Monday, May 4, 2009

Four Dead in Ohio



O Lord, Hear My Prayer


I find it difficult right now to write anything. Putting cogent thoughts together, or even messy ones, distresses.

Just plain exhaustion and an increasingly pervasive depression.

Today, infectious disease appointments -- to draw a vancomycin "trough" level, get PICC dressing changed, etc.

Tuesday, The Boutiqueur and the infectious disease infusion center.

Wednesday, the orthopods -- stitches out? Some sort of plan?

Thursday -- sleep.

Friday, Hawaiian-Shirted Neuro-Man, a supremely important appointment.

We are infusing every morning at 11 am, though we'd like to edge that more toward noon.

It's babyish, but my throat bothers me more than anything -- it represents air and life, I guess. On the way to the hospital last week, Fred and I pooh-poohed said sore throat. Then, after being tubed, both for surgery and for intensivists' amusement, it was horrible. I sound like a croaking toad. Fred checked it and saw white patches on the side that hurts -- the ID Guy, when I finally whined enough that he actually looked, said it was "an ulcer." Fred rechecked it, saw no ulcer, still saw white stuff. The Bette-Midler-Lookalike Hearsepitalist -- oh, did we clash -- flashed a light on the right side of my throat and chirped that she didn't see anything. I'm sure she didn't.

I asked for throat lozenges beginning on Tuesday evening. They were reordered twice. Never showed up. When The Fredster settled me in bed here in my beloved Marlinspike Hall, deep, deep in the Tête de Hergé, he ran by the grocery and picked up four flavors, all sugar-free. Some lowfat plain yogurt. Feline supplies.

The dead zone in my right lung is back, in spades. ["in spades"?] Technically, I have pneumonia. Thick yellow crap. You are welcome!

The Boutiqueur, from a distance of safety, opined over the phone that maybe what happened was an assault by mucus plug. All I know is that I have reexperienced the breathless terror twice at home when the I-cannot-swallow thing happened. He always tells me it is anxiety.

I don't think so. It doesn't happen when I am anxious, for one. For two, I am fairly insightful about my emotional life, cognizant of schtuff like anxiety.

Back away, back away from the volatile.

Would you believe that the only "washing up" that happened in the hospital happened with Fred's help on Wednesday night? That the bed sheets were never changed -- only a new top sheet whenever I managed to spill coffee on it. Cough. Patient care? What patient care? It was all meds, meds, meds. If Fred hadn't been there, my teeth would have grown brown fuzz.

Hey, maybe that was the idea. My brown-fuzzed teeth were at the center of a grand immunological experiment. I'm just saying.

I made an ICU nurse cry. And not from hurt, oh no. She wanted to KILL me. I kid you not. Is it my fault that she was the person who finally pushed me over the edge? She decided to invent information rather than say "don't know but will find out..." That happened a lot. I consider it lying and, at least, unhelpful to my recovery to be given misinformation. She lied about the echo results, about the monitored bed, about the phone, about my meds, about the palsy in my hand -- but above all? She ignored, and was pissed off by, my frequent frequent frequent requests that she stop-the-fuck touching my legs.

I don't do the 20 out of 10 pain scale crap. For the first time ever, in hospital, at least, I went to 10/10. It felt like every nerve fiber, muscle fiber, was twitching nonstop. My legs burned like dry old wood in a fresh flame. Yes, very Joan of Arc -- nod to Leonard Cohen (and Jennifer Warnes). No, I don't see my battle as kin to her fiery epic; Yes, I find the transcripts of her interrogations and trials fascinating reading.

So, anyway, it hurt like hell. My right foot and leg were caught up in horrible contractures. Every time someone decided to pat my knees, pass a cord or tube over my body, brush me with their humongous booby, it was like an electrical jolt that served to amplify the pain that had already been keeping me company.

I would say to This Weepy Nursey, "Please don't touch me..." This Weepy Nursey would snarl, "I know, I know, you don't like to be touched." Like to be touched? Hell, I LOVE being touched. Ah, but don't go down that road. Let her think I am just some effed-up eccentric.

They all had their ID cards hanging by lanyards around their tiny little easily-snapped necks. Bend over a patient's bed and these laminated thangs, they land on the patient. "But I didn't touch you. Gaawwwddd!" complained This Bitch of a Weepy Nurse. Leaving me to explain about ID cards, cords, tubes, boobies -- sounding like an insane person. Leaving This Bitch of a Weepy Nurse to roll her eyes, and do it again.

"But I BARELY touched you!"

So I had a meltdown. So I called her some sort of idiot in front of a colleague. So I maligned her knowledge base. She had it coming. "You don't have to talk to me like I am an idiot. Just explain it to me," said This Bitch of a Weepy [sobsob] Nurse. "Apparently, I do," was my response.

She actually brought me my standard dose of methadone as a response to the pain arc. When I told her something more immediate and short-acting was called for, she practically threw it at me and I could see "Effing Drug Addict" play across the marquee of her mind. I spared her a recitation of the half-life of methadone.

I take 15 mg of percocet for bad breakthrough pain. Two 7.5/325 tablets. And that's what the pain management service ordered for me in hospital. This Bitch of a Weepy [sobsob] Nurse, however, decided that since they only carried 5 mg tablets, that two 5 mg percocets was the equivalent order. Hellloooo? I tried pointing out that if we tried three 5 mg tablets, we'd be doin' good. But that's too much Tylenol, she countered. Damned if it doesn't come in immediate release form without ANY apap, and at the 15 mg dose, too...

Once out of ICU, there was no quibbling back-and-forth about it. People also had to be told "please don't touch; please ask/tell before touching" only twice or so, and then were kind enough to spread the word. The problem on the floor? Inexplicable! Big old white bandage on left shoulder... But still, fairly hefty "pats" on the shoulder. I never said anything, but felt my pupils explode and the smile on my face freeze into a death mask grimace... That hurt a heck of a lot less than the slightest touch to my arms or legs.

I've got to stop.

In case you don't see it, or get it, or feel it? I think there is PTSD lurking in me whenever stuff goes even slightly wrong in the hospital -- when things go majorly wrong? As Mr. T might opine: "I pity the fool."

It goes back to May 22, 2002.

The final thing that wants to leak out of my fingertips this morning, before trying to clean up this bloated corpse and set off to see the ID folk, is an accounting of how frustrating it is to explain to the student nurse in ICU that the ventilator had been turned off for a trial prior to extubation. "It's breathing for you, sweety!" she kept chirping. I wanted to scratch her face off. Finally, I put my hand on my chest, so that she could see its rise and fall versus the non-activity of the machine. "oh!" she said, and ran out of the room, ostensibly "to tell somebody." Thank God for Respiratory Therapists... I had been started on my "trial" a good 45 minutes earlier, unbeknownst to my caretakers.

See? That kind of thing doesn't matter. Best to forget it. Don't dwell on the negative. Make like a duck and let it roll off your back. Don't sweat the small stuff.

Have you ever had pneumonia, lousy O2 sats, and tried to breathe through a straw, all the while trying to positively impress the People in White with your... vivacity?

All right, next time? I will continue to exorcise my demons, particularly The Bette-Midler-Lookalike Hearsepitalist who tried to kill me with insulin.

I am so grateful for this space.

And I am sorry for making the nurse cry, for enraging her, for putting her down. I am sorry I told her that the ICU needed to do an inservice on CRPS/RSD. I was basically alone, and afraid, and in pain. And stuck back in 2002, when forces -- in the guise of Doctors and Nurses -- conspired to devastate me.

Someone, Anyone -- give me a week, and then kick me in the butt. Okay?

(O Lord, Hear my prayer! Let something treatable have grown in the lab, one of Your smaller creations that wants a more hospitable home.)

Friday, May 1, 2009

Be/Loved


Hello, Dedicated Reader Base!


I was discharged from the hospital yesterday afternoon, to the great relief of everyone involved, particularly the hospitalists and nurses. When I am a little stronger, a post on hospitalists and certain types of RN will be forthcoming. I am pretty sure that the three hospitalists (one an intensive care hospitalist, one a pulmonologist, one a whiz-girl at internal medicine) were not "Happy." And I am positive that Happy the Hospitalist (The Happy Hospitalist) would not recognize himself in the performance of these particular three colleagues.


