Friday, July 25, 2014

Read This, Thought of You...

Yesterday's "Poem of the Day" from The American Academy of Poets

Nick Flynn


Nick Flynn, 1960

Years later I’m standing before a roomful of young writers in a 
high school in Texas. I’ve asked them to locate an image in a 
poem we’d just read—their heads at this moment are bowed to 
the page. After some back & forth about the grass & a styrofoam 
cup, a girl raises her hand & asks, Does it matter? I smile—it is as 
if the universe balanced on those three words & we’ve landed in 
the unanswerable. I have to admit that no, it doesn’t, not really, 
matter, if rain is an image or rain is an idea or rain is a sound in 
our heads. But, I whisper, leaning in close, to get through the 
next forty-seven minutes we might have to pretend it does.





Thursday, July 24, 2014

Are you sitting down? A State and Federal Government SNAFU...

There are so many extant prefaces that will do, but I choose this one:

"Truth is stranger than fiction."

Yesterday, while playing with the up-and-down controls on my hospital bed, and listening to the "Summer Night" setting on my Homedics Sound Spa with 6 Sounds, Fred brought in the day's bundle of mail.  I almost missed the real challenge to my mental well-being , as we are receiving an inordinate amount of what amounts to Hate Correspondence thanks to my inExecutive Decision to cancel this year's ManorFest due to Personal Insanity.

You know, we paid through our considerable noses to have an unplottable address, so how are all these Haters getting the address to Marlinspike Hall, anyway?  Harrumph.

Unplottability refers to the deliberate concealment of several areas around the world. Unplottable locations are either magically hidden from plain sight or simply removed on maps. Common reasons for unplottability are for individual safety and the protection of certain secrets, particularly within the schools of wizardry.
Anyway -- too tired for more original segues -- about one-third of my way through the interminable gripes, most of the "we-all-have-problems-and-yours-are-nothing-special" sort -- my swollen and painful hand landed on a thick envelope of poor quality, making me cry out:  "Oh shit!  Something from the government!"

And so it was.  Apparently that brief trip to the United States of America, within which is located the land of Atlanta, itself subsumed by the backwardness of the state of Georgia -- a trip via miniature [pink] submarine and Captain Haddock's own wormhole, which originates in Marlinspike Hall's moat -- apparently, that brief trip to see the Board Certified Neurologist Doctor Raymon J Wilensky [RJW] left Fred, myself, the submarine, and all the physical holdings of the Haddock family PLOTTABLE!  How else to explain a thick envelope of poor quality from a division of the State of Georgia, made out to my Americanized moniker?

Eight pages long it was.  

It's title?  An initially agonizing, sharp-intake-of-breath inducing: NOTICE OF DECISION.

I make thousands of important decisions a day.  Still, I rarely issue an eight-page notice detailing them. That'd just be embarrassing. Besides, I have a blog for that!

Okay, to sum it up, it was from something called the "RSM Project Office."  
I went "Oooohhh!"
Then I went "Oooohhh, what the hell is the 'RSM Project Office' and do I have to freaking climb up to the Computer Turret to find out?"  

In case you've forgotten, this is the path from our cushy apartment in one of the Directional Wings off the main digs of the historic Marlinspike Hall, ancestral Manor home of the Haddock family to the modern convenience of wifi, as detailed in an early blog post:


The only way in or out, up or down, the pesky turret is via a thick rope ladder, dyed caution yellow, that extends down (but mostly sideways) out to the Manor Stables -- a remarkable outbuilding that is an alarming replica, as we pointed out in our last post, of the Knoppenburg Manor Stables. The proper term today is "agricultural building." You won't catch me calling it a barn if there are any prying ears about. Of course, the last outsider who dropped by was The Technician Overlord of Our Telecommunications Bundle, which he so wisely decided was best centered in the Hobby Room at the top of the Turret Tower. We had concocted a cover story about the rope bridge ("It's more a bridge than a ladder," Fred just said), which consists of the baldfaced lie that we are a new off season venue for those Cirque du Soleil performers who are fresh out of rehab. So the hefty diameter of that hemp monster, see, is easily explained away as necessary gear for these poor, troubled acrobats.
I'm usually not subject to such heights of embarrassment (heights, and, lately, riches) but I just don't want anyone to think that I have to zig zag my way from one Manor Wing to another, make it to the Grand Ballroom, out the entrance, patterned after Brunelleschi's bronze baptistery doors, over the drawbridge (Provided it is down! Men!), across the moat, down the lane, over the hedge, into the damned agricultural outbuilding, up the custom wheelchair ramp into the hayloft, and then, lickety-split, go hand-over-fist on the rope bridge for a good half mile... all just to get my email.


