Friday, February 29, 2008
Spokane has been nice. It's a good place for students to learn medicine. I've learned a lot, and could probably take the final right now and pass. So, thank you Spokane.
There is, however, something about Seattle that whispers to me: "home."
We head there tomorrow. For 4 weeks. It's been 14 weeks since I've lived in the Emerald City; I have some catching up to do. The truth is that I'll see a lot more of Harborview Medical Center than of my 'real' home. But that doesn't matter to me now. My next post will be from the comfy chair in front of the fireplace.
Wednesday, February 27, 2008
It's amazing to me how just a small connection formed with other people can help overcome stress, anxiety and malcontent. Medicine is too full of emotional brick walls for us to get by on our own. Sometimes just the presence of another heartbeat - or in my case, an ECG crew - is all you need to break through.
Tuesday, February 26, 2008
These days, there's a new one around every corner. Just when you get the hang of something, bam, there's another one to climb. Studying, scheduling classes, seeing patients, sleeping. There's always a new challenge. If you have any tips on that last one, I am accepting suggestions.
In November 2006 I had the pleasure of hosting Neal Lane for a visit to the University of Washington. The UW's Forum on Science Ethics and Policy invited the former NSF Director and Bill Clinton's science advisor to speak about the future of science in America. He and a large number of science superstars have come out in support of ScienceDebate 2008. Here is a video of him making a case for it.
Find your favorite science star at this page.
Monday, February 25, 2008
Sunday, February 24, 2008
Leave it to the movie's proponents to point out that this moves the opening from Darwin's birthday to the day he died (April 19). And some of them revel in this decision!
Bad form, guys. Tasteless.
White Coat Underground's slogan is "Musings on the intersection of science, medicine, and culture." That is strikingly similar to my own "Where science, medicine and society collide - and something good comes of the mess..." The author is anonymous, so you don't have to put up with any stories like the personal vignettes I tell.
DrugMonkey is no stranger to this blog, but I only now have updated his ScienceBlogs link in my blogroll.
The Inverse Square Blog is authored by a science writing professor at MIT. Reading it makes me feel like I'm sitting on a steam vent in the park on a cold winter's day. His slogan is "science and the public square." (It's just the vent keeping my science writing urges warm.)
I also put the Science Blogging Ethics Wiki in my linklist. Check it out and contribute if you have any bright ideas on that front!
She uses some great examples of people from different backgrounds and intentworking together toward a common goal and wraps up with the following account:
Walking through Dulles Airport not long after losing the 2004 election, John Kerry was stopped by a supporter. The man shook Kerry's hand and told the senator that he was an evangelical. "I voted for you," he said, "and so did a lot of evangelicals. But you could have gotten more of us if you'd tried." Kerry was floored. Evangelical Democrats?
No wonder Kerry fared worse among evangelicals than any other Democratic nominee in modern history, losing the votes of nearly four out of five. To engage a constituency, a campaign needs to at least know it exists.
Even so, the Democratic nominee this fall will have advantages Kerry never did. Sen. Hillary Rodham Clinton is a lifelong Methodist with years of experience teaching Sunday school in Arkansas who's married to the party's most prominent evangelical Democrat. Obama, a committed Christian, is more thoughtful and relaxed talking about religion than any other Democratic politician. Most important, they'll have the support of a party that is slowly starting to see that there are many faces of the faithful.
There is a reason to make friends on the other side of the aisle. We may not all agree on everything, but a lot of us agree that something needs to change. Let's find that small voice of hope and use it to tie us together in common cause.
He called Mr. Obama a “person of substance” and the “first liberal evangelist in a long time.”Let's hope the trend of his support by the electorate follows from his past two bids:
0.3% in 2004
0.04% in 2008
I am pleased to report that I still feel uncomfortable in the setting of drug company schwag or it's provider. Sometimes I feel the same squeamishness I've felt witnessing (illegal) drug transfers. Is it a coincidence? In doctors' offices: Who's the pusher? Who's the dealer? And what does that make the patients? Are they stuck in a crossfire?
Here are a few personal vignettes about my encounters with (legal) drug dealers.
