Grousing

Given the glancing treatment I recently afforded the topic of mental illness and CRPS, I thought it worth reposting this blog entry from April 2009. At that time, I was apparently reviewing some of my journals from 2005-2008. Of note? Varied and various hypocrisies, as it never seems to occur to me that I bear some sort of journalistic responsibility toward my CRPS confrères -- the same sort of responsibility I so excitedly place as a burden on others' shoulders:

This morning, I've been reading through old diary entries. Not much is worth salvaging. Now and then, I actually got beyond the lint in my navel. For example, last June, I went off on Cynthia Toussaint and her repugnant attempts to designate CRPS as "the suicide disease."

Before I spout off in this odd temporal fold of today and yesteryear, let me say that Toussaint's work on behalf of people with CRPS and, particularly, for her Women-in-Pain Initiative, has been a grand and noteworthy "awareness raising."

It just now occurs to me that you might not know who she is. This is the biography posted on her website:

Cynthia Toussaint serves as Spokesperson at For Grace and has had Complex Regional Pain Syndrome for 26 years. She founded the organization in 2002
originally to raise awareness about the disease, and later developed
fibromyalgia as an over-lapping condition. Before becoming ill, she was an
accomplished ballerina and worked professionally as a dancer, actor and singer.

Since 1997, she has been a leading advocate for women in pain, raising
awareness through local, national and worldwide media as well as public
speaking. Toussaint championed and gave key testimony at two California Senate
hearings. The first in May 2001 was dedicated to CRPS awareness. The second in
February 2004 explored the chronic under treatment of and gender bias toward
women in pain (the impetus behind For Grace’s expanded mission.) Both of these
efforts were the first of their kind in the nation. Toussaint was the first CRPS
sufferer to be featured in the New York Times and Los Angeles Times, and on
Public Broadcasting System and National Public Radio. She is a consultant for
ABC News and PainPathways, the official magazine of the World Institute of Pain.

Also, Toussaint continues to be a leading advocate for health care
reform in California. She was instrumental in changing public opinion which led
to sweeping HMO reform legislation that was signed by Governor Gray Davis in
1999. Her focus has now shifted to bringing a single-payer, universal health
care plan to all in California which will provide a model for the rest of the
country.

JUNE 12, 2008: on the rss feed today, i picked up another cynthia toussaint interview article. she is introduced to readers as someone suffering with crps/rsd – and then she blithely elaborates that it is called “the suicide disease.” that’s maybe an opinion best kept under wraps, eh? maybe i am dense, maybe a little bit touchy, but i really feel like it is not something to promote.

[APRIL 3, 2009: I am in no way a spokesperson on behalf of people with CRPS/RSD. The fact that it runs like a viscous leitmotif through this boggy blog? Okay. Well, maybe I do have a responsibility: the same responsibility inherent in any use of language. In my various woe-is-me-esque posts on the disorder, haven't I also exaggerated, haven't I played the pity card? Am I comfortable with the notion of someone newly diagnosed reading this entry from January, for instance, perhaps hoping for substantive information, or even feeble encouragement, and not for my rapier wit?

I entered "the suicide disease" into Google search and discovered that Trigeminal Neuralgia now holds the crown and sceptor. My opinion of Wikipedia took a dive when I read this: "TN is called 'The suicide disease.' In fact: for those who live with Trigeminal Neuralgia for more than 3 years about half commit suicide.[citation needed]"

It's a Throwdown! Who is dead? From what? And when did they know it? Mister Mustard! In the library! With a candlestick!

Damn straight a frigging citation is needed when alleging that half of those with TN (I love the clinical addition of "for more than 3 years") kill themselves. Given that many people consult the internet about their illnesses, and given that not all who do so have the necessary intellectual or emotional reserves to filter out the nonsense, this kind of thing is beyond irresponsible. As you scan down the results page of your "suicide disease" search, you can see the insidious path of the Wikipedia statement -- and I would hate to be a newly diagnosed TN patient faced with this outrageous stuff. I don't know whether TN is akin, or perhaps a subset, to CRPS, but it's likely. What is this my-disease-is-the-most-painful-ever competition about, anyway? Who'd want to "win"?]

cynthia toussaint feels compelled to promulgate this designation of "the suicide disease," and i have not run into a better example of media manipulation (except by the fringe right). by repeating her initial assertion, it takes on the status of truth, and of all the things that she ought to want known as TRUE about crps/rsd, *that* doesn't even rank! does she not think about the potential impact on someone who is newly diagnosed, or on someone who contemplates having to care for a loved one with this disease?

about herself, she writes (from her internationally known website -- the for grace foundation):

"In 1982, I was a 21-year-old ballerina when a minor ballet injury triggered the chronic pain disease, Reflex Sympathetic Dystrophy, also known as the “Suicide Disease.” For the first thirteen years of my illness, my doctors told me my physical problems were “all in my head” while the RSD spread throughout my entire body, leaving me bedridden and screaming in pain for nearly a decade – a pain that felt as if I had been doused with gasoline and lit on fire."

the allusion to gasoline and fire is also part of the Official CRPS Hyperbole. support groups tend to use flames as part of their symbology -- on tee-shirts, mugs, decals.

on the other hand, it actually does feels like being set afire sometimes -- except that i've no idea what being set afire feels like. we so want to be singular, special. the fish we caught, the mountain we climbed, the test we aced, the suffering we do...

unbelievably, ABC news did a series on "killer jobs: 10 painful professions," and used toussaint's experience as exemplar to make the case for ballet dancing. See how the suicide reference somehow magically appears!

Toussaint developed Reflex Sympathy Dystrophy, otherwise known as "suicide disease." RSD begins as pain limited to the region of the injury often leavingsomeone unable to move that part of his or her body. The pain spreads over timeto all parts of the body. Doctors are generally able to treat RSD within a year
of diagnosis. However, Toussaint was not diagnosed with RSD until she had spent
15 years in a wheelchair after her injury.

i forgot to mention -- she also moves her self-kill assertion from the narrow confines of CRPS to include all painful conditions: "Suicide is common for women in severe pain." oh, the hubris.

inclusion and diversity are grand.

a rap upon the knuckles of the beautiful and talented ms. toussaint, and a wink of approval for all her advocacy work.

April 3,2009: Sad to say, but one of the foremost authorities on CRPS also asserts that suicide is common among patients. Dr. Anthony Kirkpatrick wrote, in a complaint to the AMA, "I have personally witnessed patients with RSD/CRPS lose hope and commit suicide following denial of authorization for care by insurance carriers." The AMA, at the time, required eight concurrant objective findings for the diagnosis of CRPS, and that was what the complaint was about. He continues:

"As RSD progresses over time, especially without treatment, the syndrome tends to become more unresponsive to treatment. Hence, early diagnosis and treatment are imperative. RSD can remain localized to one region of the body indefinitely. In other cases, it spreads to large segments of the body spontaneously or by trauma leading to permanent deformities and widespread immobility of limbs. At an advanced stage of the illness, all patients develop significant psychiatric problems and narcotic dependency, and are left completely incapacitated. Some commit suicide."

In what now clearly is the voice of reason, Linda Lang wrote an article for the RSDSA newsletter, titled "The Taboo of Suicide."

Although a literature search reveals claims that CRPS/RSD patients have an extraordinarily high incidence of suicide, and a CRPS/RSD patient actually read testimony into a Subcommittee on Health in June of 2001, saying that CRPS/RSD leads to death and the leading cause of that death is suicide, there is absolutely no evidence to support these statements, in fact there are no statistics at all on CRPS/RSD and suicide. When asked about it in 2001, Dr. Robert Schwartzman said, "…there is no data on RSD and suicide. It clearly happens and is almost always attributed to other causes." He adds that out of 73,500 patients, he has had only three that he is sure did commit suicide.

Linda put out an alert through RSDSA, "asking anyone with CRPS/RSD who had seriously attempted suicide, thought about suicide, or knew of someone with the disease who had committed suicide to contact me. Within three hours I had 50 responses. The results of this very informal survey were very revealing. The most interesting to me was that there were just about an equal amount of responses from males and females. About 15% said they had made serious suicide attempts... Most of the responses were from people who said they thought about suicide with some frequency, though they doubted they would ever go through with it. Some felt that CRPS/RSD had taken away so much control from their own lives that thinking about suicide was a way of reclaiming that control, of feeling that if things ever got to be too much they could be in charge of their own body again by ending their lives. This was presented as a comforting thought, and actually helped them live more successfully with the CRPS/RSD. Others said that their religion prevented them from killing themselves. Many of those who contemplate suicide seem to already have established some kind of lifeline to help them."

