Saturday, March 24, 2012

Lindsey Baum, Still Missing

I check for news of her every Friday.  There is no news.  I last posted about missing child Lindsey Baum in October, 2011.

That there is no definitive news does not mean that no work is being done on the case.  In mid-February, Grays Harbor County authorities turned up the heat on a man who has long been a "person of interest" in her disappearance.  His identity is well-known, and easily discoverable, if you are intent on knowing.  I am not giving his name because, in the course of some energetic online amateur sleuthing of Lindsey's case, there have been occasional episodes of maliciousness against people whom authorities have questioned, and even against people with no connection to the case at all (except "psychic" ones).

Someone once suggested a local Youth Minister as a suspect, because he tended to be surrounded by... youth -- and published not just his name and place of employment, but a map to his home.  Someone else, who continues to wield a weird influence, dreamed the initials of an area park ranger and then damned him with the discovery that he owned a... boat.  Do you see the weirdness that can ensue?

In any event, the current real focus is on one individual, whose home and business have both been searched, and who has been interviewed several times.  Caught in a lie, he seems to be the only suspect yet identified, though there still has been no forensic evidence produced beyond the video debunking his alibi.

In a search warrant, police note over 100 items were taken from the McCleary man who owns a jewelry store in the area. The items were taken from his car, home and business and include, according to

Apparent fingernail from passenger side of car
Ropes and straps
Numerous computers and computer storage devices
Pink sheet with unknown stains
Brown duffle bag with assumed human hair
Handwritten notes regarding missing child

Just last week, authorities released convenience store footage showing the person of interest. They note that he told police he was out of town when Lindsey vanished, however, the video of him at the store proves he was actually in the area at the time.

From YouTube comment section:

The Grays Harbor County Sheriff's Department has identified two women seen in a grocery store video from the night that Lindsey Baum disappeared.  County Undersheriff Rick Scott said his agency has been able to find the two sisters, who are local to McCleary, and will interview them soon. The video clip, from Mike’s Market in McCleary on June 26, 2009, was withheld at the request of the FBI until now.
kbkwnews [posted 1 month ago]


Around 9:15 pm on June 26, 2009 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's now 14.  Her birthday is coming up on July 7.

The physical changes a young girl experiences in that particular span of ages are sure to have greatly altered her appearance.

It feels foolish to continue noting that, on June 26, 2009, Lindsey was 4-foot 9-inches tall, weighed 80 pounds, her brown hair and brown eyes offset by a hooded pullover.

Still, there are things about the face that never change. Those eyes, that mouth, the smile. Face shape, feature spacing and scale. Age-invariant characteristics. Forensic artists (and the software they use) factor in the ways a person has changed in the past, even as short a past as Lindsey's, and how relatives have aged, as well as extrapolations based on large amounts of data from the wider population.

It is reported that Lindsey has a scar over her left eye, a dark brown birthmark on her right wrist and colored fillings in some of her teeth.

But she's doubtless no longer 4'9" and not likely to still weigh 80 pounds. Fourteen to fifteen year old girls average 63-64 inches in height and 105-115 pounds in weight. Of course, her numbers at age 10 were already higher in each category than the average.

That summer evening two years ago, Lindsey had just argued with her brother, but most everyone notes that she wasn't storming off mad. She didn't have the accoutrements you think required of a modern 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 lived in Tennessee. He was deployed to Iraq not long after she went missing.  Her mother and brother no longer live in McCleary.  Life for them has been hard and cruel.

The last time I checked, a reward of $30,000 is being offered by Crimestoppers and the National
Center for Missing and Exploited Children. 

There have been many searches, search warrants, several people of interest -- but no signs of Lindsey, and no real clues or advances in the case.  Still, we all still shake our heads and mutter that someone, somewhere, knows something.  What will it take for that someone to tell that something, and will it bring the child home?

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


1-800-843-5678 (1-800-THE-LOST)

McCleary Police Department (Washington) 1-360-533-8765

Or simply call 911.

Friday, March 23, 2012

Countering CRPS Dystonia With 32 Fouettés En Tournant

32 fouettés en tournant (fr. 32 "turning fouettés") is a movement in classical ballet. It is 32 consecutively-performed fouetté en tournant.

One fouetté rond de jambe en tournant is an action where the dancer stands momentarily on flat foot with the supporting knee bent as the other "working" leg is whipped around to the side, creating the impetus to spin one turn. The working leg is then pulled in to touch the supporting knee as the dancer rises up en pointe on the supporting foot. The ability to consecutively perform 32 of these turns is considered a bravura step by the ballerina, emphasizing her strength, stamina, and technique.

War is hell, and in my latest campaign, that means lots and lots of ballet.

The spasms have returned.  There were inklings and insinuations over the past several days, feelings of building electricity, an excess of backlogged potential.  Hints of a twitch that I defeated with long, evil looks.

Is it coincidence that the bone infection symptoms have also returned full force?

At some point during the hospital stays in January and February, my orthopedic surgeon attended a conference in San Francisco, and returned a complete chatterbox.  There was much talk of stubborn post-implant infections and a relatively new concept called biofilm.

If he said it once, he said it twenty times over the next few weeks:  biofilm, biofilm, biofilm.

Still, it wasn't until my conscious self accepted the return of the infection a few days ago that I even bothered to look it up.  I thought it was a cop-out on his part, a saving grace, the excuse we were gonna use to explain this expensive failure.

I'm still trying to wrap my curly head around the Wikipedia entry, which does, I think, a superb job of framing what the biofilm discussion is about, and its scary implications -- without scaring the reader away:

A biofilm is an aggregate of microorganisms in which cells adhere to each other on a surface. These adherent cells are frequently embedded within a self-produced matrix of extracellular polymeric substance (EPS). Biofilm EPS, which is also referred to as slime (although not everything described as slime is a biofilm), is a polymeric conglomeration generally composed of extracellular DNA, proteins, and polysaccharides. Biofilms may form on living or non-living surfaces and can be prevalent in natural, industrial and hospital settings.  The microbial cells growing in a biofilm are physiologically distinct from planktonic cells of the same organism, which, by contrast, are single-cells that may float or swim in a liquid medium.