Before my clerkships, I often attended the University of Washington's Chairman's Rounds each Tuesday. That food was provided by a rotating ensemble of drug company reps. They asked for attendees to sign in, and would actively seek eye contact of the audience as we filed in. If I were dressed less formally (PhD casual), I would occasionally be interrogated about which department I was with. (My answer was always pathology.) Most times, I clipped on my medical school ID badge kept my eyes focused on the food or floor and walked past them without noting the company or drug. After all, I was there to keep up my clinical mind. I did take the food, however. Some other students and residents (but never faculty) brought or bought their own lunches...
My first rotation at Seattle's Children's Hospital was pharm-free. The free food at the daily noon conference was provided by the residency program rather than drug companies. Monday's World Wraps and Wednesday's fish burritos were my favorites. Then as an outpatient in the pediatrics clinic, I discovered that the patientmedicine samples were provided by Children's Hospital, not by drug reps. In fact, some of the residents placed the absence of "pharm food" as a positive attribute for that program.
The next stop on my magical medical mystery tour was a family practice office in Anacortes, WA. They had kicked the drug reps out years before in favor of samples provided by Group Health. The idea being that enough of the practice's patients are insured by Group Health that it will pay off to get docs in the practice of handing out and prescribing the generic meds on GH's formulary that it will benefit the insurer even if the docs give the samples to non-Group Health patients.
For the last 7 weeks, I've been in Spokane, WA for my medicine clerkship. The only evidence of pharmaceuticals at the hospital where I worked were in the ubiquitous pens and post-it notes on the floor. Not until my outpatient experience have I had direct contact with drug reps. In the endocrinology (diabetes, thyroid and hormone problems) and dermatology (rashes and acne) clinics, I've encountered piles of free handouts, cabinets full of samples, company provided patient handouts, occasional lunches and the well-dressed woman with a clipboard. "Who is this attractive lurking specter?" I wondered the first time in the endocrine clinic? She was just waiting patiently for the doc to sign a clipboard acknowledging receipt of the samples. She got in one sentence before my preceptor informed her that she had more patients to see.
I am being gradually exposed to the tight grip of pharmaceutical companies on medical practice. Fortunately, I am also experiencing some of the push-back that entities as different as private practice and world-class health care institutions are giving. Whether its the cold shoulder given by docs as they sign the receipt or the broad resistance of entire hospitals, there is certainly a tension that was not there 10 years ago. The consequences of doctors giving free samples of brand-name drugs is not always obvious to patients or doctors. But I'd like to think that the next generation of physicians is ready to approach health care in a less expensive, more sustainable manner.
We shall see.
Thursday, February 21, 2008
The president who came to office with the most glittering array of experiences had served 10 years in the House of Representatives, then became minister to Russia, then served 10 years in the Senate, then four years as secretary of state (during a war that enlarged the nation by 33 percent), then was minister to Britain. Then, in 1856, James Buchanan was elected president and in just one term secured a strong claim to being ranked as America's worst president. Abraham Lincoln, the inexperienced former one-term congressman, had an easy act to follow.And I was just rewarming to Hillary Clinton...
Wednesday, February 20, 2008
- No good camera
- No good telescope
- No tripod
Actually, I didn't need any of the above to get this image. Instead, I found a nice picture with the help of Mr. Google, then I rotated it in Photoshop to get to just the right angle, then voila! A striking representation of what I saw in the Spokane sky tonight. Well, except that the craters and plains on the moon's surface are in the wrong location...
Update! My former labmate from PhD land was interviewed on Seattle's King5 news about the eclipse. Watch the news segment here, and read about the Green Lake experience on her blog.
Tuesday, February 19, 2008
Monday, February 18, 2008
If you live in a different time zone, go to this page. 'Supposed to rain or snow in Spokane, so I'm not going to get my hopes up for seeing it this time. At least I witnessed the full lunar last August in Seattle.
Seeking scientists who can capture the attention and imagination of AP Biology students in east-central Wisconsin. Duties include posting one or more 500-1000 word entries to a weblog and participating in the online comments section. Candidates need not be local. Compensation in the form of warm fuzzies.
Sound interesting? Read this informational page. Cruise around the other entries and responses, too. But avoid this post.
Sunday, February 17, 2008
Look for more here soon.
Saturday, February 16, 2008
If you had to write your memoirs in 6 words, what would they be?This was based on a book called: Not Quite What I Was Planning: Six Word Memoirs by Writers Famous and Obscure, edited by Smith Magazine. Since I've been struggling to get my oral case presentations down to a concise 3 minute overview, this is a pertinent exercise for me. I started out with a list, but it sounded too much like a personal ad. I challenged myself too a sentence. My working six-word autobiography is:
What is your 6-word memoir?