So it's complicated. And disturbing. I tend to believe that having CRPS inevitably causes psychiatric illness; That is very scary and depressing, in and of itself. Suicide can be inviting in the middle of the night when nothing helps the pain and lack of sleep makes it sound like an option, an out. Love, money, friends, family, sanity -- each leaks out of the CRPS like a sieve.

One almost doesn't comprehend suicide's finality. Or care.

Open the canned peaches!

Al Swearengen: We're forming a fucking government.
A. W. Merrick: Who is?
Al Swearengen: Us! You and me! Come to me in a vision! Ya stupid bastard.

*A repost. Swearengen is timeless.

How to Gift the Gifter?

I love getting gifts. I love giving them even more, and will vex myself no end in the effort to find the right ones.

The process became difficult when a whole bunch o' family was added to my gift-giving list of birthdays and celebrations.

If you are estranged from your family and considering some form of reconciliation? Think carefully about how that sea change will impact your listmaking and shopping; Consider, too, the emotional impact should you end up buying a mess o'gift cards for your new bunch o'family.

(You will be further devastated to discover that these creatures wouldn't recognize a "thank you" card or note if it bit them on their rounded derrières.)

This confession will have been worthwhile if just one person is helped by my sad blathering example.

Of course, you will not have to endure what I have had to accept! Who knew that my long lost older brother would prove to be the world's most insightful gifter?

So, once again, I am accepting your ideas and stray notions about what might be the perfect gift for Tumbleweed's birthday on April 20.

and in other news: OCHOA remains a big, fat TURD

When I checked my CRPS medical feeds this morning, there were TWO articles highlighted. TWO is a lot, as there are, usually, NONE.

The first is another very general piece from Medical News Today: What Is Complex Regional Pain Syndrome (CRPS)? What Causes Complex Regional Pain Syndrome?

Complex regional pain syndrome, also known as CRPS is a rare, chronic (long-term) and progressive condition characterized by severe pain, inflammation and changes in the skin. Patients commonly describe the pain as a burning sensation...

While these sorts of articles are of little use to me at this stage of the disease, I am glad that they are being written. When I was first diagnosed, the amount of misinformation and prejudice within the scientific literature was horrifying --and depressing.

I remember asking my primary care doctor if he believed that CRPS "actually existed." The question was posed as he peered at my right foot, hugely swollen, purple, colder than cold (and on fire, too).

God bless the man. He said, simply, "Yes, I do." I hung on to that "Yes, I do" for dear life.

What I appreciate about this general interest type of article is its straightforward tone. It doesn't ignore the wasted years when the medical community considered CRPS as yet another example of female hysteria:

Sigmund Freud, (1856-1939), an Austrian neurologist who founded the psychoanalytic school of psychiatry put forward the idea that CRPS might be mainly a psychological condition, caused by some unknown underlying psychological difficulty or trauma which make patients feel pain. As subsequent research has demonstrated that CRPS patients undergo real physical changes in their nervous system, this theory has been largely discarded. Other studies have shown that CRPS patients do not have a history of mental illness prior to the onset of symptoms.

Even well-informed health care professionals struggle with the relationship between mental illness and CRPS, as it is likely impossible for them to find an emotionally healthy person with advanced CRPS.

I certainly don't consider myself emotionally or mentally healthy. I do know that, as Dr. Anthony Kirkpatrick frequently says, "psychological symptoms related to CRPS are a result and not a cause of the disorder." Traumatic Neuralgias/Neuropathic pain syndromes and An overview of amplified musculoskeletal pain syndromes are two studies commonly cited.

You may wonder why this is so. Basically, in a severe case of CRPS, such as mine, the patient faces professional, financial and social losses. There is not even the hope of dying early, though I expect that I will not see my full allotment of years. Instead, there is the prospect of constant, severe pain, little sleep, less and less function, immunosuppression, and did I mention constant, severe pain? The likelihood of ending up alone -- if not completely, then essentially?

I tend to consider the development of anxiety and depression a healthy response to an insane situation. Dr. Kirkpatrick prefaces the Clinical Practice Guidelines for CRPS this way:

If undiagnosed and untreated, RSD / CRPS can spread to all extremities, making the rehabilitation process a much more difficult one. If diagnosed early, physicians can use mobilization of the affected extremity (physical therapy) and sympathetic nerve blocks to cure or mitigate the disease. If untreated, RSD / CRPS can become extremely expensive due to permanent deformities and chronic pain. There are no studies showing that RSD / CRPS affects the patient's life span. The potential exists for long-term financial consequences. At an advanced state of the illness, patients may have significant psychosocial and psychiatric problems, they may have dependency on narcotics and may be completely incapacitated by the disease. The treatment of patients with advanced RSD is a challenging and time-consuming task.

It makes you crazy, simply and accurately put.

People harboring nutty tendencies before falling ill are only going to end up magnifying their wackiness under the unkind influence of CRPS.

And yes, it is discouraging to know that you are one of those patients... And how low one's aspirations have sunk when not being one of those patients becomes a goal, an actual freaking goal.

There is help out there in the form of pain counselors, stress management, training in biofeedback/self-hypnosis, relaxation exercises and pharmacological treatment of depression and anxiety. To be honest? None of these things (passed off by terms such as Coping Skills and Psychosocial Modalities) will help in the least until you squash That Rat Bastard Known as Denial.

Squashing That Rat Bastard Known as Denial takes firm intent and time. I wasn't fully convinced I even had CRPS until it had spread to 3 of my 4 extremities. It took even longer for me to accept that there was no cure and that most treatments are futile (when I looked to them for cures!).

The various modalities and treatments suddenly become much more efficacious when expectations are trimmed to fit reality.

Speaking of reality, I started out with two results from my medical feeds, and then got bogged down in the dangerous generalities of the article for non-specialists. The second result was published in the journal Clinical Neurophysiology [2010, March 30, 2010] and bears this snazzy title: A search for activation of C nociceptors by sympathetic fibers in complex regional pain syndrome.

I so appreciate the labor behind this article. The promulgation of the sympathetic nervous system as key to all-things-CRPS drives me... well, nuts.

Not whacked out nuts but frustrated nuts.

One of the major reasons the name of the disorder was changed from Reflex Sympathetic Dystrophy to Complex Regional Pain Syndrome (Types 1 and 2) was, precisely, that the sympathetically-maintained explanation for the genesis of CRPS and the maintenance of its pain -- was not supported by science.And science is still consistently failing to find support for this long-held but never proved theory. This is the abstract for the article about the study of sympathetic nerve fibers:

OBJECTIVE: Although the term 'reflex sympathetic dystrophy' has been replaced by 'complex regional pain syndrome' (CRPS) type I, there remains a widespread presumption that the sympathetic nervous system is actively involved in mediating chronic neuropathic pain ["sympathetically maintained pain" (SMP)], even in the absence of detectable neuropathophysiology. METHODS: We have used microneurography to evaluate possible electrophysiological interactions in 24 patients diagnosed with CRPS I (n=13), or CRPS II (n=11) by simultaneously recording from single identified sympathetic efferent fibers and C nociceptors, while provoking sympathetic neural discharges in cutaneous nerves. RESULTS: We assessed potential effects of sympathetic activity upon 35 polymodal nociceptors and 19 mechano-insensitive nociceptors, recorded in CRPS I (26 nociceptors) and CRPS II patients (28 nociceptors). No evidence of activation of nociceptors related to sympathetic discharge was found, although nociceptors in six CRPS II patients exhibited unrelated spontaneous pathological nerve impulse activity. CONCLUSIONS: We conclude that activation of nociceptors by sympathetic efferent discharges is not a cardinal pathogenic event in either CRPS I or CRPS II patients. SIGNIFICANCE: This study shows that sympathetic-nociceptor interactions, if they exist in patients communicating chronic neuropathic pain, must be the exception.

For some reason, physicians and therapists never seem to take my word for it. Maybe they will listen to The Gang of M. Campero, H. Bostock, and the inimitable T.K. Baumann -- all from the Departamento de Neurología, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile

Oh, and one J.L. Ochoa.

Uh-oh. You may recall that I called a certain Dr. Jose Ochoa a big, fat turd. He bears part of the responsibility for the pollution of the generalist literature out there, just the sort of reading that someone newly diagnosed is likely to undertake. Feeding off of unhappiness like a plump-to-bursting bloodsucking tick, this Ochoa bankrolled a comfortable life with monies from the provision of pimped-out expert testimony -- his general message being that CRPS does not exist. Happily, his opinions have been disallowed or stricken as unscientific in at least three states. I haven't seen a serious scientific notation of his "work" in a good while now. His publications have tended toward the editorial (or letters to the editors), anyway.

