Today, I introduce a new level of web 2.0 integration by incorporating social medial channels on every page of my website. Watch the short video I shot in my vlog section on this idea.

As many of you know, I relentlessly post videos on YouTube. However, you have to go to YouTube to find these videos or scour my site for the newest video that I have shot. Two things will rectify this encumbrance. First, the updates section will tell you when a new anything (video, text, section, etc.) has been posted with a direct link to it. Second, I will now have a link on every page to my YouTube videos. (Btw, another option is to subscribe to my videos on YouTube if you don’t mind an email sent to you that I have a new video shot and uploaded).

In addition, I have made a lot of changes to make this website a truly aggressive Web 2.0 platform, meaning fully integrating social media into this site with the incorporation of Facebook (a new group that I just created on Facebook dedicated to LFP’s shenanigans) that facilitates more easily my posting photos and other stuff that my staff and I are doing, e.g., thoughts that lie outside of my blog entries, vlogs, and forum postings. (Btw, you must register for Facebook to see the page). Twitter updates from my staff and me. (We’ll see how successful this is, but my staff is already getting crazy and loving to submit “tweets” [that is what short updates are called].) A direct link is also now displayed on every page to my podcasts (far right icon) that I publish in iTunes for your iPhone and iPod. Hopefully, these changes will encourage a broader sense of community, participation, and integration into what LFP has to offer our global tribe of followers.

Btw, as you probably would surmise, I really haven’t “completed” anything. This is just the beginning of the journey over the next 6 months and beyond.

I had to take my ACLS (Advanced Cardiac Life Support) renewal this past weekend, as a requirement for maintaining my surgery center’s credentialing. I have always been bored out of my skull during these courses but not this time. Robert Twite, RN, brilliantly created a session that allowed me to sense his passion and his “why” (see Tuesday’s blog). His mission in life was to help others truly save others’ lives. I assume his vision for myself and as part of his crusade (see Wednesday’s blog), I posted a video on how to do good CPR and why to do it. My teaching skills for CPR pale in comparison to his so forgive me Robert for my feeble attempt but I need to get this message out to my readers and followers of this website.

What I found very interesting were a few things. First, he mentioned the idea of “hands only CPR” that has come into vogue recently was very very intriguing. He argued that many advocates have shown that just doing chest compressions without mouth-to-mouth can have very similar or same outcomes in survival. There are a few reasons for this. First, the air that is recycled from your lungs and breathed into the individual is filled with CO2. Second, if you breathe too often and too much (which is the natural tendency to do), you can make chest compressions less viable owing to a rise in pressure inside the chest wall. Rapid, early, and hard chest compressions can save a life.

Second, he talked about how we believe in the past that we better check a pulse before starting CPR. Well, yes, that is not a bad idea but not at the expense of starting early CPR. What he argued is that without chest compressions in someone who does not have a pulse will lead to a quick death. If you perform chest compressions in someone who has a pulse, the only negative outcome is a sore chest. Even if you find a weak pulse, additional CPR can oftentimes supplement the cardiac output of blood and lead to a better outcome. He offered the example that in children who even have a pulse but a slow one like at 60 beats per minute (that is slow for a child), the advice is to actually do CPR to improve blood flow. So if you check a pulse, then I check a pulse, and we both don’t know if there is a pulse, we are wasting precious time for no reason. Forget all that and start high quality CPR. Crappy chest compressions do nothing. High quality chest compressions only offer 25 to 30% of a normal amount of blood to flow out of the heart. Also, remember that you must lift off the chest, i.e., let the chest completely recoil back to an inflated position because you need the blood to return to the heart as well.

Finally, if your business does not have an AED (automatic extrenal defibrillator), you need to get one. Early shocks from this device will lead to a life saved. Without one, even chest compressions might not be enough. These devices will actually guide you when to shock and when not to. Basically today, the goal is 2 minutes of sustained high quality CPR with chest compression to breaths of 30:2 followed by the AED announcing when 2 minutes are up to determine if you need to be shocked or not. Even after a shock or not shock, continue CPR until told to stop. The AED however should interrupt CPR at the earliest time possible since the earlier you get an AED on someone the higher chance of survival for that person in many cases if the rhythm is shockable like ventricular fibrillation, which is a common cause of cardiac arrest.

