Saturday, July 10, 2010

Charles Bernstein :: Leslie Scalapino



As noted earlier, there are some wonderful éloges floating around for Leslie Scalapino, who died May 28, 2010.

Charles Bernstein has pointed many of them out, as well as providing gentle suggestions about what really matters by virtue of his blog gleanings.

Here is his own memory of her, published in SIBILA, poesia e cultura. He addresses something that most gloss over, or address pedantically, in an of-course kind of way: the pesky business of Scalapino and poetic intention, inseparable from "the integrity of the work itself." A huge part of my appreciation for her work springs from the fact that it is work.

Leslie Scalapino’s Rhythmic Intensities

Scalapino Memorial
Poetry Project at St. Mark’s Church
New York, June 21, 2010

The poet dies, the poet’s work is borne by her readers.

When I first encountered Leslie Scalapino’s work I was hard hit by its psychic intensity, formal ingeniousness, and rhythmic imagination. I felt I came to the work late; the first book I read was
The Woman who Could Read the Minds of Dogs, which while published in 1976, I didn’t read till around 1981. The psychosexual dynamics of the work and its ability to make dislocation a visceral experience immediately became, once I had taken in the magnitude of Scalapino’s project, a capital point on the mapping of poetry associated with L=A=N=G=U=A=G=E magazine, one that deepened and enriched that survey. When North Point published Considering How Exaggerated Music Is in 1982, Scalapino’s work became an indelible part of my poetic firmament, that imaginary company each of us chooses but that also chooses us. That is, I feel as much chosen by Scalapino’s work as that I was doing the choosing; her work entered into and changed my consciousness about what was possible for poetry, changed the terms for all of us working along similar lines.

Every once in a while I would say something to Leslie about
Considering How Exaggerated the Music Is. She would shake her head, slightly laughing, “Oh Charles not the music: considering how exaggerated music is.” As in her music, the music of her poems. Not exaggerated in the sense of hyperbolic or overstated, but as in extravagant, wild and wandering.

Starting in my earliest conversations with Leslie, when I would try to describe qualities I found in her work, she was adamant in resisting interpretations she felt countermanded her intentions. When I would say, but you know, Leslie, readers will respond in many different ways to a poem, she would give no ground; for her, how a work is to be interpreted was part of the poem: not just her intention, but part of the integrity of the work itself. I felt her rebuke to my more porous view of interpretation to be magnificent and improbable, for as much as Leslie set the bar for interpretation a bit higher than actual reading practices will ordinarily sustain, she demonstrated her fierce commitment to poetic meaning and also the truth in the form and materials, sincerity in Zukofsky’s sense: that reading was a social bond that necessitated the reader’s recognition of the formal terms of the work. So there was a right way to read, not in the moral sense but in a very practical one, as in a right way to operate software so it works, does the job for which is was made.

And you could say that Scalapino created a new and thrilling poetic software, allowing for a phenomenological unique experience, something like a 3- or 4-D poem. Her overlays, repetitions, and torques enable proactive readers to enter the space of the poem as something akin to a holographic environment. The present time of the work is intensified by her echoes (overlapping waves of phrases) of what just happened and what is about to happen, so the present is expanded into a temporally multi-dimensional space. Her undulating phrasal rhythms are in turn psychedelic, analytic, notational, pointillistic, and narrational. Think of it as deep-space syncretic cubism. And Scalapino’s performances of her work, many collected at
PennSound, are crucial guides to entering this hyperspace.

Scalapino’s poetry was central to my poem/essay
Artifice of Absorption, which I wrote starting in 1985. In Artifice of Absorption, I noted that Scalapino’s rhetorical repetitions create a disabsorptive/affective charm: the slight, accented, shifts in similar statements operate as modular scans of the field of perception, building thick linguistic waves of overlay and undertow, the warp of a thematic motif countered with the woof of its torqued rearticulation.

When I visited Leslie and Tom in Oakland a few weeks before Leslie died, her luminous and effervescent stoicism, the nobility in which she acknowledged death lurking in her garden, was fused with her refusal to give up on life and her urgent, tragic recognition of the work she still had it in her to do that she would not be able to do. She spoke of how much she wanted to come to New York to read her new work, and so together with Stacy and Tracy we made plans for her to read here tonight. In Oakland in May, we laughed together at the moment’s literary gossip and we talked about her just finished book,
The Dihedrons Gazelle-Dihedrals Zoom, written in the late style of Floats Horse-Floats or Horse Floats; she knew it would be her last.

I sent her my response to this work just days before she died, trying to do justice to the work and hoping that she would accept my description as apt, which Tom tells me she did:

The Dihedrons is an ekphrastic implosion inside our severed human-body/animal-mind. “Memory isn’t the origin of events,” Scalapino writes early in this magisterial work, which restores the synthesis of events to its place as meanings' origin. The Dihedrons Gazelle-Dihedrals Zoom -- as much a work of grotesque science fiction as a poem --cracks open the imaginary reality astride reality. In the stadium of its visionary composition, the everyday floats vivid strange: in time, as time, with time, beside time.

Scalapino’s poems, from her first book to this last, probe politics, memory, perception, and desire, creating hypnotically shifting coherences that take us beyond any dislocating devices into a realm of newly emerging consciousness. Like a sumo wrestler doing contact improvisations with a ballerina, Scalapino balances the unbalanceable poetic accounts of social justice and aesthetic insistence.

Every once in a while, I’d say something to Leslie about her book series, calling it O Press; she would shake her head, slightly laughing, “Oh Charles not oppress, O Books”! “Oppression is our social space.” Leslie, with the support of Tom White, created one of the great small presses of our time.

I keep thinking about her titles, which are among the most amazing, fantastic, and unexpected of anybody ever … And her essays, which are models of a non-expository, exploratory style remains foundational for any activist poetics.

Like a ballerina doing contact improvisations with a sumo wrestler.

The poet dies, the poet’s work is borne … by us, in us, through us, as us.

It’s the longest day.

Considering how exaggerated music is.



It's thanks to Bernstein's use of it as a citation that I came to love this bit from one of Giraut de Bornelh's songs:

And they say
If I would just sing lighter songs
Better for me would it be,
But not is this truthful;
For sense remote
Adduces worth and gives it
Even if ignorant reading impairs it;
But it's my creed
That these songs yield
No value at the commencing
Only later, when one earns it.



image is of a troubadour casket

Thursday, July 8, 2010

CRPS: IASP Diagnostic Criteria Taken to Task


The latest news from my MedWorm CRPS-related feeds addresses the diagnostic criteria established by the International Association for the Study of Pain (IASP). The longheld general opinion is that these criteria have "high sensitivity," but "poor specificity," with the resultant complaint of overdiagnosis of CRPS.

It's a good dialogue to have at this time, and one that needs to be renewed periodically, as the hard science attempts to catch up with the clinical expressions of the disease. The summary conclusion of this round of talks is a clear preference for the Budapest CRPS Criteria over the IASP recommendations most widely in force. For an excellent summary (and yes, it will seem repetitive to some of you) see Dr. Bruehl's power point presentation here, on CRPS taxonomy. The IASP criteria are sometimes shorthanded as "the Bruehl criteria," remember!

