Category: medicine

Smelling of Pickles

jono55

I don’t know if you have noticed it or not, but there is one product that has invaded and taken over the entire spectrum of health, homemaking, and cleaning do-it-yourself tips and therapies on the web. If you google almost any problem you are having this product will very likely be found among the possible solutions.

What is it? Why, Apple Cider Vinegar, that’s what. Has your pet peed on the sofa – use warm water, ACV, and maybe a drop or two of dishwashing liquid. Fungus on your feet – the same solution. Digestive system giving you fits – drinking two tablespoonfuls of ACV every morning may very well put you right. Dry skin or eczema – a little dab will do ya. The list goes on.

We’ve tried a couple of applications where it seemed to work, and several others where the jury is still out. Just to see, you know? So far there have been no reports of genetic breakage in people who use the stuff, no errant strands of DNA out there to cause mischief or cancers. I actually like the repurposing of a homely substance like this, and can easily imagine how all these recommendations came to be.

Good Lord, look at that mess on the stovetop, hand me something to clean it off with, would you?

All we’ve got is this jug of vinegar.

Well, bring it here, it’s probably better than nothing.

******

******

We all know about ear-worms, those times when a pesky tune keeps repeating in your head all day in spite of your attempts to cancel it. While I dislike the term itself, I don’t contest its reality. Most of the time this is benign, except for the times when the tune is one that soundly deserves to be forgotten, like anything recorded by the Starland Vocal Band.

What I’m having trouble with this week is not a song but an equivalent, a memory of an event from a long time ago. A memory that will not be civilized and allow itself to be tucked away. It started as a dream fragment, and now has moved into my waking day. Ordinarily I wouldn’t care much, except that this one is from a horror documentary in which I was a player.

Station 55 at the old University of Minnesota Hospital was where the children were cared for whose ages were between one and five years. This meant that it was where the majority of children hospitalized with acute lymphatic leukemia could be found. This incident took place in 1966, when I was a first-year house officer, and involved a four year-old girl named Emily who had ALL. In 1966 the 5 year life expectancy for ALL was zero percent. Therapies might achieve a brief remission, or even two brief remissions in rare instances, but that was it.

Oh, there was a report from Philadelphia of a single child who had made it to five years, but our hematologists believed him to have been misdiagnosed. All of the rest had perished in the unquiet ways that childhood cancer afforded them.

Emily had achieved her first remission, but was right then at a very vulnerable stage, with not enough platelets in her bloodstream to stop a bleed if one began, and not enough white blood cells to fight off an infection should one develop. Allow enough time to pass and these necessaries would come back, but right now she was walking a precarious line indeed.

One afternoon, not long after the noon meal, Emily got a nosebleed. First it was a slight trickle that we tried to stop with topical anticoagulation. Then it became a gusher where we packed her nose with cotton, which she absolutely hated and where she fought our efforts. Any four year-old would do the same, as it was a hateful and uncomfortable process. But it seemed to do the trick. We stood back from her bed, and she was able to settle down, while looking awfully pathetic with those cotton plugs in her nostrils.

And then Emily threw up a truly massive amount of blood that she had swallowed. The bleeding that had been prevented from escaping through her nose had not stopped but had been swallowed instead. At that moment everything went into high gear, at a speed fueled by growing desperation. We began repeated transfusions of whole blood to try to keep up with losses. We gave packs of platelets to try to plug the leaks that we could not see. We called in the ENT surgeons to see if packing from behind would be feasible.

But the bleeding would not slow down. The child’s gown would be changed and soon the new one would be completely soaked. The bed was a jumble of bloody sheets littered with empty gauze packages and tape spools from attempts at inserting larger intravenous cannulas to give more fluids more rapidly. A clear memory is the look of terror in Emily’s eyes, staring at us out of her blood-covered face. There was terror on the faces of the staff as well because we knew too much to believe that we could save her life but were too filled with fear to accept any other outcome.

The staff kept working for more than two hours, well beyond the point where there was a child left to save. Emily had long before this lost consciousness and had needed to be resuscitated several times. Finally, when yet another arrest occurred, one of us had the strength to call it quits. I no longer remember which of us it was that had that much presence of mind.

That evening I was at home, sitting at the supper table with my oldest kids, who were ages two and three. They were being their normal messy selves at table, squabbling with each other, playing with their food … the moment was filled with opportunities for me to reprimand them. But I didn’t. At one point I realized that I had completely tuned out everything else and had been staring fixedly at them for several minutes. Just watching two small children being very slightly naughty. But oh my, they were healthy.

******

******

In med school, as I rotated through he various clerkships, I went from wanting to become a general practitioner to thinking that OB-GYN was the place for me, to pediatrics. After the pediatric clerkship experience I no longer wavered and realized that this was what I wanted to do.

Some of my medical school classmates would ask why – why choose this specialty? The kids that we dealt with were so ill and their clinical courses often heartbreaking to watch. My answer was always this question. If we all stopped going into pediatrics, would the children stop needing help?

******

Apropos of nothing, this is a favorite photograph of my parents Joseph and Eleanor, taken at a popular Minneapolis dance hall, the Prom Ballroom. This would have been in the early 1940s.

My existence is entirely their fault.

******

One of my favorite scenarios in a play or movie is where several strangers are stranded in an isolated location, usually a hotel or a diner. Most often they are sitting out the weather, and in the course of several hours we learn who those people are and how they came to be in this place.

A perfect example is the film Key Largo, where a group of criminals are trapped with Humphrey Bogart and Lauren Bacall. A tropical storm brings them all together at a small tourist hotel and the drama flows from there.

We watched a variation on that theme this week in a Netflix movie entitled No Exit. A snowstorm gathers several people at a rest stop, where we find that everybody has a backstory, unbelievable coincidences come at you every ten minutes or so, and the off-label uses of a nail gun becomes the story line toward the end.

Key Largo is a great movie, a classic. No Exit comes no closer to greatness than the text on a cereal box rivals War and Peace, but it does achieve serious grisly.

******

Along the pathway of your life, I’m certain you have run across the interesting process of imprinting in various species. For instance if when a greylag goose hatches you take care of it and keep it with you in its first days out of the egg, it thinks you are its mother and will follow you about the barnyard from then on.

Well, looking back on my own days here on planet earth, it’s pretty obvious that part of my having a crush on a girl was that I imprinted, just like one of those goslings. All things that person liked became my own favorites, at least for a long while. Sometimes that “long while” outlasted the relationship itself. Music fell into this category of things.

So when I read the obituary of Giovanna Carmella Babbo this morning, there was a twinge. And I turned to my music collection to find that there were quite a few of her songs in there left over from 1956, when I “went steady” for a year with a girl who eventually (figuratively) stopped the car, told me to get out, tossed my class ring out the window and went on to meet another guy while I trudged the weary and desolate miles to home.

Now if you are Giovanna Carmella Babbo, and you want a recording career, someone is bound to tell you that a name change might be a good thing. At least that was true in the fifties. So this singer became known as Joni James, and she was very large through that decade and a few years into the sixties. In my listening this morning I recalled the powerful angstiness of teen-age romance, and the talent of the singer whose work was the soundtrack to my year of going steady.

Have You Heard, by Joni James

The recording is dated, with the lush string arrangements that were so common in that decade. And the lyrics are often a bit over the top. But you know, I still like her voice, and those of you who have ever fallen hard for somebody along your way know that there is no such thing as “over the top” during such times.

******

The Bar Keeps Gettin’ Lower

jono55

I don’t know if Lauren Boebert is the dumbest Representative in Congress, but If there is someone less capable, I’d hate to think about who that might be. She is from western Colorado and makes my head ache whenever I think about her at all, so I had to take a couple of ibuprofen this past week when the two videos started being news. You know, the videos where she tells a bigoted and racist story involving Representative Ilhan Omar to two different small groups of people. In both of them she all but directly accuses Omar of being a terrorist. The thing is, the two stories don’t agree with one another, and apparently describe a meeting that never happened. So she is not only a racist and a bigot and a dumbass, but a liar as well.

It reminds me of an old saying (I am paraphrasing Mark Twain here): If you tell the truth you don’t have to remember what you say. I would say that she is an embarrassment to the Republican Party, but we all know that this isn’t presently possible. To embarrass that party, that is. It is at a very low ebb indeed. But in another few months we’ll get to see if the GOP can find somebody less offensive and more credible to run in that district. You are free to use Boebert as a sign of the health of the party if you want to. It would be like taking its temperature. If they run her again, shame on them. If she is elected again, shame on us.

******

From The New Yorker

******

When will these golden days of Fall ever end, and we can get down to the business of shivering and scraping the sleet from our faces? If the trials posed by Winter are good for me because they build character, I am afraid that my character is probably slipping quite a bit this year.

I have become too used to this soft life where my choice of coat to wear when I leave the house doesn’t determine my survival. Why, just this past Wednesday I accompanied Robin to her physical therapy appointment wearing only a pair of shorts (cargo) and a light fleece sweater. And I was fine. And it was December.

I know in my heart that this blissful weather won’t last forever, and that I can once again begin my annual period of kvetching about how cold it is and won’t the wind ever stop blowing and how my back aches when I have to shovel snow. But right now, daily life is no trial at all.

******

From The New Yorker

******

Since I am definitely in a reverie frame of mind, another medical student story. When I rotated as a junior student to Ramsey County Hospital in St. Paul for the internal medicine clerkship, our group was oriented by the assistant chief of medicine. His speech started out like this:

“In the last group of students we had some problems with a couple of your classmates who were rude and arrogant in their behavior toward members of our nursing staff. Let me be clear on this point. We work hard to attract and retain excellent nurses here on the medicine wards. We have no trouble at all getting medical students. Do you catch my drift?”

******

I accompanied Robin on her visit this week to see Dr. Judkins, the orthopedic surgeon who did her knee reconstruction. He took several X-rays to check on things, and as soon as I saw them I asked for copies, which he kindly provided. I thought you might be interested in what a total knee replacement looks like on X-ray.

The first picture is taken from the front, and compares the operated knee with its mate on the left. The second view is from the side.

NB: I had the patient’s permission to share these images with you, of course. To do otherwise would be to court havoc.

******

Christmas is upon us. The first flakes of it start falling these days a little before Halloween, followed by flurries leading up to Thanksgiving, but after that … the gloves are off and it’s a by-god blizzard from then on. There are days when I get two different catalogs from the same company.

Our home decorating for the holiday has gradually simplified over the years to where now we purchase a red candle and a green candle and put them on the dining room table and call it a job well done. (Well, maybe just a bit more than that). Gone are the days when one agonized over garlands and which Christmas Village building to add this year and what box did we put those Fitz and Floyd pieces into last year anyway? I don’t miss them much.

My grandparents Jacobson, whose way of life still informs my own in so many ways, decorated for Christmas by bringing out a box from the attic that contained perhaps a dozen small items. Ida would distribute them around her little home each year, never adding new ones, always caring carefully for the old. Each piece had some meaning to her and Nels, and a story that went with it.

There was only one thing that was electrified, nothing that blew up into monstrous size to be maintained by a roaring air pump, nothing that had a famous maker’s label, nothing that said “Look at what special things I have done with my house.”

