Light My Fire

Last week I saw a woman who had apparently fallen into a campfire at midnight. Arriving in the ER about two in the afternoon, she said she only came in because once she woke up and loked in the mirror, she realized it was kind of bad. (Another testament to the amazing anesthetic powers of alcohol.)

She didn’t need to see anyone immediately…there was very little to be done other than make sure she got the right kind of follow-up…and so while we were finishing up her paperwork, she walked out of the ED saying she needed to smoke a cigarette. No, she was careful to explain, she wasn’t addicted to nicotine. It was a “hand and mouth kind of thing.” Which is good for her, because I thought she was addicted to the flames.

Bathday Perils

Let’s face it…we’re not all neat freaks. While the United States may represent the most overwashed, overshaved, and nit-free society the earth has ever known, there remain significant variations on the theme. It’s not politically correct to say that some patients stink, so we have our own set of euphemisms to describe their condition. Terms like “earth-centered” and “someone really comfortable with themselves” are examples of these covert comments. Over the years I’ve favored noting that someone was “allergic to soap,” conveying the hygiene message in a way that medicalizes the condition to free the patient from confronting their real problem, like we do with other stuff such as fibromyalgia (meaning “depression”) and metabolic syndrome (meaning “fat”).

Recently, though, I’ve had to reassess my use of this phrase. Witness the allergy list on one particularly aromatic patient I saw in a small hospital in Missouri (transcribed verbatim, including spelling):

Allergy on Medicine

Asprin
Pencillion
Demroal
Dervect
Sulfer
Keyflex

Other allergies

Tomatoes
Strawberries
Purex
Dail
Joy
Palmolive
Irish Spring
Milkweed
Wasp, bees, misquites, tick bites
Pine sole

Avoiding hives is the best excuse ever for not washing. I stand, adrenaline in hand, corrected.

Musings at McDonald's

I’m sitting at McDonald’s waiting for the car’s semi-annual wash and detail. I’m trying to write, but without much success, for as far as I can tell the soundtrack playing above my head seems to intersperse “Do You Wanna MAKE LOVE or Do You Just Wanna FOOL AROUND?” in between other, perfectly reasonable songs. I’ll hear Journey sing “Faithfully,” or the perennially underrated Lou Rawls will croon “Lady Love,” and all will be right in the world, and then I’m suddenly back in college and trying to decide exactly where the fine line is between making love and fooling around, and exactly how many Long Island Iced Teas it will take at Harry Starker’s on the Country Club Plaza in Kansas City to get the date d’jour to consider the same question.

Oh, wait, the music just changed. Now they’re playing a medley of tunes…and I use that term metaphorically at best…by Bread. I wonder if I can poke out my brain with a spork?

(Sorry to interrupt, but the corporate lawyers at McDonald’s just called. They would have me remind you a spork must be handled with care in order to prevent injury, that the points are sharp, and that if you have questions about the use of the spork you should ask your wait staff for help, call our customer service number at 1-800-OK-SPORK (and rest assured that “spork” is pronounced the same in Bengali), or review the instructions found at www.bereallyreallyreallycarefulwithyourspork.com. If you have any concerns that are not addressed, DO NOT USE THE SPORK. They would also have me remind you that McDonald’s properties do not actually distribute the spork, but that this utensil is available to the public at Taco Bell, KFC, and other PepsiCo-owned entities, and that the McDonald’s corporation would be happy to provide support for your spork-induced injury suit against these dastardly PepsiCo corporate pirates who put their profit before your health and safety. After all, if they cared about you they’d spend the extra dime and get you a separate fork and spoon, right? Let’s get ‘em!)

World Cup Farewell

(This was written during my self-imposed hiatus, so it's a bit dated. But it does provide important follow-up information...)

One last World Cup note before we tuck away the soccer ball for another four years. Listening to the “play-by-play” announcers for the past four weeks have convinced me once again that American culture, while eminently democratic in appealing to the masses (including me), lacks a sense of refinement and grace. It’s not just that soccer…okay, football…is referred to as “The Beautiful Game,” and it’s not only that you win but you lose points if you don’t do so with style. It’s the use of phrases such as “He performed nobly for his country” after a particulary good defensive play, and the liberal scattering of words like “rarified” and “tenacity.” By way of contrast, an American commentator described World Cup Final as, “like putting a pig on lipstick.” (And while it may not represent culture, nobody does enthusiasm like Andres Cantor, the Univision commentator who says the word

"¡GOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOLLLLLLLLL!"
followed closely by Al Michaels asking, “Do you believe in miracles?” during the 1980 Winter Olympics, Russ Hodges shouting “The Giants win the pennant! The Giants win the pennant!” way back in 1951, or Jeff Spicoli letting us know that “That was my head! I’m so wasted!”

