Saturday, July 12, 2014

The Primacy of Silence

I am rationalizing as fast as I can.  Without a goal, though, it's much like treading water, no rescue of self or others the end point, just lactic acid weighing down the legs and my uselessness made manifest by drowning.

At camp one summer, I qualified for the final exam in a Red Cross Certified Advanced Life Saving course. The elite bunch of us candidates were given instructions on what to wear.  Jeans, a leather belt, a button-up long sleeve shirt, a short-sleeved tee underneath, lace-up shoes, ankle-length socks, and a hat.  I remember how unspecified the hat seemed.  How color did not matter, how function trumped style.  We all had on, as a final layer and defense against pubescence, one-piece bathing suits.

It was early morning and there was fog on the camp lake.  We took our final exam off the end of a rickety pier.  The examiners seemed matronly, an odd remembrance, since I am sure they were not matronly. Maybe everyone looked a little heavy, given the extra layers we had piled on.

So all candidates jumped into the cool, slightly stinky pond water, and tread water for a specified time.  Then we were to take off the jeans, shirt, tee, belt, shoes, and socks.  I suppose we did something with the hats, but I cannot remember what.  Some of these items were to be transformed into flotation devices.  Some of them I saw fit to let drift to the slimy pond's bottom.  I lost points for giving up on my lace-up boots. Perhaps, if I had saved them and made it to an illusory desert island, they'd have supplied sustenance enough for the whole class, for a month, at least.

Then we showed off our proficiency by floating a bit, hanging on to those inflated blue jean legs, for example, or resting our heads on pouffed out tee shirts.

That's when I began to have cramps in my calves, as I was more treading water, still, than honestly floating with confident reliance on my deflated jeans.  Still wish I could visualize the hat.  I keep thinking that it was some sort of oddity, like an old lady's gardening helmet, and not what you'd expect, like a San Francisco Giants baseball cap.

I long ago decided that I was not going to trapped inside my family's predilection for silence, and its awful predatory and coercive ways of underscoring the primacy of silence.  This blog, every email I write, most of my conversations -- they all honor that long ago decision.  It comes off as narcissism, as a form of anti-socialism.  It reads as an inability to edit, not just my verbal production, but my private thoughts, as well.

I am reminded of how Rothko, Picasso, and many "unknown" artists would occasionally allow rancor under their skin, and be coerced into producing the finest of representational art, in some unexpected and banal medium.  To prove that they were classically trained.  To prove that they could draw intricacy like nobody's business.  They usually managed to achieve something reminiscent of the best boy or best girl in the final year of prestigious art school, a something or other to promote their impressive portfolio.  Especially fun are the naive artists, the primitives, when they break into some Parisian metro near-photographic pen-and-ink brilliance. Everyone feels secretly foolish after these displays.  "See, I can do what you think I cannot.  I simply choose not to, I choose another way.  Which I have now, of course, dirtied and demeaned for wont of proving this silly ability to you." We like to blame the other for our pricked pride, our mainlined production, our betrayal of ourselves.

My hat was of woven grass and had a plastic flower, something approximating a yellow mum without the fragrance.  I guess it was supposed to float up side down, and perhaps serve as repository for my boots, spare keys to our dorm, a cabin-without-a-lock, and my pyrography award plaques.  Next time, a fez, or a Stetson.

One of the instructor's had to save me, and she went all out -- "for the sake of demonstration," she whispered in my ear.  My chin ensconced in her palm, to both keep my head above the pond's water and to maintain control of my body, should I decide to panic and, as the drowning sometimes do, attempt to take my rescuer with me to my watery grave.  I am glad she did not decide on that scenario, as a firm grip on my hair would be the next step.

With a smart scissor kick and a modified side-stroke, she brought me successfully to shore, or, in reality, to the slimy ladder on the side of the pier.  I scrambled to my feet, and rejoined my classmates.

It wasn't an ego-destroying failure, but it stung.  Had I passed, I'd have been part of the group swim from the cordoned safe-swim area for all campers across the lake to wild waters and a very famous rope swing. As it was, I ate ice cream and watched two of my compatriots forget to let go of the rope whilst safely over open water. Ouch.

© 2013 L. Ryan

Wednesday, July 9, 2014

high, low and in-between

yes, i know that i've posted this video/song before.  i will probably post it again.  get over it.

I come from a long line
High and low and in between
Same as you
Hills of golden
Hails of poison
Time’s thrown me through
And I believe I’ve come to learn
That turnin’ round
Is to become confusion
And the gold’s no good for spending
And the poison’s hungry waiting

What can you leave behind
When you’re flyin’ lightning fast
And all alone? 
Only a trace, my friend,
Spirit of motion born
And direction grown.
A trace that will not fade
In frozen skies
Your journey will be
And if her shadow doesn’t seem much company
Who said it would be? 