In summation, that Dr. Jose L. Ochoa remains a big, fat Turd; the J.L. Ochoa doing actual work, study, and evaluation? He is a Prince, a Peach, a Pear.

Proverbial Pain: I got your "evidence" right here...

I am having the proverbial hard time. I know, same old, same old! When pain becomes proverbial, that's bad. One feels extra superfluous when one's pain is superfluous. I tweeted last night -- yes, I tweet -- that suicide is my first thought now when I wake in the morning, and that sleep is my greatest waking desire.

Escapism, you know!

I am not threatening suicide, never fear. I am responsible for several lives and take that responsibility seriously. My own life may feel devalued (that word superfluous keeps popping into my linguistic centers) but I honor the integrity of those around me, and recognize the possibility that my wisdom is... impaired. And that, my friends, is to really say the LEAST.

My life: the split infinitive!

Are you familiar with the Aussie/Brit expression "pain in the proverbial"? Here's a great example from Australia Network's English Bites -- the discussion is about Ipswich toilets and the relative unavailability of women's toilets. [What can I say? It was the first result that popped up.]:

In Queensland, one local government has decided that there are not enough toilets for women. And it's going to do something to improve the situation.

WOMAN: ...[W]hen you're in a hurry, you got things to do and you've got to stand there for ten minutes and wait -- It's awful yeah.

WOMAN: If there's an urgent need you really are ah, in trouble.

PETRIA WALLACE: It's a universal pain in the proverbial. Women queuing for public toilets while men are out in a flash.

PAUL TULLY: Well look it's a bit small. You've got a couple of female toilets. The third one which is just for staff only. It's not very adequate compared with the male toilets next door with the couple of urinals and the regular toilet and there's times like when the movies finish when it's just jam packed.

PETRIA WALLACE: Councillor Paul Tully has made it his mission in life to rescue the women of Ipswich from time-wasting toilet queues.

For some reason, in the U.S.? People feel compelled to not leave their interlocuteurs hanging, worrying needlessly about just *what*, exactly, is the adjectival object. U. S. Americans will tell you, clearly, that the proverbial pain is in the ass, or some other quite definitive place.

An Indian living in Singapore wrote an entire blog post detailing the source of his dolorous dolour, his Pain in the Proverbial -- which he has renamed:

...the GART (or Gluteal Assault and Resultant Trauma) syndrome. It is better known as the pain in the proverbial, and no, I am not referring to anyone's spouse or children here. Many learned men of science have attributed reasons ranging from muscle problems, piriformis syndrome, sacroiliac joint restrictions and even sciatica to it. But as far as I am concerned, it is all thanks to the weight of my wallet.

Note the vocabulary, note the lack of the word ass.

Wait! I almost forgot why I logged in to Blogger. There has been another illustrious, earth-shattering, and completely unexpected contribution to the research into one of the major sources of my pain in the proverbial: CRPS.

I hope those of you who have CRPS/RSD will heed my advice and take a seat on your proverbial before I unveil the exciting news.

Okay... Are you ready?

I don't want to prolong your agony, so I am going to go straight to the masterful and shocking conclusion put forward by these researchers at Ziekenhuis Rivierenland, Tiel, in The Netherlands. You probably recognize a few of these names, especially Dr. Paul Zollinger, a Professor of Orthopedics who has published extensively on CRPS.

Indeed, it is from these folks, especially the CRPS I Task Force, that I expect important breakthroughs -- as they pursue the basic research so long ignored, especially in the area of inflammatory response.

Drum roll, please. Oh, the title of the article? It's very catchy: Evidence based guidelines for complex regional pain syndrome type 1.

Woo hoo! Can you handle more?

"The purpose of this study was to develop multidisciplinary guidelines for treatment of "
CRPS-I."

ohmygod! I'm getting the vapors from all this excitement.

Oh, I am the cruel one, aren't I, making you wait for the scintillating conclusion?
Well, I don't want to be known as any sort of impediment to progress, any kind of pain in the proverbial, so here it is:

"Based on the literature identified and the extent of evidence found for therapeutic interventions for CRPS-I, we conclude that further research is needed into each of the therapeutic modalities discussed in the guidelines. "

Support Rep. Alan Grayson and HR 4789

Representative Alan Grayson may prove to be my next political hero, a role and an honor not frequently filled. He is the author of H. R. 4789 and presented it this way (in case you are stubbornly refusing to watch the YouTube video above!) back on 12 March:

This simple four-page bill lets any American buy into Medicare at cost. You want it, you pay for it, you're in. It adds nothing to the deficit; you pay what it costs.

Let's face it. Health insurance companies charge as much money as possible, and they provide as little care as possible. The difference is called profit. You can't blame them for it; that's what a corporation does. Birds got to fly, fish got to swim, health insurers got to rip you off. And if you get really expensive, they've got to pull the plug on you. So for those of us who would like to stay alive, we need a public option.

In many areas of the country, one or two insurers have over 80% of the market. They can charge anything they want. And when you get sick, they can flip the bird at you. So we need a public option.

And they face no real competition because it costs billions of dollars just to set up a national health care network. In fact, the only one that's nationwide is . . . Medicare. And we limit that to one-eight of the population. It's like saying that only seniors can drive on federal highways. We really need a public option.

And to the right-wing loons who call it socialism, we say, "if you want to be a slave to the insurance companies, that's fine. If you want 30% of your premiums to go to 'administrative costs' and billion-dollar bonuses for insurance CEOs who figure out new and creative ways to deny you the care you need to stay healthy and alive, that's fine. But don't you try to dictate to me that I can't have a public option!"

And there is a way left to get it. By insisting on a vote on H.R. 4789. Three votes on health care, not two. The Senate bill, the reconciliation amendments, and the Public Option Act.

We got 50 co-sponsors for this bill in two days. Including five powerful committee chairman. But we need more.

Sign our Petition at WeWantMedicare.com.

Call. Write. Visit. Do whatever you can do to get you Congressman to co-sponsor this bill, and push it to a vote. Right now, before it's too late.

Let's do it!


Here is the complete text of the full bill:

HR 4789 IH

111th CONGRESS

2d Session

H. R. 4789

To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States to buy into Medicare.

IN THE HOUSE OF REPRESENTATIVES

March 9, 2010


Mr. GRAYSON (for himself, Mr. FILNER, Mr. POLIS of Colorado, Ms. PINGREE of Maine, Ms. SHEA-PORTER, Ms. SCHAKOWSKY, Mr. FRANK of Massachusetts, Mr. KUCINICH, Ms. EDWARDS of Maryland, Ms. WATSON, and Ms. JACKSON LEE of Texas) introduced the following bill; which was referred to the Committee on Ways and Means

--------------------------------------------------------------------------------

A BILL

To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States to buy into Medicare.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,


SECTION 1. SHORT TITLE.
This Act may be cited as the ‘Public Option Act’ or the ‘Medicare You Can Buy Into Act’.

SEC. 2. UNIVERSAL MEDICARE BUY-IN OPTION.
(a) In General- Part A of title XVIII of the Social Security Act is amended--

(1) in section 1818(a), by striking ‘or 1818A’ and inserting ‘, 1818A, or 1818B’; and

(2) by inserting after section 1818A the following new section:

‘UNIVERSAL BUY-IN‘Sec. 1818B.

‘(a) In General- (a) Every individual who--

‘(1) is a resident of the United States;

‘(2) is either (A) a citizen or national of the United States, or (B) an alien lawfully admitted for permanent residence; and

‘(3) is not otherwise entitled to benefits under this part or eligible to enroll under this part;

shall be eligible to enroll in the insurance program established by this part. An individual may enroll under this section only in such manner and form as may be prescribed in regulations, and only during an enrollment period prescribed in or under this section.

‘(b) Enrollment; Coverage- The Secretary shall establish enrollment periods and coverage under this section consistent with the principles for establishment of enrollment periods and coverage for individuals under section 1818, except that no entitlement to benefits under this part shall be effective before the first day of the first calendar year beginning after the date of the enactment of this Act.

‘(c) Premiums-

‘(1) IN GENERAL- The provisions of subsections (d)(1), (d)(2), and (d)(3) of section 1818 insofar as they apply to premiums (including collection of premiums) shall apply to premiums and collection of premiums under this section, except that--

‘(A) paragraphs (4) and (5) of section 1818 shall not be applicable; and

‘(B) the estimate of the monthly actuarial rate under section 1818(d) shall be computed and applied under this paragraph based upon costs incurred for individuals within each age cohort specified in paragraph (2) rather than for all individuals age 65 and older.

‘(2) AGE COHORTS- The age cohorts specified in this paragraph are as follows:

‘(A) Individuals under 19 years of age.