Anyway, the short version:


Surgery went well, although we failed in our goal of putting in a full shoulder prosthesis because the orthopedic surgeon found more infection... that continues to *not* grow in petri dishes. Later that night, I twice went into what we will call respiratory distress -- O2 sats dropped from the low 90s to the 30s within 5 seconds. I learned the meaning of gratitude at that moment, because my nurse happened to have just walked in the room. I mean, being on continuous monitoring doesn't do a whole heck of a lot of good if no one is watching! She stuck to me like glue until a Super-Duper Respiratory Therapist arrived, who then rescued me a second time. We were on our way to Intensive Care before the third episode even had a chance. I don't remember the third go 'round, anyway, as I was, if you can believe these medical types, "obtunded," and they proceeded to tube and then attach moi to a vent.


Yadda yadda -- I'll spare 'ya. [EEGs, CT scans, MRIs, echos, blood sugars and more!]


After some mis / management -- that wasn't all that big a deal, so long as you weren't the patient -- and a few days time, I am home. With the infection still blooming, and the explanations still lacking. We're doing i.v. vancomycin through the PICC line again.


The Poor Fredster. He is sleeping in this morning, and I am so glad. He is lovely, have I told you?

Thursday, April 23, 2009

Undifferentiated Mush

I haven't slept in 44 hours. Oddly enough, I find myself fighting the urge to sleep. This tends to happen when I'm stressed -- but really, if this is stress, then I am one lucky person. The surgery on Monday, and the tedium of being in the hospital, probably in isolation again, is exacting its toll -- in advance.

How do I know I will be stuck on the other side of people floating in yellow paper gowns with shockingly bright blue latex-free gloves? Because I have assurances it won't happen from my internist and his Supernurse Sidekick, from the admitting orthopedic surgeon, his PA, *and* his nurse, from the Infectious Disease doctor and *two* of his PAs, as well as from the Director of the Infusion Center.

Each person is quite sincere and well-meaning -- and all of them make reference to "common sense." And yet, not one of them is willing to do the leg work of ordering cultures, then checking on the results, and writing orders implementing or discontinuing the innumerable ickitudes of isolation. I know this because of the previous four admissions during which we danced this same dance.

La Bonne et Belle Bianca Castafiore refuses the paper and plastic garb. She either sneaks in without them to begin with, or dons them with great fanfare out in the hall, only to rip them off like a cheap costume once inside the room. Ah, ah, ah! Je ris! Oui, je ris! Simplement de me voir, si si si, si belle dans ce sacré miroir, ah-ah-ahhhh! I know, I know! Out of the bonny blue she has begun to produce operatic riffs...

Anyway, I have plugged my nares with antibiotics, washed every inch of my body with Hibiclens, lanced the multitude of dark, oozing, stinking boils... just kidding about that last part. "Multitude" is kind of an overstatement, used for shock value.

So this afternoon, as the preregistration nurse is doing her thing an d swabbing the nares and the axillary hot spots, I will be smiling my secret smile, secure in the knowledge that Science is going to fail me, once again.

I bet you a dollar. The results will be negative, no growth -- but because hospital protocol requires two successive negative results, that is where the ball will get dropped. I can orchestrate the production before surgery -- but after? That's a different ball of sealing wax.

It is within the realm of the possible that you've no idea what I am babbling about. Don't worry, for you are not alone in falling short of perfection. I have a clusterfuck of medical issues -- lupus, avascular necrosis (which engendered three joint replacements and several pinnings, plates, and screws of fractured bones), adrenal (and renal!) insufficiency, and the everlovin' CRPS/RSD. Oh yeah, and a fair amount of aortic regurgitation.

Also an aortic aneurism.
And a partridge in a pear tree.

The short version of the pertinent? Somewhere along the line, pathogens moved into both of shoulder prostheses -- and then developed into a more classic osteomyelitis. Last August/September, my awesome orthopedic surgeon removed my right shoulder prosthesis due to massive infection and "replaced" it with a silly little antibiotic-impregnated spacer. This surgery did not go very well, and resulted in schtuff like ventilators, pressors, ICU, and an extra visit to the surgical theatre. Despite having lots of evidence for the lab to work with, nothing grew in the cultures. In December, he had to remove the left shoulder prosthesis, and gifted me with another spacer. The infection spread into the entire shaft of the humerus, which -- in ShoulderMan's words -- "pretty much exploded." Mid-February, he went back in on the right side, and put in another total shoulder prosthesis. We are hoping to repeat that achievement this coming Monday on the left side.

I know that my navel is not the center of the universe. Trust me, I am as disgusted as you by this constant worrying and teasing of details over which I have no control -- and about which you have little interest.



How did I miss that the Taliban are within spitting distance of Islamabad? Was it because of that navel thing, or maybe fever, pain? No. I was, quite simply, derelict in my duty as a Planetary Citizen.*

ISLAMABAD, Pakistan — Pushing deeper into Pakistan, Taliban
militants have established effective control of a strategically important district just 70 miles from the capital, Islamabad, officials and residents said Wednesday.

The Taliban pushed into Pakistan from the Swat Valley. We are assured that Islamabad is not in imminent danger, and yet:
Buner, home to about one million people, is a gateway to a major Pakistani city, Mardan, the second largest in North-West Frontier Province, after
Peshawar.

“They take over Buner, then they roll into Mardan and that’s the end of
the game,” a senior law enforcement official in North-West Frontier Province
said. He asked that his name be withheld because was not authorized to speak to
the news media.

My God. I think it is time to focus on what matters.




*"The beliefs I have to defend are so soft and complicated, actually, and, when vivisected, turn into bowls of undifferentiated mush. I am a pacifist, I am an anarchist, I am a planetary citizen, and so on." Kurt Vonnegut

Wednesday, April 22, 2009

Deninel: A Stream in New Hampshire


I can usually riddle my way through misspellings.

But I am tired of a certain woman's insistence that her husband is in a state of: deninel.

The first time she typed it out, I smiled indulgently (my most obnoxious smile, unfortunately). By the third repetition, I was mouthing deeeee-nigh-yul,deeeee-nigh-yul,deeeee-nigh-yul.

There ain't no damn word DENINEL.

dee-nin-ul? dee-nin-ul?

Do not mess with Retired Educator when she has not slept a wink, nor a nod, and she ain't a' blinkin' none, neither.

Bless this lady's heart. She goes on to write:

"My husband has cirrhosis of the liver and hep c, he is also bypolar! He refuses to take meds and is in complete deninel!!! The stress is about to kill me , my faith is strong but he wears me down!!! We have two children at home 17, and 15 , I have went to work to help support us."

Before I lapse into a pool of melted Jello (somehow I picture a very red mix of cherry, watermelon/kiwi, and raspberry, all pulsating at roughly 120 beats a minute) out of sympathy for her situation, my God, why can't people manage to make verbs agree with subjects? Is it hard? No, it is not.

Sorry, I meant: No, it are not.

She can spell CIRRHOSIS but not bipolar?

Her screenname involves use of one of my favorite words: poot. As in: I pooted, you pooted, he/she/it pooted, we pooted, you pooted (again), and they pooted. This is a Free Poot Nation.

And, of course, in addition to being slang for flatulence, "poot" has a history of diplomatic implementation, because the Venerable Bush preferred "Pootie-Poot" as sobriquet for Putin, the former {*cough*} President of Russia. You know, the guy who is now {looooong *fart*} Prime Minister of Russia? Second-in-command {baritone *belch*}?

Oh, the hilarity, back in February of 2001, when we could afford to yuck-it-up but good:


INSIDERS are admitting that President George W. Bush's penchant for bestowing his own nicknames on close associates has provoked the first crisis of his new administration.

"Internal communications are in turmoil," confesses a high-ranking Bush aide known as Frenchy, though he doesn't know why. "The president says get me Knuckles on the line, or where's The Eskimo, or let Bones and uptown handle this," he laments, "and nobody has a clue as to who he's talking about."

Vice President Dick Cheney, a seasoned Bush handler, refuses to confirm or deny reports that he plans an internal White House telephone hot line where senior advisors, cabinet members and others can call in to find out their current presidential nicknames and those of their colleagues.

But knowing who's actually who among themselves has become a high-stakes guessing game for the Bush team members — as was underscored by a recent trip to Kansas City by a bewildered secretary of state, Gen. Colin L. Powell.

The president had ordered that Bullets be sent to represent the administration at a town meeting on farm subsidies. Assuming Bullets to be Mr. Bush's informal name for the only ex-military figure among his top aides, a member of the White House staff conveyed the word to General Powell. He was halfway to Kansas City aboard Air Force One before the goof was revealed: Bullets is the president's nickname for the secretary of agriculture, Ann M. Veneman. Mr. Bush's response to the snafu was quoted as, "Why for heck's sake would I send Balloonfoot to do Bullet's job?"

