Living All the Ages of Man (btwn 3:48 AM and 5:26 PM)

It's 3:48 in the wee morning.

I am tired of getting up every 40 minutes, so let's pretend rested vigor and proceed with the day. Imagine an exclamation mark, if it helps.

Has anyone ever suggested that you fake it until you make it? Should that helpful advice figure among the chesnuts your friends serve up, I share your pain. It's not like someone telling you that a pinch of sugar will make your marinara sauce *pop* or even that those oversized scrub pants make your butt look... not huge, exactly... more like -- misshapen. No, it is clearly a critique of your very essence, and understand this, if nothing else: you have been found ANNOYING.

It has been a long while since I've been permitted to voice complaints around The Manor. A year and a half or so ago, Fred begged for me to suffer in silence. We were spending most of our time in hospitals and doctors' offices, infusion centers and labs. I was out of my mind with pain and infection.

Nothing has changed, except that, now uninsured, my doctors are struggling to keep me going until the advent of the Great Interim High Risk Pool, which will then enable them to toss me back into the operating room to relieve me of my shoulders and any other infected bones/hardware.

I cannot recall whether I was brave enough to set that down in this blog. Did I? I cannot remember. Anyway, that is apparently the final judgment -- since we cannot even identify, much less eradicate, this bleeping infection, the orthopedic surgeon and my internist, both, are lobbying for making me even more of a Depressed Freak.

My internist also won't let up on his contention that my right leg needs to be chopped off.

Ouch.

Ouch, I say!

These thoughts make me cry and sear my brain cells. I smell burning brain. Okay, maybe it is just the fever.

I honor Fred, and understand his need not to have to face what I must face. He will deal with things as if they are surprises sprung upon him by a maverick world. The man has more capacity for denial than anyone I've ever met. It still puzzles him to find me hunched over this laptop, sweat dripping from my matted hair (*ew*!), eyes glazed, so rosy-rosy cheeked. At his incredulous glance, I whisper: "I'm okay. It's just the fever." At my whisper, he reflexively asks: "Why do you have a fever?"

And I imagine tossing him to the Imaginary Monsters in the Real Moat.

[Apologies to Marianne Moore.*** If you love her poem (one version of which is at this post's end), her imaginary gardens with real toads, you should familiarize yourself with the publication history of it -- it's fascinating. And wonderfully instructive.]

So I confess that it is not others who shame me into faking it until I make it, but rather that it is a form of self-flagellation. Why else would I have spent an hour and a half rubbing lemon oil onto a variety of wooden tables while the rest of my country homesteaders snored in peaceful oblivion?

Four end tables, a console table, a coffee table, and a... plain old table. Our Little Idiot, Dobby the Runt, kept me company. He is the SmellMeister and insists on sniffing whatever I am involved in. I fill my HillaryClintonForPresident water bottle and he must sniff the liquid, then taste it from my finger. I do believe that one day he will save me from poison, this furry and personable little tastetesting pink nose of a cat. He smells the clothes both going into the washer and emerging from the dryer. Always well-behaved, he sniffs most everything we cook or bake, and to see him caught in a spasm of rapid eye-blinking is a fair warning that someone ought to have left out that last tablespoon of cayenne pepper.

Even whole suites of rooms away from her, Dobby goes into nose and eye spasm whenever La Bonne et Belle Bianca pops the top of a Diet Coke. There must be microscopic bubbles that travel directly to His Pinkness, as his reaction to the carbonization process borders on the pathological. Whenever flu strikes, we have to shield him from the nefarious effects of Alka-Seltzer Plus.

Anyway, if you've not been advised to stiffen your upper lip and make like tragedy is not your constant companion: Lucky you!

My penance-based life, au contraire, is founded on the mortification of this pesky flesh. I'm paid up through Early Eternity just by the simple virtues of CRPS! Actually, misguided ascetic notions of self-worth are commonly exemplified by flagellantism. I'm not kidding -- keep the thought in mind and go out among The Brethren and The Sistren. You'll see. (The World has become not much more than a Gathering of Frustrated Self-Anointed Life Coaches who, upon realizing that others are not lined up, breath bated, to hear their wisdom, opt to march in the streets, whipping themselves. Remember Perugia -- not for Amanda Knox and murder, but for its cutting-edge medieval flagellants!)

To the right is a bronze, circa 1480,
from the Galleria Nazionale dell'Umbria, Perugia.

Another way of foisting pop behaviorism on folks is to sing out, with a smile in your voice: BEHAVE your way to success! It's a favorite among the dOCTOr Phil crowd, but probably not his most quoted, as it sometimes has only a fist-in-the-eye as a reply. My Self-Annointed and Appointed Life Coaches, all of whom have excessive time on their hands, and none of whom are sitting next to me at 4:14* in the wee of the morning, live to employ this dictum (from a distance, though).

[*There has been a brief blogging interruption as I kissed His Fredness off to bed, murmurmurmurmurmuring him into the gentle arms of his fatigue.]

Fred, my friends, is pooped. He spent much of the day pretending to be a farmer, picking vegetables and busting up clods of unrepentant clay with the steel-reinforced kevlar toe-guard and toe-cap of his cemented-construction Doctor Martens 7A43TEAK Industrial TrailBlaz safety boots.

Except for those darned boots, he passed the Look-At-Me-I'm-A-Farmer test. Hogwashers and all.

You'd probably be shocked to learn that, in addition to hanging out with the Local Fringe Element -- in our case, a bevy of Existential Feminist Lesbians (I don't care what the ladies screech, you cannot infer one term from the mere presence of another) -- Fred is a Founding Member of the Red and Anarchist Skinheads [RASH]. Another proud New York Native "fighting to win back the subculture from neo-Nazi groups."

It's the quiet druid you have to watch out for. Smile.

Fred said he did some well-timed spitting out at The Farm, and would have gladly climbed a rope suspended from the gymnasium rafters if there had been one. The urge for exertion of masculinity was nearly overwhelming but he stopped short of a chew and a spit.

