The Lost Career

I was talking to one of my colleagues who’s an orthopedic surgeon and was reminded of how I made sure I would never be an orthopod.

When I was in the first year of my Emergency Medicine residency and even more flippant than I am now (hard to believe, right?), I was doing an orthopedic surgery rotation on the service of the Chairman of the department. The Professor was an ex-military martinet in the very worst sense of the word, and given that at that time in my life I thought of myself as the Hard Rock Café of medicine (love all, serve all), some conflict was probably inevitable.

One morning he put up the x-ray of a patient he had operated on the day before. He was praising the wonderful realignment of the bones, the way they matched together, how the screws in the plate locked into the bone just enough to provide security but not too much to put the bone itself at risk. I was doing my routine post-call yawn when he turned to me. “Dr. Rodenberg,” he said with the scorn that only a Professor can muster for an intern who does not recognize the absolute primacy of his own specialty and the insignificance of anything else, “why am I remarking about the fine alignment of this fracture?”

“I don’t know sir,” I replied. “Maybe it’s self-gratification.”

Other than a steely glare from The Professor, there was no further comment on the X-ray, and another resident saved the moment by smoothly transitioning into the next case. But I was promptly informed “through channels” that if I ever decided a career in orthopedic surgery was my destiny, there would be no letter of recommendation forthcoming. Go figure.

Vegas Vacation, Part III

All in all, our time in Vegas was lots of fun. Perhaps a bit more placid than I might have anticipated, but we were all middle-aged and most of us married, the occasional one respectably so. With that in mind, here’s the true highlight of the trip.

Thursday night we were at The Rio (fine scenery) and it was time to head back to home base. There were six us and a rental Hondo Civic that seats five. So one of our number (who shall rename nameless because it was such a stupid thing to do) volunteered to get into the trunk so there would be enough room to fit all of us in the car. The trunk was popped open, Kevin (oops) folded himself in, and I took four photos for documentation. The door was closed with the appropriate “thunk,” and the rest of us piled inot the car. There was some thought of lingering a while and getting a drink before we left, but we were uncertain of the oxygen content of automotive trunks. Besides, nobody was really looking forward to giving him mouth to mouth ventilations. He doesn’t brush real regularly.

(By the way, this decision was made without the benefit of significant amounts of alcohol. I’m thinking that we had been drinking, transport of the extra person would have involved a spider monkey, a party hat, gelato, and duct tape.)

We came out of the parking lot, pulled into a turning lane, and found ourselves immediately adjacent to two of Clark County’s finest law enforcement officers. It was probably a good thing we weren’t trying to jam us all in the care by sitting on laps, as I’m sure that would have violated some sort of traffic regulation. (Turns out it does…Nevada Revised Statute 484D.495, to be precise). So we were very glad that Kevin had chosen to stow away in trunk. On the other hand, we were a bit afraid of what would happen if at that moment he decided that the combination of exhaust fumes and disorientation were too much and pulled the glow-in-the-dark level to pop out in full view of the gendarmes.

(It turns out that I didn’t need to worry about disorientation. I thought he might get motion sick through a “sensory mismatch”…the semicircular canals in the inner ear that that control balance would tell him that his body was moving in space, but his eyes would see only darkness, and the two conflicting inputs would induce nausea and vomiting. I had no idea how we would get that stuff out of the trunk. Plus, Kevin had been to the buffet with the rest of us, so I knew whatever came up would not be just liquid that make evaporate in the desert heat before it was time to turn the car on the following day. But Kevin did a great job of focusing, continually texting us from the trunk, keeping himself oriented by the glow of the cell phone screen and noting, “I’m okay. I’m okay,” just like Jodie Foster did in the movie Contact before she was dropped into the alien machine and became a reclusive lesbian. Or maybe it was the other way around.)

We’re nearing the hotel, and then we’re past it. Suddenly our anonymous chauffer (let’s call him “Armando”) realizes he missed the turn. So it’s time for a you-eee (no idea how to spell that) to get back to the main entrance. He takes the turn, and suddenly we hear pounding behind the back seat and a small muffled voice shouting, “Hey! You didn’t tell me about that!”