A number of us have decided that we love the pig, however, so we’re already planning to head out to the 2014 World Cup in Brazil. It just looks like so much fun…and we have our own vuvuzelas… that it would be wrong not to go. So we started talking about other places you could have the World Cup, and that maybe we could resolve world issues through soccer. Maybe Israel could hold the World Cup, teams could be based on religious preference, and they could duke it out over Jerusalem as a way of brigning peace to the Holy Land. Personally, if we do it that way, my bets are on the Catholics. They’ve got a drawing pool of Argentina, Brazil, the Guays (Para and Uru), Italy, Spain, and Portugal going for them. Second place would be the hard-working protestants of Northern Europe…the Germans and the Dutch. (I would put the English in this category, but I don’t think there’s anything that can make those folks play together. Divine might only goes so far.)

This idea is similar to something my father came up with many years ago. He noted that virtually every athlete will, at some point, thank heaven for the most recent victory, despite the fact that God, being the author of life, death, and the universe, probably had other things on his mind than bestowing his grace on an NCAA Division III contest. But since every victorious athlete believes that God is on his side, my Dad thought that the best way to sort this out is to have a football bracket similar to March Madness, with all the teams from religion-based colleges included. (No secular humanist powerhouses, like Alabama, Texas, Florida, or Cal-Berkley need apply). That way you get tussles like Baylor at SMU, Brigham Young against TCU, and Notre Dame against Brandeis. The winner would clearly be the team that God really favors in the end.

(Personally, I’m not so sure that God doesn’t pay attention to football. I like to believe that the Lord is a long-time Saints fan…it fits…and maybe he does intervene in miraculous ways. I mean, Peyton Manning throws a last minute interception in the Super Bowl? Peyton Manning? How can you not see divine hands at work here?)

I this idea a lot, and I know my father’s willing to put good money out there on the Disciples of Touchdown Jesus. And I’m pretty sure he’s right. After all, Peyton did throw that interception…

(Here's the updates. Paul the Octopus, the Clairvoyant Cephalopod who correctly predicted the outcome of every World Cup match involving Germany, had died. Viewing was held at the Olive Garden in Munich.

Larissa Riquelme, the Paraguayan lingerie model who pledged to run naked in the streets of Asuncion if the national team won the World Cup final, has not let a loss in the quarters stand in her way. As her tribute to the bold Guyanos, she was pictured in various patriotic poses in the 7th issue of the newspaper Diario Popular. They're quite stirring, and bound to engender a significant amount of national pride. Yep, that's the euphemism we'll use for that.)

Cost Containment

The first health care provider a most patients see in the ED is the Triage Nurse. It’s a pretty challenging role. The nurse out front becomes the face of the ED, not only responsible for making sure that patient and their families feel welcome and cared for, but also for sorting out the wheat from the chaff, the patients with true emergencies from those who are simply hangers-on.

The other day I saw a patient who had presented to the triage nurse with chest pain. As the story goes, she had gotten a case of the munchies that morning and, finding nothing in the icebox box save a package of questionable “Brown ‘n Serve” sausages, she popped one into the microwave for a bite. Following the obligatory “ding” from the Radar Range (I’m showing my age here), she grabbed the casing and shoved it into her gullet. However, she had neglected to wait the recommended three minutes for the sausage to cool, and developed a severe burning discomfort in her lower chest as the wrapped pork shards flamed down her esophagus and into her stomach.

In many hospitals, triage nurses are also responsible for initiating medical care protocols based on the patient’s chief complaint. Doing so often speeds care, especially when physicians are busy and cannot get to the patient to order labs, x-rays, and certain medical treatments within a reasonable time. They’re really a very good way to increase both efficiency and enhance patient care. However, these protocols are blind to circumstances and to costs. Which is why, by the time I got to the patient, she had been subject to a full cardiac workup, including an EKG; a chest x-ray; and a complete laboratory profile including blood count, coagulation studies, chemistry panels, and enzyme studies to look for evidence of heart damage. I have no idea how much all that cost the taxpayers, because Lord knows this patient is not paying her own bill.

Being the doctor, who works off no set protocol other than the 10% of medicine that is science, the 30% that is common sense, and the 60% that is voodoo, my workup cost the taxpayers less than a dollar. It was called a cold can of Sprite.

Problem solved.

