Tantalizing Woo?

This is the sort of article that should light the short fuse of my intolerance for woo.  Am I becoming tolerant of woo?  Oh, no.  Rather, desperation has opened my mind.  Also, I've experienced too many strange things in my journey with CRPS, and have had occasion in the past few weeks to much (too much?) reflect on that.

Should you be unfamiliar with the term "woo," here is the definition from the Skeptic's Dictionary:

Woo-woo (or just plain woo) refers to ideas considered irrational or based on
extremely flimsy evidence or that appeal to mysterious occult forces or powers. 

Here's a dictionary definition of woo-woo: 

adj. concerned with emotions, mysticism, or spiritualism; other than rational or scientific; mysterious; new agey. Also n., a person who has mystical or new age beliefs. When used by skeptics, woo-woo is a derogatory and dismissive term used to
refer to beliefs one considers nonsense or to a person who holds such beliefs. 

Sometimes woo-woo is used by skeptics as a synonym for pseudoscience,
true-believer, or quackery. But mostly the term is used for its emotive content
and is an emotive synonym for such terms as nonsense, irrational, nutter, nut,
or crazy.

I receive "alerts" from various search engines whenever there is a publication about CRPS.  It's a freewheelin' situation, that!  Most of the publications touting CRPS in some form or other are instances of pure crap that do not even rise to the level of woo.  In other words, clicking on those links keeps me supplied with malware and buck-toothed rodent infestations, making me grateful for an excellent internet security system.

The thing is, sometimes there's a gem buried in the steaming piles.

Today's discovery involves anecdotal "evidence" noted and relayed by a layperson, and what's worse?  The layperson is also the parent of a child with CRPS.  Red flags should have been strewn across my visual field and my stomach ought to have spewed acid with abandon.

Did I mention that the CRPS symptom being addressed involved spasms and disordered movement?  Did I note that the father in question is some sort of "neuroscientist"?  The flashing lights of the local Early Woo Alert System are making rainbows through the prisms hanging in the bedroom window.

Pretty!

Maybe it's the honesty of the tale that makes me open to its possibilities.  Perhaps it's the appeal of something simple taking down the hubris of CRPS.  For sure, it makes me think of my own quirky discoveries with the disease -- a certain antibiotic consistently correlated with marked improvement in the burning sensations common to neuropathic pain, for example.  Many positive experiences related to any diet, drug, or choice that fought "inflammation." All unsupported by science, all unsupported, even, by people upon whose opinions I'd come to rely.  That's the nature of orphan diseases -- one clings to evidentiary science but is surrounded by opinion and storied marketing forces.

One of the touchstones among the advances in research and treatment of CRPS, for me, is the narrative behind the use of ketamine and other NMDA receptor antagonists.  The whole "ketamine coma as a treatment for CRPS" came about by an astute observation in a single case.  A woman was in a terrible car accident that necessitated a medically-induced coma for some weeks.  Ketamine was used to induce the coma.  She was noted to have CRPS in one extremity, and as time passed, improvement was noted in the limb as she remained comatose.  A hypothesis was born more than any earth-shattering scientific discovery. Someone dared to wonder "what if...?"

Well, I've about exhausted the theme of observational wonders in the application of intellect to the problems encountered by CRPS patients and their caretakers.  It's reassuring to learn that we have some smarty-panted people in our midst.  Now let's listen to them, but with discerning ears, caution, and a heightened awareness of woo as ballast for our desperate hopes and need.

**   ****************************************************************   **'

Could Something as Simple as a Mouthguard Be the Cure to What Ails You?
BY EMMA YOUNG • June 24, 2014 
When Vince Clark’s son, Ryan, became sick, he devoted himself to understanding the neuroscience and trying to find effective treatments.

Complex regional pain syndrome (CRPS) doesn’t really involve normal pain networks, but rather enhanced sensory perception. “Just blowing on your skin is excruciatingly painful. That’s what it was like for Ryan,” Clark says. Physical activity became torture. Muscle tremors and spasms, which can happen with CRPS, were also a huge problem. The initial treatment, with a very high dose of an antidepressant drug, made things worse. “For minutes, sometimes hours at a time, he couldn’t breathe easily. It was a parent’s worst nightmare,” Clark says.

Eventually, through a patient support group, Clark made contact with another neuroscientist whose daughter had CRPS. “He came to me and said, I’ve found this thing—it seems crazy—but look what it does. Let’s try to figure out how to understand this.”

This “thing” was an orthotic—a mouthguard, on which patients bite down. There’s evidence that orthotics can relieve pain and ease movement in people with problems affecting the head and neck. It’s so cheap and simple, Clark thought it was at least worth a try with his son. “At one point, Ryan was in the wheelchair and we couldn’t give him drugs, and he was in too much pain to do the physical therapy he needed to do. So we got him to bite down on a simple wooden tongue depressor. That was the first day he walked for almost a month.”

Clark plays me a video of Ryan. He’s leaning heavily on a walking frame, struggling to take a step. Then the tongue depressor goes in, and he bites down on it with his back teeth. Suddenly, he stands, and he can walk with just a single stick. Clark plays me another video. A woman walks awkwardly, bent over, dragging her legs. A car crash years earlier left her seized up, struggling to move. She bites down on an orthotic—a more stylized version of a bunch of tongue depressors—and she stands straight up and walks. The person recording the video is stunned. “This blows my mind,” he says. “I can’t believe this!” Clark says. “There are people with motor illnesses, Tourette’s, dystonias, tremors where the person can’t open their eyes any more…. I can show you videos of patients with all those illnesses and more. If you just put a stack of tongue depressors on their teeth and they bite down, the symptoms of their illness can disappear almost completely.”

Clark is as well aware of the placebo effect as anybody else. But an imaging study, which he has just completed, shows what he calls “pretty significant changes” in brain function as people bite down. The changes are in the cerebellum, a region that plays an important role in controlling movement. Clark thinks that biting down might work by stimulating the trigeminal nerve, a thick nerve that connects to the central nervous system. “Historically, before anesthesia, when doctors did surgery, they let a patient bite down on something. The modern assumption is that this was so you don’t grate your teeth and break them. But why do people grate their teeth when they’re in pain?”

Clark is well aware that much more work is needed on a possible role for orthotics in helping with pain and movement disorders. But orthotics, like transcranial direct-current stimulation (tDCS)—which is showing great promise in preliminary trials for treating pain—are of no interest to pharmaceutical companies. And there’s a mindset in the U.S., at least, Clark argues, that makes it hard to drum up support for funding trials of cheap, simple devices like this. “We’ve come to believe that more complicated technology is always better. I think that’s a fallacy. It’s not always better. It’s certainly almost always more expensive. You look at these images of patients getting better with an orthotic. If this was after brain surgery or a new drug, people would be swarming to learn how to do it. We don’t have doctors lining up.” In the U.S., he argues, on the whole, doctors look for more expensive treatments, because they can make more money from them.