Thank God. {rolling of the eyes}

So my Macho Darling and the Existential Feminist Lesbians hauled home to The Manor three kinds of beans and some lovely English cucumbers. Turn by unsuspecting turn, three EFLs and Fred sheepishly whispered in my ear that, despite an entire day exposed to manure and burlap, they were unable to identify the bean varieties. He alone, though, thinks the English cucumbers are zucchini.

What?

Oh. Nothing exotic. Yellow wax, French green, and snap pea.

I knew, somehow, when I typed "chew and spit," that it would end up biting me on the ass. A person shouldn't have to look up every dang thing just to avoid some sick unpleasantry.

Chew and spit, in my agrarian world, refers to the gross practice of chewing tobacco and the ensuing spitting out of its nasty juices in a well-controlled stream. Sometimes called chaw rosin, I became familiar with the stuff during a stint at the Gothic Wonderland, a place that owes its existence almost entirely to Mother Tobacco. Don't listen to the revisionist histories which have the Duke Endowment funded by the family's textile and energy ventures... It's all about tobacco.

[My favorite phrase in the Duke.edu bio of James Buchanan Duke describes the Dukes as "[a]rdent Republicans and sympathetic to the downtrodden"!]

I loved the colors and smells of the nasty leaf -- I even visited the fierce and weird auctions that used to be common in local curing barns, trying to decipher the alien poetry spewing from deep within the auctioneer's throat, interspersed with dashes of Christian scripture, and, some say, visitations by the Holy Ghost, as speaking in tongues was not all that uncommon.



Needless to say, I actually do have some understanding and compassion for those raised in the tobacco culture, those who did the actual culturing of the stuff. The reference to chaw rosin, to chew and spit, was a fond and innocent one. [For the record, I stopped smoking around 1994, in fits and starts. Fred? He decided to show me up by quitting... overnight. Smoking is now prohibited in The Manor, though some inviting peppered floral scents waft around on the odd summer evening.]

So would someone please tell me when, exactly, spit and chew became the buzz words for an eating disorder? Like bulimia and anorexia, it is a singular disorder, usually an obsessive compulsion. And lest you be so innocent as to think that C & S might still be a reference to some wholesale grocers or a green engineering design firm, think again. It's much more likely to refer to buccal violence against chocolate-dipped macadamia nuts with a side of whipped cream.

I am further informed that this technique is attributed to Elton John, that its unexpected down side [s:h:o:c:k] includes tooth decay, lots of time demands, and the tendency to shoplift, as it is an expensive eating disorder to maintain.

I dunno. This fake it 'til you make it, behave your way to success movement may be the key to our mutual survival. I will deny the existence of pain, sleeplessness, and disability, and others can deny the existence of calories or God.

What totally sucks? The denial game usually works.

Give it a try -- C'mon! Unless your Gender Rules prohibit, plaster a rigor-inspired grin on your face, smear some raspberry-flavored gloss on those dry lips! Carefully layer concealer under the eye and apply a bit of eyeliner to the lash line. Don't forget mascara, wear something bright to match the vibrant scleral petichiae, and punctuate all utterances with a delighted giggle. (Or, if you are writing, with LOL.)

This is all getting really old -- this emotional gumbo, this lack of sleep, the failure of my environment to pity me. Complaints about my inefficacy are pouring in, despite the make-up, the perky colors, oiled tables, and promises of three bean salads, galore.

Body dysmorphics have taken over my language, and feminist lesbians have stolen away Fred's libido.

Dobby is sniffing my fear with suspicious beady eyes.

I putz away the day, come back to this very blog post, begun after 40 minutes of sleep, 13 hours and 38 minutes ago, in hopes of returning, finally, to bed. A storm rages outside, and three of the four felines are in my clothes closet. Fred slept a proper night's sleep and is now considering a nap. (Farming is hard work.)

The Manor's various Denizens (and Mavens... Never forget the Mavens) are resolute in their message of disdain for my psychic pain. Uncle Kitty Big Balls, the sole cat to brave the storm outside the comfort of my organic cottons and angora leg warmers, announces, in no uncertain terms: *Ack*:*Ack*. I think this means, in MarmySpeak, "Take your pain medication, with a side of muscle relaxant, grab a bowl of lowfat plain yogurt, carefully doctored with aspartame and vanilla extract, put your ass on the mattress, your feet on some pillows, and reread The Once and Future King."

The three frightened cats' tails are all twitching in unison, as they mewl at moi in between syncopated ronronnement.

Yes, something makes me look up mewl. I can't be happy with what I already know, cannot even behave my way to success in the World of Words.

You probably were already familiar with MEWL and PUKE.

My online dictionary cheerfully chatters about it being a well-known "phrase," modified from mewling and puking -- which did finally start the ringing of all sorts of bells inside my poor head.

I know, you are way ahead of me, but cut me some slack, would you? I just got up, sort of, haven't had coffee yet, and eveyone here is mad at me. Mewl! Puke!

Yes, Shakespeare rang those bells, and when Shakespeare sets a bell to clanging, there's no unringing it.

It's the cheery Jaques from As You Like It who intones the well known monologue on the Ages of Man:

All the world's a stage,
And all the men and women merely players;
They have their exits and their entrances;
And one man in his time plays many parts,
His acts being seven ages. At first the infant,
Mewling and puking in the nurse's arms;
And then the whining school-boy, with his satchel
And shining morning face, creeping like snail
Unwillingly to school. And then the lover,
Sighing like furnace, with a woeful ballad
Made to his mistress' eyebrow. Then a soldier,
Full of strange oaths, and bearded like the pard,
Jealous in honour, sudden and quick in quarrel,
Seeking the bubble reputation
Even in the cannon's mouth. And then the justice,
In fair round belly with good capon lin'd,
With eyes severe and beard of formal cut,
Full of wise saws and modern instances;
And so he plays his part. The sixth age shifts
Into the lean and slipper'd pantaloon,
With spectacles on nose and pouch on side;
His youthful hose, well sav'd, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion;
Sans teeth, sans eyes, sans taste, sans everything.