All three of the following studies were published in the online version of PAIN: The journal of the IASP.*


Development of comprehensive diagnostic criteria for complex regional pain syndrome in the Japanese population

Masahiko Sumitani, Masahiko Shibat, Gaku Sakaue, Takashi Mashimo, Japanese CRPS Research Group

Received 31 July 2009; received in revised form 21 January 2010; accepted 23 March 2010. published online 07 May 2010

Abstract
Complex regional pain syndrome (CRPS) is a syndrome that describes a broad spectrum of sensory, motor and autonomic-like features with unproven etiology. The International Association for the Study of Pain (IASP) diagnostic criteria of CRPS shows high sensitivity but poor specificity. Using statistical-pattern-recognition methods, American researchers have suggested a new set of criteria offering acceptable sensitivity and high specificity. However, non-American CRPS patients present distinct subsets of CRPS-related signs/symptoms from those of American patients. Here, we followed a series of American studies to develop a set of CRPS diagnostic criteria that would be most suitable for the Japanese population. A standardized sign/symptom checklist was used in patient evaluations to obtain data on CRPS-related signs/symptoms in 195 participants meeting the IASP criteria. Using factor analysis, we grouped CRPS-related signs/symptoms into five distinct subgroups (trophic change, motor dysfunction, abnormal pain processing, asymmetric sudomotor activity and asymmetric edema). Discriminant function analysis of these subgroups, regarding their ability to discriminate between CRPS and non-CRPS etiology, indicated that modifying the IASP criteria could increase clinical diagnostic accuracy in the Japanese population. Our diagnostic criteria are not exactly the same as the American criteria, indicating a need for more regionally based CRPS diagnostic criteria. Different sets of CRPS diagnostic criteria could lead to dissimilar patients being diagnosed as CRPS, however, presenting problems for translation of therapeutic effects found in various studies. Therefore, we further recognize a need for a global set of common CRPS diagnostic criteria.


I have to say that the words "unproven etiology" fairly jump off the page, even though I understand that determining the larger cause-and-effect relationships -- generally noxious events and nerve injuries -- is not equivalent to establishing useful, science-supported proven etiologies, being more in the nature of events. (Leave my sentence alone!) What is especially important is to reiterate that hanging everything from the nail of sympathetically-maintained pain [SMP], and diagnosis by sympathetic block, is definitively outmoded, and usually just plain wrong.

The necessity for regionally-based (or nation-based) diagnostic criteria makes enormous sense, particularly given the rigarmarole above of unproven etiologies. It is gratifying, though, that the five (or the Budapest 4!) basic subgroupings for CRPS symptoms hold "true." The practicing medical world dearly loves a checklist.


Modifying diagnostic criteria for Complex Regional Pain Syndrome by Stephen Bruehl, Ph.D. appears in the same issue (Volume 150, Issue 2, August 2010). Dr. Bruehl, of Vanderbilt, is a clinical psychologist, specializing in "Endogenous Pain Regulatory Systems and the Psychobiology of Emotions":

The general focus of Dr. Bruehl’s work is on understanding the functioning of endogenous pain regulatory systems in healthy individuals, and possible dysfunction in these systems associated with chronic pain. Endogenous pain regulatory systems are complex, involving descending pain inhibitory pathways mediated in part by both endogenous opioid and alpha-2 adrenergic mechanisms. Moreover, there appear to be adaptive functional interactions between the cardiovascular and pain regulatory systems that serve to maintain homeostasis in the presence of painful stimuli. Dr. Bruehl’s work focuses on the interface between these areas, and how chronically painful conditions alter the normal functioning of these interacting systems.


Dr. Bruehl figures in the [Budapest] group publishing the third article in this PAIN "series" on CRPS, as well:

Validation of proposed diagnostic criteria (the “Budapest Criteria”) for Complex Regional Pain Syndrome

R. Norman Harden, Stephen Bruehl, Roberto S.G.M. Perez, Frank Birklein, Johan Marinus, Christian Maihofner, Timothy Lubenow, Asokumar Buvanendran, Sean Mackey, Joseph Graciosa, Mila Mogilevski, Christopher Ramsden, Melissa Chont, Jean-Jacques Vatin

Received 18 November 2009; Received in revised form 19 March 2010; Accepted 20 April 2010. Published online 21 May 2010.

Abstract
Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the “Budapest Criteria”) regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS.




* PAIN® is the official journal of the International Association for the Study of Pain® (IASP).

Wednesday, July 7, 2010

Lindsey Baum :: Update


There are a few new items of note regarding the case of missing 11-year-old Lindsey Baum. June 26, 2010, marked the one year anniversary of her disappearance while walking home one evening from a friend's house in her hometown of McCleary, Washington.

The reward for information has grown to $30,000.

More surveillance video has been released in the hope that the men (one in a black plaid shirt, the other in a red tank top) who figure in them may have seen something important on that evening last summer.

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

To read all entries about Lindsey on this blog, click here.


Man wearing a black plaid shirt:


Man wearing a red tank top:


The black truck:

Tuesday, July 6, 2010

The one where reality lives up to expectations...

A short post, and an odd one, but I need to do it.

(Is it terrible to be terrible?)

(Yes.)

Following Sammy's death, an internet troll decided to separate me from the herd, decided to be lioness to my nervous, flighty, incompetent gazelle.

We both visit a certain website dedicated to... well, a fetish. Not a fetish that would cause you to gasp or make milk go up your nose, no... more of a common fixation turned art project, if you will.

A minor, not major, fetish.

And that's minor as in "inferior in importance," not "underage child."

Why, look! I am sweating bullets.

As always happens on sites dedicated to x, y, or a minor fetish, an actual community has evolved midst the serious virtual business of reviewing videos and talking shop. It's not a warm and fuzzy nuclear family; No, it's more of a dysfunctional and fuzzy one.

Holiday gatherings are just a scream.

The gentleman who runs the site established the usual area in the back (behind the stacks of cardboard boxes and piles of mostly empty paint cans and ancient twined-together newspapers), where regulars and irregulars, alike, can vent about almost anything. And so we do.

And so I did. I began a thread about Sam-I-Am and as time passed and he became so ill, I revived the thread to share the sad news of his final illness. It helped, in a small way, because as diverse a crowd as it is over there, people are dependable. Folks love their pets, and such simple commonalities transcend politics and all our other contrived differences.

(Are you still with me?)

The pointy-nosed skank of a troll just couldn't stand it.

She suggested that I donate Sam-I-Am's body to a vet school, ridiculed my grief for a pet, and asserted her image of me as a dried up old lady prune presiding over dreary afternoon salons.

To her friendly comments, she attached, for my viewing pleasure, a video of a feline necropsy.

