Doctor NOS

Distracted

2006-07-31T19:18:00.000-07:00

Been distracted from blogging at work and at home, both of which are going great.

So I started a new job and have had some adventures in medicine, but nothing blog worthy on either front.

The world is about the same. This new war seems like the old war, just new faces and dates. Few Americans connect any dots, so don't expect Americans to suddenly 'get' the fact that our failure in Iraq is creating an emerging regional power, Iran, now pushing for destabilization across the region. Our client state, Israel, will fight our enemies by proxy, kill many, solve nothing.

But on the brighter front, I took home a fat bonus, but then reading about various CEO salaries... One man's fat is another man's skinny.

Vacation

2006-06-25T18:05:00.000-07:00

I've been on vacation after the move. It's been pretty great. Caught up with the kids, wife, and some books. I bought Gore's book, which will probably be in lieu of the movie (until Netflix), which is just a picture book, but scary enough. Meanwhile, I plugged away at Diamond's Collapse. This is a scary book.

Mrs. NOS bought Fast Food Nation, which is cool because it shows what people who lack souls do when they win the gamble of fast food business. I'm half reading it. Because Diamond is so thick, the Fast Food book goes down like a biggie shake.

Otherwise summer life is good.

Moved

2006-06-18T20:21:00.000-07:00

Mostly moved. Wow, what a trip. Everything's gone pretty smoothly so far. We packed everything and crated it, shipped the rest in bulk, and got ourselves on an airplane. Tough going. But we made it. As for our stuff, I'm going to assume it's all good.

On the plane ride over there were about 50 military recruits of varying sizes sitting all around us. They got a connection, so one measure of their numbers was how few people were waiting around for bags.

When I say something like "military recruit," the image comes to mind of a big strapping guy with short hair. That must be the after-shot These guys were the before-shot. Sorry, I used the word shot.

Anyway, they were about 18 or 19, clearly traveled in packs of 3 to 5 sub-packs, and gave each other hard times. But boy, were they young. When I was 18, I felt like I was pretty tough. Actually, because I got served alcohol by 19, I must have looked fairly old. These kids, for the most part, did not look like they would be legal for another few years at least.

Wish Bush could have been there to explain why they're going to Iraq.

Moving

2006-06-14T16:42:00.000-07:00

So we're moving. Last night I spent many hours taking things out to a packing crate and now the place is empty. But in a house, empty doesn't mean empty, just devoid of the large stuff. There are still toys, mats, and folding chairs on the floor. The kitchen still has stuff in it.

Uggh. I've moved before, but never with two girls. Oh the headache.

Anyway, we fly out on Saterday.

Great Run

2006-06-13T12:23:00.000-07:00

Yesterday I went for a great run. It was 7 miles, or so I'm told, and it went from an undergrad college to a beach, then back up a huge hill. Meanwhile the sun was setting. Lovely. That is all.

Delete

2006-06-06T09:58:00.000-07:00

Today I deleted the email address of one of my mentors who died early of cancer. It was fast, but that wasn't a blessing. Oddly, for a doctor, he must have known the prognosis was grave, yet he fought it all the way to having terrible complications on chemo, including some pretty horrific things involving bowels. When Romeo's buddy gets cut, what does he say? The wound is as deep as a grave, and by tomorrow you will find me a grave man? That's about the size of it.

Knowing that he died was horrible enough. It's been about 3 years since I'd even spoken to him. But to go through my email addresses (I was cleaning e-house anyway) and actually delete his, sending this byte of information into oblivion (or is there a great collection of deleted emails and addresses on another e-plane?) was a terrible thing. Of course, the email itself was only the connection, the portal through which one could speak to this man. Without the man, the portal was dead anyway.

In happier news, I finished a marathon over the weekend under 4 hours. Although I'm slow, I'm steady. And although I'm steady, I'm not all that steady. My split times decresed markedly after mile 21. Now I feel as sore as Jeff Skilling is going to feel on prison day number 2. Walking is a pain, stairs are torture. Is this what it is to be old?

419

2006-05-31T19:31:00.000-07:00

Tried to sell a surfboard. Got a great response:

Am using this medium to notify you of my son's interest in particular brand of surfboard, Hence the need to get in touch with you on the negotiations.Making a check payment now let me know your giving price for the merchandise excluding shipping fare to africa, nigeria preciselly..Shipment will be handled by a shipping agent.
Let me know if its still in good condition and ready to be sold..