— Jaques (Act II, Scene VII, lines 139-166)

Shakespeare, I see, has brought me to my untimely [melancolic] end...

Unless I choose to check out what promises to be a new toe-tapping favorite, "Sal, let me chaw your rosin some." It's the child of Gid Tanner's Skillet Lickers, and dates from roughly 1930. Tanner's country songs were called "rural drama stories," and I can't think of a more fitting genre to investigate as I go about putting my internal house in order. There's one in particular I want to find -- something about a "corn licker still."

[Spoken: Ah Riley, Lets go down to see old Sal.
See if she wants to give us a cud of
that rosin to chew on this morning.
(Riley:) All right, let's go down to that sweet gum tree and find out.
All right. We'll go down and play her a little tune called
Sal Let Me Chaw Your Rosin Some. Let's go boys.]

(Fiddle)

Jump up Jinny, jump up Joe,
You never get to heaven till you jump Jim Crow.

(Fiddle)

Cabbage in the garden, Peas in the gum,
Sal let me chaw your rosin some.

(Fiddle)

Hogs in the garden sifting sand,
Sal is in love with the hog-eyed man.

(Fiddle)

Along comes Jinny and along comes Joe,
Along comes Jinny with her apron on.

(Fiddle)

Cabbage in the garden, peas in the gum,
Sal let me chaw your rosin some.
(Fiddle)

Hogs in the garden sifting sand,
Sal is in love with the hog-eyed man.

(Fiddle)

Jump up Jinny and jump up Joe,
You never get to heaven (un)less you jump Jim Crow.

***** ***** ***** ***** ***** ***** ***** ***** ***** ***** *****
Well, it's been fun, but I've reached my end and will at least go assume the recommended positions for sleep. I've heard good things about them! Enjoy Marianne Moore's poem, and -- if you don't already know -- try to figure what parts she ended up resigning to footnote status, and which she kept as the primary poem. She was a card, was Marianne.

***Poetry

I, too, dislike it: there are things that are important beyond all
this fiddle.
Reading it, however, with a perfect contempt for it, one
discovers in
it after all, a place for the genuine.
Hands that can grasp, eyes
that can dilate, hair that can rise
if it must, these things are important not because a

high-sounding interpretation can be put upon them but because
they are
useful. When they become so derivative as to become
unintelligible,
the same thing may be said for all of us, that we
do not admire what
we cannot understand: the bat
holding on upside down or in quest of something to

eat, elephants pushing, a wild horse taking a roll, a tireless wolf
under
a tree, the immovable critic twitching his skin like a horse that
feels a
flea, the base-
ball fan, the statistician--
nor is it valid
to discriminate against 'business documents and

school-books'; all these phenomena are important. One must
make a distinction
however: when dragged into prominence by half poets, the
result is not poetry,
nor till the poets among us can be
'literalists of
the imagination'--above
insolence and triviality and can present

for inspection, 'imaginary gardens with real toads in them', shall
we have
it. In the meantime, if you demand on the one hand,
the raw material of poetry in
all its rawness and
that which is on the other hand
genuine, you are interested in poetry.

--Marianne Moore

Re-post -- Medical Bloggers: Touche Pas A Mon Pote!

J'ai passé une nuit blanche... during which I found myself missing Nurse K and her now defunct blog, CrassPollination. I hope that it, like the Phoenix, will rise from the ashes, or at least become available in some other format. Ummm, like a book -- that'd be cool.

Anyway, that led to laughing at my various references to her fine anecdotes, and my virgin shock at the âpre, biting depictions of the dread Problem Patients and the manner in which the well-raised, polite ED nurse reacts to them.

I don't know exactly why my dander was all up, back in November of 2008. By then, I had had the second of six surgeries, was not able to sleep at all (to the point of true toxicity), and was in the kind of pain that births dreams of loaded guns. I also had really just started to read medical blogs with any sort of attention. Okay, yes, I also had begun to hear the dreaded "ewww, you're a complicated patient, aren't you?" Add to that that I was a licensed, charter member of the Annoying Chronic Paineurs, and yeah, I might have been a tad bit touchy.


A hard time, to be sure, but I'm not the kind of person to project my issues onto someone else.

Cough.

Anyway, when I am feeling all righteous and stern, these medicos piss me off. When I am thinking straight? I am oh-so-grateful for each and every one.

*In deference to my broken leg, I am not going to make my damned fingers waltz around to see if the links in this repost remain in effect, and accurate. Do it your own self!

Cough.
Sniff.




"Touche pas..." has long been a favorite saying (and message) of mine. Indeed, I've always wanted the T-shirt. But how to explain to someone unfamiliar with both the situation and the language what it means? I had never googled it -- oh, the amazing act of googling! Anyway, I found this short passage, which does a pretty nice job of it (though the lack of an accent puzzles me -- why get something almost right?):

A Powerful Political/Social Sign: "touche pas a mon pote"
One of my favorite social-change campaigns of all time came to my attention recently when I saw it in the background of a film shot in Paris.

It's the ubiquitous yellow hand of the French anti-racisim organization SOS Racisme, which travels the French visual landscape coupled with the phrase "touche pas a mon pote," which translates roughly as "don't mess with my buddy."

The straight-ahead everyday slang of the phrase in French --- it's literally what one would say in a street confrontation --- and the powerful yellow hand have always been a model for me of really understanding both the potential audience for a social change initiative and the moment of decision the designer/strategist is trying to influence. This is what you say to protect a friend, and the implied strength-in-numbers and the sense that "we are watching you" and holding you up to social shame makes the slogan an absolutely brilliant piece of writing.

In an earlier post I quoted science writer Daniel Goleman on research showing that the more someone is perceived to be "like me" the more our empathic brain circuits are activated.


My name is Retired Educator, and I am addicted to medical blogs. (Hi, Retired Educator!)