‘(B) Individuals at least 19 years of age but not more than 25 years of age.

‘(C) Individuals at least 26 years of age and not more than 35 years of age.

‘(D) Individuals at least 36 years of age and not more than 45 years of age.

‘(E) Individuals at least 46 years of age and not more than 55 years of age.

‘(F) Individuals at least 56 years of age and not more than 64 years of age.‘(d) Treatment- An individual enrolled under this part pursuant to this section shall not be treated as enrolled under this part (or any other part of this title) for purposes of obtaining medical assistance for medicare cost-sharing or otherwise under title XIX.’.

A Thousand Little Wacos:::Apples and Cabbage

I know, I know. Given all that I have read, seen, and heard in just the past week, how can I continue to claim astonishment? I don't know, but it is the truth.

I am profoundly shocked, surprised, and appalled -- yes, again!

The Washington Post reported on the angry, and sometimes violent, reactions of those whose universe was apparently rocked by the signing of the health reform bill on Tuesday. As previously noted, bigoted speech and threats of physical harm began to percolate, then boil.

A good part of my day was spent making composed salads, boiling and poaching anything I could get my swollen and fumbling hands on. Faced with the remains of such an effort, I always try to make stock, something that cooks everywhere value as gold. I visualize all this hatred as that nasty, speckled foam that sometimes forms a head on a pot of bubbling chicken stock -- you know, the stuff that begs to be skimmed away.

Yes, I would much rather think about cooking. Have any of you used the much-touted-by-Alton-Brown Grains of Paradise, in lieu of pepper?

Who would knowingly or willingly incite people to such offensive extremes?

Meet imminent blogger and budding brain trust Mike Vanderboegh.

Some of the vandalism appears to have been instigated by an Alabama blogger, Mike Vanderboegh, who encouraged his readers to throw bricks at the windows of Democratic headquarters across the country. Vanderboegh, a former leader of the Alabama Constitutional Militia who is headlining an open-carry gun rally in Northern Virginia next month, issued a call to the modern "Sons of Liberty" on his libertarian political blog to break windows nationwide to display opposition to health-care reform.

A vandal threw a brick into the glass doors at the Monroe County Democratic Committee's headquarters in Rochester overnight Saturday, attaching a note that quoted Barry Goldwater: "Extremism in defense of liberty is no vice."

Vanderboegh did not respond to questions Wednesday from The Washington Post, but he took credit for the incident in an interview earlier this week with the Rochester Democrat and Chronicle. "I guess that guy's one of ours," he told the newspaper. "Glad to know people read my blog."

Vanderboegh is a member of an Alabama militia, once worked as a warehouse manager but is now disabled by diabetes, hypertension, and congestive heart failure, for which he receives a disability check from the government to the tune of $1300/month. Someone in TwitterLand says that he doesn't use Medicare, to which he'd be entitled virtue of being a gimp, but instead enjoys excellent coverage from his wife's work benefits. More power to him.

His Blog, the Sipsey Street Irregulars, flies under the waving rubrique of The Doctrine of the Three Percent:

The Three Percent are the folks the Founders counted on to save the Republic when everyone else abandoned it.

And we will.

There will be no more free Wacos and no more free Katrinas.

For we are the Three Percent.

We will not disarm.

You cannot convince us.

You cannot intimidate us.

You can try to kill us, if you think you can.

But remember, we’ll shoot back .

We are not going away.

We are not backing up another inch.

And there are THREE MILLION OF US.

Your move, Mr. Wannabe Tyrant....

What is a "Three Percenter"?
During the American Revolution, the active forces in the field against the King's tyranny never amounted to more than 3% of the colonists. They were in turn actively supported by perhaps 10% of the population. In addition to these revolutionaries were perhaps another 20% who favored their cause but did little or nothing to support it. Another one-third of the population sided with the King (by the end of the war there were actually more Americans fighting FOR the King than there were in the field against him) and the final third took no side, blew with the wind and took what came.

Three Percenters today do not claim that we represent 3% of the American people, although we might. That theory has not yet been tested. We DO claim that we represent at least 3% of American gun owners, which is still a healthy number somewhere in the neighborhood of 3 million people. History, for good or ill, is made by determined minorities. We are one such minority. So too are the current enemies of the Founders' Republic. What remains, then, is the test of will and skill to determine who shall shape the future of our nation.

The Three Percent today are gun owners who will not disarm, will not compromise and will no longer back up at the passage of the next gun control act. Three Percenters say quite explicitly that we will not obey any futher circumscription of our traditional liberties and will defend ourselves if attacked. We intend to maintain our God-given natural rights to liberty and property, and that means most especially the right to keep and bear arms. Thus, we are committed to the restoration of the Founders' Republic, and are willing to fight, die and, if forced by any would-be oppressor, to kill in the defense of ourselves and the Constitution that we all took an oath to uphold against enemies foreign and domestic.

We are the people that the collectivists who now control the government should leave alone if they wish to continue unfettered oxygen consumption. We are the Three Percent. Attempt to further oppress us at your peril. To put it bluntly, leave us the hell alone. Or, if you feel froggy, go ahead AND WATCH WHAT HAPPENS.

Again: I know, I know. I copied and pasted Vanderboegh's brilliance above just before passing out from exhaustion in the wee hours -- I thought that, like my many bowls of composed, succulent, and enticingly fragrant composed salads, it would improve for having sat unmolested overnight.

I am, as you and I share this convivial moment, munching on one of the chicken salads. It is close to sublime, the sweetness of some of the ingredients set off by the bite of quickly sautéed mustard greens: Not your average chicken salad. Very little mayonnaise, yet enough. I am most pleased that the bowl is now almost empty as the Minions of Marlinspike Hall have apparently been scavenging while I slept, confident that upon awaking, The Doctrine of Three Percent would have homogenized enough to make palatable sense.

My un- and sub- consciouses rival such rabid gun-owners' intent by making plans to feed the world on composed salads (chicken, potato, cole slaw, salmon, shrimp, taco) until we are all so sated that the notion of hurting, killing, or humiliating one another smothers under the weight of gustatory contentment.

Sometimes I feel sorry for God, and render unto Him fervent apologies. More often, though, I cook.

So Vanderboegh took for the title of his blog the story of one Phillip Sheats Gordon, an "ATF target" who booby-traps his home with all sorts of exciting little technologies and weapons before facing off with government-type intruders. As he is, sniff, riddled with cancer, what does he have to lose, holed up as he is in his -- you guessed it -- Sipsey Street home?

Philip Sheats Gordon figures in what is described as "Vanderboegh's upcoming novel, Absolved."

My forthcoming novels all disappeared a few years back, sunk by the embarrassment of their many announced yet never-accomplished arrivals. I decided that kitchen duties were more my thing. Anyway, as best I can figure, Vanderboegh has written five chapters, neatly, correctly, and duly numbered and then he has, in apparent frustration, jumped to Chapter 31. Wannabe writers everywhere understand that impulse!

Over at Think Progress blog, I discovered that Vanderboegh is currently driven to "protect" the lives of the Democratic leadership. (Well, that's how *he* put it. Were I listed among his protectees, I'd be in full-fledged flight away from his sort of defense.)

VANDERBOEGH: I am telling you we are motivated to break windows, we feel a deadly threat from the Federal government and the orders that the Democrat party has given us. [...]

COLMES: You’re telling people to break the windows of Democratic headquarters. You’re telling people to commit acts of vandalism. You’re supporting breaking the law.

VANDERBOEGH: May I tell you my personal motive for doing this? I’m trying to save the lives of Nancy Pelosi, and every one of these people who do not understand the unintended consequences of their actions. [...] Because they are not paying attention to the million of people across this deepening divide that politics no longer avails them. [...] We refuse to participate in the system, and we refuse to pay the fines, and we refuse arrest. Now where do you suppose that’s going but a thousand little Wacos.

Excuse me while I go whip up something for the populace -- something filling, warm, comforting.

I am thinking apples and cabbage, followed by an insulin-challenging dessert. I might even fall head-over-heals into my own pitiful stereotype and brew a pot of Earl Grey. Ah, but that means making scones...

A thousand little Wacos. Sweet Jesus.

