Skip to content

Coz Blog is an exploration of hobbies, ideas, stories, happenings, and viewpoints. I'm a Surgeon by trade, gentleman farmer at heart. My favorite things outside of solving problems in the operating room are being out in nature and raising my rare Seraphim pigeons which you can see at my other blog, Coz Lofts. Have fun exploring my site!
David Coster M.D.

Where I Have Been…

20120830_092633

It has been a good long while since I’ve written a thing on this blog. At first it was because I became so disillusioned with the news of the world with which I was being bombarded every day; it just seemed like the human populace had lost its collective mind, and what could I possibly say about all of the insanity around me that would matter to anyone anyway?

And then, in the Fall of 2013, in the midst of my aggravation with the world as a whole, a much more pressing personal problem arose when my youngest son, at 23, called to say he hadn’t been feeling well for a few months; just tired and run down at first, but then fevers and night sweats for no apparent reason. I made him make an appointment with an infectious disease doctor who, in a matter of minutes, determined that he had lymphoma, a cancer of the lymph nodes. It was obvious on his physical exam.

I can look back on this past year and a half now with more calm, but only because my son is thankfully still here and was in remission for about a year, giving him and the rest of us a window of opportunity to gain perspective. Now we are back at it again with chemotherapy and a stem cell transplant planned in about six weeks.

When I sat down to write about it, and almost never being at a loss for words,  I thought it wouldn’t be difficult, but I determined after pages of prose that I couldn’t properly write about it, or rather that I didn’t really want to share the experience with that degree of intimacy. Everything I put into words seemed trite, and I realized I simply could not express properly what has happened to him, me, his mother, his brothers, his fiance, his sisters-in-law, and his “Dad #2” (my husband) in the process of going through this. Oh, I can describe it, but no description seems to accurately capture the feeling of where we have been. It has changed us all, that’s all I know, and everything about it feels too personal to share completely, though some day that may no longer be true. I’ll keep the writing of that story on my “list of things to do” just in case.

January, 2019. Well, this story is definitely due for an update. When I wrote it I didn’t think about the fact that it was a cliffhanger. So…Sam underwent back-to-back stem cell transplants with chemo and radiation. He was very sick but his doctors at The Siteman Cancer Center at Barnes Jewish Hospital in St. Louis had a trick up their sleeves with a new protocol from Stanford University. And now…he’s back to his old self, healthy once again. He married two years ago and he and his wife have a very interesting life now in St. Louis where she is an artist and he is a partner in the game company Butterscotch Shenanigans. We don’t know what life will bring going forward, of course, but we are very grateful.

The Moss Garden in Iowa

Wait a minute….you mean Japan? No, not exactly. I mean it’s possible to have a beautiful Moss Garden in Iowa simply by locating the correct micro-environment. Like the Japanese, we have many opportunities to take advantage of microclimates in our own yards and gardens if we just stop a minute and look around! With a little ingenuity one can make almost any garden in Iowa.

I first saw pictures of Moss gardens in exotic books about Japanese gardening, and although I had on occasion stumbled across logs and soil dripping with moss while hunting Morels in the Spring in the Iowa woods, and found big patches of moss growing in the oddest places in town, it just never occurred to me to make the effort to cultivate moss.

Yet I had a very annoying little garden spot on the north side of the house, a narrow little space between the sidewalk and some cut limestone and pebbles against the house that was constantly filling up with moss. In fact, I had to fight the moss off! It would grow up over the stems of the Begonias and Impatience I planted there, stunting the poor things. The space always annoyed me, as nothing I did there ever seemed quite right, and the space was sort of an after-thought, the last thing I attended to every year.

So one day I was in St. Louis and decided to visit the Missouri Botanical Gardens. What a treat! The place is stunning, and any reader who has the opportunity and any interest at all in gardening should go! Water Gardens, conservatories, annuals, exotics, the weird, garden sculptures, massive Asian style gardens, herbariums, and on and on! Just a stunning place. And there I stumbled upon a Moss Garden hidden on a peninsula under a copse of little trees overlooking the big pond in the massive Japanese Gardens. It was quiet with a stone path leading into a little stone hut where one could sit and admire the carpet-like appearance of the moss with little red crab apples scattered across it while ducks and Canada Geese landed on the pond. Each person who came in became instantly quiet, as if they were in a sanctuary of sorts. It was really not just beautiful, but a beautiful thing to experience.

Glass Water Globe Sculptures floating on a pond at the Missouri Botanic Gardens.

