I’m pretty excited by this one. Details to follow, but I improvised something I liked a few weeks ago in Palo Alto and started to mold it into an actual composition earlier this week when I was back out West. I also picked up Reason 7.0.1 and when the work is completed sometime next month, hope to record it in Reason rather than Finale. The piano sound in Finale is good enough, but has some harmonics that are readily apparent and often distracting. I originally improvised this piece in Reason 4.0.1 and the piano sounded very nice. Unfortunately, Reason 4.0.1, I came to find, was incompatible with the new version of OS X I’m testing so I had to upgrade. Which is all fine.
Recent Updates Page 2 Toggle Comment Threads | Keyboard Shortcuts
I had had some ideas about writing a choral piece, but as I improvised something in a hotel room across from Stanford in Palo Alto, CA, it became clear that this would not be well-suited for anything but piano. So this work completely came into being from a 31-minute improvisation that was reworked into a solo piano piece lasting 45-50 minutes.
The piece is largely based on two notes (d-f) as well as a two-chord sequence that I came up with while visiting the NAMM museum in Carlsbad, CA on vacation and playing one of their synthesizers. I wasn’t sure what to call the piece and gave it the provisional title tbd as a placeholder, but the name stuck.
Between 1996 and 1997, I composed a long work for brass sextet called brass piece for arielle victoria. I was pretty fond of it, but wrote it with the idea that, because so much of it required fairly continuous playing, the performers would have to be adept at circular breathing. At the time, I didn’t think it was a big deal, but it turns out that it was, and I’ve since come to realize that there was very little chance that it would ever be heard other than in a suboptimal MIDI performance with sampled instruments. And that’s where things have stood since 1997, except for the last section that was arranged for string quartet and can be heard in an excellent performance by the Rangzen Quartet.
I had long toyed with the idea of scoring the entire piece for strings to circumvent the performance challenges, and this has now resulted in this arrangement for string quartet and contrabass. Other than some minor tweaks in a few sections, it is identical to the original brass work, but should pose no significant challenges in terms of performance. The audio file is not idea, of course, since strings are harder to convincingly sample compared with piano and a few other instruments, but overall it works
At least the Chicago Tribune didn’t mention that gynecologist by the same name (see question #5)40.088156 -75.141043
The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.
Here’s an excerpt:
600 people reached the top of Mt. Everest in 2012. This blog got about 4,600 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 8 years to get that many views.
In late November, I had some time to improvise and managed to come up with the raw elements for two different pieces. One of these turned into two voices. The other improvisation was slow and quiet, basically just half notes followed by an eighth note rest. This was restructured into a new piece called for four. There are a maximum of four voices at any given time, so it could be performed by four instruments (eg, two violins and two celli) or for piano. The score includes a piano reduction along with the same notes displayed on four individual staves. It’s ppp throughout, and the tempo can be a low of quarter = 20 to a max of quarter = 40. Thus, depending on the tempo chosen, the piece can take as little as 23 minutes or up to 46 minutes to play.
By coincidence, the composition of the work overlapped with the horrific deaths of children and adults at an elementary school in Newtown, CT. I mention this, because it struck me that the slow final section of the piece flutes and trombone was composed around the same time as a similarly terrible gun-related massacre in Aurora, CO.
for four was originally improvised in Palo Alto, CA in late November, 2012 and restructured into a composition in Wyncote, PA and Palo Alto between 12/13 and 12/18/12.
I will release it soon, but last night I finished (I think) a work called two voices, for keyboard or any two instruments. It started as an experiment I was playing with three nights ago, in which one voice plays all the black keys and the other plays all the white keys. There are five black keys and seven white keys, so one has all 12 tones to play with. I wanted to see, just out of curiosity, if I could take some very banal themes and make them at least somewhat interesting. I was also curious how long this nonsense could go on.
I imposed another constraint: each measure had to have each voice play all of its assigned notes. And no chords.
If you haven’t figured out by now, I was really unsure of this approach, since it doesn’t seem entirely conducive to improvisation, which is how I generally compose and thus manage to avoid systems and processes, which are the bane of folks like me who hate academic and mechanical methods to write music. Surprisingly, one can actually manage to improvise within these constraints, and even make what I think is a pretty good piece of music.