Microbes form a biofilm in response to many factors, which may include cellular recognition of specific or non-specific attachment sites on a surface, nutritional cues, or in some cases, by exposure of planktonic cells to sub-inhibitory concentrations of antibiotics. When a cell switches to the biofilm mode of growth, it undergoes a phenotypic shift in behavior in which large suites of genes are differentially regulated.
At the bottom of the entry, there are some references, one of which turned out to be pure gold.  There is a Biofilm Community!   No, it's not a chummy chat room and I don't sense too much political intrigue -- though intrigue there certainly is, apparently in the form of lurking corporate presence. (Go figure.  It's a growing problem.  An expensive growing problem.)

The Biofilm Community, then, is a repository.

I haven't immersed myself in the slime talk yet, because as I said, I've been in denial, I mean, I've been twitching.

You probably don't believe that despair comes instantaneously to me when the spasticity hits.  But it does.  Instantly, I am yelling, moaning, cursing, writhing, trying to rock my legs to and fro, to beat the gesticulations at their own game.

Fred slept through most of it -- across the Manor, cuddled with Buddy and Dobby, snoring on the horsehair loveseat in  La Recepción -- remember La Recepción?  

The space that we are in today served [the Haddocks] as Reception Hall during the American Civil War, and for roughly 60 years afterward. Back then, it was worth their Snooty While to allow a more plebeian sort of individual to attend the legendary Marlinspike Hall Afternoon Teas. 
Marmy stuck with me, while the boys were off bonding in a snooze.  She climbed onto my chest and flicked my face with her famed fluffy tail.  Then she *ack-ack*-ed at me in a clearly derisive manner.

"Fine," I countered, between screams, "What would you have me do?"

And with that, she danced the Rose Adagio from Act 1 of The Sleeping Beauty, one of the most challenging pieces for any feline ballerina.  I think she actually did it more effortlessly without the four props, Aurora's rose-bearing suitors.  I loves me an Aurora who doesn't hang on to a Prince's hand, don't you?  Marmy extends from attitude to arabesque, my little kitty Cojocaru, with nary a thought of support.  I'd insert the Cojocaru video -- as I couldn't grab the Flip recorder fast enough to document The Fluffy Butt's rendition -- but YouTube won't allow it to be embedded.

Anyway,in addition to a calm and sovereign Aurora, the cat has a point.

I can lay here flopping around like a detoxing crackhead or I can sublimate my intense pain and existential terror by watching YouTube ballet videos, feeling the power, flex, and release of every step, every leap, every stretch.

The spasms have returned?  Pshaw!  Game on.

[First up in the Distraction Campaign?  Chroma -- a lovely way to pass 25 unmedicated minutes.]

For the error bred... (REPOST)

This was first published in April 2011.

I just checked her latest vlog entry, made March 19, 2012. Her eyes leaped off the screen, and I thought "smouldering." Her nose, still large, now seems more streisandesque than a problem. The brows are still an issue.

Whatever the heck that room is used for -- the room she films in -- it has at least had a coat of white paint.

There has been a recent change in the formulation of her HRT, and it's apparently a big deal, because she expects her face to change a lot in just a few days.

The hair on her legs is sparser, and softer.
The hair on her head appears unchanged.

Yesterday was her birthday; She's now 25 and living her life "as the real me" -- about which she says, "Like wow... I mean, like wow." She's been doing HRT for 485 days and is trying to raise money for her surgery. She has a petition to that effect over at, but has not had much success. Luckily, she has insurance, though I imagine gender reassignment surgery includes a host of incidental expenses.

Her breasts are now beautiful (but still "sore"), approaching a C-size cup. Gone is her hesitant and wimpy goal of the B-cup!

Her voice still drives me ape shit. She has a brand spanking new blog, too, with only one entry thus far. You'll never guess the topic. "How I got my female voice." Oh. Dear. God. Anyway, she's fearless, and she's doing it, and she's happy (or, more precisely, "happier").


For the error bred in the bone
Of each woman and each man
Craves what it cannot have,
Not universal love
But to be loved alone.
-- W.H. Auden

Something about her face.  No makeup.  She was peering out at me from YouTube, looking as tense and afraid as I was bored and grumpy.

Angular, ungainly.

She frequently brings both hands to her face, tremulous, frightened of her own touch, as if she might break herself into unfortunate pieces.  And it's soft, she reports and sometimes tender, like her breasts.  The urge to touch herself, to land a finger tip breathlessly on a cheek, in squeaky whispers, on an inhale, strange, there, on her cheek, her chin, her shaky index, it all points to something I just cannot see and do not appreciate.

She's a naive whore, I think, and mentally frown in my general direction.
Okay, she's just naive.  It pisses me off that she has no shame.  Isn't that right?  Wouldn't you say that the truly naive have no comprehension of shame?

The first thing I thought, though, was that she had a huge nose.  Large pores, blackheads.  She looks a lot like Margaret B. -- from high school.  Margaret was not my friend, by which  I mean that I was insincere.  I liked her when there were no witnesses and made fun of her with others.  We were both on the tennis team.  Her feet turned out in a weird way, she wore her long woolen hair in a single braid down her back and you could use the word tendrils and her hips came up -- uncomfortably --extra high.  We spent a fall weekend together at a tournament in the mountains, sleeping on the floor of this rich girl's living room.  It was the first time I ever played on clay.  I went two rounds, she went one, we were childish with the CB radio during the drive home.  Margaret ended up at West Point and searching her, googling her, turns up little beyond her brigadier generalship.  I'd spit on me were I her.

This one is no brainiac, no athlete.  A narrow, flat mouth, thin lips that were trying to be something else, like lush, maybe.  A daydream of lush.

Overgrown eyebrows, but I've seen worse, sometimes in the mirror.  If there is straining intensity in her face, it's weirdly in her eyebrows.  I am proud of her for not plucking them until she knows how to do that;  I fear for her sanity should she overpluck, should she lose their line, and while yes, I am saying something ridiculous, she wears her insanity like an old friend.