This blog is not intended to replace formal basic life support training but to encourage you to get certified. In the meantime, if you haven’t yet and the occasion arises where you need to save a life remember early and hard chest compressions with recoil time and get an AED fast and furiously then continue until help arrives. Don’t err on the side of checking pulses, checking pulses, then looking at each other. Most likely CPR and an AED will save a life more than whatever the ambulance or physician can do. Outcome studies have shown that only 2 things matter for survival: good quality and early CPR and an AED early, not fancy drugs or airways. Two things in conclusion: get CPR certified and make sure that your workplace has an AED on site. Thanks Robert for the brilliant education. I hope I can spread your message out there to all who can hear.

As many of you know, I love beautiful clothing, mostly Italian, where most of my design influences come from. However, I am celebrating today as the third and final installment on good design and quality craftsmanship, English tailoring and design. Anyway, the Italians learned their trade from the English to begin with. Although Armani is perhaps synonymous with great suit design, they are mass manufactured and lack the attention to detail that only Savile Row suits bear. I have many Armani suits that begin to fall apart at certain points over time due to the sloppy tailoring. Yes, the design is great but the craftsmanship is lacking. Armani has also brand extended themselves to mean very little. Mr. Armani does not even design most of the stuff that goes out with his name on it.

I was watching the movie, Layer Cake, with Daniel Craig and loved his suits. I attentively watched the rolling credits at the end to see who designed them. It was Kilgour. With that, I contacted Kilgour to have a suit made up for me. Since I have no time (not to mention the expense too) to fly to London for several fittings, Kilgour routinely flies out to the States to fit you. Unfortunately due to my extensive lecturing, I missed about 3 to 4 of their visits extending the time to actually complete my fittings to over 2 years time. I finally got my brown hopsack suit that I absolutely love. Perhaps I wear it too often for a brown suit but who really cares.

Kilgour began in 1882 and has gone through different iterations of a name, most famously, Kilgour French & Stanbury, which is still the official name of the company. Kilgour has dressed such timeless personalities as Fred Astaire, Rex Harrison, and Cary Grant. The only real negative today is that Kilgour has made a concession to the mass market through adding a ready-to-wear collection by Carlo Brandelli. Beautiful but not bespoke, as we are trying to focus on in this blog.

I think the art and craft of tailoring has been lost through mass-market consumerism. I love the idea that a tailor slaves as an apprentice to master his craft and then has the dignity and patience to create a work of art. A full bespoke suit can take 80 hours to make with what the website touts as “4000 baste stitches through the chest.” To be honest, I just went with an entry-level bespoke but it is already the most fantastically looking and feeling suit that just conforms to the body. I asked for a softer shoulder but in the future I would love to try Anderson & Sheppard, which makes a much more unconstructed suit. I think old world craftsmanship has become a dying art.

To continue my blog series on good design and quality craftsmanship, I would like to feature what I consider the ultimate watch company, Patek Philippe. Not Rolex? No way. Yes, I also own a Rolex (and I love it). Rolexes are machine made and mass produced. Pateks are handmade and individually crafted. For the non-watch connoisseur, Patek may be a foreign term. For the watch connoisseur, a Patek is the ultimate prize and the quintessential watch on the planet.

I own just one but I waited over a year to get my watch. I attained a discontinued model that I had to have, as it reflected everything I loved in good design: an understated white face, black roman numerals, tapered hands, and a classic white gold hobnail patterned bezel that is self-winding with a date window. Pateks are actually great investments because they almost invariably go up in price and have steadily done so. You can easily sell your used model for more than you paid for it. I love Patek’s slogan used in their ads: “You never actually own a Patek Philippe; you merely take care of it for the next generation.” Patek Philippe holds over 70 patents and is the only manufacture that crafts all of its mechanical movements according to the strict specifications of the Geneva Seal.