To balance all these formal requirements, I wanted to provide a lot of choice for the performer, so that each performance would be unique. There are no dynamics, nor is there any tempo indicated. Each measure gets repeated a minimum of eight times, so that if one really likes a particular measure, knock yourself out and repeat it even more times.
There are a few measures in which both instruments (or hands on the keyboard) are in different tempi, since the upper voice is playing five notes in the same time as the lower voice plays seven. Otherwise, it’s pretty straightforward.37.612952 -122.383920
I’ve been using my wife’s former iPad (first generation) for many months now, in addition to my iPhone 4S. The iPhone has a retina display and is pretty fast, with an A5 processor, so it is still very useful and I have not jumped on the iPhone 5. Which is good, since I don’t have a lot of disposable income and am not sure I want to get sucked into another two-year contract with AT&T, given its disdain for its customers (eg: charging for using the iPhone as a hotspot).
The original iPad: not very fast and the display is often very pixellated, especially if dealing with iPhone apps that have not been redesigned with the iPad’s display specs in mind. But it’s been usable, even as a laptop replacement for short trips to the EU. Still, watching apps like FaceBook take 30 seconds or more to load, and having each tab in Safari load content when selected due to a lack of RAM, makes it clear that the iPad’s limitations are a daily reality. For reading Kindle books and watching videos, it’s great. For most other things, it is often slow. And forget even thinking of running iOS 6, since it isn’t supported on that iPad.
So I have been very interested in the (then-rumored) iPad Mini for some time, since while smaller, it would run iOS 6, be less expensive than a 9.7″ iPad, be more portable, and would have to be much faster than the original iPad. When it was announced earlier this week, I was very keen on preordering the 32 GB model with cellular coverage (Verizon) tomorrow on the 26th. It’s light, has the same A5 processor as my iPhone 4S, the smaller non-retina display screen would probably be good enough (it has a bit higher pixel density than the same display on the iPad 2), and typing probably would be reasonable, at least with thumbs.
But then I started comparing prices with the iPad 4. Yes, the iPad 4 is more expensive, but there is some overlap with iPad Mini prices. At first, I was pleased to realize I could get a 32 GB Mini with 4G for a bit less than an iPad 4 without 4G ($559 vs $599). While I don’t use my 3G very much on my current iPad, since I’m usually within range of WiFi or else am in Europe where I have a data plan for my iPhone and don’t need a redundant one for my iPad, I could see scenarios where having 4G would be useful, especially if it were a Verizon iPad Mini and I set it up as a hotspot for my MacBook Pro on a train without WiFi.
And then I started realizing that while the iPad Mini isn’t a smaller iPad or a larger iPad Touch, other than the form factor and the addition of 4G, it is basically a larger iPhone 4S, the same iPhone I bought over a year ago. And that’s where it starts to fall down. Yes, the iPad Mini has more robust WiFi (it can connect to a 5 GHz WiFi network whereas my iPhone 4S can’t), but for common use, that is not going to be a deal-breaker. But at $559 for innards that are largely last year’s iPhone, I’d rather spend the extra $170 and get an iPad 4 (32 GB, 4G) with a retina display, a very fast processor (faster than the iPhone 5), and a larger screen that is more usable when I want the iPad to serve as a laptop replacement. And more and more, it will serve as a standalone computer, not just as a content reader.
I know the iPad Mini is more portable and would probably make something like Modern Combat 2’s multiplayer mode usable on a device larger than my iPhone (it is not very usable on the full-sized iPad, at least for my hands). But I was really hoping it would have been priced around $250 to start. This time next year (or earlier), when Apple comes out with an iPad Mini that has a retina display and a faster processor, I’ll be stuck with a $559 device that might not hold its own with more recent apps that require higher CPU capabilities. If a 2-year-old+ iPad is now so obsolete as to not even load the latest version of iOS, what will happen to the iPad Mini when it is one or two years down the line?