I remember two garlands, each six feet long, one red and one green, a very small créche, a ceramic wall plaque of Santa’s smiling face, and a pair of candlesticks representing angels. There was only a handful of other treasures, but when you walked in their door and saw these few items out in the living room, it was instantly Christmas.

I almost forgot the tree.

Since their home was too small for a real tree, there was an inexpensive plastic one about a foot and a half high, that stood on an end table and was in no way trying to look realistic.

A placeholder is what it was, indicating where a dramatic Fraser fir or a luxurious Colorado spruce might have stood if there was room for it. Or if Nels and Ida felt it was needed.

******

Down On The Farm? Ewwwww … Nossir!

jono55

So far I’ve not been too excited about the coming electric vehicle “revolution.” The cars are smooth and fairly reliable, and they will carry a person comfortably from one place to another as long as those two places aren’t too far apart. Some of them will accelerate from zero to 60 miles per hour in around three seconds, which is a really useful characteristic for a car to have, especially with many more older drivers on the road whose reflexes may have slowed a bit. Put Grandpa at the wheel of a new Tesla, for instance, and if he gets a cramp in that right leg he can be going 100 mph before he hits that light pole in the parking lot at City Market.

But a vehicle is on the horizon that finally gets my pulse up a few beats. The Rivian pickup truck is the one. It is not a truck meant for serious work on a farm or at the workplace. No, no, there will be none of that. Manure will never touch its bed. It is meant for the well-heeled wanderer, to be used primarily for glamping. If you want to load it up with everything the price is somewhere north of $91,000.

It’s true that the truck can get to 60 mph in a hair over 3 seconds. It can tow 11,000 pounds. It can be configured to have 15 inches of ground clearance. It has a motor on each wheel, which adds up to a total of around 800 horsepower. It can drive through a river that is three feet deep. And to top it all, my friends, it can do this:

Now I admit that there are very few times in my life when I have wanted to do a “tank turn” as in the video. There were those two episodes when I found myself having taken a wrong turn and briefly going down the wrong direction on a busy highway where it would have been handy, but that’s about it.

So I don’t think that I’ll put my order in just yet. For instance, I would like the truck to go quite a bit farther than its 300 mile range before it runs out of electricity. And if they would knock $50,000 off the sticker price it would be a lot more attractive. But I think I may have finally found an electric vehicle that would fit the style in which I imagine myself living, that of the gentleman adventurer.

******

Followup photo of Robin in her PT outfit at the Mountain View Therapy center this week.

I think it’s quite stylish, but Robin vehemently disagrees. Whenever I suggest that she wear it out in public I get the look that says “Just shoot me first.”

******

From The New Yorker

******

We’ve now used up all of our Thanksgiving leftovers, so the day is officially behind us and we can go on to other things. It’s always painful when you look up from licking the last crumbs from the bowl that the decadent marshmallow-encrusted yams were served in and see the look on the face of your spouse which is “Who is this disgusting person?”

But crushed egos recover, as I know mine will, in time. And Robin really should be used to my habits by now if she was paying attention at all over the past 29 1/2 years. Perhaps when we were dating I concealed my tendency toward gluttony from her, but I’ve been open about it ever since. The telltale orange-stained fingertips indicating that an entire bag of Cheetos were now history, or the half-eaten ice cream carton that any knowledgeable archeologist can see was taken down to that point by a man with a spoon in his hand and no sense of decency at all. Oh, and how about that slice of turkey in the Tupperware container that is missing a chunk with a bite radius that exactly matches my own. These are among the telltale signs of a person not to be trusted with your edibles.

*****

From The New Yorker

******

As recently as five years ago, I was taking no prescription medications. When friends would list the several drugs they were taking for this and that I admit that I thought to myself “Poor bastards, they have been afflicted, but I, for reasons quite unknown to me, have not. Perhaps it’s because I have lived such an exemplary and blameless life.”

Those thoughts have come back to haunt me now as I spend part of each morning and evening shoving chemicals down my gullet in order to preserve life and limb. That is, at least statistically because no sensible physician makes guarantees as they hand out prescriptions for the many tablets, caplets, capsules, and powders at their disposal.

At present I take one to calm down that sneaky blood pressure, one because the laboratory tells me that my lipids are slightly out of whack, and one aimed at reducing the likelihood of having another stroke. I also take one to calm my allergies down, a part of my immune system that continues to get more robust with time, while experts tell me that the rest of that same system is going all to hell (life does have a sense of humor).

So there is no more feeling superior to my contemporaries for me, as I am right in there in the pharmacy lines with everybody else, munching on yet another slice of humble pie.

******

Lastly, here is a short sketch from SNL that you might enjoy.

Jon: This has my nomination for the best Saturday Night Live sketch of the year.

Robin: I don’t know ’bout that.

******

Cruelty

jono55

******

(From the Montrose Daily Press)

There is a herd of elk (the one in the article above) that lives in the valley leading into the town of Telluride. A couple of weeks ago we passed it as we were driving into the village, and what a beautiful group of animals it was. There was a stag in the group who had antlers that were as magnificent as any I’ve seen outside of photographs. We pulled our car over just to watch them for awhile. Because they are accustomed to people and cars, we were within 50 yards of the herd without seemingly bothering them at all.

Some days after our visit, a coward went into the area and killed a bull elk from the herd. It would have been as if one walked up to a group of cows and shot one. No more courage or skill was required than that. What they did was apparently legal but I wonder … how do you boast about shooting a cow?

No matter how one twists logic to justify it, the “sport” of hunting involves the killing of other creatures … for fun. The whole sorry business is despicable.

******

******

Robin continues to mend steadily but at a slower pace than she would like. At least that is how I would think about it if our situations were reversed. But then I have never claimed to be stalwart in the face of discomfort of any kind. When I was a child spending time on Grandpa Jacobson’s farm, I would often get slivers in my hands. Since I had been taught that leaving the splinter in there was going to either bring on the nightmare disease of “lockjaw” or my hand would swell up and fall off, I had to seek help. And the help available was Grandma or Grandpa.

Grandma’s approach was to sterilize a small needle in a flame and then carefully unroof the splinter and extract it with a tweezer. Grandpa, on the other hand, would pull a pocketknife from his overalls and set about carving out a chunk of my flesh that would hopefully contain the bit of offending vegetation. It wasn’t that he was anything but a kind man, but when such a knife is the tool you have to work with, that is what happens.

So whenever I had a choice I would hide the injury until we got back to the house and Grandma could take over. Even then there was an embarrassing amount of grimacing and whining on my part until the thing was done. I’m not sure, but I expect that I might do the same today in similar circumstances. Heroism does not run strong on my side of the family.

******

******

My favorite sort of cartoon is one that surprises me. One that takes me somewhere when I didn’t even know that I was traveling. The drawing above this paragraph is an example. It’s quiet, subtle, but is obviously taking place in some alternative universe. The clearest indicator is the dog being in the operating room in the first place. Such a thing could never happen, at least in the U.S. … or could it? There would be so many barriers to the animal getting in there, so many doors to get by and so many nurses and technicians trying to catch it and expel it from the premises.

Now look again. While the OR staff are all masked, none of their noses are covered, which is a totally unacceptable break in protocol. If we’re going to spread something from human to human, what issues from our noses is an excellent way to do it. Not everyone in the country appreciates this, though. I see it every day in the public square as one of the things our local drizzlewit population does when presented with mask mandates.

Lastly … those naked feet. God knows what microorganisms we carry about on our feet from day to day, but finding a pair of tootsies exposed like that in the operating suite would be enough to horrify any nursing supervisor to the extent that they would surely come down with a variant of PTSD.

No, this cartoon limns a place of fantasy where the beam from the overhead lights cuts sharply through the surrounding darkness and isolates the six characters (I include the dog and the owner of those feet) in their very own world. It’s a great cartoon.

******

Even for an operation on one’s knee, there are modifications of the home that are necessary. For instance, we’ve added several useful hardware items to the furnishings – a chair in the shower and a walker, for instance. Also we’ve temporarily retired several area rugs and put them out in the garage to prevent them from causing tripping and falls.

Said rugs are now piled high enough to pose hazards to anyone in that part of the building and may prove an effective burglary deterrent. “Honest, Officer Krupke, I had no idea that a stack of rugs could do that to a person. Do you think a good mortician … ?”

******

Krupke, Krupke … now where did I hear that name? Oh, yeah … right here, from 1961 …

******

I have a nomination for the best book title of 2021. It is Josh Ritter’s “The Great Glorious Goddamn Of It All.” I have it on my list for winter reading. How could I not?

******

Doctor, Doctor, Give Me The News …

jono55

It’s Monday morning and we’re at the local hospital by 0630. A few minutes in admissions and then up one floor to the surgical suite. At this point Robin is whisked away by a very pleasant masked woman. I will not see my friend again until she is in recovery. I wish her well before she disappears behind a door. The well-being of the person I love most in the world is now completely out of my hands for the next several hours. I will learn what the OR staff wants me to learn when they want me to learn it.

At this point I am going on 99% confidence and trust in the process. Trust that everyone on the OR staff knows their role cold, is in good physical and mental condition, and that Robin’s body will do its part as well. But there is that 1% of me that worries. You can’t have been in this business and not have some reservations, because you have a personal collection of stories of snafus in the operating rooms that go back 50 years.

I did not sleep well last night and I am nodding in the waiting room, in danger of falling off my chair and embarrassing myself. So I am the second person in the line for hot coffee when the cafeteria opens at 0730. The other person looks like they’ve been here all night. It’s a little known fact that spending time in a hospital waiting room in magnifies every defect in your appearance and costume. If you normally look slightly haggard, now you are actually scary-looking and small children clutch at their parents’ clothing as you pass. Creases in shirts and pants appear as if by magic, generally going in an unnatural diagonal direction across your body. The same goes with creases in your face, and bags under eyes that you never had before are now the size of fanny packs.

I don’t know why or how this happens, but I have observed it thousands of times in others before today, and it is starting to show up in my mirror-reflection this morning.

By 1000 hours the orthopedist has stopped by to tell me that all went swimmingly, and that Robin will soon be moving to her room. By 1030 I am talking to her in person. At 1400 the nurses get her up for a short walk in her room. At 1600 she takes another walk down the station corridor before returning to her bed.

Quite a day, actually.

******

I have developed an affection for the physical therapist who managed Robin’s treatment after surgery. Not because of his professional skills, which were excellent, but because he laughed at all of my lame attempts at humor. Convincingly. That is not an easy task, since I have heard tapes of myself doing jokes and mostly they just make me want to step into a closet until everyone goes away.

But Fred is neither condescending nor patronizing. He’s the audience of one that you dream about.

******

In anticipation of the next several days, which we will call Just What I Kneeded week here at BaseCamp, I present a trio of hospital-based toons stolen from The New Yorker.

***

***

******

The Many Pleasures of Nitpicking

jono55

It’s four in the morning and I am trying to edit a post on my blog and there is a fly in the house. Just one. In the entire place. And it has obviously taken annoying me as it’s life’s work. It can’t bite me, and there is no uncovered food to worry about being contaminated. But what it does do is walk on my head at random intervals. When I make a swipe at it it easily evades my primitive defenses and disappears into the murkiness that is the house at this time of day. Then suddenly there it is back again, traipsing across my scalp without a care in the world.