E. Molloy

I'm thinking of something like this:

Dear Mr. Molloy,

It takes a caring father to buy their son a '9 foot surfboard.' To be clear, in my part of the US, this means a 9 inch phallic instrument of pleasure, which I'm sure your son told you about since he lives out here and it is common knowledge. I commend you on your open mind and excellent english. Perhaps you could have your son drop by and I could show him how it works. He'll probably want a lesson in 'surfing' which I could also provide at no extra cost. Let me know when he'll show up, I live at: fake address.

Otto.

Advice for Lay and Skilling

2006-05-26T17:12:00.000-07:00

I'm a doctor, never been a prisoner. However, I've taken care of plenty of ex-prisoners, future prisoners, and prisoners. Therefore, I feel I am as able as anyone to give some advice.

First of all, Mr. Lay and Mr. Skilling, you done bad. And as bad as you done, you will receive it. My normal advice is to avoid prison at all costs. You guys fucked that one up already by not only breaking the law, but by getting caught. But it is not too late to make a run for it. You have tons of money. A tent in Mongolia beats the hell out of hell. And a boat going nowhere is even better. Granted, you loose your bail money, but from what I've seen, 5 mil is a small price to pay.

So let's say the feds meet you at the dock. Now what? It is called prison.

Here is my advice:

Prepare. Mr. Skilling: look into the mirror. You look like you just swallowed tweety bird. Someone is going to use their penis to wipe off that smirk unless you excercise some control here. Get rid of it. Mr. Lay? You look weak. Sorry, you just look like a pussy. Guys, get hard. Hard in face, hard in mind, hard in body. Lift some weights during appeal so that you are mean and strong. Or at least appear to be.

Upon entering prison, you will be shocked. Do not show this. Do not regard people who yell at you, who taunt you, who throw things at you. Be strong during this time because first impressions go a long way.

Upon the first challenge: someone will try to do something to you. Steal your food, shoes, flick your ear, it doesn't matter. You must immediatly try to hurt that person. Even if that person is 6'7 and 300 lbs of muscle. Because everyone else is watching. If they see you cave in and allow this something to occur with no fight, then you become a target to all of them. There is always an easier target somewhere. Same goes with rape.

Roomates. The odds are actually pretty good that your roomate is going to be stupid, harmless, and addled by drugs - more on that later. Make friends with this person.

In case of a riot, lock yourself in somewhere safe.

Do not get ill, need dental work, or get injured. Prison hospitals are next to morgues without a dividing wall. If things get too much, learn how to fake a seizure.

Do not do drugs while in prison, that gets a lot of people into trouble.

Get God. Good job Mr. Lay, for already latching onto this like a baby onto a nipple. God will not help you in prison, but this god delusion is shared by members of the criminal class and might make you some extra friends you didn't have before. But do not bad mouth Allah.

Use your strength. Sure there are guys in prison who would gut you like fish out of spite, but these are rare, even in jail. Most people in prison are the stupid ones: they got caught, just like you. And most are in jail for drugs related offenses. Putting this together, most prisoners are stupid drug addicts. They need drugs, they like drugs. And you know what? Money buys drugs. Bribes. You guys are still way rich. Spread this around, but don't be too open about it. This is a terrible balance. Because as soon as you start paying protection money, then they will bleed you dry of money. Good thing you have a lot of it.

Do you know how much Guards make? Well let me tell you that they can make more than pediatricians with overtime and they never had to do a residency: up to and over 100K a year. This is not to say that all of them do that well. I know that doesn't seem like a lot to either of you, and you would be correct in thinking that for an extra amount of money, they might actually keep an eye on what goes on in the showers.

OK?

Another thing to consider is to change your names and become black or hispanic or asian and join a gang. Too late for that?

You guys are really fucked, so remember the tent.

Chapter 2-3

2006-05-21T11:00:00.000-07:00

I broke up the first chapter into 2 sections. It was way to long and had a natural break. In real world news, the NY Times has a great article on our failures regarding the Iraqi police force. Some say democrats and liberals continue to bash Bush. I say, reality continues to bash Bush.

Mr. Azure looked at the group.

“This is going to take planning. Nime is very fast, so we need to be fast as well. We need to talk to her for a long time, not just the usual hellos and goodbyes. Does anyone have any ideas?”

Caruso lifted up his faded back petal and said, “I don’t see how you could talk so fast. This Nime speaks quicker than the two little sprouts,” gesturing to Illy and Lilly.

Mrs. Scarlet looked around and said, “Well, that is true. I’ve never heard flowers who speak as quickly as you two dears. You two have the most amazing gift for talking. Must be because you practice all the time. Can you try to speed yourselves up?”

Illy said, “Well, we might be able to. We could see how fast we could be.”

Caruso let out his hoarse laugh that Illy and Lilly didn’t like very much, “Be. Bee. Ha.” Illy said it didn’t take much to amuse the old flower, Lilly said it took nothing.