If I’m going to spend over $500 for a tablet, I’d rather it not have a CPU that is the same as the phone I bought a year ago and a worse display to boot. As an investment that I’d want to use for 2-3 years, I’m not seeing the iPad Mini as a smart purchase, at least for my needs. For an entry level device, it is a beautiful thing from what I’ve seen on the Web, and wil serve a lot of people very well as an e-book reader and as a way to watch videos. But for gradually serving as a device that is easier to write with on a regular basis, this is not that device. Had it been either less expensive or had a more compelling processor (such as an A6) and a better display, that would be a very different value equation. But consider the iPhone: while it is very usable and preferable to maintain an iPhone for two years, we’re also talking about a device that is also generally under $300 for most folks (even under $200). For nearly double that cost, I’d want something that I know will not feel very underpowered in a year. And the iPad Mini is somewhat underpowered for 2012. When an iPod Touch has a retina display but Apple’s new small tablet computer doesn’t, that just seems odd.
So in the end, I’m likely going to grab the iPad 4 tomorrow as a preorder. If someone thinks I’m misjudging the iPad Mini, please let me know in the comments. I’m not saying the iPad Mini is a bad thing; it’s not. If it were, this would not be a tough decision. But for my needs, I’m not sure at that price point it makes much sense to not spend a bit more on a comparable iPad with better overall specs.
I had an idea for writing a work for two flutes and a bass trombone. By splitting the notes between the two flautists, I could write continuous lines without requiring circular breathing and also write chordal music that would not be possible for one flute and a brass instrument, in the absence of multiphonics. And let’s face it, multiphonics are pretty harsh in terms of their sound quality.
This work could also be done by two identical treble instruments and a bass instrument. It is important that the two higher-pitched instruments be identical, but there is no reason this could not be accomplished by two violins or two oboes and a tuba, for example.
The last several minutes are very quiet, and largely consist of chords followed by silence, not too unlike the earlier work hevron-deir yassin.
The score is here.
Audio file (mp3) is here.
I’ve been living in the Cheltenham area for several years now, and my family has used Abington Memorial Hospital’s services as needed. I’ve known the ob/gyn chair, Dr. Joel Polin, for many years professionally, and also know that he is as supportive of abortion access as I am. Not many abortions take place annually at Abington; somewhere between 50-100/year overall. But if many are like the procedures I once performed at an inner-city hospital in Philadelphia, these are not cases that could be done at a freestanding clinic such as Planned Parenthood or Philadelphia Women’s Center. Access to abortion within teaching hospitals is important, both for the patients and for the next generation of abortion providers (ie, the residents). Hospitals are much less of a target for anti-choice protesters, and it is also easier to manage the occasional complication (abortion is a very safe procedure, but complications minor and major can happen). A few years ago, I counter-protested against some anti-choice folks at Abington, and I know that the hospital had stood up for reproductive rights and maintained their abortion services in the face of some opposition.
That may change. In a very surprising move, the Board of Directors of Abington Memorial Hospital has moved forward with a Letter of Intent to merge with the local Holy Redeemer Hospital, a Catholic hospital located not far away in the Meadowbrook section. As a result, even though Abington is the stronger party financially, abortions, selective reductions and physician-assisted suicide cannot be performed at Abington under the merger.
Now, physician-assisted suicide is not permitted in the Commonwealth of PA, so that is a nonissue. But abortion and selective reduction will be forbidden at Abington, as they would be at any Catholic sectarian entity. Under agreement, contraceptive and sterilization access will be maintained at Abington.
Some might say that this is really not too bad. Unlike what happens at Catholic institutions, women will still be able to get their contraceptives, and men and women can also undergo sterilization. There will still be IVF services and other assisted reproduction at Abington (just as Holy Redeemer has reproductive endocrinology services that involve assisted reproduction). Not many women locally undergo abortion, selective reduction is probably very uncommon even with all the IVF and ovulation induction going on, and this isn’t Mississippi. There are abortion providers in the Philadelphia area, including a hospital-based service at nearby Albert Einstein Medical Center (disclaimer: I have an adjunct faculty appointment at Einstein, but have no financial or other interest in that institution).
But this is not a minor issue; this is a problem of nuclear proportions. And it’s not just about abortion, but affects women who have very desired pregnancies. Here are some questions and issues that help demonstrate why this is a big deal:
• Selective reduction (which is not always thought of in the same context as abortion, as the intent is to sacrifice one or more multiple fetuses to save the remaining); for those women with triplets, quadruplets and higher-order multiple pregnancies, they will either have to undergo reduction in Philadelphia or else take their chances with the outcome
• Preterm premature rupture of membranes (PPROM); will Abington physicians be permitted to induce labor in that situation or would they have to wait for intrauterine infection to evolve into sepsis? This is not a theoretical situation; this exact scenario played out with our former Senator’s wife (Karen Santorum). In that case, she made her own personal choice to delay labor induction. While it is not what I would recommend, I respect her choice as a patient. But that was her own choice, not one imposed upon her by a Catholic hospital.