I am distracted beyond measure. I know that flies don’t laugh out loud, but I swear that I hear tiny chuckling noises. Such is my state of mind. Serenity is lost. Creative writing is impossible because my mental processes have been commandeered by this winged pestilence. There is a single word flashing across the marquee of my thought-stream.

REDRUM! REDRUM! REDRUM!

But now the fly has gone … somewhere. It’s been fifteen minutes or longer since I felt its presence. I know it hasn’t left the house, there is no exit available to it. It’s only waiting for me to relax and to begin to think that I can reclaim my day. Even though its life is (on the average) only 28 days long, it is very patient and probably is now reclining in a closet against one of my sweaters, filing its clacky little nails and waiting for just the right moment to come out and take one more hike …

******

I am thinking that Senator Joseph Manchin is the Democrat’s equivalent of Senator McConnell. He seems to care less about doing the right thing than increasing his personal power, and is willing to wield that power widely for as long as he has it. If it were not for the slender margin of the Democratic majority, who would care what Manchin thought? He’s a backward-looking man who is still selling bags of coal to anyone who will buy, even as the earth begins to burn around his feet.

Reading about politics is a good way to spoil a good morning. My grandson who is spending some time with us is 29 years old. Here is the list of people who have been POTUS since he was born:

  • Bill Clinton (president fellatio)
  • George W. Bush (president Iraq/Afghanistan or bust)
  • Barack Obama (president who cares if I didn’t do squat – I’m rich, rich!)
  • Donald Cluck (president disaster)
  • Joe Biden (president wake me up when it’s over)

Now is that a lackluster list to contemplate or what? Keep in mind that these are the presidents, the holders of the highest office, and at least theoretically our best and brightest. God help that grandson if he starts looking at the sorry state of members of Congress during this same period. (I would never suggest that he do so unless a competent psychotherapist was right there in the room with him to ease him over the depression that would inevitably result).

A worm blob

I recently read an article about a blob of worms and its fascinating behavior. As I was reading I realized that without even trying my mind had made that squirming ball into a metaphor for American politicians and politics. Read the piece, watch the video, see if you don’t come to a similar conclusion. If not, please tell me why. There are days when my spirit could certainly use a boost.

******

Our cats are already settling into winter behavior patterns. Basically this means more time spent indoors and less time in the back yard. They are eating more, sleeping more, and occasionally looking about as bored as any critter can look.

It has become apparent over the years that Robin and I are not stimulating company for a cat. At our best we are the providers of food, the openers of cans, and minions who deal with kitty litter in all of its delightful forms.

At worst we are poor conversationalists and don’t seem to know on our own when the best times are for the brushing of fur and for scratching behind the ears, and need to be reminded (sometimes forcibly) about doing our duty in these areas. In addition, we often let the weather get completely out of control, allowing wind, rain, and cold to run rampant on the other side of the cat door. Year after year we humans never seem to get any better at this. It’s enough to make a feline weep in frustration.

I know for a fact that Willow is thinking that if she had opposable thumbs and the keys to the car life would be a completely different story at our house.

******

******

Robin and I got our booster shots of Covid vaccine this week. Just as before, it took 24 hours before we started to feel mildly lousy, but within another six hours our bodies were returned to us in fine shape but for sore arms. We are now armored as well as is possible here as players in the ongoing Montrosian soap opera I will call Days of the Numbnuts. The theme of this show is that over the first several episodes half of the town’s occupants are revealed to be mindless drones who get their instruction and misinformation from foxy television screens.

It isn’t long, however, before we find out that the drones are dying off one by one from a mysterious illness that results in their exploding at social gatherings. One cup of punch and they go blooey, leaving quite a mess behind for the host and hostess to clean up. By Episode Six no one is inviting them to anything any more, and they have only themselves to talk to. This is a state of affairs that they bitterly resent, but those TV screens are not providing them any help at all.

Not sure where this will all go from here, but the drama is mildly entertaining if you can just distance yourself and watch it as if you were an anthropological observer from Neptune. At least that’s how I am handling it these days. It makes me less crazy.

******

Sanity Isn’t Everything

jono55

The television series “Bosch” is over and done after seven seasons. No more years promised or hinted at. But it is still out there to be enjoyed, because this is streaming-land, where you can have a second chance if you missed it the first time around. And if you did miss it, here’s why you might want to take a moment to put it on your list.

Everybody looking nice and noir here in this poster.

It seems that there has been one police procedural series at a time that is clearly superior ever since “Hill Street Blues” came on the scene, and Bosch was one of those for Robin and I. Taken from a series of books by Michael Connelly, we got to watch characters rise, fall, stumble, surmount obstacles … to develop in ways that we might not have predicted.

Titus Welliver as Harry Bosch. A good actor gets a fine role. What’s not to like?

The lead character, detective Harry Bosch, had a childhood that was so unjust, so nightmarish, that it made him a crusader for fairness and justice in his police work. Crusaders can be prickly people, and his character is all of that. But most of his behavior is … admirable.

Watch an episode or two if you are between series. You may get as hooked as we were and be glad for it.

******

I’m reading The Great Influenza, a book about the pandemic of 1918. Now (I can almost hear you asking yourself) why would a sane person read about one pandemic when they are in the midst of another one, the end of which is nowhere in sight? I think the answer is in the words “sane person.” Sanity, if you will search the pages of this blog going back as far as you want to, is not a quality I have ever claimed for myself. It’s not even a goal that I aspire to, to be honest.

My own variation of not quite on the beam does not involve the use of meat cleavers, AR-15s, or other violent tools and actions. It’s the kind of looniness that at its worst others probably find at worst irritating or annoying, at best amusing.

But about the book. If we think that we have it bad today, it is instructive to see what happened in 1918. Think bulldozers in Philadelphia digging mass graves to help alleviate the piling up of corpses in hospitals, morgues, mortuaries, and homes. Think what seemed like an ordinary influenza season turning into a nightmare as the virus mutated into something much worse, a killer of amazing swiftness and ferocity. Think a disease that hit hardest at the young and fit and was tolerated better by the infants and senior citizens of the time, turning the usual run of a disease on its head.

The author tells a good story, and he has a fantastic story to tell. For me, the introductory chapters on the development of American medical science were eye-opening. Where we went from backwoods medicine to the best laboratory benches in the world in less than a generation, and from the far periphery of science smack dab into the center, a position we still hold. Where doctors went from incompetent butchers to the gods of society that they became. This latter was especially interesting to a former doctor-god like myself, who had to turn in his celestial robe and scepter some time ago and who has been living contentedly as a mortal ever since. (I really don’t miss all that, although I will tell you that if you ever get the chance to party with the seraphim, you’ll never be the same).

******

******

Back when I was in the process of becoming a divorced person, I sort of lost my mind for a while. I kept bad hours, slept too little and often ate things that were not fitten to eat. I would be up nights writing poetry, most of which I recognized the next morning as drivel, some of it as just okay, but then I would read one that was really good. One which contained ideas and writing that I recognized as not mine.

Out of these experiences came my theory of how my cranial contents, and perhaps yours as well, truly operate. First of all, this spongy bit of tissue tells me what to do to keep all of the nutritional substances that it needs coming in on a regular basis. It ponders odd things without cessation, and it does this without my bidding or leave, and often without my complete understanding. It prompts me to carry it around to different places, I suppose because its fairly confined life would be too boring if it didn’t have new things to look at.

But it has become obvious that what I used to regard as my brain I now realize is a brain. It doesn’t really belong to me, and is actually pretty independent of me. But I can “rent it” like a tool when I need it to tot up a column of figures or type a blog entry like this one. When my rental hour is up it doesn’t stop but keeps on going like that mad little bunny with the drum.

Anyone who has ever begun to meditate will recognize themselves here. You sit on your cushion, arrange your arms and legs just so, and then begin focussing on your breathing. Almost immediately your brain takes off on a tangent. You bring your attention back to the breath and in a few seconds that monkey mind is off again, following its own muse. You wonder why this is so, and why you don’t seem to be in control of your thoughts. Well … now you know what I think. Perhaps you have a better explanation?

******

What’s That Smell?

jono55

I caught part of an NPR broadcast a couple of weeks ago where the chef from Noma, one of the most famous restaurants in the world, discussed his new book. It was all about fermentation. In the interest of truth and all that, I admit that I never heard of him or his restaurant before listening to him on the radio. That’s not altogether surprising because it is in Copenhagen.

But he made fermentation sound so interesting, and it sounded like it had all the attributes of being a great hobby. One where at the end you can eat your output. That’s what cooking is to me, and why I find it such great fun, even though my skills are still so rudimentary. (For myself, here is where I separate cooking from meal planning. The former is what I enjoy, the latter is a chore that I have to do.)

After the broadcast I thought of the ways that I had already used fermentation without thinking about it. Baking bread, feeding sourdough starters, making kefir, brewing my own beers (which were excellent), and one stab at making my own wine (which produced a horrible beverage).

There was that time when I tried to make unyeasted bread, just like in the Old Testament. I mixed up the dough and then left it uncovered for days, as the recipe directed. Nothing seemed to be going on, with no evident rising of the bread-to-be, and eventually I baked the lump of dough to see what would happen.This produced a rounded, beautifully browned, and totally unyielding flour brick that could not be sliced or torn. I could not even drive an ice pick through it.

I finally gave up thinking of it as a food. What if I did eventually break off a piece? Obviously, I was not able to eat rocks. So I tossed it into the back yard to the two Siberian huskies that I owned at the time, and they were able to gnaw it down to nothing, but it took the two of them a week to do it.

I ordered the book today and look forward to adventures in sauerkraut, kimchi, and other more exotic delights. I will study each recipe carefully, especially the mortality rates that come from eating the foods produced. I want to keep that number on the low side, if I can.

******

Nandi Bushell, a 10 year-old Englishwoman, is some sort of drum prodigy, and apparently has a considerable YouTube following, especially in the UK. She challenged a favorite of hers, Dave Grohl of the Foo Fighters, to a drum battle. This is the result.

I’m sorry … she wins the cute part of the duel instantly. Grohl never had a chance. They even dressed alike. Can’t stand it.

******

Life is not fair … we pretty much all know that this is not true by the time we’re teenagers. It can be interesting, hard, joy-filled, complicated – but not fair.

But what I read on Thursday morning went so far from fair that I am speechless. Almost. Remember just a couple of weeks ago I reported on studies that showed that alcohol shrinks our gray matter? The stuff that we think with? Researchers have found out some new stuff about coffee, and it seems that in regular drinkers, coffee shrinks the gray matter as well, although it seems to rebound if you quit drinking it. Whaaaaaat? Hello, Great Spirit … what is up with that?

At any AA club, if a fire broke out, the first thing the members would save would be the coffeepot. It is an essential part of the meeting, when we are newly out of the swamp and blinking like bats in a bright light. And now they are telling us that this life-altering beverage may have a dark side of its own? Not fair.

Chalk another one up for the Trickster, that spirit found in many forms in Native American legends and stories. Just when we are feeling we might have a handle on things, he pulls out the rug.

******

You may have noticed that I talk very little about the talents and intelligence of my fellow physicians. That is because the garment that is the medical profession is cut from a very big piece of material. For example, some physicians are outright idiots. Here Sanjay Gupta and Jake Tapper are discussing a doc who is in a class of her own. As she speaks, you will find that you understand magnetism much better than the good doctor does. Probably a lot of other things, too.

Oy.