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

Red Cabbage and Apple Salad With Ginger Vinaigrette

Ingredients
3 tablespoons apple cider vinegar
1 1/2 teaspoons grated peeled fresh ginger
1 teaspoon Dijon mustard
1 teaspoon honey
1/2 teaspoon minced garlic
3 tablespoons extra-virgin olive oil
1/4 teaspoon kosher salt
1/8 teaspoon ground black pepper
2 cups packed shredded red cabbage
2 cups packed shredded Napa cabbage
2 cups thinly sliced Granny Smith apple
2 teaspoons fresh lemon juice
1/4 cup golden raisins, plumped in hot water
1/4 cup toasted, unsalted sunflower seeds

Media Matters for America has tackled a summation of the right-wing media's history of violent rhetoric. Serve yourself a heaping bowl of this delicious and detoxifying cabbage salad and ponder the map Sarah Palin has made, marking the locations of legislators who voted for the health care reform initiatve -- marking the locations with cute little crosshairs. I think a nice loaf of crusty bread would go well with this vegetable dish, as it soaks up irritating stomach acid.

More Close Encounters of the "Bob" Kind

Has enough time passed since the jubilant signing of the Health Care Reform Bill and its necessity of 20 pens that we can settle down and speak the truth?

Like... what a terrible disappointment it is that the public option was sacrificed, when it alone would have made this true reform?

Like... how despicable conservative obstructionists have been? How heartless, and cruel? How manipulative and disrespectful of their own followers, that they have, essentially, abused free speech by inciting to riot, by screaming "fire, fire, fire" in the cramped and dark theatre that is the U.S.A.?

Like... how uninformed and illogical many citizens are, and how driven by out-of-control emotion -- fuming, frustrated anger that has all the hallmarks of a two-year-old's temper tantrum, except that two-year-olds don't usually wield the weapons of bigotry?

And (having taken a quick look at today's news headlines) like... how if the Democrats could adopt just a tiny bit of right-wing anality, the bill would not be subject to a re-vote on the basis of parliamentary mistakes? Just because you have succeeded in doing, in a marginal way, what is minimally moral, does not mean that you should fail at following the rules for governance. Yes, I am a nerd, and often a wonk. Yes, I am frequently appointed to be the Ball Buster Rule Diviner -- often seen as a curse, due to the thankless nature of the work, but that role is necessary to success. I haven't yet scoped out who the House Parliamentarian is... but 30 lashes with a limp noodle might be appropriate.

So I ran across this Emperor Bob person/persona on Twitter, then briefly visited his blog, Emperors Rants and Observations, where he can be found addressing the Various Issues of the Day, from campaign finance reform and climate change to the health care reform initiative and Alaskan politics. He's keen.

Oh, Faithful Readers:
I am so tired this morning.

My internist and I, recognizing an infection flaring in my left shoulder, decided that I should return to my poor orthopedic surgeon. Um, poor in the sense that the man has operated on me eight times since 2005, replacing shoulders, removing shoulders, putting in antibiotic spacers, taking them out, and so on, but has not managed to get any of the bacterial specimens to grow in the laboratory environment. Without identifying the offending bug, the correct antibiotics cannot be applied to the situation.

And now the pain is getting worse on the right side, and... {whisperofdenial} my left hip. Both of those joints have "hardware" implanted, thus making them attractive breeding grounds for germs. But we won't think about that today.

So, Fred loaded me and my super-duper powerchair into Ruby, the Honda CR-V, and we sped off to see said surgeon.

You are a fool if you believe that being without health insurance does not affect the standard of the care you receive, even in the form of advice.

ShoulderMan opined that he wanted another "aspiration under fluoroscopy," which would be the fifth or sixth time we tried that particular trick. It is painful, not particularly dangerous, and expensive. But, for me, the overriding factor was that it has never produced a piece of useful data.

If samples of purulent pus taken directly from my humerus during surgery and rushed to the awaiting petri dishes in a sophisticated hospital lab also cannot produce the identification of the offending organism, why do we keep pretending that these painful and expensive aspirations are in any way superior?

I reminded ShoulderMan that since I had last seen him, I had been priced out of my health insurance -- my Faithful Readers know well that I just could not swing $1513 a month for premiums, plus the $5000 more in deductible, and all of that on top of the thousands not covered. I live on private disability insurance due to the combined effects of CRPS in all my limbs (and now, face), avascular necrosis, lupus, Addison's disease, aortic insufficiency and so on, ad infinitem, ad nauseum.

Believe me, I tried to stay insured. It took the help of my state's Insurance Commissioner for me to have coverage to begin with, once COBRA expired. But BCBS eventually was demanding 97% of my income... and I dare you to criticize me for folding, at that point.

ShoulderMan said: "I don't get it. You ought to have MEDICARE."

{we have had this exact conversation already several times over and over again, not to be repetitive or fall into a déjà-vu sort of iterative redundancy}

Moi: "Yes, Dear ShoulderMan, I ought to. {actually, i tried to pull off an oughtn't i? but couldn't spit it out.} However, I fail to qualify because most of my working years were spent in university systems that did not pay into Social Security but rather into poorly funded and criminally operated pension funds. I lack ONE work credit, in the amount of $830, toward eligibility."

ShoulderMan replied, with a fair amount of dripping condemnation in his voice: "Well, why don't you do some work for a week, maybe tutor some local college kids, and turn that in?"

Moi: "Hmm, wow, I never thought of that." Okay, that's a lie. What I really said was:

"I have been informed by my Disability Insurer that to do so would mean the loss of my disability income, and it would be well over two years before any substantive replacement from governmental sources would kick in."

ShoulderMan muttered: "Oh, well... Okay. So I think we need to get this aspiration done and consult with a new Infectious Disease doctor, maybe over at Charity Hospital. This is the kind of thing that cannot be ignored..."

And he promptly exited, stage left.

His minion, PA Bob, then did something that reduced me to tears. Yep, here I go again, even crying into my laptop.

He came over to me, handed me the official pink and yellow copies of codes for the visit, so that I could check out and pay (which I obviously was prepared to do). As he walked into the crowded hallway, he said, loudly:

"Why, wasn't that nice of Dr. ShoulderMan. Look, he marked the box for 'No Charge' so that you don't have to pay for this consult."

Dr. ShoulderMan, who moves at roughly the speed of light, was long gone and already ensconced in the next exam room, so Bob was not making points with him... Leaving me, once again, to wonder why Bobs, in particular, are so intent on confusing me! For a succinct treatment of my history with Bobs, read this.

I've never engaged in a political dialogue with either PA Bob or his boss, having intimated from various remarks that they are both ultra-conservative and that ShoulderMan may, in fact, be an Evangelical (I intend that to reference the Conservative Evangelical Movement, à la George W. Bush).

Aside: Here is one of the fairest succinct explanations of Evangelicalism that I've run across. It comes from an address by conservative EPPC Senior Fellow Wilfred McClay* entitled American Culture and the Presidency, delivered either in Fall 2004 or early 2005.

As a faith that revolves around the experience of individual transformation, it inevitably exists in tension with settled ways, established social hierarchies, customary usages, and entrenched institutional forms. Because evangelicalism places such powerful emphasis upon the individual act of conversion, and insists upon the individual's ability to have a personal and unmediated relationship to the Deity and to the Holy Scriptures, it fits well with the American tendency to treat all existing institutions, even the church itself, as if their existence and authority were provisional and subordinate, merely serving as a vehicle for the proclamation of the Gospel and the achievement of a richer and more vibrant individual faith.

Anyway, there is nothing abstract in the nature of how being an uninsured (and uninsurable) citizen impacts my life. It truly may contribute to my death, as I have spent the first few working hours of this day on the phone with the aforementioned Charity Hospital -- and the helpful pickings are, let's say, slim. The clinic system there may eventually help me, but there are no appointments to be had anytime soon.

Unbelievably, three times (like Peter's crowing cocks), I was told to go to the Emergency Room!

I have avoided a close rereading of what Obama signed, and what Congress is continuing to work through, precisely because I am not yet convinced of the permanence of any change -- but clearly, I am going to have to dedicate time to it today.

Because if there is no fairly immediate help for me in the legislation, I am close to abandoning all hope. I cannot continue with daily fevers up to 101, the attendant sweats, chills, and pain -- on top of my usual severe pain from CRPS and AVN -- I cannot sit in waiting rooms for hours, especially now that my left hip may have joined with the Infected Skeletal Alliance.

Oh, boo-hoo! What a sob fest this post has turned into! But I am going to leave it as is, if only for its potential to serve as a shaming mirror the next time I decide to whine.

The saving grace here is this YouTube video from Emperor Bob, an amazingly calm rant to which I will return with frequency... Thanks, Bob! [Correction -- a correction which blows the whole Bob Phenomenon to hell, but maybe you won't notice -- that is not Bob on the video. No, the star of that show is one "old fart rants," who has quite the head of steam built up over on YouTube!]