Dark brown limp hair that I almost want to say was "of indeterminate length," except that that's a stupid thing to say, given that -- voilà -- there's her hair, right in front of me, visible, and it's from just below her chin in the front to slightly below the shoulder in the back.  I'd still say "of indeterminate length" because it clearly isn't done doing what it's going to do, yet.  And it's greasy, and parted in the middle, and really, really shy.  Shy indeterminate hair.

Lacking in chin.
Maybe not.  It might be a function of the camera's position, and another extension of shy indeterminacy.

We're all crowded together in a room with blistered paint on old plaster, a storeroom?  There are piles of things and brown cartons.

The one time she glanced back at the closed door, she looked scared.  So scared that this single act spliced itself into my viewing eyes and she began to do it over and over, if only on my computer monitor.  There's something out there and it could get her.
She's in a black and orange tee that looks like it might say DEATH NOTE, but it's blurry (my eyes, not her video) and stylized, so I am not sure.  Maybe that is a band.  Maybe that is a statement.  Wait, give me a minute.  Okay... it is an anime site -- based on the manga by Tsugumi Ohba that has been the basis for a couple of movies and a novel.  The same graphic that is on her t-shirt is displayed at the anime web site.  I visited her YouTube Channel page and she has "anime" listed as an interest.

I scanned a couple of her videos and in all she was in a dark t-shirt with a long-sleeved white tee underneath.  In a few, she wore her hair in two screaming Cindy Brady pigtails.

Wire-rimmed glasses.

Even knowing from the description that she is only in week 22 (or maybe it was 27) of HRT in a journey from male to female, when I turned the sound on, I was stunned.

There's no put-on lisping or anything but there is almost a palpable fear of her own voice.  It's a near whisper and there's a dearth of control.  Or maybe it's an abundance of tremor, tribulation, fear.
Fear.  Or fear.  It's fear. 

Except I don't think she is afraid.  She's deliciously happy although she defines things like "freedom and happiness -- wonderfully synonymous, at present, I think -- as "not being noticed," and "not being stared at" the first time she went out as a woman, to T.J. Maxx.  Which is funny, because she's not flashy, she's not in-your-face adamant about anything. I cannot imagine her catching my eye in a store for any reason whatsoever, except maybe concern for the pools of anxiety in her eyes.

When she stumbles into puddles of urgency, she whispers.

"Freedom and happiness" include the day she was able to be "honest" with her parents...

I wish I could leave that sentence alone:  "Freedom and happiness" also include the day she was able to be honest with her parents...

This is what she said, verbatim:  "I had my first experience with freedom and happiness the day I was able to come out to my parents, be honest, and assure them I was not gay."

My heart sank.  But this is about her, her face, nose, and chin.  Her hobby t-shirt, her blistered paint, her storeroom, her strange flitting voice, a creaking whisper. 

Her fear of what is behind that door.

Her experience, the very first one, with freedom and happiness, at T.J. Maxx as a straight woman and then again in an old-fashioned panelled den, browns and greens, in plaids, maybe with the television volume turned down low (but not off), while she and her folks nodded together in the electronic glare of heterosexuality.

She shows us the pills she must take every day, including the aspirin "for clots." That makes her blush, almost, and she hastens to explain that "blood clots," and then to stumble-mumble about "risk of clots." She doesn't know what that means, not in this early video. 

So she blushes, whispers, thinks "crotch," somehow, when she displays the 81 milligrams, the 1.25 grains, and she is just as palpably afraid of the capsules and tablets as she is of gay men -- but there's a bit of awe on the side, too.

She is hoping to have breasts soon, and wants cup size B, "not A."  When I magically skip ahead two months in the vlog, she keeps pulling up her t-shirt, peeling up the long-sleeved white undershirt, exposing a third layer -- a plain, though ribbed, almost-a-camisole black tank top -- under which, she murmurs, she wears a bra.  And I think, so long as your voice stays that way, even undeniable truths like the clear outline of an underwire push-up brassiere remain insinuations.

In one of the later vlogs, almost voiceless, she rejoices that her leg hair is not clumping up and getting stuck in the razor.  "It's less!" she whispers, and rejoices -- but does not smile.  "It's soft..."

She thinks her teeth are too big.  She doesn't say that, it's just something I know. 

What I really want to know is what the deal is with her damned voice? I went to her very first video report and listened to the deeper, male tones -- but they were just as hesitant, just as much not right as the breathy mess that came later.

If I knew how, I'd create a temporal disconnect between image and sound, a purposeful bad post-production dub job, so that I could drill down on other details, so that there'd be interesting interstices.  So that I could escape the feathery breath.

The little bit that she writes is full of typos and misspellings but "live," she is articulate, even in the discomfort of an ill-fitting voice.  Some things will doubtless work themselves out (the best, most reliable gift of repetition):  hormone replacment thrapy, day of remberance, my hormonal transistion.

I only saw one comment over the course of five or six of her video submissions. While YouTube viewers are famous for their callous nature, hiding nastiness in anonymity, the one comment she received was a generic good wish from a stranger to which she responded, in rapid succession, four times --

From Nebs Blog Second Gender Bender Contest

in equivalent abstractions,
equally meaningless
except for the powerful message
that, being unused to conversation,
she will smother interlocuteurs
with a swarm of verbiage of fuzzy intent. 

I really want to forget her but don't think I can.

Thursday, March 22, 2012

Additional Sanctions Against Scott Reuben

Scott S. Reuben: Debarment Order


The Food and Drug Administration (FDA) is issuing an order under the Federal Food, Drug, and Cosmetic Act permanently debarring Scott S. Reuben, M.D. from providing services in any capacity to a person that has an approved or pending drug product application. FDA bases this order on a finding that Dr. Reuben was convicted of a felony under Federal law for conduct relating to the regulation of a drug product under the Federal Food, Drug, and Cosmetic Act. Dr. Reuben was given notice of the proposed permanent debarment and an opportunity to request a hearing within the timeframe prescribed by regulation. Dr. Reuben failed to respond. Dr. Reuben's failure to respond constitutes a waiver of his right to a hearing concerning this action.Show citation box

The one where Buddy goes to the vet...

