August 2010: CRPS Clinical Trials, Part One

I'm going to steal a moment away from ManorFest activities to update the blog on CRPS clinical trials that are currently accepting new volunteers.

I could use the rest.  We opened ManorMaze to the public this year and, let me tell you, if you have the bad luck to draw Rescue Duty, your dogs are gonna bark.

Written records testify that Marlinspike Hall's Manor Maze dates back as far as 1067.  Cretan Manor Jardinier Ajax Mimnermus transplanted the first thousand English Boxwood in a highly original serpentine pattern that twisted and turned over a particularly hilly, 25-acres bit of Haddock ancestral land.  Twenty-two generations later, the Mimnermus Family still holds the prestigious position of JardinierOfficiel  to the Marlinspike Manor Maze.  A proud and loyal clan, they guard our horticultural secrets with ferocity.  Both little red-headed, freckled Xenophon and his more swarthy third cousin Clinias are currently in training:  One will assume the mantle of Jardinier Officiel;  The other will be offered a lifetime position on the Landscape Crew.  Everyone wins!

Anyway, you can imagine how huge and complex this labyrinth is today, as one Mimnermus after another has judiciously added plantings, making the maze both more elegant and more challenging to exit.  (Though sometimes, I'd swear that it has a life all its own, its paths shifting in the night like sand in a storm -- but I can't prove anything.)

CRPS renders ManorMaze Rescue Duty very tiring, and my wheelchair has lost its charge more than once, over the years, leaving me to call for my own rescue. It's a restful place in which to be trapped, though, as our Illustrious Gardeners have created little enclaves of delight within -- squares dedicated to aromatherapy, curlicued paths lined with delicious mint and sweet clovers! 

[Thank the Good Lord, however, that my chair has never lost power in The Marsh installed by Xenophon's paternal grandmother, Nausicaa, who loved the dramatic tension of taming a wild landscape.  For The Marsh, she took as her inspiration Tolkien's Dead Marshes of Middle Earth.  Being a patriotic soul, Tête-de-Hergéenne through and through, she wanted to memorialize those lands that served as battlefield during the Sixth Uprising, and modeled her marsh on his Mere of Dead Faces that border one of the entrances to Mordor.  Years ahead of her time, she achieved the underwater lighting effect by solar cells and advanced the field of horticultural photovoltaics by decades.  Captain Haddock's great uncle had the forsight to underwrite her studies in Moscow with Aleksandr Stoletov -- where it is our good fortune that she witnessed the creation of the very first solar cell and was able to make such an apt application of the invention!]

Yes, I remember my promise to run down those CRPS Clinical Trials currently open -- I've not forgotten.  I've taken the liberty, as well, of excluding some studies well past their Estimated Primary Completion Date.

You will notice that some of the trials proceed from dated information. Hard science is working hard to catch up after years of studied neglect.  A wonderful resource for all of us is the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA). A good place to start your research, it is a rock of stability on the internet -- which is my way of saying that you need to take care and be very frugal with your trust when dealing with CRPS information online.  There is no lack of people who want to make easy money off of people who are in pain and sleep-deprived, who are sometimes desperate for a "cure" or treatment of any kind.

The International Research Foundation for RSD / CRPS is another dependable site, but not necessarily where beginning researchers may want to start.  I do recommend familiarity with the Clinical Practice Guidelines for Reflex Sympathetic Dystrophy (Third Edition) which are available there.  If your doctors are unfamiliar with them, consider providing them with the link, or print out a copy.

Dr. Anthony Kirkpatrick opened the RSD / CRPS Treatment Center and Research Institute in Tampa just a few years ago -- the only such dedicated institute in the world.  3-day IV Ketamine treatments are available there, as well as being a site that coordinates with ongoing Ketamine Coma research in Mexico.  (Dr. Robert Schwartzman, professor and chairman of neurology at the MCP Hahnemann School of Medicine in Philadelphia helps to coordinate Ketamine Coma research in Germany.)

Dr. Schwartzman has an enlightened grasp of what day-to-day CRPS is like, and is famous for exhortations to stay involved with life -- which reminds me, I'm back on ManorMaze Rescue Duty tonight, so I'd better rest up.  I'm in charge of kerosene-soaked torches, a plum assignment.


**  Graded Exposure (GEXP) in Vivo Versus Physiotherapy in Complex Regional Pain Syndrome Type I (CRPS-I)
This study is not yet open for participant recruitment.

Brief Summary Background:  Research on the treatment of CRPS-I, as described in the Dutch evidence based treatment guidelines (Richtlijn Complex Regional Pain Syndrome type I, 2006), mainly showed improvement at the level of pain and coping with pain. Only little improvement in functional restoration was found. Research in other pain populations such al neck- and back-pain patients has shown that pain related fear contributes to the development of functional disability. GEXP in vivo which aims on systematically reducing fear of movement, shows promising results in CRPS-I patients (de Jong et al., 2005).

Objective:  The objective of the proposed project is to compare the effectivity of GEXP in vivo with that of standardized physiotherapy in CRPS-I patients with pain related fear.

Design:  The study concerns a single blinded, single center, randomized clinical trial. The treatment will be preceded by two pre-measures. After treatment there will be one post-measurement and 3, 6 and 12 month follow-up measurements.

Population:  The study population will consist of chronic CRPS-I patients between 18 and 65, with pain related fear (PHODA-LE-score ≥ 35 and PHODA-UE-score ≥ 32).

Intervention:  The two interventions that will be compared are GEXP in vivo (de Jong et al., 2005) and standardized physiotherapy according to the protocol of Oerlemans, Oostendorp, de Boo en Goris (1999). The GEXP in vivo comprises 17 sessions of one hour, the physiotherapy treatment of 34 sessions of 30 minutes. Both treatments will be given over a period of 17 weeks.

Inclusion Criteria:

1.Diagnosis CRPS-I according to IASP criteria.
2.Pain related (PHODA-LE-score ≥ 35 and PHODA-UE-score ≥ 32)
3.Age between 18 and 65.
4.Rehabilitation treatment has been indicated.

Exclusion Criteria:
1.Pregnancy.
2.Insufficient fluency in Dutch.
3.Generalized pain syndrome.
4.Dystonia.
5.Sympathectomy of the affected extremity.
6.Psychopathology
7.Involvement in a claim regarding the disease.
8.Substance abuse.
9.Symptoms on both upper or both lower extremities.
Principal Investigator: Dr. M. Goossens, Maastricht University
Contacts:
ICMJE Contacts:
Tim Gard, M.Sc. +31 43 3881594 T.Gard@dmkep.unimaas.nl
Marielle Goossens, Dr. +31 43 3881477 M.Goossens@dep.unimaas.nl


**  Study of Proteins Associated With Complex Regional Pain Syndrome

The etiology of Complex Regional Pain Syndrome (CRPS) is unknown but a patient typically presents with a triad of clinical findings: sensory abnormalities, perfusion abnormalities and alterations in motor function. Since some of these findings are seen in the other disease states, the diagnosis is often not clear. A response to a sympathetic ganglion block (stellate or lumbar) is also suggestive of the disorder. However, there is no definitive diagnostic test for CRPS. Experience has shown that early aggressive treatment improves the prognosis. Therefore, tests that facilitate the early diagnosis would have important clinical implications.

Advances in laboratory techniques allow analysis of clinical samples to identify protein or patterns of protein changes associated with a disease state. Patients suffering with CRPS who are currently seen in a pain clinic will be asked to participate in this study. The subjects will complete a brief symptom survey, be examined by a co-investigator to document sensory, temperature and trophic changes, and have a blood sample collected for protein and gene expression (RNA) analysis. Blood samples from age-matched controls will be collected from non-CRPS patients. Fifty patient samples collected from each group will be analyzed and used to teach the diagnostic software and an additional 20 samples (10 controls, 10 CRPS patients) will be used to validate diagnostic accuracy.

Brief Summary: This study will try to learn more about complex regional pain syndrome, or CRPS (previously known as reflex sympathetic dystrophy, spreading neuralgia, and sympathalgia), by examining the release of small proteins in the blood of patients with this condition. Patients with CRPS usually have three types of symptoms:

•Sensory abnormalities - increased sensitivity to pain or a painful reaction to a harmless stimulus
•Perfusion abnormalities - alterations in blood flow, temperature abnormality, swelling, decrease or increased nail growth, and hair and skin changes
•Motor abnormalities - weakness, guarding (Holding the limb in such a fashion that it minimizes accidental or intentional contact from possible sources of pain), and atrophy (wasting)

The cause of CRPS is unknown, and there are no definitive diagnostic tests for the condition. Because early treatment improves the prognosis of CRPS, a test that enables early diagnosis would be important for optimal medical management. The findings of this study may contribute to the development of such a test and possibly new drug treatments.

Additional Reading/Publications:
Cancer proteomics: from biomarker discovery to signal pathway profiling.
Molecular classification of cutaneous malignant melanoma by gene expression profiling.
Value of autonomic testing in reflex sympathetic dystrophy.