Clark would love to see funding for big randomized controlled trials of simple, cheap devices, like orthotics, or even colored lenses for kids with developmental disabilities, which were adopted in the California school system after pressure from parents but which have not been well-evaluated. Given the growing evidence for the effectiveness and safety of tDCS, the case for expensive, gold-standard trials in this area is perhaps even stronger. “On average drug companies spend five billion dollars for every new drug that comes to market. A lot of that is on failed drugs,” says Clark. “If you spent five billion dollars on tDCS, you would, I suspect, get the same benefit as developing 100 new drugs—it looks like it could be applied so many different ways.” He urges the U.S. National Institutes of Health to fund the necessary work.

This post originally appeared on Mosaic as “Low-Tech Pain Relief” and is republished here under a Creative Commons license.  I found it in Pacific-Standard: The Science of Society.



© 2013 L. Ryan

Balanchine's Agon: Diana Adams and Arthur Mitchell, Anxiety and Beauty

Agon (1957) is a ballet for twelve dancers, with music by Igor Stravinsky and choreography by George Balanchine. Composition began in December 1953 but was interrupted the next year; work was resumed in 1956 and concluded on April 27, 1957; the music was first performed on June 17, 1957 in Los Angeles conducted by Robert Craft, while the first stage performance was given by theNew York City Ballet on December 1, 1957 at the City Center of Music and Drama, New York (White 1979, 490). The composition's long gestation period covers an interesting juncture in Stravinsky's composing career, in which he moved from a diatonic musical language to one based on twelve-tone technique; the music of the ballet thus demonstrates a unique symbiosis of musical idioms. The ballet has no story, but consists of a series of dance movements in which various groups of dancers interact in pairs, trios, quartets etc. A number of the movements are based on 17th-century French court dances – saraband, galliard and bransle. It was danced as part of City Ballet's 1982 Stravinsky Centennial Celebration.

Just what was needed for this day, these times:  A 27-minute ballet with 12 dancers, the creation of Igor Stravinsky and George Balanchine.  Within that frame, a 1 minute 44 second concentration on Diana Adams and Arthur Mitchell, who danced the début for the New York City Ballet in December 1957.  That short video elicited this comment on YouTube (Yes, a YT comment worth repeating!):

mproche571:Diana Adams and Arthur Mitchell in Agon. It just doesn't get better. Later dancers brought more strength and athleticism, but no one demonstrates the anxiety and beauty of this most particular Balanchine ballet and Stravinsky score the way that they do.

With its emphasis on form, erotic play, and design, Agon has been called an "argument-free ballet." It was the last collaboration between Stravinsky and Balanchine, and I think that is what many people miss -- this only works, this music and that choreography, through collaboration.  Presented as a concert, Stravinsky's work is almost universally panned.  What I'd give to see the score outline, which apparently includes the contemporaneous description of the dance.  Collaboration.

Igor Stravinsky and George Balanchine in rehearsal
while working on Agon in 1957. Photograph: Martha Swope

In 1934, as George Balanchine was working on what would become the first ballet he would choreograph in America, Serenade, Igor Stravinsky was asked by the press about whether he personally saw a future for ballet. Stravinsky replied, with characteristic frankness, "There is not a great deal of good ballet music. Either it is sunk in the dance or it is irrelevant to it as a rule. Music and dance should be a true marriage of separate arts, a partnership, not a dictatorship of the one over the other." 

Diana Adams and Arthur Mitchell rehearsing Agon
From "Moments in Time: Tracing the history of diversity in ballet"
by Gus Solomons jr

December 1957: George Balanchine pairs Arthur Mitchell and Diana Adams in Agon’s erotically charged pas de deux. In a world still a decade away from the civil rights movement, this was casting as political act, and it shocked some members of the ballet community. Twelve years later, Mitchell founded Dance Theatre of Harlem, a haven for classical dancers of color.

Embedding has been disabled for "NYC Ballet's Megan LeCrone on George Balanchine's AGON," but please watch it... for Megan LeCrone is to Agon as Diana Adams was to Agon.  It's eerie.

The pas de deux is one of Agon’s most unique features. The music sounds disjointed, with few instruments being used at a time, but it is still possible to identify the basic components: an adagio, two variations and a coda with the key difference of a role reversal for the dancers, the woman seeming to lead the male into assorted extreme poses rather than the opposite. There are several famous images such as the one where the ballerina wraps around her partner with her leg in attitude, or her 180º arabesque whilst the male dancer is lying on the floor.

Uploaded to YouTube by NeryssaPaige -- 11 July 2012


Compare to this later video of a rehersal with Arthur Mitchell paired with Allegra Kent. I'd love to know the date, should any Dear Readers know it.  (Not to be missed, though to be read with a calming agent at hand, is Kent's autobiography, Once A Dancer.  Preface it by reading Joan Acocella's review... and give the book purchase a second thought.)


Uploaded to YouTube by Approximatesonata --  5 December 2012

Agon is the Greek word for contest; the movements of the ballet are named after French court dances. The score was commissioned by New York City Ballet with funds from the Rockefeller Foundation and dedicated to Lincoln Kirstein and Balanchine by the composer. Together, Balanchine and Stravinsky designed the structure of the ballet during the creation of the music. The outline for the score specifies in detail, with exact timings, the basic movements for twelve dancers clad in simple black and white costumes.

Agon, part of the repertoire of the Dance Theatre of Harlem --
 DTH Founder and Artistic Director Emeritus: Arthur Mitchell 

The "12-tone serialism" technique employed in Agon for the first time by Stravinsky is explained well, for those of us stupid in music, at the Ballet Bag, a website dedicated to "freshening" the art, and supplies helpful interpretive notes, too:

Even though Agon starts with a diatonic, non-serial structure, Stravinsky combined parts that had a tonal centre (think of the violin solo in the coda of the first pas de trois) with serialist parts (the flute, mandolins & harps in the Galliard). In order to concentrate on other works and further his experience with serialism Stravinsky shelved Agon for a couple of years and then returned to create the central – very serialist – part of the work (the first coda and the bransles, ie. the moves from side to side), following Schoenberg and Webern’s ideas. 

Besides the new composition techniques, Stravinsky also used specific instruments to identify the dancers in the ballet – brass for men and woodwind for women – as well as traditional French court dance references: the bransles (couples dancing in circle, side to side), galliards (an athletic dance with plenty of jumps),  sarabande and pas de deux/quatre.

Sadly, a satisfying video of the whole, I cannot find.  Below is an honorific, of sorts -- part of a gala on the occasion of the 10th anniversary of Balanchine's death -- The Balanchine Celebration in 1993.



Peter Boal, Zippora Karz, Kathleen Tracey, Albert Evans, Arch Higgins, Wendy Whelan, Darcey Bussell, Lindsay Fischer,

And just to leave you laughing... and why not, with all this unexpected balletic divertissement... here is a charming interview with Arthur Mitchell who relates Balanchine's personal vision for "sixteen nubian dancers":

The Ways of Worry, With a Side of Depression

A reposting from 17 March 2010. Why? Well, it's been hit on quite a lot by visitors to The Manor over the weekend. When I reread it, it also struck most of the chords being played in Marlinspike Hall today, right down to the major 13th chord that Fred conquered in the wee hours of this Monday morning.  Enjoy!