Shhhh!  I'm hiding out in the Computer Turret.  Buddy the Freakishly Large Kitten, who has the claws to match his moniker, needs rounding up for his first visit to the vet.  Not his actual first, of course -- it's his actual second visit, but the first happened without any muss or fuss, as he was not yet freakishly large, and was, in fact, very tiny, and lost in that peculiarly endearing stupidity of extreme-babyhood.

Buddy can con you in a New York minute.  And if his somewhat vacuous expression doesn't start you down the yellow brick road of his various diversions, he has those claws.

He exploits the "awwww..." factor like nobody's business.  Just yesterday, he sauntered up to me as I lay in my come hither pose, draped across my wheelchair, praying for death.  I wasn't feeling so hot.  Well, I was HOT, but, oh, never mind.

He doesn't so much meow as coo.  Maine Coons must be the mockingbirds of the feline community.  So he coos at me, and lifts an eyebrow.  I'm his bitch, and he knows it.

My shoulder hurts like hell.  It hurts worse since I discovered, yesterday morning, the Return of the Fistula (same one, same spot, same everything).  But no matter, I'm Buddy's bitch, and I know it.

Through a series of incisive questions, I determined that Buddy required that a certain ball, the soft, orange one, with the weird spikes, be retrieved for a rousing game of Fetch.  Odd, he usually reserves Fetch tournaments (he and Dobby are Fetch aficionados of the First Order) for the moment I enter REM sleep, which explains my dearth of dreams.

Ouch.  I am not sure that dearth can handle a personal possessive pronoun.

The ball in question turned out to be tucked under the edge of a Persian rug.  The Persian rug was under an antique console table.  Under the antique console table, also weighing down that expensive bit of carpet, was an oversized brass-studded leather Ottoman ottoman, filled with huge rocks.  Just kidding.  No rocks!  Oh, and on the console table?  Two huge celadon vases and an 800-pound concrete Laughing Buddha.

It's not your average graceful, eye-soothing console table.  Lovely turned, tapered legs, yes. But a loud, look-at-me marble top and a heavy, thick, very rectangular plinth that doesn't give the turn or the taper of the legs half a chance.

Yes, I have given that particular Haddock acquisition to the Manor a great deal of thought.  You would, too, if you had moved it, twice, while in a wheelchair and with only one functioning arm.  First, of course, I moved the Ottoman ottoman.  Those Turks and their darned footstools.  Actually, my extensive research shows that the word ottoman came into use as a designation for these bits of furniture because of the early 19th-century affinity for all things deemed oriental, and the act of reclining was considered, of course, oriental. [Don't look at me.  I just report these things.]

Proof that everything is political?  Even this ethnocentric perversion of simple furnishings turns out to be based on imperialist designs, in this instance, by one Napoléon Bonaparte, who molded the codification of orientalism in art with Description de l'Égypte, ou Recueil des observations et des recherches qui ont été faites en Égypte pendant l'expédition de l'armée française (English: Description of Egypt, or the collection of observations and research which was made in Egypt during the expedition of the French Army).

He was a great codifier, Napoléon!  Still, although his failed attempt to colonize Egypt and Syria inspired a wealth of artistic propaganda, napoleonic heavyhandedness was perpetuated by conflicts that continued throughout the century: first with the Greek War of Independence, then the French conquest of Algeria, and, in the 1850s, by the Crimean War.

I'm just saying.
For a completely different point of view, steeped in a more modern sense of the mercenary, read this.

As for the West and our affinity for glossing?  Well, Egypt, Turkey, Egypt, Turkey, who can tell them apart?  What matters is that all these [near] Eastern folk love to RECLINE.  

"What can Egypt be like?" wrote Eugène Delacroix, "Everyone is mad about it."

The Women of Algiers in Their Apartment, 1834
Eugene Delacroix

Right. So!
We're out of coffee, in case you were wondering.

Anyway, Buddy finagled the recovery of his orange spiky ball, and I got to take some extra pain medication, as a result.  In the process of checking out how The Wound had fared during my furniture-moving, vase-lifting exploits, what was kind of obvious was the Return of the Fistula.  Those of you who are detail-oriented may remember that The Fistula first came to my attention following a similar instance of exertion, after The Clearing of the Back Porch.

I crack myself up.  I knew that I'd regaled you, Dear Readers, with the Tale of the Back Porch but had no idea that there was a freaking Fistual Thread!  It appears I haven't consigned The Fistula to further literary recognition since November 7, 2011, when I noted, in my usual fashion, so devoid of drama:
These are the available choices:    
Either my head is going to explode or I am going to cry.
In June 2008, when I began elle est belle la seine la seine elle est belle, it was, mostly, a response to that same immense frustration, and my attempt to both restrain my tears and keep my head.  I thought that throwing fanciful and funny verbiage at my problems might release enough of the stultifying pressure for my lacrimal glands to dry up and -- should my head actually explode -- I wanted to have the documentation required by Guiness World Records.

I'm a Guinness junkie.  That's where I first read about SHR, Spontaneous Human Combustion.  One of the first things Fred shared with Abbot Truffatore and Father Anthony, over cocktails, was my firm belief in the reality of Spontaneous Human Combustion. He even requested some sort of ritualized intervention, as the three of them sat there, tying knots in cherry stems with their tongues.  Yes, Fred unwittingly polluted my chances with those Cistercian Power Brokers. I didn't get to see The Holy Foreskin, their most prized relic, until months after he did.

Does no one else see the hypocrisy?  I mean, so I believe in the ability of the human body to burst into flames without an outside agent or an inciting accelerant.  They believe a bit of shriveled foreskin is imbued with The Sacred.  Hello?

I don't think I can hide out up here much longer.  There's too much to do and it really stinks of cowardice.