Yes, Dearest Readers, I did ["have to freaking climb up to the Computer Turret..."].  Because the (800) number listed for said RSM Project Office is One Of Those Maniacal Menu-Operated Weapons Of Governmental War Attrition Tactics. Also, as Our Beloved Milanese Nightingale, the Bianca Castafiore, recently discovered, we only have functional cell phones whilst leaning at a 70 degree angle out one of the turret's bow-and-arrow openings, necessitating that Sven Feingold stop his important topiary shaping to come up and hang on to our telephoning ankles for the love of God, and also for His Sake.

See? Either way, these "RSM Project Office"  arseholes from Atlanta, Georgia, necessitated the arduous journey to the Computer Turret.  Yesterday being Monday, that meant that my huffing and puffing and slip-sliding through the intervening barn, now renovated as the Carny Rehab Facility, meaning that, yes, red-faced, sweaty moi would be interrupting a post-weekend Group Therapy Session of pissed-off carnies. And why are they pissed off?  It would have been a great weekend for them, full of gainful employment and illicit drug transactions, had ManorFest 2014 gone off as scheduled.  And who cancelled ManorFest 2014 due to "personal insanity"?  That's right, moi again!

Anyway -- I made it to the Computer Turret, though more than disheveled, Sven batting off the intrepid acrobats with a police-grade head crusher and the occasional zap of a Taser.  He held my ankles as I plunged out the window and dialed the useless Georgia government phone number... then returned, using the stairs, this time, to his appointed duties.  We need to petition the Captain for a raise, or supplemental gratuities, or something, on behalf of Sven.  Just the fact that he's keeping The Castafiore occupied ought to be worth considerable "executive bonus" points to Archibald Haddock, y' know?

Okay, so I was stuck with email to shoot through the moat algae and out the other end of the wormhole to Atlanta, Georgia Land.

I wrote the email produced below, though for purposes of transparency and The Fair Reporting Act As It Applies To Blogs About Fictive [shut UP!] Lives, the last paragraph was added after 5 emails were returned as "undeliverable," except 1 reply from "customer service."


Please read this email in its entirety, paying attention to the details,
wherein lie many of the pertinent details. 
My name is, for your purposes, L. Ryan and today I received the "RSM Project Office"'s
denial of my "request for benefits." 
It's a fascinating document, for primarily two reasons. 
*One: I did not request Medicaid benefits. That must have been a glitch inthe ACA Marketplace application I completed in October 2013, as I would
never deign to bother the Great State of Georgia and its forward-looking
policies toward health care. I don't have that kind of time to waste. 
*Two: At the end of the document, I was intrigued to discover that Ireceive SSI benefits in the amount of $331.57. Why "intrigued"? Because I
don't receive SSI benefits.

If you'd please squelch the errant SSI payments I supposedly receive, I'dbe forever grateful. 
If, however, I somehow deserve that money... oh
please, send me a check that covers the last 14 years of our lives,
non-taxable, and that doesn't deprive me of the rest of my [private disability] "benefits." 
If someone has, by chance, been collecting SSI in my name? Well, it'sprobably your job to deflect that bit of larceny back to the federal
government. I've done my part as an [expatriate] citizen and submitted a fraud report,
just moments ago.  Having no "company" name to supply, I used the
"RSM Project Office" name and address as the fraudulent party.

I sat up here knitting apple and banana cozies, answering the occasional frantic email from family members, most perturbed, though, by the missing emails, and the cold-as-ice family sentiment poseurs -- figuring that SIX emails to the Department of Human Services should jolt some bureaucrat into a reply.  Yes, I mentioned in one of the [...] deleted segments that I am the Queen of Gullibility.  I am, I swear.  The thing is, once you screw with me, I don't forget you, ever, and, unfortunately, the organization for which you work is also tainted with your evilness, even if you have cozies on your rusty toaster and your 1970's avocado Salad Shooter.