The first lady herself is reported to be "baffled" by her husband's nickname for her. "I hung up five times yesterday when he called to ask what was for dinner," said a flustered Laura Bush. "I thought it was a wrong number when the guy kept asking for Stretch."

Meanwhile, President Vladimir V. Putin of Russia is reportedly both baffled and incensed that on his first call to the new American president, Mr. Bush addressed him not as Mr. President or Mr. Putin but Ostrich Legs.

Mr. Cheney, who is said to believe his own Bush nickname to be either Hopalong or Crash-Dive (signed presidential memos evidently differ), has reportedly come to dread full cabinet meetings. "When George W. starts with the `Good morning, Skeezix' and `Let's ask The Undertaker," says one cabinet member, who thinks he himself may be Spinach Man, "they all look over at Dick for help, and he's as lost as they are. And if Dick doesn't know who the president's talking to, who does?"

A White House nickname hot line, should Mr. Cheney set one up, would be helpful but no panacea. High- ranking administration officials are still likely to refuse the call when their secretaries announce it's The Pecos Kid for Snooky. Foreign leaders beyond nickname-hot- line range will surely bridle at being called Nine Pin or Hound Dog by a fellow head of state.

And what of Mr. Bush's intimate circle? One old friend returned as Not Known At This Address a 50- pound shipment of Texas barbecue beef bearing the presidential seal, addressed to "The Big Goober." His name is Darryl.

Compounding the confusion is Mr. Bush's creativity with sobriquets, verging on free association.

"His nickname style isn't anything you can decode," points out a close observer known only as Four- Eyes. "Like, say, calling tall guys Shorty and right- handers Lefty. Why is Attorney General John Ashcroft Snake Hips — or is that Rumsfeld? No, he's Pistol Pete. Wait a minute, maybe Rumsfeld is Chickenman and Pistol Pete is Christie Whitman. Aw, I give up."

Asked by reporters about the impending nickname hot-line project, the president himself expressed surprise at the idea and said he had no information he was aware of.

"For that," he replied, "You'd have to talk to Stilts."
I have been up all night, which explains the incredible profundity of this post, but somewhere in the steel trap that is my mind, an analogy, nay! A causal relationship was forming. Okay so some of it was forced. A lot forced.

Nana
Poot (yes, that is this distressed woman's *chosen* moniker)? Meet the man secure enough in his... um, masculinity to come up with "Pootie-Poot," and the Author of Much of My Discontent, and perhaps the Author of Some of Yours. I sincerely hope that you will be able to access some meaningful help for your husband and your entire family.

Tuesday, April 21, 2009

Long-lasting nerve block:::Slow-release technology

This research may well improve the usefulness of nerve blocks, which are often used in the management of CRPS/RSD pain. I'm unclear as to whether this translates into the preferred sympathetic block. (Of course, I maintain that the continued emphasis on SMP, or Sympathetically Maintained Pain, is a colossal waste of time and resources unless the treatment response is in the very early months of CRPS. I am pretty sure that I progressed to SIP, or Sympathetically Independant Pain, within the first six months or so of onset.)

Of course, there is the ever distinct possibility that I don't know my ass from a hole in the ground

Long-lasting Nerve Block Could Revolutionize Pain Management

ScienceDaily (Apr. 16, 2009) — Researchers at Children's Hospital Boston have developed a slow-release anesthetic drug-delivery system that could potentially revolutionize treatment of pain during and after surgery, and may also have a large impact on chronic pain management.

In NIH-funded work, they used specially designed fat-based particles called liposomes to package saxitoxin, a potent anesthetic, and produced long-lasting local anesthesia in rats without apparent toxicity to nerve or muscle cells.

"The idea was to have a single injection that could produce a nerve block lasting days, weeks, maybe even months," explains Daniel Kohane, MD, PhD, of the Division of Critical Care Medicine in the Department of Anesthesiology at Children's, and the report's senior author. "It would be useful for conditions like chronic pain where, rather than use narcotics, which are systemic and pose a risk of addiction, you could just put that piece of the body to sleep, so to speak."

Previous attempts to develop slow-release anesthetics have not been successful due to the tendency for conventional anesthetics to cause toxicity to surrounding tissue. Indeed, drug packaging materials have themselves been shown to cause tissue damage. Now, Kohane and colleagues report that if saxitoxin is packaged within liposomes, it is able to block nerve transmission of pain without causing significant nerve or muscle damage.

In lab experiments, the researchers evaluated various formulations--various types of liposomes containing saxitoxin with or without dexamethasone, a potent steroid known to augment the action of encapsulated anesthetics. The best liposomes produced nerve blocks lasting two days if they contained saxitoxin alone and seven days if combined with dexamethasone.

Cell culture experiments and tissue analysis confirmed that the formulations were not toxic to muscle or nerve cells. Furthermore, when the team examined expression of four genes known to be associated with nerve injury, they found no up-regulation.

"If these long-acting, low-toxicity formulations of local anesthetics are shown to be effective in humans, they could have a major impact on the treatment of acute and chronic pain," says Alison Cole, PhD, of the NIH's National Institute of General Medical Sciences, which partially funded the work. "This slow-release technology may also have broader applications in drug delivery for the treatment of a variety of diseases."

Kohane is currently optimizing the formulation to make it last even longer, while avoiding local and systemic toxicity. "It is conceivable we could have a formulation that is suitable for clinical trials before too long," he says.

The research is published online on April 13 by the Proceedings of the National Academy of Sciences. The study was supported by the National Institute of General Medical Sciences. Hila Epstein-Barash, PhD, was first author on the paper.


--------------------------------------------------------------------------------

Journal reference:

Hila Epstein-Barash, Iris Shichor, Albert H. Kwon, Sherwood Hall, Michael W. Lawlor, Robert Langer, and Daniel S. Kohane. Prolonged duration local anesthesia with minimal toxicity. Proceedings of the National Academy of Sciences, 2009; DOI: 10.1073/pnas.0900598106

You and Your Breasts

Yoo hoo! Over here, over here!

You probably know this already. I didn't.

I was cruising around over at YouTube, watching very sober, intellectual-type videos that all involved, for some inexplicable reason, seriously cute kittens (my preferred sort of Talking Head: The Feline Pundit).

Then it happened. It happens a few times a day. For someone like me? That means daily surprise...

Directed-at-me advertising (also known as: targeted, customer-directed marketing).

I hate it. Rather than broadening my horizons, these ads do nothing but remind me of restrictions, limitations, foreshortening -- "the effect of perspective causes distortion." Do I want to be reminded that my browsing choices reflect an intense interest in things like low carb snack foods, veterinary anesthetics, neurological disease, Indonesian wedding cake decorating, kitty litter (and other human-oriented bowel regimens)?

In addition to holding the key to my personal financial future, Google just plain impresses me, which is, of course, why it remains my favorite bit of equity.

Anyway, I saw a link that I'd never noticed before that took me gently by the puffy hand and led me to: YouTube Interest-based Advertising and You.

This reminds me of one of The Fredster's favorite Early Job stories. He was working as an engineer for a smarmy doctor, T.R. Shantha, M.D., who owned a collection of rental properties and motels. (This guy was -- rather belatedly -- convicted of medical fraud just two years ago. He did things like infuse patients with hydrogen peroxide. His clinic laid claim to "safe and effective, nontoxic, scientifically-based alternative” medicine that could “cure or control most cancer and other chronic disease.") Shantha was incredibly money-hungry*. He authored several erudite monographs, of which Fred retains one exceedingly rare copy that we hope to be able to cash in for a small fortune some future rainy day: You and Your Breasts.

Until that time, it will remain one of our most consulted works of reference.

(Choo! Choo? Have you seen my train of thought?)

Back to YouTube. The next click led me to Google Ads Preferences which, in turn, led me through the steps necessary to opt out of interest-based advertising!

Then, loving my readership as I do, I rushed "here" to tell youse guys about it in my usual, straight-up, clear-as-crystal way.

If you are bugged by ads purporting to represent your burning interests, this is one way to blend back into the tepid sea of anonymity.

*Umm, Fred quit when approached to burn out a family behind in their rent. Not in the job description. (Not to worry, My Guy did the right thing...)

Monday, April 20, 2009

The S-Word

First, I hope it is as beautiful a day where you are as it is here. The eyes rest on flowering trees -- the colors! The sky draws them up to a crystalline blue that goes on forever.

Okay. Snap out of it.

