M. S. F.

(I am pretty sure that I am repeating myself with this post, but no matter … I will boldly go where I have gone before).

Now this will definitely give some of you a chill, but I actually used to teach medical students. In fact, I did so at some level during my entire time in the trenches. During my last few working years, I was heavily involved in the pediatric junior clerkship at the USD School of Medicine, where every eight weeks or so a group of innocents were ushered into my presence, and then from on high I would pass along one imperishable dictum after another, some of which I had made up only that morning.

There was, however, one story that I told nearly every group, and it involved a recitation of the first few lines of the poem by Rumi, “Cry Out In Your Weakness.”

A dragon was pulling a bear into its terrible mouth.
A courageous man went and rescued the bear.
There are such helpers in the world,
who rush to save anyone who cries out.
Like Mercy itself, they run toward the screaming.

Rumi: Cry Out In Your Weakness

I would tell the students that since they had deliberately chosen to be among the helpers who run toward the screaming, that they could give themselves a pat on the back for making that choice. That the best of them would spend their careers running to help those who were bleeding, vomiting, seizing, or losing it in ten thousand other creative ways. Events that many people might cross the street to avoid.

(Of course, not all physicians are noble souls, but in my lecturing I was addressing the better angels of the students’ natures).

There is one entire group of physicians that I have long admired greatly, those working in Médecins Sans Frontières (Doctors Without Borders). These folks not only run forward to try to save the bear, but they go right into the dragon’s mouth to do it. In my tiny way I have supported this organization ever since I first became aware of its existence. Whenever money became available for charitable donations, MSF was at the top of my list of good places to send that dinero along.

Where does MSF do their good works? In more than 70 countries, as this 2021 graphic shows. If you are curious to learn more about them, clicking on this link to their website may be of help.

If you look closely at the graphic you will see that there are no MSF clinics or outposts here in Paradise. Of course not. This is Paradise.



We all know that the human population world is divided into two major groups, and those are morning people and evening people. I have always been in the former group. I personally think that this is the better of the two, but if you were to poll my own children, you might get different results. When they were growing up and too young to defend themselves, all four of them were evening people. To hear them tell it, living with me was therefore by definition a form of Hell.

One day one of my daughters let me know that having to answer such probing questions as How’s school? How are things going? What are you doing today? before breakfast was just too much to ask. Hunched over her beverage she looked up at me and said: Dad … get a life.

During her last two years in high school, I had admired what seemed to be another daughter’s industriousness. She would rise early, get herself dressed, and be off to school often even before I took my place seated at the kitchen counter. But years later I learned that she did this to avoid having to encounter me in my role as Mr. Smileyface, waiting like a garrulous spider at the center of my web.

Since then I have learned to temper my approach to the early hours of the day. I am no longer annoyingly exuberant, but quietly composed. Inside, however, I am churning with all sorts of cringe-inducing salutations and subjects that just have to be explored right this minute. If you ever stay overnight with us, be careful what you say to me anywhere near the coffeepot at dawn. I am easily triggered.

One More Cup of Coffee, by Bob Dylan


Former president Cluck has surprised … no one … with his announcement that he is once again a candidate for our highest office. On Tuesday he spit out a mouthful of embalming fluid and spoke at an event where he shared the astounding and completely unexpected news with a number of his followers.

Now those among us who still have some of our critical faculties in working order realize that this man’s previous performance as POTUS should disqualify him from running for anything but commissioner of cucarachas. But we live in a time where a narcissistic huckster can hijack a major political party. However, it was that same party of political masochists who opened the door and invited him to come in and beat them up … please. A party that now can’t get him to gather his cronies and thugs and go home. Cluck is one of those bad companions that their mothers warned them about.

I have little sympathy for the Red Party in all this. They collectively forgot what their job descriptions were. Something to do with supporting the Constitution and serving their country, I think it was.



One afternoon, after an exhausting session of trying to chew gum and walk which ended up with my going in circles in my own garage, I resolved to answer once and for all – do I have any chance of acquiring multitasking abilities? Because up until this time I have been a consistent failure at doing what many others seem to take for granted.

So I sent away a blood sample, specifically asking: Do I have any genetic material that would suggest that multitasking is something that I might learn, given enough time?

The answer came back almost indecently swiftly: NO. In fact, Mr. Flom, you have almost no such material at all. This is quite amazing, with your levels being about the same as the average axolotl, an amphibian so dim that it never learns to breathe on land.”

“In fact, we at the laboratory were wondering how you managed to type the letter accompanying your sample. Did you have help? Are you quite recovered from the effort it must have been for you?”


I prepared a lengthy reply to the sarcasm that was so obvious in the lab report, but while walking to the mailbox to post it I forgot what I was there to do, and so the envelope remained in my rear pants pocket until it had gone through the wash. At that point I abandoned the whole project.


And finally, if you have the sneaking suspicion that your doctor is ruder these days, you might be (gasp, cough, choke) correct. Medscape performs an online survey where they ask physicians if they have witnessed certain behaviors in their colleagues, and this year there was a small uptick. Here are the numbers from this years’s survey.

(Now keep in mind that the numbers below do not mean, for example, that 86% of physicians were bullies, but that 86% of physicians surveyed reported seeing such behavior during the year.)

  • 86% Bullying or harassing staff
  • 84% Making fun of patients
  • 55% Using racist language
  • 44% Being physically aggressive with patients
  • 43% Inebriation at work
  • 34% Lying about credentials
  • 30% Trying to date a patient
  • 27% Embezzling or stealing

When I looked over the list I thought back over my own professional lifetime and realized that I had seen all of these but embezzlement. In fact, when I was working in northern Michigan there was a situation where a small-town doctor was unmasked as an impostor. He had never gone to medical school at all, but had falsified the documents he was asked to produce. He had been working in this community for nearly ten years when he was exposed.

The most interesting part of the story was that while the medical societies and the legal authorities were going about prosecuting the man, the town itself wanted him back. They thought he was doing a terrific job. They went so far as to present a petition asking for his release and allowing him to return to the community.

Apparently a good bedside manner goes a long way. Sadly for the village, their petition was denied.

Vaseline Machine Gun, by Leo Kottke


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