A view of the Moss Garden overlooking the pond in the massive Japanese Gardens at the Missouri Botanic Gardens in St. Louis. It is covered by a copse of flowering crab apple trees, allowing in dappled light. Nearby is a stone hut where one can sit and meditate. It’s a stunning view.

So home I went determined to make a moss garden if it was the last thing I ever did. My space for it is not exactly private, located on a public sidewalk, but it’s a very quiet street and a very quiet sidewalk, so it didn’t matter. I turned the soil and raked out the moss that already existed, putting it in a pile. Sticks, leaves, and plant residue was removed and the surface smoothed. The moss was replaced in a patchwork with wide open spaces inbetween. Several missions around town and in the woods located patches here and there of two other varieties of moss which were harvested and brought back to be pressed into the soil in various spaces, adding to the patchwork of color and pattern, as each variety was a little different from the next. Then a trip to the woods for other types, and finally even to an abandoned house or two where I found some really unusual mosses growing on old boards, shingles, and even curtains. (The roofs had caved in, allowing in rain and just enough light to create an optimal moss environment.) If the moss was adherent to a twig or sliver of wood, I just brought the whole thing. Eventually I obtained at least six different varieties of moss, all of which I pressed into the soil.

A freshly planted Moss Garden using patches of Moss harvested in town, in the woods, and from abandoned buildings in the area.

Then it was a matter of watering regularly to keep it moist, though Iowa is a pretty wet place and most of the time I had to do nothing. Moss likes a bit of sunlight—-not total shade—-and this spot had a short period of direct sunlight in the morning and late afternoon, dappled shade for part of the day, and total shade for part of the day, just about perfect. Plus it was relatively cool compared to other areas around the house. The biggest problem was the squirrels who, for some reason, seemed to want to know what was under each piece of moss, turning them over repeatedly until I wanted to catch each one of them and give it a good thrashing. Eventually they became mostly bored of their tiresome game, but they still poke around in there almost every day doing some sort of devilment, the little monsters. The other problem was simply keeping grass clippings and what not off of the surface. In order to thrive, the moss has to get air and light, so it has to be kept free of detritus. So from early Spring until late Fall I attend to this task with a little bowl and a hand held brush with soft bristles, going out every couple of weeks and cleaning it off. In the Fall I just let winter take over; the leaves cover it or they don’t, I don’t care. By March 1st, though, I uncover it to find bright green happy moss already expanding on the cold ground. It grows a lot during long periods of cold as long as it’s not January and twenty below. The snow on top of it keeps it warm enough to continue to spread under the snow. Moss is tough. In the summer it can dry out completely and appear to be dead, only to revive itself with late Fall rains. Aside from the occasional sweeping, it’s not difficult to manage. It gets so thick weeds can hardly get through it.

A nearly mature Moss Garden.

As a final touch, one can add stones, boulders, statuary, and an occasional tuft of grass or single flowering plant to the patch of Moss for artistic interest. It’s a very simple but beautiful look that causes those strolling by to stop and ponder for a moment—a bit of Zen for just a moment before walking into the daily insanity of regular life.

Completed Moss Garden with stone statue, Oklahoma Moss Rock, River Pebbles, and colored Glass Pebbles.

Videos of Seraphim Pigeons at Coz Loft

1.This video was made after bringing my remaining Seraphim home from the pigeon show in December, 2011. I had put up a new set of breeding boxes, and the birds were quite excited by this turn of events. Most of the young adults in this film still have a few colored feathers which will soon be replaced with pure white. Four of these birds were sold, leaving eight for breeding.

http://www.youtube.com/watch?v=IMs_274tgJM

2.This video is a more close-up look at the same Seraphim as they happily show off in the loft. It’s a lot more fun to see them up close; their “faces” are very cute and neotinic (child-like) with their big eyes and short little beaks. They are such a blinding white that it’s hard for the camera to accommodate properly for color and light.

http://www.youtube.com/watch?v=adHDxfU7ja0

3.The following is a video of two baby Seraphim from two different sets of parents. Note the differences in markings. They both demonstrate the recessive red feathers seen as juveniles, and primarily in a pattern mostly on the wingshields and tails. This is typical of Seraphim young. They will molt to pure white as adults. At this age they do not demonstrate the more dramatic appearance seen in the adults—-they just look like clumsy little babies, because that’s what they are. They don’t know what they are doing!

http://www.youtube.com/watch?v=35ssm-JD6to&feature=related

4.Here is a Seraph cock doing a little courtship dance for a very pretty brown lacewing oriental frill hen. Males will show off to any hen, but this one simply was not interested and flew off and left him standing there.

http://www.youtube.com/watch?v=6xemb5uE5a0

Robotic Surgery

One of the newest developments for minimally invasive operations  in General Surgery is the application of robotic technology to routine abdominal and pelvic surgery. The DaVinci Surgical Robotic System developed by Intuitive Surgical  is the leader in the field. This robotic system is exactly what it says – intuitive. It is a well designed system that is extremely easy for the surgeon to use and has many benefits for the surgeon and the patient.