{x-sneeze}

Second, this proposal of the Obama administration strikes me as stupendous -- and in more ways than are initially apparent. [I woke up *deep* -- a reg'lar Think Tank. Actually, I woke up to a barrage of the nimble-tongued Captain Haddock's verbiage. More on our, um, conversation in the minute or so it takes you to read this article.]



U.S. May Convert Banks’ Bailouts to Equity Share

Published: April 19,2009
WASHINGTON — President Obama’s top economic advisers have determined that they can shore up the nation’s banking system without having to ask Congress for more money any time soon, according to administration officials.

In a significant shift, White House and Treasury Department officials now say they can stretch what is left of the $700 billion financial bailout fund further than they had expected a few months ago, simply by converting the government’s existing loans to the nation’s 19 biggest banks into common stock.

Converting those loans to common shares would turn the federal aid into available capital for a bank — and give the government a large ownership stake in return.

While the option appears to be a quick and easy way to avoid a confrontation with Congressional leaders wary of putting more money into the banks, some critics would consider it a back door to nationalization, since the government could become the largest shareholder in several banks.

The Treasury has already negotiated this kind of conversion with Citigroup and has
said it would consider doing the same with other banks, as needed. But now the
administration seems convinced that this maneuver can be used to make up for any
shortfall in capital that the big banks confront in the near term.

Each conversion of this type would force the administration to decide how to handle
its considerable voting rights on a bank’s board.

Taxpayers would also be taking on more risk, because there is no way to know what the common shares might be worth when it comes time for the government to sell them.

Treasury officials estimate that they will have about $135 billion left after they follow through on all the loans that have already been announced. But the nation’s banks are believed to need far more than that to maintain enough capital to absorb all their losses from soured mortgages and other loan defaults.

In his budget proposal for next year, Mr. Obama included $250 billion in additional spending to prop up the financial system. Because of the way the government accounts for such spending, the budget actually indicated that Mr. Obama might ask Congress for as much as $750 billion.

The most immediate expense will come in the next several weeks, when federal bank
regulators complete “stress tests” on the nation’s 19 biggest banks. The tests
are expected to show that at least several major institutions, probably
including Bank of America, need to increase their capital cushions by billions
of dollars each.

The change to common stock would not require the government to contribute any additional cash, but it could increase the capital of big banks by more than $100 billion.

The White House chief of staff, Rahm Emanuel, alluded to the strategy on Sunday in an interview on the ABC program “This Week.” Mr. Emanuel asserted that the government had enough money to shore up the 19 banks without asking for more.

“We believe we have those resources available in the government as the final backstop to make sure that the 19 are financially viable and effective,” Mr. Emanuel said. “If they need capital, we have that capacity.”

If that calculation is correct,Mr. Obama would gain important political maneuvering room because Democratic leaders in Congress have warned that they cannot possibly muster enough votes any time soon in support of spending more money to bail out some of the same financial institutions whose aggressive lending precipitated the financial crisis.

The administration said in January that it would alter its arrangement with Citigroup by converting up to $25 billion of preferred stock, which is like a loan, to common stock, which represents equity.

After the conversion, the Treasury would end up with about 36 percent of Citigroup’s
common shares, which come with full voting rights. That would make the
government Citigroup’s biggest shareholder, effectively nudging the government
one step closer to nationalizing a major bank.

Nationalization, or even just the hint of nationalization, is a politically explosive step that White House and Treasury officials have fought hard to avoid [....]

Where did I leave my helmet? The vociferous bloggers who enjoy scaring themselves and others with the big, bad S-word (Saltimbanco, sidereal, soprano, stellar, sorrow, sideshow, setters, Suzie Q? -- Oh, a psychiatrist would have a field day with such a list!) -- Okay, so strictly speaking, Edmund L. Andrews, the author and unacknowledged second cousin to Julie Andrews, she of potty-mouth fame, prefers the N-word -- which is just silly.


Yeah {cough} -- the vociferous bloggers in double knit polyester pants and stiff yellow polo shirts, through which one can determine the inny-or-outy situation of the navel, hissing away like the nasty snakes that they are! Whoa, Nelly, Retired Educator -- Settle down, there, Champ!


Puh-leeze. Vociferous double-knitted bloggers don't scare me. I just got off the phone with none other than Our Benefactor, in whose Ancestral Manor we are living, and whose generosity we enjoy. I mean it; We really enjoy it.


I was still half-asleep but hearing The Captain's voice booming in my ear brought me to wakefulness in an instant. Believe it or not, he's still hanging out in Africa with the good and faithful Bongi -- apparently, they enjoy regaling one another with Tales of Glory Days. Not that their present endeavors aren't Story Worthy, mind you.


Why am I speaking of The Captain, why of Bongi? It is a question of curses, creativity, catharsis, and, probably, but unconfirmed, the odd crumpet. Well, okay, *strictly* speaking -- something I endeavor to no longer do, in my felicitous retirement -- Bongi's concern is less The Art of Cursing and more the management of the surgical theatre, and saving lives.


Which is not to say that The Captain hasn't saved his share of lives.


You wanna talk Pirates? The mere mention of Captain Haddock makes their blood run cold. No need to have Navy SEALS pop 'em in the head -- no, they abandon ship as well as booty when they hear the Captain approach. One is more likely to hear him first, see him second. (I love the word "booty": A nautical term for treasure; American slang for buttocks...)


So anyway, half-asleep, I put the phone to my lovely cauliflowered left ear (too many years of MMA) to hear: Army of bachi bozouks, why are you still abed?

Oh, Captain, My Captain, is that you? mumbled lazy-ass me.

In the name of billions of blind whales -- who else would call on the Emergency Red Phone in the Visitor's Wing of Marlinspike Hall? Sub-products of ectoplasm, who's been using my minutes? Hairy cucumbers! Stinking goat-bearded dolphins!


He was on a roll.


Toward the end of our rollicking conversation, he inquired as to my reaction to Obama's performance, these first hundred or so days.


"Courageous and Bold," I proffered.


"Christ of a Commie Bleating Bolshevik," he countered, in a scary **whisper**.


"Whatever floats your boat, Captain," I hissed.


"Ship. Ship. Whatever floats my God-damned SHIP!"


Note the day and time. Even Captain Haddock becomes crass when discussing politics.


I think shifting ownership from common cash to shares is... very American, smart, and -- what I like most -- it drastically decreases the opportunity for graft chez some of these smarmy corporations.

I am going back to bed. Clouds are moving in. We may have to find a new place to live.

Go GOOG.

Sunday, April 19, 2009

Aaden Gosselin


When I grow up, I want to marry Aaden Gosselin.

Cry Me A River ::: Susan Boyle

Wow. At first, I didn't recognize her voice but about a third of a way in... Yes, that is her.

It is still very difficult to believe that this is an untrained voice -- but the more biographical articles continue to insist upon it.

The frumpiness, I believe, and hope that they will leave Ms. Boyle to her own frumpitudinal devices. If she wants to make herself over, cool. Pluck that brow! Style that hair! If she doesn't, I believe the world has learned the heavy-handed Book/Cover lesson. Oh, who am I kidding? We've learned the lesson only as it applies to *her*.

There were only 1000 copies made of the 1999 charity album -- funded in part by the Whitburn Community Council in West Lothian, where there must be something in the water.... I'd pay top dollar to hear The Broxburn Public Band cover Bohemian Rhapsody.

Doesn't every copy have a master? Let's start pressing those babies!

I know so little about music, only what the Brother-Units taught me, and what Fred has spent years refining (He is a Recovering Audiophile), and yet, like anyone, I know what I like. I like this version of Cry Me A River, and am astonished by things like her phrasing and -- perhaps most astonishingly? Her *restraint* -- the lack of which ruins a good many bluesy ballad.

Those who can, sing. Those who can't? The blither and blather on about phrasing and restraint.

In summation: Wow.

Saturday, April 18, 2009

WTF




I have tried to avoid falling into the blogging trap of "What the Fuck?" postings -- because, really, one could spend all one's time going "What the Fuck?" these days.

Still, this morning's mail provided a great WTF opportunity. I just can't figure this out.

S. Clusterfuck, M.D. -- Medical Director, Vice President of Clinical Programs with Bull Crap Bull Skeet of Tête-de-Hergé -- wrote me the following letter:

Dear Retired Educator,

Maybe you've avoided tests ever since your school days. But did you know that getting medical tests when you need them is one of the best ways to protect your health? Regular checkups can uncover any new developments early in the game. And that gives you and your doctor the best chance of preventing or controlling problems.