I am one of those barely-there people. If you sneak a peek behind La Belle Bianca Castafiore's considerable operatic girth, there I am, ensconced in this drafty, ancient manor with my darling, but essentially clueless, Fred, and with the real brains behind the outfit -- the Felines.








Once upon a time, I was -- sniff -- a rising star; More importantly, I had considerable fame as a clothes hound and shoe afficianado. Chronic illness and pretty severe daily pain has reduced me to unknown status, and my wardrobe to oversized organic cottons, with the occasional silk and linen blend, all bearing the satanic marks of elastic and screeching velcro closures.









Sleeping became difficult, and it is not an exaggeration to say that the rising sun became an emblem of survival. The computer, and its incredible access to almost anything one can dream up, was a great tool to wield in the middle of those long nights. I was a member of several online communities of people who were also in pain, who were suffering from the same acronyms. Boy... was that depressing.









One 3 am (apparently, the witching hour), I was searching for information on a medical test that I was about to undergo -- something that doctors just adore -- and my googling returned a hit that turned out to be transformative. I had never before ventured into the blogosphere, thinking it a "place" for only the Smarmiest of Smarty Pants. I was ill-prepared for the pleasant shock of reading this acerbic nurse's blog. It beat the hell out of the navel-gazing and shrill cheerleading of the online support groups.

And so it was that Nurse K's blog, Crass-Pollination: An ER blog (ED if you're... oh, never mind), was the first medical blog I ever read. Medical blogs helped me get through some of the long nights that were already medically oriented, anyway -- and intense. It's much better to laugh than to cry -- and infinitely better to snort-laugh than to weakly titter. Nurse K supplied lots of those snorts, although I now regularly read a good dozen other medical blogs that are equally entertaining and informing.







These medicos are intelligent and creative people, turns out. For whatever reason, blogs maintained by Other Liberal Educators proved... unsatisfying. And so, I was hooked.

I never expected to learn some of the things that I have, however -- mostly things pertaining to intense professional frustration. There are a host of other nominatives that I sometimes would like to apply but won't. Probably. Well, maybe. We'll see. As I said way back in the beginning, whose blog is it anyway? That snappy-snippy attitude, and that respect, is due every blogger. Well, not every blogger. Well, maybe. We'll see. Cela dépend.

(Please recall: I am the prof who declares that "Yes, there *are* stupid questions, just as there *are* stupid students. That said, I never doubt my own ability to salvage all students and most questions. It is called getting to the heart of the matter.)

It turns out that learning what particularly challenges [blogging] nurses, doctors, and other health-related workers has impacted my interactions with those self-same people in my life. In some ways, it has been marvelously helpful -- mostly, it encourages me not to blather on and on, as I tend to do when not feeling well. I need to be an efficient, honest, and straightforward patient, since I expect as much from the people trying to help me. I now don't provide much in the way of information that is not pertinent to whatever the specific situation might be, and I do not ask for things that I might have in the past (mostly creature comforts -- a blanket, a pillow -- but also that meal that never came, or the medication that never arrived).

Unfortunately, the thing I learned most was fear of these people. Before anyone flies into some sort of fury-driven arrhythmia, let me qualify that use of the word "fear." It is the same fear that I experience when driving near speeding, lane-hogging, long distance rigs on the highway-- and it feels like a prudent response.

These [blogging] doctors, nurses, et al, are not malevolent, and they would not purposefully hurt anyone in a lasting way. I believe, however, that a small minority *does* intentionally inflict temporary pain -- they confess it, and they confess it with a certain amount of very disturbing pride. Of course, there will be a complete disavowal -- instead, my lack of humor will be suspect, or my intellect (more likely my worldliness, or common sense, saying, "Jane, you ignorant slut," to which I can only say, "Dan, you pompous ass...") Shoot, we all recognize the urge and understand it -- but acting on it? Oh, what are the words? Hmmm. Oh, yes: wrong and amoral. Criminal?

Faced with an annoying waste of time that is a woman faking a seizure, the response is:
I head to the cabinet that holds the STAT 16 Fr Punitive Foley Catheter, and Nurse Tinkerbell heads for the cabinet that holds the STAT 16g Punitive IV Catheter.It's called a "16 Squared", and it's the first line treatment for ODs and fake seizures.

[The whole entry itself is totally hilarious, and I am a great fan of this particular blog.]

The punitive foley and i.v. catheter are tame examples, really. Maybe what is most disturbing is that I have no difficulty believing that this sort of thing, and worse, happens. I guess it is not supposed to matter because no lasting damage is done, or the patient is presumed too stupid or "crayzee" to ever know.

And, it must be said, in this election time, that there are systemic cruelties that no human can match -- the idiotic aspects of EMTALA law, the medication too expensive to be had, the follow-up care that just won't happen, the dumping that has never really stopped (go ahead, challenge me on that, I dare you. I double-dare you. I will name names!).

Abuses? Good God, I don't know how health care professionals (I am thinking primarily of the ER/ED environment) maintain any semblance of a good attitude in the face of all the social ills that masquerade as physical or mental health emergencies. I imagine that almost everyone they see is at least a dual diagnosis. Despite this terrible complexity, they are called on to treat the presenting symptoms, the presenting problem -- but the background of addiction or some other chronic disease invariably creeps in to complicate the visit. It takes a lot of disciplined skill to keep the "emergency" visit on an "emergency" track.

In the blogs about emergency medicine, you will read stories of women wanting pregnancy tests or ultrasounds at 3 am -- after arriving via ambulance, no less -- and tales of homeless people who want something to eat (a sammich) and a place to sleep. Drug-seekers are an enormous drag on the general goodwill and dealing with them daily may well be enough to tarnish even the finest of attitudes. These folks are usually allergic to all medicine except opiates, and attempt to steer their treatment straight toward the drug they desire. WhiteCoat, who rants at another insightful and entertaining blog spot, tells a story respectful of all comers: "Drug Seekers Suck." There are *countless* number of blogged posts generated by the frustration of dealing with drug-seekers -- would that that provided something beyond temporary catharsis.

