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November 2004

Al Tiramisu

The readers' reviews on the Washington Post site annoy the fool out of me. But criticisms of Al Tiramisu piss me off. For years now, I've been getting there once a year or so and I have never had anything less than a brilliant experience. Last night was the same. Even though it was a Saturday, I gambled that I could at least get a seat at the bar -- which I did. And they were gracious and friendly and the food was magnificent. Yes, it's expensive. If that's a problem for you, DON'T GO! But I cannot fathom people who complain about the service. From my very first visit there, where the waiter gave me a table with a little more light because he saw that I'd be reading and writing, to last night, when the hostess joked with me that I'd had those same sardines on my previous visit (which I had -- but that's a year ago!) and Luigi came over to visit for a bit, I have never felt anything less than being in a place that was a pretty good substitute for being at home.

Osama on video

The campaigns are trying to figure out what to do with the bin Laden video. Am I being naïve to think that the notion that Osama is trying to influence the election is kinda nuts? It's that weird obsession that the political people have. Seems to me that Osama is simply trying to rattle the cage, and to make the point that from his standpoint, the election is irrelevant. No, I don't think he's trying to swing the election one way or another -- I think he doesn't care! That's what he says, and I'm willing to take even a maniac at his word. The reaction just points out the incredible solipsism of the political element -- which is a significant part of the problem that got us into this.

National Museum of the American Indian

The NMAI has an aggressive agenda. Those who imagined that walking through it would be an experience akin to the American Indian galleries of some mid-level midwestern museum, perhaps coupled with a touring exhibit of woven baskets, are in for something different altogether. Everything about the museum is gathered around one idea – that American Indians are here now, a vibrant 21st century conglomeration of cultures, that are bonded together by the iniquities of the past but are determined to come out of the shadow in which they’ve been relegated and take their rightful place among the many ethnicities making up this mulicultural world.

The exhibits of “old stuff” – dolls, and projectile points, and beaded objects and all – are in wall cases near the corridors; lots of objects, crammed into the cases, making an eerie echo of the kinds of anthropological displays of yesteryear. While the objects in them may be delightful and exemplary in themselves, the display makes an ironic statement about the way those objects have always been shown. The themed exhibits, designed with considerable input from the tribes represented, are very Smithsonian in style – obsessed with their educational mission, and their “all objects are of equal interest” approach to the minutiae of daily life. The crowds were so thick that is was difficult to judge how effective they are. And since I come to this with considerably more background knowledge and awareness than most people, it’s impossible for me to adequately gauge the impact that it might have on someone whose awareness of Indians is shaped only by the movies (where the only Indians are 19th century Comanche, Apache, Kiowa and Sioux), and television (where they are simply absent).

I think they’ve done a fine job. If there are a few rough edges, that’s to be expected. Over the next decades, they’ll shift and adapt and learn different ways to tell the same and more stories. The most important thing, is that they are invisible no more.

The Phillips Collection

There are just a few museums where I can be reasonably assured of seeing work by every member of my painter's pantheon (Goya, Daumier, Whistler and Rothko) in a single visit -- and the Phillips Collection is one of them. For quite a few years now, it's been one of the primary stops on each visit to DC, so I became a member some time ago. This is the first chance that I've had to get there since the renovated Goh annex opened, and they're inaugurating it with the marvelous Calder Miro show. These two have been among my very favorite artists for very many years, and I've seen quite a bit of their work over time, but had never thought of a connection between them. Turns out they were dear friends who worked closely together and who extended their range of ideas by their collaboration. Once it is pointed out to you, the links are very obvious, and the curators have done a fine job of arranging the show in such a way as to highlight those relationships.

Typically, when I go to see a show, if I have time, I go through it twice. On this visit, it was the Calders that grabbed my attention on the first pass, and on the second I was more absorbed by the Miros. (Perhaps I need to try to get there one more time today or tomorrow before I leave town). Of all of the astonishing work, it was the six (?) constellations by Miro that I found most breathtaking. I've seen individual examples from that set, but seeing a group of them together, and seeing how they relate to each other, was quite a remarkable experience. The color washes are tremendously pleasing and absorbing, and the patterns of dots and swirls and images on each are exhilirating in their movement and life. Interesting to find out that he painted them in response to impending war and out of fear that the Nazis would make it impossible for him to paint. One fights against the darkness with deliberate joy.

Between my two passes through the show, I took time for the permanent collection which, as always, is a matter of stepping from room to room, past masterpiece after masterpiece. And one is always startled to see a famously familiar painting and to realize, oh yes, this is where this one resides.

The only minor disappointment was that the Rothko room has not been reinstalled yet. I was a little disconcerted, because I had saved that for last, but when I went to the area where the Rothko room used to be, I found that the gift shop has been placed there. I asked at the desk on the way out and the girl there assured me that the Rothkos would be reinstalled, although she was a little vague about where and when. So when I got home, I emailed the PR office to see if they can give me clearer information.

