Strip Search

On the airplane this morning from Kansas City (Slogan for Today: “We’re Colder Than Your Ex”), I learned from a fellow passenger that Dallas’ main problems during Super Bowl week were not ice, snow, and ticket fiascos. They were actually critical shortages of limousines…and strippers.

The problem with the limos did not strike me as funny. The shortage of strippers did, given that stripping is essentially a spectator sport (at least in the public arena) and any one stripper can theoretically entertain any number of viewers. However, it is true that as opposed to football or baseball, where a view of the entire field is critical to understanding the ebb and flow of the game, the area of focus is really an on-stage cylinder extending six and a half feet from the floor and within arm’s reach of a centrally located pole. (To be frank, I suspect that most spectators are concerned with an even more narrow area of focus, but I may be wrong. It might really be all about personality and intellect. See “The Whore of Mensa” by Woody Allen.) So given the narrow range of interest, distance becomes an issue, and either an excess of strippers or telescopes are needed to maintain the required proximity. Besides, it’s awfully hard to toss dollars down from the cheap seats.

Anyway, the Super Bowl Stripper Shortage got me thinking about a conversation held a few weeks ago in a western Kansas ED. One of our nurses was complaining that her husband had gone to a strip club in Salina rather than joining a group of ER folks for a night on the town. This was news to me, because I really never saw Salina…while the home of the first girl I ever saw non-clinically unclothed…as an epicenter of adult entertainment. True, it is just twenty miles down the road from Exit 272 on Interstate 70, known popularly as the “Exit of Sin” because off the north ramp is the Lion’s Den Adult Supermarket and just to the south is the Russell Stover Factory and Outlet Store. It’s an efficient way to knock out nearly a third of your deadly sins in one stop. And just in case the gravity of your offense is lost on you, as you get back on the westbound road there is a large billboard reminding you that “…the EYES of the LORD are upon YOU.” (Interestingly, there is no such sign as you get back on the highway eastbound, which probably reflects the thought that if you’re headed towards the land of the heathen liberals, like Topeka, you’re a lost cause anyway.)

I was thinking about the odds of having a strip club in Salina, and then recalled that this would not be so unusual given that I had seen a “Gentleman’s Club” in Great Bend. Great Bend is a town of about 10,000 people located on the Great Bend (gentle turn) of the Ar-KANSAS River (mostly dry). The main landmark is a ten story tower public housing project in the middle of the Town Square. The strip club is located in a steel building on Kansas 183, and was noticeable only because it was across the street from Braum’s Officially Delicious Ice Cream.

This got the mental wheels working, and I think I’ve figured out how to resolve any future stripper shortages at major sporting events. Strip clubs need to be organized into farm systems. Places like Great Bend are the rookie leagues; Salina is A ball, and Topeka (where the parking lot outside of the strip club always seems much busier during the legislative session) is AA. Larger places, like Kansas City and Denver, represent the AAA level, just before the majors such as New York, Miami, LA, and Dallas.

You can see how this would work. As strippers in the majors get injured, go on the disabled list, age out, droop, or sag, their places are taken by those brought up from AAA. This progression moves through the ranks, opening up new opportunities at the entry level. Organizations can even offer coaching along the way to improve individual performance and bottom line revenues. (Yep, I really said that). Plastic surgeons can serve as Team Physicians. I see nothing but a growth industry here. (I really said that, too.) And when there’s a shortage, like during Super Bowl week, just call folks up from the farm system.

I can barely wait to buy my team jersey.

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One other quick airplane note: On Southwest, they give out crackers shaped like little airplanes. Instantly regressing to the guy who dissembles animal crackers by having the run around the table, then biting off the limbs followed by nipping at the head (I’m sure a psychologist can have a field day with that one), I took the crackers and had them soar around my seat, accompanied by the obligatory “swooshing” sound.

After a minute of play, I bit off the engine. The cracker went quiet, then plunged to the floor.

There were no survivors.

Cat Nips

There’s an unfortunate man who comes to the ED a lot. He has terrible heart failure, and isn’t a clinical candidate for a heart transplant. Most of the time he stays alone in his room, keeping to himself, simply waiting for his time to end. When he feels especially lonely, he calls EMS and comes to see us. It’s what passes in his life for a social call.

So we’re trying to figure out what we can do to help this man, to help him build a relationship with someone or something other than the health care system of this fine community.