Apple and Banana Cozy by BeadlesandPins at Etsy.com

[Oh, damn.  Fred just dropped a bottle of chardonnay. What a technological breakthrough, live blogging! Now, had I knit a chardonnay cozy, might that bottle remain intact?  We'll never know.]

Oatmeal Cable Knit Wine Cozy, $12, etsy.com

[Kind of disturbing, huh, this "cozy" craze?]

Well, anyway... This is the text of my email to the federal government Social Security Fraud Tip Thingy:

I was notified by letter yesterday from the "RSM Project Office" of the State of Georgia DFCS department of their decision regarding two things, an application for Medicaid coverage and my monthly SSI income. 
The small problems I have with this notification are mostly covered by these facts:
1.  I never applied for Medicaid -- unless the ACA Marketplace submitted the request in my name, something I explicitly asked not be done.
2.  I DO NOT RECEIVE THE $331.57 PER MONTH IN SSI THAT THE "RSM PROJECT OFFICE" CLAIMS THAT I DO. 
Either someone out there is receiving that amount in my name or the "RSM Project Office" just sits around making up stuff to foil anything to do with President Obama's landmark legislation.   
I consider either possibility equally probable. 
This is not a joke, despite my attitude.  I have no idea how long "I" have been receiving this imaginary money, but should I, indeed, prove eligible for its receipt, please forward it to my sad bank account, with interest.  In lieu of that, please find and arrest the person/entity who is enjoying that government benefit in my name. 
[...]
Do I really believe that a division of Georgia's government has stolen SSI funds from the good and decent Federal government?  No.  But I do believe they are ignorant enough and blinded by political animus to overlook an obvious bit of fraud.  I've asked them to report it... I doubt that they will. 
Sincerely,  
Moi 
Ah, those of you out there who just love State and Federal SNAFUs are waiting, breath-bated, for the one response that DID come!  Well, here you go, and look, Fred just found another bottle of chardonnay, duct-taped under the kitchen table by Bianca "Wile E. Coyote" Castafiore.  Just in time.

On Wed, Jul 23, 2014 at 2:35 PM, <customer_services_dfcs@dhr.state.ga.us> wrote:


Good afternoon,
Your request has been forwarded to the DFCS Fair Hearing Unit for review and response.
Have a great day.


© 2013 L. Ryan

Tuesday, July 22, 2014

some ordinals... but not others...

let's see.

first, great thoughts of flaming balls of courage (in the southern style) to miss kate mcrae and her lovely family out in california, land of all possibilities, ocean, sky, sand, and forest.

she's had a neurological scare, and i suppose that any neurological symptoms suddenly showing up in a brain cancer survivor makes one want to redefine "scary" and scream "bleeeeccckkkkkkk!"  just guessing.

so she has an mri and all that stuff coming up so that we can dismiss scary and stop yelling  "bleeeeccckkkkkkk!" -- thereby rendering us all much more acceptable to be around.

second, great thoughts of flaming balls of freaking courage, pain relief, and waves upon wave of energetic laughter, even of the cosmic sort, to our brother-unit el profeso obstinado, the former grader boob.

no, grader boob is not dead, deceased, but he is kinda gone. on a temporary basis.  he recently penned the humorous observation:  "I was asked to come in for an interview to one of the full-time spots I applied for months ago. The universe has a sense of humor."

it's simply that, due to a cancer invasion, el profeso obstinado has knocked off the hours he usually dedicates to red-penning and instructive, encouraging marginalia.  there is also the small detail that such activity would be even less compensated than usual.

let's see, i've pulled off a "first," and a "second," and without much difficulty, i could add a third, fourth, and fifth.  but i'm not feeling ordinal.



© 2013 L. Ryan

Saturday, July 12, 2014

The Primacy of Silence

I am rationalizing as fast as I can.  Without a goal, though, it's much like treading water, no rescue of self or others the end point, just lactic acid weighing down the legs and my uselessness made manifest by drowning.



At camp one summer, I qualified for the final exam in a Red Cross Certified Advanced Life Saving course. The elite bunch of us candidates were given instructions on what to wear.  Jeans, a leather belt, a button-up long sleeve shirt, a short-sleeved tee underneath, lace-up shoes, ankle-length socks, and a hat.  I remember how unspecified the hat seemed.  How color did not matter, how function trumped style.  We all had on, as a final layer and defense against pubescence, one-piece bathing suits.