I'd gotten to the museum feeling worn out and weary from the intensity of the last few days. As I crossed the street toward the entrance I wondered if I even had the energy to really look at the work. Two hours later, I emerged refreshed, enlivened, rejuvenated, bubbling with happiness.

MLA/AAHSL Leadership Fellows

It is a little disconcerting to be considered one of the distinguished leaders of my profession. When did that happen? But here I am, participating in the capstone event, the closer, for the MLA/AAHSL Leadership Fellows program. The schedule has been quite intense, but it's been a very good experience. All day at NLM on Wednesday, with Carolyn hosting us for dinner at her pied-a-terre; a half day yesterday at ARL, talking mostly about AAHSL stuff, and then a couple of hours in the afternoon at AAMC headquarters. There was a very nice reception and graduation ceremony in the evening and then it was back to Bistrot du Coin with Shedlock and several of the fellows. Long days. Today we've got a couple of hours on government relations and then a couple of scholarly publishing.

Despite the long days, it has been very engaging and illuminating; as rewarding as the whole program has been. As I said to Roger late in the day yesterday, given my experience with the NLM Associate Program, and all of the people who have helped me out over the years, I was very eager to be a part of this program, in part to pay back some of what I feel I owe. But, as usual, once again I think I've gotten more from the experience than I've provided. I guess that's just the way that it works.

Bistrot du Coin

Frequently, my first night in DC, I'll have dinner at Bistrot du Coin. This trip, I'm staying at Topaz, so it's an easy walk across the circle. The weather is perfect. After the mugginess of the Gulf Coast in Biloxi, this refreshing coolness, just below seventy degrees, is a delight.

On a Tuesday night, the place is buzzing, but not jammed. It feels comfortable and homey. I know what's on the menu and I know what I'll have -- the hanger steak with shallot sauce (which includes a large roasted shallot), and perfect pommes frites. I order a bottle of Gigondas from a waiter who has served me many times before. I write a letter to Lynn and he stops by to admire my fountain pen and bemoan the fact that no one writes letters anymore. But I do. She could make a separate collection of letters from this restaurant.

I eat slowly, I read some of Rilke's Letters on Cezanne, I watch the crowds, mostly young and out on dates, a few singles reading, like me. A cheese plate for dessert, of course, and then back across the circle to my comfy room and game 3 of the World Series.


It took awhile for me to understand what a realist painter Georgia O’Keeffe was, and why she would get so annoyed when people would call her work symbolic or stylized or abstract. At the moment I’m on a plane from Atlanta to DC, and the scattered small clouds reach across the sky just like in those huge late paintings of hers that I know from the Art Institute.

Just a week ago I was flying back from Boston. Yesterday I drove to Birmingham from Biloxi. (At least I’m moving a little further along the alphabet by going to DC.) This is the intensely busy stretch that I’ve been watching come closer on the calendar. But the traveling itself doesn’t bother me. I like being on the planes, I like checking out the different hotels. I don’t like not having enough downtime and solitude. So I’m glad for today. I’ll get to Topaz by 4:00, and have no plans for the evening other than to wander out and find a nice meal at a familiar restaurant.

I realized some time ago that I have undoubtedly spent more time walking the streets of DC than I have of any other city since the town I grew up in. Over twenty years now of coming at least once a year, sometimes more (I think the longest I’ve ever been away was once stretch of nineteen months). And always I find time to walk the streets, to pop into the museums. I always feel at home.

Driving to Biloxi

It is much easier packing for a trip by car. When flying, you rethink every item -- is this something I really need? -- trying to get it down to the minimum necessary. In the car, it's the other way around -- is this something I might need? Throw it in!

The time factor is very different as well. The plane doesn't care if you're there or not, so the morning of a trip by plane, I'm watching the clock closely, planning carefully what needs to get done so that I get out of the house on time. Last night, when I asked Lynn what time she wanted to leave, she said, "About 10:00." That means anywhere between 10:00 and 11:00. No pressure.

It should be sunny between here and Biloxi. Most of the drive is on the interstate, so it'll be boring as hell. But it'll be pretty on the Gulf, despite the casinos. The temperature there is still in the upper eighties.


After the intense daylong NEJM meeting at Countway, I needed some time to myself, so I bowed out of dinner with Mark, Tom & Cheryl. I stopped for an hour at the Museum of Fine Arts, and then strolled back to Nine Zero, breasting the crowds heading for Fenway Park and what turned out to be the astonishing game 5 of the league championship series. A little email in my hotel room and I was ready to head out to find a restaurant. I walked into the North End, sure that I could find something!

I remember that marvelous afternoon a year ago, when Mark, Philly, Lynn and I set off into the North End to have lunch. Mark had a couple of places in mind, but they both turned out to be closed for lunch and we ended up at Café Assagio (a perfectly wonderful choice – we had a great meal and really bonded telling couples stories). I wondered if I might be able to retrace our steps and find one of those restaurants.