To take charge of your health, talk with your doctor about these ideas:

The microalbumin test checks for early signs of kidney damage by measuring the amount of protein, called microalbumin, in your urine. Damage to your kidneys may cause you to need dialysis treatments.

We're available 24 hours a day, seven days a week to help you live a healthier life.

Sincerely yours, and a pat on the derrière to La Bonne et Belle Bianca Castafiore,
S. Clusterfuck, etcetera etcetera...


I ask, with equal sincerity: WHAT THE FUCK?

Friday, April 17, 2009

I am the ostrich, Goo goo ga joob

Oh, Happy Day!

My heart is basically unchanged from the last echo in August 2008. Hooray! The same doctor who called me last year, and managed to scare me to death, called a few minutes ago. He chose his words carefully and I asked no questions -- it was a refreshingly short and sweet conversation.

If you read just a few of my posts, you know that I am obsessed with detail, as if by managing them all, I might bring order out of disorder. (You know, *that* old trick!) So why approach the echocardiogram results in the manner of a head-in-the-sand ostrich**?

Because it is something I cannot control. Because I have decided to trust the cardiologists. Because I made myself ill yesterday, wondering what having an aortic dissection might feel like, if -- that is -- I were so lucky as to survive long enough to feel anything. Because I entertained notions of having endocarditis again, or left ventricular failure -- that which left me with severe cardiomyopathy a decade ago. (And from which I spontaneously recovered! Turned out to be lupus-related.) I remembered how difficult it was to do anything as strenuous as, say, turning over in bed! Remembering that has been good for me, reminding me that the fatigue I feel now is oh-so-benign in comparison.

I was also very passive because just going to that hospital triggers reliving the traumas of May 2002.* In the aftermath of that horrid, life-altering, and criminal experience, I think lies were told to my cardiologist -- a man that I highly respected. I know now, after getting my medical records, that my heart doctor was the one I should thank for my survival -- he did the initial resuscitation and got me from the orthopedic floor to the ICU. I am so thankful to him and suspect (read: *know*) that the orthopedic surgeon (Carson) and the Head of Anesthesia told him I was suing, that I blamed him, or something. Because he completely changed.

[[The Anesthesia Chair? Sweeney Todd? At the time, he doubled as my pain management doctor, unfortunately -- God did he turn out to be a conniving, self-involved, heartless bastard -- and yes, I would slap the "criminal" label on him, too. Maybe more easily than anyone else besides Carson. He was in a position to do lumbar blocks and early intervention physical and drug therapy *immediately*. How dare he not report what state investigators eventually decided was a Sentinel Event? How dare he make light of what they all did to my effing life, choosing to moan to me, instead, about the changes investigators insisted be made in his department? Above all? How dare he not diagnose and treat my CRPS for over 19 months? In the days before yesterday's echo? I dreamt about meeting Sweeney Todd and Kelman in the elevator at the Doctor's Building. I was mute. Unable to speak. When we all exit the elevator, the doctors start to walk off. But Sweeney Todd turns around, walks over to me, sneers {He kinda looks like Cheney} and whispers: "What was that, Retired Educator? I can't hear you..."]]

I have asked The Fredster repeatedly if my memory is correct -- the memory of this same cardiologist telling me that I no longer needed to be followed, that I need not make another appointment. Fred was there, you see, and sometimes I need confirmation that what I remember is correct. Because this memory makes no sense! Of course, I needed to be followed, and, of course, I needed to make more appointments -- this was part of what the guy who called today was screaming at me last year. ("Why haven't you been seen? Why haven't you been having yearly echos?" and other pithy observations, such as -- when I asked what symptoms to watch out for with this aortic aneurism thingy -- "There won't be any symptoms. There won't be time." Oy! I thought I felt the very heart under discussion sink.)

This year? In a matter of minutes, I was literally breathing easier. My neck seemed to untangle itself, along with a disparate collection of sensitive internal organs. I felt like a walking miracle. Except for the walking part, I believe I am!

The aortic valve is maybe a little more "thick," the aortic insufficiency still moderate, and the aortic "dilatation" is just a smidge larger (+.14 centimeters to 4.79) -- but these observations don't amount to any real important clinical change or call for any intervention. I am "good to go" for surgery on the 27th. No growth on the valves -- that was also a concern, given the bacteria floating around in me.

An infinitely better reaction than that of last year:

dear all,

would anyone like to borrow some trouble?

i had my echo at 8:30 this morning. i asked the tech how it looked and she gave me a thumbs up and a "looks good to me." so we go home and i plan to pay some bills, declutter my piles of paper, etc.

ring ring ring.

it is one of the cardiologists. he is talking fast, and i cannot understand the words.

so... my heart is pumping well. i still have my usual aortic regurgitation from my bum aortic valve. and then there was that other thing. oh what was it?

oh yeah! where the aorta attaches to the heart ("the aortic root"), well... it is kind of dilated. like in an aneurism. i become a regular chatty cathy -- i ask if this precludes me having the surgery on monday and he says, no, that will be fine. then he starts to yell at me about how i need to have echos regularly -- that they found this dilation back in 2003. i don't *remember* that! (after i hang up and am talking to a weeping fred, he reminds me -- my cardiologist told us that it wasn't as bad as it looked on the echo -- and that i did NOT need to foillow up with him anymore! fred remembers that vividly.)

anyway, it measures 4.65 centimeters. i ask what needs to be done about it -- and the guy fairly hoots! (he actually was very nice) "major open heart surgery," says he.

well, what kind of symptoms should i be looking out for? and i am getting a chill just typing his response.

"you won't have any symptoms."

as in, it blows, i die. (hence, the weeping fred.)

there must be something extremely wrong with my mental health, this all seems like a great big joke to me! whahaha! what's gonna happen next?

i told fred that this is definitely an incentive to live in the moment.

so -- i guess it is a good thing i don't have hypertension.

whahahahahahahahaha!



******************************************************************************************************************* * Should you, Dear Reader, deign to click on the hyperlink and go visit the post over in Happy the Hospitalist's Land, please also note this comment I added as a sort of amendment. Then, as now, my tiny case of PTSD was rearing its ugly head:

La Belle et Bonne Bianca Castafiore, here. I serve as the willing public persona to one Retired Educator -- retired precisely due to the événements detailed above. We failed to provide a few details, not because they were not salient, but because it is difficult to type without shoulders!

**There was a third surgery to that illustrious hospitalization. When my cardiologist was working on me, he inserted a line in my femoral artery. A hefty little embolus formed a day later and emergency surgery was necessary as my leg was pulseless and a lovely ciel blue. *That* complication? Blameless and completely acceptable by me, something that occured in the order of things. Unfortunately, in the aftermath, our relationship was sacrificed to the Medico Brotherhood of Paranoia.

**My surgeon disappeared for a week after the ICU fall. I asked to have a new surgeon -- that request was both squashed and denied. I asked to see a patient advocate and was told that there were not any, but would I care to speak to a nun? Wile E. Coyote had nothing on these people. When I left the hospital, we thought that I had made three complete incident reports, and I *trusted* that there would be some record made in my chart. Dumb. Dumb. Dumb. What did I recommend in those lively conversations? Inservice education about adrenal insufficiency and how to spot the admittedly vague symptoms in patients undergoing surgery. Dumb. Dumb. Dumb. Legal action? Not even on my radar. I was being told that the incredible sensitivity and horrible shooting, burning pains in my leg and arm were the result of "too much pain medication" [?] and/or "a psychological problem." Would I care to see a psychiatrist? Rather than be offended, as I was, I should have said "yes." The nun, the shrink, and I might have really hit it off. Add a social worker and we had 4 for bridge.