*Wilfred McClay is the 2009-2010 William E. Simon Distinguished Visiting Professor at the School of Public Policy. He is the SunTrust Bank Chair of Excellence in Humanities at the University of Tennessee at Chattanooga, where he is also professor of history, since 1999. He is Senior Scholar at the Woodrow Wilson International Center for Scholars in Washington, DC, Senior Fellow at the Ethics and Public Policy Center, and has served since 2002 on the National Council on the Humanities.

Major sigh, and where is the ibuprofen? "The SunTrust Bank Chair of Excellence in Humanities"?

Has It Come To This?

New Vigilance Needed in Wake of Healthcare Vote

by David Silverberg
Monday, 22 March 2010


Violent domestic extremism poses a real threat.

In the wake of the divisive 219-212 House vote passing healthcare reform, authorities need to heighten vigilance against extremist violence against government facilities.

The year-long healthcare debate was emotional and divisive and while the vote may have resolved the issue legislatively the passions it aroused are unlikely to die down soon.

In such an atmosphere extremist violence is a real possibility, particularly directed against government installations or symbols of government authority. Coming on top of a census process that has also been infused with extremist charges, homeland security officials at all levels of government should be especially vigilant against potential attacks from domestic sources.

Domestic extremist terrorism has long been on the homeland security radar. In 2009 a report by the Office of Intelligence & Analysis in the Department of Homeland Security (DHS), titled, Rightwing Extremism: Current Economic and Political climate Fueling Resurgence in Radicalization and Recruitment noted that while there were no specific plots under way, "rightwing extremists may be gaining new recruits by playing on their fears about several emergent issues." These included the election of the first African-American president and the economic downturn. It also reported that extremists were recruiting returning Iraqi war veterans. Homeland Security Secretary Janet Napolitano later disavowed the report as having been released prematurely without proper vetting.

More recently, on March 2 the Southern Poverty Law Center released its own report, Rage on the Right , reporting that "The radical right caught fire last year, as broad-based populist anger at political, demographic and economic changes in America ignited an explosion of new extremist groups and activism across the nation." According to this report, 363 new "Patriot" groups formed in 2009, with 127 of them being militias and the formation of 136 new anti-immigrant groups.

As though to underscore the volatility of the current situation, yesterday, as the House of Representatives voted on healthcare reform legislation, tens of thousands of demonstrators descended on Washington to demand comprehensive immigration reform, an issue that may prove even more passionate and divisive than healthcare.

Read the rest here, at Homeland Security Today

Stand, and Remember

I just heard that Glenn Beck has admonished John Lewis for "comparing" himself to "civil rights activists."

He is not worth my time, Glenn Beck, yet he requires attention because of the uncritical thinkers who are following him.

John Lewis, though, needs no defense from anyone; He need only stand, as he has always stood.

The rest of us, however? We are required to remember, and to share those memories with an abundant spirit.

From The Biography of John Lewis:

He was born the son of sharecroppers on February 21, 1940, outside of Troy, Alabama. He grew up on his family's farm and attended segregated public schools in Pike County, Alabama. As a young boy, he was inspired by the activism surrounding the Montgomery Bus Boycott and the words of the Rev. Martin Luther King Jr., which he heard on radio broadcasts. In those pivotal moments, he made a decision to become a part of the Civil Rights Movement. Ever since then, he has remained at the vanguard of progressive social movements and the human rights struggle in the United States.

As a student at Fisk University, John Lewis organized sit-in demonstrations at segregated lunch counters in Nashville, Tennessee. In 1961, he volunteered to participate in the Freedom Rides, which challenged segregation at interstate bus terminals across the South. Lewis risked his life on those Rides many times by simply sitting in seats reserved for white patrons. He was also beaten severely by angry mobs and arrested by police for challenging the injustice of Jim Crow segregation in the South.

During the height of the Movement, from 1963 to 1966, Lewis was named Chairman of the Student Nonviolent Coordinating Committee (SNCC), which he helped form. SNCC was largely responsible for organizing student activism in the Movement, including sit-ins and other activities.

While still a young man, John Lewis became a nationally recognized leader. By 1963, he was dubbed one of the Big Six leaders of the Civil Rights Movement. (The others were Whitney Young, A. Phillip Randolph, Martin Luther King Jr., James Farmer and Roy Wilkins). At the age of 23, he was an architect of and a keynote speaker at the historic March on Washington in August 1963.

In 1964, John Lewis coordinated SNCC efforts to organize voter registration drives and community action programs during the Mississippi Freedom Summer. The following year, Lewis helped spearhead one of the most seminal moments of the Civil Rights Movement. Hosea Williams, another notable Civil Rights leader, and John Lewis led over 600 peaceful, orderly protestors across the Edmund Pettus Bridge in Selma, Alabama on March 7, 1965. They intended to march from Selma to Montgomery to demonstrate the need for voting rights in the state. The marchers were attacked by Alabama state troopers in a brutal confrontation that became known as "Bloody Sunday." News broadcasts and photographs revealing the senseless cruelty of the segregated South helped hasten the passage of the Voting Rights Act of 1965.

Despite more than 40 arrests, physical attacks and serious injuries, John Lewis remained a devoted advocate of the philosophy of nonviolence. After leaving SNCC in 1966, he continued his commitment to the Civil Rights Movement as Associate Director of the Field Foundation and his participation in the Southern Regional Council's voter registration programs. Lewis went on to become the Director of the Voter Education Project (VEP). Under his leadership, the VEP transformed the nation's political climate by adding nearly four million minorities to the voter rolls.

Keep your eyes on the prize, hold on.

From Outrage to Grief: Trying to Understand

When I read the news this morning, my outrage boiled over, pooling into disbelief. As the day wore on, it evolved into something akin to grief.

I have decided it to be a good thing that I am shocked, as opposed to nodding sagely and murmuring that "I am not surprised."

I am shocked and I am surprised. Profoundly so.

The insanely angry, sputtering atmosphere the Tea Baggers have created allowed one of their peculiar fetishists to think it a grand idea to yell "nigger" at John Lewis, who has lived a life of integrity and service, first as a civil rights leader, and then as an elected representative from Georgia.

Obscenities were shouted at other members of the Black Caucus, and, just to be equal opportunity bigots, Barney Frank had to endure lisps and being called a "faggot."

Someone spit on Congressman Cleaver of Missouri.**

Signs screamed: "If Brown can't stop it, a Browning can" and "We came unarmed [this time]." Then there is the artwork depicting President Obama, sporting a Hitleresque moustache for good measure, being shat out the arse of an ass.

ADDENDUM:

And racism and gay-bashing apparently wasn’t all. Add anti-Semitism to the list.

A staffer in Rep. Anthony Weiner’s office reported a stream of hostile encounters with tea partiers roaming the halls of Congress. The less harmful stuff was mockery. But they left a couple of notes behind. One asked what Rahm Emanuel did with Weiner in the shower, in a reference to... ex-Rep Eric Massa. It was signed with a swastika, the staffer said. The other note called the congressman “Schlomo Weiner,” among other [things].

There is good stuff being written every minute of every day, and some of it helps me to understand the fear-filled feelings of disenchantment (or whatever, searching for an honorific mot juste on behalf of the right wing nauseates me right now).

But not much tops what The Onion did last November. It came back to mind as I attempted to watch Meet the Press and skim commentary on yesterday's doings because the Word of the Day for Republicans, in advance of the historic House vote on health care reform, turned out to be unconstitutional.

If I thought something unconstitutional, I'd use that argument straight away, and not pull it triumphantly out of my... hat -- at the very last. But that's just me.

Area Man Passionate Defender Of What He Imagines Constitution To Be

Spurred by an administration he believes to be guilty of numerous transgressions, self-described American patriot Kyle Mortensen, 47, is a vehement defender of ideas he seems to think are enshrined in the U.S. Constitution and principles that brave men have fought and died for solely in his head.

"Our very way of life is under siege," said Mortensen, whose understanding of the Constitution derives not from a close reading of the document but from talk-show pundits, books by television personalities, and the limitless expanse of his own colorful imagination. "It's time for true Americans to stand up and protect the values that make us who we are."

According to Mortensen—an otherwise mild-mannered husband, father, and small-business owner—the most serious threat to his fanciful version of the 222-year-old Constitution is the attempt by far-left "traitors" to strip it of its religious foundation.

"Right there in the preamble, the authors make their priorities clear: 'one nation under God,'" said Mortensen, attributing to the Constitution a line from the Pledge of Allegiance, which itself did not include any reference to a deity until 1954. "Well, there's a reason they put that right at the top."

"Men like Madison and Jefferson were moved by the ideals of Christianity, and wanted the United States to reflect those values as a Christian nation," continued Mortensen, referring to the "Father of the Constitution," James Madison, considered by many historians to be an atheist, and Thomas Jefferson, an Enlightenment-era thinker who rejected the divinity of Christ and was in France at the time the document was written. "The words on the page speak for themselves."