The car stops, and the bellhop asks if we need help with our bags. We motioned him around to the back of the car. Imagine his surprise when we popped the trunk and Kevin jumped out. (I’m not at liberty to use his exact phrase, but let’s say it had, lots of something to do with sacred excrement.) And of course he didn’t get a tip, because the luggage walked inside on its’ own. For my part, I was just happy it was Kevin who came out of the trunk and not an angry naked Chinese mobster with a tire iron. I’ve seen “The Hangover.”

It’s Vegas. Things happen. And maybe they stay there…unless it’s a really good story.

Vegas Vacation, Part II

No matter where I go, I like to make new friends. For a while, my best friends at the Prairie Band Casino just north of Topeka were a group of dwarves who spent their days Bustin’ Barrels. I was also lucky enough to be invited to the Village People Party on several occasions, and got to experience Lobstermania as well. But the problem with casino friends is that they’re never faithful.

(Uncompensated plug: The Prairie Band Casino is really a very nice set-up. The layout is open, the staff is friendly, the place is well-run, and the slots seem looser than most. The Three Fires restaurant has very nice steaks, but lots of places in Kansas do that. What really sets it apart is the adjacent hotel, which is unexpectedly opulent and features outdoor hot tubs around burning council fires. A really nice overnight getaway even if you don’t gamble. Very cool.)

I’m not really much of a gambler, but I’m surely not above dropping a twenty into the penny slots every now and then. That’s how I met The Frog Princess on my first trip to Vegas. The Princess and I have had a thing going on for two years. (The Bride, bless her, is not only understanding of our relationship but in fact encourages me to spend time with The Princess as a way of strengthening our marriage through a mutually enjoyable pastime and stop me from fretting over her shoulder while she plays slots for real…and most often wins.) The Princess Looks like a green Orion slave girl from Star Trek (TOS: The Menagerie) with Jessica Rabbit curves and a somewhat more puffy face. When the reels line up just right, she wiggles her hips, winks at you, and puckers her lips as her generous amphibian bosom heaves, pleading with you. “Spin some more, big boy. Come and get my bonus. Max bet, 100 lines, five credits per line. Go on, take it. You’re a man. Take it from me. Get my bonus. And bring me a big bag of flies.” Which of course you do, because she’s The Princess. You do the single line, one credit bet for the Lady of Wal-Mart. The Princess is royalty.

I will here state for the record that I was unashamedly in love with The Princess. I would spin her dials over and over, shout the word “Princess!” when she herself showed up on the reels, and would stroke the console with a touch reserved for only the most intimate moments when she would grace me with a credit here and there. Even when I was not playing, when I passed her in a casino (she exists in many different casinos, a situation which I can only attribute to her powers over the space-time continuum), I would touch the screen as I walked by and whisper, “Pretty Pretty Princess” or “Princess, I love you,” or some other phrase that would, under any other circumstances, get me a nice healthy dose of Thorazine and an immediate appointment with the psychiatrist of your choice. But this was Las Vegas, where the presence of pole dancers is said to affect the way cards lay out on the blackjack table, so a guy fondling a slot machine is really no news at all.

I truly believe, based on results, that for the first two years of my affections The Princess loved me back. But this visit was different. I felt the same, but while she was just as accommodating as always, I could tell something had changed. She would still take me for a spin, but there were no more rewards, no more wiggles, winks, giggles, or grinds. I tried to ask her what was wrong. Did she need time? Did she want commitment? But I never got an answer as my heart slowly fell to pieces, twenty dollars at a time.

I was at a loss. I appealed to Zeus, who had often heard my prayers and responded in a creditable fashion. But the mighty Olympian was no help at all. I made an offering at the altar of Zeus II. I made a repentant pilgrimage to the Palace of Riches. I tried to find myself in the Tiger’s Realm. I spent time watching the Nursing Follies. I even looked to befriend the Dam Lumberjack Beavers. But none could help me lift my despair.

It was later that I saw him. The Frog Prince III. Newer, flashier. More ways to win. Bigger bonuses. And I was still The Lonely Human I.

If you’re reading this, Princess, I still love you. Every time I hear a croak, I think of you. Come back soon.