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

Interesting times.

I continue to struggle with excesses of pain and disability, not always doing so in a way that is particularly laudable, but I do the best that I can.

Dealing with serious health problems without the benefits and protections of health insurance, I spend most of my time flying along the continuum between abject terror and irresponsible giddiness -- picture a nearly-out-of-control luge run down the streets of San Francisco. Woo hoo!



Any neat freak knows that when entropy works up a head of steam... cleaning, straightening, organizing, list-making (and all their anal adjuncts) become the logical and necessary response.

Yes, my world was much improved when I broke down the Sushi Maker Kit into its individual components. Storing my little jar of Wasabi powder with its spicy compatriots almost eliminated the need for my three antidepressants. Putting the Pickled Ginger in the fridge next to the Fish Sauce almost completed my brief, unmedicated happiness. That means that adding the Sushi Rice Vinegar and a very sexy dark Soy Sauce to our existing collection of vinegars and prepared sauces provided such an over-the-top sense of personal plenitude that my mouth risked being permanently puckered.

But then came the unexpected addition of stuff like two insulins (plus the prohibitive cost of those dumb little blood sugar test strips), expensive antibiotics, a trip to the emergency room, and the necessity of consulting certain specialists again. As I shelled out the big bucks for medications and health services over the course of the last month -- and I mean just those medications and attention that were absolutely necessary to life -- my insecurities continued to win out over any residual sense of well being.

There was nothing left to organize, and the only things available for tossing belonged to Bianca, Fred, or the various remnants of the Haddock clan.

Intolerant of my troubled need to eliminate all that is not essential, the ingrates keep hauling their possessions back from the county dump. Sometimes, they even scream and yell, calling down Iniquities from Heaven onto my Humble Head. I suppose I should be grateful not to have to deal with the cursing power of The Captain. His distant cousins seem only to be able to manage some stuttered denigrations.

I mean... think of what Captain Haddock might say, based just on the things he's said before:

Pachyrhizus-eses-eses! Parasites! Patagonians! Pestilential Pachyderms! Phylloxerae! Pickled herrings! Pirates! Pithecanthropic montebanks! Pithecanthropic pickpockets! Pithecanthropuses! Pockmarks! Politicans! Poltroons! Polygraphs! Polynesians! Profiteers! Psychopaths! Purple profiteering jellyfishes! Pyrographers! Pyromaniacs!

And that is just the letter P.

A brief aside in my otherwise tightly-knit narrative: {!lordy!::!lordy!} My Dearest Readers, allow me to share my discovery of a website that will help us all, from neophyte to habitués, in the conjuring of powerful and effective curses. I mean curses in their most witchy sense. This gem of a site has come in quite handy and I join hundreds, nay thousands, of people whose cursing abilities (and, by extension, quality of life) have been vastly improved by its use. Take the case of this poor person whose own curses were just too doggoned weak and downright pitiful to make people stop calling her names. Without busting a barnacle, The Captain could have reduced her to tears in under ten words. But, good news! She came away reassured that, by properly casting her circle and by healing any breaches in her perfect Sphere of Protection, she is "untouchable by such others, even invisible to low-life." Help is out there, folks, for most every problem humankind can come up with... **
When the physical symptoms of this runaway osteomyelitis decided to ramp up their influence on my general ill-being, it became even more difficult to clean, sort, organize, disinfect, and prioritize -- to rule over my environment.

So I decided to get deeply depressed.
Despite having already paid for those three antidepressants.

As if I had planned my Descent Into Neurotransmitter Hell, somewhere in that period of murky time, I stopped taking the one [very, very expensive] medication that really was helpful to my chronic blues and switched to one that was featured on the $4 Walmart Generic List. It has not YET proved a suitable replacement.

So there I was: unable to use my arms very much -- which put quite the crimp in my vacuuming and polishing routines -- and tormented by the CRPS demons that daily tempted me to perform Do-It-Yourself amputations with a rusty scalpel.

I thought a lot about suicide. Oh, hell, I always think about suicide. There was, though, a qualitative difference and [a whole bunch of deleted, très personal crapola that can be reduced over high heat and finished with a tablespoon of unsalted butter...].

Yes, I did just refuse to share something with You! (And aren't You glad?)

And yes, I did just find shelter within a well-crafted and delectable Cooking Analogy!

Because once I determined that my suicidal thoughts were pretty effing dangerous and did actually threaten my survival? The search for Comfort began in earnest and that included, obviously, Comfort Foods. In fact, I mean to submit for publication my written philosophical proof that the correct formulation is "eat to live." No, wait. That should be: "Live to eat." Hmm. Well, I *do* know that to NOT publish is to perish... and if I don't get insurance soon? Taking "live" out of the equation simplifies matters enormously.

Don't worry, I won't include my "permanent and total" uselessness as part of the argument. I won't ever let on that I miss, I need, I cherish, those university days of endless investigation, teaching, sharing, exploring. Ah, the rarefied air of pumpkin-carving, martini-guzzling, day-of-the-dead-ing academics. You won't read about *that* regret here, no sir!

And so it was that the denizens and mavens of Marlinspike Hall (as well as some of our closest starving neighbors) were treated to three different kinds of Rice Pudding, a sad reproduction of Lunchroom Tamale Pie, all sorts of composite salads, aromatic pans of roasted and caramelized root vegetables, various bhaji (onion remaining the favorite), paneer, and -- of course -- sushi.

Okay, so sushi is not traditional Comfort Food. But think Bento Box. A sushi roll, some tempura,and simple things like half a hard-boiled egg, raw baby veggies, some beloved furikake (we like a not-too-salty gomashio) over rice. I am a neophyte at pickling but have heard the call -- and witnessed chefs accomplishing it in the space of half an hour, making the process even more appealing.

I suppose what I am describing is more Comfort Cooking than Comfort Food, although we have indulged in several incarnations of childhood Macaroni and Cheese. Throwing myself into time-consuming processes is really just another variation of the classic advice given to people dealing with clinical depression: *do* something! Whereas once I might have played a few sets of tennis or taken a dip in The Moat, now I do "quick pickles"of onions and carrots, or stuff roasted poblano peppers with tiny cubes of eggplant. At least my compulsive needs and tendencies serve to nourish the bodies of the souls I love.

[O! How could I have forgotten SOUPS! It has gotten to the point where I can barely tolerate canned prepared soups -- all that salt and tired taste. There is something so very grounding about a successful soup. Building flavors and foundations, eliminating the superfluous, elevating the humble. Also, let's face it, I am the Queen of the One Pot Meal.]

Then, too, there's the resultant mess. I get to moan and groan but secretly delight in the cleaning up necessary to my continued culinary success. Yes, it is painful to wash dishes. Yes, it hurts like the bedeviled dickens to mop the kitchen floor. Still, when these tasks are moved from the "just because" category to the "must be done" rationale? Someone has to do it... Lately, I do hit the wall during meal preparations and even though I clean as I cook, I have had to turn the mess over to my compatriots. There is much less guilt involved, though, because I have, at least, fed them.

