Outside my studio the sky is clearest blue. I think of many years of pleasure listening to Bach’s last, unfinished work, the Art of the Fugue. After thirty-five years and more of listening (it took ten years for me to hear the work as melody and architectonic grandeur) it remains ever fresh. The work grows more beautiful, like the sounds of the sea, the patter of rain, the murmur of the wind, ranks of cloudscapes and rainbows, a snow capped mountain range soaring into the heavens. Bach is of nature as nature is of Bach. The artist and the web of nature are distinct antipodes of a universal sameness — evolutionary poles that stretch across a cosmos of thought and action — the world entire. The Art of the Fugue plays in my heaven. Eternally.

The Great Dewdrop in Space

When we contemplate the whole globe as one great dewdrop, striped and dotted with continents and islands, flying through space with other stars all singing and shining together as one, the whole universe appears as an infinite storm of beauty.



“Columnist Charles Krauthammer slammed President Obama for going on an “ideological holiday trip in Cuba, while the world burns” on Tuesday’s “Special Report” on the Fox News Channel. Krauthammer said, “I thought the whole story of this presidency, and its foreign policy, was seen in the split screen. On one side, you had the video footage of the attack in Belgium. This is the real world, and on the other side was Obama, in the fantasy world he inhabits, where Cuba is of some geopolitical significance, in his mind, but none in the real world geopolitically.”


On a rare clear morning — the first day of summer 1992 — flying across the Bering Strait from the Yukon delta toward the Diomede Islands and the Chukotskiy Peninsula of Siberia, I imagine the gray sun-silvered strait as seen from on high by a migrating crane, more particularly, by the golden eye of the Crane from the East, as the lesser sandhill crane of North America is known to traditional peoples on its westernmost breeding territory in Siberia. The sandhill commonly travels a mile above the earth and can soar higher, to at least twenty thousand feet — not astonishing when one considers that the Eurasian and demoiselle cranes ascend to three miles above sea level traversing the Himalaya in their north and south migrations between Siberia and the Indian subcontinent.

Two Visions for Healthcare

Last week I attended the Forbes Healthcare Summit in New York City. Over 200 healthcare leaders converged on Lincoln Center to discuss and forecast the future of healthcare in the U.S. The heady atmosphere of the conference will provide material for a number of blogs. In this blog I would like to focus on two different visions for the future that emerged in the conference. The first vision is an extension of our current trajectory in which space-age technology yields dramatic, but expensive, health outcomes. The second vision is one in which common-sense medicine produces low-cost very good health over a large segment of the population, but is not necessarily designed to accommodate specialized high-technology procedures.

Science of Inequality

But … it is part of the American mythology that everyone has the opportunity to be rich.

How is healthcare different from a commodity?

“How is healthcare different from a commodity?” may be as enigmatic as Caroll’s riddle from Alice in Wonderland, “Why is a raven like a writing desk?” Lewis Carroll did not posit an answer to the riddle, but many people have suggested answers. My favorite may be, “Because neither one can ride a bicycle.” Because healthcare in the U.S. costs more than 17% of GDP and health outcomes lag behind other industrial countries, the answer to the healthcare question may need to be less frivolous than the answer to the raven question.

The Quantum Eye & “SECRETS . . .”

Computer models are many orders of magnitude slower than needed to account for the speed of thought. A Neurologist has calculated that if the brain was a standard serial or a parallel computer, it would take more time than the age of the universe to perform all the necessary calculations associated with just one perceptual event. But if the brain were a quantum computer, it would try out all the various possible combinations of data arrangement at once, and thus, unify its experience. So, in essence, the brain operates very similar to how science theorizes a quantum computer to work even though quantum computers do not yet exist. (source online)


To see into a rose in its full glory, pistils stretched out to seduce pollen from darting bees, delicate and ferocious, an immolation of blushing colors, is to see paradise lost, the innocence of Eden slain by dragons, a sinister sacrament of bloody wafers.


HAVANA (AP) — President Barack Obama and Cuban President Raúl Castro tussled Monday over differences on human rights and democracy but pledged to keep working on a new path forward between their two countries . . . (Obama bowed to Raul’s insults).
Asked by an American television reporter about political prisoners in Cuba, Castro seemed oblivious, first saying he couldn’t hear the question, then asking whether it was directed to him or Obama. Eventually he pushed back, saying if the journalist could offer up names of anyone allegedly imprisoned, “they will be released before tonight ends.” (Cuba arrested hundreds days before Obama came to avoid protests in Havana.) “What political prisoners? Give me a name or names,” Castro said. He added later, “It’s not correct to ask me about political prisoners in general.” (Political correctness from a dictator!) After responding to a handful of questions, Castro ended the press conference abruptly, declaring, “I think this is enough” (Allowing free press briefly in for Obama made him very uncomfortable as with any dictator.) In a history-making meeting in Havana, Castro praised Obama’s recent steps to relax controls on Cuba as “positive” but deemed them insufficient. He called anew for the U.S. to return its naval base at Guantánamo Bay to Cuba and to lift the U.S. trade embargo. (More baksheesh for the Castro dictatorship) “That is essential, because the blockade remains in place, and it contains discouraging elements,” Castro said . . . Castro worked to turn the tables on Obama by saying Cuba found it “inconceivable” for a government to fail to ensure health care, education, food and social security for its people a — clear reference to the U.S. (Most Cubans live far below the poverty level. Almost all Cubans struggle to live on twenty to twenty five dollars a month.) “We defend human rights,” Castro said. “In our view, civil, political, economic, social and cultural rights are indivisible, interdependent and universal.” (This from a brutal dictator whose brother imprisoned and slaughtered tens of thousands.) “The future of Cuba will be decided by Cubans not by anybody else,” Obama said. “At the same time, as we do wherever we go around the world, I made it clear the U.S. will continue to speak up about democracy, including the right of the Cuban people to decide their own future.” (Raoul no doubt laughs on the way to the bank with new funds from the U. S.) As Castro prepares to step down in 2018, he’s held firm against any changes to Cuba’s one-party political system. (In short, he told Obama to go to hell with his democracy.)

Information management that improves health outcomes and reduces costs

I would like to start this blog with a story about my college-age daughter. Like most college students, she likes pizza. Beth, because she is a modern child completely comfortable in the information age, orders her pizza over the internet. She can monitor the progress of her pizza online. She knows when the cheese has been applied and also the pepperoni. She knows when the pizza has been placed in the delivery car, and she knows, within a few seconds, when the deliveryman will knock on our door. She also knows the deliveryman’s name.

US Healthcare as a Complex System

Healthcare in the U.S. is complicated. There are dozens of components: hospitals, hospices, assisted living facilities, nursing homes, home care, pharmacies, pharmaceutical companies, the Food and Drug Administration, the Patent Office, specialized physicians, general physicians, physicians assistants, nurses, medical device manufacturers, Medicare, Medicaid, private insurers, self insurers, employers, self-employed, wellness centers, chronic conditions, acute conditions, end-of-life conditions, rare diseases, personalized medicine, cosmetic surgery, concierge medicine, and many more. The complication is impossible for any single person to penetrate or understand.