Most professionals worth their salt know frustration -- if they don't, they've chosen a niche of safety, more power to them. What said professional chooses to do with that frustration, however, speaks volumes.

Moi? In the built-in cabinets of the Ivory Tower, I kept a stash of amazing weaponry to throw at students, although chalk would always do, in a pinch. I converted every departmental or university-wide insanity into a reactive act of pique, usually in the form of a scathing letter -- or, if the matter were truly weighty, a collective effort with colleagues. Maybe a sit-in, or a huffy petition. When the problems were "emergent," so was my response. When the issues were more some systemic form of illness, working toward a cure required much, required deep study, required patience. Of course, I understand that an academic or intellectual emergency does not really matter, in that grand scheme of things, in, cough, the order of things. Except for two specific instances*, life itself was never in question -- although divestiture from South Africa did seem to matter... Blogging medical professionals, par contre, exist within a world of pain walled off from the rest of us. Not unlike an abscess. (Sorry, that came unbidden! But, really, how true! A good incision and drainage might be just what a doctor might order...)

And like the whining teenager, there's no way [we] could ever understand.

It must be very wearing to deal with the people who are inappropriately demanding the considerable medical talents of an emergency department. You don't have to follow many medical blogs before the problem list is set: people on Medicaid, the uninsured, drug-seekers, people with chronic pain, fibromyalgia, headache, homeless people, alcoholics, addicts, and general dirtbags who don't appear sufficiently grateful for the ministrations received. Just looking at the list is enough to make *me* sigh with anticipated fatigue and frustration. What can I say? I am a real fan of the genre and of the brave people driving the narration.

Then, it happened. Nurse K put me on the list. Oy! There it was: reflex sympathetic dystrophy (the inaccuracy of the name continues to be perpetuated by both sufferers and medicos alike -- nevermind that sympathetically maintained pain is not necessary to the condition, or that it does not include causalgia -- because CRPS is just too unwieldy to say!)

Anyway, this is the entrapment post in question:

CRAYZEE NOS
52 y.o. female with a past medical history of something like:
Fibromyalgia, chronic pain in other conditions, anxiety, depression, panic disorder, bipolar II, hyperventilation syndrome, cyclical vomiting, restless leg syndrome, reflex sympathetic dystrophy,IBS, endometriosis, L4-L5 "bulging disk", bunionectomy
AND
CABG 6 months ago....

...presents with "chest tightening". In the last month alone, she's had five negative chest-related work-ups including a clear cardiac cath.

Geez, Crayzee, why'd you have to have that CABG on there? Now we have to treat you like a real patient.

As part of the banter that appeared in the comment section following the post, Nurse K had occasion to write: I think all crayzee, anxiety-mediated diseases and "pain out of proportion to exam" complaints should just be lumped together under this ICD-9 code.

I often wondered how people with fibromyalgia felt when they were under attack. Now I was in the same position, and it pissed me off.

For all of five minutes! For what use is anger in the face of ignorance? And since stamping and stomping ouT ignorance has been the calling of my life... surely this would qualify as one of those euphemistic "teaching opportunities"!

Well, no. I don't have the energy or -- after that terribly uncomfortable aforementioned five minutes -- the desire. No, once again I come away convinced that these people are dangerous (and I hear the explanatory retort of 'we are just venting... we're professionals but we are also only human... we'd never say these things to patients or act on them...').

How much do you think it would blow these med bloggers minds to learn that they are teaching the public to second guess and seriously doubt their capacity for satisfactory treatment and diagnosis?

Of course it must be reiterated that the offending, offensive bloggers are a small minority, and I wish I were less thin-skinned, more able to "consider the source." Shoot -- it is illuminating just to remember the traits likely to a blogger to begin with! There is a need to be right, a desire to pontificate, a hope to be known -- just as there is knowledge to share, experiences to detail, and much fun to be had. And so it is that I remain enamoured of these talented people and the incredible tales of humanity they have to share, and wish the medical bloggers the best.

But always remember, and never forget: Touche pas à mon pote!

*Two students of mine, both Freshmen, turned in suicide notes as homework, and in so doing, cemented my rapid-turnover grading habit forever. Thankfully, both students lived; Sadly, they both had to drop out of college, though I am sure they returned -- both were phenomenally gifted.

Army suicides set another yearly record

Since January, 140 active-duty soldiers have killed themselves while another 71 Army Reserve and National Guard soldiers killed themselves in the same time period, totaling 211 as of Tuesday, Gen. Peter Chiarelli, U.S. Army vice chief of staff, told reporters at a briefing Tuesday. But he said the monthly numbers are starting to slow down as the year nears its end.

"This is horrible, and I do not want to downplay the significance of these numbers in any way," Chiarelli said.

For all of 2008, the Army said 140 active-duty soldiers killed themselves while 57 Guard and Reserve soldiers committed suicide, totaling 197, according to Army statistics.

"The general trend line with the exception of a couple of months has been down."

[addendum, 11/25/2009: The sentence above rankles. Pisses off. Depresses. When last the military issued statements about the alarming number of soldier suicides, it was wayyyyyy long ago -- as far back as FEBRUARY 2009. So, between February, traditionally our second month of the year, until now, NOVEMBER 2009, which I consider our eleventh month, that makes... a whopping NINE MONTHS. I have trouble with any establishment of a statistical "trend" based on nine months of data, and even more trouble when "a couple of months" belie the claim. I'm just sayin'.]

In February, when I was reacting to another anouncement of record-setting soldier suicides, one of my posts engendered the following comment:


Anonymous said...

http://www.healthieryou.com/harm.html
this article relates that 31000 people committed suicide in America....a rate of 85 per day. So the soldiers rate of 5 per day seems to be a little lower then civilians.....so whats the problem?
Steve

February 8, 2009 11:01 PM

I answered this way then, and suspect that an investigation into the mathematics of the current figures will reveal similar prejudices:

Bianca Castafiore said...
Hi Steve,

Well, first, any loss is one loss
too many -- on that, we can all agree.