**This ought to interest everyone. I was thrown into a Hell after all this happened -- I kept returning to the same doctors because my trust was not eroded. (Okay, so I am an idiot.) I thought and expected that people would be honest with me. When I finally went to a new neurologist, he left the exam room after about 5 minutes and came back with a heavy tome that had pictures of "classic" presentation of CRPS. Those photos might have been of me, they were that similar. He is wonderfully direct, and even though part of the same system as my former neurologist, quickly laid out the apparent plans for obfuscation that I was up against. Apparently, it was expected that I would sue. I would love to have sued... but had no capacity to handle anything but getting through the day. My friends and loves were angry with me... they would apparently have felt better were I to receive money. Go figure. Anyway, New Neuro Man tried to throw all available treatment at my CRPS, then still confined to the right leg and the left arm, and I tried to find some peace. I did, though, contact the state and report what I felt was a pretty awful state of affairs, and the previously mentioned Sentinel Event was declared, and investigators descended on the joint for a few days. Following that, I was dropped like a hot potato as a patient by everyone except my internist and my newly acquired neurologist. There is a 2-year statute of limitations for legal action. I had contacted the state medical society about the surgeon's various bizarreries (I cannot write about them, cannot take that stress), and they answered that he could not be censured or even investigated based on the information given. Whatever. I had completely given up trying to get the hospital to even pay those few bills it promised to cover (ambulance, bed, PT), and was living on 2/3 of my teaching salary -- the pay out of my longterm disability insurance. We had bought a house just a few months before this surgery -- a place to slum when we strayed from
Marlinspike Hall, deep, deep in the Tête de Hergé. Ten days before the statute would expire, I received a call from the Legal Dept of the hospital, asking me to please submit any outstanding bills relating to that hospitalization. I was of (at least) two minds and told them so. "Here are the bills you promised to pay," I wrote, "and here is what you ought to feel compelled to pay, because it would be the right thing to do." Negotiations began and they gave me a [very] small settlement.

Have you ever heard of an unsolicited settlement before?

**The last thing I have to say is that it is true that an apology and openness and Real HELP would have met all my needs, and might have saved my life from being ruined. Please, doctors, nurses, and administrators -- give that a try before you mire yourselves in heartless paranoia and ugly assumptions.

**I am not sure that you've done me any favors, making a post of my info -- but I am having to relive it anyway, given that today's circumstances link up with those of yesteryear. Did a hospitalist save me? Yes, though no doubt my internist would have come through, stud that he is. I never met the man. I have a smudged and bent card with his name on it and am told by the Fredster that he was incredible and that I am lucky he was there. If this is the kind of thing you do, Happy -- well... God bless you.

December 22, 2008 5:10 PM
__________________________________________________________________________________________
**
"Ostriches have three main strategies when attacked. They can run away, they can kick, or they can try to hide (eg, when nursing the eggs). When hiding, they will sometimes lay flat on the ground, with the long neck and head also on the ground. In the rippling heat haze of their native Africa, they can look just like a grassy mound.

The myth that an ostrich will stick its head in the sand, in an effort to hide, may have begun with that great Roman thinker, Pliny the Elder (23-79AD). His real name was Gaius Plinius Secundus. Pliny was a man of intense curiosity about the world around him. His nephew, Pliny the Younger, wrote about him, “He began to work long before daybreak. He read nothing without making extracts; he used even to say that there was no book so bad as not to contain something of value. In the country it was only the time when he was actually in his bath that was exempted from study. When travelling, as though freed from every other care, he devoted himself to study alone. In short, he deemed all time wasted that was not employed in study.”

In 79 AD, Mt. Vesuvius erupted - and covered and then preserved the city of Pompeii. While most people ran away from Vesuvius, Pliny went straight into the danger zone to look, learn and rescue survivors - and died in the attempt. In his honour, the most violent volcanic eruptions (such as Krakatoa) are called ultra-plinian.

Before his death, Pliny had almost completed one of the earliest comprehensive encyclopaediae. His Natural History, in 37 books, was a remarkable attempt to summarise all the knowledge known to the Romans. He claimed that he covered some 20,000 topics, which he partly got out of some 2,000 books, which in turn were written by some 100 authors. In fact, he was one of the first writers to acknowledge other authors from whom he quotes, and also one of the first to have a table of contents. His Natural History remained a fundamental source of knowledge to the West through the Dark Ages.

So what did Pliny have to say of ostriches? In Book 10, Chapter 1, he writes, “…they imagine, when they have thrust their head and neck into a bush, that the whole of their body is concealed”.

Historians assume that this single sentence is the root of the myth about ostriches burying their head in the sand."

Wednesday, April 15, 2009

As the World Peeks

I love sites like this one: "The Cleveland FalconCam is an entertaining and educational project that follows a pair of peregrine falcons nesting on Cleveland's historic skyscraper, the Terminal Tower."

Many thanks to William the Coroner, a new member of the He's-A-Very-Good-Boy Club. Don't ask me to release The Members List as it is protected under some amendment or other and you'd have to climb over my dead body to get it.

Stop harrassing me! Stop harrassing me, I say! Start your own damned He's-A-Very-Good-Boy Club Chapter! It's not hard -- I mean it's not like there are scads of candidates just waiting for this coveted nomination. Guillaume-dissèqueur-des-cadavres? He's only #15 (order is by Date of Inclusion and does not imply any sort of Ranking by Very-Good-Boy Values).

The most costly items to get your Chapter started? Definitely the uniforms, sashes, and badges.

Okay, du calme, du calme.

When you are a confirmed world traveler, it is a shock to the system to be stuck at home, even a home as splendid as Marlinspike Hall, deep, deep in The Tête de Hergé. Brother-Unit TW -- soon to be a Birthday Boy -- keeps my lungs expanded and my feet tucked in imaginary hiking boots with his blog, American Idyll -- illustrated by his photos of the Grand Canyon.

I bet most blogonauts have wholesome webcam favorites of the natural history sort -- another that I love to watch -- you know, on a slow day? Le collectif des écureuils (squirrels) -- either at the blog or over on Facebook. It's not exactly a webcam dealie -- more a family story along the lines of Meerkat Manor.

We love Meerkat Manor and used to watch it religiously -- until we decided to do a Meerkat Manor Festival and discovered that, yes, it *is* possible to get sick of meerkats.

Less wholesome, but nice with a glass of wine, is the panoramic view from the restaurant atop the centrally located Printemps department store. Someone tried to stick their tongue firmly in their cheek, but there was apparent slippage -- the cameras sit in Restaurant Déli-Cieux: Ouch.

And yikes.

Of course, you can find something for everyone over at EarthCam.

Today, they are featuring New Yorkers running for the Post Office to get those taxes mailed...
Yes, it is Tax Day Cam!

2009 Achilles Walk for Hope & Possibility in NYC


RSDSA at the 2009 Achilles Walk for Hope & Possibility in NYC
June 28, 2009 Central Park

Online Registration and Forms are now available!

Walker and Virtual Walker Registration Available
Click here for more information

Team Co-captains: Jackie Drake and Marsha Tyszler

Since RSDSA promotes public and professional awareness of CRPS, a neurologic syndrome characterized by severe and persistent pain that can lead to disability, we are charged with educating those afflicted with the syndrome, their families, friends, insurance and healthcare providers about the potentially-disabling pain it causes.

We have teams in the Achilles Walk for Hope & Possibility to promote awareness and encourage support for people with CRPS and their family and friends. Our participation highlights the disabling part of the syndrome and offers hope to those who suffer from it.

You can participate in the walk and raise pledges, or put together a corporate team. Perhaps your company has a matching funds arrangement for not-for-profit fundraising events. Visit the website or contact us to get started!


Susan Boyle

Perfect song choice for the world right now, and for all the bleary-eyed U.S. Americans staring at tax forms...

She is obviously trained. I mean, the diaphragm just doesn't start to do that on its own -- forget her vocal cords. It is so hard to believe she is just now being discovered -- and that is the story we want and long for -- an honest, unassuming person rising out of obscurity, referencing a life of "hell," singing from Les Mis! Mwa ha ha! Brilliant, absolutely brilliant.

Well, hmm. This is the most I've been able to find out about her, since *she* is the story:
She is a veteran of abuse. She was starved of oxygen at birth and has learning difficulties as a result. At school she was slow and had frizzy hair. She was bullied, mostly verbally. She told one newspaper that her classmates' jibes left behind the kind of scars that don't heal.

She didn't have boyfriends, is a stranger to romance and has never been kissed. "Shame," she said. Singing was her life-raft.

She lived with her parents in a four-bedroom council house and, when her father died a decade ago, she cared for her mother and sang in the church choir.
One of the best comments I saw as I cruised around, searching for credible information about the talented Ms. Boyle (and, for some reason, I seem to want her last name to be "Hodges," as I entered that errant search term over and over, perplexed...) -- anyway, this still being in the moment, I laughed to read this:

"I prefered the heavy guy with the funny teeth who sang opera." I'm thinking he means Paul Potts. I'm also thinking he could use a few moments of reflection.

Well, there was also this... and anglophiles everywhere may now call out a hearty "spot on!" --

"Are we really patting ourselves on the back for recognizing that an unattractive woman over the age of 30 might be talented at something?"

Mr. GetAGrip said, "[T]he only thing more cynical than writing her off based on her looks is elevating the performance based on her looks..." Pshaw! Taking all of the circumstances, or at least all we know, it is a great performance.