******

Once in a great while something peculiar happens, and I suspect that others have had the same experience. Out of nowhere I will be struck with the most intense feeling of longing. Enough to pause me in whatever I am doing in order to give the emotion my full attention.

But it is not longing prompted by anything I can put my finger on, nor is it for anything specific. No golden day of yesteryear or place that I have been or person who has been lost to me. The feeling is not attached to anything that I am conscious of at all. It is always accompanied by a light sense of melancholy. If I were a composer I might write a song that could bring those feelings out where they could be shared, and some of the sharpness of the poignancy eased.

Wait … someone already wrote that song for me, and his name was Francisco Tarrega. The song is Memories of the Alhambra. The yearning for something intangible is right there in this excellent short piece of music.

******

From The New Yorker

******

For three days now, we’ve been privileged to have Aiden and Claire as house guests. Ages 16 and 11 years, respectively. All in all, I think it’s going pretty well, with the kids being very tolerant of our foibles, and Robin and I returning the favor. They brought their bicycles along, and the four of us have been cruising the neighborhood and the trail along the Uncompahgre River. Later this morning we’re headed for the reservoir at Ridgway, where one can rent paddle boards and small kayaks and such. The temps are right around 90 at the hottest part of the day, so we have definitely been pacing ourselves.

Aiden had it in mind to make a short movie during his stay here, and so we are filming that epic one scene at a time, in between doing other enjoyable things. He’s quite proficient in filmmaking and very serious about the project. Watching him at work has been a lot of fun. He is a very good kid – smart, polite, talented, and self-aware. When I think back on how surly and selfish I was at the same age, I am embarrassed for my teen self.

Claire has revealed a side of herself that I had not noticed before, that of being a wise observer. She’ll be yakking on the phone with friends, turning cartwheels in the living room, singing songs in a language she made up, and then suddenly and quietly she becomes this real-life wise woman and says just exactly what needs to be said at that moment. It’s a startling transformation when it happens, and a delightful thing to behold.

******

There is good news from Lima, Peru. Daughter Maja continues to make progress toward independence in her recovery from Guillain-Barre syndrome, although slower than she would like. She has also been offered (and accepted) a job at the school in St. Paul where she worked before she took positions first in China and then in South America. Couldn’t happen to a nicer person. She definitely deserves a break or two after the past months. Maybe three breaks, come to think of it.

Speaking as the overprotective old fool that I seem to be at times, I will be glad to have her back in a country that is not in total lockdown, and where the possibility of visiting her exists. There are a lot of foxes out there in the world, and when the sun goes down I like to think that my chicks are safe for the night.

******

Daughter Kari alerted me to the fact that one of the most perfect foods in the world is 100 years old this year. Cheez-its. I am talking about the original flavor here, of course. There have been many new ones brought out in the past decade, but that original … my oh my … .

Other companies have tried to imitate this paragon of cheesy crispiness, but they have all fallen way short. That’s not just my opinion, by the way, that’s the honest to god truth.

So I plan on celebrating the centennial of Cheez-its by cracking open several boxes in the coming months. I see it as my sacred duty.

******

Report From The Empire

jono55

It’s been more than a year since we brought you up to date on the status of the Empire. I have no excuses (and as Emperor I am not required to have one) but we’ve all been busy, nest-ce pas? There have been changes, however. We’ve opened a branch in California and are soon to close one in Peru. In August granddaughter Elsa will carry the Imperial flag to Stockholm, Sweden, and plant it firmly there. The excitement is palpable.

Since the Empire is small, even though it stretches halfway across the world, we have to be very careful about what we say about our closest (and biggest) neighbor. Who might that be? Let’s just say that its national bird is the eagle, its national song is The Star Spangled Banner, and its national fool … well, that is an office that is constantly in rotation, but in modern times it nearly always is filled by a prominent Republican.

.

At present that office is shared by a troika featuring Kevin McCarthy, Lauren Boebert, and Marjorie Taylor Greene. All of them trying to show as clearly as they can why people have so much trouble trusting politicians.

Here in the Empire we don’t have politicos as such. Our system of government consists of the Emperor and the House of Merry Pranksters. The position of Emperor is a hereditary one, and can be traced back to when Emperor Hackberry the First was chosen by acclamation at a meeting held in 1655 in a fairly disreputable inn named The Empty Pocket. As I recall, it was on a Tuesday afternoon in October.

Members of the House are chosen through the National Lottery when we buy those tickets at the grocery store. We are proud of the fact that we can vote and have a shot at a tidy jackpot at the same time. The function of the House is basically to whisper into the ear of the Emperor what they think about an issue. And what they think that the general public thinks about that same issue.

It is considered bad form to talk to the press about anything important, and we have no domestic television or radio stations. What holds everything together is that we have a small population. Everybody knows everybody else – their business, their foibles and errors, and where they spend their Saturday nights. We are peacefully governed, mostly because we know that if our group isn’t in the leadership position right now, we will eventually be given our turn sometime soon down the road. We also know that being in office is mostly a bother, and are proud of the fact that it is never a passageway to great wealth. (We think that’s a problem for that large neighbor of ours.)

******

The Empire has largely avoided the whole Covid thing. We didn’t go anywhere, and basically no one came here. It’s not because our homeland isn’t lovely, but we don’t have that big thing, that major tourist draw. There are no mountains, we are at least 2500 miles from any large beaches, and our populace indulges itself mostly in un-showy pastimes. I wouldn’t say that it’s boring, but let’s just say that when ten 0’clock rolls around you don’t have to tell an Imperial citizen that’s it’s quiet time.

We did vaccinate everybody, though. It’s one of the virtues of having a small population where each member has his or her head screwed on properly. So we had no trouble reaching 100% of eligible citizens, and when vaccines approved for children come around, we’ll get to them, too. The controversies confounding our larger neighbor are baffling to us, to say the least. They would be comical if the consequences weren’t so dire. 591,000 dead, with more to come. It’s hard to imagine, isn’t it? How could they have gone so wrong?

Sometimes … we simply have to weep for them. There’s nothing else for it.

******

******

Some sobering news from England.* In a fairly large study British researchers came to the conclusion that there is no safe amount of alcohol to drink, when it comes to long-term brain health. Those two glasses of burgundy per day that we thought were actually healthy for us may not turn out to have been such a good thing after all.

If further studies bear these findings out, it shouldn’t really come as a complete surprise. After all ethyl alcohol is a toxin. When we drink enough to feel that sense of relaxation and ease that we enjoy, it is because our cerebral neurons are faltering under its influence.

A few years ago at Springfield State Penitentiary in South Dakota, administrators had to remove all of the hand sanitizers from the premises. The reason was that some resourceful prisoners had learned how to extract the ethanol from the product so they could use it as a beverage. But why was ethanol in the hand cleaner in the first place? Because it is very good at killing things.

*Pun intended

******

I will end with something to appeal to all those fond of low humor. Which pretty much describes my entire family of origin.

Lena: “There is trouble with the car, sweetheart. It has water in the carburetor.” 
Ole: “Water in the carburetor? That is ridiculous.” 
Lena: “Ole, I tell you the car has water in the carburetor.” 
Ole: “You don’t even know what a carburetor is. I’ll check it out. Where is the car?”
Lena: “In the lake.” 

******

News of the World

jono55

Twenty-four hours after receiving our second dose of Covid vaccine Wednesday forenoon, we felt normal. Twenty-eight hours after receiving the shot we were achy everywhere. At twenty-nine hours we cancelled supper since neither of us were hungry. By thirty hours we were ibuprofenized and in bed, where Robin had an excellent case of chills going. By forty hours post-injection we felt well once again.

Not a bad trip, all in all. Shows that our bodies knew something had happened and were reacting to it.

******

Sweet Jesus, it is presently 37 degrees below zero in Eveleth MN, where daughter Kari and her husband Jon reside! That it not a wind chill number!

Oh, my friends in the Midwest … you who are still dealing with that pesky polar vortex and those sub-zero temperatures, I feel your pain. Well, not really … that’s a bit of an exaggeration … but I do wish you well in the version of the third Ice Age you are experiencing. Not that I would trade places or anything. I kind of prefer the thirty degrees Fahrenheit that is outside my window at present.

If I were in your place, I would purchase a small electric heater, take it home, then drop it into my pajamas and turn it on. I would then climb into bed and not come out until life was once again bearable.

What I would not do, if I were a Minnesotan, is to go and stand on any of the bridges over the Mississippi River. January and February were always the months for jumpers. People who took their troubles with them and looked down into those dark waters. Waters that promised oblivion … at moments when oblivion seemed a good choice for the day. The poet John Berryman did just that, on January 7, 1972. He leapt from the old Washington Avenue Bridge, which no longer exists.

So stay home, turn up the heat, and order pizza delivered. Avoid bridges. And remember … this, too, shall pass.

******

Finished the novella “The Body,” by Stephen King. Spoiler alert: the kids find the dead boy, have a conflict with some young sociopaths, and then return home. What? You knew?

It was a good short read, especially since the movie has become such a thing. It did add some material, like what occurs in the boys’ lives when they first return home and in their next couple of decades.

.

******

Friday was a darn dank day, damp and drippy. Robin and I were a disconsolate duo, dreaming of drier, dandier summer days.

So she retired to her woman-cave to practice singing French children’s songs, and I made soup while listening to Mozart. It turned out to be just the right thing to do. Making soup is one of the more creative acts that one can do in a kitchen. At its heart is the need to feed oneself with whatever is at hand, and to make a little bit of food go around. But you don’t have to spend too much time in a recipe book to find that soups can also be very complex and decidedly costly, involving ingredients unavailable on the Western Slope except by mail or special courier.

My chosen soup was one of the endless variations using butternut squash. It allows one to whack away at a large assortment of vegetables, bring out the big ol’ dutch oven/soup kettle, and simmer until the house is full of an aroma that makes you healthier just sniffing it.

So where does Mozart come in? He popped into my head for no apparent reason. Perhaps my brain was doing some early spring cleaning and stirred up an old bit of mental lint. Anyway, I reminded myself of the first album of classical music I ever purchased, and that would have been when I was fifteen. I had decided that I was going to become a cultured individual, and learning about classical music was to be the initial step.

So, I knew something of Mozart, and looking around town in 1955 I found a recording in a local music shop of his horn concertos which were touted as being the best ever. The artist was a man called Dennis Brain, an Englishman.

Among members of my family of origin Englishmen in general were not highly prized. For one thing they all drank tea instead of coffee, which everyone knew was God’s beverage. And they were all so utterly posh and spoke the language so intimidatingly well. But I was on a quest, so I bought the album anyway.

If it meant putting on airs I was perfectly ready to do just that.

‘Twas a very good buy, as it turned out, and good accompaniment Friday for fiddling with a soup kettle on a drizzly winter afternoon, to boot.

[BTW: I never did become that cultured personality that I was aiming for. Rock and roll came through town and off I went to join the circus.]

******

Peter Piper Picked A Peck … et al

jono55

I tried a new recipe this past week for potato soup, and the soup itself was just okay. What was a pleasant surprise was a sub-recipe for making pickled jalapeños, which you then used as a topping when serving the soup. Those jalapeños were v.e.r.y tasty, and could be used on other soups, sandwiches, scrambled eggs, etc. Here’s how you do it:

Thinly slice two jalapeños, discarding the seeds if you like. Put slices in a bowl and squeeze in enough lime juice (2 limes) to cover them. Add a pinch each of salt and sugar. Let sit at room temperature while you make the soup. (The jalapeños can be prepared up to 5 days ahead of time and stored in the refrigerator; they get softer and more pickle-y as they sit.)