However, on certain days, even several days in a row, I cannot even get out of bed. Getting up to go to the bathroom reduces me to tears and invites that peculiar terror of falling.

How do I manage my Uninsured Anxiety then, when even more than usual my infected bones and burning legs take charge?

That is where I was yesterday. I tried napping, reading, watching the Idiot Box, playing bridge, poker, mahjong. Tweeting, emailing, and pontificating ensued. (There has to be severe melancholia for me to venture to Facebook.)

All to no avail.

The need to clean, fix, straighten, prepare, chop, serve, wash -- that need was not being met.

And so it was that I found the latest incarnation for my sublimation needs: old letters and cards. We all have them, stashed away somewhere. Through the years, I have gotten rid of some pieces of mail that probably should have been kept. Nonetheless, I have a small trove of keepsakes -- and in my depressed, anxious, uninsured state, gathering them together for storage in one suitable spot seemed The Thing To Do.

You probably know the punchline.

As I read through letters from my brother, from friends, I tried hard to stay suitably depressed, to lament times gone by, never to be recaptured. Instead, as you already know, giggles and hoots and even a few guffaws were the result.

I know some funny people.

Here, let me show you:

In my first year of college -- at a college I only attended for one year -- I met a wonderful woman, a Senior to my FreshPerson. She presided over the Poetry Club and over the hearts of two remarkable, diametrically opposed, men. The Poetry Club was her excuse for hanging out with one of those men, the one she would not go on to marry but whom she loved most. He was the son of an oil baron -- no, I am not kidding -- who flitted around the world in dissipated fashion when not attending Our Humble School. Very Lord Byron ("mad, bad and dangerous to know").

We will call the byronesque, filthy rich heir Bill because that is his name.
Her, we will call Kathleen, as that is her name.
We won't mention the very successful lawyer husband because he was, in many ways, irrelevant at the time of Kathleen's various missives. They went on to make beautiful children and achingly darling lives.

Oh hell. His name is Jim.

The summer before she married Jim, erudite lawyer-to-be and classic Good Guy, Kathleen experienced a massive amount of doubt. I learned to listen and not opine (especially as I was against the upcoming union). At the time, I was at a large public university earning an undergraduate degree at the speed of light. She was finishing a Master's in Anthropology at the better known school down the road.

It was a December day when I found this muted Paul Klee postcard from Kathleen in my mailbox. The writing is minuscule (I had forgotten her incredible handwriting!):


I haven't had any sleep in forever. Insomnia for two days followed immediately by four nights of sleeping in the living room of a trailer which then housed seven other people. My family drove to Pennsylvania to see relatives and Jim joined us for about 40 hours, 35 of which were spent either sleeping in separate rooms or in the company of a vast number of relatives. Still, everybody likes Jim and somehow he managed to impart to me a faith in our relationship's future which had recently been missing on my part. The paper I sweat blood to write is finished -- so finished it looks as if it must have been effortless to write. I'm fighting letdown, wondering if I really have the courage to hand it in only to have somebody say "So what?" And there is so much shit work to do to finish off the semester. I can't remember if I've written to you since you called, but even now, when I think about the little shit "Bob,"* I literally get blind for a minute because I'm so pissed off that somebody would do something like that to you. It's things like that that make me realize I'm very capable of violence. I love you, take care of yourself.

Postscript: A week or so ago, I read The Portrait of a Lady. I understand better why Bill was so much against marriage for me. In fact, he once compared me to Isabel Archer. Speaking of Bill, Jim drew me a lovely portrait of Bill at Our Wedding: with a red cushion strapped to the top of his head (both rings on top), Bill will come leaping down the aisle (great graceful bounds) with his hair streaming in the breeze behind him and his beard leading to the fore, he will pirouette ethereally above the assembly in a pale green leotard. Breathtaking thought, hmm?

*The "Bob" of which she speaks is this one.

A week before she was finally and irrevocably betrothed, Kathleen canceled the wedding and called for my Incredible 1965 Baby Blue Cadillac to carry the both of us away to my family's beach cottage at Morehead City, on Atlantic Beach. We had a grand time: She got quite the sunburn; We drank a lot of wine. We talked, but barely mentioned boys or men.

We ate our weight in boiled shrimp, served on fresh newspaper, dipped in ketchup and garlic butter.

The wedding was put back on the schedule but we stayed at the beach until the day before... lost in the sun, sand, and water. We did not answer the phone. We were out of reach and touch, out of time.

As it worked out, Bill did not attend.

Struggling to remain upright on my stilt-like Fancy Sandals, I still saw Kathleen's eyes sweep the church, and knew who she was looking for. We both later received clever "cara mia" letters of explanation, Italy the postmark.

The Klee on the front of the postcard is titled Parcimonieusement garni de feuilles, 1934, but I also see a cold winter night in a small mountain town, on an even smaller college campus -- a center of sober rectitude -- Bill in an old pea coat and impressive boots, dashing from tree trunk to tree trunk as Kathleen and I stagger, laughing, through the snow. One of us, I'm sure, is reciting poetry. If you squint and tilt your head to the left, you can just make out my second floor dorm room, in Cannon Hall.

So, I am putting this little bit of Kathleen, Bill, Jim, and "Bob" in the accordion folder purchased just for such a project as this.

Next, Brother-Unit Grader Boob's 2001 Christmas card, "made for [me] by Adjuncts on Bicycles -- Impoverished Athletes Extraordinaire."

Odd, I don't feel quite so depressed, and while my legs remain a source of suffering, the suffering seems dim and far away. The fever, sweats, and shoulder pain from infected bone? Pshaw!

So, for anyone wondering, that's where I am at -- cleaning what is often not even dirty, cooking when often there is no one even hungry, and lost inside temporal dislocations of memories that I am pretending to sort and organize.

Here is a list of everything I have learned

Exactly how transparent am I?
That bad, huh?

Did you ever grow so sick of yourself that waking up still here provokes the first apology of a day crammed to the rafters with apologies, and Apology's Echoes?

Here is a list of what I have learned in the short time since my brother was diagnosed with an awful metastatic case of cancer:

He can still be an asshole.
I continue to direct my emotional issues, like projectile vomit, onto others, and try to absolve myself of the guilt by choosing "strangers."
We're none of us strangers.
Should you work in the medical field, and our paths cross, woe unto you, and woe unto me, and, especially, waves of great sadness at the destructive forces of anger.
There are no excuses for the rampant stupidity of the medical folk I've been gifted with these past few weeks.
There is an abundance of hope and good feelings about the medical folk who now surround my dear brother, and I know the feelings of affection that grow in their heart for him.
It's inevitable.
Ants and spiders, particularly of the small and "cute" variety, are allowed to live.  I vacuum and mop around them.  I escort them into the great outdoor holdings of the Haddock Family Corporate Manorship. Marlinspike Hall has never been so clean, nor so infested with small, suddenly fearless insects scavenger types.
Dreams are finally a relief.
My pain did not become subsumed in the pathos of his pain.  It remains.  It's inevitable.
I beg others to forbear and badly need to develop the talent in its most personal, intimate form.
I still have the talent to be one with him -- without his knowledge and consent, but since he can still be an irritating asshole, the need to apologize for the psychic intrusion simply does not exist.  How liberating!
When I eat a green salad that is also full of vibrant reds, yellows, and more shades of "green" than the descriptor can imply, it's into his stomach -- pleasantly balanced and accepting of the vegetative offering -- that it goes.  I use about a teaspoon of excellent red balsamic vinegar as dressing most of the time and tend, at least in the last week, to eat the salad entirely with my fingers.  But I don't lick my fingers, 'cause that would be gross.  He sighs with contentment.
I recognize the edge of my own skin as the edge of myself.  His skin, however, has become amorphous, penetrable.  Until your fingertips hit the cancers' limn.  That's the wrong word, or is it?  To carefully outline, tentatively touch, desirous to probe but fearful.
Death is not the enemy, never has been.
God is not interesting.
Pound's ant's forefoot will, indeed, save you, if salvation is needed.
Love is precious, and everywhere.
Fred is afraid of dying.  I must tend to that, maybe later today, or early tomorrow, if he can manage to get his ass out of bed before noon.
My brother remains my touchstone for most of the good and right things that I know.  That goes, actually, for both of my brothers, but as they both can be assholes, and since only the one is in immediate peril from pain and suffering, Grader Boob's status as Primary Touchstone shall prevail, for the time being.  I've completely overwhelmed our elder brother with my inappropriate emotional lability and neediness.  Actually, I'd like to call it "emotional incontinence," as that makes me laugh.  I am trying, actually, though you'd never guess it, to make that elder brother laugh, as he does zing through Captain Haddock's wormhole in the moat for the occasional stealthy visit.  I love them both from *here* to eternity.  Does anyone mind, except for the medical professionals propped up in all my corners, if I take a few ibuprofen?
How are they "assholes," and how dare I call them "assholes"?  They are not, of course. They simply refuse to conform to my standards, needs, and a way of behaving that would make life infinitely easier for ME.
Am I aware of my seeping narcissism?  Oh God, yes.
Every day since his diagnosis, which now seems an aged elephant whose stink has been in my nostrils for at least a decade, my brother has accepted the resultant intrusions of advice, concern, panic, judgment, and other violences, large, small, and medium, with grace.  The asshole.
He even issued me a blanket, nonrefundable statement of forgiveness.  The asshole may regret that, as my sins pile high, but I believe him.  He is, to my knowledge, the only person of import in my existence who has never lied to me.
He is afflicted with the same genetics and inheritances, however, and that saddens me the more I think on it, and have, therefore, cut down on the time spent thinking of nature and nurture, genes versus the oppression of our progenitors.  Sometimes, I even remember the beauty of my father's eyes and the taste of a "mortgage buster" tomato sandwich.

How do we tolerate these things we learn:
"These matters that with [ourselves we] too much discuss
Too much explain?"




Yeah, well, you know Eliot HAD to happen on this blog, in this matter, eventually.  Dr. Seuss shall have equal time in my brother's cancer journey.  Maybe I will even have something original to say.

I'd offer you quotes from the Brother-Unit, himself, but he is being an asshole, and nothing but a quipster, at the moment.  Actually, and this is quite serious, he is obsessed with his "ass," and how it hurts.  No one is particularly quotable when ass pain has reached such a consuming proportion of an already overwhelming amount of pain.

Maybe I should cut the boy some slack.

Have I tried subsuming his pains, his cancer, calling it into my own wrecked body and self, instead?  Well, duh, Dear Reader.  And the universe doesn't roll that way, or didn't you know?

Time to relocate my legs, and perhaps add opiates to the ibuprofen.

Love to the Brother-Units.  For those in the know -- the StepMother-Unit is recovering from her emergency surgery, though her 85-pound little self also tried to assault one of her nurses, prompting the name plate on her hospital door to be changed to "Boom-Boom Baba," and our stepsister to be nominated for sainthood. The tiny pugilist has successfully farted, reports the dear stepsister, and therefore may now have broth. This should improve her mood immensely, we hope, and cheer her, somehow.

The biological Mother-Unit remains in-and-out of dementia, and cursed with the actions of sociopathic offspring.  Karma is a bitch.

I'm in a world of pain, and withdrawing from a drug that my new insurance, represented by its plethora of doctors, nurses, and pharmacists, could not see its way to renewing, despite two week's worth of effort, at least, on Fred and my parts.  We spent most of Friday in a pharmacy, and thought ourselves victorious over The Beast, only to discover that the pharmacist managed to refill another drug that began with the same two first letters as the one I need.  It's one of three drugs I use to fight the screaming ninny spasms of CRPS, so this weekend has been fun, fun, fun.

So, I say again:  Karma is a bitch.

It's lovely outside, but too hot. The felines are wonderful, and Fred is fine, as soon as we take care of that Death Fear issue.  He's been beyond "fine," actually, more in the range of "wonderful."

Be well, all.







© 2013 L. Ryan

If It Is Tuesday...

Cape May During Hurricane Sandy

If it's Tuesday, then Monday must be over.

Anyone wishing to argue about space and time continua or parallel string bikinis may simply go take a dip in the moat.

Because, damn it, Monday is over.  We start fresh.  All devices have been charged.  The Manor is pristine, the grounds are pruned, raked, and -- where absolutely necessary -- mowed.  Sven Feingold putters about giggling, so something is up with the latest ManorFest Maze design.  La Bonne et Belle Bianca Castafiore stays on her cell, when she can get reception, because she is *this* close to garnering a position as spokesperson for a major weight loss company that specializes in busty divas.  Just the exercise and muscle toning from running up and down turret stairs and sprinting around Captain Haddock's miniature submarine wormhole gateway will make her lose a few dozen dress sizes.  Should Marlinspike Hall ever successfully be enveloped in a wifi bubble, the Milanese Nightingale may well gain back all the fat she's discarded chasing a phone signal.

Our various herds and fruit orchards are all in their proper states.  The monks next door are reworking their Christmas Catalog of Wasted Calories and the Abbot, Fred, and I have been designated taste-testers.  Life is sweet.

But Monday.

The Mother-Unit that actually raised moi decided to need emergency surgery.  In a test of the emergency surgery system in the coastal backwaters of her slice of paradise, she encountered the requisite number of idiots at the local beach bum hospital over the weekend.  So, in a way, Monday was her salvation, as it brought an influx of actual medical practitioners leaking grains of sand onto the spit-shined checkerboard hallowed hospital halls.

I was a tad bit worried when I looked up her surgeon's credentials to find that he also enjoyed the practice of ophthalmology.

I've not seen her in decades but every description begins with her diminutive stature.  She has everyone and everyone's brother worried about her weight -- no busty diva, she.  I want to scream sometimes.

Oh, about what?  I need to particularize my need?

I want to scream at the "but she's so tiny," "she can't take it, she has no... reserves!"