Second, you are quoting data from 1996/7!

Lastly, "so what's the problem?"

The numbers, if it is gonna remain a numbers game, need to be relative in terms of demographics.

February 9, 2009 9:06 AM

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.

NanaPoot (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.

The Bering Strait Bridge

Very strange and totally unexpected, this. That my political will should find its voice again and finally slough off the dead weight of the malignant illogical who have dominated discourse for so long: hate-mongers, and shrill, every last one of them, fostering straw argument upon intended lack of clarity, and through pure laziness and underestimation of audience, linking unlike to unlike, as if the rejection of one entailed the necessary rejection of the other.

Parse *that*, my friends.

Friggin' obfuscators. But, you know, at worst, obfuscators waste my time.

Piety in rhetoric is the real cagey beast -- is, in fact, most often a downright out-and-out shitty rhetorical device.

I challenge you. Think of a person of your acquaintance whom you'd qualify as "pious." Now, are you having warm fuzzies or are you feeling a wee bit disgusted -- either with said person or with your own hypocritical self?

I'm just sayin'.

To keep myself in check, for you must concur that I'm on the edge of discourtesy, I had recourse to A List Of Fallacious Arguments -- from which the following is a citation:

In the context of debates, a Pious Fraud could be a lie. More generally, it would be when an emotionally committed speaker makes an assertion that is shaded, distorted or even fabricated. For example, British Prime Minister Tony Blair was accused in 2003 of "sexing up" his evidence that Iraq had Weapons of Mass Destruction.

Around the year 400, Saint Augustine wrote two books, De Mendacio[On Lying] and Contra Medacium[Against Lying], on this subject. He argued that the sin isn't in what you do (or don't) say, but in your intent to leave a false impression.

As much as I would love to talk, discuss, and debate salient points of socialism/Socialism or Democratic, Republican, and Libertarian sensibilities -- for I would be in a position to learn a lot, and want to, too -- I can no longer stomach the clinging, dangling, desperate dingleberries posited by some right wing journalists and bloggers -- those cozy little pearls of turds in the middle of what might have been an honest communication...

William Bradley wrote a piece today for HuffingtonPost.com, making reference to the recent reign of bombasters and generally blowing off steam. All citizens of good political will need to get this crap out of their collective and individual systems. Open the window and scream that you aren't going to take it anymore.

CNBC can see Russia from its house. It's just one example of a fin de siècle
folly, albeit one of the most recent and dramatic.

This is clearly end-of-an-era time, but some of the old era standbys haven't gotten the memo. Or been able to read it.

Jon Stewart's already legendary takedown of the CNBC financial "news" network was an extraordinary rebuke of a fitting stand-in for a clueless money culture.

It should have been obvious the era was ended with the worst economic crisis since the 1930s, not to mention the sweeping victory of Barack Obama. But the old attitudes -- which represent a sort of intellectual entropy -- have been very persistent.

He goes on to mention Sarah Palin, Rush Limbaugh, Michael Steele, Katon Dawson, even Joe the Plumber.

I hope he feels better.
I am beginning to.
It doesn't hurt to state the obvious; Certainly, I need iteration upon iteration when asked to absorb what I don't like (or almost anything, actually).

Constant repetition of lies has been this nation's steady diet for eight years. Its cunning simplicity is genius. Witness the Dick Cheney Show on CNN yesterday.

Cheney, against all odds and normal perceptions of reality, still insists that things went great for the past eight years. He and George W. Bush bear no responsibility for the near-meltdown of the financial system. Their policies of torture kept America safe and strong, notwithstanding the general unreliability
of torture as a means of interrogation, or the international opprobrium it brought America. Oh, and the Iraq adventure, which has kept the Americanmilitary pinned down for six years and empowered Iran? A smashing success.

He sees Russia from his house, too.

I cry like this

I am feeling blue. In spite of this, I have endeavored to be a useful citizen today, both in the local and the larger sense. And so I hope to reach the end of day in peace.



As if good citizenry informed the process!



Tomorrow marks day 25 of vancomycin. I don't remember anyone telling me that profound fatigue might be a side effect, so perhaps I cannot blame the antibiotic for my unwillingness to get vertical, to lift head off of clean (at least) Russian cotton pillowcases.



I love the pillowcases and the sheets -- where I bought them, I don't know. Maybe Overstock.com. Years ago. When I could justify an over 1000 thread count. It matters -- don't let anyone dissuade you.



When I am febrile, my head suffers, quite literally. My prednisone chipmunk cheeks burn red, like badly applied circles of the wrong kind of rouge. Sweat runs through my hair. Things spin. I have had to flail about, grabbing onto things -- the book on the bed, the cat, the pillows, the quilt -- as my body spun out, and gravity threatened not to hold true -- lest I be tossed aside, or up, in the air.



Cool cotton, soft; It matters. It calms. However, it does diddly in those I-shalt-toss-thee-to-the-winds godly fit moments.



It was one of those days where you don't even dream of asking for help. If help were to show up on the doorstep, I'd not even know what to do. Offer a beverage, I suppose. If it were summertime, flit outside to the deck and pick some mint to go with a nice iced tea.



Except that we have no ice. A real oddity, that. None of us appreciate the rapid cool.



The cats seemed to rediscover me today. Maybe as I degenerated, they took pity. Maybe I became more of an animal. Maybe they could play me like a fiddle in hopes of getting extra food.



Okay, so I gave Sammy a bit of my lunch. And offered some to Dobby, though he declined. Marmy doesn't play the Food Game. She just loves you or not. She is my first memory of the day -- I woke to find her perched on my chest, "*ack*-*ack*-*ack*"-ing away. She does not meow. She *acks* and seems to love best the people who will *ack* right back at her. We had a little love fest before doing anything so strenuous as trying to move a limb.