I mean, you can just sit there and eat the darn things right out of the bowl.

******

On Saturday I was talking to my brother Bill on the phone as he described how absolutely miserable he was in the sub-zero wind chills of his day there in Faribault MN. Snow was swirling on the highways, discouraging traveling more than necessary distances. Just before we terminated our conversation, he made the mistake of asking how my weather was at that moment.

I told him it was 48 degrees and blue skies here in Paradise, and the closest we ever get to a polar vortex is reading about it in the papers. I swear you could hear his face fall. I wasn’t going to bring it up, not being a man given to gloating, but … he asked.

******

Our second dose of Covid vaccine is coming up on Wednesday. Some of the folks who received their first immunization at the same time that we did a month ago are starting to natter about possible side effects of the “booster shot.” Listening to them, it’s like being back in elementary school, where the rumors of what that “booster shot” was going to do to you were rampant. Up to and including your arm falling right off in the classroom, so that you had to pack it home at the close of the school day.

Just to be on the safe side, I’m going to offer my right arm (I’m left-handed) this time as the injection site, just in case … you know … it falls off.

******

Our new Subaru has some technological stuff going on that is amusing. It knows when you are crossing a lane divider and beeps at you unless you have clearly signaled a lane change. It also will not allow you to tailgate, but maintains a safe and predetermined distance between you and the car in front of you.

Now if you put these two together, it means that on the highway you can put the car on cruise control, take your hands off the wheel, and it will drive itself. Now it’s not a “self-driving” car in any real sense. It doesn’t know where you’re going, for instance, and will just keep cruising down that traffic lane forever.

However, when you do take your hands completely off the wheel, the car knows it, and sends you a message to put those damned hands back where they belong. But, like I said, it’s amusing.

******

One night a long time ago, during my single period, I was up late watching television when an entertainer came on and stole the show with his performance of I Go To Rio. I hadn’t heard of Peter Allen before that night, and after watching his routine I was a fan. I didn’t know that he was gay at the time, but I do remember thinking that this was a guy who really knew how to wear orange.

Here’s a video of a real showman, from 1978. Died in 1992 of AIDS-related cancer.

******

Let It Be

jono55

It’s been an emotional week here in Paradise. The Pema Chodron book that am in the middle of reading is so applicable to recent events in our lives that it’s uncanny. Each evening I finish one short chapter before retiring, and it helps me to clarify and to center myself. To be present with what is, rather than resisting it sounds so dry unless you are actively practicing it. Until you really need it.

Of course I ‘need’ it all the time, but I feel that poverty most strongly in harder times. I’ve heard said more than once in AA meetings that “he’s not the first person to find God in the back seat of a police cruiser.” Those hard moments are the ‘foxhole’ sort of events, where the supplicant tries to make his deal with the Universe for a specific purpose. When we realize that our ideas of control in our lives were mostly fictions. Stuff we made up.

******

******

We’re already in the beginning of mud season here in Paradise. Yesterday Robin and I took our regular 4-mile walk on asphalt exclusively, with exuberant gumbo on both sides of the trail. On one occasion I saw footprints in the mud that suddenly vanished, as if the person had simply been swallowed by the muck. Is there such a thing as quick-mud?

Yesterday was the sort of day that our cats just gave up on. Not so cold, not so windy, not so rainy, but a little bit of all of these. So they became part of the furniture, changing their sleeping stations every couple of hours or so. Whenever they did step out for three seconds, they would come back indoors indignant, giving us an angry Rrrowwwrrr as if we were to blame.

I just hate being judged by animals, don’t you? And it’s so frustrating that they won’t listen to your explanation that humans are not in charge of the weather. They walk away even as you are talking to them, tail in the air, the picture of disdain. So rude.

******

There are interesting little dialogues that are happening between people who are receiving the Covid vaccine. What they all come down to is: When you’ve had both doses, are you going to manage your life differently?

So far my answer has been: Nope. When most of the rest of the Coloradans have had their vaccines, then I will walk out the door without a care. But a new category of entertaining does open itself up. We have several friends up and down the street in our little part of town, all of whom are senior citizens, and all of whom will have been immunized within the next month or so. From my standpoint, I think that they would be safe to have over for dinner and a chat. Like in the good old days when I was blissfully unaware of the novel coronavirus’ existence.

The reason for persistent caution in approaching the general population is that the vaccine we received is 95% effective in protecting us, not 100%. That means that 5 out of every 100 people who receive their two doses are not protected, but they don’t know who they are, since no post-vaccine blood testing is being done. If I am one of those 5 people, it’s like I never got the shot.

It’s a numbers game, to be certain.

******

Fleurs du Mal

jono55

Here is how the Covid vaccine process is shaking out in Greater Paradise (otherwise known as the state of Colorado). Phase Ia vaccinations are underway, and Phase Ib will be upon us when … well, we don’t exactly know. What is happening is that people in Phase Ib are asked to sign up to establish themselves as part of the group (we did ours online), and then one day we will receive some sort of notification as to when and where we can be vaccinated.

Robin and I are in group Ib by virtue of age, as you can see in the diagram below.

After reading about the mentally unstable Wisconsin pharmacist who deliberately left 500 doses of the vaccine out to spoil, and someone else’s idea that to make the supplies go further we reduce the amount of vaccine given, I am not quite sure what to expect. It could conceivably go like this:

Policeman: Awright, keep the line straight, you guys, stay on the north side of the rope. And stop moving about back there.
Vaccinee: But it’s cold out here, good lord, the wind chill is zero degrees.
Policeman: You don’t like it, Mr. TenderBody, well, you can just go home if you want to.
Vaccinee: Naw, naw, never mind, I’m stayin’.
Policeman: Here’s the nurse now.
Nurse: Would everyone from the man with the lavender beret to the woman with the decorative layer of cowpoop on her boots take one step forward. Okay, now roll up your sleeves, if you will. Well now, sir, let’s just draw up your medicine.
Vaccinee: Is it supposed to be green?
Nurse: The color is immaterial, good sir, just relax and all this will soon be over.
Vaccinee: What’s that funny odor?
Nurse: I don’t smell anything out of the ordinary.
Vaccinee: It’s coming from the green stuff.
Nurse: Sir, could you please stop with the comments? You are making the people in line behind you nervous.
Vaccinee: I think I’d like to go home and think about it.
Nurse: Too late for that. We have quotas to fill, you know. Barney and Vito, will you grab him?
Vaccinee: But I don’t want the shot any more.
Nurse: Is that all this is about? Don’t worry, sir, all you have to do is sniff the vial. There will be no injection at all.
Vaccinee: Sniff it? Does that work?
Nurse: Not quite sure, but we’re all learning together, aren’t we? Now if you’ll just let me wipe off your nose with this alcohol swab …

(Just to be clear, when my dose becomes available, no matter what its physical characteristics may be, I’m taking it. Enough, already!)

******

On Monday morning there was an earthquake in Tyndall SD, which is about twenty-eight miles from our former place of residence in Yankton. It was only 3.1 on the Richter scale, but already the insurance claims are coming in, claiming substantial damages. Earl Putz says that fifty-two of his prize-winning steers fell into a huge crack that opened up and then closed again. Mabel Pergola says that her mental health has been permanently altered by the event, and that aftershocks are occurring on the hour in the middle of her abdomen, one centimeter to the left of the navel.

Ms. Pergola is also claiming loss of consortium with her husband, Elbert. When our reporter asked how she could ever have noticed this, since the earthquake had occurred only two hours prior to this conversation, her reply was: “You don’t know Elbert.”

******

I will mention the events of Wednesday only briefly. They are at the point of being dissected minutely, and we may all be feeling even more ill by the time this process is over. Or we may feel exultation.

The first is the riots, encouraged by P.Cluck himself and his Republican enablers. A merry band of traitors they are, and they deserve anything unpleasant that may happen to them in the days to come. At supper last evening the title of a book of poetry by Baudelaire came to mind. It was Fleurs du Mal (Flowers of Evil). Cluck and the boys have been planting the seeds of those flowers all along, and you know what – I told me so. The part of my brain that never sleeps, that keeps me breathing and my internal organs churning away, knew that this moment was coming. Even while the part that reads and writes and signs checks said: “No, not even they would go that far.” I will have to give my gut more credit and listen to it more carefully in the future.

The second is the Democratic wins in Georgia. It makes it possible to finally get past the McConnell roadblock that has held America back for so many years. Imagine how long it might have taken to achieve something as straightforward and necessary as the assembling of a cabinet by Mr. Biden, had this not happened. Bless everyone who had a hand in these victories, because they were victories for us all.

It is sunrise in America, mes amis. What kind of day will it be?

******




Tripping Badly

jono55

Robin and I watched the movie Phantom Stitch the other night, a film in which mushrooms play an important role. Now, one of the basic hazards of life (for listeners) is that when a person attains a certain age, nearly everything reminds him or her of something in his or her past. So here’s a personal mushroom story.

I was living and working in the Upper Peninsula of Michigan, and had been there for a couple of years. There was a substantial “counterculture” contingent living up there, who enjoyed the natural gorgeousness and lack of close supervision by authorities.

One summer afternoon I was taking my turn covering the Emergency Room, when I was called to see a young man with a beard and shoulder-length hair, attired in well-worn jeans and a faded flannel shirt, and who had ingested some mushrooms that had made him quite ill. He had been vomiting for hours and was moderately dehydrated as a result. I examined him quickly and then turned to the nurse, who happened to be a person who had quite a lot of knowledge of local fungi.

“Did he bring in any of what he ate?” I asked.

“No, but I’ve been saving what he threw up in case we need to send it away for study,”the nurse replied.

“How to find out what it was … ?”

At that point, the patient, who had been lying there motionless but for the rise and fall of his chest with his breathing, eyes closed and looking as completely miserable as you care to imagine, said two words in a low and groaning voice:

“Amanita muscaria.”

Amanita Muscaria is not “poisonous” per se, rather it is a hallucinogen/narcotic. When you eat it dried, freshly cooked, or drink water it has been cooked in, you will become intoxicated, or possibly just get sick and vomit all over the place.

Forager Chef.com

Et voila! It turned out that the man had been seeking hallucinations by ingesting that fungus but instead ran headlong into a common effect which was to become extremely nauseous. He was provided with intravenous hydration, moved into a quiet space, and discharged a few hours later in good condition.

Amanita muscaria

So the first and last case of mushroom poisoning I ever saw was diagnosed by the patient himself, and that diagnosis communicated to me in Latin. You might not believe this, but that didn’t happen every day.

******

A Dick Guindon cartoon

******

Love this song, from 1986. The video is by a group called ‘Til Tuesday, which was fronted by Aimee Mann, a very talented woman who has gone on to do some beautiful things in music.

******

Same Dude Different Day

jono55

I’m starting to be concerned. Here we are two days into 2021 and I still feel like the same guy I was last year.

Is it because I didn’t make any New Year’s resolutions? Because I didn’t. Not one. If you could paint resolutions blue somehow, a view from a small drone would show a trail behind me of little sapphire-tinted piles of broken promises to myself stretching all the way back to the horizon. I think that I can safely say that no New Year’s resolution of mine ever made it to February in one piece.