Truth be told, my only response was a fairly clean-burning anger and a clarified vision of what she must be like. I have managed to hold that anger in check while "in public." In private, I have longed for a few minutes alone with her, a meeting that she would not leave unscathed. (Okay, so maybe she could beat me to a pulp with just the tip of her long, forked, wicked tongue... On the other hand, I have no compunction about running over her flabby ass with my wheelchair.)

In high school, I dissected a cat, and while I wish there had been a fetal pig option, at least I cannot be shocked by the sight.

I said something terminally witty, something along the lines of how she needed psychiatric help. So original! So scathing! (And yet, so true...)

Then I decided the SheTroll could serve as helpful antidote to the poison of our loss. When my sorrow reaches the Point of Emotional Silliness, I only have to imagine her fetid breath, her previously-referenced flabby ass, and her sociopathy to bring me back to Sufficiently Grounded Reality.

Then, too, I thought to employ some of the maturity and smarts people keep insisting I have on hand, and try to let it go. (No, not "let go and let God..." -- just "let it the hell go...")

It turns out, of course, that people, especially fetishists, are just lovely. Yes, you are right -- I've been tackled by that punchline before and doubtless will again.

When I checked my box at the hoodoo voodoo site yesterday, I was heartened and touched by the expressions of juju sympathy over Sammy's death from the gathered brethren and sistren.

There was universal disdain for the necropsy-nattering troll, and I felt much better about things.
Not about Sammy, about *things*. Fred and I both burst into unexpected tears, mostly as we witness the grief of the remaining cats -- and no, it is not our anthropomorphism in play. All three are greatly altered in their behavior and are clearly bringing forth their curiosity, sadness, and confusion.

Anyway, as to the reason I am writing, and you are reading... THIS? I just opened another bit of mail over at this site, from a member I don't know well, but who has always been very nice, and often funny. She enclosed a link to a 2008 news article published in the UK's Independent, saying that she just wanted to share in the great gulping laughter she experienced when she initially discovered the article -- which features none other than our own beloved troll.

Troll extols herself as an academic, perhaps a researcher, touts having "worked with" Margaret Mead and other tossable names -- most recently, while analyzing moi-même, she pronounced herself a therapist. She's a swirling dervish of an expert in everything.

(Funny, in what proved to be a not-far-off impulse, it went through my mind that she was more likely a Dominatrix for Droopy-Diapered Adult Babies... that seemed both more her speed, and definitely more her crowd.)

It turns out she's a Phone-Sex Operator*, recasting herself as Scheherazade.

Oh, my heart is light, my laugh is gay, and Sammy, somewhere, is chirping himself into a good, long purr.






THE TROLL, PICTURED ABOVE, DESCRIBES HERSELF:
I'm 60 years old, have a BA in cultural anthropology from Columbia University, and I've been married for 25 years. I have a son in his last year of college who lives at home. He's a double major in English Literature and Religion. Men call me for an infinity of reasons – but mostly for what I call 'Executive Stress Relief'. It's not sex; it's a cocktail of testosterone, fuelled by addiction to pornography, loneliness, and the need to hear a woman's voice. I make twice the money I made in the corporate world. I work from home, the money transfers into my bank account daily. I'm Scheherazade: if I don't tell stories that fascinate the Pasha, he will kill me in the morning.


From the news article's introduction by Catherine Townsend:
When I see the late-night ads for premium-rate phone sex lines featuring nubile, tanned young women, I get curious about who is actually on the other end of the phone. Like many people, I sometimes imagine that she's a bored housewife, moaning and calling herself a "naughty girl" while smoking a fag and doing the ironing.

But whether they are working in a packed call centre wearing headsets or from home wearing lingerie, phone-sex operators (or PSOs) are as diverse as the callers. I can definitely see the appeal of wanting to make money from talking dirty, like the Americans pictured here in Phillip Toledano's compelling portraits. But these women (and men, some very successful PSOs have been boys with high-pitched voices!) have to do so much more: they have to morph into a role that is part therapist, part sexual surrogate. They also have to improvise and create multiple personae in order to play the submissive secretary, the naughty nurse, the adult baby, the porn star or the barely legal teen girl.


Our Vaunted Troll was also noticed by some of her fellow Columbia alums, over at the Columbia Bwog (the 24/7 blog incarnation of The Blue and White, Columbia University’s monthly undergraduate magazine). In the comment section after the blog entry entitled, "You, too, could be a phone sex operator," a few salient points were raised, as in: Is there even a major available at Columbia in cultural anthropology? Given the Vaunted Troll's age, might not her Columbia have been GS or Barnard? (I'm sure Barnard collegians everywhere are delighted by the suggestion.)

The most repeated comment, though, was a request for "eye bleach, stat!"


* Some of my best friends are Phone Sex Operators.
** Unfortunately, just a few weeks after this post was written, I had to leave PTZ for good... driven off, not by a skanky PSO, but by something even worse, a skanky moralist -- a woman prone to fits of pique and fixated on "hating" me (her verb choice -- and we honor her verbal decisions because she is a... writer. Mwa ha ha! Snort!). 

The photography that accompanies the article is exceptional, and was published in book form by the artist, Phillip Toledano, in 2009.

Saturday, July 3, 2010

Sammy







We're going to miss our Sammy Boy, an excellent cat and superb friend. Dobby, his little idiot companion, is quite lost but will find his way.

Friday, July 2, 2010

Bozos on the bus


The future is fun! ... The future is fair! ... You may already have won! ... You may already be there!


I'm a great one for denial. As much as I post about CRPS research and various studies, as much as I do the moan-and-groan, I have not much wanted to know more about CRPS and dystonia.

Along with its torturous companion, neuropathic burning pain, dystonia is beginning to characterize this period of the disease (in me). It is awful, it humbles me daily, and it's time that I learned a little more about it, since denial is reaping its usual reward of... not much.

I need a primer in terminology. Spasms, tics, movement disorder. Abnormal postures. Twisting, repetitive movements. Thirteen different forms of dystonia, proper... many more diseases of which it is a symptom. Focused in one location, generalized. Hurts a little, hurts a lot.

Obviously, I don't have a primary dystonia (I'm not sure of the correct way to say that...) -- mine is secondary to CRPS, and began, in terrible earnest, last year, or seven years after the onset of the disease. From the beginning I had spasms and tics, but they were well controlled, for years, with stretching and exercise, with baclofen or tizanidine. Even when it was not well controlled with medication, the pain and discomfort was tolerable for a long while.

Now, though, the twisting and spasming covers more area -- mostly of my right leg -- and lasts for hours. The generalized violent tics are extremely painful, enough so that I cannot refrain from yelling sometimes. No matter how many times I experience them, they are always a surprise.

Researchers estimate dystonia as occuring at a rate of between 5-30% of the CRPS population. Other than that, research hasn't provided us with much information, except the usual disturbing interest in pegging dystonia as a functional, faked symptom. Thanks ever so much, researchers, for keeping that pointless application of science alive, and presumably, well-funded.