Puh-leeze.  This is a woman who was a fierce ballerina.  I watched her employ many tricks of the dancing trade as she guarded her lithe status through the years -- as if it mattered once she was no longer expected to enter rooms via a grand jeté.  She is not anorexic in the strict definition of the malady.  Nor is she an alcoholic, nor does she abuse prescription drugs, in spite of a lifelong celebration of Happy Hours and a honking bottle of bazillions of phenobarbital kept in the last drawer of her dressing table.

Anyway, she survived the weekend, and made it through a scary surgery with style.  And got -- with us -- to Tuesday!  Yay, Mom!  Point your toes and twirl, twirl, twirl!

Equally wonderful about this day?  Grader Boob gets his first doses of chemotherapy!  His story has become so sad, beset with that ogre of physical pain and the great deceivers of the mind that pain welcomes. If you're a Dedicated Reader, you've seen me act out that drama, o'er and o'er.  Therefore, rejoice in Tuesday, for shrinking those tumors will result in less pain, and less pain will allow sleep, and sleep will further decimate the pain cycle.

All together now:  "Shrink, tumors, shrink!  Shrink, tumors, shrink! Shrink, tumors, shrink!" I have an accompanying tune in mind, but don't want to limit your creativity as you dance your way through this Tuesday, chanting, cavorting, and casting Grader Boob tumor cells into Tumor Cell Inferno.

Use any musical genre that works.  Though I have to admit that "country/western" somehow doesn't fly. Feel free to prove me wrong. Something in a Texas Two-Step, maybe?  Just be stylish.  This is my brother we are talking about.

He's simply riddled with cancer, the reprobate.  His new oncologist, who seems a very good dood, is starting the meds today whether he is admitted to the clinical trial or not.  And no, I am not stupid.  Prevailing winds, insight, what is not said -- I'm on it.

Given that it's been over 6 weeks since the official diagnosis, it is fair to say that the new oncologist's very life may have hinged on that decision, as I was gathering weaponry to bring down on his toupéed head if something were not done this week.

Would I kill to improve Grader Boob's Quality of Life?  Let me see.  Hmm. Yes, of course I would.

Wouldn't you?  If I were willing to personally extrajudicially execute Pinochet, Jesse Helms, and various other errors, an attempt on the life of someone impeding the life of Grader Boob is one of those famed "slam dunk" decisions. The weird problem with my Kill List, and this has been the case since roughly the 1970s, is that once penciled in for an extrajudicial execution, my Listees just... drop dead.  Or are taken out in the wrong fashion, a tragedy equal to the horror of their continued existence.  If you have any insight into how I might stem the tide of these unworthy deaths and promote the karma-cleansing of my efficient Kill List, the comment section is all yours.

If you're lathered in a cold sweat and thinking of calling the Interwebs Keystone Kops, relax. I was voted the Family Member Least Likely To Commit Murder.

So, it is Tuesday.  The Mother-Unit may yet gambol along the edge of her watery front yard, scotch and soda in one hand, the other arm gracefully indicating the vastness of the Atlantic.  The Brother-Unit may get to drop the F-bomb on another set of undergraduates, or he may be granted furlough to gambol alongside the Mother-Unit, leaving now and then to swim out past the breakers.

Have I told you lately, Dear Readers, that I love you?  Particularly You... That's right, You.

Instructions for Tuesday:

• Point your toes and twirl, twirl, twirl!
• Shrink, tumors, shrink!  Shrink, tumors, shrink! Shrink, tumors, shrink!

© 2013 L. Ryan

Amputation for Complex Regional Pain Syndrome

photo, amputated limbs, "field day," civil war...

Informed Decision-Making Regarding Amputation for Complex Regional Pain Syndrome Type I

Marlies I. Bodde, MD; Pieter U. Dijkstra, PhD; Ernst Schrier, MSc; Jan J. van den Dungen, PhD; Wilfred F. den Dunnen, PhD; Jan H. Geertzen, PhD
J Bone Joint Surg Am, 2014 Jun 04;96(11):930-934.
http://dx.doi.org/10.2106/JBJS.M.00788

ABSTRACT

Background: Literature on complex regional pain syndrome type I (CRPS-I) discussing the decision to amputate or not, the level of amputation, or the timing of the amputation is scarce. We evaluated informed decision-making regarding amputation for CRPS-I.

Methods: We describe our findings in a retrospective study of the decision-making process of thirty-six patients who underwent amputation for CRPS-I at our university medical center from 2000 to 2012. Additionally, we present the incidents preceding the CRPS-I, the reasons for and the levels of the amputation, and the outcomes after the amputations.

Results: Team members and the patient decided together whether or not to amputate and the level of amputation. Issues such as level of pain or allodynia, infection, desired length of the residual limb, joint range of motion, strength of all extremities, ability to use walking aids, and psychological “green, yellow, and red flags” were weighed in this process. There were no complications during the amputation surgery, a 22% rate of complications (infection in all but one patient) immediately postoperatively (reamputation not required), a 72% rate of phantom pain immediately after or within the first three months after the amputation, and a 77% rate of phantom pain more than one year after the amputation.

Conclusions: Informed decision-making regarding amputation for CRPS-I remains a complex process for which little evidence is available to support patient choices; patient-specific outcomes are not predictable. However, amputation should not be ignored as a treatment option for long-standing therapy-resistant CRPS-I.

FOOTNOTES

Investigation performed at the Department of Rehabilitation Medicine, Center for Rehabilitation, and the Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, the Netherlands

40 Miles West Of Baghdad

The best lack all conviction, while the worst  

Are full of passionate intensity.   

--Yeats, The Second Coming

Any excuse for Yeats. But let's move on.

How often do we get to label Joe Biden as "prescient"?  Doesn't the partitioning of Iraq now seem downright wise (though a tad tainted with imperialist hubris)?  Would that ANY of this mess depended on USAmerican actions or ideas!

Prime Minister Nouri al-Maliki grand design to eliminate Iraqi Sunnis from any role in government, a fallow field for ancient seeds that was largely fueled by the disbanding of Sadam Hussein's military (a very sarcastic tip of the hat to L. Paul Bremer), and the astounding arrogance and ignorance of the Bush administration.

Long schooled in the long view, Arab Shiites, Arab Sunnis, and the northern Kurds (to mix sects and ethnicities) in the region must have snickered into their famous head gear, beards, and shiny western suits as they saw the foundation laid for the perfect storm that now threatens, in the form of a revolutionized Al-Qaeda "offshoot" ISIS (DAESH in Arabic), first the "stability" and lives of Iraqi citizens, and second, the "stability" of the entire region.

Some Chicken Littles have the sky continuing to lower over the First World, as well, with frequent references to oil prices.

President Obama, Secretary of State Kerry, and those responsible leaders in Congress are facing the impossible issue of what-to-do-now in the sucking vacuum of an illegal war marked by the profound loss of USAmerican treasure, and the current President's political premises and promises regarding the Iraq war. You remember, the one that didn't have any Al-Qaeda element, much less WMDs, in evidence.

We left with Bush' slogan ringing in our ears -- which always reduces to that tired "give a man a fish, feed him for a day;  Pretend to train his army, and run, run, run away."  Which always has a syncopated background track cover of those grabby, raspy McCain lyrics:  "Bomb, bomb, bomb, bomb, bomb... Iran."

