Friday, June 25, 2010

Lindsey Baum: One Year Missing

Last July 20, I wrote my first blog post about missing 11-year old Lindsey Baum:

Around 9:15 pm on June 26, Lindsey J. Baum, an 11-year old from the tiny town of McCleary, Washington, disappeared while walking from a friend's house to her home, only four short blocks away.

She just had an argument with her brother, but most everyone notes that she wasn't storming off mad. She didn't have the accoutrements you'd think of when thinking of a runaway -- no money, no cell phone, no change of clothes.

Some friends set out with her, so she was accompanied for a while before they peeled off to go to their own homes for dinner, or homework, a bath or shower, whatever.

Two of those four blocks are reported to be somewhat industrial -- though we are talking *rural* small town. One block away is access to a major highway.

As any child would be, Lindsey was troubled by her parents' recent divorce. Her father lives in Tennessee. This detail is the one I have to shrug off -- in my family, similar circumstances played a role in my eldest brother's decision to run away. But he was a savvy teenager, a world traveler; Lindsey just turned 11 (a grand birthday celebration surely awaits her), and only knows McCleary.

Tomorrow marks the first anniversary of her disappearance. There have been no sightings, no productive new information, and in this age of information and its technology, that is almost unheard of. Indeed, I would have thought it impossible that in the span of a year, there are no leads to proffer, no tantalizing tidbits to ponder and inspect.

I have wondered, even, what the significance might be of such a complete absence of clues. Unfortunately, to follow that path means to go crazy with notions of vast conspiracy. Fortunately, there is no lack of volunteers willing to go nuts by noting such things as the disturbing habit of such-and-such Youth Minister to be surrounded by... youth. (It only gets worse. A local park ranger, who was identified, not from some actual association with Lindsey, but by a psychic who dreamed his initials had the gall to own a supremely suspicious... boat.

I do not imply that nothing has been done -- not at all. Far from it.

There have been frequent searches, interviews and re-interviews (and amateur sleuthes have had a field day inventing all sorts of suspicious people). A substantial reward has been offered. The FBI is on the case, Interpol has been alerted, and the local Grays Harbor County Sheriff's Office has worked long and hard, and will continue to do so.

Rather than mark tomorrow's anniversary by failure and lack, Lindsey's mother Melissa has helped organize an event called a Day of Hope:

McCLEARY, Wash. (CBS/AP) A "day of hope" will be observed Saturday in an Olympia park on the one-year anniversary of Lindsey Baum's disappearance.

Police are still looking for possible leads in the case and hope that they will one day be able to determine what happened to Lindsey, who was 10-years-old when she went missing on June 26, 2009 while walking home from a friend's house in McCleary, Wash.,west of Olympia.

During the observance, called "Lindsey's Day of Hope and Awareness for the Missing," balloons will be released for Lindsey and all of the other missing persons of Washington state, reports The News Tribune. It will take place from 2 p.m. to 8 p.m. in Olympia's Heritage Park.

Previously, police have enlisted the help of the FBI, bloodhounds, and searchers on horseback, but there have been no signs of the missing 4-foot-9-inch, 80 pound girl.

Melissa Baum, Lindsey's mother, says that her daughter was upset by the recent divorce of her parents, but says Lindsey did not have enough money to run away, nor had she ever tried to run away in the past.

After nearly a year of searching, her mother fears the worst.

The search for Lindsey continues, and authorities are offering a $25,000 reward for information regarding the young girl's whereabouts, as well as information leading to the arrest of and charges against the person or people responsible for her disappearance.

If you have any information regarding Missing Child Lindsey Baum, please call the Grays Harbor County Sheriff's Office at 866-915-8299.

I finished my first post about Lindsey by explaining how I'd heard of her. SecretWave101 was bothered, early on, by the scant attention being paid this dear child. Full of vim and vinegar, I vowed to follow the case, and publicize it here. I stand by that promise, even knowing now how little help this actually is.

I learned about her over at Dr. SecretWave101's blog. He notes what many of us have seen in our own communities: How legwork and media savvy are manditory to keep the faces and stories of our stolen children front and center in the public's view.

He notes other stuff, too -- having to do with the privilege of stereotype and the insidious mechanisms by which missing and exploited children receive airplay.