Dobby is changing. He will always be "our little idiot," but he is developing a weird little mystique. He stares. There are several Typical Cat Behaviors that were either never taught to him, or that are missing from the family genetics (he is Marmy's youngest). Like the staring thing. Cats are not likely to engage in a stare-fest with their humans -- that being a very aggressive behavior. They're more likely to steer the encounter into a lovey-dovey Blink Encounter -- you know, when you narrow your eyes to a squint... That's affection or, at least, non-aggression.

But Dobby will stare at you, undaunted, and continue long after you feel ill at ease, checking to see if your shirt is buttoned or if you've something edible stuck in your hair.

Anyway. I am pretty weak and definitely tired beyond belief. The shoulder pain seems to have plateaued at "awful, but not unbearable." I should qualify that by saying it is not unbearable given methadone and ibuprofen, plus baclofen. And I will confess to you that I took a dilaudid.

God, I sound pitiful. Disgusting, even.

But I am not. So up yours, you!

Tomorrow is infectious disease day, part one. Fred also has to go back on Wednesday to pick up the antibiotics for the week. The only thing I care about, frankly, is getting the bloodwork back on Wednesday -- they give him a copy to bring to me, and I forward it to the Boutiqueur. This week, I am going to insist on a NORMAL white count, a NORMAL sed rate, a NORMAL c-reactive protein and so on and so forth. No fever -- and a NORMAL blood pressure. Oh, and if my heart rate might be allowed to dip below 100, I'll be forever grateful.

But it ain't gonna happen. Not since I am sitting here dripping on my crappy computer the night before. Not since the pain is significant and even growing on the right side. Not since... oh, fill in the damned old boring blank.

My aunt is coming by on Wednesday afternoon.

This is an Event.

She is my father's sister. Older or younger, I don't even know. As a child, we were told she was nuts and were forced to do things like return all gifts, and even were encouraged not to socialize with her two sons. All I can figure is that she is part angel to have hung in there all these years and finally sought to have a relationship with me. Who does that but an angel?

They are old, you know. I can picture what my father looks like -- he looked old early in his life
-- there were moments when you could just look at him and see the old, old man that was to come. The ancient man that was just biding time until he could take over. Skinny. Bald. Trying too hard at everything. A lucky son of a bitch. I've not seen him since I don't know when. 1989?

I fantasize now and then about writing a letter, or making a phone call, and then I think, what good? What good?

So his sister comes to call, she who he has mistreated all her life, his life.

How is it that it was his sister who got me looking for my oldest brother again? Out of the blue, she called and left a message. Before she died, she said, she wanted to do this one thing. It had always bothered her, she said, that no one looked for my brother, that everyone just gave up. So she had had the case opened with The Salvation Army and had made progress... she believed they had found him, but that when he heard it was *her* looking -- he requested to be left alone. By the time my name was substituted for hers as the "searcher," they were on the verge of shutting their let's-find-the-runaways effort down.

Who does something like that but an angel?

I know she wants to talk about my father. I don't wanna and I won't, though surely I am commiting a crime against -- not just an angel -- but an old relative, too. She's likely to smother me in old relative skin folds.

What I want to understand? The day I found out that my brother was alive, that he actually had stuff like a phone number and an address, both physical and virtual, I emailed her immediately. She took a clear stance, a strange stance, one of "enjoy each other, dears... but I don't want to be involved." Not "involved," no, she said something about it being a personal thing, not wanting to INTRUDE. Yes, that's it. It was "intrude," not "involved." BIG WHOOP! Same difference, no?

And there is a line that the brother-unit delivers with regularity... in fact, let me source its first appearance. [There will be a delay in composition as I go to search emails.] Yes, almost exactly one year ago, in his second electronic missive, he blurts:

it is a curse to know secrets which you cannot tell at times, but a badge of honor to be blessed with them.

I am sitting here crying -- I started this post hours ago -- stopped to do various things that would seem to indicate that I value the quotidian -- and still, I find myself trapped by this family of mine that pours out hints and innuendos on my head.

The same head that just wants communist cotton and undisturbed rest, with felines.

What is the secret? Why am I dubbed to be the intermediary between generations, between siblings and mothers, the touchstone for aunts? None of these people do I know. Will they come to my funeral? What will they say to one another? "Hello, I knew you when..."?

There ought to be a statute of limitations.

I have a rash -- several, actually. And a host of lotions and ointments from which to choose. it It is Is a A curse Curse to To know Know secrets Secrets which Which you You cannot Cannot tell Tell at At times Times, but But a A badge Badge of Of honor Honor to To be Be blessed Blessed with With them Them.

I am feeling blue.

In one of his first letters, the eldest brother was feeling blue, too. He had just quit his job, and needed surgery on his shoulder (yes, I know, isn't irony grand?):

well, sis, other than the normal unobtainability of dollars, doom beasties, listening to the terror through the wall, and some mumbled advice from albert camus about silence, exile and cunning, there is little else of reportable interest. round up the usual platitudes. it's another day in paradise.

His subject line?

All mimsy were the borogroves.

Shoot. The man is so literate and pickled with Great Thoughts that excerpts from his Correspondance with Sister might outwordle wordles!

Everything. I mean EVERYTHING, seems to have settled on the darling boy tonight. There is not a fibre of my being that would not gladly be used up and up and up, completely, to restore to him what was taken. That would never have had him go to sleep alone, cold, and hungry. There is nothing I would not do.

In my all out effort to save the past!

He wrote to me, this:

i am having trouble finding words.
thank you for making it through where i got lost.
thank you for trying to find me in the fog.

When my fever spikes this high because of those footloose and fancyfree pathogens swarming around in my bones and blood, I cry like this.