Thursday, February 14, 2008
But lest you think me a total scrooge, I did purchase a couple of doses of phenylethylamine for my true love.
Tuesday, February 12, 2008
Monday, February 11, 2008
One way that hospitals are starting to address the challenge of caring for such diverse patients as car crash victims, IV drug users and uninsured folks with chronic disease is to stratify the care given after you walk through the door (or metal detector). For example, San Francisco General Hospital's free wound care clinic for IV drug users saves a lot of money by providing care there rather than in the expensive ER. By moving less urgent cases into a special care track, hospitals can save money and provide more appropriate care.
An article in today's NYTimes spins it a different way:
An increasing number are taking steps to bring civility and even hospitality to the emergency room, in part because, for all their turmoil, they remain vital points of entry for paying patients whose eventual admission accounts for needed revenue.So not only is the ER a place to provide health care, it is the point of entry for revenue producing units - I mean patients. So we better make them happy or they will take their care (and reimbursements) elsewhere! Unfortunately the article focuses on remodeling costs and a laundry list of NY City ER's that are under construction.
There is great potential for improving the frontline care for uninsured and underinsured ER users. Sure, customer service reps are nice, but I am guessing that patients really just need problem-focused care. (Score one for family medicine!) If I go into emergency medicine, I want to be part of creative solutions to sorting what is a mixing pot of symptoms, diseases and emergency that keeps medicine affordable, but send patients home less likely to return.
You don't know how catchy that sounds until you speak it aloud. Say it with me, "Science Debate 2008." Now with syncopation. Now in a group with your friends. There we go - that should be enough to convince you. If not, continue reading.
A couple of units of time ago (I'd put my money on months), I signed up to support Science Debate 2008. I have to be honest, though: I wasn't entirely sure what I was supporting. In principle, the idea is easy: collect the remaining standing presidential candidates to answer questions about science, health and the environment. Among my many questions about this concept were: Would candidates for president actually all come together to debate science? How would you involve Democrats and Republicans before the nominations were set? Would people care?
I underestimated the mobilizing power of Chris Mooney and Sheril Kirshenbaum of The Intersection. They have collected a wide range of Nobel Laureates, university presidents, politicians, science bloggers and regular Joes to endorse the idea. And now with the help of the AAAS, the National Academies and other major institutions of science, a date has been selected and the four remaining candidates have been invited Philadelphia's Franklin Institute to talk about science.
How appropriate! In the tradition of Franklin's Junto, these four leaders will come together to debate questions of morals, politics, and natural philosophy. Yes, I too can dream.
Is your name among the list of supporters? It isn't? Head to this site to sign up. Don't think it matters? You're wrong! There are currently 13,000 signed on to this idea. The networks and media folks need to see an interest among the people to make coverage effective. That's you! They're current goal is 20,000. If you want to do more, contact the campaigns or write letters to your newspaper. If you wish to consider this more carefully, head over to Nature magazine's story about Science Debate 2008. They remain skeptical of the idea, but I believe their criticisms are mostly hollow.
This debate could have an impact on Pennsylvania's primary or could be one of the first formal interactions between the presumed nominees from each party. Either way, I think Ben Franklin would be proud.
Sunday, February 10, 2008
The reason I decided to make a post is an observation from Saturday's caucuses. About 160 folks from my precinct showed up. 5 delegates went to Obama & 3 to Clinton. The strange thing about the speeches people gave was that several individuals decided to vote for Clinton because the media had wronged the Clinton family, made fun of Chelsea, or otherwise unfairly represented Hillary. Few people actually detailed the candidates' positions. The most interesting speech was by a man my age who had lived in Obama's state legislative district in Chicago before moving to Seattle.
I've procrastinated enough. Back to the grind.
Wednesday, February 06, 2008
- I'm a doctor.
- I invented an artificial heart.
- I take Lipitor.
- I feel great.
- You should take Lipitor.
- You'll feel great.
- You'll be a doctor.
- You'll invent an artificial heart.
Okay, maybe not that last one.