Research Lindsey's story and retell it on your own blog -- or where you will. You're likely more creative than I am -- the point is to disseminate, remind, encourage. Yes, and annoy, I suppose, if that should become necessary. (It's
de rigueur here at Marlinspike Hall, deep, deep in the Tête de Hergé!)

To see all posts about Lindsey, click here.

The Long and the Short of It

Wow. What a difference a day makes!

Isner is out, losing in a fast, straight-sets match to Thiemo de Bakker, during which the American had no aces -- versus the 113 aces served to Mahut on Tuesday... Wednesday... and Thursday.

Today's match, over in 94 minutes, was the shortest men's match thus far in the 2010 Wimbledon tourney.

I'm surprised he was able to move at all.

For my daily whine: why, oh why, must Clijsters be paired against Henin?

Noteworthy: Mauresmo, very happy, it seems, in her retirement, is coaching Michael Llodra... who lost a close 4 set match to Roddick on Wednesday. Now she can chill and have a little beaujolais on some veranda somewhere.

Funny -- after her win at Antwerp, where someone awarded her a nice bottle, she said, "Tout le monde va penser que je suis alcoolique"!

I haven't been very forthcoming about my picks for this year... I am, to be honest, pretty sick, as well as emotionally drained by nursing Sam-I-Am. He will only rarely take food, and then only small bites from my hand. It is uncomfortable for him to lower his head to a bowl -- so my hands are met in offering every half hour -- a dish of water, a plate with small palatable morsels, treats of all kinds. I will spare you the play-by-play, as it is quite simple: He is a dying cat, much loved and well-cared for, and loving and caring, generously, in his turn. We hope he will turn the corner and live months, maybe years longer, but it does not look likely.

Anyway, I will go with my sentimental favorites -- why not? So that'd be Roddick and Henin. I apologize, in advance, to them -- as I have an extensive history as a Sport's Jinx.

As in Judo: Apoplexy Justice

When I am reduced to burps and gurgles over some antic by Dick Cheney or by the way torture citations are lightly glossed, tossed, and reseasoned before being plated and served up as homegrown and fresh from the garden...?

And when the subterranean amoral violence that diminishes us as both a nation and a species is explained away by that particular cavernous Talking DeathHead?

When the two are intertwined by the tendrils of justification (national defense, intelligence, terror:terror:terror) then I am simply apopleptic* and can only thrash about, trying to find my voice.

Thank goodness, then, for Buckeye Surgeon and his posts on torture, and his refusal to let Cheney off the hook.

I officially became a fan of the Buckeye Surgeon last May, when he published the post: Baudrillard and the Hyperrealism of the Parathyroidectomy

This is going to be a bizarre post; I'm just warning you.

I've been reading from Jean Baudrillard recently. Baudrillard is a post modernist French thinker/philosopher who writes about the preponderance of images, signs and representations in our technologically-driven, post modern lives. A lot of what he writes is almost deliberately obscure and esoteric. You find yourself re-reading entire chapters two or three times because nothing makes sense and you get pissed off thinking hey I'm not a moron, I have advanced degreees why is this guy being so intentionally obtuse? I sort of hate Baudrillard, actually, for that reason. But he does have some interesting takes on the nature of reality that are rather illuminating.

I believe the exact wording of my thought at the time was... chouette! [True, I had to put aside the whole Forget Foucault (Oublier Foucault) nonsense... which was submitted to Foucault, himself, for publication in Semiotext(e) and to which Foucault, himself, never replied. Which is to say, don't miss Sylvère Lotringer's interview, Forget Baudrillard. In short, what must be acknowledged is the impossibility of participating in a field of study or in its criticism, without complicity.] Buckeye Surgeon plays on the subject/object shenanigans chez Baudrillard, and, oddly enough, chez super-specialized endocrine surgeons, as well. Actually, not odd at all, given consumerism à la Baudrillard. Hyperreality and this consumerism mark the Baudrillard of the 70s, the on-again, off-again marxist "thinker" in evolution as provocateur.

There are precious few medical bloggers who could pull that off, and even fewer that one would want to. I found myself wanting to hear Baudrillard on Abu Ghraib (war porn), among other things, through the filter of this particular midwestern general surgeon.

So recently, when he decided to beg all questions, in To blog or not to be, I was bummed, and responded snarkily.