It was early morning and there was fog on the camp lake.  We took our final exam off the end of a rickety pier.  The examiners seemed matronly, an odd remembrance, since I am sure they were not matronly. Maybe everyone looked a little heavy, given the extra layers we had piled on.

So all candidates jumped into the cool, slightly stinky pond water, and tread water for a specified time.  Then we were to take off the jeans, shirt, tee, belt, shoes, and socks.  I suppose we did something with the hats, but I cannot remember what.  Some of these items were to be transformed into flotation devices.  Some of them I saw fit to let drift to the slimy pond's bottom.  I lost points for giving up on my lace-up boots. Perhaps, if I had saved them and made it to an illusory desert island, they'd have supplied sustenance enough for the whole class, for a month, at least.

Then we showed off our proficiency by floating a bit, hanging on to those inflated blue jean legs, for example, or resting our heads on pouffed out tee shirts.

That's when I began to have cramps in my calves, as I was more treading water, still, than honestly floating with confident reliance on my deflated jeans.  Still wish I could visualize the hat.  I keep thinking that it was some sort of oddity, like an old lady's gardening helmet, and not what you'd expect, like a San Francisco Giants baseball cap.

I long ago decided that I was not going to trapped inside my family's predilection for silence, and its awful predatory and coercive ways of underscoring the primacy of silence.  This blog, every email I write, most of my conversations -- they all honor that long ago decision.  It comes off as narcissism, as a form of anti-socialism.  It reads as an inability to edit, not just my verbal production, but my private thoughts, as well.

I am reminded of how Rothko, Picasso, and many "unknown" artists would occasionally allow rancor under their skin, and be coerced into producing the finest of representational art, in some unexpected and banal medium.  To prove that they were classically trained.  To prove that they could draw intricacy like nobody's business.  They usually managed to achieve something reminiscent of the best boy or best girl in the final year of prestigious art school, a something or other to promote their impressive portfolio.  Especially fun are the naive artists, the primitives, when they break into some Parisian metro near-photographic pen-and-ink brilliance. Everyone feels secretly foolish after these displays.  "See, I can do what you think I cannot.  I simply choose not to, I choose another way.  Which I have now, of course, dirtied and demeaned for wont of proving this silly ability to you." We like to blame the other for our pricked pride, our mainlined production, our betrayal of ourselves.

My hat was of woven grass and had a plastic flower, something approximating a yellow mum without the fragrance.  I guess it was supposed to float up side down, and perhaps serve as repository for my boots, spare keys to our dorm, a cabin-without-a-lock, and my pyrography award plaques.  Next time, a fez, or a Stetson.

One of the instructor's had to save me, and she went all out -- "for the sake of demonstration," she whispered in my ear.  My chin ensconced in her palm, to both keep my head above the pond's water and to maintain control of my body, should I decide to panic and, as the drowning sometimes do, attempt to take my rescuer with me to my watery grave.  I am glad she did not decide on that scenario, as a firm grip on my hair would be the next step.

With a smart scissor kick and a modified side-stroke, she brought me successfully to shore, or, in reality, to the slimy ladder on the side of the pier.  I scrambled to my feet, and rejoined my classmates.

It wasn't an ego-destroying failure, but it stung.  Had I passed, I'd have been part of the group swim from the cordoned safe-swim area for all campers across the lake to wild waters and a very famous rope swing. As it was, I ate ice cream and watched two of my compatriots forget to let go of the rope whilst safely over open water. Ouch.


© 2013 L. Ryan

Wednesday, July 9, 2014

high, low and in-between

yes, i know that i've posted this video/song before.  i will probably post it again.  get over it.





I come from a long line
High and low and in between
Same as you
Hills of golden
Hails of poison
Time’s thrown me through
And I believe I’ve come to learn
That turnin’ round
Is to become confusion
And the gold’s no good for spending
And the poison’s hungry waiting

What can you leave behind
When you’re flyin’ lightning fast
And all alone? 
Only a trace, my friend,
Spirit of motion born
And direction grown.
A trace that will not fade
In frozen skies
Your journey will be
And if her shadow doesn’t seem much company
Who said it would be? 