******

The largest share of the exercise walks that Robin and I take are down along the Uncompahgre River, which passes through Montrose on its way to a rendezvous with the Gunnison River about 20 miles from here. Most of the scenery along those walks is very pretty, with trees and shrubs planted according to Mother Nature’s grand and seemingly random plan. There are areas, as there are along so many rivers I’ve seen that are close to towns, where the carelessness of past generations has piled up, with unattractive industry still making a mess of the shoreline. But there is so much of it here that it spoils a good walk.

This past week the birding has been exceptionally good as we stroll along trying our best to get those heart rates up. There are the usual scads of robins and legions of sparrows (that I haven’t bothered to learn to tell apart from one another), but we’ve also seen a great blue heron, a small flock of mountain bluebirds (seen two days in succession), and a group of Bohemian waxwings all fluffed up against the chill.

[None of these photographs are my own. But they have been purloined in a good cause.]

  • Mountain Bluebird
  • Mountain Bluebird
  • Mountain Bluebird
  • Bohemian Waxwing
  • Bohemian Waxwing
  • Bohemian Waxwings

******

The New Landscape Department

Things Will Get Better, Seriously by Paul Krugman
We Just Saw How Minds Aren’t Changed by David Brooks

******

Colorado made the news this week for the wrong reason. Somehow the first case of the more contagious variant of the Covid virus showed up near Denver, in a guy who never went anywhere. To the medical sleuths, this strongly suggested that perhaps there was somebody else in our fair state who has it that we don’t know about as yet. That’s going out on a limb, I know, but these epidemiologists are a wild and crazy bunch.

So now I have a new level of paranoia, what with the new variant stacked on the non-masked multitudes, and all this atop the basic worrisome virus that you can’t see, smell, or taste and which at its whim can either kiss you lightly on your forehead or make you completely dead. Ach, himmel, what’s a guy to do? We already have our groceries delivered by workers in Hazmat suits, irradiate our incoming mail before ever touching it, and take regular Lysol baths. I even tried brushing my teeth with hydrogen peroxide but had to give that up when I nearly foamed myself into oblivion.

******

I saw something truly stunning yesterday, and unfortunately I didn’t have my camera handy to record it. A shame, really.

We had decided to take a scenic drive just to get out of the house for a couple of hours and ended up passing through Redvale CO, a very small town with a very large number of Cluck flags still flying. That wasn’t the stunner. It was the old pickup with a camper on the box. A homemade cloth sign whose dimensions were about 4×6 feet was affixed to the side facing the street, and it declaimed in large letters: Burn Your Mask!

Just think for a moment of the depths of stupid and hostile that such a banner signifies.

Burn Your Mask! Good lord.

******

Windfall

jono55

I received wonderful news this morning, and it came just in time to take care of those pesky Christmas bills and quite a bit more. I’m thinking new car, home remodel, trip to some country that will accept Americans … . It all started with this message in my inbox. It’s the second such note that I’ve received, but instead of just deleting it, I pondered.

At first I thought “scam.” And then I thought, how lucky for Mr. Landolt (if it isn’t a fraud). And then I thought … maybe I am Mr. Landolt. There are seven letters in his last name, and there are seven letters if you combine my first and last and name. Perhaps it’s a code. That’s it! It’s possible that I am now 850,000 dollars wealthier than I was at breakfast.

I can hardly wait to hear back from the folks at financialtrustfunds024 about how the funds are to be transferred to my personal accounts. So if I owe any of you a debt that I have somehow forgotten, this would be the time to remind me. Otherwise I can be found online later today trying to spend 850,000 dollars in the most imaginative way. Let’s see … is foreign travel even a possibility yet … ?

******

Well, I have a new car ordered to be paid for through my windfall. I wanted something reliable, economical to operate, good-looking, and comfortable. This is what I chose.

It’s a Rolls-Royce Phantom, which gets surprisingly good mileage, comes with pretty much everything you could imagine as standard equipment, and they even send a small British man to live with you who can adjust anything that goes amiss. On long drives you keep him in the boot. The only problem is that I think it’s a foot longer than my garage.

The runner-up was this thing in the pic below, which the salesman guaranteed could just about get me anywhere I wanted to go, and came in an armored, bullet-proof version. It also has enough ground clearance that it could run over a medium-sized cow (a recumbent one) without hurting the animal. But it was seriously deficient in the cupholder department, so I went with the Rolls.

And after all, how many times a week do you need the capacity to drive over livestock?

******

Next I plan to turn to my physical appearance. Imagine my delight when I found that I could purchase six-pack abs! Here is a before and after of a patient who had such a plastic procedure done. The process is called abdominal etching. And you don’t need to do a single sit-up or plank to get them. Just be appropriately wealthy and slightly nuts.

******

I see no reason to stop with the abs, if you can afford it, and can have your entire body “etched”all over. My only problem is that all of the “before and after” shots that I found are of men who are fifty years younger than myself, and I’m not sure what the surgeon would do about that. Maybe better think about it for a while longer … .

******

The Covid vaccination programs are, of course, being reported on minutely, and there are screwups galore in who gets one and who doesn’t, plus the ethical problem of rich countries buying up all the doses and leaving poorer nations scrambling for help. I said “of course” because this is a never before type of massive human endeavor and how could we not be clumsy at it? The important part is that they are getting the vaccine out there, people are being immunized, and if it takes longer than was originally planned that’s unfortunate, but the direction is clear. At some point during 2021 we will be able to walk out our front doors, unmasked, and greet our fellow humans with handshakes and hugs and in so doing catch influenza just like in the good old days.

I’m looking forward to it.

******

Flyover State

jono55

We’ve been treated to the sounds and sights of a great deal of traffic here in Paradise since the first of November. Aerial traffic, that is. Every day flights of Canada geese pass by. Not huge flocks, but many, many smaller ones. And periodically high up above the geese there will be a string of sandhill cranes passing overhead, with their very distinctive croaking calls.

The number of cranes migrating through our area is small compared with the huge flocks that pass through Nebraska and the Platte River area. They are fascinating birds who have been around much longer than we humans.

Sandhill cranes have one of the longest fossil histories of any extant bird.  A 10-million-year-old crane fossil from Nebraska is said to be of this species, but this may be from a prehistoric relative or the direct ancestor of sandhill cranes. The oldest unequivocal sandhill crane fossil is 2.5 million years old, older by half than the earliest remains of most living species of birds, primarily found from after the Pliocene/Pleistocene boundary some 1.8 million years ago. As these ancient sandhill cranes varied as much in size as present-day birds, those Pliocene fossils are sometimes described as new species. Grus haydeni may have been a prehistoric relative, or it may comprise material of a sandhill crane and its ancestor

Wikipedia

If you spend a few moments watching them you have no problem with thinking about sandhill cranes as descendants of dinosaurs. Everything about them says ancient, from their appearance to their voice.

*

Sandhill cranes are not on an endangered species list, and therefore hunting them is legal in Colorado. It’s one of those times when I must scratch my head and wonder why? What is it about those people who upon seeing birds like these makes them want to grab a gun and kill them? For sport. For fun. I don’t get it.

I am reminded of an old joke, one of those that are slightly cringeworthy because of the truth within them.

A man is arrested and brought to trial for killing a protected bird. He pleads with the judge, “Your honor, I was lost in the wilderness for three days without food, and the eagle attacked me. I fought back in self-defense, and I ate it because I was starving.” The judge listens to the tale and rules that the man is not guilty. But he turns to the man and asks, “Well, now that we’re done with all that, I admit that I am curious to know, what does bald eagle taste like?” “Well, your honor, it’s like a cross between a snowy owl and a whooping crane.”

******

******

Only two days until Christmas Eve. My letter to Santa went out weeks ago, trying to account for any sluggishness in the mails. Picking and choosing what to ask for used to be difficult, because although there were thousands of things that I wanted, there was very little that I needed .

And there was that phrase from the Bible that had nagged at me for years, found in Luke 3:11, which goes like this: He answered them, “He who has two coats, let him give to him who has none. He who has food, let him do likewise.”

(A confession is in order here, because I still have more than two coats as of this writing.)

And so some years back I asked my family to direct their gift-giving impulses from me and toward those whose needs are greater by far than my own. One of the needy groups that I know a little about and have admired for a long time is Medecins Sans Frontiéres (or Doctors Without Borders).

.

If there are any physicians who are more courageous and less guided by self-interest than those who work for this organization I don’t know who they are. These men and woman take their skills to work in areas where I would tremble to even drive through. My hat is off to all of them and to the indigenous helpers who make their work possible.

******

Here are a few pix from our walk up at the Black Canyon National Park on Sunday afternoon. Weather = perfect. Snow = clean and pristine.

******

Cold Hard Facts

jono55

I don’t know what went wrong, but we’re having a wee bit of Winter already here in Paradise. Saturday night it got down to 2 degrees F. Over the past few days several inches of snow have fallen and I actually had to shovel it away twice. Shovel. Me.

When Robin and I took our walks over the weekend we dressed in so many layers we looked like the kid in the movie A Christmas Story.

Even thought we might have looked a bit ridiculous, there’s no point in challenging the elements, is there? There are only two possible outcomes in such an endeavor … survival or frostbite.

We go for survival every time.

Sunday was cold enough that the cats were presented with a feline dilemma. Every instinct said “Go outside and do your thing!” And so they went through the flap on the pet door and were hit in their furry faces with the frigid reality that waited for them out there. They would try repeatedly but in less than a minute they were back each time.

Now, right next to the pet door is a bigger door meant for humans. Poco will make a run through the cat-flap, come back inside all disappointed, and then go stand in front of the big door meowing to be let out. Apparently he thinks that each portal leads to a different world, and maybe the next one will be nicer.

******

I had only one experience with frostbite, but it was enough. At seventeen I was working part-time at a Red Owl grocery store in West St. Paul MN. I lived about a mile from the store, and walked to work rain or shine.

One snowy Saturday morning it was cold and windy and off I went to work, leaving the house at 5:00 AM and underdressed as usual. No hat, no protection for my ears, not enough jacket … you know the teenaged drill. When I reached the store my right ear was an unusual dead white color and felt quite firm when compared with its mate on the other side of my head. In the warm indoor air it now came back to life with a vengeance.

The appendage went from white and numb to red and painful in no time at all, but it wasn’t done with me yet. Within two hours it had swollen to twice its size. So here I was dealing with my duties and the general public looking all unbalanced … normal on the left and a crimson Dumbo on the right. By the end of my shift the thing was blistering and altogether nasty-looking.

It took a week for that ear to get back to normal. I guess that I was fortunate that it didn’t blacken and drop off, since it was sort of useful to have around, especially when it came to wearing glasses later in life. I did learn something, however, and never repeated my performance.

******

******

The first Covid vaccine doses are on the trucks and planes and headed for everywhere. I am not too worked up about it, however. Each article that I read about who gets it first seems to move my personal category further down the list. As far as I can tell, if there are any doses left over in January 2025 I can apply for one and see where that gets me.