Mr. Azure just watched. And then he said, “Nime seems to be particularly drawn to you, Mrs. Scarlet. Is it possible for you to make yourself more appealing to her, so that she will stay for longer? Something to bring out your lovely red color even more?”

“Why, Mr. Azure, I don’t know, I mean...” Mrs. Scarlet blushed deeply.

Illy and Lilly gasped loudly, and truth be told, with bitter envy, because when Mrs. Scarlet blushed, her color grew so red she looked as red as a poison berry. Or that’s what Caruso said later. He told them a poison berry bush once grew “A ways down the hill. “Actually a nice bushy fella he was. Hated that his berries were poison, but the red was the warning, see? He’d say, ‘I tried to warn em.’ Just the way he was, poisonous, and there’s no changing what you are, if what you are is poison.”

Nime flew toward the flowers at that moment. Bees do spend some time with the flowers they visit because, as hive creatures, they know the value of good social relations. Nime very much wanted to linger, relax, see and smell the flowers, but the hive always needed more nectar. Quotas were difficult to meet early in the season, and Nime held herself to the highest standards. Overall Nime felt bad about not spending enough time with the flowers, but not nearly bad enough to want to miss a quota.

She knew that the flowers liked having her there; after all, they made nectar for her. She knew their nickname for her, and liked it. Her real name wasn’t really any name at all. To the hive she was Three-Seven-Left-Work-Two-Without, meaning she hatched out of the third section of the hive at seven degrees to the left, and that she was a worker, second class, never given royal jelly as a baby. This was her exact designation, location, and circumstance of her birth and life. It was both more than and less than a name.

She preferred Nime.

When she flew up to the flowers that afternoon she intended to stop and chat. Yesterday, several worker bees saw a wasp, setting the hive abuzz. Various high ranking drones organized soldier bees and the hive’s defenses and lowered nectar quotas. The hive needed information about the wasp’s location and perhaps the flowers knew something.

Nime flew up to the patch as Mr. Azure, the quiet blue flower, said something she couldn’t quite make out. Mrs. Scarlet’s red became Red. The Red captured Nime’s eye and filled her mind. After she landed right on Mrs. Scarlet’s petal, which seemed to glow next to the greenery and dirt, she felt slightly woozy. The pale yellow flowers started talking.

“Hi!” And at the same time the other said, “Wait!” “Wait for just a second!” said one while the other said, “We have something to ask you!”

Nime collected Mrs. Scarlet’s nectar and captured the pollen with her fur. The flowers in this patch made a lovely light and sweet nectar, but not a great deal. “OK. But first, have you seen any wasps? Yellow jackets actually.”

Illy and Lilly’s petals opened wide at that. Mr. Azure answered for them all, “No, we have not, but we do have a matter we would like to discuss.”

“Go ahead. Mind if I watch while you talk?”

Neither Illy nor Lilly stopped talking until the end of their story. By then, Nime was sitting on the ground, watching Mrs. Scarlet’s Red fade to her normal red.

“Well, what can I do? I’m only a bee. I’d like to help you, but I can’t even talk to the tree. I’m too small to fly up to his main trunk and he’s too big to hear me, even if I could.”

The flowers all drooped and looked a bit withered up at that point. Nime gathered up Mr. Azure’s nectar and thought. “Well, you know. I could help actually. You’re on the south side of the tree. You can’t see it, but there’s a north side. It’s the shady side. There’re toadstools that grow right on the tree. At least I think they’re toadstools, mushrooms anyway. Or fungi? They lead all the way up his trunk. Probably they lead all the way up to his ear. I could tell one, then he could tell the next, then the next, and so on, until the last one tells the tree.”

Mr. Azure, “That’s incredible! How did you think of that?”

“Well, that’s how our hive does it. If I see a new flower patch, I’d go back to the hive, and I tell 5 people, then they’d each tell 5, and before you know it, the whole hive knows. What is the tree’s name?”

Caruso spoke, “When he was a little sapling his name was Max. If he gets the message, he’ll help us out. He was a good little sap.” Here he looked at Illy and Lilly. They each thought he was going to look at them like they were not good kids, so were surprised to find Caruso’s droopy face looking at them kindly, but only for an instant. Then his voice became stern, “He’ll help us. He used to be my little big seedling.”

Mr. Azure said, “We need to tell him to move his main south branch to the west by ten degrees. That way we can get the morning sun, and Max won’t lose much sun for himself. I’ve worked it out. So remember the following message: move main south branch west 10 degrees.” Mr. Azure was excited and was about to tell them how he had worked out that plan, but Mrs. Scarlet interrupted, for which Illy, Lilly, and Nime were grateful.