I know it made my day.

And besides, here at elle est belle la seine la seine elle est belle? Cynicism is a four-letter word.

Earnings










GOOG announces tomorrow.
Let us pray...










Extremism on the rise

Yesterday, Fox News put this out -- along with many other news outlets. So I had my choice of where to steal, um, lift, uh, where to *get* this info.

I was impressed by the integrity with which Fox relayed the story -- my stereotyping of that particular source being rather strong and negative.

Contrary to some other versions, the Fox story, after dealing with the gist of things, goes on to question assumptions.

What about extremism among the leftists?

The Homeland Security folks were ready -- referencing an earlier study done of those liberal numbnuts.

Fox did seem a little put out that the leftwing version of extremism à la The Homeland Folks concentrated less on the potential for violence and more on their propensity to understand and use technology.

Just a small dig.

Heh.

Seriously, though -- this assessment is not exactly a surprise to most of the citizenry. God bless, in fact, those for whom it *is* a shock, for they are surely... remarkable people --

Who most likely have their living room furniture covered in plastic and freezers full of what they call "TV Dinners."

I am afraid for Obama. I fear the people so rocked by race as to turn to the inflammatory reflex of violent response.

The growing degree of want and sense of loss for some U.S. Americans, particularly those whose losses are compounded by personal devastation, sacrifice, and, perhaps, war, will also drive extremist impulses -- and how to track these people without empowering Big Brother? (I know, I know. How many times have I already figured in FBI tapes -- those funloving people sporting videocams back in the days of my 'maintes manifestations'? I always posed full-faced and smiling.)

The question/thought I hope we all continually reflect upon? Whether or not, in order to preserve First Amendment rights (as we diversely interpret them), protection of the fringe elements of the extreme right and left must constitute the line in the sand.

The Department of Homeland Security is warning law enforcement agencies
that recent news is helping "right-wing extremist groups" recruit new members
and could lead to violence, and warns about the possible recruitment and
radicalization of returning veterans.

The report, issued last week, is part of an ongoing review of extremists on both ends of the political spectrum.

The latest assessment by DHS' Office of Intelligence and Analysis found
no specific information that domestic right-wing terrorists are currently
planning acts of violence, but right-wing extremists may be gaining new recruits
by playing on fears about the recession and the election of the first African
American president. The office called them "unique drivers for right-wing
radicalization and recruitment."

"Right-wing extremists have capitalized on the election of the first African American president, and are focusing their efforts to recruit new members, mobilize existing supporters and broaden their scope and appeal through propaganda, but they have not yet turned to attack planning," the assessment reads.

"The current economic and political climate has some similarities to the 1990s when right-wing extremism experienced a resurgence fueled largely by an economic recession, criticism about the outsourcing of jobs and the perceived threat to U.S. power and sovereignty by other foreign powers.," it continues.

The report also suggests that returning veterans are attractive recruits for right-wing groups looking for "combat skills and experience" so as to boost their "violent capabilities." It adds that new restrictions on gun ownership and the difficulty of veterans to reintegrate into their communities "could lead to the potential emergence of terrorist groups or lone wolf extremists capable of carrying out violent attacks."

"Proposed imposition of firearms restrictions and weapons bans likely would attract new members into the ranks of right-wing extremist groups ... The high volume of purchases and stockpiling of weapons and ammunition by right-wing extremists in anticipation of restrictions and bans in some parts of the country continue to be a primary concern to law enforcement," the report says.

The assessment notes that right-wing recruitment grew in the 1990s
but subsided after increased scrutiny by the government following the 1995
Oklahoma City bombings.

It does state that in 2009 "threats from white supremacist and violent antigovernment groups ... have been largely rhetorical and have not indicated plans to carry out violent acts."

"Nevertheless, the consequences of a prolonged economic downturn-including real estate foreclosures, unemployment, and an inability to obtain credit-could create a fertile recruiting environment for right-wing extremists and even result in confrontations between such groups and government authorities similar to those in the past," reads a key finding in the assessment.

DHS spokeswoman Sara Kuban said the April 7 assessment is one in an ongoing series published by DHS "to facilitate a greater understanding of radicalization in the United States."

"DHS has no specific information that domestic right-wing terrorists are currently planning acts of violence, but right-wing extremists may be gaining new recruitments by playing on their fears about several emerging issues," Kuban said.

Tuesday, April 14, 2009

Nice People: What should I get the Brother-Unit TW for his birthday?

I've noticed it happen chez other bloggers, so why am I surprised? The slow and steady erosion of my distinctly tough outer shell due to the influence of...

nice people.

You know who you are.

Thank you for looking past my whines, thanks especially for laughing with me -- it's always appropriate. Sure, maybe there is a *smidgen* of laughing at me -- again, always appropriate, but I can sometimes hear the guffaws and snorts flying around rooms and cars, spacious mansions and cute efficiencies. (I have rented my share of cute efficiencies -- and "rooms" located in various odd relationships to the central housing [basements, "wings," garages])

I imagine them as angel farts. Gaseous Tinkerbells.

So, my little gaseous tinkerbells, my darling angel farts -- Will you do me a favor? (Ay caint heeeear ewe, gashush tenderloins!)

You will!

Wonderful, thanks a lot.

My brother-unit TW's birthday is April 20. We have an incredible story, I suppose, though the more people I come to know, the more I learn that "estrangement" is the common exception that proves a bunch o'rules -- like "absence makes the heart grow fonder" and "home is where the heart is." I would say "blood is thicker than water," but I don't want to malign TW.

Oh, that photo up there is one of TW's -- he works and plays and loves as a guide to Grand Canyon serious trekkers. In the colder months, and to make enough money to feed his cats, he labors as a bookie. This photo is from a blog post of his called A Parable of Immortality (Thomas Wolfe).

He was basically abandoned by my original nuclear family (yes, we were armed) -- as a young teenager, and at a time and place that was simultaneously wondrous, dangerous, and mythologizing. He spent some time following The Dead. He was shot in the gut by a deranged CIA operative. He ate out of garbage cans, was homeless. He is BRILLIANT and KIND and the only way he could have turned out that way is through the good gifts of being receptive and generous.

Through the years, we weren't allowed to speak of him. His name and my Mother's name were anathema and a person could be punished or their suitcases retrieved from the attic for speaking their names. He changed his to Tumbleweed. Oh, yeah, and I am pretty sure he's been very wasted from year to year, but then, haven't we all? I bear my Mother's name as my middle name, I guess because I was born on her birthday... but still -- after all these years -- under duress about these god-forsaken names, I say: My name is Retired mumblemumble Educator.

I love him a lot. I wish there were more to offer than the meager "Gee, I'm sorry we left you a continent or so away, alone -- oh, and hungry -- maybe in a little danger. Glad you survived, there, good buddy. Made a man of you, didn't it!"

I forgot probably more about him than I really knew. I had a rich fantasy life and both of my brother-units filled in as Superheroes. I didn't even know his mumblemumble name, just the first name, discarded. But I always remembered that he was born on Adolf Hitler's birthday, April 20.

Will you help me figure out a gift for him? I know you can't, really. But would you try? He's very well read, so I am afraid to get him books. We share a lot of the same musical taste, so there'd likely be a redundancy if I sent music. There was a sentimental item I hoped to send at some point, but I ran over it and cracked it with my wheelchair as I was chasing The Felines out of my office.

Our grandfather's pith helmet. It still smells like salt and loam.

TW has been clear that he's not interested in frilly reunionesque drama... me, neither. I have had two dreams -- the same dream, twice -- where I held something in my hand and was reaching out to give it to him -- so I know that somewhere in me, there is a real notion of "gift." There is something that I am supposed to give him.

Do you know what it might be?

Thanks, friends. (As for such matters as price range? Well, I used to be brilliantly rich, enormously laden with gold and lucre of all kind, but now am essentially destitute, dependent on the good Captain Haddock for food and shelter. So I am thinking $50-$75. Ar!)