The way it works is this: As usual, the patient is given a general anesthetic and prepped and draped in the typical manner. The abdomen is filled with carbon dioxide through a tiny nick in the skin through a specially designed safety needle. A 1.2 centimeter incision is made and a thin plastic cylinder called a trocar is gently pushed through the abdominal muscle and into the abdomen with an easy back-and-forth twist. A miniature camera lens is placed through the trocar and into the abdomen to look around, the image highly magnified on a TV screen hanging from the ceiling on a movable arm. Two, three, or four more trocars are placed through additional tiny incisions, the number depending upon the number of robotic arms needed for the operation at hand. A trocar is placed for a bedside assistant to use as well.

The robot is then rolled to the table and docked, each arm attached to a trocar and then loaded with the surgeon’s choice of instruments for the case.

The surgeon then leaves the table and and takes a seat at a nearby console from which he will perform the operation. He slides his seat up to the “cockpit,” places his forearms on a horizontal rest, places the thumb and third finger of each hand into the hand controls, places his feet in position to run four different foot pedals to adjust the camera and robot arms and energy sources for the operation, and places his face into a forehead console that contains a large screen where the camera image is magnified in 3-D.

Every movement the surgeon makes with the fingers of each hand is transmitted directly to the instruments locked in the arms of the robot. The movements are absolutely precise. The instruments are especially designed with “wrists” that make them work like tiny little hands inside the abdomen, making it possible for incredible rotation, extension, and flexion of the working end of the instrument; in fact, it acts almost exactly like the surgeons regular wrist and hand. The robot sensors indicate the exact center of the trocars at the level of the muscle in the abdominal wall so that all robotic arm movements use that point as the movement fulcrum; there is thus no tension of any sort placed on the entry point in the muscle. It is as if the surgeon climbed inside in miniature to do his work.

The surgeon can thus do the operation inside within a smaller space and without pushing and pulling on the abdominal wall muscle. The magnification is tremendous, and everyone in the room can see the operation in real time on various monitors hanging around the room as it is performed, making it easy to anticipate the surgeon’s needs. The assistant at the table helps by passing sutures and needed materials inside to the “hands” of the working instruments as requested by the surgeon, and assists with retraction, irrigation, and suction as needed. If a surgeon is teaching, he can “write” on one of the TV touch screens in the room with his finger-tip, showing the surgeon at the console, who can see the writing in his own viewfinder, exactly where to cut, sew, retract, or place an implant. The technology is so advanced, in fact, that one could sit at a console in the comfort of their living room here in Iowa and operate on a patient anywhere in the country!

Since everything is highly magnified, blood loss is reduced to nearly zero. Every tiny little blood vessel is easily seen and coagulated before even a drop of blood can be lost. The instruments make it possible to sew with ease and get into places where one cannot normally work using regular laparoscopic instruments while operating at the bedside. Anatomical landmarks are easily located and sensitive structures avoided. As a result of all of these improvements, the patient awakens with even less discomfort than they would have with regular laproscopy (minimally invasive surgery). Their hospital stay is frequently shortened as well.

As for the surgeon, he/she can work while sitting comfortably and without stress and strain to the neck, back, and shoulders; they can see better and work efficiently. At the end of the case they are not sore and exhausted.

So with robotic surgery, everyone wins. The operation is performed with ease for the surgeon, the patient feels better and goes home earlier, there is less need for transfusion, return to work and regular life is facilitated, the surgical team can see and help more productively, and costs are reduced for the insurance carrier.

There is, as always, one downside. The technology is expensive and is a big investment for the medical center. Nonetheless, the overall process likely results in less cost in the overall system. Even newer technology coming down the pike will further enhance our ability to perform operations with even higher precision. It makes it a great time to be a surgeon, as this technological revolution is a fascinating challenge for us and is exactly the sort of development that gives us renewed interest, excitement, and pleasure in our work every day. For me, it has always been the process of finding and then learning and applying better methods in surgery and medicine that has kept me interested every day—-the constant challenge of it all from a professional and intellectual standpoint. Add in the improved experience and outcomes for my patients, and it makes for a really happy combination for all of us.