I know, I know. [Like Frank Drackman -- which is a phrase I never ever thought I'd write -- I have a framed Master's of My Domain upon the office wall...]

I am so happy he continues to blog, even happier to know that he does so with his young daughter in mind.

Who else is going to keep that upstart, Atul Gawande, in check?

* At those moments, I am at such a remove from the inane boggle-headed chirping about how "il faut cultiver notre jardin" that I am, to overestimate myself, dangerous. I nod along with Jean-Luc and pump my cold, purple fist at his "Je me contenterai d'ajouter qu'il y a aussi sans doute un peu de malice chez Voltaire..."

“As in judo, the best answer to an adversary maneuver is not to retreat, but to go along with it, turning it to one’s own advantage, as a resting point for the next phase.”

— Michel Foucault

Thursday, June 24, 2010

on loaded guns and father's day

Father's Day, for me, is a shameful day. Understand, please, that the shame is mine, not his.

Honor thy father and thy mother is the fifth commandment in the Christian Top Ten, and the first commandment to add a Carrot to the Stick.

Honor your father and your mother,

that your days may be long

in the land which the Lord your God gives you

--Exodus 20:12 (RSV)

One of my favorite off-the-cuff and exceedingly clever remarks to make? "Ewww, that is sooooo Old Testament!"

It's so wonderfully scathing a thing to say in response to some wannabe's harsh judgment or other. Sniff.

After dropping promptly out of college during my second semester, I toyed with this course and that course, using up precious elective credits while working as a nurse's aide in what was euphemistically called a "neurological post-intensive care unit." (Think carrots, peas, corn, eggplant.)

I lived with Baber, a drop-dead gorgeous woman who suffered various addictions -- to cocaine, marijuana, tequila, moonshine, cigarettes, and sex. She was lots of fun, for a while, until her Probation Officer began dropping by too often, and for the wrong reasons. If you get my blaring drift.

Somewhere toward the end of our year together, The Baber lost her job as a Respiratory Therapist, became a short-skirted waitress, began to deal coke out of our apartment (she had, believe it or not, a hollow-ended pool cue that sometimes came into play), and received her second Driving Under the Influence citation. Actually, I think these things are listed in the wrong order. Whatever. It all seemed to happen at the same time, belying cause-and-effect neatness.

Part of Baber's DUI sentence included the temporary suspension of her driver's license. She insisted I go to court with her that long ago early morning, getting us there right on time in her jaunty Toyota stick shift, expertly maneuvering into a choice parking spot three-quarters up a tree-lined, steep, and narrow street.

I learned to drive in a vintage pristine 1965 baby blue Cadillac, which resembled nothing so much as a boat, after which I was gifted with a white 1963 Ford Falcon, my first automotive love. That was the extent of my experience as a driver. (Please note that as I got older, so did my cars.)

So it was no surprise, to me, at least, that I almost got us killed on the way home. We lived in a mountain town, a *hilly* mountain town, to boot, which helped not at all as I struggled to hold my place in line at stop signs and to respond to Baber's barked, angst-driven instructions.

After that, my roomie called on her many other friends to get her from points A to B to wherever.

I remember a strong feeling of disconnect during those final weeks of living with Baber. I was working Night Shift at the hospital so as to free up my days and evenings for two classes: The Bible as Literature and The History of Western Civilization, Part One.

People like to play the game of "where were you when...?" -- I guess because it creates a reassuring collective -- something we had more of when we were less evolved. Where were you when John Kennedy was shot, and Robert? Where were you when you heard that Reverend King had been assassinated, that four were dead in Ohio? Where were you when they tore down the Berlin Wall, when Nixon resigned? When Lennon fell, and George died, and Pinochet got off scot-free? Where were you when the Challenger blew up, when the Twin Towers came down? When Michael Jackson overdosed, when Obama won the election, when the market crashed?

Where was I when I first encountered Plato's man in a cave, chained both fore and aft to his fellows, facing a blank wall, that blank tablet on which was cast the shadows of things?

Sigh. Everyone fancies themselves a semiotician.

Reference the shadow.
Reference the thing, itself.
Reference the thing that cast the shadow.