Patek Philippe was founded in 1839 by Antoine Norbert de Patek and François Czapek. In 1844 Mr. Patek met the French watchmaker, Mr. Adrien Philippe in Paris where the latter presented his pioneering stem winding and setting system by the crown. Eventually Czapek left the company and the company was rechristened Patek Philippe (that is actually a bit of a truncated story to the evolution of the brand name.) Patek manufactures everything in house with master watch craftsmen who perform 1200 operations to create a single watch, which can represent over 600 hours of work on a single watch followed by 30 days of observation and evaluation for each timepiece. A self-winding watch runs for on average 1200 hours before it leaves the factory.

Each watch is individually assembled, polished and regulated by hand. They even polish parts that the owner will never see. I like this statement on aesthetics: “We strive for timeless aesthetic perfection. Beauty is also present where it cannot be seen. Bridges are angled, polished by hand and decorated with Côtes de Genève, and circular graining, or perlage, embellishes every movement. That an owner might never be able to see these many aesthetic touches does not discourage us. This is simply the way we make watches. Beauty, albeit understated, is all-pervasive at Patek Philippe. We know that the hundreds of parts operating in harmony make a watch work, but it is beauty that brings a watch to life.”

I was scouring the Internet for something I remember reading that for the ultimate in horological difficulty, the grand complication, a single man would work every day for 6 months to complete one such watch. Pateks represent the ultimate in style, taste, and craftsmanship (in my opinion).

I have had tremendous response to my philosophically and psychologically bent blogs. However, I would like to take a break this week from that topic. Another one of my deep passions is the eminent melange of good design (creative and understated artistry) and quality craftsmanship (handmade, individualized, technical quality work) that I adhere to in my profession of plastic surgery. The companies that I am going to celebrate I own NO stock in but want to share with you some great finds that you may or may not be aware of already. Besides the two qualities aforementioned, I also look for a brand to be a specialty house that does not vaunt a meaningless number of brand extensions (again like what I love in my practice which is being more of a specialist than a generalist in plastic surgery). Further, the brand should be one that a connoisseur prizes compared to the “obvious” brand that every consumer is familiar with. Okay here goes…

My first brand that I was introduced to many years ago by a good friend of mine, Tim, with whom I grew up, is OMAS. I remember opening the lovely package and wondering, “What is this? I have never heard of it.” I was hoping for a Montblanc, of course. Tim explained to me that the OMAS pen was a work of exceptional craftsmanship and design. I was not impressed since I had never heard of the brand. Now, I am in love with the beauty of OMAS and prefer it over any other pen. No, I am not a rabid collector. I really own a couple of OMAS pens but I love their design work. My favorite is the OMAS 360 which is a work of gorgeous beauty (featured in the photo) that has a 3 point triangular design that fits perfectly in one’s hand. It also looks really cool and is so simple in its design, echoing what Louis Sullivan popularized, “Form Follows Function.”

OMAS is an Italian pen company founded in 1925 by Armando Simoni, hence the name OMAS (Officina Meccanica Armando Simoni) and has been handcrafted since then. Each pen is handcrafted and requires over 100 stages to completion. The 12-sided models are shaped individually and polished by hand with cork. To create a celluloid model requires about 100 working days and reflects what their website calls a “goldsmith’s masterpiece”. Celluloid is a product of cellulose treated with camphor in an ether solution that is long and complicated with the above-stated 100 days of a production cycle to yield a sturdy, resilient, light, polished, and pleasingly tactile pen. Although practically speaking I do not often use a fountain pen, the broad-nibbed fountain pen offers the most delectable feeling during writing and creates the most gorgeous trail of ink across a sheet of paper, especially what I love the blue-black ink. Okay, enough salivating over a pen. I hope you enjoyed this blog even though you might not care too much about pens.

Wall Drawing #146. All two-part combinations of blue arcs from corners and sides and blue straight, not straight and broken lines. September 1972

We are going to define a different type of culture than the last 3 days of blogs: a little more refined culture so to speak (just kidding). As you would surmise, these blogs are about getting to know me, your surgeon, a little bit better and for me to reach out to you, the reader, with my aesthetic sense of what I consider beautiful. Of course, if you do not like modern art, this blog will be devastatingly boring or foolish. My buddy, Mark Wettreich, who owns an incredible European Art Gallery that focuses on “real art”, would look askance at this blog. I doubt Mark reads my blogs. However, if you are, please stop reading here.