It's a great little perch, the Computer Turret. I can see Fred down there, all red-faced and sweaty, struggling to strap the oversized pet carrier into the front passenger seat.

Oh, my God, there's a Buddy paw clawing its way out, talons extended... Run, Fred, run!

POSTSCRIPT [visual]:

Buddy, back from the vet... and healthy as a horse...

Wednesday, March 21, 2012

Scott Reuben "MD": His Unmitigated Gall

Twenty-six thousand patients die each year in the US from NSAID induced complications. Paul White, an A & A Editor, has estimated that billions of dollars of Cox-2’s were sold based on Dr. Reuben’s papers and he adds,  “For now, at least, neither the drug companies nor Reuben’s co-authors are officially sharing in the blame, but that’s expected to change."

“There’s a lot of responsibility to pass around,” White says. “It’s all being focused on Scott Reuben, but the reality is there are many other responsible parties." We will never know how many patients received NSAIDs during a very stressful and high risk time and how many may have been injured or died from Cox-2 related complications.

-- "Welcome to the Fraudosphere," PainPoints

The Affordable Care Act contains some interesting, little known provisions, among them a strengthening of the preexisting federal False Claims Act.  As one article put it, "experts warn that doctors need to be ready." Guffaw!

It was this expansion of liability that resulted in GlaxoSmithKline's $750 million in penalties for having sold "mixed-up products, diabetes drugs with too much or too little of the clinically effective ingredient," and for manufacturing drugs in "a nonsterile area of the facility that was used to make injectable drugs and [using] a water system contaminated with microorganisms."

In 2009, the Health Care Fraud Prevention and Enforcement Action Team (HEAT) in the first six months of operation recouped almost $3 billion in penalty payments.  The ACA provides $350 million over the course of a decade for the work of the HEAT Task Force.  That's a pretty decent return.

All of that reading and talk of fraud made me wonder what the inimitable Scott Reuben, MD might be up to these days, now that he's out of prison and all.

By the evidence, he is no closer to renouncing the self-serving tendencies that got him to the Big House of Correction to begin with.  He continues to offer the transparent excuse that he was out-of-control due to undiagnosed bipolar disease.  Undiagnosed (and unremarked upon) for well over a decade!  Even his wife, a psychiatrist, failed to pick up on it during all those years that he spent assiduously committing one of the worst known cases of medical and academic fraud.

I guess we should file the following document under "Unmitigated Gall," next to my previous ten posts about Scott Reuben, the Medical Madoff.

Department of Health and Human Services
Civil Remedies Division

Scott S. Reuben, M.D.,
(O.I. File No.: 1-09-40105-9),


The Inspector General.
Docket No. C-11-664
Decision No. CR2481
Date:  January 6, 2012


Petitioner, Scott S. Reuben, M.D., asks review of the Inspector General’s (I.G.’s)
determination to exclude him for five years from participation in the Medicare, Medicaid,
and all federal health care programs under section 1128(a)(3) of the Social Security Act
(Act).  For the reasons discussed below, I find that the I.G. is authorized to exclude
Petitioner and that the statute mandates a minimum five-year exclusion.

The sole issue before me is whether the I.G. has a basis for excluding Petitioner from
program participation.  Because an exclusion under section 1128(a)(3) of the Act must be
for a minimum period of five years, the reasonableness of the length of the exclusion is
not an issue.  Act § 1128(c)(3)(B); 42 C.F.R. § 1001.2007(a)(2).

The parties have submitted their written arguments (I.G. Br.; P. Br.), and the I.G. filed a
reply.  With his brief, the I.G. submitted four exhibits (I.G. Exs. 1-4).  In the absence of
any objections, I admit into evidence I.G. Exs. 1-4.

I directed the parties to indicate in their briefs whether an in-person hearing would be
necessary and, if so, to describe the testimony it wishes to present, the names of the
witnesses it would call, and a summary of each witnesses’ proposed testimony.  I
specifically directed the parties to explain why the testimony would be relevant.  Order
and Schedule for Filing Briefs and Documentary Evidence, Attachment 1 (Informal Brief
of Petitioner ¶ III) and Attachment 2 (Informal Brief of I.G. ¶ III) (Sept. 9, 2011).  The
I.G. indicates that an in-person hearing is not necessary.  Although Petitioner does not
directly respond to the question, he does not contend that an in-person hearing is
necessary and lists no potential witnesses.  I therefore conclude that an in-person hearing
is not required.

Petitioner must be excluded for five years because he was 
convicted of felony fraud in connection with the delivery of 
a healthcare item or service. 1

I make this one finding of fact/conclusion of law

Petitioner was a Massachusetts anesthesiologist who contracted with the drug
manufacturer, Pfizer, Inc., to conduct clinical studies on patients to determine the efficacy
of a certain drug in treating post-operative pain.  Pfizer paid for the studies.  Petitioner
subsequently claimed to have conducted the studies, administering the tested drug to 100
post-surgical patients and a placebo to another 100 post-surgical patients.  He published
papers in a scientific journal claiming to have achieved success with the tested drug.  In
fact, he had not enrolled any patients in any study, and he fabricated the “results.”  I.G.
Ex. 3 at 12-16.

On June 24, 2010, Petitioner pled guilty in federal district court for the District of
Massachusetts to one count of felony health care fraud, 18 U.S.C. § 1347.  Under that
provision, a person commits health care fraud if, “in connection with the delivery of or
payment for health care benefits, items, or services,” he “knowingly and willfully
executes, or attempts to execute” a scheme 1) to defraud a health benefit program or 2) to
obtain, “by means of false or fraudulent pretenses, representations, or promises,” money
or property owned by a health benefit program.

The court accepted Petitioner’s plea and entered judgment against him. I.G. Exs. 2, 4.
In a letter dated June 30, 2011, the I.G. advised Petitioner that, because he had been
convicted of a felony offense related to fraud, theft, embezzlement, breach of fiduciary
responsibility or other financial misconduct in connection with the delivery of a
healthcare item or service, the I.G. was excluding him from participation in Medicare,
Medicaid, and all federal health care programs for a period of five years.  I.G. Ex. 1.