“Well, we have to make it nicer than that, don’t we? We have to say please, don’t we? Otherwise we’ll be thought of as rude. How about, ‘Dear sir, the flowers below are getting no sun. Please move your main south branch ten degrees to the west. This will uncover the flower’s morning sun, thank you.’”

“And Caruso says hi!” Shouted Caruso.

Nime asked, “Is that OK? OK with everyone?”

They barely had time to answer, and she buzzed off.

The GOP's Got Priorities!

2006-05-18T11:39:00.000-07:00

It's hard to be a repub in Washington these days. Scandals of Jack A-off, HUD secretary, Duke, wiretaps, CIA director cronyism, rising debt, inflation fears, Iraq, borders, entitlement spending, Katrina, war on science, etc are draining. Must be hard going to work when work is where you hurt America on all fronts.

When all is going so poorly for America, it is time for the GOP to rise up, and fix what needs to be fixed. And out of all that needs to be fixed, what America needs to be fixed at this moment is gay marriage.

Good to know we have the GOP looking out for us! What a good use of their time. Of course, with one move, the GOP can distract attention from all failings to the gay threat and pander to the religiomaniacs. Sweet.

Back to Bush

2006-05-15T14:22:00.000-07:00

NSA wiretaps reminds me of my own preface. At first there is balance, as in checks and balances between subsections of the government, and all live in harmony. And then comes a situation that appears like it is balanced, but hides a secret imbalance. And then there's the fall.

Just like that, there may be evidence of a fall. We will see. The NSA thing is scary enough, but if the government is actually looking specifically at Dana Priest's phone records, then we are past harmony.

Read the fringe and disturbing opinions that are posted there. I find these comments only slightly less disturbing than the content of the post.

I posted myself. Essentially, Bush has turned America into a country with which I am not familiar. These posters do not share what I consider one of the chief American values, found in our bill of rights, of freedom of the press. One writes, "This only helps our enemies and right now I believe ABC news is an enemy of the US."

If anyone doesn't like the behavior of the free press (personally, I think they're finally waking up and they've been asleep over the last 5 years) in this country, then perhaps they would like a country that has no free press. North Korea and Iran are two that come to mind. Enjoy the move.

Stay tuned to this story. Bush is our Nixon.

Chapter 1

2006-05-13T11:53:00.000-07:00

I didn't revise this very much.

Chapter 1.

Hillary wasn’t her real name, although it was her given name. Instead, everyone in the patch called her Illy. This was not to be confused with her sister, Lilly, who’s not real name was Lillian.

Lilly and Illy were sister flowers. They had only just sprouted that spring, but in that time they spent so much time next to each other, talking and gossiping, giggling and laughing, that their roots grew entangled. Even above stem level it was difficult to tell exactly where one started and the other began. Sometimes they even spoke for each other, but they did not tolerate any other flower in the patch ever confusing them.

“I’m not Illy,” Lilly would say.

“I’m not Lilly,” Illy then echoed. Their voices sounded the same, especially in indignation.

“Lilly is a brighter shade of yellow, just by a hint,” Illy would say. And to that, Lilly would say, with a great deal of both exasperation and satisfaction, “Illy has a lovely yellow rim around her petals that you can see best on that one.” Illy wagged her petal with the slight yellow trim back and forth, admiring the way the shadow played off it. That was Illy’s favorite petal. Illy would tell the rest of the flowers that Lilly’s cup was slightly deeper than hers, to which Lilly would say that Illy’s petals were slightly rounder than hers. This could go on a long time because with each turn, Illy loved Lilly more and Lilly loved Illy more, and when that happens you don’t want to stop.

Much like you, the other flowers in the patch found it very confusing.

Caruso, who bloomed for many seasons past, said, “Oh, will you two sprouts just knock it off. You look the same to me. Always have and probably always will. Some of us were here when the tree was just your size. And we’d have been better off if we would have nipped him in the bud as well.”

Neither Illy nor Lilly particularly cared for Caruso at these times, but they always adored the other two flowers in the patch, Mrs. Scarlet and Mr. Azure.

Mrs. Scarlet did try her best to tell them apart, and would be terribly sorry when she got them confused. She would usually say, “Oh, you poor dears. I am sorry. So very sorry. It looks like I did it again. Now, you are Illy, and you have the brightest green green leaves and perfect petal position. And Lilly, your stem looks like it is as straight as, well I do not know what it looks as straight as, but anything else that looks straight, doesn’t look as straight, and your stamens are as long as they are elegant.”

To this, the two would blush and giggle, waving their long, elegant stamens about. Later they would compare their green leaves and straight stems to the others in the patch and feel very fine.