Where was I in that famously pivotal moment when I was washed in the Allegory of the Cave? Turns out, it was one experience that took place at two different times. Once at its first reading, in that mountain city, in the campus library, where I sat peering out a huge plateglass window at the golden light, setting. The bookend of the experience came 6 or 7 years later. I was walking down Shattuck Avenue in Berkeley, and came upon a beautiful blue shoe, a woman's pump, silk. One left shoe and I was awash in the arbitrary nature of the sign, and in what Plato makes Socrates call "truth"!

What a rush.

Okay, let's get it out of our collective system. This was years ago, before hegemony and eurocentric became part of my stilted academic vocabulary, definitely prior to the time when I began to question the validity of The Canon, and a few universities away from reading Gramsci (as a requirement).

I was as if lost at Baber's place, never feeling it even half mine, despite paying half the rent. Work was rarely fulfilling, and if the Allegory of the Cave could rock my world, imagine my stupefaction when faced with the poet Isaiah, with Socrates drinking hemlock because his principal and the Superintendent of the School District deemed his teaching impious and too snarky for impressionable students. [In case you are wondering, I've topped out today at 101.3.]

Time with her was not a waste. I made some good and lasting friends, earned some easy college credits, and saved my money. I met a man and fell in love. I met lots of men, in fact, mostly musicians from Baber's work. I generally found them in the kitchen, searching desperately for coffee, happy to let me brew a strong pot while they played guitar in the living room. Baber was never an early riser.

But as someone famously said, about something else entirely: "Things fall apart; the centre cannot hold..."

Baber had a gun that somehow made its way under my pillow, and the man I loved was called home. I felt a failure at 19, and spent 50-60 hours a week talking to people who literally oozed, telling their parents, their pregnant wives and lost-without-her husbands that "you never know..." I was sleeping with the husband of a bisexual friend -- actually both Baber and I were -- in exchange for unlimited organic carrot juices at his downtown health food store -- also for pot and blueberry shine.

One day, the precariousness of everything became too much. It had been well over a year since I had called... home. As if it were a habit, I picked up the phone and dialed numbers like an automaton.

The rift between me and my father is bottomless and so wide I cannot see the other side.

"Please come get me," I whispered.

"I'll be there tomorrow afternoon," Dad said. "Be ready to go..."

I may have 3 semester hours that were awarded for the apt completion of The Bible as Literature, but I had forgotten, let's say, that though Deuteronomy and Exodus are credited with the Ten Commandments, they cannot hold a candle to the grave legislation of Leviticus, written around the time of the Babylonian exile, and not, as some hold, by Moses -- but by that amorphous group designated P, for Priestly Sources.

"You shall rise before the gray headed and honor the presence of an old man, and fear your God: I am the LORD" (Leviticus 19:32).

Reverence, fear, curse, honor, obey, mock, scorn, contempt -- Biblical parent language is loaded language.

As I write this, it has been 20 years since I have spoken with or seen my father. I think of him everyday, which does neither him nor me any good, but it is, in all honesty, the very best I can do. I know you think otherwise. Sometimes, usually early in the morning, in the kitchens not making coffee for musicians, the man I loved long dead, and Baber's rabid enthusiasm finally understood as the manic portion of bipolar disease... I also think that I could do better.

There are no guns in The Manor, nor under my pillow -- and there never will be. That's the last full measure of my devotion.

My Life had stood - a Loaded Gun -
In Corners - till a Day
The Owner passed - identified -
And carried Me away -

And now We roam in Sovereign Woods -
And now We hunt the Doe -
And every time I speak for Him -
The Mountains straight reply -

And do I smile, such cordial light
Upon the Valley glow -
It is as a Vesuvian face
Had let its pleasure through -

And when at Night - Our good Day done -
I guard My Master's Head -
'Tis better than the Eider-Duck's
Deep Pillow - to have shared -

To foe of His - I'm deadly foe -
None stir the second time -
On whom I lay a Yellow Eye -
Or an emphatic Thumb -

Though I than He - may longer live
He longer must - than I -
For I have but the power to kill,
Without--the power to die--

--Emily Dickinson

Wednesday, June 23, 2010

the match that would not end

i just had to document that the score is 55-55 in the fifth set.

that's right. "set." as in, tennis set. fifth, as in, there were four that came before.

mahut versus isner, the longest game ever... dastardly even. to say these guys are tuckered (even though the match has been spread over two days) is a ridiculous understatement. play has now run over the 9-hour mark.

the quality of the *serving* alone is awe-inspiring.

the first 60 or so games, i thought "how cool to be witnessing tennis history."