In sum:


...[D]ystonia with CRPS usually happens in the hand and causes the wrist and thumb to curl in, called flexion. In the leg, it starts in the foot, sometimes causing the toes to "claw." Researchers also noticed that patients with CRPS and dystonia tend to be younger than patients with CRPS without dystonia, and the more extremities affected, the more can be affected. Dystonia can come on gradually or it can come on suddenly. It also usually begins on the same side as the injury before the CRPS.

There isn't a connection between when the injury happened and when CRPS and the dystonia begins, so sometimes it is hard to tell what follows what. As well, it isn't known if bracing or immobilizing an arm or a leg after injury makes it more likely for dystonia to develop. Researchers have also looked into the psychological aspect of CRPS and CRPS-related dystonia, but that, too, hasn't found anything.

All the research results in there being no clear understanding of what causes some patients with CRPS to develop dystonia and not others. Because of this, no clear treatments have evolved. Medications don't seem to help and while psychosocial interventions may help some patients, they don't help all. Physiotherapy, tried with some patients, could make the situation worse, rather than better.


In another study, the researcher could not see his way to CRPS and Dystonia being co-existing disorders, not even after tossing in the adjective unusual. The good Dr. Schott, from the National Hospital for Neurology and Neurosurgery, in London, authored one of those... review articles (upper lip raised in a hapless sneer... nothing personal Dr. Schott). From this glommed together review of the glommy literature, we find:


Not all patients with CRPS develop dystonia but many do. And the timing can be anywhere from a week to five years before the dystonia starts to show up. There are a few cases where dystonia occurs first, and then CRPS develops, but it's usually the other way around.

The symptoms of CRPS may even get better as the dystonia comes on. This suggests that separate mechanisms are at play. Scientists generally agree that both problems stem from a dysregulation of the central nervous system. But exactly what happens in each condition is still a mystery.

Doctors are looking for predisposing factors for the onset of dystonia. Does it only occur when there's a bone fracture? Or is it more likely to develop when the limb has been in a cast? Does surgery trigger it? Perhaps there are genetic or environmental factors.

Right now there are more questions than answers. The complex interaction of the nervous system with the immune system and the motor system are part of the picture. What are the biologic and mechanical pathways? This remains unknown and is still the focus of many studies.


G. D. Schott. Peripherally-Triggered CRPS and Dystonia. In Pain. August 2007. Vol. 130. No. 3. Pp. 203-207.


Okay, so now I've read two oft-cited articles on CRPS and dystonia, and, as usual, feel like the exception to the rule. I also feel that familiar feeling of marginalization -- and my bullshit detector is going off.

I know that researchers cannot report what they have not researched... just as I know that calling for further study is a line not unlike "take two aspirin..." The interest isn't there because the money isn't there to stoke the interest.

Or maybe I am bitter.

Moving right along... the next bit of scholarly help I run into blithely pegs the appearance of dystonia in a CRPS patient as La Belle Indifférence, or as conversion disorder. This is a scant case study of a 46 year old woman with CRPS and dystonia after a knee injury, and who does not respond to any treatment (from Cognitive Behavioral Therapy to spinal cord stimulator; from amitriptyline to steroids; from sympathetic blocks {rolling:my:eyes} to arthroscopy). From what I can gather, this author, Dr.Fraser Duncan of University Hospital, Birmingham, Edinburgh (July 2008) relies almost exclusively on... you guessed it! The work of the good doctor Schott!


We Bozos have a saying: 'When you put on the nose, it grows.'


Ach mein gott but I am tired. I will take this up again soon... and in the interim, will rest easy knowing that there is, as usual, no one driving the bus...

Excuse me while I go twitch, spasm, twist, and scream.


The future's comin', and there's no place to hide!




Pithy bolded and browned quotes are from I Think We're All Bozos on This Bus by Firesign Theatre.

Thursday, July 1, 2010

Sarah Palin's Wild Ride!


Buckeye Surgeon apparently couldn't stomach any more of the Palin mythology, specifically the massive pile of folklore dedicated to the Untouchable Topic of Trig, even more precisely, Trig's Birth Tale.

She's Looney Tunes, and tells either a terrible fiction or an even more terrible truth.

Give the entire post, and the growing commentary about it, a read:
I'm sorry, but I just cannot resist any longer. The fantastical, magical realism surrounding the events of the birth of Sarah Palin's 5th child Trig just have to be reviewed. (Come on, there's a medical slant to the topic, right???)

Please take a moment to
listen to or read the transcript of an interview ex-Governor Palin gave to a reporter in 2008. To recap:

In April 2008, Sarah Palin was 43 years old and 8 months pregnant with a known Down's Syndrome child. She had had two previous miscarriages. For some reason she flew to Dallas, Texas to give a speech at a national governor's conference. Early in the morning on the day of the speech, Mrs. Palin states that she started to feel some cramps and noticed leakage of some fluid. So she called her OB in Alaska who apparently reassured her that everything was cool (and who now refuses to speak to anyone from the media about the incident). Again, she describes fluid leaking from between her legs, suggesting a possible premature rupture of membranes (i.e her water broke). While 8 months pregnant with a special needs child. At age 43.
[Click HERE to read the entire exposé]

Wednesday, June 30, 2010

\im-ˈpȯr-tənt

All photos from American Idyll, a blog maintained by my eldest Brother-Unit, TW (plus the maintes beautiful contributions of ruuscal). American Idyll is dedicated to the Grand Canyon, and to the river, because, as TW notes: the river knows...










"...Let us go," we said, "into the Sea of Cortez, realizing that we become forever a part of it; that our rubber boots slogging through a flat of eel-grass, that the rocks we turn over in a tide pool, make us truly and permanently a factor in the ecology of the region. We shall take something away from it, but we shall leave something too." And if we seem a small factor in a huge pattern, nevertheless it is of relative importance. We take a tiny colony of soft corals from a rock in a little water world. And that isn't terribly important to the tide pool. Fifty miles away the Japanese shrimp boats are dredging with overlapping scoops, bringing up tons of shrimps, rapidly destroying the species so that it may never come back, and with the species destroying the ecological balance of the whole region. That isn't very important in the world. And thousands of miles away the great bombs are falling and the stars are not moved thereby. None of it is important or all of it is.
-- John Steinbeck (from "The Log from the Sea of Cortez"**)




































**The Log from the Sea of Cortez is an English language book written by American author John Steinbeck and published in 1951. It details a six-week (March 11 – April 20) marine specimen-collecting boat expedition he made in 1940 at various sites in the Gulf of California (also known as the Sea of Cortez), with his friend, the marine biologist Ed Ricketts. It is regarded as one of Steinbeck's most important works of non-fiction chiefly because of the involvement of Ricketts, who shaped Steinbeck's thinking and provided the prototype for many of the pivotal characters in his fiction, and the insights it gives into the philosophies of the two men.