According to sources who have read the nation's charter, the U.S. Constitution and its 27 amendments do not contain the word "God" or "Christ."

Mortensen said his admiration for the loose assemblage of vague half-notions he calls the Constitution has only grown over time. He believes that each detail he has pulled from thin air—from prohibitions on sodomy and flag-burning, to mandatory crackdowns on immigrants, to the right of citizens not to have their hard-earned income confiscated in the form of taxes—has contributed to making it the best framework for governance "since the Ten Commandments."

"And let's not forget that when the Constitution was ratified it brought freedom to every single American," Mortensen said.

Mortensen's passion for safeguarding the elaborate fantasy world in which his conception of the Constitution resides is greatly respected by his likeminded friends and relatives, many of whom have been known to repeat his unfounded assertions verbatim when angered. Still, some friends and family members remain critical.

"Dad's great, but listening to all that talk radio has put some weird ideas into his head," said daughter Samantha, a freshman at Reed College in Portland, OR. "He believes the Constitution allows the government to torture people and ban gay marriage, yet he doesn't even know that it guarantees universal health care."

Mortensen told reporters that he'll fight until the bitter end for what he roughly supposes the Constitution to be. He acknowledged, however, that it might already be too late to win the battle.

"The freedoms our Founding Fathers spilled their blood for are vanishing before our eyes," Mortensen said. "In under a year, a fascist, socialist regime has turned a proud democracy into a totalitarian state that will soon control every facet of American life."

"Don't just take my word for it," Mortensen added. "Try reading a newspaper or watching the news sometime."

**Battery: A battery is the willful or intentional touching of a person against that person’s will by another person, or by an object or substance put in motion by that other person. Please note that an offensive touching can constitute a battery even if it does not cause injury, and could not reasonably be expected to cause injury. A defendant who emphatically pokes the plaintiff in the chest with his index finger to emphasize a point may be culpable for battery (although the damages award that results may well be nominal). A defendant who spits on a plaintiff, even though there is little chance that the spitting will cause any injury other than to the plaintiff's dignity, has committed a battery.

CRPS Pediatric Case Study: Successful Use of Pamidronate

The successful use of pamidronate in an 11-year-old girl with complex regional pain syndrome: Response to treatment demonstrated by serial peripheral quantitative computerised tomographic scans
Authors: P. J. Simm, J. Briody, M. McQuade, C.F. Munns

ABSTRACT:
Complex regional pain syndrome (CRPS) is a disorder that can cause significant functional morbidity. While it usually presents in adulthood, it has also been reported in children. Multiple treatment modalities have been reported with mixed success. Bisphosphonate therapy has been shown to be effective in adult patients, but there are limited data in children. We report the successful use of intravenous pamidronate therapy in diminishing pain, improving function, and restoring bone mass in an 11-year-old girl with CRPS of her left lower limb following a tibial fracture. Previous treatment with intense physiotherapy and regional sympathetic blockade had not improved her symptoms. Pain improved within weeks of the first pamidronate infusion, with subsequent improvement in function. The benefit in pain reduction and function was sustained during the 2-year treatment regime. Improvement in bone mass and density was demonstrated by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computerised tomography (pQCT). pQCT scans showed marked improvement in bone size and geometry and muscle bulk on the affected side. No adverse affects were reported. We conclude that intravenous pamidronate was associated with reduced pain, a return of function, and recovery of bone and muscle parameters in a child with CRPS. Before definitive conclusions can be drawn, a randomised controlled trial similar to those undertaken in adults previously is required to fully validate this approach.

Published in Bone, Volume 46, Issue 4, Pages 885-888 (April 2010)

[Received 7 August 2009; received in revised form 9 November 2009; accepted 25 November 2009. published online 14 January 2010.]

Albania

I was just flipping through my listed favorites over at YouTube and came across this oldie-but-goodie from the Cheers era. I like the kind of smile it gives me.

No surprise, probably, that Coach was my favorite cast member.




Over at Ken Levine's blog, we find this information about the episode from script writer Tom Reeder:

Hi, Ken --

As it turns out, I was the writer of that script. It was called "Teacher's Pet", and the storyline had to do with Sam going to night school to get the high school diploma he'd never achieved. Inspired by Sam, Coach also went back to finish up -- he was a couple of years short. Coach proved to be a more diligent student than Sam, because he developed his own unique mnemonic devices. One of them was a song (to the tune of "When The Saints Go Marching In") that contained facts about Albania for an upcoming Geography test: "You border on the Adriatic"... "your land is mostly mountainous"... "and your chief export is chrome".

In fairness, I think Sam Simon may have supplied some of the words for the song, and I may not have the lyrics exactly right, but I'm pretty certain "your chief export is chrome" was the last line. Nick Colasanto really sold it. It was pretty funny.

Update on Missing Child: Lindsey Baum

As is usual, I come away confused by the latest articles, posts, and messages about Lindsey Baum, the 11 year old girl missing from McCleary, Washington, since June 26, 2009 -- abducted, it appears, on her short walk home in what was then a peaceful, naive, and quiet town.

In what I *think* is a typographical error, one news source announced that the reward grew to $120,000. The last I heard, just a few weeks ago, it was $20,000.

Now... $120,000 sounds grand, and let's just run with it! [I haven't yet blogged about my opinion of someone driven by monetary gain in this matter, have I?]

Lindsey J. Baum's case was featured on Nightline Tuesday night. The emphasis was on the techniques employed by the FBI's Child Abduction Rapid Deployment (CARD) team -- from interviewing residents and developing profiles to investigating the whereabouts and activities of area sex offenders. The associated ABC News article can be found here.

I recently declared that I would not contribute to the burgeoning use of expressions employing the word "disconnect" as a noun.

There is a real disconnect between what the ABC News show and articles put forward, in terms of the FBI's activity in McCleary, Washington, and the information more locally sourced.

Even so, I will dutifully report that in the wake of this coverage, 12 people have become persons of interest in the case, 2 of whom are apparently of considerable interest.

The best summation of what appears to be a stalled investigation, despite the FBI's special team antics?

"Somebody saw something and somebody suspects something," said Melissa Baum [Lindsey's mother]. "Somebody knows something and they're not coming forward. I think that's my greatest frustration through this all is, I know there's somebody out there and for whatever reason, they're not sharing whatever information that they have."

Once upon a time, not so long ago, I would never have believed that someone could withhold information about a missing child. Of course, I never thought anyone would reach my blog by typing this into their search engine, either:

I know what happened to Lindsey Baum...

Earlier posts about Lindsey on this blog can be found here.

It's Bob: The Rules of the Road

REPOST from March 26, 2009 This recounts the "Bill"-episode to which my friend Kathleen refers in the next post.


On a recent road trip, Fred took the wheel and appointed La Belle Bianca Castafiore, swathed in a pink feather boa and topped with a demure chiffon petal hat with netting (in ivory), to ride Shotgun.

It would be tacky of me to point out that she wore a *stunning* brick red sheath dress.

According to About.com, that well-known authority on haute couture, the sheath dress "features a figure-hugging silhouette with a defined waist (no belt or waistband). This short (mid-calf or shorter) dress works well in sleeveless styles on well-toned bodies."

I will give you a moment.

As you can imagine, I was fairly put out -- offended in both my fashion sense and my profound sense of decorum -- because I am of the Old School. To ride Shotgun, a person must call Shotgun and wear only fine natural fibers, textiles that obey the dictates of a discrete palette. It is a privilege to be earned, that one merits, not a given right to exercise -- sort of like healthcare. But I won't quibble over words of hierarchy, over Terms of Snoot; I will simply posit the well established Official Shotgun Rules, according to which:

* Shotgun must be called, and the calling witnessed.
* Shotgun may only be called within the timeframe established within the traditions of one's merry company. In our case, this would be within 5 minutes of departure, and when every potential rider and driver is in the presence of the dragster, the very lovely Ruby, Honda CR-V.
* You must have shoes on. No one cares if you sport shoes in the car or upon arrival, but you must be shod, chaussé, in order to call Shotgun.
* If Shotgun is not called by the time a hand grips the shotgun door handle, appointment shall be made by the driver. (Here at Marlinspike Hall, Tête de Hergé, we deviate from the International Rules, whereby: Shotgun can no longer be called once someone's hand is holding the shotgun door handle. This officially stakes their claim to Shotgun and calling it at this time is just redundant. This is one scenario where a person does not actually have to say Shotgun to get the seat. This rule's importance is that no one has to be around for you to stake your claim to Shotgun, whereas usually one other would-be occupant must be present for you to call it.)
* Rock, Paper, Scissors resolves all disputes -- from map-reading and how best to evade rush hour traffic to who shall pay for gas and, more important than fuel, sundries. (Why more blogosphere time is not devoted to the discussion of sundries -- from bar snacks to oddments -- I don't know, for ours is a sundry-driven culture.)
* And the rules go on and on, open to careful revision due to the plastic, evolving nature of Shotgun. You get the idea. This is not a wild, ungoverned affair -- we are civilized, we do things a certain way. Tradition *matters*.

