In more recent news...

My parents came to visit me last week - I don't think I've been so excited to see them EVER!  I was like a small child the day before my birthday on the day I was due to go to the airport and pick them up.  Like me, I don't think they were expecting much from Utah, what with it being soooooo high on everyone's list of places-to-see-before-you-die!  By the time they were going, I think they'd been won over by the sheer beauty of the state - even if there is some deep oddness that goes with it.  (Is there a Nobel prize equivalent for understatement?  I think I deserve one!)

They arrived on Tuesday night and on Wednesday, I met them for lunch and then we went for a wander around Temple Square (because you have to, right?  It would be like not going to Agia Sofia or the Blue Mosque when you go to Istanbul/Constantinople, or skipping the Acropolis in Athens) and a tour of the Beehive House.  That was hilarious!  Two lovely girls trying to put the hard-sell on me, my dad, and some other guy who was doing the tour: "What religion were you brought up?"  My ingrained Catholic guilt made me reply "Catholic, sorry", when I've been practicing for months that the next time I get asked that question, I'll answer "I'm a Pastafarian, but my husband and kids are Jedi".  Bah!  Now I'll have to go back so that I can have my ésprit d'éscalier moment.  Goddammit!

Tabernacle - Organ Recital

Thursday, I met the folks at the Tabernacle for an Organ Recital.  That was impressive.  The acoustics in there are incredible.

Dad wanted to get a nice jacket, or rather, Mam wanted Dad to get a nice jacket, so I suggested a suit shop that I've passed on the bus every morning for the past six months, not realising it was a Mormon clothes shop.  Seriously!

Click for larger view and see just what
a missionary can get for under $700!

That evening, we went to watch the Tabernacle Choir rehearsing.  They were in the Conference Centre for that and while the acoustics weren't as good as in the Tabernacle, it was still an amazing spectacle.  I tried to upload a short video here, but the technology gods are not on my side unfortunately.

Friday morning, we hit the road and headed south to Moab.  Dad and I hiked around Arches National Park, and this time, I got to do the Park Avenue trail and actually climbed up to Delicate Arch: it was so worth it!  We had dinner in Moab, before heading 50 miles further south to our (dingy) motel in Monticello.

Park Avenue trail

Me at Delicate Arch

Next morning, an early rise, and back up to Moab where I ran the Canyonlands half-marathon in 2:04, a personal best, thank you very much!

At the starting line

At the finishing line
(I'm going by my chip time... I started WAY back!)

That afternoon, I took the folks to Dead Horse Point and Dad and I took the trail across the headland to the Point, while Mam met us there with the car.  Thank Jeebus that she did, because by that stage, I don't think I had the energy left to trek the mile and a half back to the Visitor Centre!

Mam & Dad at Dead Horse Point

We stayed in Moab that night and on Sunday went back south to the Needles District of Canyonlands National Park, stopping off at Newspaper Rock on the way.

Newspaper Rock
Needles District, Canyonlands 

I hadn't been to either of these before and they were really impressive.  We couldn't go up to the actual Needles, because that would have been a full day's hike and we weren't really in that sort of mood.  Also, my legs were still a bit stiff from the day before, but we did several of the shorter trails (between half a mile and 3 miles each) and had some amazing views of the Needles in the distance.

Needles District, Canyonlands

Needles District, Canyonlands

Wooden Shoe Bridge
Needles District, Canyonlands

Back to Moab that evening and on Monday morning, we set off for the Island in the Sky in the northern end of the Canyonlands National Park.  Visibility was very poor this day, with high winds and sand blowing up to obscure much of the view, but it was pretty incredible all the same.  I'll just have to make sure to bring my Jedi family back here when they arrive in 3 weeks (EXCITED!!!).

Grand View
Island in the Sky, Canyonlands

Green River
Island in the Sky, Canyonlands

Mesa Arch
Island in the Sky, Canyonlands

View through Mesa Arch
Island in the Sky, Canyonlands

Schaffer Canyon Trail (yes, that is a road!)
Island in the Sky, Canyonlands

We drove back to Salt Lake City that evening, via Highway 128, which runs along the Colorado River and is the route of both half-marathons that I've run in Utah.  It was lovely to drive up there safe in the knowledge that I wasn't about to get thrown out of a bus and made to run back to town!  

Highway 128

Highway 128

I took a sneaky day off work on Tuesday and chilled out with the folks, cooking a big ol' dinner and my roommate Linh, her fiancé Pete, and my friend Sarah came over to meet my parents and eat and drink and generally be merry.  Mam and Dad dropped me to work on Wednesday morning on their way to the airport and I'm still here, while they're off having fun in Richmond, Virginia now.  Lucky ducks.