“He needs a kitten,” says the Unit Clerk.

The Tech shakes her head. (Brace yourself, and remember we are in the ED, not a place for normal humans.)

“No, that’s a bad idea. When he dies, the cat’ll eat him.”

This was new knowledge to me. I had no idea that cats ate dead people. That being said, the story of Oscar, the cat that sits by dying residents in a Massachusetts nursing home, makes a lot more sense. Oscar’s not there to provide comfort to those heading towards the Great Beyond. Apparently, he’s out looking for a snack.

Because this is the ED, however, the conversation doesn’t stop just because it’s breached the limits of decency. The Nurse pipes up next.

“You know, if he got several cats, he can save on funeral expenses.”

“So he would be consumed by pussy,” says the Tech.

Metaphorically, I hope.

Counting Down

Some years ago I learned that if I count backwards, visualizing the numbers while I count and matching each number with a deep full breath, I can often get myself to sleep. It doesn’t always work, and if I hit 70 before feeling that disjunction that happens just before nodding off I usually give up. Patience has never been my strong suit.

(Numbers are easier to count than sheep. I used to try to count sheep, but when I did my tangential thinking…helped along by The Bride…meant that suddenly the sheep were being given names, and personalities, and life histories. There was Alice the Sheep, Betty the Sheep, Charlie the Sheep, and so on. The brown sheep was named Pedro. The black sheep was Shaft.)

You would think that counting backwards would be a pretty easy thing to do, and it used to be quite routine. But since I got back into full-time clinical medicine, I notice that no longer do I count down routinely from 100. Some nights it’s everything I can do to not count backwards as follows: 300, 150, 100, 75, 60, 50.

Forty self-esteem points for the reader who can tell me why.

Goin' a-Courtin'

You may have heard that earlier this week, a federal judge in Pensacola has ruled the new Health Care for All Act (or The Job Killing Socialist Manifesto, depending on your political stripe) as unconstitutional. The basis for the ruling, as I understand it, was that there is no constitutional allowance for the federal government to mandate that private individuals purchase a specific product (like health insurance).

I can’t say I’m really upset by this interpretation, especially as the government-subsidized purchase of private health insurance it made very little sense to me. It seems an inherent contradiction that the same insurance companies that have been labeled as significant contributors to the crisis in health care...and reaping massive profits as a result...should be rewarded by an infusion of public dollars. Of course, both Republicans and Democrats were perfectly happy to give public money to the large Wall Street firms that drove the current recession, so I guess I shouldn’t be surprised. And I recognize that both the subsidy and the individual mandate are political compromises made to garner support for passage of the law, and that compromise is the essence of policy. But I’m still not thrilled with it. If health care coverage for all Americans is as critical as we are told (and I personally believe that it is), then the logical solution is to establish a baseline, no-frills, economy-class, bring-your-own-snacks level of care for all. If the private sector can add services on top of this baseline, and individuals choose to make those purchases, so be it.

Commentators on television and radio have made it clear that no matter who won this round in Federal Court…and so far the score is tied at two decisions apiece…the battle won’t be over until the issue hits the Supreme Court. While I understand that the Supremes have an unpredictable streak (and have ever since Diana Ross left to pursue her solo career), unless there is a sudden retirement on the bench the chances are a conservative court will at least hold the individual and employer mandates within the act as unconstitutional. And while technically the rest of the Act could still be legit, in reality the financing for the entire scheme falls through if the individual and employer mandates are not in place.

What I know for sure is that these court decisions are pure theater, much like the show put on by the Transportation Security Administration. They obscure the real issue, which is an irretrievably broken system of care. Nobody has ever denied that fact. I can’t think of any voter who is unaffected by a lack of access to care or runaway costs, nor a policymaker of any stripe who will say the status quo is just fine, thanks for asking. Nor can I, despite all the posturing about keeping government out of health care (and right now between 45- 55% of all health care costs in this country are borne by governmental agents), can I find anyone willing to forgo their own Medicare or Medicaid benefit, nor any policy maker willing to take them away.

(And for the record, and because with my fetish for linguistic accuracy it drives me nuts when people say it, government funded healthcare programs are not evidence of socialism. Socialist health programs involve government ownership and control of all elements of care. Nobody has ever threatened to nationalize the hospitals or make all health care workers government employees. Even the subsidies for health care coverage within the new law go to support vibrant private sector insurance companies. So get over it.)