Back to my anecdote. Here is the rule that, when broken, finally chapped my delicate hide that day: If someone is driving an automobile other than its owner and the owner becomes a passenger, then the owner automatically gets Shotgun. When applied, this rule shows respect to the owner of the car.

Ruby, the Honda CR-V, is mine. She is equipped with Bruno, the wheelchair lift. Bruno is also mine. My point? I am the owner; I rule. I get Shotgun, de jure, de facto.

That La Belle Bianca Castafiore decided to sing out and "call" Shotgun for the first time in her morbidly obese life was just... quaint; That Fred delighted in this aberration? Well, *that* was... dégoûtant!

And so it was that we set out, framed in a modern Decameron, novellas waiting to spring from our lips -- we, the happy travelers, escaping the smog, oppression, and pestilence of our city.

Castafiore up front, me in the back. Fred, all pleased with himself, at the wheel. Truly the makings of a literary event, a salon on wheels.

First, we told tales of hitchhikers and of hitchhiking. I am not a good story or joke teller -- in fact, people around me are prone to disappear, if disappearance is at all possible, when it is my turn to jest or narrate. But in this instance, I had a captive audience.

Still, it was difficult to think of tales that were not already known to Fred. This had me delving, unfortunately, into my supply of Squirrelly Stories. The Good Fredster and I have been together for 18 years -- certainly a relationship that I treasure, and his opinion one that matters much. I was not, however, feeling particularly, um, close to him at that moment, and so it was that I risked his disdain and introduced my audience to Bob.

I dropped out of college at the end of my freshman year. There is no fascinating subtext. It was a perfectly ordinary case of rebellion and confusion. So I moved to a neat-o city, took a short nurse's assistant training, and got a job at a large charity hospital, where I worked in the Post-Intensive Neuro Unit. I am sure these units are now called something that sounds much more chic.

Having been in a whirlwind romantic relationship the previous year, part of the reason for my disaffection with academics, I wanted only to make enough money to keep body and soul together, audit some courses at the nearby university after work, and maybe meet some interesting folk who could show me more of life. To say that I was lacking in savoir faire was an understatement.

Enter Bob.

We met at work. Bob was an LPN -- his job was to dole out the meds. He was 15 years my senior, kind of scruffy, spoke with the distinct regional twang, and seemed truly compassionate to the odd mix of patients we had. On one end of the floor, there were mostly post-op back patients, laminectomies, fusions, diskectomies, and the like, with an occasional brain tumor thrown in for good measure. On the other end? Gorks.

I was there for about two years before I resumed my academic career, finally majoring in what made the most sense: Romance Languages and Literature, with a minor in Anthropology.

Toward the end of my stay, Bob asked me out. I was once again in another relationship at the time, but it was one with no future -- a much older married man who owned a health food store, sold drugs, and raised pythons on the side. Phil's marriage was "open," and I was actually on good terms with his wife, getting to know her rather well over coffee in the mornings. (She was sleeping with my roommate. Indeed, our kitchen was an interesting place to start the day, for in addition to her fondness for Phil's wife, my roomie Debra had an affinity for musicians of all genders and orientations, and she regularly brought them home. It was a toe-tappin' place.)

I had the Castafiore woman and Fred wrapped around my little finger at this point. Fred seemed to be overheating, in fact. His gaping mouth was quite like that of a fish out of water. His face clearly read: Where has my demure and straightlaced Retired Educator gone? How can the trollop of this tale be the same person as my Beloved Smarty-Pants?

Hmm. Earlier I said there was no subtext. There is always a subtext, Dear Reader! Usually, several. But it kills a story to spell them out, much as starting with the punchline kills most of my jokes. I so wanted to tell Fred how great it had been to learn, as part of the lesson of those years, that I was a good and decent person.

Anyway, Bob and I had dinner, then went for a drive in the country.

He cranked up the radio, reached over and took a big plastic bag from the glove compartment of his truck, plopped it down between us, and said, "You first!"

In that bag was a rainbow of pills, tablets, and capsules. Probably over a thousand of them.

Smirking at my sudden paralysis, Bob reached in, scooped half-a-handful, popped them in his mouth, and swallowed them down with his beer. I was cold, and shivering, so scared. By then we had driven well into the mountains, and nature, too, was cold.

Something told me to make myself small. I retreated into my seat and said not a word as Bob returned to the bag of goodies several more times and started on another beer. I had not a clue where we were.

About an hour into the drive, Bob began muttering strange things and shooting scary looks at me. I had assumed monstrous proportions in his mind; I had become some sort of threat.

He did the only logical and gentlemanly thing -- he suddenly pulled the truck over and pushed me out, then drove away at high speed.

For the first time in my 20 years, late, late on a cold night, alone out in the boondocks, I flexed my thumb.

Three cars sped by with no intention of stopping to pick me up. In my heart, I was relieved, for I knew they were all ax murderers.

By the time the burly, hirsute dude in the 18-wheeler Mack truck gently pulled over onto the gravel, I was in tears and hugging myself out in the icy air, feeling strangely insubstantial.

He had a thermos of black coffee, and the heater in the cab was humming. We didn't talk much. I told him where I lived, not thinking that a real hitchhiker would hardly expect to be taken straight to one's front door -- not thinking, also, that Debra might not appreciate me showing an unknown trucker where we lived.

He probably risked some hefty traffic fines by taking that truck onto residential streets, but he did indeed deposit me at my front door -- with not a threatening word or glance, not a moment of rebuke. All I told him was that my boyfriend must have developed car trouble -- leaving him to figure why I would be waiting for my boyfriend up on a deserted ridge in the middle of the night, sporting a coat that was a winter joke.

Fred shook his head. "You were lucky. And you were stupid! And..."

Without a hitch, I began my second "Bob" tale.

Fast forward. I had resumed the life that was expected of me, but at a furious pace. I was completing three years of coursework in two, working full time -- and I was doing it with panache, success.

I am in control. I am cruising.

One night, as I was getting ready for bed when the phone rang.

"Hey, Future Educator! How are you doing, girl?" called out a friendly male voice that was *very* familiar.

"Fine. Really well. Thanks for asking! Who is this?" I asked.

"It's Bob!"

One of my brothers is named Bob. I had a classmate name o' Bob. This Bob was clearly not, however, either of them.

It hit me like a bolt of lightening! "Bob B? Is that you? I didn't think we would ever talk to each other again, after that stint you pulled out on the parkway. You never did apologize, you know..."

Bob and I talked for over two hours -- telling war stories of what it had been like to work with the Laminated and the Gorked, hashing out what happened between us -- he had been under so much work-related and personal stress of which I had been *totally* unaware.

The next night, another marathon phone session. This time, though, he said he'd be heading my way the following day, for a nursing conference taking place at my university. Would it be all right if he stopped by?

"Stop by? Why not stay here and save the motel/hotel money?"

I gave him directions to my apartment. He was to arrive around 7 pm.

After classes, I rushed home to straighten up the place, then back out to do some shopping (flowers, coffee, tea -- and dairy). Back by 6, I smoked a couple of cigarettes, thumbed through some books. By 8, I was discouraged, and hungry enough that I went ahead and cooked the dinner I had planned. A cheese soufflé, my show-off standard.

The phone rang around 10.

"I can't do this to you. I have to tell you the truth. First, don't worry. I am not in your town, and I won't ever show up. I do this for kicks."

"Do what for kicks? What are you talking about. Look... I am over what happened that night. It was a life lesson..."

"Call people up at random, long distance. Tell them my name is Bob. Talk for hours. Learn all there is to know about them... You see, everybody knows a Bob."

And so it was that I won the storytelling competition, winning by an incredible margin over the tired "night I wrecked my motorcycle," and the old "pendant ma jeunesse..." soliloquy.

Best of all, when we pulled into a gas station to refuel, use the restrooms, and acquire sundries, I successfully trumped the Castafiore and Fred, both, by calling Shotgun and regaining my rightful place in the world.

Do I know how lucky I am?

You betcha!

[Download The Decameron, as ebook, for free at the Gutenberg Project.]