It turns out that some other people think the Jarvik Lipitor relationship is fishy. There's a big splash in the NYTimes today about how Jarvik misrepresents his physical activity level in the commercial where he is rowing in a scull across Washington State's Lake Crescent.
Someone did dome pretty good digging on this one.
Check it out over at The Differential. Then tell me what you think. Really. I have thick skin.
My last post about how to vote in Washington State was convoluted and heavy on personal commentary. Here is a simple explanation, with appropriate links.
Are you a Republican? If so, half of the delegates will be determined by a primary election, and half will be decided in the caucus this Saturday. Go to the state party webpage. That site will connect you with each county's party, but you will need to figure out your precinct in advance. If you are in King County, use this tool.
Are you a Democrat? All of the elected delegates are decided this Saturday at the caucus. You might as well tear up your absentee ballot. Democrats in Washington have never used a primary to decide a presidential candidate; hey probably never will. To find your caucus location, go to the state party caucus finder. You only need a name and a zip code, and that server will tell you where to go for the caucus and will remind you of your precinct number.
What's my precinct number? Good question. If you know your precinct number when you get to the caucus, it will save you from waiting in a long line. Most counties have web lookup tools like this one for Martin Luther King County.
Haven't registered to vote? It's too late for you to vote in the primary/caucus, but it's never to early to register for the vote that counts the most. In the state of Washington, you can register online.
Want to know your voting history and information about where to vote? Go to the Washington Voter's Vault. There you can be reminded of which elections you have participated in back to 2004. Which is pretty cool.
Want to Reed more about the primary and caucus system in Washington state? Check out this useful FAQ sheet prepared by the Secretary of State.
Were you thinking of trying to spoil the other party's election by crossing over between the caucus and the primary? Think again! From the FAQ sheet:
Voters can participate in both the party caucuses and the Presidential Primary as long as they participate on behalf of the same party.Is there anything else you need to know? Well, you should probably have a good idea of who to vote for pretty soon. If you haven't made up your mind, Clinton (Pier 30 warehouse Thursday), Obama (Key Arena Friday) and McCain (Before the 2/19 primary) will all be visiting the state in the coming days. Michelle Obama will visit Spokane and Janet Huckabee will be in the state for two nights. Ron Paul may also be making another stop. (He's been in WA quite a bit already.) Look for them! This Seattle P-I article has the most current details so far.
Both major parties plan to hold their caucuses on Saturday, February 9, 2008, ten days before the primary. The parties will invite voters to participate in the caucuses and will require participants to sign an oath declaring their party affiliation.
Voters participating in the Presidential Primary will be asked to sign an oath submitted by the political parties indicating that the voter has not participated in the other party’s caucus process. Each party will receive a list of voters who chose to affiliate with that party in the primary.
This post may not have been any shorter than my last one. Hopefully it is more informative.
Tuesday, February 05, 2008
It is strange for me, but a lot of my decision here originates in my gut. I like Obama's approach better. I'd rather have a chat with him than Hillary (though both are in my current top ten!)
Am I glad I did this live blogging thing? Yes. I prefer knowing that I spent 5 hours watching politics than a football game. I did miss out on some quality time for studying topics like HIV disease, and I could have been touching up some comments for reviewers on that paper. But I made this choice. And I don't regret it. It will, however be a while before I live blog. And next time, perhaps I'll just re-edit the same post so that I don't back up my (5) loyal readers' site feeders!
And if for some reason, you missed it live and want to experience my unique perspectives on each state as various major media outlets called them, click here and scroll to the bottom of the page to read my reviews as the polls closed.
Cali has lots of memories now that my folks moved there. Favorite science memories include trips to the Monterrey Bay Aquarium and my very first scientific conference: the American Society for Artificial Internal Organs in San Diego circa 1999.
Coolest part about AK for me involve watching the marine mammals from the deck of the Alaska Marine Highway System ferry on a poor man's cruise between Juneau, AK and Bellingham, WA. If you stay tuned, you'll start hearing tales from a Fairbanks delivery room come this May.
Oh yeah. Arizona. Clinton won. McCain won.
It hardly matters that Obama is projected to win here, what with 6% of the electorate registered as Democrats... At this point, it looks like Clinton has been successful in the states that matter most. At 9:00 PM tonight, I can safely say that my vote in Washington will matter (should I be able to get back over the passes this weekend.)