Now that the well-trained Iraqi troops have stripped off their uniforms, literally, and fled before what appeared to be, in Mosul, a smaller and weaker force, knowing that those 1,000 or so ISIS troops their 10,000+ well-equipped, crack-trained fighting force faced were but the tip of a desert iceberg.

Mosul, Tikrit, Fallujah...

"Now."
This is "now."

Remember way back when?  Remember how police and army recruitment centers were prime targets for bombs, bombers, shoot- 'em-ups?  In our short view, a desperate ploy to derail the democratization of a country long split at least three ways -- three ways too complicated for USAmerican country builders to fathom.  In the regional long view, a snickering foreshadowing of an interminable drama.

The Obama administration cannot indulge in laying blame at the feet of Bush, Cheney, Wolfowitz, Perle and their traitorous deceptions, cannot curl up in a mass fetal position at the thought of hoping Syria's Bashar al-Assad remains in despotic power, and imagining Iran's smirk rising above the horizon's mess like a festive Cheshire Cat.  I hear whispers about Jordan, and shouts from the ISIS leadership that "slaughtering" Abdullah II is on the To-Do List.

But I, who am nobody, can indulge.

From one of Daily Kos' cobbled posts (that I've now lost) --

 Former Ambassador to Croatia Peter Galbraith is claiming President George W. Bush was unaware that there were two major sects of Islam just two months before the President ordered troops to invade Iraq, RAW STORY has learned. In his new book, The End of Iraq: How American Incompetence Created A War Without End, Galbraith, the son of the late economist John Kenneth Galbraith, claims that American leadership knew very little about the nature of Iraqi society and the problems it would face after the overthrow of Saddam Hussein.

A year after his “Axis of Evil” speech before the U.S. Congress, President Bush met with three Iraqi Americans, one of whom became postwar Iraq’s first representative to the United States. The three described what they thought would be the political situation after the fall of Saddam Hussein. During their conversation with the President, Galbraith claims, it became apparent to them that Bush was unfamiliar with the distinction between Sunnis and Shiites. Galbraith reports that the three of them spent some time explaining to Bush that there are two different sects in Islam–to which the President allegedly responded, “I thought the Iraqis were Muslims!”

From a cache of  The Heretik now defunct blog archive for August 2006, the chilling --

From the Known Unknowns Department: “While I don’t doubt the central thesis that Bush is not particularly intellectually curious, it’s almost inconceivable that anyone—let alone a man whose father was CIA Director, Vice President, and President—would not at least be aware of something so basic.” So we are left now in the conundrum. Bush did not know and can plead a certain ignorance which is no defense for what now goes on in Iraq. Or he did know and went ahead anyway with no clue of the consequences. The idiot of the past meets the fool of the future. So we slouch toward Baghdad.

Cheney was rife with casting USAmerican troops as long-awaited, oh-so-welcome liberators, and glossed religious and ethnic sectarianism as the tried-and-true propaganda of good versus evil.  Delving further into that heart thief's verbiage might engender a myocardial infarction of mine own. Let's just keep it simple:

My belief is we will, in fact, be greeted as liberators. . . . I think it will go relatively quickly, . . . [in] weeks rather than months. – Cheney, Meet the Press, September 14, 2003

Wolfowitz.  I hate nausea and vomiting more than the prospect of squeezing chest pains often described as what one might experience should an elephant kneel upon one's rib cage.  Wolfowitz brings up PTSD images of Pepto-Bismol pink pachyderms upchucking via every unduly hairy orifice onto my pristine self.  I'll pass.

Instead, gird your gastrointestinal tract for Peter Oborne's five-part documentary from 2006, one of the best I've seen.  It bears a new hearing, a new look, given that ISIS (or ISIF?) is, at last report, about 40 miles west of Baghdad, whose most western enclave is friendly to them, being largely the home of Sunni Iraqis. Baghdad residents of sufficient wealth wasted no time in becoming, not a merrily mixed city of diverse hatchet-buriers, but savvy wall-builders.  The Shia majority population is arming, looking to show the beleaguered retreating state army how "it" is done.  The Kurds, looking down from the north, must feel like bat-wielding sugar junkies in a plain of unattended piñatas. Sure, the gas masks detract from that frivolous depiction, but can you blame them?

Peter Oborne, political editor of the Spectator, reports on the West's exit strategy for Iraq. He believes the invasion of Iraq is proving to be the greatest foreign policy failure since Munich. Oborne argues that the plan to transform Iraq into a unified liberal democracy, a beacon of hope in the Middle East, is pure fantasy. Reporting on location with US troops in Sadr City, and through interviews with leading figures in Britain and the US, Oborne argues that the coalition and its forces on the ground are increasingly irrelevant in determining the future of Iraq - a future that's unlikely to be either unified, liberal or democratic.

We, of course, are saddened indeed by the events in Indochina. But these events, tragic as they are, portend neither the end of the world nor of America's leadership in the world.
Let me put it this way, if I might. Some tend to feel that if we do not succeed in everything everywhere, then we have succeeded in nothing anywhere. I reject categorically such polarized thinking. We can and we should help others to help themselves. But the fate of responsible men and women everywhere, in the final decision, rests in their own hands, not in ours. 

-- President Gerald Ford, Tulane Graduation Address, April 23, 1975

 Special police will be required to undergo training on human rights and the meaning of the rule of law, Bush said. All nine Iraqi police academies, he said, will place added emphasis on personal and professional ethics. And U.S. battalions will partner with Iraqi special police units to provide mentoring, Bush said, as part of a program similar to one that succeeded with the Iraqi army.
"These U.S. forces will work with and train their Iraqi counterparts, helping them become more capable and professional, so they can serve and protect all the Iraqis without discrimination," Bush said.
Numbers of Iraqi border police, now at about 18,000, will be bolstered, Bush said, with the goal of having 28,000 border police trained and equipped by the end of the year. The border police will benefit from a new customs academy in Basra, Bush said, and will work with U.S. and coalition personnel, including experts from the U.S. Department of Homeland Security.
The president said efforts also will focus on increasing the numbers of trained local Iraqi police, now at about 80,000 officers. The goal, he said, is 135,000 trained and equipped local police. Local police will be teamed with experienced U.S. and international police officers, Bush said, focusing on nine key cities that have seen intense fighting with terrorists.
"And by strengthening the local Iraqi police in these cities, we'll help them earn the confidence of the local population," Bush said, "which will make it easier for local leaders and residents to accelerate reconstruction and rebuild their lives."
Bush acknowledged that training the Iraqi police hasn't always gone without a hitch. "Yet, we're making progress," he said.
"As we bring more Iraqi police and soldiers online in the months ahead," Bush said, "we will increasingly shift our focus from generating new Iraqi forces to preparing Iraqis to take primary responsibility for the security of their own country."
More than 35 Iraqi army battalions have assumed control of territory, the president said, including almost half of Baghdad province.
"And in the year ahead we will continue handing more territory to Iraqi forces, with the goal of having the Iraqis in control of more territory than the coalition by the end of 2006," Bush said. 