Section 1128(a)(3) provides that an individual or entity convicted of felony fraud, theft,
embezzlement, breach of fiduciary responsibility, or other financial misconduct in
connection with the delivery of a health care item or service must be excluded from
participation in federal health care programs for a minimum of five years.  See 42 C.F.R.
1001.101(c).  Because Petitioner was convicted of felony health care fraud, he is subject
to exclusion.

Petitioner does not deny that he was convicted of felony fraud in connection with the
delivery of a health care item or service.  Instead, he attributes his misconduct to mental
illness, points out that his practice as a clinician is unblemished, argues that he has paid
his debt to society, and maintains that he is ready to resume his medical career.  These are
simply not bases for overturning a mandatory exclusion.

For these reasons, I conclude that the I.G. properly excluded Petitioner from participation
in Medicare, Medicaid and all federal health care programs, and I sustain the five-year

Carolyn Cozad Hughes
Administrative Law Judge

Photo credit:  Details

Four Days Post Rotationplasty: Go, Hannah, Go!

Hannah's Mom updated her progress again today.  From home! My admiration grows with every communication detailing this young girl's courageous journey.  I've copied below the section that I find most inspiring, as it details some of the intricacies of adjusting after rotationplasty -- an orthopedic surgery I'd never heard of before being referred to Hannah's CaringBridge Journal.

[In case you were wondering how I "pick" the four kids I follow, I don't -- not in over two years, anyway.  I wait for the day when one child's journal entry asks for intercessory prayer on behalf of another child.  I'm all about referentiality, "degrees of separation."]

If you decide to follow Hannah, please be a faithful cheerleader.  In the days and years ahead, there are going to be some rough times of inertia to offset the many good times of clear and positive progress. But be real... I think this kid is equipped, not just with a "new" leg, but with all kinds of radar!

This amazing child, only 4 days past her rotationplasty, was able to leave the hospital and go home. Now that her body has changed so dramatically, we are all in a bit of a learning curve as to how to navigate the logistics of everyday "normal" life. I will never again take getting in and out of a chair for granted. The amazing thing is that this girl is able to get in and out of her wheelchair on her own, with only the help of another person to balance her. I've taken a few videos that I'm going to try to upload to YouTube so you can see just how determined and strong she is. The only physical difficulties she is facing at this point is the splint on her "new" leg-which must stay on at least 2 weeks-maybe longer. She's wrapped from her rotated foot all the way up to around her hip and waist. That makes navigation challenging at best. Also, the thigh muscles are having to be retrained b/c they aren't really thigh muscles--they're actually calf muscles. We're having to train them to go in the opposite direction than normal. This is a challenging and painful process but she's doing exercises to help with this. Once the splint is off, she'll then have to train her ankle muscles to go the opposite direction as well. 

Tuesday, March 20, 2012

the thing with feathers

I had a heck of a time using Blogger last night and hope the issues have been resolved.

Other hopes for today?  That GOOG will shoot up to 700 or so.  That URBN will at least reach that point where I can comfortably bail.  That Marmy Fluffy Butt's left eye ceases to seep, so she can have some relief from her allergies.  That I successfully capture on video the behavior that inspired Dobby the Runt's nickname of "Butt Boy." [And that the video be appropriate for a G-audience.]  That Fred stop racing toward the drawbridge  in his sleep [He keeps hearing knocks and "yoohoo"s in his dreams.  Twice already this morning, he's gone flying by, knees pumping, chest out, yelling, "I'm coming, I'm coming!" My reassurances that there's been nary a knock and not even one "yoohoo," were met with drowsy disbelief.]

Let's see, what else?  I hope that My Hero, Ms. Hannah, gets to go home from the hospital today, after her successful rotationplasty last Friday. Her Mom summed things up yesterday this way, on her CaringBridge site:

I could not hold back my tears of joy as I watched Hannah--my "miracle baby"--do her physical therapy session. She did almost everything on her own. She only had help from physical therapist for balance. Hannah did not flinch or pout or complain or cry. She said it didn't hurt at all and was no big deal. She stood up on her own for a 5-count then sat back down and did that 5 times in a row. Every day I am more amazed by this kid. I'm so proud of her!

I know there are more hopes percolating inside my head and heart.  Dare I give them voice?

I hope that the two-inch nugget glimpsed under the bed (from whence I was retrieving my grabber -- using my cane!) is not what I think it is.  This is the Poo-Free Zone of The Manor.

I hope that federal officials can charge George Zimmerman in the murder of Trayvon Martin, as well as investigate any malfeasance on the part of the Sanford police.  There are several reports that seem credible of officers attempting to "mold" witness statements into a form friendly to Zimmerman's twisted version of the crime.

I hope that yesterday's despair doesn't taint today's progress.  The return of fever, sweats, and that particular pain of the bone infection really got to me, for some reason.  As if another couple of far-from-routine surgeries, $250,000+ in hospital and LTAC bills, intravenous vanco and Cubicin, oral Bactrim, and the wound vac experience were not enough to make me realize that I'm in the midst of another failed attempt at a cure, it took my inability to pop the top off of a can of Progresso soup to have it all sink in.  [The soup?  Tortilla y pollo, doctored for more heat.]

Other fantasies?  That I could spend this Persian New Year with  my former best friend, the Wild Iranian Lesbian, admiring the beautiful table, the flowering hyacinth, the optimistic gold fish.  My hope, of course, is for her year to be a wonderful trip around the sun.

I dare to hope that the Ellerbecks have a measure of comfort, somehow, today.  

I wish Captain Haddock would just go ahead and surface in the moat, in his jaunty little pink submarine -- the threat of a Domestic Inspection is so much worse than the actual wielding of The White Glove.  [Fred found The Castafiore waxing the steps of Buonarroti's Spiral Staircase again, and spritzing the Old Masters with household cleaner laced with ammonia.]

