presented here. ER Murse talks about interhospital turf wars over a trauma level designation. When things get really bad, as HealthBlawg describes, sometimes it may be best to just pull the plug.

David Williams from Health Business Blog interviews the founder of DoubleCheckMD, a free, public web-based medication service that checks interactions and utilizes natural language technology to correlate patients’ symptoms, in their own words, against drug data. I was skeptical given the marketingspeak from the interviewee, but I checked it out before including it here, and it is worth a look.

Toni Brayer at Everything Health laments the whole SCHIP fiasco. I never understood the argument that because certain adults and/or families above a certain income level might be newly eligible (and improperly so, say opponents) if passed, why that would be reason enough to deny coverage (a non-partisan fact) to so many children.

To send this edition off on an uplifting note, here is the finale of Howard Hanson’s, second symphony. Hanson is practically synonymous with the Eastman School of Music in Rochester, NY. He also wrote this symphony at a time when most composers of his day saw romantic, melodic music as an anachronism, preferring instead to embrace the atonality that was emerging from Europe. Hanson, a consummate melodist, unapologetically subtitled this symphony “The Romantic.” While Hanson is not as universally known as Copland, his legacy also lives through all of the Eastman students who have carried some of his spirit with them.

Culture and Media:
Christian at MedJournalWatch presents a absolutely fascinating case study in Africa about body image issues (!?!) and a surprising trend in the perception and desirability of body fat.

Jolie Bookspan at The Fitness Fixer shows how she performed martial arts movement analysis “old school” with high speed film years ago. Later, she returned to this area, except she was the model FOR a computer and even had her moves included in a video game. Cool stuff!

In the spirit of both Thanksgiving and the upcoming holiday season, Paul Levy of Running a Hospital shares his daughter’s essay on Salon.com about fruitcake and family tradition. It’s an extra click from his post, but the Salon article is an excellent read and well worth the extra navigation.

Canadian Medicine talks about how Canada’s health department warned against using a Chinese preparation of caterpillar fungus. Gee, ya think? I wonder how those meetings went. “There’s a fungus among us!”

Postlude:
I hope you enjoyed this edition of Grand Rounds! I hope everyone has a safe and happy Thanksgiving. Regardless what country you’re reading from, I know there’s something to celebrate and be thankful for–after all, you’re alive and reading this, aren’t you?

Grand Rounds leaves Mexico from Puerto Vallarta a few hours away and sails for the Philippines, home of next next week’s host, Prudence, MD. ¡Adios y buen viaje!

“No problem,” I thought to myself. I just needed a tool to “normalize” the audio so that the mostly classical music doesn’t have the all the dynamic range of the natural louds and softs. Right now, a median volume would mean that soft passages would be unhearable and louder passages (though musically appropriate) would potentially wake her up. Then, I thought, “Wait–I can’t be the only person to have needed this. Let me Google this…”

I could have sworn what I was going to use was a tool/plugin that does “normalization.” After beating my head against that wall for a few days with no good results, I found that what I was looking for is what’s called dynamic compression. “Compression” seemed totally the wrong word to me, because to compress is to remove redundant data to fit a smaller space (and “decompression” would fill it back in). But NOOOO–some crazy group of audio engineers decided to call a limiting of dynamic range–that narrowing the gap between the difference of louds and the softs–”compression.” That’s what radio stations have been doing for years so you can hear everything in car w/o having to ride the volume control, as well as giving extra “punch” to certain audio frequencies so you think one station sounds better even though they play the same recordings.

Jacking with the dynamic range of the latest “Arcade Fire” track is one thing, doing it to a symphony or a string quartet is something different. Classical music is the domain of serious audiophile engineers analyzing acoustics in concert halls, obsessing over the minutiae of different polymer tiles, their placement, etc. all to provide the best aural experience for a live performance. When recording, mics are placed strategically to capture the ambience of the hall, but also throughout the stage. You want to hear the crispness of a freshly rosined bow on a string, the collective breath before a horn section’s opening, the higher frequencies in the “blat” of a low-brass instrument. Trying to dampen these subtleties is blasphemy.

“Baby Einstien” sells 22 minutes of toybox-synthesized classical lullaby crap for $10 on iTunes Music Store. That’s a serious cash-cow; even pop CDs are at least 50 minutes or so. Even if I bought both volumes, that’s not even 45 minutes of non-repetitive music. It is, however, homogenous in terms of timbre and volume, which, along with clever marketing, is why it sells. I’d rather have my daughter listen to the real thing, but I also have a practical need here as well. So imagine my own self-loathing when I subjected many wonderful pieces to a transmogrifying audio laboratory like a Maestro Mengele, removing the artistry, audio quality, and individuality to make a homogenous, similar, and ultimately inferior final product.