Holy Cards, Batman!

This past summer I went to a wedding in El Dorado, Kansas. El Dorado is not only home to the Kansas Oil Museum, but is also the childhood home of President Obama’s mother. As El Dorado is good GOP territory, there is not, and will never be, a sign commemorating the event. But the wedding itself was really very nice. The bride was beautiful, the groom nervous, the parents proud, and the priest did a great job of explaining the process of the mass as well as the rationale why only practicing Catholics were able to have snacks in the middle of the service. (No word of what the Catholics who are done practicing and actually good at it are allowed to do.) And like most houses of worship there’s a lot of literature scattered throughout the pews. I was especially taken by a small card with a photo of Pope Benedict XVI on one side and a prayer for his wise guidance of the Church on the other.

I had seen Holy Cards before with pictures of saints on one side (like Saint Dominic, Saint Theresa, Saint Pierre, Saint Thomas, Saint Pierre Thomas, Saint Brees, and Saint Whodat) and appropriate prayers on the other, but the Pope card was a new one. This got me thinking that maybe there’s a market out there for Pontiff Trading Cards. You’d have a picture on the front of the Pope in full regalia, and on the back you’d have his stats and a small vignette:

Leo XIII (Vincenzo “Prayin’ Vinny” Pecci)

Year Team League SS EW SC WB IT

1901 Papal Catholic 4,800 2 18 7,010 0

Leo XIII was the first Pope to have his voice recorded on a phonograph, reciting “Maria ha Avuto un Piccolo Agnello” into a tinfoil cylinder. Or maybe that was Thomas Edison. They looked a lot alike.

(In case you were looking for the code:
SS = Souls saved
EW = Encyclicals Written
SC = Saints Canonized
WB = Wafers Blessed (in thousands)
IT = Impure Thoughts
The latter is the equivalent of fielding errors.)

I see real potential here, especially with the rare and collectible rookie cards.

I’m not sure that this idea translates well to Judaism. We really don’t have designated rabbis in charge of the whole shebang, and while congregations may belong to an umbrella organization for their own theological bent each temple or synagogue pretty much runs its own show. (Old joke: Name the kinds of Jews. There’s Reform Jews, Conservative Jews, Orthodox Jews, Orange Jews, Grapefruit Jews, Apple Jews, Grape Jews…)

The closest thing we have to folks who are “card-eligible” are the leaders of the ultra-orthodox Chasidic sects, who from an outsider’s perspective seem to spend a lot of time out-davening and out-fruitful-and-multiplying each other. I’m thinking that while the front of the card would again feature a picture in complete uniform (which, with black coat, long bread, and hat would look pretty much like all the other uniforms), the back might look something like this:

Shmuel “The Kreplach” Kapowitz

Year Sect NC CO BL DPH PS PA

1964 Lubavitch 8 613 11.5 7 3 2

Rebbe Shmuel once smelled bacon, but studied the Zohar to obliterate the memory and then soaked in a mikveh for a week to ensure his place in the world-to-come, Ha-shem be praised.

As usual, there’s a code:
NC = Number of Children
CO = Commandments Observed
BL = Beard Length (inches)
DPH = Davens/hour
PS = Pigs Seen
PA = Pigs avoided

I thought about adding a “Circumcisions Performed” category, but ran out of space and snipped it off at the end.

(One last saint story. I went to ninth and tenth grades at Brebeuf Preparatory School, a Jesuit high school in Indianapolis, Indiana. The school was named after St. Jean de Brebeuf, a Jesuit missionary to the native peoples of Canada who died a martyr. I know this because on the wall of the cafeteria was painted a mural of the saint tied to a stake, flames around his feet, red-hot hatchets strung around his neck, while half a dozen hooting Iroquois danced around him in glee. Forget the total lack of political correctness in the picture…learned white man tortured by savages, that kind of thing. Can you imagine trying to eat lunch looking at that? Understandably, there was no hot lunch line. Hail Brebeuf Forever!)

Excuses

The astute readers of this blog (and by definition that’s everyone, because if you read this blog you automatically fall within the category of “astute”) will have noticed that this writer has been, to put it mildly, dysfunctional over the past few months. Those who know him personally have seen in it his failure to engage in society in any meaningful way save occasional cryptic notices on Facebook (the modern day gossiping fence); those who know him only from afar have probably noticed little change except for a lack of those annoying “New Post up on The Blog!!!” notices accompanied by a proliferation of what Everett Rees, my high school English teacher who had a habit of massaging his male student’s shoulders and whom we used to call eccentric and now call someone who can’t get married in California, would have called “cheerleader exclamation points.”