Perhaps the best way that I conceive of my art is of its high graphic design quality. In essence, I really appreciate good design. It appeals to me fundamentally at every level. I love beautifully designed clothing, furniture, cars, anything really (and you know by now my obsession with Apple.) I would have loved to have been an industrial designer. Johny Ive move over (he is the Apple brainchild who has revolutionized the world more times than I can remember.)

Okay, now to the core of this blog. I absolutely love Sol LeWitt. He just died last year. He was an amazing American artist whose structure, clean, and graphic sense of the world I absolutely loved. I am going to insert here my paper that I wrote for the Archives of Facial Plastic Surgery in 2003, which never saw the light of day since the editorial board believed (perhaps rightly so) that my monograph on art did not highlight the beauty of the face. Well, besides the editorial board, you will be the first to read this article that never got published:

“Wall-to-Wall Beauty”

Samuel M. Lam, M.D.

Although Sol LeWitt has produced a prodigious amount of art over the past half century – from sumptuous two-dimensional geometric prints to elaborate three-dimensional cubed lattices, his most significant contribution to the art world remains the wall drawing. When asked if the sobriquet “originator of wall drawings” properly applied to him, he replied, “I think the cave men came first.” His cheeky reply aptly evokes his self-dismissive attitude that permeates his entire life and career. He has constantly upheld the primacy of ars gratia artis and subserved his ego to his artistic ambition. He often declines to attend media events in his honor, arriving late or not at all, and has refused to pose for a portrait by his celebrated artist friend, Chuck Close, because he wanted the public to pay attention only to the art rather than the artist. Even the large-scale retrospective of his work that opened at the San Francisco Museum of Modern Art in 2000 required years of coaxing before he could be convinced that he should participate, given his concentration on the future direction of his art rather than the past.

Part of an entrenched anti-commercialism is expressed in the very idea of a wall drawing. Unlike canvassed works that can be bought and sold as a commodity, a wall drawing lacks this vital attribute of market viability. Although LeWitt never explicitly foreswore a commercial intent, he stated, “I never think about selling a work while doing it.” LeWitt had even naively proposed that any artist that desired to replicate his wall drawings could do so to widen the public consumption of his work but has since retreated from this untenable position given the inferior reproductions that were spawned without his oversight. LeWitt’s massive wall projects are often executed by hired hands under his supervision, as he subscribes to the Conceptualism school that embraces the artistic idea more than the mechanical process, so long as the construction effort remains true to the original design. In fact, the colossal wall installations that are delicately fabricated for a specific site are often completely destroyed at the conclusion of the prescribed event.

LeWitt embarked on his first wall creation in 1968 for a group show at the Paula Cooper Gallery in New York. He wanted a medium that could offer him the most two-dimensional representation of his two-dimensional art, in a word, flatness. He wanted his created work to convey its true two-dimensional essence, which could not be accomplished on a canvas that by its very nature was a suspended three-dimensional object. Beyond this consideration, the artist was motivated by early twentieth-century Russian art that celebrated visual art within the context of a defined setting. His architectural sensibility may have also been partly informed from LeWitt’s time spent in I.M. Pei’s studio a decade earlier. His later sculptural monuments would also resonate with architectural vibrancy. This pairing of art and architecture achieved its fullest expression in the German Bauhaus and the Dutch De Stijl movements of the early twentieth century that prefigured LeWitt’s efforts fifty years later.

LeWitt’s contemporaries of the 1960s were also explicitly and subtly exploring the immediate environment in which their art was displayed. Dan Flavin’s fluorescent light sculptures illuminated the entire room in which they were exhibited and cast a luminescent glow and shadow on neighboring walls, floors, and ceilings. In fact, Flavin is credited with introducing to LeWitt the expressive and intellectual nature of serial, permutated forms that would become an integral element in LeWitt’s idiom. Donald Judd’s wall-mounted sculptural pieces were also intimately tied to the wall from which they were suspended. Similarly, Andy Warhol canvassed the Castelli Gallery with Cow Wallpaper, a work that must have resonated with LeWitt; and Eva Hesse’s Accretion that consisted of numerous fiberglass tubes propped along the expanse of a blank wall echoed LeWitt’s aesthetic ethos. Despite all of these varied concurrent artistic endeavors, LeWitt would most fully exploit the architectural interior and transform it with his site-specific wall installations.