-- DOD News Article, January 10, 2006

We're leaving behind a sovereign, stable and self-reliant Iraq with a representative government that was elected by its people. We're building a new partnership between our nations and we are ending a war not with a final battle but with a final march toward home. This is an extraordinary achievement... " 

– President Barack Obama, Fort Bragg, December 14, 2011

 So any action that we make take to provide assistance to Iraqi security forces has to be joined by a serious and sincere effort by Iraq's leaders to set aside sectarian differences, to promote stability and account for the legitimate interests of all of Iraq's communities, and to continue to build the capacity of an effective security force. We can't do it for them. And in the absence of this type of political effort, short-term military action -- including any assistance we might provide -- won't succeed.

So this should be a wake-up call. Iraq's leaders have to demonstrate a willingness to make hard decisions and compromises on behalf of the Iraqi people in order to bring the country together. In that effort, they will have the support of the United States and our friends and our allies.

Now, Iraq's neighbors also have some responsibilities to support this process. Nobody has an interest in seeing terrorists gain a foothold inside of Iraq. And nobody is going to benefit from seeing Iraq descend into chaos. So the United States will do our part, but understand that ultimately it's up to the Iraqis, as a sovereign nation, to solve their problems.   

-- President Barack Obama, WP transcript of oral remarks, 13 June 2014

 © 2013 L. Ryan

Coded Message to a Pilgrim

A good Friday evening to you, Dear Readers. This post is written in code, so those of you not privy to elle est belle la seine la seine elle est belle top secret ways, first, I scoff in your general much too hopeful direction, and, B: Lots of luck!

My beloved pilgrim,

I just left a rambling telephone message on your answering machine.  You're likely out earning a living -- what a notion!

It just occurred to moi that, given your proclivity for working ridiculous hours -- entirely by choice and love of the pursuit of green, snort! -- you may not have been rabidly checking your incoming emails.  Having a life and all.

So I wanted you to know that our favorite professor encountered big changes and may have brushed shoulders with a bit of luck and a person of optimism this past Wednesday.  As I am becoming a basket case every Tuesday evening, and something resembling an Orca-sized New York street vendor pretzel during Wednesday's official time stamp... only to dissolve like an Orca-sized New York City street vendor pretzel left out in LA's Macarthur's Park and its famous rain.

Are you still there?  Good, because I'm pretty sure I was able to shake off any doped-up readers who decided to read on, after being so thoroughly discouraged from that endeavor -- my Beloved Freaks!

MacArthur's Park is melting in the darkAll the sweet green icing flowing downSomeone left the cake out in the rainI don't think that I can take it'Cause it took so long to bake itAnd I'll never have the recipe againOh, no

One day, when we meet to discuss all of the many things over which we've been mutually blessed to marvel, we can discuss Jimmy Webb's (and Richard Harris') contribution to the culture.*

Honest to Goodness, though, I hope we can hoist something cold and frothy, first, and examine our mutual navel lint before diving into such depths.  Two fools in a pool...

The Good Prof, weak and limping along in a fog of pain and confusion, was released from the care of the Bone Dood, and handed over to a hematologist oncologist.  Unfortunately, and this sums up the charm of the Bone Dood and his massive "Institute" quite well -- not a criticism; just what we all know is true at large, excellent medical joints -- GB was given no clue as to why he was now being sent to a frigging Blood Cancer Doc, but resigned that the tumor in his shoulder, the tumors in his lungs, and the as yet unidentified LUMPS in his pedagogical ass all logically added up to a burning need for a Blood Doctor.  Oy!

When last we left GB, he was being led down the corridor to a Radiation Oncologist who was gonna "debulk" -- a new verb favorite -- the shoulder tumor to provide him with pain relief.

Odd, but Bone Dood's dawdling in making that step happen proved to be, well, something a smart musculoskeletal oncologist might do, as hurtful as it seemed to moi.

Because Blood Cancer Doc deals often, and well, with persons diagnosed with [don't click on this next link without a cat in the lap and whiskey in a glass] metastatic renal cell carcinoma -- which, despite being located in spots far afield from the kidneys, are still "renal cell carcinomas."

Wanting a euphemism for "kidney(s)" -- and who does not? -- I discovered that "the biblical Hebrew equivalent of the English idiom heart and mind, is כּליות ולב --  i.e. kidneys." This will prove useful in future coded messages, eh?

Blood Cancer Doc was warm, thorough, optimistic, and ready with a plan.  No radiation, no surgeries, but an immediate, time-sensitive (duh!) application to a clinical trial.  Forty pages of information for this pained, tired jokester of an Educator to cull through, decipher, and to which he will dedicate 14 months of his life, IF accepted.

Turns out that had our Intrepid Teacher undergone *any* radiation, or treatment, really, of any kind, he would have been ineligible for the clinical trial, or would have had to delay starting. IF he's accepted.

That news should be had around next... you guessed it!  Wednesday!  Regardless of the response, the friendly, warm, optimistic Blood Cancer Doc is prepared to begin chemotherapy next week.  Either way, he promises it will reduce the pain.

In the interim, he will be kept busy as a bee with testing.  The application and attendant clinical reports also require that the pathology/histology report not be older than 21 days, else our underemployed-overworked loved one will have to undergo another deep biopsy under general anesthesia.

True to form, his major complaint remains... the famed ASS (good luck decoding that acronym, my Intrepid Readership!).

I love him so.  You love him so.  And all three of us still love bad jokes, excellent thought, the sound of rushing rivers, and wild, wild beauty. No code needed.

Smooches Galore.  I love you so...

The old grey donkey, 

Eeyore, stood by himself 

in a thistly corner of the Forest, 

his front feet well apart, 

his head on one side, 

and thought about things. 

Sometimes he thought 

sadly to himself, Why? 

and sometimes he thought,Wherefore? 

and sometimes he thought, 

Inasmuch as which? 

and sometimes 

he didn't quite know 

what he was thinking about. 

--A.A. Milne

Winnie-the-Pooh

Hebrew text from the Dead Sea Scrolls,
from Psalm 145

* "MacArthur Park" is a song by Jimmy Webb, originally composed as part of an intended cantata. Webb initially brought the entire cantata to The Association, but the group rejected it.^[1] Richard Harris was the first to record the song, in 1968; it was subsequentlycovered by numerous artists. Among the best-known covers are Donna Summer's disco arrangement from 1978 and Waylon Jennings's version recorded in 1969 and his recording of the song from 1976. Maynard Ferguson,^[2] Stan Kenton^[3] and Woody Herman all performed big-band jazz arrangements.

While it was a commercially successful song multiple times after it was released, "MacArthur Park" used flowery lyrics and metaphors (most famously, love being likened to a cake left out in the rain) that were considered by media such as the Los Angeles Times to be "polarizing" and "loopy".^[4]

Since its original release, the song became associated with the NBC, most notably with the late Johnny Carson. Harris sang the song in the final episode of The Tonight Show with Johnny Carson in 1992.

 © 2013 L. Ryan