It’s starting to remind me of what the U.S. Air Force taught me about military triage. In civilian life, the person with the worst injuries, where survival is seriously in question, moves to the front of the line. In combat situations, they are placed in a category named “expectant,” and moved to an area where they are given pain relief but are out of view while resources are focussed on the more obviously salvageable. The idea being to get soldiers back to the front wherever possible in the shortest amount of time.

The ultimate goals of combat medicine are the return of the greatest possible number of soldiers to combat and the preservation of life, limb, and eyesight in those who must be evacuated.

https://ke.army.mil/bordeninstitute/other_pub/ews/Chp3Triage.pdf

So even though people like myself are in a high-risk category should we become infected, the medical powers-that-be have decided that since we can still walk ourselves right back into our homes we should just stay there until it is safe to come out, end of story.

I get it. I may not love the implications, but I get it.

I can wait until Hell itself freezes over. That’s another thing the military taught me.

******

The Wishy-washy Need Not Apply

jono55

Monday morning I was peacefully reading the Times of New York when I came across an article that mentioned the Democratic Socialists of America. I don’t really know much about those folks and therefore I spent a couple of hours wandering through the website of the organization , and it was interesting.

They are serious people, passionate people, and … well, I’ll let you read a paragraph from their Constitution to get the flavor of what they are about.

Article II. Purpose.

We are socialists because we reject an economic order based on private profit, alienated labor, gross inequalities of wealth and power, discrimination based on race, sex, sexual orientation, gender expression, disability status, age, religion, and national origin, and brutality and violence in defense of the status quo. We are socialists because we share a vision of a humane social order based on popular control of resources and production, economic planning, equitable distribution, feminism, racial equality and non-oppressive relationships. We are socialists because we are developing a concrete strategy for achieving that vision, for building a majority movement that will make democratic socialism a reality in America. We believe that such a strategy must acknowledge the class structure of American society and that this class structure means that there is a basic conflict of interest between those sectors with enormous economic power and the vast majority of the population.

Constitution, dsusa.org

I won’t claim to have read everything on the site, but what I did go through left me feeling that perhaps I wouldn’t join up, that a group of 70,000 such firebrands weren’t out looking to recruit wishy-washy octogenarians like myself as members (I could be wrong in this). While I agreed with a great many of the points they made, there was a doctrinaire flavor about their prose that reminded me of … Strelnikov.

You remember Strelnikov, don’t you? He was a character in the film Dr. Zhivago who was a true believer. Now, he was also a Communist, not a Socialist, and I do recognize that they are very different entities, so using him as my illustrative example is unfair from the get-go. But that flavor …

But hey, let me introduce (or re-introduce) you to Commander Strelnikov, who I found to be one of the most fascinating characters in a movie filled with them. Here he is in his office in a train car, interviewing Zhivago, a person who his soldiers have just arrested.

******

I know that I have talked previously about the book, The True Believer: Thoughts On The Nature Of Mass Movements, by Eric Hoffer. Hoffer was a longshoreman who had an amazingly fertile brain and a keen eye for the quaint habits and delusions of human beings. It was published in 1951 and was one of those you have to read this sort of books in that decade, especially for college types who were practicing their intellectual pretensions, as was I.

It’s a book that may help explain Cluck’s populism to those who are still puzzled as to the why? of the past several years. True Believers are not troubled by inconvenient opposing facts, they just run right over them as fables of the other side.

******

For a piece of good old-fashioned far-left-wing music, I offer you The Internationale for your listening pleasure. It is played here by ani di franco. Don’t worry about being corrupted by it, it is an instrumental. As to the words, well, it depends on which translation you are following. There is a long article on the song, in Wikipedia, that makes for very interesting reading.

******

Monday morning I went back for my last checkup following cataract surgery. You could tell how pleased the clinic staff and the surgeon were that I got such a superb operative result, so I’m glad that I kept the appointment, if only for their sake. I will still need glasses, and still do not have Superman’s X-ray vision, so at this point in life I think that I’ll finally give up on that particular fantasy. It was a much more intriguing concept to a young man … these days I really don’t care to see my friends without their clothes, nor do they, I suspect, have any hankering to see me au naturel.

I may have mentioned that the eye surgeon, whose name is Bennett Oberg, looks to be about twenty years old. He is tall, good-looking, slender, youthful … let me just say that you would have no trouble telling the two of us apart. In fact, he appears to be so young that as I was leaving I leaned over toward him and said in a conspiratorial voice: “Just between the two of us, Oberg, you’re not really a doctor at all, are you?

******

******

You may have noticed in the weather box in the sidebar that some of the outposts of the Empire are becoming quite chilly. This morning, for instance, the Evelethians will be getting dressed while huddled around the woodstove, in their six degree air.

Of course, such an experience can be oddly pleasant, except for the person who has to get out of bed first, to stoke the fire in the stove. To all such stokers in the world, we offer a hearty thank you.

******

Mental Lint

jono55

This latest chapter in the nationally televised serial The Cluckshow is surprising even the gaggle of old hands who gather ’round the woodstove of a chilly morning. Yesterday the group, which hardly ever agrees on anything, unanimously came to the conclusion that there are a significant number of Americans who are perfectly daft.

No matter how many sober people come up to the mike and say that the election process wasn’t corrupted these misguided ones continue to believe the opposite and that somehow their champion will pull off a miracle.

.

It doesn’t help that they are supported in their delusions by some very corrupt people indeed, people like Senator Turtle, who stand to gain by keeping governmental matters in a continual state of chaos. So much of the public chatter is how Cluck disrespects our traditions and the nation’s best interests (and he does) but Cluck suffers from serious mental disturbances. This gets him exactly one smidgeon of sympathy. Sen. Turtle does the same thing but is completely venal, which qualifies him for no smidgeon at all.

So the members of the hot stove club went home yesterday wondering how things ever got so bad that we all agreed on something. It was unsettling, to say the least.

******

A gallery of images of Senator Turtle

******

Yesterday as I was listening to NPR I found that I had moved even further down the list of People Who Will Get The COVID Vaccine First. When this all started I felt confident that my age and many infirmities would put me right up there after emergency room physicians. But as each new draft proposal comes out my number gets further from being called.

So after spending some idle moments reflecting, I have voluntarily assigned myself to a new place in that therapeutic line. I plan on waiting until I see that all serial killers in solitary confinement in maximum security institutions have been protected, and then I will step forward. I believe that in this way I can avoid most disappointments.

******

No Love, No Tacos

jono55

Here’s a simple little story that was a total day-brightener for yours truly. It’s about La Carreta Mexican Grill, a small restaurant in Iowa that mixed politics with business and some of the blowback that resulted. My hat’s off to Alfonso Medina for his clear thinking in these murky days. This guy is the sort of citizen that will help bring us out of the mess we’re in. Someone who believes in the promises of America and acts upon those beliefs.

A man who is closing his place of business on Election Day so that his employees can vote, while he himself volunteers as an election worker. (BTW, he is also paying those employees their salary on that day.)

I wish we lived closer to Marshalltown IA … how could their tacos not be excellent?

******

BTW, about Mexican restaurants. My first visit to a new one is always the same. I order their beef tacos.

I think of my “system” as a sort of biopsy of the kitchen output, if you will pardon the clinical comparison. It tells me what I need to know about the place. If that simple, uncomplicated item is not savory, if the sauces are lacking in interest and authority, if the shells are stale … why bother with the Camarones a la Diabla? They are very likely to be an expensive disappointment.

Oddly, one of my favorite tacos was served up not in a Mexican establishment but at the salad bar in the Bonanza restaurant in Yankton SD. I say “was” because try to find a Bonanza steakhouse anywhere today. There are only a handful left in the U.S., victims not of Covid-19, but of rising beef prices and changing dietary tastes.

We have a number of Mexican-themed dining places here in Paradise, most of which are interchangeable and unremarkable. Close your eyes and you wouldn’t know which one you were in. They have the same offerings, the same plastic menus, the same unadventurous menu items. No one with chiliphobia would be threatened by what what comes out of their kitchens.

******

I have lived in Montrose for nearly seven years, and before that in Yankton SD for several decades. In all that time, I have not had what I would consider a thorough physical examination. The kind that I was taught to do in medical school. The kind that picks up problems when they are smaller and potentially more treatable.

Now, for me personally it has not been a disaster. I can fill in a lot of the gaps with my own self-exams, at least of the places I can reach. I can stand in front of a mirror and check probably 90% of my skin surface. In this way I try to avoid nasty surprises. Otherwise the physicians that I have encountered have basically looked at only what I was complaining about, and usually in a more superficial way than I was taught to do.

My present doctor, who seems a capable person, has never asked me to undress, but listens through my clothing to my heart and lungs, a poor second to placing the stethoscope directly on the skin. I could have a skin lesion the size of New Jersey and she wouldn’t know it unless I brought it up. During my very recent brush with a serious problem (and although I am soooo grateful for the excellent care that saved my personal bacon), no one ever did a complete neurologic exam, or looked at the rest of my body for indications of possible reasons I might have had a stroke at the tender age of only 80 years. This in spite of the fact that my disease was of the central nervous system.

On the other hand, I had two CT scans, an MRI, an echocardiogram, and beaucoup lab tests. It would have been hard for any occult disease process to make it past those inquisitors, so I am not too worried.

My own training was at a very different time, I admit. A time when we were much more dependent on the physical exam to help us come to a diagnosis. The CT scan, the MRI, and the echocardiogram were yet to be discovered. So it would seem that extensive and time-consuming physical examinations are not prized the way they once were, and maybe that’s not a bad thing. Maybe they are only artifacts of a dinosaur age of medicine.

But god forbid that these physicians ever have to go to work on a day when the electricity is off.

******

In the Humor section of the New Yorker this week was a series of caricatures of “other otuses.” This was one of the most tasteful of the lot.

******

Today I will haul myself to Grand Junction for a visit to the Stroke Clinic. I have a few questions for the neurologist, and also wanted to give him the chance to see me with pants on. I am a much more impressive person when fully clothed, and in the name of full disclosure, I think he deserves to know that.

Otherwise I am doing well and the only change in my life is a single new medication. I have no problems that I didn’t have before my adventure of two weeks ago, and those basically come down to remembering where I put my car keys and to zip up before I go out in public.

Yesterday I was on the phone with friend Bill H. and he asked if Robin and I planned to cut back on our explorations and hikes because of this hour-long brush with an alternative reality. The idea being that we might be sometimes hours away from the terrific care that I received this time. And in the case of a stroke, everyone knows that hours is too long.

.

I have given that a lot of thought, and decided against making big changes. If I were to push this line of thinking all the way I’d have to rent an apartment across the street from the hospital and have my groceries delivered, just in case … . So we plan to live our lives as before, not out of some false sense of bravado, but because making sure that we’re never more than an hour from a stroke unit doesn’t work out well in real life. We will minimize the risks where we can, but there is really no risk-free existence, is there?

The number of ways that life could catch any of us unawares is infinite. So we all cover the bases we can, and then we lock the door behind us and go out into the that uncertain world, anyway.

******

I Now Pronounce You …

jono55

Although the wind blew and the smoke hid the sun, Amanda and Lee were married on the grounds of a South Dakota hunting outfitter in a very well planned ceremony. Bride and groom were cool as the proverbial cucumbers, while the bride’s parents were somewhere on the other side of the vegetable spectrum. Being a parent can occasionally be tough, and a wedding is one of those instances where you are called upon to exercise skills you were not given at birth, learned in school, or picked up at the coffee shop. In short, you are flying somewhere near blind.