Each thought the world of Mrs. Scarlet, and each envied her color. Her red was of the fullest shade. It was a pure red, with not a hint of an adulterating yellow, green, or blue. At the base of each of her petals, Mrs. Scarlet had a bright yellow dot, as if left there by dew. When combined, each yellow dot formed a larger circle, perfectly surrounding her center. She had many petals, each one slightly overlapping with its neighbor, giving an impression of both fullness and delicacy.

Mr. Azure did not address Illy or Lilly by name, so seldom got them confused. The former fact was lost on Illy and Lilly, the other was a subject of great discussion. Mr. Azure seldom spoke to them at all. In fact, he rarely spoke to anyone in the patch. He usually watched the tree above them.

Mr. Azure was a simple and flat flower, and in his basic anatomy resembled Illy and Lilly. He had only 5 petals, the largest pointing down. The lower petal had a lovely central pallor that seemed to catch the reflection of the top petals, highlighting their perfect symmetry.

Both Illy and Lilly liked Mr. Azure principally because of his blue color. His petals were so blue that they seemed to have added depth and mass, even though they were as thin as the wings of a butterfly. The blue petals changed shades over the day, deepening and darkening. Because Mr. Azure hardly ever spoke, he never bothered Illy and Lilly while they watched his petals changing, which was something the girls often did.

Illy would say to Lilly, “Did you –”

To which Lilly would cut in, “see that?” Just at a moment when Mr. Azure’s blue became bluer than seemed possible.

His petals also changed as he bloomed from bud to full flower. And so every day he seemed a riper blue than the day before.

Mrs. Scarlet told them that Mr. Azure would become a deeper blue day by day until he began to go to seed, which was something that Illy and Lilly had not done before. Mr. Caruso told them the stories about going to seed, and also about the Mother, the Balance and the Harmony, and the seeds that brought need.

Both Illy and Lilly knew their seeds were also pale imitations, and would not entirely consume them, but the thought of going to seed frightened them. Shortly they would loose their petals, then grow monstrous seed pods, dry out, and then retreat into their own seed pod, deep in the ground where they would stay all winter, sleeping.

As it was now, Illy and Lilly barely ever slept. There was always something going on. And after something went on, there was that something to talk about. And after that, then they could always talk to Ms. Scarlet, or watch the blueness of Mr. Azure change as he silently watched the tree, or bother Caruso to tell them stories about winter.

Mr. Caruso had very good stories, which made him tolerable.

“One winter day I was sleeping, which is something you two will be doing quite a lot of come winter, and it wouldn’t do you any harm to do more of it now, so that the rest of us wouldn’t have to listen to you all the time. Yimmering and yammering. Oh so blue this, oh so blue that.”

Those were exactly the times when Illy and Lilly didn’t particularly care for Caruso. Each glanced at Mr. Azure, but if he heard, he gave no sign.

“So anyway. I was sleeping. During winter, sleep is a long thing, but it is also a light thing. You’re always just a second from getting up if something happens and just a second from falling deep into sleep if it doesn’t.

“That’s when Something happened. And it got me up, but I didn’t know what that Something was. It was a big Something though. On the ground. Standing on the ground I mean. Because then I heard that Something again.”

Lilly couldn’t stand it, “was it a rabbit?” Rabbits were very ferocious creatures. Caruso flatly refused to tell them any rabbit stories until the next season, “at very least, for your own good, and stop asking me!” which was something he told Illy and Lilly almost every day.

”It was a hoof. But it might have been a horn.” His voice dropped to a whisper, but it was such a loud whisper that anyone could hear. “That was the Something. And there was more. I could feel the hoof hit the snow. And start scraping. As it scraped at the snow, it came to me through the cold, hard topsoil. Soil during winter isn’t like it is during the summer. During the summer, it gets nice and loose, and your roots can breath. They can relax somewhat. But during the winter...”

“Caruso!” Illy and Lilly liked to keep Caruso on track. They were neither very diversionary.

“OK, OK. You’ll see. So what I was saying was that I felt that hoof, or horn, scrape the snow. And then scrape the snow again. It felt like it was directly above me. It sounded like thunder, but it felt like it was hitting me right in the face. Scrape. Scrape. Scrape. And then I heard something even more terrible. Something I hope you never hear.”

At this, Caruso drifted off. He sort of bent up and his stem became even more crooked while his petals seemed even more disheveled and faded than ever.

“Caruso?” Illy asked. “What did you hear?”

“I heard munching.”

“Munching?” Lilly’s voice trembled slightly. “Munching on what?”