Vegas Vacation

I’m out here in Las Vegas on a “guy’s trip” with a few friends from work. I really like Las Vegas. While it’s all plastic, in no way does the city pretend to be anything else. It’s an oasis of insanity in the normalcy of the desert where nothing makes sense and everything is intentionally out of place. It’s a fake city of fake cities, of New York and Paris and Luxor and Venice and Rome and Camelot. It’s a place where untold miles of dust are suddenly punctuated by the brilliant vegetation of a golf course, but where the grass itself is limited to the tee and the green because it doesn’t want to grow, and you can’t tell a sand trap from the fairway because, well, they’re both sand. It’s a place where every hotel has its’ own mall, every mall has a Tiffany’s, and every buffet serves everything just in case they can find someone to eat it. (And they do.) It’s a place where with one glance I can have my self-esteem both inflated and shattered at the same time. And I’d be untrue to myself if I didn’t insert a small man-oriented note and say that there are more exquisite breasts (and other body parts) per capita than any city in the world. (I’m told that per woman, there are actually the same requisite number of breasts, so perhaps this is a function of volume.)

I say all this about Las Vegas not to denigrate it any way. In many ways, it reminds of a grown-up version of my own Daytona Beach, another tourist mecca that simply is what it is and doesn’t lay any pretentions to being anything else. I’ve heard that Las Vegas is actually a pretty good place to riase a family, with good schools, low taxes, and a low crime rate off The Strip. But so are places like Ulysses, Kansas (a very nice town, with no disrespect whatsoever), and nobody road trips to Grant County.

(At one time I considered applying for the job of Director of the Health Department for Clark County, Nevada. I can’t recall if I sent in the application or not, and I don’t know if I would have taken the job even if asked. At the time, I was commuting two and a half hours back and forth by air from Kansas City to Tampa every other week to see The Child, and that just about killed me…no idea what a five hour commute each way and a three hour time change would have done to my biologic clock. But I would have been perfect for the job. As the former Director of the Health Department of Volusia County, I was in charge of the Sanitation of Sin for the Eastern Time Zone. Why not take the same job up for the West?)

Anyway, here’s a few “Vegas Tales” from the trip. Hope you enjoy them. Parts II and III to follow.

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We all decided that a fun thing to do on Wednesday would be to go sit by a pool. The first step in this process is to figure out which pool you want to sit by. There are specific criteria one uses in this selection process. Here is a partial list:

1) The number of hours of sun the pool received in an average afternoon in order to facilitate the conversion of 7-dehydrocholesterol to Vitamin D, promoting bone health and preventing rickets.

2) The probability of finding enough chairs for seven people to sit together to build camaraderie and gawk in unison at the more shapely passers-by.

3) The temperature of the water so as not to induce contraction, shrinkage, and possible future fertility issues.

4) The likelihood of seeing hot women with exceptional breasts (volume and/or quality) who will most likely not talk to us because we are

a. Fortyish
b. Flaccid (at least visibly)
c. Dweebs
d. Not internet kazillionaire dweebs

5) These may or may not be in order.

In order to properly inform the selection process, we had to view at least eight pools to get an appropriate panel to choose from. As it takes forever to get between the casinos on foot (“We’re sturdy! We’re men! We can WALK! ), this means that by the time we chose a pool, it was too late to get back to the hotel and get our swimsuits that afternoon. So the actual pool visit was put off until the following day.

The swimming pool at Cesaer’s Palace is a magnificent thing to behold. Nestled within the “Garden of the Gods,” there are a whole series of pools named after the Roman deities themselves. Lots of space, very decadent padded loungers and cabanas, attentive wait staff, blackjack under a waterfall, excellent scenery. There is even the “Venus Pool Club” featuring “European-style bathing.” In the name of decency, this pool is screened off from the other, more family-friendly (In Las Veags, that’s a relative term) dunks. It turns out, however, that if you have a telephoto lens on your digital camera you can see over the screens form two pool terraces up. And I’ve been led to believe that inside the Venus Pool what you will find is thirty pale bald and flabby men who are not ashamed at all to be topless, three similarly coiffed and attired women (who may equal the men in breast size, but it’s a close call), and one incredibly nice piece of plastic work whose sole job I think was to serve as bait.

What I like to do at a pool is sit. So while my compatriots were splashing around threatening to do cannonballs in four foot water (WARNING: I do not bring spinal immobilization gear nor skull tongs with me on vacation) and finding out which bartender couldn’t add well to source the cheapest drinks, I was perfectly happy to watch over our towels and tennis shoes. I had a few drinks, read my book, got some sun, and talked for some time about what I was reading to a charming young twinkie two chairs over with a budding interest in science fiction. Four and a half hours later, the shadows from the hotel had overlapped my chair. I had finished my book, my face looked tan, and I had a nice red stripe down my chest and stomach from where I kept my shirt on to avoid getting my shoulders burned, but forgot to button it up the front.