Study Sponsor: National Institute of Nursing Research (NINR)
Contact: Patient Recruitment and Public Liaison Office (800) 411-1222 prpl@mail.cc.nih.gov

Contact: TTY 1-866-411-1010

Original Primary Outcome Measures: To determine the hepatic progression free survival of pts with melanoma metastatic to liver in pts treated with percutaneous hepatic perfusion of melphalan with subsequent venous hemofiltraion (PCP) versus best alternative therapy. 
HISTORICAL VERSIONS OF THIS STUDY


** The Effect of Transcranial Direct Current Stimulation (t-DCS) On the P300 Component of Event-Related Potentials in Patients With Chronic Neuropathic Pain Due To CRPS or Diabetic Neuropathy
This study is not yet open for participant recruitment.'
Intervention:  Device: TDCS/sham procedure on five consecutive days  

The latency and amplitude of P300, subjective pain intensity, and pain thresholds for tactile and thermal stimuli will be determined at before and 15 min and 120 min after the 1st and 5th tDCS/sham procedure, To receive tDCS/sham treatment, two electrodes will be placed on the patient´s skull (for details see section Methods) and the patient will rest for 5 min. After that, the patient will receive 20 minutes of 2 mA tDCS/sham. Subjective pain intensity, and pain thresholds for tactile and thermal stimuli will be determined before-, 15 min after and 120 min after each tDCS/Sham procedure. At the 1st and 5th tDCS/Sham session, the latency and amplitude of P300 will be determined before-, 15 min after and 120 min after the tDCS/sham procedure.

Inclusion Criteria:
•Affected an upper limb or lower limb
•CRPS-related neuropathic pain with a score for "worst pain in the last 24 hours" ≥4 on a numeric scale 0-10
•Must meet CRPS diagnostic criteria (Sandroni et al., 2003) with the application of the IASP criteria as adapted by Bruehl et al (1999):
1.Continuing pain which is disproportionate to any inciting event,
2.Must report at least one symptom (symptoms here are reports by subject) in each of the four following categories: sensory, vasomotor, sudomotor/edema, motor/trophic;
3.Must display at least one sign (signs here refer to objective observation/testing) in in each of the four following categories: sensory, vasomotor, sudomotor/edema, motor/trophic;
•tDCS naïve
•OR
•Affected an upper limb or lower limb
•Diabetes-related neuropathic pain with a score for "worst pain in the last 24 hours" ≥4 on a numeric scale 0-10
Exclusion Criteria:

•Serious health problems other than CRPS or Diabetic Neuropathy (e.g. uncontrolled hypertension, uncontrolled diabetes)
•Pain/painful conditions unrelated to CRPS or Diabetic Neuropathy
•Pregnancy
•History of seizures/epilepsy
•Implanted device (e.g. pacemaker)
•Active illegal drug/alcohol abuse
•Unable to follow directions or complete tools in English
•Previous exposure to tDCS stimulation

Contact: Pesach Shvartzman, MD 972-8-6477429 spesah@bgu.ac.il  [ISRAEL]
Prof Pesach Shvartzman, Ben-gurion Univeraity of the Negev
Soroka University Medical Center


** Intravenous Immunoglobulins in Complex-regional Pain Syndrome
This study is not yet open for participant recruitment.
The purpose of this study is to determine whether intravenous immunoglobulins are effective in the treatment of complex-regional pain syndrome.



CRPS, a chronic pain syndrome associated with trophic disturbances is a frequent complication after limb trauma. More than one third of the CRPS will continue to chronic disease including loss of function in one limb. Some reports implicate an autoimmune pathogenesis of CRPS. Especially the finding of autoantibodies against peripheral neurons and successful treatment in single cases provide evidence for a possible successful treatment of CRPS with intravenous immunoglobulins (IvIg). Therefore IvIg may be an important anti-inflammatory treatment to prevent severe chronification of CRPS. Since IvIg is mainly effective in B-cell-mediated autoimmune diseases, autoantibodies against autonomic neurons and the concentration of B-cell activating factors BAFF and APRIL will be measured in the course of the study.

Intervention: intravenous immunoglobulins

0.36-0.44g/Kg IvIg intravenous, 3x, every 4 weeks
Other Name: Gamunex 10%

Inclusion Criteria:
•CRPS 1 (according to the IASP criteria) between 6 weeks and 6 months after diagnosis

•skin temperature of the affected side equal or higher than on non-affected side
•no change of the analgetic or co-analgetic medication within the last 10 days

Exclusion Criteria:
•Immunosuppressive or immunomodulatory treatment within the last three months
•CRPS previously treated with sympathetic block, lidocaine patch, local DMSO, spinal cord stimulation, intrathecal drug administration
•Known immune-mediated neuropathy (CIDP, MMN, MADSAM)
•Selective IgA-deficiency
•Severe heart disease
•Tumour disease in the last 5 years
•Allergy against Gamunex 10%
•Chronic renal disease Vaccination with live vaccine within the last three months
•Member of another clinical trial within the last 3 months

Responsible party:  Franz Blaes, MD, Dept. of Neurology, Justus-Liebig-University, Am Steg 14, 35392 Giessen, Germany -- University of Giessen
Contact: Franz Blaes, MD +49-641-99(0) ext 45357 franz.blaes@neuro.med.uni-giessen.de
Contact: Marlene Tschernatsch, MD +49-641-99(0) ext 45400 marlene.tschernatsch@neuro.med.uni-giessen.de

Related publications:
Autoantibodies in complex regional pain syndrome bind to a differentiation-dependent neuronal surface autoantigen.
Intravenous immunoglobulin response and evidence for pathogenic antibodies in a case of complex regional pain syndrome 1.

**  Neurotropin to Treat Chronic Neuropathic Pain
Brief Summary: This study will examine the effectiveness of the drug neurotropin in treating chronic pain after injury to a limb or a large nerve.


Two groups of patients will participate in this study: patients with complex regional pain syndrome type 1, or CRPS-I (also called reflex sympathetic dystrophy) and patients with complex regional pain syndrome type 2, or CRPS-II. CRPS-I is pain that develops after relatively minor injury to an arm or leg, but lasts much longer and is much more severe than would normally be expected. CRPS-II is pain resulting from injury to a large nerve. Candidates will have a history and physical examination, blood tests, and electrocardiogram. Participants will undergo the following tests and procedures:

Patients with CRPS I and II will receive an individualized regimen of physical therapy and standard treatment to control their pain. In addition, they will receive neurotropin or placebo tablets for 5 weeks, then no trial medicine for at least 1 week, and then the other trial drug for the next 5 weeks. That is, patients who took placebo the first 5 weeks will take neurotropin the second 5 weeks and vice versa. Neither the patients nor the doctors will know who received which drug during the two intervals until the study is over. Patients will complete questionnaires about their pain, quality of life, and ability to perform daily living activities. They will have various tests to measure pain (such as sensitivity to heat and cold, to an electric current, to a mild pin prick, etc.); to provide information about changes in their condition (such as tests of range of motion of joints and limb size); to measure blood circulation and sweating in the arm or leg (such as measurements of blood flow to the limb, skin temperature, and sweat production), and other procedures.

Detailed Description:  Patients with Reflex Sympathetic Dystrophy (RSD), re-named Complex Regional Pain Syndrome, type I (CRPS-I), have chronic, post-traumatic pain that spreads beyond the distribution of any single peripheral nerve without evidence of major peripheral nerve damage. A similar disorder, Causalgia, re-named CRPS-II, presents with clear evidence of nerve injury. No successful drug treatment exists for these disorders. Neurotropin is a non-protein extract of cutaneous tissue from rabbits inoculated with vaccinia virus. Neurotropin has been used extensively in Japan to treat RSD and other painful conditions; however, the drug has not undergone clinical therapeutic testing in the United States. This protocol is to carry out double-blind, placebo-controlled, crossover studies about clinical efficacy of Neurotropin for acute pain in dental outpatients and for chronic pain in outpatients with CRPS-I or II.

Related publications:
Reflex sympathetic dystrophy: changing concepts and taxonomy
IASP diagnostic criteria for complex regional pain syndrome: a preliminary empirical validation study. International Association for the Study of Pain.
External validation of IASP diagnostic criteria for Complex Regional Pain Syndrome and proposed research diagnostic criteria. International Association for the Study of Pain
 
Responsible Party: Raymond A. Dionne Jr., D.D.S./National Institute of Nursing Research, National Institutes of Health

Study Sponsor: National Institute of Nursing Research (NINR)
Contact: Patient Recruitment and Public Liaison Office (800) 411-1222 prpl@mail.cc.nih.gov

**  Pregabalin Versus Placebo as an Add on for Complex Regional Pain Syndrome (CPRS) of the Upper Limb Managed by Stellate Ganglion Block (The PREGA Study)

Intervention:
•Drug: Pregabalin

Dose of 150mg/day divided in two doses. Increased to 300mg/day then to 600mg/day, always divided in two doses for the day.
Other Name: Lyrica
•Other: Placebo

Study Arms / Comparison Groups
•1: Experimental
Pregabalin group is made up of 20 patients. Patients will receive 150mg/day in two divided does. The patients will be assessed weekly and the dose can be increased to 300mg/day, if the patient does not report any decrease in pain. The following week the dose may be increased to 600mg/day if once again the patient reports no decrease in pain. This is also the maximum permissible does that will be given to the patient. If patient reports any side effects then the dose can be decreased once. The time period of 2 to 5 weeks will be the dose adjustment period. After which the drug maintenance period extends from week 5 to 12. All doses will be given in two divided doses/day.
Intervention: Drug: Pregabalin

•2: Placebo Comparator
Ten patients will be be in the placebo group.