Unless you can afford to hire a wedding planner, and even then there are hundreds of questions to answer and so very many checks to write

But it all went down so well. It was a lovely time, and Robin and I are very happy for the couple and wish them long and happy years together. They have already been through more trials than most newly marrieds and deserve a break. A good, long one.

******

To bring things back to the ground a bit. We left the grounds shortly after the ceremony, skipping the reception and wedding dinner, which were to be held indoors. This had been our plan from the beginning and we stuck to it. There were only three attendees who were masked, and we were two of them. Our plan also includes self-quarantine when we get back to Paradise.

I don’t know about you, but we really don’t love this era of the coronavirus. It’s like a big paintball battle, but one where the opponents are invisible and the paint is poisonous. Sheeesh.

******

… Nothing To Fear …

jono55

I find that in some ways I’m not a good person to discuss Covid-19 with. My internal sensors regarding exposure and risk are set differently from that of many other people that I know. I am missing some of the fear that they describe. Not all of it, but some. This is not due to courage, since I have no more of that quality than anyone else, but it comes from repeated experiences over a medical lifetime.

On Christmas Eve of 1966 I was a pediatric intern on call. A critically-ill infant had been admitted that day with meningitis, and I was covering for the physician responsible for her care. At around 10:00 P.M. she suffered her first arrest, and I began CPR immediately using an infant-sized bag and mask and chest compressions. At her second arrest an hour later, the bag malfunctioned and became unusable, and someone had to be dispatched to another area of the hospital to retrieve another. In the meantime, I used mouth-to-mouth respiration. We were once again successful in bringing the child around, but by midnight she had died in spite of our efforts.

The next morning the lab reported out the causative infectious agent as meningococcus. The members of the team that had worked with her were prescribed sulfonamide tablets as prophylaxis, and I dutifully took mine for the designated number of days and that was that.

There was no pause when the mask failed, I believed that this is what doctors did, this was part of the “contract” I signed when I decided to become a physician, even if I hadn’t thought it through as fully as I might have.

Over the years there were less dramatic episodes, but the theme was always the same. We (members of the medical team) would protect ourselves as much as was possible, but we entered those sickrooms, gave those treatments, did what was necessary to do. It was our job and we adapted to that reality in our minds.

So I completely understand the concerns and actions of workers in hospitals today who have to work with scanty protective equipment. You don’t prize your own life any less, but you took on the job on a sunnier day and now you are working in a hailstorm.

BTW, not every health care worker I have met feels this way. Some of them begin looking for the exit at the first sign of danger. I recall when Yankton SD’s first AIDS patient showed up at the hospital with appendicitis. It was early in the course of the AIDS epidemic, when information about transmission was still pretty sketchy.

It took a while to round up an OR crew to do the surgery necessary on that Sunday afternoon. Some personnel refused to answer the call. But others did, the operation went well, the young man went on his way, and his caregivers suffered no adverse effects.

So I protect myself, those around me wherever I can, and I limit my exposures. But I am intimately acquainted with the knowledge that there are perils in the world. A viral particle, a frayed bit of electrical wiring, a car being piloted by an intoxicated person. If you think too much about all the hazards that life provides, it could be almost paralyzing, couldn’t it? But we all open those doors and leave those safe spaces when the need arises. We suit up and show up. You and I.

******

While I’m talking doctor stuff, I have a true short story for you. On a summer Sunday afternoon in 1967, a very ill six year-old boy was admitted to University of Minnesota Hospitals with fever, lethargy, and a dramatic rash. None of us assigned to this patient recognized the rash, so we stat-paged the chief resident on dermatology to come to the admitting examination room.

Now, for the most part, stat pages are extreme rarities in dermatologists’ lives. It is one of the attractions of the specialty, along with regular hours, weekends off, and freedom to vigorously nag anyone with a suntan. So when the derm chief resident heard the page, he grabbed a piece of equipment to bring with him to what would possibly be the only emergency call he would ever receive.

My question to you is: what did he bring with him? (Answer is below)

******

From The New Yorker

******

He brought a camera.

******

We watched the Democratic convention again on Tuesday and Wednesday night, on ABC live. It’s interesting how the “meeting” is being presented, and of course it is basically all scripted and managed. But still some of the speakers come through those LEDs and LCDs pretty well. So far my favorites have been Michelle Obama, Barack Obama, Kamala Harris, and Jill Biden.

ABC has George Stephanopoulos managing a shifting group of commentators sitting at a long and socially-distanced desk. So long that not all of them are in the camera’s view unless one pulls it back a good distance. They jumped into the discussions whenever there were pauses in the “convention” schedule. I found them largely annoying.

For instance, at this point in the history of the republic, I don’t really care what Chris Christie thinks – about anything at all.

******

Smoke is in the air this morning, so heavy that we can barely see the silhouettes of the San Juan Mountains to the south and the Uncompahgre Plateau to the west. And the closest fire (below) is a hundred miles away from us, north of Grand Junction.

Another large fire near Glenwood Springs has closed Interstate 70 for about a week now, with no predictions as to when that vital highway will be open again. East-west traffic is being rerouted in several directions, one of them being through Montrose along Highway 50. When we returned from Leadville a couple of days ago, there was heavy traffic both ways on a road that is usually lonesome traveling.

It is truly crispy here in Paradise. The amount of rain we’ve received at mi casa this year wouldn’t make two pots of good coffee.

******

Made up a quart of ghee yesterday. Got into it while learning something about Indian cuisine a while back. It’s a simple chore that produces something which is priced akin to liquid gold in grocery stores. All you need is some unsalted butter, a saucepan, and about twenty minutes of your time. Ghee is great for cooking, since it provides buttery flavor but does not brown or smoke at ordinary cooking temps. And it keeps for months at room temperatures.

There’s a decent tutorial at this website if you’re interested.

******

Burning Perfectly Good Food

jono55

We’re having the Manns over for dinner tonight (Wednesday). Grilling outdoors and serving on the deck, where any stray coronavirus particles can be puffed away by the evening breezes before they have a chance to land. All of the distancing stuff will be observed, food preparation is being carefully done, and we earnestly hope not to share anything with our guests but clean vittles and our lovely selves.

It’s our first such social foray since the outbreak began. The Manns live just up the street, and are people who frequently pop into our minds as “We should have those folks over sometime and get to know them better.”

The evening forecast promises that it will be rainless, warm, and almost windless. There will be tunes, of course. What summer night would be complete without them? It’s a touch of the homely at an extraordinary moment in time.

******

There is a form of cancer called a pheochromocytoma. It originates in the adrenal gland, which normally produces several hormones, including adrenaline (epinephrine), which is a fight or flight hormone. A “pheo” can over-produce these hormones, and occasionally if one unwisely presses too hard on the tumor during a physical exam there can be a dangerous flood of these substances into the patient’s bloodstream.

So where am I going with this? The P. Cluck gang seems to me to be the political equivalent of a pheochromocytoma. They are a cancer on our body politic for certain, but not just any old tumor. If it is squeezed or threatened in any way out comes all manner of violent and unhealthy behaviors and pronouncements which do further harm to our citizenry and our country. When the moment comes in November this neoplasm needs to be cut away ruthlessly from the corridors of power.

Too overblown a comparison? Perhaps. I do tend to overblow. It’s one of the things I like most about myself.

******

******

The cookout went very well. First of all, the gods of weather cooperated by providing one of those soft summer evenings you dream of in February. And the company was excellent. Zoom has been a boon and we are grateful for it, but there is nothing like face to face conversation. For me, all substitutes pale before it.

Unfortunately and eventually twilight turned to dusk turned to darkness and our guests had to go home, where they feared to find that their new puppy had probably reduced some rugs to shreds. It’s the difference between puppies and kittens. (Although a kitten can take a nice couch and turn it into a ratty-looking mess pretty quickly.)

I had a friend while in the Air Force who told stories about raising a St. Bernard from puppy-hood. One day he and his wife returned home to find that their new charge had chewed the entire arm from their couch. And when describing paper training, he grimly volunteered that when your puppy weighs fifty pounds, its toilet habits present an emergency.

******

Heroism comes in all flavors and sizes. My own experiences have taught me that over and over. I will explain.

When I was working in Buffalo NY in the late 70s, it was at a hospital that was transitioning from an old-line private institution to a county hospital. Which led to a disconnect. The buildings themselves were located in an older and genteel part of town, while the populations that it served were elsewhere. At the pediatric clinic, I worked every day with a succession of grandmothers who were bringing in their children’s children for well-child care.

These women saw to it that those babies received their immunizations and examinations even when it required taking city buses and transferring two and sometimes three times, through the toughest part of town, to get there. Summer and winter. Rain or shine, they suited up and showed up. My own children were still small back then, and whenever it was my turn to bring them to their pediatrician for the same care, I generally regarded it as a chore eating into my precious day and would whine about the time spent.

But not these women. They saw the same visits as important enough to the lives of their charges to spend most of a day in transit just to get them done. To me their actions were heroism, of a very quiet and uncomplaining sort.

******

Miss It?

jono55

Even though I’ve been retired quite a while now, there are still times when meeting new people that I am asked what I used to do when I was a productive member of society. I tell them I was a children’s doctor. Their followup question is frequently “Do you miss it?”

I usually give the short answer “Parts of it.” And that seems to satisfy the stranger.

The long answer is that there are parts that I miss terribly, and some that I wouldn’t revisit for anything you could offer me. There are also parts, quite a lot of them, actually, that bored me to death.

I do not miss being the bearer of bad tidings to parents. Not in the slightest.

I do not miss the routines, where a well-tuned android could do the same thing that I did, perhaps better because they are sooo reliable and never forget.

I do miss the thrill of waiting in an emergency room for the ambulance to arrive, with a team beside me. Not knowing exactly what was coming, and worried/scared each time that I would not be up to the challenge. Then to be completely lost for a time in the struggle to sometimes reclaim a life and hand it back to the person. That, I miss. (Adrenaline junkie variant?)

For similar reasons, I miss the excruciating nervousness during a high-risk delivery, when the baby-yet-to-be-born’s vital signs had turned to merde. Waiting with the knowledge that there was no one else in the room with the skillset that I had, and wanting so achingly for the obstetrician to please get that baby out and give it to me so I could do what I knew to do.

That, I miss.

I miss the puzzles posed in differential diagnosis, where a patient or parent tells you a few things, an examination tells you a few things more, and perhaps the lab or x-ray departments make a contribution as well. And then it is you, using that mainframe in your head going over and over the data, back and forth, testing and rejecting hypotheses before you finally come up with an answer. Sometimes you have weeks to make up your mind, sometimes a tiny fraction of that time.

That’s a longer answer to the question.

The one that if I tried to give it each time I was asked, I would probably end up talking to the back of the stranger’s head as they walked away. We don’t always really want the answers to the polite questions we ask.

******

******

I, Too

by Langston Hughes

I, too, sing America.

I am the darker brother.
They send me to eat in the kitchen
When company comes,
But I laugh,
And eat well,
And grow strong.

Tomorrow,
I’ll be at the table
When company comes.
Nobody’ll dare
Say to me,
“Eat in the kitchen,”
Then.

Besides, 
They’ll see how beautiful I am
And be ashamed—

I, too, am America.

******