There is the highway
And the homemade lovin’ kind
The highway’s mine
And us ramblers are getting the travelling down
You fathers build with stones
That stand and shine
Heaven’s where you find it
And you can’t
Take too much with you
But daddy, don’t you listen
It’s just this highway talkin’

All things that are alive
Are brothers in the soil
And in the sky
And I believe it
With my blood
If not my eyes
I don’t know why we can’t
Be brothers here
I know we should be
Answers don’t seem easy
And I’m wonderin’
If they could be

-- townes van zandt

Prayer of Pan Cogito – Traveller

Prayer of Pan Cogito – Traveller

Thank you for creating the world beautiful and of such variety
And also for allowing me in your inexhaustible goodness
To visit places which were not the scene of my daily torments

- for lying at night near a well in a square in Tarquinia while the swaying
bronze declared from the tower your wrath and forgiveness

and a little donkey on the island of Corcyra sang to mi from
its incredible bellowing lungs the landscape’s melancholy

and in the very ugly city of Manchester I came across
very good and sensible people

nature reiterated her wise tautologies the forest was
forest the sea was sea and rock was rock

stars orbited and things were as they should be – Jovis omnia plena

- forgive me thinking only of myself when the life of
others cruel and irreversible turned round me like the huge
astrological clock in the church at Beauvais

for being too cowardly and stupid because I did not understand
so many things

and also forgive me for not fighting for the happiness of
poor and vanquished nations and for seeing only moonrise and museums
- thank you for the works created to glorify you which
have shared with me part of there mystery so that in gross conceit

I concluded that Duccio Van Eyck Bellini painted for me too

and likewise the Acropolis which I had never fully understood
patiently revealed to me its mutilated flesh

- I pray that you do not forget to reward the white-haired old
man who brought me fruit from his garden in the bay of the island of Ithaca

and also the teacher Miss Hellen on the isle of Mull whose
hospitality was Greek or Christian and who ordered light
to be placed in the window facing Holy Iona so that human
lights might greet one another

and furthermore all those who had shown me the way and said
kato kyrie kato

and that you should have in your care the Mother from Spoleto
Spiridion from Paxos and the good student from Berlin who
got me out of a tight spot and later, when I unexpectedly
ran into him in Arizona, drove me to Grand Canyon which
is like a hundred thousand cathedrals standing on their heads

- grant O Lord that I may forget my foolish and very weary
persecutors when the sun sets into the vast uncharted
Ionian sea

that I may comprehend other men other tongues other suffering
and that I be not stubborn because my limitations are
without limits

and above all that I be humble, that is, one who sees
one who drinks at the spring

thank you O Lord for creating a world very beautiful and varied

and if this is Your temptation I am tempted for ever
and without forgiveness

--Zbigniew Herbert

© 2013 L. Ryan

Tuesday, July 8, 2014

Wonderful Competency

This is a pleased-as-punch pass-along of a report published yesterday in Consultant for Pediatricians, as part of their "photoclinic" --

    [Citation: CFP. 2014;13(7):330-331]

There's not one thing remarkable about it.

Except it shows evidence of prompt response to a new case of CRPS, an awareness of IASP "Budapest criteria," and a complete absence of NeuroStupidity.

Way to go, Mfon Ekong, MD; Anissa Meher-Homji, BS; and Lynnette Mazur, MD, MPH of the University of Texas Medical School at Houston!

Complex Regional Pain Syndrome

A 10-year-old girl presented with a 3-month history of right knee pain and difficulty walking after her pet German shepherd bumped her leg. She also complained of a 2-week history of hair growth below her right knee.

On physical examination, she had edema, a 12 × 10-cm patch of hair, and decreased range of motion of the right knee. Results of complete blood count, erythrocyte sedimentation rate, complete metabolic profile, creatine kinase tests, and myoglobin tests were normal. Findings on magnetic resonance imaging were unremarkable.

The girl received a diagnosis of complex regional pain syndrome (CRPS) and was hospitalized for inpatient physical therapy. An indwelling catheter was placed for a femoral nerve block. Ropivacaine was continued for 8 days, after which the girl was transferred to a local rehabilitation facility to continue physical therapy, along with continuous passive motion (CPM) of the knee. She was started on gabapentin, fluoxetine, vitamin D, and as-needed diazepam, and was discharged after 1 month to continue her treatment at home.

CRPS, formerly called reflex sympathetic dystrophy, is a painful syndrome accompanied by physical changes in the affected extremity. Dysfunction of local sympathetic and autonomic nerves may be responsible.1-3

Our patient reported 3 of 4 symptoms (allodynia to clothing, edema, and decreased range of motion) and 2 of 3 signs (hyperalgesia to pinprick and allodynia to light touch) meeting the clinical diagnostic criteria for CRPS set forth by the International Association for the Study of Pain (IASP) (Table).4

[read the rest of this wonderful competency HERE]