The Log from the Sea of Cortez is the narrative portion of an unsuccessful earlier work, Sea of Cortez: A Leisurely Journal of Travel and Research, which was published by Steinbeck and Ricketts shortly after their return from the Gulf of California, and combined the journals of the collecting expedition, reworked by Steinbeck, with Ricketts' species catalogue. After Ricketts' death in 1948, Steinbeck dropped the species catalogue from the earlier work and republished it with a eulogy to his friend added as a foreword.

Tuesday, June 29, 2010

off to the showers

I've been stuck in bed for four days now, and sad to say, it's the best place for me. Every hour, I try to get Sammy to eat and drink, settling for a bite, downright giddy should he show more interest. Getting out of bed and into the wheelchair is so painful that I bypass Salty Tears and go straight to Total Despair.

It's not my shoulders, I don't think, because they don't hurt more than normal -- and my fever is actually higher than is usual. If you really want to know, I think it's a delayed reaction to the losses achieved by virtually every one of my Wimbledon favorites.

Yes, from the Belgian women [Vera Zvonareva just defeated Kim Clijsters] to sexy Andy... from... Oh, hell. I cannot get over Andy's loss. That was likely the blow that inflamed every freaking one of my osteoporotic joints. Huge congratulations to Yen-Hsun Lu, of course. Ranked 82, unseeded, the Taiwanese player's win was his first in four years of Wimpleton competition.

There is so little known of him that you will quickly become inured to the fact that his dead father was a chicken farmer. There are only so many ways that even the most talented of journalists can find to say "son of a chicken farmer."

Roddick and Lu had played three matches prior to this, Roddick winning all three. I confess to not paying great attention to this meeting, as I suffered from Assumptions.

Still, my interest flickered when the second set went to a tie-breaker. And again, when Roddick's return of service stayed perfectly flat. The last set was clearly his best, too late. Darned son of a chicken farmer!

When Roddick responds defensively to a lesser player playing hot, he opts for predictable safety, and fails to convert, fails to aggress. He just generally fails. So while his play since returning to competition after his knee surgery truly is excellent, the mind and an inhibited strategy cannot be trumped.

Lu, on the other hand, went with a more zen approach: “Today I just take a time, serve regular, and stay with him, try to find a chance and to win the set, set by set, set by set, until end, I shaking hand and I win. Yeah, I just don’t think.”

Lu's next opportunity for mindless advancement? Novak Djokovic, in the quarterfinals.

Is there an answer to why Andy only managed to convert one of eight break opportunities or is it as simple as complaisancy, and perhaps the last piece of his particular puzzle?

Clearly, he has improved tremendously as a result of intensely rehabilitating his knee. When he is "on," there's nothing finer!

No, complacency is the wrong word. Not self-satisfied, not unaware of trouble or danger.

Not non-chalant, either -- coolly unconcerned or indifferent. Not without warmth or enthusiasm.

I am at a loss. The danger is that I will choose an outside agency -- the wind, the sun, the stress, maybe even Yen-Hsun Lu, himself.

Never underestimate the son of a Taiwanese chicken farmer.

Now that all my picks have been eliminated, whom do I now choose to jinx? Let's see... I think I'll go out on a limb and choose Serena (Venus was eliminated this morning). What can I say -- I am a daredevilish sort. On the men's side, anyone but Roger, please. I love Nadal, but am very fond of Soderling. So... anyone from that side of the draw, I guess!

Berdych, I don't know at all. Ranked 13, on paper, he doesn't look to stand much of a chance against Federer. The great news is that the paper won't be playing. The awful news is that, after his shakey first two matches, Federer has cranked everything up a notch, and pretty much destroyed Jurgen Melzer on Monday.

The dirt on Berdych is that he tends to choke... if ever there were an occasion amenable to choking, I am guessing that the Wimbledon quarters is it. *

Okay, well, I am soaked in sweat. I am going to head for the shower to desalinate.
If that wasn't already a word, it is now.


* Okay, so this would be me, a day later, eating my words. Yum, yum! Not only did he not choke, Berdych won. Meaning that he elevated his play, looked awesome, and totally embarrassed Roger Federer, who proved less than sporting during his meeting with the press afterward. Instead of acknowledging Berdych's superior play, he produced a litany of his physical woes, and claims to have "[given] the match away." You don't get to Federer's level of competence without a healthy ego, but it would be nice to see some humility. Berdych earned his win today with deep and powerful shots, great movement on the court, and great serving. Congrats to the Czech!

Djokovic will face Berdych in the semifinals, and Nadal takes on... MURRAY! Yes, he finally has broken through and you know the Brits must be going crazy...

The other shocker today -- Serena and Venus Williams were ousted from doubles competition by Elena Vesnina and Vera Zvonareva.

The women's semi is set up as follows: Serena Williams vs. Petra Kvitova and Vera Zvonareva vs. Tsvetana Pironkova. That's right -- no Venus, no Kim Clijsters, no Justine, no Maria Sharapova. It's almost as if only Serena got the memo this year...

And, just because this is my blog and I feel like it, I would like to renew my plea for women's play to extend to best of 5-set matches. Slow-starters are often doomed in the 3-set system, and matches can end in a ridiculously short period of time. Wozniacki was out in 46 minutes! Billie Jean King has been calling for parity for over 30 years now... It's time to listen to her. In 2007, she was interviewed by NPR following the Wimbledon Committee's decision to provide equal prizewinnings to men and women players.

ROBERTS: There's an argument to be made that women tennis players play best of three, men play best of five. Often the women's matches are not as tough because there's not as much depth of field and that it's not equal work. So we're not talking about equal pay for equal work. What do you - what's your response to that argument?

Ms. KING: Well, first of all, in the entertainment business you don't get paid by the hour. And secondly, we've always been willing to play three out of five sets and if anyone knows the history of Wimbledon, they would know that when women first started to play back in the late 1800s and early 1900s, we did play three out of five. But you have to remember, we played in a corset, a full-length dress, couldn't show our ankles or our wrists. and I think one of the women that was participating back in the old days fainted or didn't feel very good and therefore the all-men committee decided that they would only let us play two out of three sets.

ROBERTS: So they shortened the sets instead of foregoing the corsets?

Ms. KING: You got it.



John Henderson took on the topic during Wimbledon 2008:
The origin of women playing three rather than five sets goes back to when sports were run exclusively by men who took the patronising view that women, poor dears, could not possibly compete for as long as their male counterparts.

This attitude is changing in other sports, particularly in athletics. For years, the Olympics allowed women to run no farther than 800 metres - the 1,500 was not introduced until 1972. Now women run all the distances, including, of course, the marathon. Britain's world-record holder Paula Radcliffe has shown conclusively that stamina, which has been defined as simply the guts to go on, is not a gender thing by doing a faster time than all her male compatriots, as well as female, in the London Marathon.


Stamina, the guts to go on. I like that.

Friday, June 25, 2010

Lindsey Baum: One Year Missing



Last July 20, I wrote my first blog post about missing 11-year old Lindsey Baum:

Around 9:15 pm on June 26, Lindsey J. Baum, an 11-year old from the tiny town of McCleary, Washington, disappeared while walking from a friend's house to her home, only four short blocks away.