Given what I can glimpse outside this casement window, newly installed in the upgraded Computer Turret, I hope to "play in the dirt again" sometime very soon, if not this day.  The sky is blue and so is the sea... Drat. Why is I Am a Child playing in my head? I fear it is the impact of thinking about the Trayvon Martin travesty down in Florida.

At least my brain picked the Buffalo Springfield version.

Uploaded by  on Jan 21, 2011

I hope, as does everyone in vicinity to moi, that I can overcome my fear of falling and take a shower today, the first since the morning of January 23, 2012.  Somewhere in this blog, in another of my awesomely introspective and well-organized posts, I detail how to maintain a pristine state without benefit of getting in the bathtub.  It's not so easy these days, and more than anything, I actually long for the feel of water on my skin.  [In my case, due to CRPS, running water feels an attack of tiny needle sticks -- tolerable, but sometimes just barely tolerable.]  My legs, especially, need a soak.

I hope, too, that I can pull off a shower without that being my pinnacle achievement for the day!

Because I also crave and want and expect and yearn for... a day put to good use.  You know, when you don't just fill the pets' bowls with food, but take careful time to sanitize the bowls first.  Did you know that eating from plastic bowls can cause pimples to sprout around a cat's mouth?  I didn't think so!  Only one of our bowls is plastic, and we use it because Marmy Fluffy Butt (aka I-choose-to-leave-my-poo-beside-the-litter-box-for-your-maximum-pleasure) will not eat out of anything else.  That reminds me.  I absolutely pine, fancy, and crave the services of an animal psychologist.

This day, cast useful, should include other bits of spot-cleaning.  The disgusting coffee apparatus that Fred uses -- and that Bianca's frequent overnighter, Sven Feingold, adores -- hasn't been washed since... well, since I last had a shower!  In between hospitalizations, while I was insane with fever and dehydration, I made several inspired online purchases, the best of which proved to be a new Bodum French press, so I am brewing my coffee separate from Fred, Bianca (and Sven).  I tell you, it was like Christmas (finally!) for a few days, in spite of the definite Lenten attitude exhibited by our UPS driver.  I had no recollection of my purchases but fortunately, some innate good sense prevailed and I only ordered household items according to an apparent "upgrade" theme.  Frilly stuff like a new dish drainer, and magnetized tools (miniature grabbers, really).  Even the more wasteful orders are not so wasteful, after all.  Not if you squint and stare into the direct sun.  For instance, even though we now have enough bonito flakes to make dashi for all of Japan, I have faith that my Buddy the Freakishly Large Kitten will eat his way through them by the end of the year.

How did the shelter staff not know that he was a Maine Coon?!

Other expectations, faith, and fancies for today?  That we can figure out the idiosyncrasies of this new wheelchair before hosting the "Wheelchair Tech" tomorrow.  It seems like such a small matter, hardly worth someone making the long journey from Tête de Herge's only Full Service Gimp Supply Store.  Still, it is not a good thing to suddenly lose power in the midst of crossing the street.  There's also the whiplash factor!  Fred, stubbornly sticking to scientific method, has debunked each of my theses about the cause of this behavior, citing "coincidence" as the underpinning for my observations.  I much desire equanimity should we tackle the problem again this afternoon.

I'd positively love to do some cooking and baking, but cannot wield a knife.  That's not true.  I just cannot safely wield a knife or expect that my knife skills won't result in personal tragedy.  Hence, the adventures with soup cans and many microwave meals.  Fred is a great cook but he's kind of in recovery right now, himself, you know.  Bianca?  Puh-leeze!  Sven can concoct some amazing comfort food dishes but I can feel my blood vessels begin to clog after the first few bites.  And it turns out that asking for help from the genetically indentured Domestic Staff can result in charges of Abuse of Power.  Who knew?  Damn those corporate flow charts.

Well, if I don't end this, and then finish revising the post that Blogger was blocking last night, I'll never get to my extensive Wish List.  Hmm, how to close, how to close?

As if you weren't expecting it!


Hope is the thing with feathers
That perches in the soul,
And sings the tune--without the words,
And never stops at all,

And sweetest in the gale is heard;
And sore must be the storm
That could abash the little bird
That kept so many warm.

I've heard it in the chillest land,
And on the strangest sea;
Yet, never, in extremity,
It asked a crumb of me.

-- Emily Dickinson

Repost: Spring Cleaning at Marlinspike Hall

originally posted 3/22/2009

I repost this annually, as much for my benefit as for the New Reader who may have wandered in by mistake. To what end? Well, to remind myself that the tasks necessary to keep order in our little corner of The Manor are mere trifles compared to what we face in the rest of Marlinspike Hall. If you are new to elle est belle la seine la seine elle est belle, this also may help you better visualize Captain Haddock's family home.  And who knows?  Thinking about spring, even if it's spring cleaning, might brighten your day.

I'd best get back to it. Medieval tapestries don't whack themselves clean, you know.

***** ***** ***** ***** ***** ***** ***** ***** ***** *****

Here, deep deep in the Tête de Hergé, it's the time of year when we tenants of Marlinspike Hall clean and straighten, rake and trim, sweep and scrub. Sometimes in matching outfits. Spring might herald a visit from The Captain to his ancestral home, and he expects to find a tight ship.

What is involved in keeping The Manor neat as a new pin? It's not terribly complicated and probably is very much like what you might do in your own home.

The Old Masters must be dusted and straight. Simple enough.

Before I made the acquaintance of The Biddington, I had to use whole bowls full of emulsion cleaner, varnish remover, and even a few drops of Domestic Industrial Strength Environmental Neutralizer for the dingiest of chef-d'oeuvres. Mrs. Biddington -- known in the industry as The Bo-Bizzle of Blue Ball Biddies -- influenced me to try cleaning our oils with various breads and doughs, even the occasional muffin and non-alcoholic fruitcake. Now I only violate EPA guidelines when working on some of the more obscure works stashed in the odd uninhabited corners of The Manor, and I wile away the winter snows by tending to them, one at a time, slowly. Cotton swab by cotton swab, corrosive compound by corrosive compound. Why such diligence? Captain Haddock likes to circulate his distinguished family's art holdings from year-to-year, so you never know when that smoky and yellowed Rembrandt self-portrait is going to see the light of day. (O! There are an annoying quantity of Rembrandt self-portraits to deal with. I keep advocating that they all should be hung in the creepy and destabilizing carny Mirror Room.)