Last November, Republicans were able to whip up the public against health care reform with a large helping of clever rhetoric and a side of fearmongering. But if the health care reform law is declared unconstitutional, people have a right to expect something else to be offered in it’s place. The GOP may have owned the last election and are drawing even in the legal war. But without a real plan of their own, one that enhances access to care while controlling costs, they are sure to lose the war. Either that, or we as people in need of care most assuredly will.

Mystery Meat

It’s lunchtime, so between patients I skip down to the Doctor’s Lounge for a bite. At this particular hospital, the cafeteria brings up some trays of hot food to supplement the usual assortment of sandwiches and chips.

I walk up to the food bar to find one of our surgeons, a fairly bright guy, looking uneasily at something chunky, pink, and breaded. Hearing my footfalls, he turns and gives me a quizzical look.

“What do you think this is? Chicken or fish, or something else?”

Now let’s get this straight. This is a guy who cuts into flesh for a living, while in general I only look at it from the outside. And he can’t figure out what kind of meat they’re serving for lunch?

I had a piece of cheese and a Coke.

Newton's Tempest

You may have heard several weeks ago about the 5,000 red wing blackbirds who died in a mass extinction event in Arkansas on New Year’s Eve. According to the Arkansas Game and Fish Commission, the official explanation is that they all perished form “blunt force trauma,” which is the clinical way to say they were “…flying into stationary objects such as trees, houses, windows, power lines, towers, etc." These crashes resulted from the fact that, “Arkansas blackbirds have poor eyesight and don't normally fly at night. The AGFC said the birds were probably disturbed by "unusually loud noises" and flew lower than normal due to New Year's Eve fireworks. The rare night flight was even recorded on radar data.”

Personally, I figured that perhaps they had become communally frustrated by the fact that they had been told that they could not migrate north for another few months and were just supposed to wait it out in The Natural State, and so they all flung themselves out of the trees from sheer boredom. (As a loyal Kansan, as especially as I write this on the sesquicentennial of our Sunflower Statehood, I feel bad for the birds. They could either spend the winter in Arkansas, or move north to Missouri. Not a good choice either way, if you ask me.)

However, my ED colleague Jason Hawver has made me aware of a new and even better theory of what did in our feathered friends. It’s called the Gravity Storm, and it’s so common I can’t believe it’s escaped the notice of science until right now. Gravity storms pull people to the ground without provocation. They appear to be localized phenomena, and just as tornadoes show a predilection for trailer parks, gravity storms seems to erupt at nursing homes. They also have a tendency to occur at specific hours, most notably sometime between when the resident was put to bed and when they failed to report for breakfast the next morning.

The results of gravity storms can be serious. Bruises and minor lacerations are common; hip fractures may result as well. I think this is worthy of further investigation, and I’ll need a federal grant to do a proper study. The grant will need to cover the costs of a theoretical physicist, an experimental physicist, an astrophysicist, and an engineer. Oh, and we’ll also need a blonde actress/waitress to provide snacks and a link to the real world. Which is my argument for including a late-forties, vaguely amusing emergency physician within the cast of the Big Bang Theory. And in comparison with the salaries negotiated by the cast in their new contract extensions, I think they’ll find my rates surprisingly reasonable. I’m my own agent. Call now!

Satellite Love: Update

My sister has provided me with an update on my blog about the Top Songs of First Love. She has informed me that Katy Perry’s “Teenage Dream” fulfills the criteria from a female standpoint:

“Let's go all the way tonight.
No regrets, just love.
We can dance until we die.
You and I, we'll be young forever.

We drove to Cali and got drunk
On the beach.
Got a motel and built a fort
Out of sheets.
I finally found you,
My missing puzzle piece.
I'm complete.”

I would argue with her that:

1) Katy Perry is a teenage DREAM, not a real girl actually doing it, so the song doesn’t count; and that

2) Building a fort out of motel sheets is a chaste activity (see Clark Gable and Claudette Colbert, “It Happened One Night, 1934); and that

3) These two kids have a RELATIONSHIP and are in LOVE; and that

4) Katy Perry is from an era of music I don’t listen to, so it doesn’t count, no matter how hot Katy Perry is nor how much I am convinced that while she married Russell Brand and I wish her happiness, I know it’s only because she didn’t meet me first; and that

5) Anybody who sings with Elmo is automatically too pure of heart for this list.

So there.