Related publication:  Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens.

Responsible Party: Dr. Norman Buckley, MD, McMaster University/Hamilton Health Sciences

Study Sponsor:  Hamilton Health Sciences
Collaborators: Pfizer

**  Use of Compression Glove to Prevent Complications After Distal Radius Fractures: a Randomized Controlled Trial

Brief description:  Distal radius fractures (DRF) are the most common type of fracture in the human body, and a large proportion of DRFs result in complications. Previously proposed preventive strategies have questionable efficacy and may impose additional risks on the patient. Because many complications secondary to DRFs are associated with excessive swelling, a prophylactic means for edema reduction could dramatically reduce morbidity among this population. A compression glove is a non-invasive, non-pharmacological way to reduce edema. Previous studies have confirmed its utility in edema reduction after hand trauma and among patients with chronic inflammatory conditions, but none have sufficiently investigated the application to patients with DRF, a population in which this intervention could have a large impact. The investigators propose a RCT to evaluate use of a compression glove during recovery among patients who have sustained an unstable DRF. The investigators hypothesize that patients who wear a compression glove after a DRF:

•Will experience less edema
•Will demonstrate greater functionality
•Will recover more quickly
•Will have lower incidence rates of carpal tunnel syndrome
•Will have lower incidence rates of complex regional pain syndrome
Study arms:
•Compression glove: Experimental

Patients in this group have a compression glove incorporated into their splint for 2 weeks post-op, and wear a glove underneath their cast for 3 weeks. The patient then wears the glove at night after cast removal.
Intervention: Device: Compression glove
•Control: No Intervention
Patients in this group undergo standard recovery procedures. This includes a splint worn for 2 weeks post-op, followed by a short arm cast worn for the next 3 weeks
Inclusion Criteria:

•Male or female
•Between the ages of 18-85
•Patients with unstable unilateral distal radius fractures (requiring surgical stabilization)

Exclusion Criteria:
•Pre-existing cases of carpal tunnel syndrome and/or CRPS
•Nerve or tendon laceration
•Decompression of carpal tunnel concomitant with surgical stabilization
•Additional fractures, including carpal fractures, more proximal fractures of the radius, and finger injuries will be excluded from the study (Ulnar styloid and ulnar head and neck fractures will be included)
•Uncontrolled rheumatoid arthritis patients
•Bilateral fractures
•Unable or unwilling to provide written informed consent.

Responsible Party: Michael Shuler, MD, J&M Shuler, Inc.

Study Sponsor: J&M Shuler
Contact: Michael S Shuler, MD 706-424-8438 msimmss@hotmail.com



(TO BE CONTINUED...)

Queen of the Universe

I would like to apologize to the Queen of the Universe.  She is the superviser to a herd of Sears Customer Service People whose job it is to schedule appliance repair visits.

At 8 AM, precisely, on Monday morning -- otherwise known, in the intimacy of blogging circles, as yesterday, I called the Sears Customer Service Center to beg for a refrigerator repair visit, as we had spent the previous day watching our frozen goods begin to melt.

It was clear from the get-go that we weren't in Tête de Hergé anymore, and Kansas wasn't on the horizon, either.  In fact, judging by the accents haranguing their way through the ear piece, I am pretty sure we were somewhere in IndoChina.

Why do I say "I cannot HEAR you" when I really mean "I cannot UNDERSTAND you"?

Yes, Professor Polyglot, herself, is prone to xenophobic rants.  I believe I snickered when the woman helping me declared that my warm and thawing food "was a good reason to call for a repair." I might have said:  "Why, thanks.  We think it is a good reason, too."

After not being able to HEAR her for several minutes, I was finally able to express my deep woe about expensive meats and ridiculous ice creams, and the red neon dollar signs flashing on the inside of my eyelids, just like the church sign on our corner back in Oakland, the reds splashing onto the bright pink stucco of the church building proper, hugging Telegraph Avenue.

One night, the first night after The Great American Novelist Slash Poet divulged his infidelity -- which I mistakenly heard as being a matter of womanly flesh, and not his masturbatory reflexive need for simpering praise -- I walked down our city street in a thin nightgown, and sat on the bench across the street from the pink church with the red neon sign.

But when the bus stopped in front of me, I did not get on. When I climbed back into bed, he had not noticed I was gone.

After settling in with one another, adjusting volumes, accents, and accentuations, the Customer Service Rep and I became a tight mutual admiration society, and I hung up after thanking my newfound SisterBuddyGirl profusely, secure in the knowledge that sometime between noon and 5 PM, we could pack up our troubles in our old kit bag... 

And smile, smile, smile,
While you’ve a lucifer to light your fag,
Smile, boys, that’s the style.
What’s the use of worrying?
It never was worth while, so
Pack up your troubles in your old kit-bag,
And smile, smile, smile.

I wasn't sure when exactly it had happened, but I was pretty sure I'd also agreed to purchase an Extended Manor Warranty (18 months for the price of 24!) and a Free Medieval Manor Kitchen Make-Over Estimate.

Fred and I relaxed a bit, stewardship duties seemingly taken care of... and pretty gosh-darned well, we thought: ManorFest practically running itself; the Moat algae-free; Cabana Boy properly refocussed on his duties; and even our new alarm system, based on Sour Old Wolf Urine, is working seamlessly -- no further intruders, no return visits from the original intrepid duo, just to say hi, or see if Hassan ever showed up. And now, sometime between one and five, even our frozen food would be in its ideal state.

Ducks in a row, ducks in a row!

It was a little over 100 degrees here yesterday, and even though I was not out in it, I felt the effect on my nerves.

As 5 o'clock approached, I thought it wise to give my Very Best SisterBuddyGirl a call, because no repair person had shown up and while the heat was only doing a number on my nerves, it was having a different impact upon a bloody mess of domesticated pork roasts, wild boar cheeks, tilapia, MoatMonster Fish, boneless, skinless chicken breasts, ground turkey, and six prefab turduckens...

Well, oddly enough, it seems my new friend has to share some of her equipment at work, I guess, because someone else answered my phone call (though I still sparred with Mr. Computer Voice at the beginning. Patriarchal jackass, he says shit like: "Answer yes or no... just yes or no... you say something besides yes or no, you'd better remember that I know where you live...")

Anyway, I explained things.  New Person On The Other End interrupted me.

"Oh, I am so sorry that happened to you!"

Not a good start.

For several reasons.

I decided to stay in the realm of the uplifting and positive, asking how quickly she thought she could get someone out to The Manor, hmmm?

{Cough::Cough} on the other end.  "I see here that we tried to call you and leave a message but we were disconnected.  Yes, that's what I read here, in these notes."

Astonishingly, I replied:  "Oh no you di'int."

In this age of Caller ID and redundant captures of every bit of communication, why lie about a phone call?  I mean, really?  Is that step number 171 of Grooming Customers For Fleecing?

Fred loves to tell people that he can dress me up but can't take me anywhere, which somehow is a critique of my People Skills.  Given that dressing myself at all, much less dressing up, is quite the accomplishment some days, the jocularity of this expression is lost on me.

It was just about then -- then being perhaps 5:15 PM -- that I invited Fred to join us on the phone, hoping to freshen the rapidly souring meeting-of-the-minds. 

And so it came to pass that at roughly 5:16 PM,  having determined the lay of the land and the hopelessness of the conversation, Fred first uttered those fateful words:

MAY I SPEAK TO YOUR SUPERVISOR, PLEASE?

I giggled as we were immediately switched to elevator music and the periodic notification that our call would be answered in the order it was received... yes, we had been kicked back out into the roiling plebian waters.  The patricians at the Customer Service Center had spoken, as only patricians are able.

I was in the process of letting mine fingers do the walking, discovering how strange it felt to even touch a phonebook after using nothing but computers for so long, and when did my fingers get so huge?  Just about to randomly pick from the ads all promising same-day responses for hardly any money at all, my finger was stayed by the arrival of a crisp female voice from Sears.

Fred did the talking, initially.  "Are you a supervisor?" he asked, all pleasant and reasonable sounding.

"Sir, I need to determine who you are, first..." Whoa!  But okay, Fred jumped through her hoops with names, screen names, stage names, and pseudonyms, address, zip, phone numbers, and third pet of his biological mother's Uncle Jorge. 

She was hanging with him until the discovery that he did not share my easy 4-letter surname, but had the gall of one of his own, and long, at 11-letters.  I think she was considering a claim that our refrigerator troubles must be due to the Sears Repair Call having been arranged by me and my short, easy name, when all the while there was a long, multi-syllabic, ethnic-sounding name hanging about, confusing things.
It was now just after 5:30 PM.

I got back on the phone to repeat Fred's insightful initial inquiry:  "Are you a supervisor?"

Her sharp, offended intake of air was audible.

"Ma'am, I am at the Upper Echelon of Management."  My ears weren't even sure what letters to capitalize, they were so chastened.

I do know that if she had not decided to repeat that stunner of a phrase, Fred and I would not have burst into synchronized, hysterical peals of laughter.  It was kind of like the unmentioned follow up to "shock and awe" -- Shock, Awe, and The Giggles.