• If there is nonreassuring fetal monitoring at < 26 weeks’ gestation, will women be given a choice of labor induction vs. stat classical Cesarean section (mandating future C/S)?
• Management of second-trimester inevitable miscarriage (eg, 18-22 weeks); will physicians be required to take unusual and medically futile measures?
• Provision of emergency contraception (EC); regardless of what the current plan and/or potential contract agreement is between the two hospitals, EC is (wrongly) considered to be an abortifacient by the Church and proscribed as much as surgical or medical abortion. So, if a victim of a sexual assault presents at Abington’s Emergency Ward (EW), will she be offered EC? At a significant number of sectarian and nonsectarian hospitals throughout Pennsylvania, EC is not offered to victims of sexual assault, so this is not a theoretical construct.
• Management of anencephalic and other lethal malformations detected with sonography or with other prenatal testing prior to, or past, the 24-week viability standard; based on Catholic teachings, abortion would not be available even in the presence of lethal anomalies
• Perinatal testing for pregnancies that are likely nonviable or severely compromised, with the potential for futile C/S if nonreassuring testing results from these actions
• Management of pregnant women with treatable cancers that are generally managed with pregnancy termination followed by definitive treatment of the malignancy (eg, stage IB cervical carcinoma diagnosed at 14 weeks’ gestation; one potential management option would be radiotherapy or D&E to terminate the pregnancy followed by gravid radical hysterectomy)
• What about the CREOG/RRC requirements to maintain AMH ‘s residency accreditation in light of the lack of training in abortion technique and aftercare?
• How will women who need postabortion care (for abortions done elsewhere) be managed?
• Will the merger affect standard management of ectopic pregnancies? I suspect not, but while treating a patient with a tubal pregnancy via laparoscopy at Graduate Hospital in the 90’s, a scrub nurse told me that if it were her, she would wait for her tube to rupture before taking action, since I was essentially terminating a life. This was a very good scrub nurse, and she knew very well the implications of untreated ectopic pregnancy, such as hemorrhage and death.
• How iron-clad is the commitment/agreement to continue to provide standard contraception and sterilization services?
• How will they weigh the life of a mother vs her unborn baby in circumstances where they may only save one life and the mother is not capable of expressing her desire? And would that differ from cases where the mother can express her desire?
• Management of severe non-immune hydrops fetalis during labor and deliver (ie, given the lethal nature of the condition for the fetus, will drainage of excess fetal fluid from various cavities be considered to effect vaginal delivery, or would that be proscribed as being similar to intact D&E?)
These are just some of the things I came up with off the top of my head in a few minutes the other week. I’m sure there are others I did not think of.
Abington Memorial is one of the largest hospitals in the county. While it is not a major academic medical center like Mass General or the Hospital of the University of Pennsylvania, it is a very large hospital that does more deliveries per year than many hospitals in the area. Over the past several years, we have lost many obstetrical services in the Philadelphia area; the hospital where my daughter was born is now a hospice or some other outpatient facility (ironically, owned by Abington Health). Two local hospitals within a short distance of Abington Memorial, Jeanes and Elkins Park Hospitals, no longer have OB care. It is not feasible for most women in the Abington/Jenkintown/Cheltenham area where I live to travel into Philly for their OB care and delivery, nor will most people choose to go to Einstein; it’s a good hospital, but it’s in an underserved area and most folks in my area just don’t go there. Einstein is building a new facility in the Blue Bell area, but unless you’re really determined to avoid Abington at all cost, it’s quite a hike from this area. So for all practical purposes, most women do not have other good options for their OB and other care.