L'esprit de l'escalier

Actually, I don't think I disgraced myself too badly, but reading back over the transcription of today's disagreement with a professor from an ivy league school, I feel like there were some points that I should have elucidated more clearly, if only I'd known I'd want to raise them... I'm going to repeat most of the exchange here verbatim, but I reserve the right to edit minimally (i.e. no ums, ahs, or repeated you knows - his, not mine!, and no-one but me will be identified).  This took place about two and a half hours into a four hour session on 'Cost Effectiveness and Decision Analysis', so it will also give you a flavour of the hell I have been enduring for the past three weeks of sitting in on similar lectures and being told the same sort of thing.  It's a wonder I haven't broken before now!

Me: Can I ask, do you see these decision trees as being some sort of post hoc rationalisation, or would...

Him: Oh God, no! Heavens, no! No.

Me: So, you would expect somebody to sit down and...

Him: Yes

Me: ... work out all these sums...

Him: Yes

Me: ... and not be able to intuitively make a judgement on all these factors?

Him: Well, on every patient, one at a time? No.  Although there are people [that have] this notion that there will be a day, there might be a day when just as you can go to your electronic health record and get information about patients like this, you can tap into a program that will use a pre-constructed decision tree and give you a result, not that that's what you have to do, but it will give you the information in real-time.

Me: OK.  But, so what is the value then of having a profession that have learnt a practice, rather than going to a computer and putting in your own symptoms and then having a print-out saying 'this is the test you should take' or 'this is the treatment you should have'?

Him: [...] you know the mechanisms.  Why do certain tests work?  What do they do?  What are they measuring?  What's the '-iology'?  What's going on at a cellular level?  You want to know what's going on inside that black box, it's important.  That's one answer.  Another answer is that, and I said this earlier but I'm gonna say it again, the main advantage of doing decision analysis is not to get the number.  The main advantage is to sharpen your thinking.  So, yes...

Me: OK, but there's other ways to sharpen your thinking than being entirely 'systematic' and positivistic about your approach to problem solving, I would have thought.

Him: Say that again?

Me: There's other ways to sharpen your thinking and consider alternative options than taking one particular track.

Him: Well, I mean, if you want to think systematically and clearly about the circumstances under which getting the test, ordering the test is a good thing to do...

Me: But, systematic thinking does not necessarily mean that you have to be probabilistic in your approach.

Him: I suppose not, but it's one way to be systematic...

Me: So, it's one alternative.

Him: You could make decisions based on other criteria than expected outcomes, but eh, this is one way of doing it...

This brought the group off on a bit of a discussion for a few minutes, but about five minutes later, he starts lecturing again and pointedly comes back to me.  I apologise in advance for what you're about to have to skim over, but I had to listen to it several times (once live and then a few times for transcribing) and I have no sympathy for you and make no apologies for what I am about to subject you to, even if it is a bit like water boarding...

Him: (to me) But I think your question was 'why do you need to know what goes on inside the black box?', and the answer is probably, maybe you don't.  But, you know, it's usually a good idea to have some vague idea if you order a test why you're ordering that test, what a positive result means [...] I don't expect you to go home and do this; I expect you to be able to use the software and have an increased appreciation of what the software is doing, which may make you a more informed user of the software [...] If you just pick up the software package and plug in numbers, you might not know what some of those options mean.  You know, these days,  people buy software and they don't know what half the options do.  They might tinker with it but I'm trying to give you a sense of what you can do with the software.  There's a whole branch, sort of an extension, of decision analysis that I didn't get into called Markoff models, which are sort of decision trees that sort of recycle themselves.  That, you sort of have an event and then you go on, you make another decision and then you have another possibility of an event and things go on and on and on.  m.  There are other extensions that involve simulating individual patients, simulating the probability, basically rolling dice for each patient in a thousand patients to get a sense of what would happen in a thousand patients when you're developing strategies, em.  These are things that the software can do and you don't really need to know how it does it, you just need to know that it can do it and rolls up those kinds of analyses

Me: But then there's a whole other bunch of black boxing going on there about how the software is written and developed and how that program, what biases are built into the program.  So, there's black boxing no matter what you're doing...

Him: I don't want to be critical of your point, but there are people who do statistics and don't know what the hell they're doing...

I'll leave it at that.  As I re-wrote this, you have no idea how much I wish I could annotate and comment on several different things within his (interrupted) monologue.  I'll make do with a comment on how this ended.  He 'didn't want to be critical' of my point, the dirty liar!  He not only completely dodged a valid criticism (open the black box on medical decision making by piling it all into a black box of software-driven analysis tools?) by refusing to engage with the question, instead going off on a rant about how people misuse statistics (using a t-test when they should've used a chi-squared test, fr'instance) to redirect (misdirect?) attention from the point I raised.  If I were a stronger person, maybe I'd have pursued it, USPOS-style, but I felt that I had taken my share of class time and I was not feeling a ground-swell of support.  Tough room.

I did at least feel like I had stood my ground, somewhat admirably.  Next time, I won't be so nervous and the arguments will be better honed from the experience of sharpening them against such opposition.  There will be a next time.