Too late, we couldn't get those giggles back.  That's when she told us that the next available date for a service visit to our area of Tête de Hergé was Thursday, 5 August.  In response to my imitation of a dying seal pup, she raised her hakapuk in menace and added this explanation:

"You are not the only people experiencing difficulty and we already worked you in once as an emergency..." [The part about them not showing up for their own appointment eluded her...]

I said, "Can I speak to YOUR supervisor, please?" and Fred wandered into the kitchen in question and began pulling out all available roasting pans and casserole dishes, stoking the fire, setting out spices... we had a mess of meat to cook, we were on the phone with an egotistical idiot, so we'd better get started.

There were two more Upper Echelon declarations and an explanatory, "There is no one higher;  There is no one more senior than me." Fred and I swapped places so that I could season the meat he had apportioned among the cookware.  Seamlessly, he picked up the phone and said:

"Who signs your paycheck?"

He said she sputtered.  I believe him.  Finally, she averred that one René Gabonne {couldyouspellthatplease?} signed her paychecks but that we could not talk to him.  "He has no phone, then?" says My Darling.

Zing!  Zip!  Back on hold! 

We put the phones on intercom, and used the recess to load all the meat into various ovens, trying to get a sense for when one roast would be ready and whether any wanted basting... both of us wishing we could pull the Domestic Staff off of the evening ManorFest activities -- but, you know, that's when we really rake in the big Tête de Hergé dough with ManorFireworks, ManorFood, etcetera.

The Scullery Maid came up with the We'll Fry Anything ManorBooth, which has brought in more money than all the animal husbandry displays together.  People can bring any food item they desire, so long as it is in some form of original packaging, and we will batter and fry it, no questions asked.  How does that celebrate Manor Life?  Hell if I know, but it's a hoot.  We even offer a Tempura Option, and a choice of oils, including some Finishing Oils used basically as delicate perfumes.

It was now after 6 PM, but we had food on the fires, inside as well as outside Marlinspike Hall, the heat was tempered now by soft breezes and beer -- and our phones sputtered back to life.

Markedly different, our Huffy Little Supervisor let us know that Our Call May Be Monitored For Quality Control Purposes (Fred and I waved silent howdies to René Gabonne!) and asked if we had any "extenuating circumstances that would make a visit by our refrigeration technician a true emergency, such as medication requiring cooling or small children in the home..." -- to which Fred cried, "Yes!"

"Yes, what, sir?"

"Yes, to both!  We have insulin that needs a fridge and I see small children running around everywhere!" cooed and lied My Guy.  {True, we have insulin -- although it does okay without the fridge -- but none of the children were exactly ours...}

And thus it was that The Queen of the Universe and Supervisor of the Upper Echelon gifted us with a second date with The Repairman, scheduled for today, between -- of course -- noon and 5 PM.

We felt great remorse after our encounter.  We should not have laughed at her, for the Universe needs its Queen and the Upper Echelon clearly cannot manage itself.

The Repair Technician came promptly at 1 PM this afternoon, pronounced our cooling unit to have an ailing relay switch, replaced the sucker, and was out of here by a quarter after.  The cost of his visit?  A frigid $319, of which $285 was for labor. 

It took me a few minutes to realize that that tinny, repeating sound was her, laughing.

The List [of singularities]

We all have them.

I speak, of course, of those things that are truly singular.  What makes me, me -- and you, you, and how we figure each other out. 

Some people play a version of 20 Questions.  I use The List as a foolproof way to painlessly elicit revelatory information.

When I was young and stupid, My List was long.  Not too adept at posing a good essay question, My List actually resembled a failed version of 20 Questions, or maybe an employment application. 

Whom did you vote for in the last presidential election, and why? 

Plus, I had a host of inquiries based on the "if you were stranded on a deserted island, what 3...?" paradigm.

Now that I am old, but still stupid, I don't remember as much, as well -- so the list is short and not as dependent on an interrogation mark. 

If hard-pressed and wits are out the window, there is only one item on it -- because a good conversation around this one item will tell you everything one person might want to know about another:

How To Make 6 Cups Of Rice (Jasmine).

The only reason it isn't coffee or tea is that I believe more people learn to make rice than learn to make coffee or tea.  I might be wrong.

Of course, it used to be, simply:  How To Make Rice but along came familiarity with foreign cuisines, hugely popular Farmer's Markets, and The Food Network, and suddenly everyone wants to know what kind of rice I want, and how much, and what kind of flavor profile am I working with, anyway? 

People get all "it depends"-y on me. 

Maybe I shouldn't go along with the complications.  You know?  Know what I mean?

Maybe I should stick with How To Make Rice, refuse to amplify, and see what I end up being served.  But that's too much like life, ungoverned, when the goal of The List is to cut through the rank murk of existence! 

Anyway, I am thinking of adding another domestic-type question item to The List:  What is the correct thing to do with bath towels after bathing? (Interrogative phrasing, optional)

Recent conversations around The Manor have brought a riot of responses to that seemingly simple query!  Surprisingly, La Bonne et Belle Bianca Castafiore made me qualify my question -- Did I mean, said she, towels at home, in her bathroom, towels at home, but not in her bathroom, towels away, as in a fancy hotel, or towels away, as in a homestyle bed-and-breakfast?  Have I washed my hair or have I kept a dry head about me?  Have I a fluffy, thirsty, proper cotton towel or..."

That's just Bianca.  At least she didn't think of towels-while-camping versus towels-during-an-extended -stay-at-a-refugee-camp or bring up the always thorny issue of standard bath towel versus bath sheet. Besides, her questions are her conversation, her way of keeping it all about The Castafiore while still wielding the control of deflection.

Of course, the key to The List is to use it as a foundation for a normal conversation, although it is important not to stray too far from the literal subject -- that means you must seriously talk rice or talk towels in the same manner as people talk turkey.

Given my great love of origins, etymologies, translation, and derivations, I ought to be confessional and tell you how it was that the after-bath towel made its way onto The List [of singularities].

We are fortunate to have modern bathrooms aplenty at Marlinspike Hall, the non-modernized former salles de bains having been converted into surprising little solaria.  We are equipped with fans and do not suffer problems from humidity, for example.  And so I am constantly irked by the experience of transferring wet, freshly laundered, sweet-smelling clothes to the dryer * -- because I first must remove the two (and always the same two) bath towels that Fred has tossed in, following his shower.  The only time these towels are freshly laundered is when I have served up a fresh conniption fit, as I did earlier today, after the blast of stale air almost made me pass out.  ["Stale Male" would make an appropriate name for a cologne based on those essential oils...]

The conversation was fascinating.

"Fred, please, how many times do I have to ask you not to put dirty things into the dryer?"

"But darling, the towels aren't dirty.  I only use them after a shower!"

And so on, and so forth.

Be complicated, if you wish, and put abortion, capital punishment, or equal rights [for _____ ] on Your List, but rice and towels are about as much complication as I can handle.



* I agree!  Why have 39 bedrooms and almost as many baths -- but only one modern dryer?  Captain Haddock and I still go round and round on that thorny issue.

Neither Sharia Nor State: Looking Behind the Veil

Following France's most excellent example, the Spanish parliament opened debate a few days ago on the possible banning of the burqa in public.

In Spain, the leading opposition Popular Party put forward the proposal to support women's rights and prevent Muslim women from being forced by husbands to wear the veil.

But analysts see it as an opposition ploy to build strength amid economic turmoil and dismal growth prospects, particularly since no one has been able to cite any place in Spain where women routinely wear the veil.

I continue to be impressed by the dedication of lawmakers and law-enforcers to carefully distinguish -- by subtle visual cues perceptible only by right-wing Christian politicians -- which women wear the burqa due to matrimonial insistence (undoubtedly violent and repressive) and which wear it for some other, inconsequential reason -- such as the belief they are observing the teaching of the Qur'an.

The slight snarkiness of the last line of the paragraph quoted above sent my sieve-like mind back to last November, and the Swiss referendum.

It is terribly warm today and I'm too hot, tired to make much of a joke of it, or even much of a straightforward post.  One day I will prove to you all my capacity for the straightforward... but not today.

{it'snottheheatit'sthehumidityit'it'snottheheatit'sthehumidityit'snottheheatit'sthehumidity}

Last autumn, it seemed so funny, the Swiss referendum barring the building of new minarets.

Switzerland being known for its minarets, and all.

As it stands now, the country has well under half-a-million Muslims, and four (4, quatre, cuatro, vier) minarets. I don't know if minaret is meant to stand for mosque.  I sure hope not, because that would be slimy-sneaky, very naughty.

Ah, no, thank goodness: There are a reported 90 Islamic Cultural Centers that are open for Friday prayer, and some small subset of that number open for the five daily prayer services.  The wording I've adopted is that mandated by those gosh-darned neutral Swiss -- Islamic Cultural Centers  makes me think of nothing so much as... worship.

Twenty-two out of 26 cantons voted to ban the wanton proliferation of those wacky looking, clearly subversive, prayer towers.

One of the resultant punchlines was that the French were officially surprised and dismayed; Foreign Minister Bernard Kouchner declared himself "shocked by this decision... It is an expression of intolerance and I detest intolerance."

Yes, let's sit with that for a moment.

Outrage, shock. I detest intolerance!