Over the past thirty years LeWitt has continued to evolve his style of wall drawings from the intimate to the dramatic. Initially conceived in the 1960s, his drawings represented little more than transference of his paper drawings to the wall without a premeditated link to the environment in which it would be presented. In the early 1970s, he began to develop an artistic idea more specifically for the physical space that it would occupy. In Wall Drawing #51 in Turin, he hired three draftsmen to connect every architectural point on the wall (light fixtures, door knobs, wall corners, etc.) to each other in every conceivable combination using blue chalk. In 1975, his art underwent a transformation yet again: he began to alter the background wall color to suit his artistic needs rather than be satisfied with the typical, preexisting white facade. He relinquished part of his artistic control to his draftsman, ordering only that “White lines from the center of a [black or yellow] wall [be connected] to specified random points” as would be determined by his skilled draftsmen. By the 1980s, LeWitt’s work achieved a strong visual vitality through use of bold geometric shapes and vibrant color schemes. LeWitt himself has commented that the newfound boldness of his work reflected the size and grandeur befitting the architectural space. His wall drawings continued to expand in scale to occupy neighboring walls, adjacent rooms, and even moving out to the outdoor environment. By the 1990s, LeWitt began to use acrylic as his favored medium rather than pencil, crayon, and India ink, which he had relied on in the past. Although LeWitt still refers to his collective works as “wall drawings”, use of acrylic transformed his drawings into paintings. The austerity of his early works gave way to the playful exuberance of his acrylic pieces that exuded bright, saturated, glossy colors with a simplified geometric vocabulary. Despite all of the intellectual rigor that LeWitt has applied to his art through his writings and advocacy of the Conceptual movement, his oversized wall drawings provide an immediate, seductive appeal that remains truly unique in twentieth-century art.

Horst Schulze, the former president of the Ritz Carlton, penned his famous Ritz Carlton motto, “Ladies and Gentlemen Serving Ladies and Gentlemen” at the tender age of 15 for a term paper in hotel school. Mr. Schulze explains how he came up with these famous words, “I started in the hotel business when I was 14 years old as a busboy. When my mother took me to the hotel to work for the first time, she said, ‘We could never go to this hotel. This is only for important people. For important, fine people. So you’re lucky. Behave yourself. Wash your hands.’ She was a typical mother. I went to the hotel and the general manager talked to my mother and me for 15 minutes and told us we could never be like the guests who came to his hotel. ‘So don’t ever get jealous. This is for Ladies and Gentlemen–very important people.’

“By the time I started working in the restaurants, I knew the guests were very important. But a few months later I realized that the maitre d’ I watched every day was just as important because every guest was proud when he talked to them. Why? Because he was a first-class professional. He was somebody special–because of the excellence he created for the guests. So when I went to hotel school about a year and a half later, the teacher asked me to write a story describing what I felt about the business. And I wrote about the maitre d’ at my hotel. I titled it, ‘Ladies and Gentlemen Serving Ladies and Gentlemen.’ I wrote we could be excellent like he was…absolute excellence. When you walked into a room, you know he was there. In any moment all of us who serve can be Ladies and Gentlemen, just like the guests. I think it’s a powerful thing that shouldn’t be missed by the wonderful people in the industry. They should understand that.”

I truly believe that my fine staff that work with me are true representatives of the motto. They are real Ladies and Gentlemen. As much as I expect my staff to treat you as Ladies and Gentlemen. I expect you to treat them as Ladies and Gentlemen. Remember that all of us in life are Ladies and Gentlemen serving Ladies and Gentlemen.

I have heard a lot of reports out there that various diet sodas can actually increase your weight and also be truly unhealthy for you. As part of my EO (entrepreneur organization)’s monthly goals, i established this month that i would minimize my consumption of Diet Coke as much as possible.