(I would beg to differ from the venerable Mr. Rees’s contention, though I continue to hold him the highest regard for sponsoring the Categories Team, a quizzical celebration of useless trivia in which I proudly claim two District Championships. The Categories Team was one of the Three Pillars of Dweebness at our high school. The others were the AV Squad, to which I did not belong, and the ZITS team, to which I did. ZITS stood for Zoo In The School, and basically consisted of feeding and cleaning cages for a host of mice, lizards, and snakes that occupied a back room in the biology departure. We would also give monkey chow to a simian named Houdini, which is why I knew before The Animal Planet that bored capuchins have a keen interest in self-pleasure.

But back to punctuation. They’re not cheerleader exclamation points because 1) I have never changed the text color to pink or purple and B) I haven’t figured out a way to make my fonts put a smiley face within the circle below the bottom-pointed oval forming the bulk of the exclamatory sign. And yes, the itemizing was on purpose, ‘cuz it’s a cheerleader thing. Ready? Okay!)

So why the absence of the blog? (This question assumes that you’re wondering why, and have not already concluded that the absence of the blog is my own way of doing a remarkable service to mankind). In short, it’s because the last three months of my life have been an unmitigated disaster. It has been a series of personal and professional catastrophes that has not been a slow progression, but has occurred on specific dates such that one can actually draw a line graph charting the time on one axis and the damage on the other. The details are and will remain mine, but the events are of the magnitude that I am angry…no, that’s too light a word, but it’ll have to do…at the world for what it’s done to me. I think I’ve played by the rules, done the right things for the right reasons, and lost everything. I had a plan; now I have none. I used to be somebody; now I am nothing. I see those of lesser ability succeeding while I drift backwards; I find my fate is no longer my own but is controlled by the insecurities and vicissitudes of others who see me as a source of…well, I don’t know what. Those things that gave me purpose and validation have been taken from me, and what results is the guy eating day-old bologna sandwiches on the airport floor and checking the meat to make sure it hasn’t changed color. (And for what it’s worth, I’m probably not very good at rhetorical hyperbole, either.)

Different people do different things when they fall apart. Some yell and scream. Some are able to refocus and find new challenges. Some count their blessings and accept their new lot in life. Some spend recklessly, drink, or gamble. What I do is nothing. I sit, I brood, I glower, and I don’t talk to anyone. Paradoxically, I talk less to those closest to me, friends and family than I do to the odd acquaintance at Golden Corral. Which is why I haven't been blogging, because blogging is talking to myself, and I’m about as close to me as anyone.

I got to thinking about this a few weeks back during Yom Kippur, the Day of Atonement. There’s a wonderful prayer in the holiday liturgy called the Al Cheit. (Don’t worry about how you say it…Hebrew doesn’t transliterate well in to English, and if you’re not semetic in some fashion you can’t pronounce it anyway.) It can be very roughly translated as “all sins,” and depending on who’s counting it reels off a list of 23 or so separate kinds of sin that we’ve managed to stray into over the course of the previous year. Usually I can find at least three that I’ve stayed away from. Not this year, I’m afraid. What I’ve been thinking and feeling over the past three months has gotten me a perfect score. Batting a thousand made me realize it's time to move on, and restarting the blog is one way to forge ahead.

(Okay, one funny story about this prayer. I grew up in a tradition of liberal Judaism. But when I first moved to Florida the only synagogue in Gainesville was a conservative one. Conservative services involve a lot more ritual and Hebrew than I was used to. So when they did this prayer on Yom Kippur, not only was it done in Hebrew of which I had a poor understanding, but it was accompanied by rocking back and forth on one’s heels and a beating of the breast that for all the world seemed like something out of a National Geographic Special on the Plains Indians and had me looking up to the sky for rain. Now, of course, I recognize that the ritual comes from the movie 300, and what I was hearing must have been Hebrew for “We are Sparta!”

By the way, while I recognize that all faiths have some ritual of repentance, I really like the way we Jews do it, and that’s not just saying so as an MOT (Member of the Tribe). It always made sense to me to do all your confessing on a single day and with all the other Jews at the same time. That way, the chances of God singling out your sin for punishment amidst the cacophony of guilt are relatively less.)

So for those of who feel like I’ve done wrong by not blogging, I truly apologize and hope that resuming our online discussion will serve as a small effort at atonement. And for those of you who thought this blog was a load of bull to start with…well, I suppose I’ll just keep on sinning. I’ve got to have something to repent for next year.