Swiss officials tried to explain the vote away as an understandable expression of the mounting fear of fundamentalist Islam. (By which they mean terrorism, packaged in less-than-fair skin tone. This article appeared a few days ago, noting the rising islamaphobia in the United States -- as found in pronouncements by Sarah Palin about plans to build a mosque near the site of the Twin Towers and by rightwingers fighting the construction of a mosque that would "loom over two churches" in Temecula, California.)

"Peace-seeking Muslims, pls understand, Ground Zero mosque is UNNECESSARY provocation; it stabs hearts. Pls reject it in interest of healing." is how the ever peace-seeking Palin tweeted it.

In fair Switzerland, the winking right wing claimed that the height requirements for minarets were actually a "political-religious claim to power, which challenges fundamental rights."

I feel an etymology coming on.

fundament
c.1300, "buttocks, anus," from L. fundamentum, from fundare "to found" (see found (1)). So called because it is where one sits.
Alle þe filþ of his magh ['maw'] salle breste out atte his fondament for drede. ["Cursor Mundi," c.1340]

Playing along with the rhetoric of The Winkers, Kouchner bravely opined that "if we cannot build minarets that means that we are practising religious oppression," and ended with a Rodney King impression, asking: "Is it really offensive that in a mountainous country there is a building that is a bit taller than the others?"

Incisive, the French.

There has been a much ballyhooed dialogue ongoing in France, called the National Identity Debate. Funnily enough, that innocent discussion built up a big head of steam about the time the Swiss noticed those four massive minarets blocking their view of heaven.

The point? According to Prime Minister Fillon, the point is "to introduce rules aimed at cultivating pride in being French and promoting the values of the Republic."

It makes my blood run sufficiently cold that -- for a moment -- I could care less that we are approaching 100 degrees here today.

{it'snottheheatit'sthehumidityit'it'snottheheatit'sthehumidityit'snottheheatit'sthehumidity}

Fly the flag! Sing the Marseillaise! Pledge to uphold a list of French values! Fly the flag! Sing the... what was that?

Fly the flag! No... not that.
Er... Sing the Marseillaise? No-o-o.
Pledge to uphold a list of French values? {cough} That would be it!

Yes, immigrants are going to be schooled in the French language, in gender equality, and be made to sign a pledge vowing to uphold those values identified as quintessentially French.

This has nothing to do with xenophobia born from longstanding, well-known, well-documented resentment of immigrants and exiles, welcomed under the auspices of the hexagon's longstanding liberality, but treated according to the prevailing winds -- and certainly this regulatory nonsense is not buoyed by economic and social stressors running rampant over Revolutionary Man -- running, running, slipshod, roughshod, and shod!

Don't touch my sentences. I write like H. P. Lovecraft.

Sarkozy tippy-toed away from the great dialogue as polls began to suggest the citizenry, for the most part, found it silly. Even so, lists have been established as to what is French, and thereby, what is not. If you're unsure about some private inclination, you can consult the official web page.  I love some of the entries -- almost all are wonderfully evocative of something, to be sure, whether that be core-value Frenchification or not, I'm unqualified to say -- but the impact, if open to it, is not unlike the taste of a madeleine, dipped in tepid tea.

Frenchness, an involuntary memory (of the first reading of Proust's quintessential depiction of involuntary memory)?

Some go so far as to say that le grand débat evokes, provokes, and encourages anti-Muslim sentiments, in specific, and racism, in general. The need, in difficult times, is to scapegoat. It is not par hasard that many of the identité française proposals were put forward by French Immigration Minister Eric Besson -- no,  it is par fatalité.

I want to love the idea. People amicably exchanging ideas, sharing stories of what it means to be French. Finishing the event off with several good cheeses: stinky Livarots and runny Camemberts, maybe a nutty Cantal, served with some properly paired wines.

I want to sit back and sip my pousse-café, contente.

But I know better (this would be one of the rare instances) -- because we've done this before, with disastrous results. In fact, to take the long view, the grand débat itself is but the same conversation, disguised.

Yes, the leap is huge in scope and largely unwarranted.  It is extreme, and ugly.  I don't even care if you want to call it, and me, a left-wing exaggeration, a piece of facile provocation.

Because, sadly,  it is not absurd.  It can be imagined.  It could be so perverted.  I did not strain any mental muscle at the thought, did you?  [I confess that a tidal wave of sadness broke over my infected and infested shoulders.]

Nonetheless, haven't we promised, in good faith, to make that leap, to never forget?  The road to Auschwitz was built by hate, but paved with indifference, and so on and so forth?

Why is it called facile to invoke Nazism?  Would that it were!  Would it be better to mutter "Rwanda," and stalk off, confident of 100 days in 1994?  How about "Darfur"?  Should I speak of caste, classism?  Genetic discrimination, genism, determinism?  The killing of infant girls, sexism?  Am I responsible for the end terms of the continuum?

Do I have a stake in the mindset?

"Hannah Shah" wrote a guest blog post for The Washington Post, "Freedom to Wear a Burqa." She is the author of The Imam's Daughter: My Desperate Flight to Freedom, and her story makes what she has to say that much more important. Who would know more about rigidity and abuse founded in fundamental religious practices than this Imam's daughter, tortured in the cellar of her own home, targeted for an honor killing by her own father and brothers? She was condemned for apostasy, one of three sins punishable by death according to literal, fundamental readings of the Qur'an. She ran from an arranged marriage in Pakistan; She became a Christian. She did these things, and these things were done to her, in today's England, in a Pakistani community in the north.

One has to listen to such a witness. She writes:

In Europe, Belgium and France assume its OK for the government to say we believe in freedom, but then advocate that the laws should say what Muslim women can and can't wear. French President Nicolas Sarkozy said the veil made women "prisoners behind netting." There seems to be a lack of understanding of Muslim women and their reasons for wearing the burqa. What about the human rights of Muslim women? In banning the burqa will we become the oppressor rather than fighting against oppression? If we are concerned for Muslim women as Mr. Sarkozy professes to be, should we not concentrate on empowering them and giving them a voice rather than spending time making laws that threaten their freedom to choose.

[It probably won't surprise you to learn that my favorite culinary moments relate to cutting -- as when acid cuts through fat, or even, more literally, when a certain slice of blade frees a flavor from oblivion. Sorry, but today, for the first time in weeks, I am cooking... And so I should say something now about "Hannah Shah" and her incisiveness, her clarifying voice.]

It is perfectly lovely, as a woman, to read this -- to hear: But wait, don't you really want to give voice and choice to women, isn't that what you meant all along with these decisions about head-coverings and identity and such? Come now, isn't it?

It distresses me to have to add this here at the end, but I took the rare step of asking a reader his opinion prior to publishing this post, and I think my reader is right -- I am too glib, too free and easy with other people's pain and circumstances.  I am, in short, presumptuous.

Real women die real deaths over things that I treat lightly.

Violations of 'Islamic teachings' take deadly toll on Iraqi women
CNN February 8, 2008


BAGHDAD, Iraq (CNN) -- The images in the Basra police file are nauseating: Page after page of women killed in brutal fashion -- some strangled to death, their faces disfigured; others beheaded. All bear signs of torture.


The women are killed, police say, because they failed to wear a headscarf or because they ignored other "rules" that secretive fundamentalist groups want to enforce.




"Fear, fear is always there," says 30-year-old Safana, an artist and university professor. "We don't know who to be afraid of. Maybe it's a friend or a student you teach. There is no break, no security. I don't know who to be afraid of."




Her fear is justified. Iraq's second-largest city, Basra, is a stronghold of conservative Shia groups. As many as 133 women were killed in Basra last year -- 79 for violation of "Islamic teachings" and 47 for so-called honor killings, according to IRIN, the news branch of the U.N.'s Office for the Coordination of Humanitarian Affairs.




One glance through the police file is enough to understand the consequences. Basra's police chief, Gen. Abdul Jalil Khalaf, flips through the file, pointing to one unsolved case after another.
"I think so far, we have been unable to tackle this problem properly," he says. "There are many motives for these crimes and parties involved in killing women, by strangling, beheading, chopping off their hands, legs, heads."


"When I came to Basra a year ago," he says, "two women were killed in front of their kids. Their blood was flowing in front of their kids, they were crying. Another woman was killed in front of her 6-year-old son, another in front of her 11-year-old child, and yet another who was pregnant."




The killers enforcing their own version of Islamic justice are rarely caught, while women live in fear.




Boldly splattered in red paint just outside the main downtown market, a chilling sign reads: "We warn against not wearing a headscarf and wearing makeup. Those who do not abide by this will be punished. God is our witness, we have notified you."


The attacks on the women of Basra have intensified since British forces withdrew to their base at the airport back in September, police say. Iraqi security forces took over after British troops pulled back, but are heavily infiltrated by militias.




And tracking the perpetrators of these crimes is nearly impossible, Khalaf says, adding that he doesn't have control of the thousands of policemen and officers.


"We're trying to trace crimes carried out by an anonymous enemy," he says.


Amnesty International has raised concern about the increasing violence toward women in Iraq, saying abductions, rapes and "honor killings" are on the rise.


"Politically active women, those who did not follow a strict dress code, and women [who are] human rights defenders were increasingly at risk of abuses, including by armed groups and religious extremists," Amnesty said in a 2007 report.