I’ve used the DaVinci robotic surgical system for a wide variety of cases, including Fundoplication for Reflux Disease, Gall Bladder removal, Colon and Rectal surgery for both cancer and benign colon diseases, Hernia Repairs, Bladder Suspensions for Poor Bladder Control, Hysterectomy and Ovarian procedures, Vaginal Suspension for Prolapse, Removal of Adhesions, Lymph Node Dissections for cancer, and others. The Urologists in our group are using it for Radical Prostatectomy for Prostate Cancer as well as major kidney operations and other procedures for the ureter and bladder. Other surgeons around the country are likewise applying robotics in their minimally invasive surgical cases, and like us, sometimes performing operations that we couldn’t do using minimally invasive techniques before!

Robotics is changing the world of surgery for the better in a myriad of ways. In my twenty year career I’ve gone from doing everything with a big incision and long hospital stays  to space-age outpatient major surgery, and in some cases now even incision-less surgery! Who could have imagined such things??!! I’m reminded of my childhood in the 60’s watching “The Jetsons”  cartoon and musing to myself how cool it would be if we actually HAD  robots and magical  artificial brains and invisible waves flying through the air that could make things around us move and do things and make our lives so much better. Well, it’s all arrived, that’s for sure, and nothing will ever be the same again. This career of mine has certainly been a fun, interesting, and yes – even magical – journey. 🙂

David D. Coster, M.D., FACS

Wicked Little Town

John Cameron Mitchell as Hedwig singing Wicked Little Town.

Recently my husband and I decided to watch the film “Hedwig and the Angry Inch.” If you haven’t seen this film, you should. (Please see my review in the “Movie Review” category in the sidebar.) The film has to be one of the most….insane? comic? tragic? things ever created. It’s about a transgender German girl who marries an American GI and moves abruptly from Berlin to a dinky little town called Junction City, Kansas during the Cold War. What happens next is too strange to really describe, but suffice it to say it is hard to be a transgender person – or any other “other” person – in such a small town where homogeneity is the name of the game. Thus the reference to Junction City as “this wicked little town” in the song by the same name included in the film, a sad, tear-jerking song if ever there was one.

Wicked Little Town is my favorite song, I think. Anyone who has ever felt like they don’t fit in or quite belong will understand why the moment they hear it.

One day we watched the film again for probably the tenth time. Every time I see it, I get something new from it. It’s always worth my time. After watching the film that day, I decided to send an e-mail to Raynard Kington and Peter Daniolos, the new president of Grinnell College and his husband, to check in and see what they were up to and invite them over for a visit. In the note, I mentioned that I had just watched “Hedwig and the Angry Inch” and how entranced I was with this song, Wicked Little Town. I then went on to say that this song in particular really spoke to me. As I was typing, my husband looked over my shoulder to see what I was writing. Upon seeing my reference to Wicked Little Town, he quickly pointed out that I should immediately delete any reference to a wicked little town, as Dr. Kington and Dr. Daniolos might think I was referring to Grinnell, Iowa, the town in which we lived and the town to which Kington and Daniolos had just moved from Washington D.C. Although Iowa is a progressive state and Grinnell had welcomed the couple as if they were long lost old friends, he didn’t want them to fear that there was anything small minded about our progressive, liberal little town, or any wicked secrets that might be adversely pertinent to a their decision to move here. I thought about it for a moment and decided he was right. They might misunderstand my statement that the song had special meaning for me as somehow referencing some unpleasant experience of my own  here, so I deleted it and finished the invitation.

We then ran upstairs to watch an extra on the DVD about the making of Hedwig. Stephen Trask, the lyricist and composer for the songs in the movie, is a very talented fellow who my husband, Kevin Kopelson, had met one summer on Fire Island a long time ago, and Kevin wanted to see what he and John Cameron Mitchell, the actor who plays the character Hedwig had to say about the making of the film. It was a fascinating story, and we were glued to the screen.

Finally, Stephen and John got to the part about the making of the song Wicked Little Town. It was noted that, of all the songs in the film, Wicked Little Town is the barest. It exposes the very soul of Hedwig. At this point Stephen began talking about the difficulty he had in writing this song; he simply could not find the words or tone to represent the experience of being transgender in some dinky little town someplace; in fact, he had no personal exposure to small town culture and had no starting point from which to write. He struggled and struggled and just couldn’t come up with anything. What must it feel like to just not belong at all to a tight-knit small community—to just not fit in any way?