“On the grass.” Caruso answered. “There isn’t much grass out here now, but there used to be plenty. You’d have a tough time of it sometimes. The grass grew so thick it was hard to shoot your stem above grass level every spring. You’d hit air, but you’d still have to clear the grass. Blades of grass are nice to look at, but it is a fact that each one of ‘em does not have a thought in their heads. In fact, they are so stupid that...”

“Caruso!”

“Oh yes. So it was munching. The scraping sound was an animal that scraped away the snow. Once it got down to the snow, I mean, grass, down to the grass, it munched on them.”

“What sort of animal was it?” asked Illy, who was always adding to her already extensive knowledge of animals.

”Well. It was an eater alright. I’d guess it was a giraffalo. That, or a buffazille.”

“A buffazille!”

“A buffazille has a great big hoof on its toes and nose, so it might have been the buffazille’s nose that I heard, scraping against the cold ground. A giraffalo has two tusks that jut out of its jaw like wooden stamens. Then again, one must always consider...”

“It was probably a deer.”

Everyone turned. Mrs. Scarlet, who had been dozing, woke with a start and looked at Mr Azure. He was already looking back at the tree when Lilly asked, “I’m sorry Mr. Azure, but what did you say?”

Rather regretfully, as though he were very sorry to have spoken at all, he turned from the tree, down to the others, “It was most likely a deer. Deer come through here quite often, actually, over the winter. We don’t see much of them now because we live off their summer trails and bedding areas. They have hooves on their feet. They dig through snow to uncover grass.” He gave an apologetic glance to Illy and Lilly, “which they eat.”

Illy and Lilly pretended they didn’t mind. If they pretended hard enough, it almost made it true.

Illy asked, “Mr. Azure, why do you spend so much time looking at the tree?”

Mr. Azure looked up at the tree again. When he looked down, he did so like he was pushing a root under a rock, slowly. “Because we are in danger. We have a problem. I’m trying to solve it.”

Lilly said, “I don’t understand.” She said it like it was a question.

No flowers spoke. Mr. Azure turned a noticeably darker blue until Caruso said, “Well, you might as well tell them. They’re going to have to know.”

Mr. Azure spoke slowly, so he wouldn’t have to repeat anything, “I don’t want to alarm you, but Mr. Caruso is correct. You may as well know. After all, we are in this together. All of us, all five of us, have a problem. We are in danger. We are in so much danger that I believe we must solve our problem if we ever want to bloom again.”

At this, Illy and Lilly gave little gasps. Of the two, Lilly would later say she was more particularly horrified, having become so fond of being in full bloom over the spring that she was already looking forward to next year’s blooming, when she thought her color would come in at a more vivid yellow. Illy would silently half agree, because although she believed she was equally if not more horrified, she did agree that her own yellow was currently much more vivid than Lilly’s.

Caruso looked saddened and even more wilted around the tips of his leaves. “You’d better explain.” He muttered to himself, but no-one could hear him clearly, so no-one paid him any mind.

Mr. Azure prepared his explanation ever since he recognized the problem over the winter. He remembered winter fondly. Within his seed husk, deep within the earth, he could doze and think, without the constant bother of the other flowers. Nor did he have to consider the ever present threat of rabbits, caterpillars, and aphids. Yes, winter was a fine time to be half alive and half asleep.

It was during the last winter that the Terrible Thought struck him. It was so nearly like a nightmare that he would have called it one, if flowers had a word for nightmare. Since they didn’t, he called it his Terrible Thought. And it was simply this: there is the tree, and there are the flowers, both need the sun. The tree is between the sun and the flowers, which leaves the flowers in the shade.

In his Terrible Thought he saw the tree’s broad, terribly effective leaves catching the light, breaking the Balance between sun and leaf, blotting out the sun, and starving the plants below. Too little sun, too little leaf. He woke with the sudden realization that they could not store enough energy to survive the winter. And if not that coming summer, then the next.

During spring he watched the tree’s leaves fill in as shade darkened the ground. He estimated that even if they did not have one single cloudy day, they would not survive the winter with enough energy to sprout the following spring.

A bit of wind pushed into the flowers just then, swaying the patch. Each felt the wind, Illy and Lilly’s thin stems bending to absorb the pressure.

Mr. Azure continued, “Unless we solve the problem, we can only hope for the survival of our seeds. Our seeds, unlike us, can use the wind to get away from the tree’s shade and find a place of Balance.” Mr. Azure thought that this was important, that his seeds get far away to a bright sunny field. But he also considered himself important, so he thought and thought about their problem, failing and failing to think of a solution. “Harmony and Balance are disrupted. Too much growth, to little trimming, too little sun, too little leaf. To solve the problem we need to attain Balance, but how? Trimming the tree? Impossible. Increase the sun? Impossible. Increase our leaf sizes? Impossible.”