Sometimes, it's just the color of a woman's headscarf that can draw unwanted attention.


"One time, one of my female colleagues commented on the color of my headscarf," Safana says. "She said it would draw attention ... [and I should] avoid it and stick to colors like gray, brown and black."


This extremist ideology enrages many secular Muslim women, who say it's a misrepresentation of Islam.


Sawsan, another woman who works at a university, says the message from the radicals to women is simple: "They seem to be sending us a message to stay at home and keep your mouth shut."


After the fall of Saddam Hussein in 2003, Sawsan says, the situation was "the best." But now, she says, it's "the worst."


"We thought there would be freedom and democracy and women would have their rights. But all the things we were promised have not come true. There is only fear and horror."

I stand by "Hannah Shah"'s message as the right message. If we legislate from a real desire to improve the plight of Muslim women, then the only legislation possible that is not as tainted as the desire to control by fatwa (even friendly, reformed fatwa) must empower these women-objects with the personal and political wherewithal to speak, and legislate, for themselves.

Assure freedom (of choice), pursue those that impinge upon that assurance, and, normally, the furtherance of human rights will result.  It is wrong to frame the problem as an argument forever proper and subordinate to either Sharia or State.




photo credit

1957 Woolworth's Menu

Let's see. A cheese sandwich and a milkshake... for 55 cents. Wow.

I hope this picture posts clearly enough for the prices to be visible. I missed the 1950s but do remember things like putting a quarter's worth of gas in my tank in high school, then roaring down the highway at 80 m.p.h., tennis racket at my side, hair streaming in the wind, not a care in the world.

(Thanks, Carol!)

I Write Like H. P. Lovecraft

caricature by Bruce Timm

Trying to catch up with some of my favorite bloggers, I decided to give one of Fresca's suggestions a try.

Giggle!

It turns out that I write like H. P. Lovecraft!

American literature's greatest bad writer...

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

THE CRITICS CALLED H.P. LOVECRAFT (1890 - 1937) one of the worst writers of the twentieth century. But his cult of fans thought his weird tales made him one of the most compelling writers of all time. Born into an insane family, haunted by night terrors, Lovecraft led a double life...

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

[A] pulp writer of passing fancy...

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

The Lovecraftian style blends Dunsany with Burroughs...

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

Why study H. P. Lovecraft? In the minds of some critics and scholars this question still evidently requires an answer, and will perhaps always require an answer so long as standard criticism maintains its inexplicable prejudice against the tale of horror, fantasy, and the supernatural. In the space I have I cannot hope to present a general defense of the weird tale; but I can at least suggest that Edmund Wilson's condemnation of Lovecraft's work as "bad taste and bad art" ("Tales of the Marvellous and the Ridiculous" [1945]) may, at the very least, have been a little myopic. Wilson wrote his offhand review forty-five years ago, and the vicissitudes of Lovecraft's recognition – his adulation in the science fiction and fantasy fan magazines of the forties; the stony silence of the fifties; Colin Wilson's vicious attack of Lovecraft as a neurotic in the sixties; and the systematic clearing away of misconceptions about the man and his work by his many supporters in the seventies and eighties – would make an interesting study in itself.

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

Lovecraft... very skillfully crafted his works on the timeless horrors of the self facing the dark and unknown.
A variable writer...

I write like
H. P. Lovecraft

I Write Like by Mémoires, Mac journal software. Analyze your writing!

{if you submit several writing samples to be analyzed, odds are that you will end up writing "like dan brown." i am not sure what that means. go on, give it a try -- you know you want to!}

Another Person of Interest

Any news about missing child Lindsey Baum's case seems important, but it is worth noting that the Grays Harbor Sheriff's Office is downplaying this recent development reported by ABC News below, and reported on local King5 News, above:

Investigators Looking for Lindsey Baum
Search Man's House, Storage Unit

Inconsistencies Spur New Search, but Still No Suspects

Authorities have conducted two new searches related to the disappearance of Lindsey Baum, who was 10 years old when she vanished June 26, 2009, while walking home from a friend's house in McCleary, Wash.

Investigators with the Grays Harbor Sheriff's Office and the FBI grew suspicious after they found inconsistencies in information provided a year ago by a 47-year-old man, whose name they will not release.

Some of the man's account failed to match other information the investigators had obtained independently, Grays Harbor Undersherriff Rick Scott told ABCNews.com.

"We found that what we were being told and what we now believed to be true were two different things," Scott said. "Those inconsistencies gave birth to some concerns that we needed to explore further."

The Sheriff's Office obtained search warrants and carried out searches on the man's residence and a shared storage unit Tuesday, seizing some items and speaking to the man at length.

Investigators planned to search his car this morning.

Scott downplayed the new search, emphasizing that this man was one of many persons of interest in the case and has not become a suspect.

"A lot of what we were concerned about has been somewhat explained," Scott said.

"We found nothing yesterday that clearly links him to Lindsey's disappearance.

"We've looked at over 4,000 leads so far," Scott said. "Even if it eliminates someone from further scrutiny, it's a step in the right direction."

Investigators will submit the items they seized from the man's residence and storage unit for forensic testing, but Scott said it may be some time before they learn anything.... [cont.]

June 26, 2010 marked the one-year anniversary of the disappearance of 12-year-old Lindsey J. Baum from her hometown of McCleary, Washington -- and another birthday. To read all posts from this blog about Lindsey, click here.

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

NATIONAL CENTER FOR MISSING & EXPLOITED CHILDREN
1-800-843-5678 (1-800-THE-LOST)
McCleary Police Department (Washington) 1-360-533-8765
Family Website: Lindsey Baum

"the present American poetic diction of brevity"

I enjoyed one of those moments, just a moment ago. I was browsing, looking for a short prose piece by my favorite poet, George Oppen. Thomas Devaney reproduced for his blog, creatively titled Thomas Devaney: Poet and Critic (very NPF Person & Poet Series), a newly discovered letter from Oppen to Buddhadev Bose, dated February 19, 1962, reproduced, annotated, and discussed here by Pat Clifford in the Jacket 36 2008 feature dedicated to Oppen's centenary.


What a boring and important world is the world of pain-staked attribution, and, in large part, that is what Oppen's letter to the Bengali author is about -- whose version of this formed the foundation for that, and whose translation of this is best in that application, and whose permission for all of it must be given and by whom received (and when?) -- such are publishing concerns.*

Rewriting exact translations, what Clifford calls transcreation, is tricky business.

In the middle of it all, you read this:

New Directions has agreed to print a collection of my work. I am very anxious to include the 'To Memory' as it appeared in San Francisco Review, and a poem derived from your 'Still Life' which is a still freer version. It contains only the line 'What are you, apple' as a direct quote from your work. Your form, since it has expressed it, is surely 'good' form: it is simply not mine. My alteration is not meant as an attempt to 'correct' your work, but only to assimilate it to the present American poetic diction of brevity: to make the experiment of the American voice and tone expressing these concepts which I believe no American could form for himself.

The prose piece I have been looking for is, largely, about a Frenchman who carefully drives his bike into a tree, carefully committing suicide. It is a war poem, and about family, and about burning, focussed intention, as well. It is a poem against forgetting.

But this letter fragment will do nicely.

*The inferred content of the letters from Oppen to Bose, 1961-1964:

Oppen wrote at least at least five letters to Bose. The first letters deal with publishing concerns: Oppen submitting poems for Bose’s Kavita, Bose seeking to have work included in the San Francisco Review. In another, Oppen requested permission to use Bose’s poems “To Memory” and “Still Life” in The Materials. Other letters concern a memorable visit by Bose’s daughter Damayanti Basu Singh to the Oppens’ apartment in New York.

Of course, as soon as I uploaded this piece, I found what I originally wanted tonight, which turns out to be Section 5 of Route. It tells of the dilemma faced by Alsatian men during World War II, when they faced the possibility of being drafted into the German army. Some went into hiding, living in holes, which came to be known as faire un trou, and some lived in those holes for years. The Germans took revenge by killing his parents, pimping his wife, stealing his children.

There was an escape from that dilemma, as, in a way, there always is. Pierre told me of a man who, receiving the notification that he was to report to the German army, called a celebration and farewell at this home. Nothing was said at that party that was not jovial. They drank and sang. At the proper time, the host got his bicycle and waved good-bye. The house stood at the top of a hill and, still waving and calling farewells, he rode with great energy and as fast as he could down the hill, and, at the bottom, drove into a tree.

It must be hard to do. Probably easier in an automobile. There is, in an automobile, a considerable time during which you cannot change your mind. Riding a bicycle, since in those woods it is impossible that the tree should be a redwood, it must be necessary to continue aiming at the tree right up to the moment of impact. Undoubtedly difficult to do. And, of course, the children had no father. Thereafter.