I will never forget the Spring day, several years ago, when my dear friend La Bonne et Belle Bianca Castafiore decided that she wanted to pitch in.

I cocked an eyebrow.
Fred produced a paroxysm of belabored coughing.
Marmy issued a subtle "*ack*-*ack*-*ack*" as she puffed her mighty fluffy butt and stalked off.
I don't know where the boys were.

In one smooth arcing movement, Bianca spritzed Aqua-CitraSolve Natural Household Cleaner and Degreaser on The Conversion of Saint Paul and The Crucifixion of Saint Peter by that murderous, kinda baroque-y, sorta manneristic imp-of-a-guy, Michelangelo Merisi da Caravaggio. I can't get the straight poop from Haddock as to how his family put its hands on the pair -- both once graced the Cerasi Chapel of Santa Maria del Popolo -- until Cardinal Tiberio Cerasi, a flighty guy, himself, and Treasurer to Pope Urban the SumpthingSumpthing, couldn't make up his flighty-guy mind about whether he wanted them or whether he wanted to commission another attempt at the religious subject matter. Those Haddocks sure were lucky.

I cannot count the hours I have spent cleaning all that lucky plunder.

I don't like to complain overly much -- but as you can see from the photo at left (taken in the Cozy Breakfast Nook behind The Spit Kitchen in the Western Wing), just getting to these suckers to wield a tentative and gentle feather-dusting requires those ladder skills you learned in high school and never thought you'd use!

Back to that Spring Day of the Spritz. This was the same day Bianca waxed the reclaimed antique oak of the risers on the biggest spiral staircase in our wing of Marlinspike Hall. "Reclaimed antique oak risers"? That's what I said. Wait while I consult the History of The Manor. Yes, here it is! The wood was original to the medieval castle of Vol-le-Bois -- and Lord knows there isn't much built of wood that usually survives that era free of worm holes and degrees of rot. Il s'agit là d'une récolte très sage des produits forestiers. Really, it seems insufficient to describe what The Castafiore did as mere "waxing." She lovingly burnished each step with as much Lemon Oil as she could force the old wood to accept (if not exactly *absorb*), and then polished it all off with liberal applications of thick and gooey Creamed Lemon Wax.

Later, in the Salle d'Urgence, she would claim an unexpected and preventable "slip-and-fall." When Fred called The Captain, Haddock's perennial fear of La Bonne et Belle Bianca kicked in and he offered her a healthy settlement. Their relationship is truly one of a twisted pretzel -- the big, soft kind that street vendors sell. Hmm. Well, the ones here, in Tête de Hergé country, are a nice combination of a Philly soft pretzel, but shaped like, and as tasty as, a New York pretzel --sprinkled with a liberal amount of Kosher Sea Salt and dipped in a good pungent mustard.

But I digress.

Back to Castafiore and Caravaggio: Did you know that one of the theories about why oils can be such pains in collecting dust and crap -- is that oil paint never dries? That's why spritzing the damned paintings was such an ill-advised approach to the maintenance of Old Masters. Bianca adores the fresh scent of Aqua-CitraSolve Natural Household Cleaner and Degreaser. "Ah! C'est fabriqué avec de véritables oranges!" she crows. And crows.

[It smells not unlike harvest time in the Florida groves when The Castafiore exits her bath in mid-morning. Bourbon French Orange Blossom, for a mere $45 an ounce -- it wafts, it clogs the nares, it is unmistakeable. She sought the same cloying scent on behalf of the saintly pair of Caravaggios.]

No doubt, too, that she wants to make everything all shiny, like that bleepety-bleep miroir. It's mindboggling, but even with her troupe being out of work due to the Global Opera Crisis, she persists on belting out, à la Ethel Merman, je ris de me voir si belle en ce miroir! I mean, really! They may very well want to mount something besides that tiresome Faust after Socialism takes over everything, including the theatre arts. Oh, what a happy day that will be! Art for all! Health care for all! No more inequality of resource allocation!

Anyway. Cough. The only reason those two priceless works were salvaged was because she did her spritzing right in front of me. In a reaction fueled by a burst of outraged adrenaline, I turned the wheelchair on Super-ZoomFast, a setting only to be used in the event of a true emergency. It requires an immediate administrator's authorization and key code. The first time I used it, both the chair and I ended up on our sides, not unlike Arte Johnson and his toppled tricycle on Laugh-In.

True Confession: I have been hording all the Velasquez works in the cool, dry nooks of the upper story of the Knoppenburg Manor Replica Stables. Sometimes, I lean back against wooden slats and think, "mine, all mine."

Wow. I haven't even begun to explain how we spruce up our digs every Spring. Maybe because it truly is a year long process. It never stops.

Keeping the antique Blue Jasper Wedgwood plaques free of cat fuzz. Maintaining the lawns -- replete with a scale replica of Wimbledon courts 1-19 plus Centre Court -- deeply green and trim. Oh, and the neverending battle to keep the black algae out of the moat... daily brushings and constant correction of chlorine requirements -- not too much, the eel and koi are kind of sensitive.

Like I said, it's simple enough. Sure, this year we may have to pay to have others do certain things -- Fred refuses to serve as chimney sweep, for example, and I am having a difficult time beating all the tapestries clean, plus I get a terrible crick in my neck trying to stop the stupid Persian rug borders from unraveling. There is a fix for the problem -- but weaving wool through all the fringe ends and warp threads -- it's called "cashmere and overcasting" -- followed by lots of fine needle work -- and my sore neck, back, and pinpricked hands are going on strike.

I am not gonna do it anymore.

Outsourcing. That's the ticket.

And La Bonne et Belle Bianca Castafiore? What is she doing this Spring Cleaning? We've put her in charge of morale.