Mr. Azure had already told Caruso on the sly, thinking the old flower would have some wisdom to share. He didn’t tell Illy and Lilly that the old flower only pointed out that there was no more grass on the ground. As the tree grew, less and less sun fed the grass. Caruso remembered when the tree was new, and grass covered the ground, always speaking their grass nonsense. “Never thought I’d miss that endless chattering. Worse than the girls even. Completely mindless talk. Utterly boring! Grass talks about only one field you know, the field of grass related interests. Field! Ha! How tall to grow, how green to get, what is the best width, what is the best thickness. Constantly. I could never pay attention and could never completely not pay attention either.”

Mr. Azure hadn’t given any mind to the lack of grass all around them. It confirmed to him that he was correct. The tree was taking all the sun and the grass was the first to go.

Mr. Azure also did not share with Illy and Lilly the fact that Mr. Caruso immediately told Mrs. Scarlet, and Mr. Azure had to spend time answering her questions.

Now Illy and Lilly knew.

Mr. Azure concluded, “That leaves us with the following question, what are we to do?”

Mr. Azure was about to go on, but it was Lilly who surprised him with a question. At least, he thought it was Lilly, it might have been Illy. “Why don’t we ask for help?”

“Help?” Mr. Azure was so struck by this that he repeated himself, which was very unusual, “Ask for help? From whom?” He thought that he had considered the matter deeply.

“Sure, help,” said the other one, who was probably Illy, “We could try to get help from the tree.”

Lilly finished, “Up at the tree leaves, there is plenty of sun, and we could just ask the tree to let some sun through.”

That idea filled Mr. Azure with an immediate sense of possibility, a feeling he hadn’t had since theTerrible Thought.

“Mr. Caruso!”

Caruso had drifted off into his own thoughts during Mr. Azure’s explanation of the problem. “Uhh!” he said, as he snapped up.

“Illy and Lilly have an idea. We could ask the tree to share the sunlight with us. You know the tree. You were here when it was on our level. We need to know what the tree is like and how we should speak to him.”

Illy and Lilly blushed at Mr. Azure mentioning them.

“Well, that was many seasons ago. When that tree first came here, he was as small as we are. But boy,” Caruso looked up at the great expanse of the trunk and branches above them, “he’s grown. He was a reasonable youngster. A loner, cause he has no patch of his own, you see? We were actually something like mates. He was all alone, just a young sapling then, and I’d already been around the year a few times. We weren’t close like Lilly and Illy here, but close enough, considering.” Caruso drifted off again for a moment, remembering. “His name is Max, but you could call him Maximum now. Maximum! Ha!”

Caruso looked at Mr. Azure, “He knew he was in for big things from the second he got here. But he never was one to take advantage. He never stole our water, and I think he probably could have, as he got big, but not so big that I couldn’t talk to him. I’m sure he wouldn’t mind helping out an old friend. The problem is that we haven’t talked for seasons now. He’s gotten too big. You’d have to get all the way up there.” Caruso pointed up at the trunk as it entered the leaves. “This is all a mistake you know. He doesn’t mean to do this. He just doesn’t know about us. He’s grown so big he’s forgotten his roots.”

Lilly was excited, “Nime could help.”

“Yeah, Nime could help,” cried Illy, who was also excited. They first met Nime as soon as they flowered and seldom stopped talking about her since. Nime was a honey bee.

In general, bees move very fast, although it might be that flowers move very slowly. At the beginning of the season both Lilly and Illy made several friendly “hellos,” and to each the bee replied “Nime, Nime, Nime.” Only after the first few visits did Illy and Lilly make out that Nime was actually saying “No time,” but so fast that the words blurred together. By then her name was Nime.

Illy thought Nime had had the most beautiful yellow hairs and particularly admired her eyes, which were a golden color of a lovely metallic hue. Lilly admired Nime’s yellow antenna. She made a point of giggling when Nime’s thick feelers tickled her petals. As Nime drank her nectar, Lilly could feel the beautiful yellow hairs that covered Nime’s legs as they picked up and dropped off pollen deposits.

Illy and Lilly were upset each time Nime appeared to favor the red leaves of Mrs. Scarlet and the blue of Mr. Azure to their pale yellow. Even though they looked forward to Nime, her daily visits never failed to make them upset. Mrs. Scarlet comforted them afterwards, “Illy, Nime is spending more and more time with your nectar, you just can’t tell it. And Lilly, Nime could clearly see your yellow trim just as clearly as I can. I’m sure of it.” Illy and Lilly were slightly less sure of this when Scarlet got them confused.