There have been maintes opportunities lately for me to embrace the PennSound Project. One of those is its author page for Oppen.

what better place to rest?

posted by brother-unit TW over at american idyll -- go visit the canyon, go stand by the river



route through
the Supai,
Boucher Trail



inner gorge
outside Agate Canyon

near Burro Spring

I remember the temple, this route I've travelled before,
I recall the bridge as I cross it again.
It seems the hills and rivers have been waiting,
The flowers and willows all are selfless now.
The field is sleek and vivid, thin mist shines,
On soft sand, the sunlight's color shows it's late.
All the traveller's sorrow fades away,
What better place to rest than this?
--Du Fu
(712--770)

Light Held Together By Moisture

posted by ruuscal over at american idyll


Credit & Copyright: Miloslav Druckmüller (Brno University of Technology), Martin Dietzel, Peter Aniol, Vojtech Rušin

Only in the fleeting darkness of a total solar eclipse is the light of the solar corona easily visible. Normally overwhelmed by the bright solar disk, the expansive corona, the sun's outer atmosphere, is an alluring sight. But the subtle details and extreme ranges in the corona's brightness, although discernible to the eye, are notoriously difficult to photograph. Pictured above, however, using multiple images and digital processing, is a detailed image of the Sun's corona taken during the 2008August total solar eclipse from Mongolia. Clearly visible are intricate layers and glowing caustics of an ever changing mixture of hot gas and magnetic fields. Bright looping prominences appear pink just above the Sun's limb.

The Sun,
with all those planets revolving around it
and dependent upon it,

can still ripen a bunch of grapes
as if it had nothing else
in the universe to do.*





Wine is sunlight, held together by water.*




*Galileo Galilei

Short Shrift: Breakout at PTZ

It was fun while it lasted.

Well, that's not true, entirely.

It's fun as long as you protect yourself with some fluid-absorbent pad of an absurd persona.

I made the huge error of going as myself [profderien], and not taking la bonne et belle Bianca Castafiore along for the ride!

Unfortunately, The Castafiore is busy with rehersals for the upcoming operatic season. We've pitched in, as well, and are selling tickets to the 2010-11 repertory as part of the Marlinspike Hall ManorFest -- proud to be the only venue with tickets available before they flood the Tête de Hergé TicketTron on the first of August.

We chose not to make much noise about it, but there has been a huge infusion of energy into our Summer Comestibles Project, which forms the heart of ManorFest (excuse me for belaboring the obvious!).

A relish here, a chutney there, here a candle, there a bramble, ohhhhhhh! (To the liberalized tune of Alouette)

Of course, this means of making pocket change is hardly unique to our humble estate, as the Cistercian monks down the unpaved country road peddle all sorts of "benevolent" crap, er, crafts and products, from Benevolent Biscuits to Ink and Toner supplies. It's the height of collusion, but my Marlinspike Pickles owe a good bit of their Pucker Power to the Monastery Mustard Glorious Garlic Blend.

Anyway, between broken hips, infected shoulders, rehersals for Gounod's Faust, batches of cucumbers, and intensive Moat Upkeep (yes, the algae is back!)? There's no time for the stress of social networking over at Poke That Pus Plug, Perforate That Sinus, and Pop That Pointy Zit dot com! [I don't know if owner Chris Azzari still has the site up for sale, but back in 2007 he was ready to ditch it for a mere $10,000 starting bid. At the time, he said he received an offer of $22,000, as well as many partnership offers. Three years later, much more media savvy, I bet he's hoping for much more! I don't think it can still be called a website flip at this point -- it's more like a senior citizen tumbling pass. As I try to support the things that I enjoy in this world,I recently enriched Chris with a donation of Ten Whole Bucks... The "DONATE" button disappeared later that same day, prompting some of the warm, fuzzy feelings I have for Azzari's site at the present time.]

Honestly, personality disorders (in multiples) are breaking out at PTZ faster than any pimple ever could, and I finally came face-to-face with the fétide, puant, malodorant, croupissant, infect, et immonde underbelly of the zit-site beastie. Who knew that the Phone Sex Operator -- who sent me a video of a cat dissection on the occasion of Sam-I-Am's death -- would end up looking like the healthier end of the mental spectrum for the website?

Oops, I forgot: LOL, ROFLMAO, etc. You see, it is often suggested that emoticons might temper my speech for the better, with the usual reasoning that my interlocuteurs can't discern when there's a little smile playing upon my lush red lips -- or a merry crinkling of the tiny laugh lines that frame my shining hazel eyes!

Short of that, I could always claim to "love" the other pimple fetishists and admire their dastardly acumen at finding YouTube videos of weeping abscesses and bubbling boils -- not just in English, mind you, but in Japanese, U.S. Southern, and Belarusian, as well. The competition is fierce and the accolades steady -- how else to keep the supply of masturbatory material coming at a generous pace?

It's a sharp mind that can plomb the depths of the zit-ified and conduct searches not just for "abscesses," say, but for its misspelled and foreign variants, as well.

Absess! Abses! Abcess! Absceso! Abcès! And so on!
(Staying abreast of popular misspellings can be a challenge to the searching poppologist.  My most recent favorite? "Purlunet")

Ah, I am going to miss that rush of adrenaline that comes from scooping the cyst, exposing the repost, and being all witty about it, too. Not as easy as it sounds, my friend, not as easy as it sounds.

Unfortunately, I tend to think emoticons the refuge of the inarticulate, and my resultant reliance on words -- put in certain order and modified at will, mind you --made some of the pseudo-writerly members nervous to the point of requiring sedation.



PTZ is a site that attracts people much like myself, I think -- people in physical pain, disabled people, insomniacs, perhaps fighting an excess of invasive medical procedures in actual, real life, on actual, real bodies. We so want to understand life's various putrefactions.
(Ewww. No, we don't!)

We just think blood and guts are cool, in the same manner that little boys and men "like to blow stuff up."

Like any fetish site, it has more than its share of unstable people, so it's easy to spend too much time catering to the psychically funked instead of just having a good time. Trust me, I have met each and every Neurological Misfire, and been subjected to the folksy stylings of each and every Ingrown PTZ Heir.
Fetish site demographics, a hot new area of statistical study, reveal frustrated doctors, frustrated lawyers, people passing themselves off as all kind of things... but above all, passing on burgeoning needs for importance. The blog-writer becomes An Author -- the risk management specialist, An Incomparable Neurosurgeon -- the Obese Hausfrau, An Intrepid First-Responder.

Given my congenital weakness and my "condition" (Walterus Mittyitis) -- you would think I'd be in the thick of all that pretense. Well, of course I was! Yes, I passed myself off as A Retired French Professor. The truth? They can't handle the truth! Already subject to severe bouts of Clinical Unworthiness, how might these fragile psyches react to the presence of someone who is lodged in a place like Marlinspike Hall, nestled in the heart of such perfection as is found deep, deep in The Tête de Hergé (très décédé, d'ailleurs)? And if they knew I was a dear friend of Captain Haddock? Imagine the whirling dervish of jealousy!
I have given short shrift to the counter-balance of wonderfully normal people over at PTZ, so allow me to lengthen that shrift (more on shrift below * ). From owner and steward Emilbus to the charming but testy Cyst Face, there are dozens of fun, knowledgable, and decent folk from all walks of life, in all sorts of circumstances. Those two, for instance, are new fathers -- I imagine that the births of their sons put a zit-popping website into proper perspective. Innaffitoften enlivens the place with a pure love of fun; Twisted Cyster joyously keeps the home bot fly fires burning; Anna Nonymous and her brother-in-law Evil Felon have even gone so far as to star in and produce what will soon be video cult classics -- So no... PTZ is not overrun with delusional depressives!
Still, and even so, I cannot help but wish I'd never stopped to scope out the less wholesome side of things.

Folks get terminally ingrown and pustulently petulant for a reason -- I forgot that. Don't push, don't call anyone on it, don't do the Dr. Phil 8-minute cure. Fear of exposure can make the barely stable personality spin out of control, or at least melt into a mess of childish tantrums.
Stress is hell on the complexion.

La bonne et belle Bianca Castafiore has further opined that there's a hell of a lot of prescribed painkillers sliding down gullets and a real heft of untreated clinical depression among PTZ denizens. Fortunately, I know *nothing* about the snarky, contrarian behavior that can ensue, given those variables! I just have to take the fat diva's word for it.

The weirdest thing, and it shouldn't be a perpetual surprise to me, as I encounter this in most insular online communities, is the way too many people decide that every word uttered by profderien somehow has to do with them. The level of paranoia astounds, and like the sebaceous cyst invaded by green-pus-producing bacteria -- it's gonna blow!
Sobering. And, ultimately, off-putting to a degree that drives "people like me" away.

Excuse me for a moment. The Cabana Boy is outside on the drawbridge screaming about an infestation of Hair and Bubble algae [Bryopsis plumosa and Dictosphaeria cavernosa, respectively], and demanding emerald crabs and Mexican turbos to stave it off, "or I am outta here!" (He's cute, the way he stomps his little feet!)
I need to go talk water parameters with him, and to do it before he forms a blood blister that no self-respecting zitmeister would deign to pierce.
You see, we maintain a high nutrient content in Our Moat, a necessity because of the Koi, as well as the Lagoon Sharks that we shelter in the winter for @Yoclutso, Beloved Twitter Twin, when she is busy with her castle and the Ark is out of commission. What do you do when your moat is overrich in phosphates, silicates, and nitrate? A flat out better sort of person, @Yoclutso sometimes mentors The Cabana Boy, whereas I state clearly to his vapid little face that he is a blatantly inefficient skimmer!
Maybe a few mangrove plants will suck up enough phosphorus that we won't need to go the macroalgae route (sort of the Activia Challenge for Moats)...
Ah, well, as far as PTZ goes, I am, of course, responsible for all of my actions, and many of them were clearly wrong.
I will mea my culpa, but I will not mea my maxima, ultima culpa. I mean, be real! I have a freaking estate to run!