I’ll give an example: the “Adagietto” movement from Gustav Mahler’s Fifth Symphony. People in the know will gasp, “You’re putting her to sleep with Mahler!??” because Mahler is known for wide variations in dynamic expression, extremely long symphonies (>100 minutes), very busy and thick scoring (over 120 members in the orchestra, plus a choir at times), and did I mention long symphonies? Relax–this is a slow movement that is scored simply for strings and harp. I even have the relevant excerpt from the score here to follow along for those that want to for the musical sections below:

Note all the instructions Gus has provided above; the score is full of details, all about to be lost. This is the final 18 or so measures of the movement before heading into the buckle-your-seatbelts finale that comes immediately after. In this excerpt, 8 minutes into the movement, we go from quiet yearning to a final gushing emotional outpouring, to a complete fade to nothing. Gorgeous, heart-tugging, and although sublime, completely unworkable to put a child to sleep. Here is a picture of the original waveform in the audio editor (Apple Soundtrack Pro) and the playable excerpt below it:

Now, the bastardized, compressed audio. Note that there is a lot of artifact bringing up the volume from the low-amplitude sections, which you can visually see in the following graphic. This is the price one pays:

Upon finishing compressing 2h of music selections, they were transferred to a minidisc set on “Repeat,” and applied that night. I happy to report it was an unqualified success. I met the dual objective of both blocking out more external noise and giving daughter something to listen to that she can carry with her, even if only subconsciously, as she grows older to appreciate it more. Part of me feels bad for blasphemy I’ve wrought (ok, I’m being a bit facetious here), but Claudia and I certainly get more quality time as daughter gets more sleep, so too bad.

Unlike the sold-out stadiums and the “Three Tenors” era where Pavarotti would use a microphone, “real” concerts at the Met, Carnegie Hall, etc. of course had no such devices for projecting his voice. Like all opera singers, he alone is the instrument, and projecting a voice to fill a concert hall is a given. However, even when backed by an orchestra, in full costume on stage during an opera performance, that voice still needs to have the power and resonance to reach the 3rd balcony seats in a hall with a vaulted ceiling. This is what people need to appreciate when considering the fact that besides the power and volume, was also the incredible simultaneous sweetness of his voice.

Personally, I’m not a big opera buff. It’s just not my thing–I’m just hardwired I guess to be a in instrumentalist. But Pavarotti was one of perhaps 2 or 3 singers that would draw me into that world regardless, and obviously, I am simply one of so many thousands.

I uploaded his signature aria, “Nessun Dorma” (”None shall sleep”) from Puccini’s Turandot to my YouTube channel just a few weeks ago. I did so because I recently found this clip among my collection (which is from 1980, well before age started to catch up with him), but also because most of the other versions on YT were from the last 10 years or so with microphones or the like, and I wanted to share a “pure” performance. I’m not going to go into Turandot’s story or translate this aria (that’s an exercise for the reader ), but the last word sung is “Vincerò!” which means, “I shall be victorious!” Even though he lost the battle with cancer, he has unquestionably conquered the musical world. His career will live forever, the lives and hearts he touched carry with them that magic, and now, like those in the opera from which he’s singing, Luciano can finally sleep.

Requiem aeternam dona eo, Domine, et lux perpetua luceat eo.

Dear Member:

This is to notify you that we have removed or disabled access to the following material as a result of a third-party notification by HOGAN & HARTSON RAUE LLP claiming that this material is infringing:

Beethoven Triple Concerto – 1st mvmt, Part 1: http://www.youtube.com/watch?v=e01FtIEeXEU

Please Note: Repeat incidents of copyright infringement will result in the deletion of your account and all videos uploaded to that account. In order to avoid future strikes against your account, please delete any videos to which you do not own the rights, and refrain from uploading additional videos that infringe on the copyrights of others. For more information about YouTube’s copyright policy, please read the Copyright Tips guide.

If you elect to send us a counter notice, please go to our Help Center to access the instructions.

Please note that under Section 512(f) of the Copyright Act, any person who knowingly materially misrepresents that material or activity was removed or disabled by mistake or misidentification may be subject to liability.

Sincerely,
YouTube, Inc.