I can hit the visit and the science in one swoop: I presented my research at a Keystone Symposium on tissue engineering and developmental biology at the Snowbird ski resort last March.
I highly recommend floating the wild and scenic upper Missouri River on a canoe if you ever have a chance. It is largely as Lewis and Clark saw it 200 years ago. Email me if you want some tips or suggestions about this gem of a trip.
This topographical map clearlyshows that Kansas is not flat. I believe this is your best bet for amber waves of grain, too... Or is that Nebraska? South Dakota? Hmmm...
Thanks no doubt to the work put forth by Tangled Up in Blue Guy at his caucus, Obama has taken the Land of 10,000 Lakes. Looks like Romney's got the red part of the state, which is surprising to me given Minnesota's tendency to elect independents. If you have been to this particular lake, you should immediately recognize its significance. A couple of posts ago, I mentioned I drove through North Dakota en route to Seattle. This is why.
Update 9:15 PST: Obama has pulled ahead by a hair in MO.
Clinton and McCain nab the Garden State according to everyone except the NYTimes.
This live blogging business is hard. Must stay focused. Maybe I'll try a checklist.
My time in Massachusetts: Staying in the Boston youth hostel to visit my sister at Northeastern.
Science in Massachusetts: Ripping my pants at the Whitehead Institute when I toured MIT as a prospective undergraduate.
Hmmm... I'll strike the checklist. How many states do I have left? 15!!!?!?!?!!! Yikes!
Oh Yeah, Fox seems to think Clinton won TN.
Of course, this one went to Obama. I wonder what the margin will be.
My most fond memory from West Virginia is a backpacking trip in the Otter Creek Wilderness with Peter Cheeze and my friend Damion. It rained the whole time. We jumped into streams to clean off the mud. The sky always seemed to brighten, only to pour harder. The trip ended with several hours at a business called Leisure Laundry in back woods WV. Later in that trip, we saw Damion's brother perform in a State Park production of The Hatfields & McCoys. Fun Times!
Image from CNN.
For those of you who run a feeder with my blog, I am sorry to clog it up today.
A Long Term Study Of The Forces Of Nature On Assorted Fruits From The Western United States"
Wood, Glass, Found Berries
January 8, 2008 - February 5, 2008
But that's all history. Today we face something bigger, something monumental, something so important that I am forced to turn to rotten fruit for guidance.
Let's start by taking account of the facts. The red rose hips are moldy. They have been consumed with different species. A mild filamentous growth is competing with a blue-green bread mold. That's right, red is being consumed by blue. More on that later. The most striking finding is that the snowberries have been consumed by a monoculture pearly filamentous species. The white rose hips are untouched. The small false grape have developed a dusting of white at the bottom inch or so of that sample. Surprisingly, the blue marbles' plaque-like mold has receded from the two fruits closest to the cork.
Here's what I draw from these findings:
- The Republicans (red rose hips) are spoiled. While not yet rotten, if one were to venture too close, a foul odor would certainly be detected.
- Red voters are thinking of crossing over to vote for blue candidates (blue mold).
- What once was portrayed as a leader/follower race on the blue side is now more balanced. One candidate has backed off on the degradation, while the other has wavered from the 'fresh' category to something better described as 'stale.'
- Whatever snowberries (third from left) represent is doomed. Maybe the middle road is still treacherous in American politics?
Monday, February 04, 2008
If you are a scientist who wants to make a difference in Washington, you can do more than vote. You can lobby! The best part is that you can get a travel scholarship to do it. I flew to D.C. last year and met with the staffs from three of my elected officials, as well as several others. The Coalition for Life Sciences sponsors three Hill Days each year. You go to D.C., get trained about how to lobby for science, and then go home enlightened/jaded/cynical about the legislative process. Sound interesting? Check out this information. The Hill Days they have scheduled are March 12, 2008, May 7, 2008 and July 9, 2008. The deadline for applications for March is February 13. By the way, this group used to be call the Joint Steering Committee for Public Policy, but who knew that had anything to do with science? I'm glad they changed their name.
I went last year the weekend after I defended. It was the first time someone (other than my family) addressed me as "Dr. Robey." If you want to read about some of my experiences, I wrote a few posts last fall about my time. Otherwise, drop me an email, and I could answer specific questions you have about it.
And don't forget to check back in tomorrow to see the ultimate in elections predictions. I've been tracking the early returns, and I think there could be a spoiler!