I will examine my behavior... I always do. Any improvements, though, made on the current Model of Moi shall remain unheralded by the Occasional Crazies and Purported Popologists over at PTZ. I'll just have to waste my stunning renovations on you, Gentle Readers, and the lovelies of The Manor!

So, good luck, Emilbus. Many happy poppin' returns!

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* My regular readers know my love of word/expression origins. Today, let's visit The Mavens' Word of the Day, where Maven Georgia just happens to be addressing the saying short shrift:

Do you remember the scene in Romeo and Juliet where Romeo says to the Nurse: "Bid her devise / Some means to come to shrift this afternoon; / And there she shall at Friar Laurence' cell / Be shrived and married."?

The English words shrift and shrive derive from an Old English verb scrifan which comes in turn from Latin scribere 'to write'. The Old English word had several meanings: 'to decree a person's lot', to 'pass sentence', and, in the ecclesiastical sense, 'to hear confession and then impose penance and grant absolution'. When Juliet goes to shrift, she is going to confession, and when she is shrived (or Modern English shriven), she has been given penance and granted absolution.

The original sense of shrive seems to have been that of 'writing or prescribing a penalty'. It never meant simply 'to write' in English, but German schreiben and Dutch schrijven, both meaning 'to write', come from the same Proto-Germanic root. The Scandinavian languages also have the 'penance' sense, which does not exist in the West Germanic languages.

Scrifan first appeared in English around 776, and scrift around 900. Both, in assorted spellings, were in common use for centuries. The meanings got a bit tangled up so that shrift at various times meant 'penance', 'absolution', and 'confession'. Shrove Tuesday, the day before Ash Wednesday, is the day when people are "shriven"--they go to confession and receive absolution before making merry on the last day before Lent begins. The three days before Ash Wednesday are sometimes known as "Shrovetide."

The earliest citation for the expression short shrift in the OED is from Shakespeare's Richard III: "Make a short Shrift, he longs to see your Head." The man being addressed is Lord Hastings, whom Richard has just condemned to death with the sentence to be carried out immediately. Time is short--and Hastings' shrift must be similarly brief. This is apparently the original meaning of the phrase: a criminal condemned to death was given only a brief time to make his confession before being executed. He was given short shrift.

There seems to be unanimous agreement among scholars on this derivation, but I wasn't able to find any solid evidence, and there are no citations. One source tantalizingly said the phrase appeared "late in the fourteenth century" but didn't give a citation. There is also a great gap in citations between Shakespeare and the first quarter of the nineteenth century when Sir Walter Scott used the phrase in several of his novels and popularized it. Did he pick it up from Shakespeare? In A Legend of Montrose (1819), a man asks what a traitor deserves, and someone replies "A high gallows and a short shrift." Joseph Conrad wrote in Arrow of Gold (1919) of "a man condemned to a short shrift by his doctor."

To give something or someone "short shrift" now means 'to give little consideration'. This sense developed late in the nineteenth century. Here is an 1887 quotation from the Times of London: "Every argument...tells with still greater force against the present measure, and it is to be hoped that the House of Commons will give it short shrift to-night."

A Web search produced thousands of current examples: A recent article in the Economist contains the sentence: "Jordan's foreign minister...predictably got short shrift from Mr. Sharon" (April 2001). And Newsweek noted that "...[risk is] often given short shrift when investors peer into the future in an area like technology" (April 2001).

All of this sounds quite benign when we think of the phrase's origin.

The Impaired and/or Incompetent Colleague

Out today, in JAMA, study results that one editorialist says "constitute a frontal assault on a basic premise of medical professionalism." The issue is the self-policing function that is allowed the medical profession, and the degree to which this function is ignored.

Physicians' Perceptions, Preparedness for Reporting, and Experiences Related to Impaired and Incompetent Colleagues

Catherine M. DesRoches, DrPH; Sowmya R. Rao, PhD; John A. Fromson, MD; Robert J. Birnbaum, MD, PhD; Lisa Iezzoni, MD, MSc; Christine Vogeli, PhD; Eric G. Campbell, PhD

JAMA. 2010;304(2):187-193. doi:10.1001/jama.2010.921

Context Peer monitoring and reporting are the primary mechanisms for identifying physicians who are impaired or otherwise incompetent to practice, but data suggest that the rate of such reporting is lower than it should be.

Objective To understand physicians' beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine.

Design, Setting, and Participants Nationally representative survey of 2938 eligible physicians practicing in the United States in 2009 in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. Overall, 1891 physicians (64.4%) responded.

Main Outcome Measures Beliefs about and preparedness for reporting and experiences with colleagues who practice medicine while impaired or who are incompetent in their medical practice.

Results Sixty-four percent (n = 1120) of surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice. Nonetheless, only 69% (n = 1208) of physicians reported being prepared to effectively deal with impaired colleagues in their medical practice, and 64% (n = 1126) reported being so prepared to deal with incompetent colleagues. Seventeen percent (n = 309) of physicians had direct personal knowledge of a physician colleague who was incompetent to practice medicine in their hospital, group, or practice. Of those with this knowledge, 67% (n = 204) reported this colleague to the relevant authority. Underrepresented minorities and graduates of non-US medical schools were less likely than their counterparts to report, and physicians working in hospitals or medical schools were most likely to report. The most frequently cited reason for taking no action was the belief that someone else was taking care of the problem (19% [n = 58]), followed by the belief that nothing would happen as a result of the report (15% [n = 46]) and fear of retribution (12% [n = 36]).

Conclusion Overall, physicians support the professional commitment to report all instances of impaired or incompetent colleagues in their medical practice to a relevant authority; however, when faced with these situations, many do not report.

Author Affiliations: Mongan Institute for Health Policy (Drs DesRoches, Rao, Iezzoni, Vogeli, and Campbell); Biostatistics Center (Dr Rao); and Department of Psychiatry (Drs Fromson and Birnbaum), Massachusetts General Hospital, Boston.

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A slightly more fleshed-out summation of the JAMA article, from PhysOrg:

"Many states have mandatory reporting statutes, requiring physicians and other health care professionals to report to appropriate authorities those physicians whose ability to practice medicine is impaired by alcohol or drug use or by physical or mental illness," the authors write. But data suggest that the rate of reporting by physicians is far lower than it should be, given the estimated numbers of physicians who become impaired or who are otherwise incompetent to practice at some point in their careers, according to background information in the article.

Catherine M. DesRoches, Dr.P.H., of Massachusetts General Hospital, Boston, and colleagues conducted a study to assess physicians' beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine. Data for the study was derived from a nationally representative survey of 2,938 eligible physicians practicing in the United States in 2009 in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. Overall, 1,891 physicians (64.4 percent) responded. Physicians were questioned regarding their beliefs about and preparedness for reporting and experiences with colleagues who practice medicine while impaired or who are incompetent in their medical practice.

Among the findings of the survey, 64 percent (n = 1,120) of surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice; overall, 69 percent (n = 1,208) of physicians said they were very or somewhat prepared to deal with impaired colleagues; 64 percent (n = 1,126) of physicians overall reported being prepared to deal with colleagues who were incompetent in their medical practice, and preparedness varied by specialty and professional age. Seventeen percent (n = 309) of physicians reported having direct personal knowledge of an impaired or incompetent physician colleague in their hospital, group, or practice in the last 3 years, and 67 percent of these physicians (n = 204) reported that individual to a hospital, clinic, professional society, or other relevant authority.

According to the researchers, underrepresented minority physicians were significantly less likely than other physicians to report, as were international medical graduates compared with graduates of U.S. medical schools. Physicians working in hospitals or medical schools were more likely to report than physicians working in small practices. The most frequently cited reasons for not reporting an impaired or incompetent colleague included the belief that someone else was taking care of the problem; the belief that nothing would happen as a result of the report; fear of retribution; the belief that reporting was not their responsibility; or that the physician would be excessively punished.

"These national data regarding physicians' beliefs, preparedness, and actual experiences related to impaired and incompetent colleagues raise important questions about the ability of medicine to self-regulate. More than one-third of physicians do not completely support the fundamental belief that physicians should report colleagues who are impaired or incompetent in their medical practice. This finding is troubling, because peer monitoring and reporting are the prime mechanisms for identifying physicians whose knowledge, skills, or attitudes are compromised," the authors write.

The researchers offer several suggestions for improving physician reporting systems, including making external regulation stronger; designing and maintaining reporting systems to protect the confidentiality of the reporting physicians; and to provide physician reporters with confidential feedback about the outcomes of any actions taken based on the report to address the concern that nothing will happen as a result of the report.

"All health care professionals, from administrative leaders to those providing clinical care, must understand the urgency of preventing impaired or incompetent colleagues from injuring patients and the need to help these physicians confront and resolve their problems. The system of reporting must facilitate, rather than impede, this process. Reliance on the current process results in patients being exposed to unacceptable levels of risk and impaired and incompetent physicians possibly not receiving the help they need," the authors conclude.

I will keep my eye open for discussions of the study in the medical blogosphere.