I received three (3) emails just like this one, two for the 1st movmenent of the Beethoven “Triple” Concerto for Violin, Cello and Piano, Op. 56, and one for the third movement. Apparently the 2nd movement didn’t violate anything. The artists were Yo-Yo Ma, cello; Itzhak Perlman, violin; Daniel Barenboim, piano/conductor (w/Berlin Philharmonic). All “A-list” performers–luminaries–in the classical world. The $300/hr-paid-lawyers above could be representing ANY of the previous artists, but in every case, I had videos from each of them separately, so why not have flagged them, too?

I also got an exactly similar boilerplate letter from Dewey, Cheatham, and Howe, LLC, about 6 Hilary Hahn videos I had. I got 6 emails, six removals, and I’m sure 6 “demerits” on my YouTube account before I even woke up in the morning that day. (Which, for HH I understand: she is a current “superstar” in the classical music world right now, but this was a TV performance on A&E) This is the problem: before I have a chance to act on anything, YouTube has mathematically decided that I ignored them not once, but 6 times; added to the previous infraction must mean that I don’t care. Action: Account Disable. My chance to do anything about either case after-the-fact? Zero.

What sucks, beyond all the lost uploading time, is by losing the account, I lost all the comments, the reputation and persona I’d established in that community on YouTube, and especially, a loss of great performances that, unless one was there to see the PBS concert that night in 1995, you’d never, ever have the chance to see again because you can’t even order it. If I’m taking money out of someone else’s pocket for broadcasting videos that I lovingly recorded to VHS 15+ years ago as a giddy teenager, then I understand. If not, then I’m just sharing with a musical community out of love; no harm, no foul.

Again, I repeat: this is classical music we’re talking about. I still can’t wrap my head around this one. I knew the day YouTube was aquired by Google that things would go south. I am sorry to say that my prediction was proven true, so close to my heart.

Even a waltz, which is an odd number of 3 is really 1, not three individual beats. Think of a pair dancing in a Victorian ballroom, the bodies really actually move on the 1 downbeat: 1-2-3 1-2-3 1-2-3. What was an odd number is, in physical human expression, one fluid motion that happens to be divided in three subdivisions. (I’m ignoring some musically famous but undanceable “waltzes” of late Romantic and 20th century composers where, while technically a waltz, a ferret on crack couldn’t keep up with dancing it.)

I am alone once again, my wife and daughter back in the USA, trying to get some order back into my life. My now quiet home is both a peaceful sanctuary to study and a prison of solitude. Our parting was exactly what I didn’t want–stressful, agitated, unfulfilled. I miss my daughter terribly–her sweet, gummy smile when she sees me. It’s so hard to study with her innocent noise, yet the empty rooms distract me with their silent cacophony.

What about 5? Oooh. Now there’s a problem. Not really anything fits into 5, being a totally disjointed number of beats between a natural 4 and an easily divisible 6. Even in visual terms, a pentagon has no real axis of symmetry while a square, hexagon and triangle all do.  The simple act of walking with a 5-beat in your head is like being on the verge of stumbling.

So too I feel like I’m stumbling along, not really sure where to put my feet, wondering if at any minute I’m going to fall. In general, I often feel unnatural, unconventional, like I don’t exactly fit in. As a med student, I stand out on so many levels: I’m way overweight, I’m in my mid-30s, it’s hard to find common ground with the young 20-somethings in class. I’m outspoken yet reserved. I seek camaraderie while at the same time knowing I can be hard to approach. My thoughts are vastly complex, but my needs as a person are rather simple. 5 takes extra time to figure out.

So what does one do with such an unnatural meter? Divide it, of course! Music in 5 naturally gets subdivided in either a 3+2 or a 2+3 pattern. Nature doesn’t have a problem with 2 or 3, so 5 can exist without seeming totally aberrant. Now It wouldn’t be right for me to make all these musical allusions and metaphors without sharing some actual music.