I have nothing against Holy Redeemer Hospital per sé. It is a good hospital. My children see pediatricians in their medical office building. I have to remind myself that it is a Catholic institution; unlike places like Mercy-Suburban and other hospitals that are affiliated with the Sisters of Mercy, Holy Redeemer doesn’t wear its Catholicism on its sleeve. I’ve yet to see a cross there, not that there is anything wrong with it (the Pieta of Michelangelo is one of my favorite sculptures, ever). But my point is that it has a pretty low-key approach to being a Catholic hospital, to its credit. But at the same time, it remains a Catholic hospital. And while the folks who run it might be willing to look the other way when Abington, under the merger, provides sterilization and contraceptive care, they clearly will not, and cannot, support any affiliated entity having anything to do with abortion. Low-key, yes, but there are limits.
So that’s the quandary. In order to have this merger go through (and the business rationale for the merger, other than the value of the land Holy Redeemer sits on for additional office and OR space, escapes me), Abington will have to adhere to the directives of the Catholic Church as regards abortion and selective reduction. I respect all religions, regardless of my own atheism, and while I might not agree with Holy Redeemer banning abortion within its own hospital grounds, it is well within its right to do so. The problem is when sectarian hospitals merge with nonsectarian ones and impose their own sectarian beliefs on medical care delivered at the formerly nonsectarian institution.
We live in a diverse country, which is a good thing. And the Cheltenham/Abington/Jenkintown PA area is known for its diversity and generally progressive population of all religions, ethnicities and backgrounds. So the idea that a proposed takeover of a Catholic hospital would lead to the loss of abortion services at our most prominent local hospital, the one that is the stronger institution at this time, is mind-boggling and offensive to many in this area. As a result, more and more people are taking a stand against the merger, and that’s a good thing.
I’ve sent e-mails and received canned responses, so I imagine most people who write will receive similar responses from the Abington management. But the more people write, the more the board and other management at the health system know there is solid opposition to this.
We also need more physicians on staff at Abington to speak up and, if it comes to it, even resign their positions. When I was an attending physician at one Philadelphia hospital, I ended up leaving to go to Pennsylvania Hospital in large part because my former dept. chair was anti-choice and decided to go over my head and cancel one of two second-trimester abortions I had scheduled in the OR there (he couldn’t cancel the second patient, much as he wanted to, as I had already placed laminaria into the cervix to prepare it). At some point, we physicians need to uphold our own principles and ethical standards. If we cannot make a decision based on medical evidence but have to comply with religious dogma in certain situations, all of us have a choice to make in terms of whether or not that is acceptable based on our interest in providing the best medical care for our patients.
Abortion is not a happy procedure, unlike much of obstetrics (although OB is often anything but happy, but that’s another discussion). I’ve never had a patient who took it particularly lightly, or who loved undergoing the procedure. But it is often a necessary procedure, both medically and from a public health standpoint. Some of my colleagues have died for providing this legal procedure. LeRoy Carhart, whom I’ve spoken with and admire greatly, has had his life disrupted and threatened on multiple occasions for his dedication to providing this service to his patients. Warren Hearn, whom I also think very highly of as a physician, is often under armed guard due to threats against his life. Those of us who have provided abortion services do not have an easy time of it. Besides the protestors and the inappropriate social stigma, many of our own colleagues (even in ob/gyn) disrespect us and treat us like undesirables. So when I hear of yet another hospital that will no longer provide abortion services, it touches a raw nerve. Many people have worked for years to do whatever they could to make sure that women at least have some places where they can exercise control over their own reproductive destinies. That’s because a lot of us feel that women who cannot control their reproduction are not truly free. So this is important to those of us in women’s healthcare, and from the responses to the Abington Board’s decision, I’m glad that this is very important to a lot of people in the local area as well.
Feel free to e-mail the management of Abington Memorial Hospital. Just to make it easier, here are their e-mail addresses (keep it civil and polite, however. This isn’t personal):
Mr. Laurence M. Merlis (Chief Executive Officer and President): Lmerlis@amh.org
Meg McGoldrick (COO): Mmcgoldrick@amh.org
Ivy Silver (Chair, Foundation Board of Trustees): Isilver@amh.org
Robert Infarinato (Chairman of the Hospital Foundation, Chairman of the Board of Trustees): RInfarinato@amh.org
Lucie Cutterson, Catholic Healthcare Comes To My Hospital: a “win-win-win-win” for Holy Redeemer Health System « Alaina Mabaso's Blog, dtoub, and 2 others are discussing. Toggle Comments