So I heartily recommend the pool at Cesaer’s Palace. Because who knew that “Starship Troopers” by Robert Heinlein was such a chick magnet?

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Here’s what medically-oriented marathon runners (clearly not me, whose exercise is confined to squinting) talk about around the pool:

Running a marathon in the desert would be tough. You’d need lots of hydration, and lots of an electrolyte replacement fluid such as Gatorade to put sodium and potassium back into you. But running to the side of the course to pick up a drink might slow you down. And what if the Gatorade has been diluted? That would be even worse, and would surely cause cramps and make you drop out of the race.

The solution, of course, is to take a frozen banana and place it in your lower GI tract. As the banana thaws, it melts, and presumably the potassium in the fruit gets absorbed into the blood stream. No need to stop for a drink, your times improve, and you finish strong.

I think they’re going to flip to see who tries this first.

The Pleasure Palace, Part II

(Since I'm currently with some friends in Las Vegas, and since there is a fair amount of adult content in this fine community, putting up the following post seemed the proper thing to do. Real travel notes tommorrow.)

One of our ED nurses, the ever-chipper Lori Stephenson, told me this tale last week.

She was caring for a young man with back pain. Not a big deal, got a shot for pain, felt better, getting ready to go home. His girlfriend, who was being seen in another part of the ED for a similarly minor complaint, ventured into his room as Lori was talking to him about back care. (The “family plan” visit is a common phenomena. The latest addition to the Rodenberg Canon of ED Rules is that the number of family members who want to be seen at any given time is inversely proportional to the severity of illness of any single person.) There was an uneasy tension in the room, with the woman glaring at the man, the man shifting uneasily on the exam bed.

“Well did you ask her?” she said.

“Hmmm...ummm,” was his nondescript answer.

“Did you ASK her?” It was not really a question now.

The man replied, irritation in his voice. “Well, you go and ask her then.”

Lori had been droning on, doing her best to provide some patient teaching as well as read the required hospital paperwork to him, a task complicated by the fact that within the health care system of the United States, sound medical advice and institutional policy are often totally different things. Admittedly, she hadn’t been paying a lot of attention to the conversation. This was about to change.

“Nurse. Hey, nurse,” beckoned the woman.

Lori, always polite, said, “Yes, can I help you?”

“Is his back pain from having relations?”

“Excuse me?” Still polite.

“Relations. He always wants to be havin’ relations. He wakes up in the morning and wants to have relations. He comes home from work and wants to have relations. I think his back pain is form having too many relations.”

Being an exceptionally bright spark, Lori immediately recognized that she had suddenly dropped into the abyss known as the Canyon of TMI, or Too Much Information. Nonetheless, she doggedly kept moving ahead, trying to regain her footing on this treacherous ground. Just like medicine, nursing is both a science and an art. So this nursing scientist tried to break the problem into its’ constituent parts.

“Is your concern about positioning or frequency?”

“He wants to lift me up when we have relations. And,” she pointed out, hugging her stomach in a peculiarly affectionate way, “I ain’t no lightweight.”

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And then there’s the story told by a social worker about a patient seen by her husband, a retired paramedic. He had been called to a home in the early hours of the morning to be greeted by a man clad only in what might be politely called his “tighty whities.” “Hurry!” he shouted with alarm. “I was doing it with my woman, and now her cummer is stuck!”

Turns out she was having a seizure.

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Which in turn reminds me of a tale of long ago, when I was an intern called to the ED at 3 AM to admit a young woman who had a seizure and passed out while having “relations.” It’s bad enough to have to get up that early, but even worse when you spend an hour trying to get information from the patient only to have every questions answered an overzealous boyfriend.

I tried one last time to get some information from the patient herself. “So what do you remember about what happened tonight?”

Once again, the boyfriend took over. “Aren’t you people LISTENING to me! We were having sex and she started to scream. The she started shaking and having a seizure, and then she passed out. What’s WRONG with you?’

A medical student with me, who had much more self-control than I at the moment, looked directly at the boyfriend. “Sir, what she had was called an orgasm. And it’s pretty obvious that you’ve never seen a woman have one before with you.”

Enraged, he grabbed the girl by the arm and dragged her from the ED. But as they were leaving, she lagged just a bit behind. “It’s okay” she whispered to us, turning her head behind his back. “I was faking anyway.”