With all the selections below, count “1-2-3-4-5, 1-2-3-4-5, etc.” in your head, flip your fingers, whatever you need to count, so you can get a real feel of what’s going on rhythmically:

1. Dave Brubeck’s “Take 5″ (excerpt): Probably the most famous 5-meter piece to modern ears and a proud start to this list, it was a classic the day it was released. My dad has the original LP and although this is the title selection, the whole album is gold. A crystal clear example of a 3+2 meter (1-2-3-4-5, 1-2-3-4-5…)
2. Tchaikovsky-”Pathetique” Symphony (No. 6), 2nd movment (excerpt): This is a twist on a twist, since this has all the right elements of that elegant ballroom depicted above, but now the graceful waltzing pair has suddenly turned into a horrific example of one person with a 5-inch-heeled orthotic shoe and the other with a cerebellar lesion. It feels this way because Tchaikovsky wrote a 3+2 / 2+3 dual pattern (ie, two measures make a single rhythmical mirror-image), but only a genius as he could have pulled off this aberration with such elegance and grace. Everything should be “wrong” here, but it’s so masterfully written, all that is perceived is beauty. Counting is “1-2-3-4-5 1-2-3-4-5, 1-2-3-4-5 1-2-3-4-5….” (it might be easier to count “1-2-3-1-2 1-2-1-2-3, 1-2-3-1-2 1-2-1-2-3….”)
3. Holst-”Mars, The Bringer of War” (from “The Planets”) If you think you’ve heard this before and you do not listen to classical music, that’s because John Williams (”Star Wars”), Hans Zimmer (”Gladiator”), and virtually every modern film composer has shamefully stolen motifs from this work written in 1916. I left the whole piece here for listening because it’s just such a bad-ass work. While the melodic motifs are mostly a 3+2 pattern, the real driving force is a straight 5 meter relentless ostinato rhythm. It’s first established in the beginning, softly and ominously with the timpani and the strings marked col legno in the score (Italian, “with the wood”) meaning to percussively hit the strings with the wood of the bow–that’s the light “clacking” noise. As the war machine moves menacingly forward, this rhythm ends up in the hands of the entire percussion battery and high brass towards the end at 4:22. Fasten your seat belt!

Maybe it’s not so bad in 5-land. 3 was always my favorite number growing up, but I’m older now, so maybe 5 suits me better. I am unique. I am creative. I am full of surprises and can vary my step, depending. I might be awkward, but like the Tchaikovsky movement, there is no less beauty there just because I’m different. I can chill out if I let myself, or I can be a relentless juggernaut driving towards whatever goal I have in my sights. I am who I am, and regardless of the fact that I am different in 5, I keep moving forward nonetheless.

As soon as I knew that her hearing was developing in the 2nd trimester, I began what will certainly be a lifelong process of teaching her about music. On Claudia’s iPod Mini, I put a small playlist of various “soothing” classical music selections. Claudia prefers rock, and sometimes I play jazz, so she got a variety to be sure, but classical music is something special on so many levels–too many for me to wax philosophical about here. One of the pieces I had in the playlist was a famous variation from Sir Edward Elgar’s work, “Enigma Variations,” where each variation on a theme had a mystery surrounding it. Musical historians are still working on that one, but the one I am referring to is entitled “Nimrod” (referring (partially) to the biblical character). This piece is very famous and is used often at funerals and memorials, namely British Remembrance Day (for World War I), where its performance is mandatory.

In spite of its use at such somber and sad events, I always think of her when I hear it. I hadn’t heard it in a few months, but since I’ve become a YouTube slave, uploading and watching videos like mad, I happened to be with her when I was preparing a video of this very work on my computer for upload earlier this week. I sat her on my lap and we watched it, and in spite of the lack of flashy anything on the screen, she actually paid attention! I put my chin on her head, listened, then looked at her angelic face seeing and hearing the music and I started crying–crying because I knew she was about to leave, but mostly because of the beauty and perfection of that moment. She, of course, just looked at me and smacked her hand on my face a few times and wondered why it was wet, oblivious to everything I was feeling.

I look forward to many such times in the future with her (hopefully I can keep my emotions in check before she thinks her daddy is a nutcase), each time being able to share more and more. She turns 6 months tomorrow–half a year that feels so much longer, yet so much like yesterday. I am including the video here (from YouTube) for your viewing and listening pleasure. I hope you enjoy.

But seriously, I have enjoyed YouTube ever since it came out, but like most people, only to watch little ditties people forward me and get a good laugh. I had no idea that there were soap operas and all sorts of things broadcast via people’s webcams–like I care about the dating life of some chick who’s known only as “T1f4nny.” Please. However, I discovered a phenomenal thing that has been sucking up all my time recently–vintage classical music videos and other rare performances. (yes, this is where you guffaw mercilessly at my geekiness) I’m talking rare footage from the 50s or 60s of Sviatoslav Richter, Emil Gilels, or David Oistrakh not previously seen outside the (then) Soviet Union or, on the other side of the spectrum, pristine (as much as YouTube can handle) footage from a live concert in Japan last year of Arcadi Volodos from someone’s camcorder. 99% of you have no idea who these people are, and that’s OK–trust me when I tell you that these are giants of their respective instruments (and yes, they are all Russian, but that’s usually the way I roll, musically).