She just had an argument with her brother, but most everyone notes that she wasn't storming off mad. She didn't have the accoutrements you'd think of when thinking of a runaway -- no money, no cell phone, no change of clothes.

Some friends set out with her, so she was accompanied for a while before they peeled off to go to their own homes for dinner, or homework, a bath or shower, whatever.

Two of those four blocks are reported to be somewhat industrial -- though we are talking *rural* small town. One block away is access to a major highway.

As any child would be, Lindsey was troubled by her parents' recent divorce. Her father lives in Tennessee. This detail is the one I have to shrug off -- in my family, similar circumstances played a role in my eldest brother's decision to run away. But he was a savvy teenager, a world traveler; Lindsey just turned 11 (a grand birthday celebration surely awaits her), and only knows McCleary.


Tomorrow marks the first anniversary of her disappearance. There have been no sightings, no productive new information, and in this age of information and its technology, that is almost unheard of. Indeed, I would have thought it impossible that in the span of a year, there are no leads to proffer, no tantalizing tidbits to ponder and inspect.

I have wondered, even, what the significance might be of such a complete absence of clues. Unfortunately, to follow that path means to go crazy with notions of vast conspiracy. Fortunately, there is no lack of volunteers willing to go nuts by noting such things as the disturbing habit of such-and-such Youth Minister to be surrounded by... youth. (It only gets worse. A local park ranger, who was identified, not from some actual association with Lindsey, but by a psychic who dreamed his initials had the gall to own a supremely suspicious... boat.

I do not imply that nothing has been done -- not at all. Far from it.

There have been frequent searches, interviews and re-interviews (and amateur sleuthes have had a field day inventing all sorts of suspicious people). A substantial reward has been offered. The FBI is on the case, Interpol has been alerted, and the local Grays Harbor County Sheriff's Office has worked long and hard, and will continue to do so.

Rather than mark tomorrow's anniversary by failure and lack, Lindsey's mother Melissa has helped organize an event called a Day of Hope:


McCLEARY, Wash. (CBS/AP) A "day of hope" will be observed Saturday in an Olympia park on the one-year anniversary of Lindsey Baum's disappearance.

Police are still looking for possible leads in the case and hope that they will one day be able to determine what happened to Lindsey, who was 10-years-old when she went missing on June 26, 2009 while walking home from a friend's house in McCleary, Wash.,west of Olympia.

During the observance, called "Lindsey's Day of Hope and Awareness for the Missing," balloons will be released for Lindsey and all of the other missing persons of Washington state, reports The News Tribune. It will take place from 2 p.m. to 8 p.m. in Olympia's Heritage Park.

Previously, police have enlisted the help of the FBI, bloodhounds, and searchers on horseback, but there have been no signs of the missing 4-foot-9-inch, 80 pound girl.

Melissa Baum, Lindsey's mother, says that her daughter was upset by the recent divorce of her parents, but says Lindsey did not have enough money to run away, nor had she ever tried to run away in the past.

After nearly a year of searching, her mother fears the worst.

The search for Lindsey continues, and authorities are offering a $25,000 reward for information regarding the young girl's whereabouts, as well as information leading to the arrest of and charges against the person or people responsible for her disappearance.

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


I finished my first post about Lindsey by explaining how I'd heard of her. SecretWave101 was bothered, early on, by the scant attention being paid this dear child. Full of vim and vinegar, I vowed to follow the case, and publicize it here. I stand by that promise, even knowing now how little help this actually is.


I learned about her over at Dr. SecretWave101's blog. He notes what many of us have seen in our own communities: How legwork and media savvy are manditory to keep the faces and stories of our stolen children front and center in the public's view.

He notes other stuff, too -- having to do with the privilege of stereotype and the insidious mechanisms by which missing and exploited children receive airplay.

Research Lindsey's story and retell it on your own blog -- or where you will. You're likely more creative than I am -- the point is to disseminate, remind, encourage. Yes, and annoy, I suppose, if that should become necessary. (It's
de rigueur here at Marlinspike Hall, deep, deep in the Tête de Hergé!)


To see all posts about Lindsey, click here.

The Long and the Short of It

Wow. What a difference a day makes!

Isner is out, losing in a fast, straight-sets match to Thiemo de Bakker, during which the American had no aces -- versus the 113 aces served to Mahut on Tuesday... Wednesday... and Thursday.

Today's match, over in 94 minutes, was the shortest men's match thus far in the 2010 Wimbledon tourney.

I'm surprised he was able to move at all.

For my daily whine: why, oh why, must Clijsters be paired against Henin?



Noteworthy: Mauresmo, very happy, it seems, in her retirement, is coaching Michael Llodra... who lost a close 4 set match to Roddick on Wednesday. Now she can chill and have a little beaujolais on some veranda somewhere.

Funny -- after her win at Antwerp, where someone awarded her a nice bottle, she said, "Tout le monde va penser que je suis alcoolique"!

I haven't been very forthcoming about my picks for this year... I am, to be honest, pretty sick, as well as emotionally drained by nursing Sam-I-Am. He will only rarely take food, and then only small bites from my hand. It is uncomfortable for him to lower his head to a bowl -- so my hands are met in offering every half hour -- a dish of water, a plate with small palatable morsels, treats of all kinds. I will spare you the play-by-play, as it is quite simple: He is a dying cat, much loved and well-cared for, and loving and caring, generously, in his turn. We hope he will turn the corner and live months, maybe years longer, but it does not look likely.

Anyway, I will go with my sentimental favorites -- why not? So that'd be Roddick and Henin. I apologize, in advance, to them -- as I have an extensive history as a Sport's Jinx.

As in Judo: Apoplexy Justice


When I am reduced to burps and gurgles over some antic by Dick Cheney or by the way torture citations are lightly glossed, tossed, and reseasoned before being plated and served up as homegrown and fresh from the garden...?

And when the subterranean amoral violence that diminishes us as both a nation and a species is explained away by that particular cavernous Talking DeathHead?

When the two are intertwined by the tendrils of justification (national defense, intelligence, terror:terror:terror) then I am simply apopleptic* and can only thrash about, trying to find my voice.

Thank goodness, then, for Buckeye Surgeon and his posts on torture, and his refusal to let Cheney off the hook.

I officially became a fan of the Buckeye Surgeon last May, when he published the post: Baudrillard and the Hyperrealism of the Parathyroidectomy


This is going to be a bizarre post; I'm just warning you.

I've been reading from Jean Baudrillard recently. Baudrillard is a post modernist French thinker/philosopher who writes about the preponderance of images, signs and representations in our technologically-driven, post modern lives. A lot of what he writes is almost deliberately obscure and esoteric. You find yourself re-reading entire chapters two or three times because nothing makes sense and you get pissed off thinking hey I'm not a moron, I have advanced degreees why is this guy being so intentionally obtuse? I sort of hate Baudrillard, actually, for that reason. But he does have some interesting takes on the nature of reality that are rather illuminating.