It is amazing how tastes change if you want them to. I LOVE DIET COKE. I thought that one thing in the world that I could never give up would be diet coke. I would rather die. I actually like it more than regular coke. However, I have now been drinking unsweetened iced espresso in the morning, unsweetened ice tea for lunch, and sparkling water (with at times a little cranberry juice) for dinner. Listen, I still need my caffeine.

Now if there is no other option at the dining establishment, I will have some Diet Coke. I am not a monk about it. What is fascinating to me is how we can easily adapt our tastes. If I sat there forcing down unsweetened tea or coffee and going “Yuck!” every day, the habit would not stick. However, I LIKE IT NOW! That is really weird for me to even say.

I remember about 20 years ago when I was traveling in Europe, there was NO Diet Coke. At the time, they only had regular Coke so that was all I drank (Now, they have Diet Coke but they call it Coca Cola Light). By the time I got back stateside, the taste of Diet Coke made me sick. I loved only regular Coke. It is astounding how our taste buds can easily change. That is why if you guys are adventurous, feed your kids something that they might not otherwise eat. I have found that parents who are not adventurous in their palate pass those limitations on to their children. Okay, that is another blog. Sorry to offend.

I have heard it say that it takes 21 days to break a habit or to establish one. I think ultimately if you hate it, nothing will stick. Somehow, my taste buds now prefer unsweetened tea and coffee. Weird.

As you guys know, I love good design no matter how cheap or expensive. I used to wear Gap T-shirts when I was a teenager but haven’t for about 20 some years favoring more “refined” Italian designs. However, I was accompanying my mother shopping for my sister’s birthday in August at the Gap. I was, of course, bored out of my mind so I meandered over to take a look at some t-shirts.

I was amazed that these 15 dollar t-shirts on sale for 7 dollars had an amazing cut, color, and shape. They had a slight stretch (no I don’t wear it that tight!) and the cutting was great. (Please don’t tell me that these shirts were made by some underage sweatshop!) I particularly like the t-shirt with a v-neck (very cool!). I don’t know what the t-shirts were like in the intervening years. Perhaps they were always like that or at least for a while. However, twenty years ago they were thick, raggedy shirts unlike what I see today.

As you guys know, I love Apple and Mac design (sorry PC-addicts out there). (Did you guys see the new unibody notebooks that came out this week?) I just love beautifully designed anything. So here’s to the simple Gap t-shirt, especially for all of you who have not tried one on in a while.

Reflexology Foot Chart

As a western trained physician who is very methodical in his scientific thinking, I have always been skeptical of “Oriental medicine”. Now that I have opened a spa that focuses on marrying the best from the East and the West, I have gradually loosened my narrow grip on my perceived reality. I have tried in the past to view my wellness concept to be broader than what we know in the West. However, naturopathic doctors and holistic doctors shun coming anywhere near an Occidental physician and vice versa. Fortunately, I was able to find the best of both worlds by having western-trained M.D.s who embrace naturopathic components in my anti-aging and vitality center.

As part of my weekly spa ritual, I really have been exploring the best of what the East has to offer. The thing that I really love now is reflexology. The idea of reflexology for the uninitiate is using pressure points on the foot to relieve bodily ailments that corresponds to nerves that are across the foot. Whenever I get a certain area touched that hurts on my foot, I start to realize how accurate the correlation is to the body part that aches for me. If anything, I get a great foot massage in the process! Even when I was in a hurry at the airport, I got a reflexology treatment over my standard shoulder and hand massage (which is part of reflexology too since the hands and ears can represent part of the body as well.)

I think it could be dangerous to substitute reflexology for treating serious medical conditions but I think it is a great stress reliever and I do believe that it is helping me balance out parts of my body that are not in alignment. I also tried a Shirodhara treatment which is part of Ayurvedic therapy in my spa, which involves dripping oil in different patterns across your forehead to open your “third eye”. Although I don’t know if the touted medicinal values can be of certain benefit to you, I do enjoy the treatment as a relaxing part of a spa experience. Okay, so I don’t believe everything just yet.