And I did -- a beautiful little place called Sage. I recognized it by location as much as anything else, although the name sounded right. When I saw the menu and the wine list, though, I knew that even if it wasn’t the place Mark had wanted to take us, it’s the kind of place he would like.

It’s tiny – I counted 28 seats – and was about half full. Finding that I didn’t have a reservation, the waiter interrogated the reservations list, and then said brusquely, “Sit there,” pointing at a two-top along the wall. He brought me the menu & wine list and poured some bottled water. He told me, “There’s no specials, the menu changes every couple of weeks. You can have any of the pasta entrees as a half order appetizer, or you can have a pasta sampler, which is a little taste of the risotto, the gnocchi and the lasagna.” How could I resist that?

For the main, I couldn't decide between the "Duet of Braised Pork Shoulder & Crisp Pork Belly with Truffled Cabbage" or the cassoulet. I asked the waiter for help and he rolled his eyes and groaned and twisted his shoulders back, looking up at the ceiling as if he'd rather mediate an argument between his wife and mother-in-law than offer a choice between those two dishes. But he came down on the side of the cassoulet. I ordered a 1998 Brunello di Montalcino and we were off.

The tables are arranged on either side of the aisle that leads back to the kitchen. The walls are that pumpkin/peach color that seems to be so popular in restaurants these days. On one wall there was a nice arrangement of twelve small oil paintings of Mediterranean urban scenes, done in the bright colors and tight focus that a contemporary art photographer might use. On the wall next to me were a series of larger abstract paintings, squares with raised squares standing out from their centers, cool colors contrasting nicely with the warmth of the walls. I wrote a bit in my journal and sipped my wine and waited for the pasta course.

The risotto is made with asparagus and is a pale delicate green, with a dollop of goat cheese fondue on top. In the last couple of years I've become pretty adept at risotto, and frequently when Lynn orders it in a restaurant (I almost never do) she'll say, "Not quite as good as yours." She wouldn't've said it about this. The handmade gnocchi incorporate cherry tomatoes, olives and basil and melt in your mouth. But it was the rabbit lasagna with chanterelle mushrooms that was the standout. A perfect blend of rich flavors -- I took the tiniest bites I could, to make it last as long as possible.

The cassoulet was beautifully done, one large sausage and several big pieces of duck, sitting on top of the several kinds of beans and broth. It was perfectly matched with the wine, and I ate as slowly as I could. This was a meal I didn't want to end.

But of course it does. My waiter cleared the plates and asked if I wanted to see the dessert menu. "Only if it includes cheese," I said. And he grabbed one and presented it to me and the list of cheeses was longer than the list of chocolate desserts. One could select three or six, and I was sensible and chose just three, and they were presented in as lovely a fashion as any cheese dessert I've ever had -- laid out on an oblong, handled wooden platter, each cheese matched with a sweet -- the french young cow's milk cheese next to chopped dates, the italian semisoft cheese sitting next to a little pool of honey, and the hard, astringent Spanish cheese next to a beautfully flavorful ripe fig drenched in its own jam.

It was exquisite. Not a single false note in the presentation, flavor, arrangement, scents and service. On a scale of ten, it is an easy ten.

I stopped in the restroom before I left. Did I mention that it's a tiny place? To get to the restroom you actually have to go up into the kitchen, and the chef has to step aside so you can get at it. The chef & sous chef stand next to each other cooking. There's no room for anything else.

That makes it easy to thank them on your way out.

NEJM Advisory Board

Yesterday was my last meeting as a member of the New England Journal of Medicine advisory board. At the end of the day, Mark Danderson took a few minutes to thank the departing board members, and to say how much of an impact we'd had on the development of the site licensing program. I know how true that is, and yet I can't help feeling that we (the board members) have gotten even more out of it. Judy Messerle pointed out that she has served on a number of advisory boards over the years and that the NEJM folks were by far the most open and engaged. This is the only such group I've been a part of, but I've heard plenty of tales of boards that were clearly nothing much more than window dressing, or, at best, a way to gauge what some of the reaction in the community might be to a policy or program that was already full developed. But Mark really made us work, he presented us with plans at the very beginning stages, and then clearly used what we had to say to refine and develop those plans.

It's been a marvelous opportunity to get such an inside look at how a publisher thinks, at such a critical time. NEJM is unique in many ways, but the challenges that it faces as an organization are similar to what all publishers are feeling. Some of the discussion yesterday turned on some of the new services that they are considering developing as they look for ways to make good use of the technology and to offer value to individual customers as well as to build on the institutional base that they've started to develop. It's a fascinating process because we are in such uncharted territory -- publishing is being transformed right before our eyes, and the NEJM that is being formed will be a very different creature from what it had become in the print world. I've learned a tremendous amount and it has made me, I think, much better able to assess and analyze the fascinating developments that are swirling around us.