To see what I mean, go here to watch a clip of Volodos from somebody’s frickin’ living room for crying out loud, playing Mendelssohn’s “Wedding March” from A Midsummer Nights’ Dream (arranged by Vladimir Horowitz and Volodos). All those words will mean nothing once you hear the first few notes, but please keep watching at least past 1:20 because that’s when the fireworks start. Now what kind of chance would I ever have had to see Arcadi Volodos in the first place much less be privvy to a private performance?! Thank you Internet, thank you YouTube.

As for MySpace, up until a few weeks ago, all I knew of it was “where the kids hang out online” and that it was always associated with various pedophile scandals since, obviously, that’s where the “kids” hang out. After hearing enough comments from some people in class about what they read, I finally logged in expecting to see nothing but teenage crap. Oh. My. God. 1/4 of the planet has a profile on MySpace, and now I do too (which is pretty irrelevant considering I never go there, but you need to create one to see much of anything). I think perhaps HALF of my medical school class actively maintain their MySpace profile, and within a week of signing up, I got a random email from a person who went to my high school asking if I remembered him (I didn’t). I had no idea so many “older” folks actively frequent MySpace. I have enough problems keeping up with blogging and emailing, so I’ll leave the MySpace to others, but from what time I did spend on there, it was obvious it had complete “black hole” status, following so-and-so’s friends, comments, etc. It’s similar to blogging in a kind of LiveJournal or Blogger way in it is a pre-built community, but SOOO much deeper and bigger. And far more hideous. I swear people’s MySpace profiles look like a scary glimpse into a schizophrenic mind.

As much as finding/following profiles of pathetic pop star wannabes on MySpace is loads of fun, I’ll stick with YouTube.

1. Living with a newborn and all the changes involved
2. Classes themselves (academic)
3. Delusional classmates that unfortuately have chosen me most recently as an outlet for their love of conflict and misery

It seems weird to say that adjusting to a newborn (now 3 months and doing great) is a lot harder than I thought (”Well duh!”), but I still didn’t think it would be this hard, especially with the piercing cries that often penetrate earplugs from across the house. Don’t get me wrong–I looooove spending time w/my daughter, but there are times I need to focus, and I’m so distractable, most especially to noise. You can flash a strobe light in front of me before I’d start to get affected, but the slightest non-conducive sound derails my mental train…it’s almost like the cartoon mouse scaring the elephant in the ridiculousness of the disproportion.

School is kicking my ass. And I don’t mean difficult, I mean Hebrew-slave-in-the-time-of-Pharoh hard work. I’d say easily 75% of this feeling comes from neurosciences. How I hate that class with the heat of a thousand suns. To quote Melville:

…to the last I grapple with thee; from hell’s heart I stab at thee; for hate’s sake I spit my last breath at thee.

Yes, that’s also from Star Trek II:Wrath of Khan, for those complaining I’m not giving true credit where it’s due. I’m not chasing neuro as my white whale, trust me–I’m trying to run the hell away. We’ve had a wonderful visiting professor from UT Houston for neurophysiology that has given us great lectures and exceptional class materials used @UTH, but the best instruction in this subject still leaves me in a fetal position in the corner after studying it for a few hours. As if I were made of Teflon, the information doesn’t stick and slides right off me. It’s not a subject that lends itself to flash cards or easy forms of brute-force memorization, so I’m trudging through. Slowly.

Lastly, there has been a lot of upheaval at my school. Just as I thought things were dying down from the Grand Rounds “bad press” I gave, one particular student decided to decided to complain once again about things in the class, only this time mail was sent anonymously. Since I manage the email lists and have had many run-ins with this individual (as well as a low tolerance for bullshit in general), I decided to publicly expose this attempt to anonymously cause trouble while simultaneously sending ingratiating emails to the student body publicly. Oh. My. God. What a firestorm this caused, and in true mentally unbalanced fashion, this person proceeded to become unhinged more and more, causing more and more problems. I could have left well enough alone, but part of me was stupid and didn’t, and part of me was obligated to reply when said individual would accuse me of things that were patently false.