(now i am kind of embarrassed for whomever wins -- and so bummed on behalf of the loser.)

now it is 56-56... 157 games in the match so far! holy moly*, guacamole!

chapeaux, all around.

6/24/2010: {CONGRATULATIONS TO ISNER! the two had to come back on a THIRD day and the match ended up lasting ELEVEN hours, five minutes... this is one that will be long on the record books. the final fifth set score? 70-68}

* [T]he origin of the word Moly... comes from Homer's Odyssey. In book 10, Hermes gives the herb to Odysseus to protect him from Circe's incantation. Homer describes Moly by saying, "The root was black, while the flower was as white as milk; the gods call it Moly, and mortal men cannot uproot it, but the gods can do whatever they like."

Tuesday, June 22, 2010

Mannitol as Salvage Treatment for CRPS? Not so much...

By definition, salvage treatment/therapy is

1. A final treatment for people who are nonresponsive to or cannot tolerate other available therapies for a particular condition and whose prognosis is often poor....
Salvage therapy is given in the hope of a cure or at least of some more quality time or a better quality existence.

The Wikipedia entry notes that "it is used both to mean a second attempt and a final attempt."

"Salvage treatment/therapy" is not a new concept to me, but it's also not one that I spend an inordinate amount of time investigating. I think that when I first started reading reports and studies, the SCS was considered out there, a regular Hail Mary of a treatment, plus oddities like Hyperbaric Oxygen Therapy... Now, I suppose the ketamine coma falls under the rubrique, as well as intrathecal catheters and intraspinal administration of narcotics, and drugs such as baclofen.

[Most articles note that the term is usually used in reference to the treatment of HIV/AIDS and certain cancers, diseases in which "final attempts" are certainly of a more dire nature.]

The advocation of mannitol as a treatment drug in CRPS is certainly not widespread --indeed, one of its most steadfast promoters is the infamous Dr. Hooshmand, who proposes its use to deter "toxic metabolic water retention in the nerve cells" and "neuro-inflammation."

INJURY: International Journal of the Care of the Injured
Volume 41, Issue 7, Pages 773-777 (July 2010)
Edward C.T.H. Tan, Marijn C.T. Tacken, Johannes M.M. Groenewoud, Harry van Goor, Jan Paul M. Frölke

Department of Surgery, Radboud University Nijmegen Medical Centre, The Netherlands

Department of Medical Technology Assessment, Radboud University Nijmegen Medical Centre, The Netherlands

Edward C.T.H. Tan is corresponding author, and may be reached at: Department of General Surgery - Traumatology, Radboud University Nijmegen Medical Centre, 690 Internal Postal Code, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 361 38 71; fax: +31 24 354 05 01.

ABSTRACT : Mannitol as salvage treatment for Complex Regional Pain Syndrome Type I

Complex Regional Pain Syndrome Type I (CRPS I) is a continuation of symptoms and signs due to a pathological exaggerated reaction in an extremity of the human body after an injury or operation. Although the clinical picture of CRPS I in the majority of patients is well known, the underlying pathophysiology remains unclear. In the Netherlands, intravenous mannitol administration used as hydroxyl radical scavenger for patients who do not respond to conservative treatment of CRPS I is advocated but little evidence supports this salvage strategy. In this study the effect of mannitol as salvage medication was evaluated in a well-defined multimodal step-up treatment protocol.

Patients and methods
A consecutive group of 68 adult patients with persistent CRPS I was analysed, who underwent a total of 100 mannitol infusions. The effect of treatment was considered per sign and per symptom according to the Veldman et al. criteria for CRPS I.

Overall improvement of CRPS I after mannitol treatment was successful in 24% after 1 week, and in 30% after 1 month. Mannitol treatment had some effect in patients with initially warm CRPS I in contrast to patients with cold CRPS I (OR=6.30 with CI [2.37–16.75]). Also patients with CRPS I at the upper extremity had more benefit than patients with CRPS I at the lower extremity (OR=3.26 with CI [1.34–7.93]). Poor results of mannitol treatment were associated with cold CRPS I (p<0.001), p="0.04)" p="0.04)."

Mannitol did not significantly contribute to the overall success of treatment in patients with CRPS I. Patients, presenting with acute, warm CRPS I in the upper extremity may have some benefit.