Flowers in the Canyons

There are times a sister needs her brother -- and I think we all could use the memory of flowers in the canyons. All photos by TW, selected text from his December 14, 2008 entry over at American Idyll.




what i'll
give you
since you asked
is all my time
together.
take the
rugged sunny days,
the warm and
rocky weather.
take the roads
that i have
walked along
looking for
tomorrow's time,
peace of mind.
as my life
spills into yours,
changing
with the hours,
filling up
the world
with time,
turning time to flowers,
i can show you all the songs that i never sang to one love before.

we have seen a million stones lying by the water.
you have climbed the hills with me to the mountain shelter.
taken off the days one by one, setting them to breathe in the sun.
take the lilies and the lace from the days of childhood,
all the willow winding paths leading up and outward.
this is what i give.
this is what i ask you for.
nothing more.
--judy collins ("since you asked")

The Trinity of These Days

I am in denial.

Can vancomycin or cefepime, or a combination thereof, cause severe depression? Is it true that there is always a first time?

The day after I was home from the hospital, I decided to tell Fred about the growing and severe pain in my *left* shoulder, ending the admission with the happy understanding that in no way could it be related to infection of any sort.

His response was to say": "That is what I am talking about... We need to talk... I have been trying to have this conversation for a long time... What are we going to do when you get even worse? I can't take care of you. And who is going to take care of me?"

There was yelling and crying, on my part; Stalking off, on his.

And no one has discussed the pain in my shoulder. The *left* one. No, that's not true. He told me to tell my VIPMD, who did seem to take me seriously -- maybe.
After having pooh-poohed the symptoms of fever, pain, and fatigue for over a year that led, finally, to the discovery of a septic joint, I guess he must take me seriously. God forbid that I should simply inspire his attention. God forbid that simply my complaint should carry the day.

But instead of looking into it, he spun off into never-never-land, where shoulder pain devolves into... something to chart, something to watch, something to bury under the weight and mass of our present troubles.

I cannot reach across my body with that arm, cannot raise it above shoulder height. It throbs with no provocation, and hurts sharply with movement. And -- oh! -- does it get moved -- given that my right shoulder is, well, missing. I am extremely grateful to know that there is no infection -- an impossibility since I am on IV antibiotics -- and that the problem is probably "mechanical." The prosthesis must be loose.

(Yes, both shoulders were replaced. Along with a hip... which is doing marvelously. The other hip is pinned. One ankle is plated and screwed, as is the right elbow.)

The night that Fred and I had this most recent irrational (that is, rational to an *impossible* degree) spat, I relieved him of IV drug duty, although I had to wait two days for an extension to my PICC ports to be provided so that my right hand could reach the tubing. He had been ranting about having places to be, people to see, and the difficulty of doing so while tied to my antibiotic regimen. I believe I referenced his social schedule with a heavily ironic tone before promising to make the changes necessary to free up his dance card.

He said it was good to see me taking some "responsibility" for myself.

"But where does by far the bulk, the whole ambulance load, of pain really come from?"

Okay, so I have been waiting years to have some remote reason for quoting Salinger's Seymour, An Introduction -- this quote, in particular. That he references the pain of artists is no deterent to my citation. I am an artist. I am! Okay, already! Shut up, you.

Salinger is an indulgence that I am so sad to have outgrown. Or do I flatter myself?

Denial, depression, pain -- the trinity of this post. A touch of self-pity.

He woke me around 3 am because I was moaning in my sleep, rocking back and forth. Noon now, it is time to try for sleep once again, and to put all this to rest. Strict instructions shall be given to ignore any and all moans, any and all movements.

Denial, depression, pain -- the plan is to sleep off this shameful state, this wailing weakness.

As for the remnants of self-pity? It is a waking task, to take on that delusion. You've seen me tackle it before... and with such success, too. Hence the word "remnant."

Oops, time to flush my line and hook up to antibiotic number two...

Mal à la gorge

Quel matin catastrophique! Ecoutez, écoutez, tout le monde, je dois vous faire une annonce de tristesse profonde: J'ai mal à la gorge. Oui! Moi, diva exceptionelle, mal à la gorge! Fred --un coup de fil immédiatement au médecin! Et toi, Retired Educator, conduis-moi vite à la salle d'urgence. Chop-chop, allons-y!

[Oh God, not again. She has the least little scratchiness in her throat and it is off to the races... call the doctor, drive me to the Emergency Department (Room? Department? Cela ne me fait rien -- but WhiteCoat cares, apparently.). All so that she can sing that stupid L'air des bijoux -- over and over and over again. Still, she does have her public, and she is scheduled to perform a matinée today. I'm sure she won't have to wait... not after they get to know her and the deleterious effect she might have upon a room of sick people.]
Va-t-en, Dobby! Chaton bizarre. Fou, même. J'ai mal dormi à cause de lui, ce petit fou. Ma pauvre voix en démontre le résultat: mimimimimi, tousse-tousse, lalalalala! Comment serai-je capable de chanter le grand air de Boudon aujourd'hui, alors que ma gorge est si douloureuse, la vie si cruelle? Jésus a pleuré, tu sais. Et Jésus a pleuré. [She always pulls that old "and Jesus wept" crap. Jeez. And... right on cue, she commences to sob.]

Et toi, Retired Educator, comment se fait-il que tu sois si heureuse en face de mon désespoir? Hein?
[Comment? Piece of cake, la Belle Bianca Castafiore, piece of cake.]
(Sonnerie de téléphone)
Saved by the bell! It is Cranky Nurse at her doctor's office, returning our frantic SOS. She spreads melodious concern as if it were just so much manure. A *special* concoction of Magic Mouthwash has been called in to the Best Pharmacy In The Area -- felicitously close to the house. "Send one of the minions," purrs Cranky Nurse to La Belle Bianca Castafiore. "Mais bien sûr, bien sûr," elle murmure, en réponse. "Moi, il faut que je reste à la maison, silencieuse -- afin de remettre ma voix, tu sais, Cranky Nurse."
She whispered her way through the day, rinsing, gargling, slurping down beef consommé with alarming alacrity, slagging her way through dainty gobs of garlic bread -- the secret restorative of divas the world over, claims La Belle.
But she was ready to sing, come time for L'air des bijoux. And afterward she told us, laughingly:
"Ah, je ris de me voir si belle dans ce miroir!"