I believe the exact wording of my thought at the time was... chouette! [True, I had to put aside the whole Forget Foucault (Oublier Foucault) nonsense... which was submitted to Foucault, himself, for publication in Semiotext(e) and to which Foucault, himself, never replied. Which is to say, don't miss Sylvère Lotringer's interview, Forget Baudrillard. In short, what must be acknowledged is the impossibility of participating in a field of study or in its criticism, without complicity.] Buckeye Surgeon plays on the subject/object shenanigans chez Baudrillard, and, oddly enough, chez super-specialized endocrine surgeons, as well. Actually, not odd at all, given consumerism à la Baudrillard. Hyperreality and this consumerism mark the Baudrillard of the 70s, the on-again, off-again marxist "thinker" in evolution as provocateur.

There are precious few medical bloggers who could pull that off, and even fewer that one would want to. I found myself wanting to hear Baudrillard on Abu Ghraib (war porn), among other things, through the filter of this particular midwestern general surgeon.

So recently, when he decided to beg all questions, in To blog or not to be, I was bummed, and responded snarkily.

I know, I know. [Like Frank Drackman -- which is a phrase I never ever thought I'd write -- I have a framed Master's of My Domain upon the office wall...]

I am so happy he continues to blog, even happier to know that he does so with his young daughter in mind.

Who else is going to keep that upstart, Atul Gawande, in check?

* At those moments, I am at such a remove from the inane boggle-headed chirping about how "il faut cultiver notre jardin" that I am, to overestimate myself, dangerous. I nod along with Jean-Luc and pump my cold, purple fist at his "Je me contenterai d'ajouter qu'il y a aussi sans doute un peu de malice chez Voltaire..."


“As in judo, the best answer to an adversary maneuver is not to retreat, but to go along with it, turning it to one’s own advantage, as a resting point for the next phase.”

— Michel Foucault

Thursday, June 24, 2010

on loaded guns and father's day


Father's Day, for me, is a shameful day. Understand, please, that the shame is mine, not his.

Honor thy father and thy mother is the fifth commandment in the Christian Top Ten, and the first commandment to add a Carrot to the Stick.

Honor your father and your mother,

that your days may be long

in the land which the Lord your God gives you

--Exodus 20:12 (RSV)

One of my favorite off-the-cuff and exceedingly clever remarks to make? "Ewww, that is sooooo Old Testament!"

It's so wonderfully scathing a thing to say in response to some wannabe's harsh judgment or other. Sniff.

After dropping promptly out of college during my second semester, I toyed with this course and that course, using up precious elective credits while working as a nurse's aide in what was euphemistically called a "neurological post-intensive care unit." (Think carrots, peas, corn, eggplant.)

I lived with Baber, a drop-dead gorgeous woman who suffered various addictions -- to cocaine, marijuana, tequila, moonshine, cigarettes, and sex. She was lots of fun, for a while, until her Probation Officer began dropping by too often, and for the wrong reasons. If you get my blaring drift.

Somewhere toward the end of our year together, The Baber lost her job as a Respiratory Therapist, became a short-skirted waitress, began to deal coke out of our apartment (she had, believe it or not, a hollow-ended pool cue that sometimes came into play), and received her second Driving Under the Influence citation. Actually, I think these things are listed in the wrong order. Whatever. It all seemed to happen at the same time, belying cause-and-effect neatness.

Part of Baber's DUI sentence included the temporary suspension of her driver's license. She insisted I go to court with her that long ago early morning, getting us there right on time in her jaunty Toyota stick shift, expertly maneuvering into a choice parking spot three-quarters up a tree-lined, steep, and narrow street.

I learned to drive in a vintage pristine 1965 baby blue Cadillac, which resembled nothing so much as a boat, after which I was gifted with a white 1963 Ford Falcon, my first automotive love. That was the extent of my experience as a driver. (Please note that as I got older, so did my cars.)

So it was no surprise, to me, at least, that I almost got us killed on the way home. We lived in a mountain town, a *hilly* mountain town, to boot, which helped not at all as I struggled to hold my place in line at stop signs and to respond to Baber's barked, angst-driven instructions.

After that, my roomie called on her many other friends to get her from points A to B to wherever.

I remember a strong feeling of disconnect during those final weeks of living with Baber. I was working Night Shift at the hospital so as to free up my days and evenings for two classes: The Bible as Literature and The History of Western Civilization, Part One.

People like to play the game of "where were you when...?" -- I guess because it creates a reassuring collective -- something we had more of when we were less evolved. Where were you when John Kennedy was shot, and Robert? Where were you when you heard that Reverend King had been assassinated, that four were dead in Ohio? Where were you when they tore down the Berlin Wall, when Nixon resigned? When Lennon fell, and George died, and Pinochet got off scot-free? Where were you when the Challenger blew up, when the Twin Towers came down? When Michael Jackson overdosed, when Obama won the election, when the market crashed?

Where was I when I first encountered Plato's man in a cave, chained both fore and aft to his fellows, facing a blank wall, that blank tablet on which was cast the shadows of things?

Sigh. Everyone fancies themselves a semiotician.

Reference the shadow.
Reference the thing, itself.
Reference the thing that cast the shadow.

Where was I in that famously pivotal moment when I was washed in the Allegory of the Cave? Turns out, it was one experience that took place at two different times. Once at its first reading, in that mountain city, in the campus library, where I sat peering out a huge plateglass window at the golden light, setting. The bookend of the experience came 6 or 7 years later. I was walking down Shattuck Avenue in Berkeley, and came upon a beautiful blue shoe, a woman's pump, silk. One left shoe and I was awash in the arbitrary nature of the sign, and in what Plato makes Socrates call "truth"!

What a rush.

Okay, let's get it out of our collective system. This was years ago, before hegemony and eurocentric became part of my stilted academic vocabulary, definitely prior to the time when I began to question the validity of The Canon, and a few universities away from reading Gramsci (as a requirement).

I was as if lost at Baber's place, never feeling it even half mine, despite paying half the rent. Work was rarely fulfilling, and if the Allegory of the Cave could rock my world, imagine my stupefaction when faced with the poet Isaiah, with Socrates drinking hemlock because his principal and the Superintendent of the School District deemed his teaching impious and too snarky for impressionable students. [In case you are wondering, I've topped out today at 101.3.]

Time with her was not a waste. I made some good and lasting friends, earned some easy college credits, and saved my money. I met a man and fell in love. I met lots of men, in fact, mostly musicians from Baber's work. I generally found them in the kitchen, searching desperately for coffee, happy to let me brew a strong pot while they played guitar in the living room. Baber was never an early riser.

But as someone famously said, about something else entirely: "Things fall apart; the centre cannot hold..."

Baber had a gun that somehow made its way under my pillow, and the man I loved was called home. I felt a failure at 19, and spent 50-60 hours a week talking to people who literally oozed, telling their parents, their pregnant wives and lost-without-her husbands that "you never know..." I was sleeping with the husband of a bisexual friend -- actually both Baber and I were -- in exchange for unlimited organic carrot juices at his downtown health food store -- also for pot and blueberry shine.