To make matters worse, there was an incident involving a successful attempt to steal questions from an exam of a visiting professor via a fake email. As a class officer, I was somewhat involved, then fully involved because of my IT background. I don’t know where it’s going to go, but attorneys at both school are involved dealing with both theft of intellectual property and fraud. Academic honesty/honor code is the least of this person’s worries. I won’t go into more detail, but said unstable student now says I had something to do with it with no evidence whatsoever. I feel like I’m in junior high. It scares the living hell out of me that people this unstable and disconnected from reality will actually be in a position to tangibly affect people’s physical lives in less than 2 years. I truly hope this person grows up, gets psychiatric help, or chooses another career–whatever it takes.

So that’s the short verison of what’s been going on. For those who have emailed me privately without a reply, please don’t think I’ve ignored you…I promise to reply soon. After my neurophysiology exam on Monday, we move on to neuropharm, and my life will be a bit better for a while (pharm is so much more my cup of tea). I’ll be more communicative after the weekend, I promise.

As I’m writing this, I’m listening to an interesting recording of Mozart’s Requiem that I downloaded (more of an “early music” interpretation with thinner orchestration and faster tempos), and I already feel better. Even ending with a driving in a fugue in a minor key, my spirits are lifted along with the prayers sung in the text. Thanks Wolfie.

(^**Data is consistent given books would have a much better compression and hence smaller files for the same time duration)

So there you have it: if I click “Library” and just press “Play,” as of the date of this writing, it would be until May 5th before my library finished!! There’s about a 2G discrepancy with the total from what’s listed, and that’s exactly those orphaned/perhaps repeated files that I’m trying to fix. In case you were wondering, I have 3 160G drives connected to my G5 (2 internal, 1 external) so space isn’t the issue. However, this is getting WAY too big to manage. iTunes organizing everything for me is great, but it’s an all-or-nothing problem. Either I keep everything in one folder (which I don’t–those things which are long backed-up already are in a separate folder outside my home directory) or I have to manually manage names/etc outside of iTunes. I would like something more “smart,” allowing me to place files where I want them yet be able to manage them easily from iTunes, both in a playlist way and also have at least an indirect way of accessing the filesystem (disk) from within iTunes so I can manage filenames/locations and have iTunes update intelligently rather than it go, “Duh…Where did the file go, duh….” like it does now.

So there’s a good news and bad news situation I now face: the good news is finally finished acquiring the “Great Pianists of the 20th Century” series–all 200 CDs. (we won’t discuss exactly how…*drums fingertips together in evil fashion*) The bad news is, well, with 17G of files (not my decision to encode in 320bit MP3!) and many files which need massive ID tag editing, what’s the best way to go about it so that I 1) have access to these files from iTunes (and therefore my iPod), 2) don’t overwhelm my home folder, 3) don’t intermix these files (which already are backed up to DVD-R) with my other music, and so on. Don’t worry, it’s nothing I’m going to solve tonight or this week, even.

I’m not learning much endocrine physiology or neoplastic cellular signaling (for pathology) dealing with these things, but I am who I am, and this is quintessentially me.

Just like in any professional field, one should be judged on merit. There have been too many Anna Kournikovas. Jansen is a serious talent. I bought the “Four Seasons” CD and it was awesome. The latest “style” for baroque instrumentation and interpretation is to basically beat period instruments within an inch of their life, pushing tempos, etc. Her ensemble doesn’t ignore this trend, but they don’t sacrifice lyricism either. They definitely had some fresh ideas. If you don’t have a good copy of Vivaldi’s “Four Seasons,” go to iTunes Music Store and check it out. Meanwhile, I’ll indulge my own fresh ideas…

On their little heads, the newborns in the maternity ward are wearing stereo headphones and their tiny hands seem to move to the rhythm of the music. From the first hours of their lives, the babies are tuned into Mozart at the Kosica-Saca hospital in eastern Slovakia.

“In the womb, the baby listens to the mother’s heart beat which represents a source of protection and good feelings. We have the baby listen to music so he can recall his mother during the period immediately after the birth when he is not with her,” [the doctor] said.

I’d probably stunt my kids growth with Shostakovich or Prokofiev, since I’m obviously into 20th century Russian music. Mother’s heatbeat, Stalin-regime-induced percussion, same difference.

TiVo is not working properly (which is post in and of itself) and I had no VHS tapes to record anything, so I just simply watched and enjoyed. I’ve been in the country a week, and already I’ve seen more true artisitic programming (even apart from these) than I did in the US in the last year. I look forward to new gems I might find, if only I had a channel guide (and it was accurate…)