I worried some of you by posting in so much pain and anger a few days ago. The pain is down a notch but it does appear that I am in a new phase (or whatever, as the kids say...) of disease with CRPS. No one really knows. There is always the worry of what the infections are doing. Also of what the infecting organism is! And *where* it is! Thursday morning, I am having another echo done to check my funky junky valves and see how my aortic aneurysm is doing -- I am too tired to get out of bed many days, have developed the disgusting habit of passing out now and then (more like going momentarily "black" -- a cold tunnel sort of thang) and my bloodwork sucks. That's suspicious, I guess, for my aortic insufficiency to perhaps have worsened. We'll see on Thursday. And, as confusedly related earlier today, the infection and the steroids have caused my blood sugar to rocket out of control. (At this very moment, I am in awe. IN AWE, I say! How can a person be simultaneously nauseated to the nth degree and starving? I have almost stopped eating the last 4-5 days... I suppose it's not all that inexplicable -- pain as I'd forgotten exists, blood sugars weirded out, fever, worry, fear, added-on pain meds. Oh, yeah, and all of that prednisone...)

This pain... sorry, I'll stop.

Is that what I *am* -- all of that krap jumbled together as a woe-is-me? Am I become "woe"?

Better than "woo," I suppose!

From the Skeptic's Dictionary:




Woo-woo (or just plain woo) refers to ideas considered irrational or based on
extremely flimsy evidence or that appeal to mysterious occult forces or powers.

Here's a dictionary definition of woo-woo:

adj. concerned with emotions, mysticism, or spiritualism; other than rational or scientific; mysterious; new agey. Also n., a person who has mystical or new age beliefs. When used by skeptics, woo-woo is a derogatory and dismissive term used to
refer to beliefs one considers nonsense or to a person who holds such beliefs.

Sometimes woo-woo is used by skeptics as a synonym for pseudoscience,
true-believer, or quackery. But mostly the term is used for its emotive content
and is an emotive synonym for such terms as nonsense, irrational, nutter, nut,
or crazy.










Most of the time, I align myself with The Skeptics. My nature, I guess. It's not a way of being that is all that wonderful, and I am trying to change. But, in the shift from Konstant Skeptick (say that, fast, twenty times) one must beware the allure of woo-woo.

Ahem. Excuse me while I whack the butt, oh-so-rhythmically, of Our Little Idiot, Dobby. He loves it -- and we will all be in jail should some representant of the SPCA drop by. (Yeah, but "dropping by" ain't all that easy, here at Marlinspike Hall, deep, deep in the Tête de Hergé. The roads are frequently out, and we have an impressive, and recently renovated, moat.)

I'm back. Where is my train of thought? Choo?
Oh, a b'day gift for Tumbleweed.

Once, when he returned home after a brief run-away, I didn't see him standing there looking down on a bunch of us kids organizing a baseball game. And when I did see him, it was clear that It Was A Moment In Time. Like it was yesterday and not 40 years ago, I see him. When I first saw the cover of Nashville Skyline, Elliott Landy's famous photograph, I gasped -- that's TW standing there -- a fuller face, less of a nose, more sensual lip -- but the same attitude, dress, guitar, expression. A traveler on the road, knowing something.



That's TW: a traveler on the road, A Song of Myself. A paean of all that could be.

Shit. I've made myself sad. Oh, what to get him? Maybe I will sleep tonight. Maybe I will dream dreams, and see what I have in my hand for my brother.

My BS

Major Boogers! Captain Secretions! Holy Hay fever!

No, not allergies, just a random outburst, but with a theme.

I am being put on sliding scale insulin. [Late breaking update! No insulin! Yay! He is adding Amaryl. Wise Choice, Wise Choice...] Too bad I have never paid much attention to the uptight and innately irritating Diabetes Educators that come to my bedside whenever I'm in ICU. Given that I only learn well in cement-blocked classrooms, where I sit in the back, huddled with a caffe latte, it was always a waste of breath.

Fred just sketched the major points again for me -- in a matter of 2-3 minutes -- and wasn't condescending or obtuse or nothin'.

It's the infection that has caused my blood sugars to go schizophrenic. That's what I was told. I don't understand how or why that could be, but if so, at least I will be able to stop the insulin when the infection(s) is cured. Right? "Before" -- I was put on Starlix because steroids were elevating the blood sugars. Now infection gets the blame.

Wanna hear how wacky these readings are? (Ha! Whose blog is it, anyway?) Let's see... Oh, and before every meal, I take 2 120 mg Starlix, an oral med designed to help keep this krapola under control.

Sunday -- at 8 am it was 135. Around 2 pm, I ate one boneless, skinless nuked chicken breast with herbs, had sugar free Jello with one dollop (about 1 tablespoon) sour cream. Four hours+ after eating that? 286.

How about the creepy fact that if I test blood sugar between 10 and 11pm, the readings are always between 240 and 250?! Is that not creepy?

I don't sleep much. Several times late at night, I have tested because of an inexplicable weird feeling (a host of generalities) -- to find readings in the 300+ range. It was my understanding that hyperglycemia didn't really have any symptoms --but I seem to have some sort of sensor -- vision is blurry, thirst, and a vague sense of not feeling well.

One day when I was really hit with fever and pain -- 252 was as low as I could get --even with an almost zero carb diet and starlix. I hope Dr. Go-to-guy's Nurse can explain this schtuff to me.

This morning, my fasting reading was 195.

Shoot. I don't wanna give myself shots. Cure the freaking infection.

Monday, April 13, 2009

Doctor Scott Reubin: Reprise


I bet you thought he'd faded from my memory -- me and my mind like a steel trap. Wrong! There is just a dearth of information out there, which means, I fear, nothing good.

It is odd to me that only non-medical people seem to be urging the precise and intense application of criminal charges on the hide of Dr. Scott Reuben, fraud extraordinaire.

Tufts, where do they stand? Patients, colleagues? Those innocent "co-authors"? The, cough, innocent, gag, drug companies? The FDA?

Who really believes that he did all the work of conducting fake clinical trials and the resultant fake articles and fake peer reviews and all the other fakiness... without help?

We cannot afford to let this case fade from attention.

To refresh the particulars of the case, here is an excellent take on the crime, found over at e-patients.net, "Dr. Reuben deeply regrets that this happened."

"Dr. Reuben deeply regrets that this happened." Isn't that a riot? Isn't that the most insulting response imaginable?

Back on March 23, Gilles Frydman put together a post on what he tongue-firmly-in-cheek called
"the third... in the unfortunate series about conflicts of interest":


In truth the quote is from one of his attorneys. Dr. Reuben, a world-famous anesthesiologist and former chief of acute pain management at Baystate Medical
Center, Springfield, Mass, one of the campuses of Tufts University School of Medicine is accused to have fabricated over 13 years at least 21 medical studies
(and perhaps many more among the 72 papers written by the good doctor) that
claimed to show benefits from painkillers like Vioxx and Celebrex, 2 drugs since
withdrawn from the U.S. and worldwide market due to safety concerns of an
increased risk of cardiovascular events (including heart attack and stroke).
Most, if not all, of these articles are in the process to be retracted. The
wonderful Dr. Reuben also wrote to the Food and Drug Administration, urging the
agency not to restrict the use of many of the painkillers he studied, citing his
own fabricated data to prove their safety and effectiveness....

Even better Dr. Reuben published fabricated studies showing the great effectiveness
of a combination treatment using 2 drugs from Pfizer, Celebrex and Lyrica. No
one paid attention to the fact that, like Dr Robinson and Dr. Ridker et al. Dr.
Ruben was regularly paid by pharmaceutical companies. In fact he was active as a
member of Pfizer speakers bureau until recently and received, from 2002 to 2007,
5 research grants from that company. Besides the evident culture of greed that
has infected a lot of the medical research activities, there must be something
even deeper that can convince doctors that it is OK to put many lives at risk by
falsifying results.

Flummoxed? Wait, there is more! Dr. Reuben’s attorney also said there were extenuating circumstances! I kid you not. As usualno one is really talking. Dr. Reuben is on extended medical leave. Tufts University doesn’t seem to know him anymore. I guess everybody is trying to get the story to disappear under some heavy duty carpet. But this story cannot disappear....

The fraud didn’t stop at the published articles but was also used in
multiple letters in response to valid scientific articles to destroy the
scientific findings of honest researchers....

The clinical impact of the fraud will be profound. Jacques Chelly, MD, PhD,
MBA, director of the Division of Regional Anesthesia and Acute Interventional
Perioperative Pain at the University of Pittsburgh Medical Center (UPMC), said
that the fraud has left multimodal analgesia “in shambles”. He added

“the big chunk of what people have based their protocol on is gone.
we have stopped giving celecoxib and pregabalin to surgery patients until we
have some very formal evidence that we should do something else. In this day and
age, doing multimodal [therapy] is expensive. Any institution is going to look
at evidence-based clinical decisions, and unless we have very strong data, it is
a problem. Since most of evidence is now unreliable you really don’t have any
evidence that the combination is working...."