One day, the precariousness of everything became too much. It had been well over a year since I had called... home. As if it were a habit, I picked up the phone and dialed numbers like an automaton.

The rift between me and my father is bottomless and so wide I cannot see the other side.

"Please come get me," I whispered.

"I'll be there tomorrow afternoon," Dad said. "Be ready to go..."

I may have 3 semester hours that were awarded for the apt completion of The Bible as Literature, but I had forgotten, let's say, that though Deuteronomy and Exodus are credited with the Ten Commandments, they cannot hold a candle to the grave legislation of Leviticus, written around the time of the Babylonian exile, and not, as some hold, by Moses -- but by that amorphous group designated P, for Priestly Sources.

"You shall rise before the gray headed and honor the presence of an old man, and fear your God: I am the LORD" (Leviticus 19:32).

Reverence, fear, curse, honor, obey, mock, scorn, contempt -- Biblical parent language is loaded language.

As I write this, it has been 20 years since I have spoken with or seen my father. I think of him everyday, which does neither him nor me any good, but it is, in all honesty, the very best I can do. I know you think otherwise. Sometimes, usually early in the morning, in the kitchens not making coffee for musicians, the man I loved long dead, and Baber's rabid enthusiasm finally understood as the manic portion of bipolar disease... I also think that I could do better.

There are no guns in The Manor, nor under my pillow -- and there never will be. That's the last full measure of my devotion.




My Life had stood - a Loaded Gun -
In Corners - till a Day
The Owner passed - identified -
And carried Me away -

And now We roam in Sovereign Woods -
And now We hunt the Doe -
And every time I speak for Him -
The Mountains straight reply -

And do I smile, such cordial light
Upon the Valley glow -
It is as a Vesuvian face
Had let its pleasure through -

And when at Night - Our good Day done -
I guard My Master's Head -
'Tis better than the Eider-Duck's
Deep Pillow - to have shared -

To foe of His - I'm deadly foe -
None stir the second time -
On whom I lay a Yellow Eye -
Or an emphatic Thumb -

Though I than He - may longer live
He longer must - than I -
For I have but the power to kill,
Without--the power to die--

--Emily Dickinson

Wednesday, June 23, 2010

the match that would not end



i just had to document that the score is 55-55 in the fifth set.

that's right. "set." as in, tennis set. fifth, as in, there were four that came before.

mahut versus isner, the longest game ever... dastardly even. to say these guys are tuckered (even though the match has been spread over two days) is a ridiculous understatement. play has now run over the 9-hour mark.

the quality of the *serving* alone is awe-inspiring.

the first 60 or so games, i thought "how cool to be witnessing tennis history."

(now i am kind of embarrassed for whomever wins -- and so bummed on behalf of the loser.)

now it is 56-56... 157 games in the match so far! holy moly*, guacamole!

chapeaux, all around.

6/24/2010: {CONGRATULATIONS TO ISNER! the two had to come back on a THIRD day and the match ended up lasting ELEVEN hours, five minutes... this is one that will be long on the record books. the final fifth set score? 70-68}

* [T]he origin of the word Moly... comes from Homer's Odyssey. In book 10, Hermes gives the herb to Odysseus to protect him from Circe's incantation. Homer describes Moly by saying, "The root was black, while the flower was as white as milk; the gods call it Moly, and mortal men cannot uproot it, but the gods can do whatever they like."

Tuesday, June 22, 2010

Mannitol as Salvage Treatment for CRPS? Not so much...


By definition, salvage treatment/therapy is

1. A final treatment for people who are nonresponsive to or cannot tolerate other available therapies for a particular condition and whose prognosis is often poor....
Salvage therapy is given in the hope of a cure or at least of some more quality time or a better quality existence.

The Wikipedia entry notes that "it is used both to mean a second attempt and a final attempt."

"Salvage treatment/therapy" is not a new concept to me, but it's also not one that I spend an inordinate amount of time investigating. I think that when I first started reading reports and studies, the SCS was considered out there, a regular Hail Mary of a treatment, plus oddities like Hyperbaric Oxygen Therapy... Now, I suppose the ketamine coma falls under the rubrique, as well as intrathecal catheters and intraspinal administration of narcotics, and drugs such as baclofen.

[Most articles note that the term is usually used in reference to the treatment of HIV/AIDS and certain cancers, diseases in which "final attempts" are certainly of a more dire nature.]

The advocation of mannitol as a treatment drug in CRPS is certainly not widespread --indeed, one of its most steadfast promoters is the infamous Dr. Hooshmand, who proposes its use to deter "toxic metabolic water retention in the nerve cells" and "neuro-inflammation."


INJURY: International Journal of the Care of the Injured
Volume 41, Issue 7, Pages 773-777 (July 2010)
Edward C.T.H. Tan, Marijn C.T. Tacken, Johannes M.M. Groenewoud, Harry van Goor, Jan Paul M. Frölke

Department of Surgery, Radboud University Nijmegen Medical Centre, The Netherlands

Department of Medical Technology Assessment, Radboud University Nijmegen Medical Centre, The Netherlands

Edward C.T.H. Tan is corresponding author, and may be reached at: Department of General Surgery - Traumatology, Radboud University Nijmegen Medical Centre, 690 Internal Postal Code, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 361 38 71; fax: +31 24 354 05 01.

ABSTRACT : Mannitol as salvage treatment for Complex Regional Pain Syndrome Type I

Introduction
Complex Regional Pain Syndrome Type I (CRPS I) is a continuation of symptoms and signs due to a pathological exaggerated reaction in an extremity of the human body after an injury or operation. Although the clinical picture of CRPS I in the majority of patients is well known, the underlying pathophysiology remains unclear. In the Netherlands, intravenous mannitol administration used as hydroxyl radical scavenger for patients who do not respond to conservative treatment of CRPS I is advocated but little evidence supports this salvage strategy. In this study the effect of mannitol as salvage medication was evaluated in a well-defined multimodal step-up treatment protocol.

Patients and methods
A consecutive group of 68 adult patients with persistent CRPS I was analysed, who underwent a total of 100 mannitol infusions. The effect of treatment was considered per sign and per symptom according to the Veldman et al. criteria for CRPS I.

Results
Overall improvement of CRPS I after mannitol treatment was successful in 24% after 1 week, and in 30% after 1 month. Mannitol treatment had some effect in patients with initially warm CRPS I in contrast to patients with cold CRPS I (OR=6.30 with CI [2.37–16.75]). Also patients with CRPS I at the upper extremity had more benefit than patients with CRPS I at the lower extremity (OR=3.26 with CI [1.34–7.93]). Poor results of mannitol treatment were associated with cold CRPS I (p<0.001), p="0.04)" p="0.04)."

Conclusion
Mannitol did not significantly contribute to the overall success of treatment in patients with CRPS I. Patients, presenting with acute, warm CRPS I in the upper extremity may have some benefit.