He just couldn’t feel it.

A few weeks later, he went on, he and his partner, Michael Trask, were invited by some friends to visit them in a small college town in the Midwest; “Ah, this might be just what I need to clear my head and give me the space to think about and write this song,” he thought. So off he went. As he rode from the airport into the countryside, miles and miles of farmland and open sky lay before him. He rode for an hour in open space before finally reaching the small town of his friends, Jared Gardner and Beth Hewitt. It was two days before he finally wound down enough from his city world to begin to feel the town he was in, to explore, to imagine what it must be like to be someplace where everyone knew who you were and what you did every day. And then, finally, while sitting at a desk in his friend’s duplex – in Grinnell, Iowa – the words finally came.

My jaw dropped; I turned to look at Kevin as he turned to look at me, our open mouths mirror images, our eyes open wide. “Oh MY GOD!” we both yelled at once. “GRINNELL IS THE WICKED LITTLE TOWN!”

And then we were in hysterics for the next half hour, nearly dying with laughter at the irony; at both the IDEA of Grinnell – of all places – as a wicked little town, and our not knowing it was the wicked little town when deciding to delete the reference to Wicked Little Town to keep the new college president from thinking Grinnell might be a wicked little town!

And that’s the story of how Grinnell became the essence of the Wicked Little Town song in Hedwig and the Angry Inch, and how we almost spilled the beans to the new Grinnell College president and scared him away.

So “salutations!”to you all from Grinnell, Iowa, – our own wicked little town, better known as one of the “best small towns in America” – where in truth, you could – like Hedwig – be transgender and hardly anyone would bat an eye, but everyone would certainly know it!

David Coster, M.D.

Coz Loft 2011 Show Results

James: Best in Show, AOV, High Standard (HS). Des Moines ISPA Fancy Pigeon Show, December 2011. James is the founding Seraph cock of one of my Seraphim lines.

[Note: I have moved all of my current Seraphim breeding/sales information to Coz Lofts at cozlofts.wordpress.com. Please enjoy the Pigeon Loft articles here, but for current news and opportunities for Seraphim go to the new dedicated Seraphim site.]

My birds did very well at the 2011 ISPA Fancy Pigeon Show in Des Moines in 2011, all scoring from 92 to 95 on a scale of 100, with three birds scoring “High Standard” at 95 and three others @ 94. This experience with my twelve show birds exceeded my expectations. I’ve kept back eight of those birds for breeding stock, including James, Best in Show Seraph cock.  NoBand couldn’t compete since he had no band, but the judge scored him for me anyway and felt he was pushing a 96. He is the founder of another Seraphim line in my loft. SuperJock likewise will be staying put, along with his son, GiantHead, a spectacular young cock still too young to breed but already paired up with the best hen from 2011. This is my team for this year, and I am hoping for even more success. One of these days I would like to have the almost impossible to achieve Royal Standard in my loft!

In January all the birds will be set up for breeding. I can allow only a limited season due to space limitations, so if any of you fanciers out there want a pair of high quality birds this year, drop me a line and I’ll breed extra designer birds just for you out of a combination of these great blood lines. You can reach me at cozmd@aol.com.

The Seraphim Club International

A pair of Seraphim enjoying the snow.

As much as I enjoy writing stories about my own Seraphim and sharing pictures, I thought there should be a bigger web presence to make it easier for Seraphim fanciers to get information about this beautiful rare breed.  So I called Anne Ellis, the designer and originator of the Seraph, and after a lengthy and lively discussion we concluded that it was time for the already existing Seraphim Club International to take its place on the digital world stage! So check it out—here is the web address:

http://seraphimclubinternational.wordpress.com/

It is a digital compilation of articles, photos, and all that is known about the Seraphim pigeon and their development. I am the editor of the site, and Anne oversees and approves content. Breeders and fanciers can locate other breeders with high quality Seraphim for their own lofts, compare notes on raising Seraphim, get advice on breeding to the standard, learn about genetics, read the incredible story of how the Seraph was designed and developed, read new and original articles by Anne, ask questions and get answers, and make new friends. There is no fee to join or subscribe to The Seraphim Club International in the interest of promoting the free exchange of knowledge and The Seraphim Fancy.

David Coster
1333 Broad St
Grinnell, Iowa 50112
cozmd@aol.com
Coz Loft