Sunday, February 03, 2008
What was it?
Shoot, I'm getting forgetful in my old age.
I'm sure it varies by market, but that this spot costs about $250,000 dollars in Boston. Now we know where that $32 million raised in January is going. Might it have been cheaper to buy a national spot?
I still haven't decided, but things keep pointing in the direction of Obama for me... I'm going to review the two remaining Dems' positions on health care again before I make a decision.
What am I doing with my time not spent in front of the TV?
- During the daylight, I'll be sledding.
- At night, I'll be working on manuscript revisions.
Hat tip to The Caucus blog, who by the way, misuses an apostrophe in the second paragraph of the post. It's not like I never misuse punctuation, but doesn't the NYTimes need to be held to a higher standard?
*I'm actually not sure this is true, but it sounds true. Can anyone out there help me fact check?
Saturday, February 02, 2008
1) How many of those bacteria cause disease?
2) How many of them do you not have in your mouth already?
3) What's the equivalent transfer from multiple hands going into the same snack bag?
Frankly, I'd rather get someone else's mouth bacteria than their hand bacteria. Because you know what hand bacteria is the same as? That's right, folks: butt bacteria. And butt bacteria can cause real problems.
And there's one more thing. If you really want to stay healthy during the Super Bowl, don't bother with safe dipping. In this case, I advocate dip abstinence. What's in those dips? Mayo, cheese, sour cream, butter; this equals fat, fat, fat, salt salt salt. And that's before we consider the chip... Now I don't have any evidence behind this, but my hunch is that this stuff will kill you faster than the bacteria you'll pick up this afternoon.
Just say no to dips and chips. You'll avoid anxiety over bugs, and your waist will thank you.
Friday, February 01, 2008
These are the small joys of being a third year medical student.
It's nice to be home. Kindof. We've transformed this very brown apartment that the University of Washington provides for us into a semblance of home. Cut apart calenders adorn the walls, her orchids contrast with the snow outside, and my art projects sit around screaming out for explanation.
Today was our last day of inpatient call in Spokane, WA. Eight more weeks of medicine to go, but more on that later.
Today offered nice closure for me. At 1:00 I was invited to do a knee arthrocentesis. (At 12:45, I watched a video about how to do it.) After one unsuccessful poke (not deep enough), the syringe started to fill with a slightly cloudy yellow fluid. I pulled 20 cc out, disconnected the needle and proceeded to extract another 25 cc to reduce the joint space pressure and provide symptomatic relief. We then sent three vials to the lab for cell counts, Gram stains and chemistry.
A successful procedure.
But wait! There's more!
My senior resident had arranged for a rheumatologist to look at the sample. We were thinking septic arthritis (arthritis caused by infection), but had a suspicion that something else was going on. The patient didn't have a fever, both knees hurt and both wrists hurt; this is all a little strange for an infectious cause.
The thing is, the rheumatologist happened to be across town. Guess who filled the role of messenger. I've written about how medical students don't do a lot that is not duplicated. How could I forget about the vital role of urgently transporting samples? I was surprised about how important I felt walking around with a biohazard transport container. (Thinking in my head the irony of the statement, "Get this to rheumatology, STAT!")
When I found the office where the sample was to be read, it turns out that the doc was really busy and someone had totally botched up his microscope. He was having a dandy of a time getting the sample in focus. Isn't it convenient that I spent four years in a pathology research lab hunched over scopes? When I had finished preparing the wet mount, I called him over to look at something like this:
I've said it before, and while it may come off as a little pretentious, I kindof like the sound of:
What's your diagnosis, doctor?
After leaving the scope much better than I found it, I headed back to the hospital, where we promptly started dexamethasone therapy and discontinued the vancomycin he was on (His ears had started to ring).
My adventures concluded by visiting the patient to update him about what we found and how we changed his medicines. I left his room at 3:45.
This is medicine: suspicion, diagnostic procedure, microscopic laboratory examination, diagnosis, therapy decision. Hopefully the result is a patient free of pain and home for the Super Bowl.
You better believe I'll think twice before telling someone "I'm waiting for a lab result" again.
This patient agreed to my writing about him on the internet. ("After all, it's not like you're sticking me with a big needle," he said.) Also, my wife attests to the accuracy of my portrayal of our evening .