There is the highway
And the homemade lovin’ kind
The highway’s mine
And us ramblers are getting the travelling down
You fathers build with stones
That stand and shine
Heaven’s where you find it
And you can’t
Take too much with you
But daddy, don’t you listen
It’s just this highway talkin’

All things that are alive
Are brothers in the soil
And in the sky
And I believe it
With my blood
If not my eyes
I don’t know why we can’t
Be brothers here
I know we should be
Answers don’t seem easy
And I’m wonderin’
If they could be

-- townes van zandt

Prayer of Pan Cogito – Traveller

Prayer of Pan Cogito – Traveller

Lord
Thank you for creating the world beautiful and of such variety
And also for allowing me in your inexhaustible goodness
To visit places which were not the scene of my daily torments

- for lying at night near a well in a square in Tarquinia while the swaying
bronze declared from the tower your wrath and forgiveness

and a little donkey on the island of Corcyra sang to mi from
its incredible bellowing lungs the landscape’s melancholy

and in the very ugly city of Manchester I came across
very good and sensible people

nature reiterated her wise tautologies the forest was
forest the sea was sea and rock was rock

stars orbited and things were as they should be – Jovis omnia plena

- forgive me thinking only of myself when the life of
others cruel and irreversible turned round me like the huge
astrological clock in the church at Beauvais

for being too cowardly and stupid because I did not understand
so many things

and also forgive me for not fighting for the happiness of
poor and vanquished nations and for seeing only moonrise and museums
- thank you for the works created to glorify you which
have shared with me part of there mystery so that in gross conceit

I concluded that Duccio Van Eyck Bellini painted for me too

and likewise the Acropolis which I had never fully understood
patiently revealed to me its mutilated flesh

- I pray that you do not forget to reward the white-haired old
man who brought me fruit from his garden in the bay of the island of Ithaca

and also the teacher Miss Hellen on the isle of Mull whose
hospitality was Greek or Christian and who ordered light
to be placed in the window facing Holy Iona so that human
lights might greet one another

and furthermore all those who had shown me the way and said
kato kyrie kato

and that you should have in your care the Mother from Spoleto
Spiridion from Paxos and the good student from Berlin who
got me out of a tight spot and later, when I unexpectedly
ran into him in Arizona, drove me to Grand Canyon which
is like a hundred thousand cathedrals standing on their heads

- grant O Lord that I may forget my foolish and very weary
persecutors when the sun sets into the vast uncharted
Ionian sea

that I may comprehend other men other tongues other suffering
and that I be not stubborn because my limitations are
without limits

and above all that I be humble, that is, one who sees
one who drinks at the spring

thank you O Lord for creating a world very beautiful and varied

and if this is Your temptation I am tempted for ever
and without forgiveness

--Zbigniew Herbert



© 2013 L. Ryan

Tuesday, July 8, 2014

Wonderful Competency

This is a pleased-as-punch pass-along of a report published yesterday in Consultant for Pediatricians, as part of their "photoclinic" --


    [Citation: CFP. 2014;13(7):330-331]

There's not one thing remarkable about it.

Except it shows evidence of prompt response to a new case of CRPS, an awareness of IASP "Budapest criteria," and a complete absence of NeuroStupidity.

Way to go, Mfon Ekong, MD; Anissa Meher-Homji, BS; and Lynnette Mazur, MD, MPH of the University of Texas Medical School at Houston!


Complex Regional Pain Syndrome

A 10-year-old girl presented with a 3-month history of right knee pain and difficulty walking after her pet German shepherd bumped her leg. She also complained of a 2-week history of hair growth below her right knee.

On physical examination, she had edema, a 12 × 10-cm patch of hair, and decreased range of motion of the right knee. Results of complete blood count, erythrocyte sedimentation rate, complete metabolic profile, creatine kinase tests, and myoglobin tests were normal. Findings on magnetic resonance imaging were unremarkable.



The girl received a diagnosis of complex regional pain syndrome (CRPS) and was hospitalized for inpatient physical therapy. An indwelling catheter was placed for a femoral nerve block. Ropivacaine was continued for 8 days, after which the girl was transferred to a local rehabilitation facility to continue physical therapy, along with continuous passive motion (CPM) of the knee. She was started on gabapentin, fluoxetine, vitamin D, and as-needed diazepam, and was discharged after 1 month to continue her treatment at home.