Safety Patrol

Security screening at the airport still drives me as crazy as it did eight years ago when I first wrote about it in a column for jems.com. I’ll spare you the painful details of a reprint, but essentially my objection is not that we do screening, but that we do so in a fashion based not on any science or risk-based assessments, but on the need to be politically correct. I forget where I heard the term, but someone once said our airport screening process in nothing more than “Security Theater,” and I think that’s just about right.

I was fretting about this today as I pondered if my two prepackaged fruit cups with natural juices (8 oz by weight, uncertain by volume) were going to get through the “no fluids” rule. Would they think that the pieces of grapefruit floating in the extract was real fruit, or a clever ruse to hide kerosene? I also wondered if my bottle of cologne, which says it contains 1.4 ounces but somehow needs a three inch block of glass to contain it, would pass muster as well. Fortunately, I passed, and Seat 23C has never eaten healthier or smelled better.

(Do you ever wonder how much the confiscation process depends on the immediate thirst or hygiene needs of the individual TSA screener?)

Anyway, this reminded me of my favorite stupid security story. When I first moved back to Kansas in 2005, I was flying back to Florida a lot to see the Pre-Bride and The Child. One one of these trips, I literally blew a tire while turning into economy parking in Kansas City. (No ,I didn’t go over the exit grid the wrong way, but that’s an excellent guess. You know the polls that say 90% of drivers think they have above average skills on the road? I’m the other 10%.) I had a spare tire in the trunk but no jack, and was running very close on time and couldn’t wait for a repair truck to come from the service station on airport grounds. So I figured the best thing to do was to buy a car jack in Florida, and take it back with me in two days time. That way I could fix the flat in the parking lot, avoid the cost of a service call, and have a new jack in the trunk for any future needs.

Once in the Sunshine State, I went to see the Pep Boys and got my jack. (Pep Boys. Manny, Moe, and JACK. Get it? It’s now 10:15 in the morning and I’ve been up since four driving over from Daytona to pick up a nonstop flight and a cheap fare in Tampa. Cut me a break.) The jack was the kind has a base plate on one side and a lifting plate on the other enveloping a screw that you turn to make the jack go up or down. Fully rotated, the screw allows the jack to lie flat, about four inches tall. Perfect for carry-on, I thought, as I approached the security screening in Orlando (an airport which has still not talked to Walt Disney World about how to move people through an attraction.)

In retrospect, I should have seen this coming. It’s only a few years past 9/11, and here’s this disheveled guy taking a late night flight halfway across the country with car repair equipment and a Dave Barry book as his carry-ons. I undoubtedly fit somebody’s profile somewhere. (I still remember a picture book my parents had about the Kennedy assassination called “Four Days.” There was a picture of Oswald’s perch atop the Texas Book Depository. There was a fast food bag next to the windowsill, with a caption noting that “The assassin dined on fried chicken ad pop while patiently waiting to shoot the President.” I must have been that guy.) There’s no telling what I might have done with the jack if forced to spend the next two and a half hours seated next to someone who wanted to talk and talk and talk and talk and talk and didn’t have really great…yeah, ummm, yeah. (I was still single, at legally, back then). So I would have been annoyed, but probably would have understood, if the whole kit and caboodle was taken away.

(By “whole kit,” I mean the jack. It’s hard to justify the book as a dangerous airborne weapon. “Prepare to discuss Dave Barry’s treatise on exploding toilets or I’ll take this plane down and all the inflight magazines with it!” On the other hand, if you tossed a book out the window from 36,000 feet, physics tells us it would hit the ground 47 seconds later at a speed of 1035 miles per hour. And there’s that whole explosive decompression thing as well.)

The jack actually came in two pieces. One was the jack itself, which was the heavy lifting base with the screw that raises the car up and down. The second piece was a ten ounce forged metal handle that you used to turn the screw. So what the TSA Officer did to protect the skies was to confiscate the handle, allowing me to take the ten pound steel jack itself on board without any problem whatsoever.

Now that’s security.

Primary Colors

A friend of mine recently said that she was watching a pod of right whales off of Flagler Beach. I had no idea that all whales were Republicans. Does that mean there are left whales swiming off the coast of the Blue States?

It reminds me of the time someone asked me where Liberal, Kansas was located. The answer, of course was ten miles to the left of Conservative.