CRPS, formerly called reflex sympathetic dystrophy, is a painful syndrome accompanied by physical changes in the affected extremity. Dysfunction of local sympathetic and autonomic nerves may be responsible.1-3

Our patient reported 3 of 4 symptoms (allodynia to clothing, edema, and decreased range of motion) and 2 of 3 signs (hyperalgesia to pinprick and allodynia to light touch) meeting the clinical diagnostic criteria for CRPS set forth by the International Association for the Study of Pain (IASP) (Table).4


[read the rest of this wonderful competency HERE]





Wednesday, July 2, 2014

CRPS in the Context of (Neuro?) Autoimmunity (With Thanks to Mice)



Researchers at the University of Liverpool have taken a major step forward in understanding the causes of a disorder which causes chronic pain in sufferers. 
Complex Regional Pain Syndrome (CRPS) is a serious condition affecting a limb after an – often small – accident or operation.  It can cause severe pain lasting many years, as well as limb swelling, hair and nail growth changes, and muscle atrophy, but until now there has been no clear evidence of the cause. 
Now the research team from the University’s Institute of Translational Medicine alongside colleagues at the University of Pécs, Hungary have successfully transferred antibodies from the serum of patients with CRPS to mice, causing many of the same symptoms to be replicated. 
Dr Andreas Goebel *, who works in the University of Liverpool and is a Consultant in Pain Medicine at The Walton Centre NHS Foundation Trust, led the study.  He said: “CRPS is a serious condition which isn’t fully understood.  The findings of this study hint at a cause for it – harmful serum-autoantibodies – and raise the possibility of finding a treatment.”
[Read more of the story HERE from HealthCanal - Health News]
* Dr. Goebel's considerable research in chronic pain and CRPS HERE]

What to say?  It sounds momentous, yes?  But really, quite a bit of research, years old already, has been done that points to "clear evidence of the cause." Unfortunately, "THE cause" sort of thinking goes hand-in-hand with the "Silver Bullet Cure" crowd, and denies the complexity of the "syndrome." Be that as it may, it's a reflection more on the dumbing-down of pseudo-medical journalism, and not a reflection on the quality or bounds of the research on which the article is "reporting."

Why, for instance, do proponents of immunological causation feel the need to ignore the brain?  Just thought I'd toss that out there, as something not particularly helpful, but indicative of either/or thinking that just does not fly when dealing with the intricate relations and processes of the human body.  The peripheral and central nervous systems and their functional counterparts as parasympathetic and sympathetic impulses/small fibre neuropathy/glands run amok (hypothalamic-pituitary-adrenal -- HPA -- axis dysfunction)/immune system dysfunction/inflammation/psychosocial and environmental influences/and the darned partridge in a pear tree.


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



A CRPS-IgG-transfer-trauma model reproducing inflammatory 
and positive sensory signs associated with complex regional pain syndrome


ABSTRACT
The aetiology of complex regional pain syndrome (CRPS), a highly painful, usually post-traumatic condition affecting the limbs, is unknown, but recent results have suggested an autoimmune contribution. To confirm a role for pathogenic autoantibodies, we established a passive-transfer trauma model. Prior to undergoing incision of hind limb plantar skin and muscle, mice were injected either with serum IgG obtained from chronic CRPS patients or matched healthy volunteers, or with saline. Unilateral hind limb plantar skin and muscle incision was performed to induce typical, mild tissue injury. Mechanical hyperalgesia, paw swelling, heat and cold sensitivity, weight-bearing ability, locomotor activity, motor coordination, paw temperature, and body weight were investigated for 8 days. After sacrifice, proinflammatory sensory neuropeptides and cytokines were measured in paw tissues. CRPS patient IgG treatment significantly increased hind limb mechanical hyperalgesia and oedema in the incised paw compared with IgG from healthy subjects or saline. Plantar incision induced a remarkable elevation of substance P immunoreactivity on day 8, which was significantly increased by CRPS-IgG. In this IgG-transfer-trauma model for CRPS, serum IgG from chronic CRPS patients induced clinical and laboratory features resembling the human disease. These results support the hypothesis that autoantibodies may contribute to the pathophysiology of CRPS, and that autoantibody-removing therapies may be effective treatments for long-standing CRPS.

An interesting site:  Centre for Immune Studies in Chronic Pain

© 2013 L. Ryan

Wednesday, June 25, 2014

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

Monday, June 23, 2014

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 – sarabandgalliard 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, SerenadeIgor 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.