Mr. Azure looked at Illy and Lilly as though he wanted to get back to looking at the tree. “Honey bees always work. That may be why Nime can never stay and talk. I’m not sure Nime can help us. She may lack the time, ability, as well as the inclination, even if she can understand us. We may be too slow for her.” He paused and looked up at the tree. “But I think we have to try.”

Preface

2006-05-09T21:31:00.000-07:00

Hey, I changed the story a bit, revising and revising. This is the preface to the kids book.

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

At first the world had no needs, for all the world had Balance. Sun to leaf, and leaf to sun, part to part, and part to all: all were found in Balance. Eaters balanced growth, and harmony balanced eaters, and nothing grew unbalanced.

The eater Drasil spoke to the grower Opyn Loc. Drasil asked her to grow something both beautiful and new. And so she grew a flower and it was something both beautiful and new. But Opyn Loc asked the eaters to resist the flower, for it was not in Harmony and hid a secret imbalance.

Yet when Drasil examined the flower, he found it to be something of balance and something of harmony. And when the flower named Myrr spoke of its hidden nectar, then Drasil first knew hunger and want. Drasil ate from the nectar and when he ate, from stamen to style, Drasil and Myrr made a new Harmony.

The seeds were something new again. But they did not have Balance. The seeds spread through all there was, and they began to grow. Those that grew from sun became sun. From water, water; plant, plant. And Eaters. Eaters became eaters, and the eaters of eaters.

Some seeds have Myrr’s shape, some can turn sun to food, and some have even her flower, but all are pale imitations of the first. Fallen things, the flowers from Myrr need sun to be seen and air to be smelled.

Opyn Loc grew in paradise until the seeds. After the seeds, with Balance lost, from Harmony came discord. The seeds brought need. The leaf needs sun as the root needs soil. Balance occurs where Harmony accounts for all needs. This is the only blessing left.

The story bored Lillian. She did not feel for one instant that her petals were degenerate things. Neither did Hillary. She felt that if the seeds brought her along, then she could live without a perfect Balance.

Of course, Lillian and Hillary were young, and the young should have no need of such stories, for such stories are like decay, present only where youth and growth are not.

A Fish Story

2006-05-08T20:00:00.000-07:00

Just when you think Bush can't go any lower, in polls, he makes a joke. Although most of the liberal blogs aren't saying this, what follows was a joke. When asked the best moment of his presidency, he said that he pulled out a 7 lb perch from his lake in TX.

Some fun facts about perch, they only grow to about 2 pounds, they'll eat anything, they're easy to catch.

Perch facts

Oh, and if you haven't seen the Colbert video yet, then you must.

Best satire I've ever seen, ever read, bar none.

Fault

2006-05-05T11:51:00.000-07:00

Recent news that British are healthier than Americans while enjoying the same rates of smoking, obesity, and lack of excercise seem to implicate the US health system. That may be. But I'd say there's a lot more to it than that. First of all, these are two different cultures (and for proof of that, watch a Benny Hill episode), so there are literally thousands of differences. While the British may smoke more, they certainly walk more. This morning, I walked to my car, drove to work, and have essentially been sitting ever since. In the UK, that is unlikely to happen.

But to move onto health care. What a difference prevention makes! UK's got it. We don't. End of story. My medical school friends who are in primary care make 6 figures by small margins. Those in specialties can make more than double that, while working about the same.

Here's how it works. Two cases.

Mrs. Peach is 25, she establishes care with a primary care doctor to treat her thyroid condition. That doctor does so. He also recommends she stop smoking, which she does. He recommends she stay healthy, which she does, eating whole grains, avoiding trans fats, and excercising. She goes through life. At 40 she needs a gall bladder surgery and at 50 a thyroid nodule comes out. Whe has carpal tunnel at 55. At 85 she becomes forgetful and is on three pills: one vitamin, one thyroid pill, and an aspirin. She dies in her sleep at the age of 88. The cause of death is deemed cardiac, but no lesions are discovered at autopsy. Most doctors would say off the record that she died of old age (but you can't put that on the paper).

Mrs. Drain is 25, but has no health insurance, so the thyroid condition goes without detection while Mrs. Drain becomes obese. Mrs. Drain smokes and never considers the effects. Mrs. Drain walks when forced. Her obesity literally squeezes a back disk inot her spine and she requires a surgery and another one to correct the first. Her knees start to go, further preventing her from walking. At 40 she needs a gall bladder, and at that time diabetes is discovered. Because her habits are established by then, weight loss is impossible. She goes on meds to control the diabetes. At her next visit, he doctor cannot feel a pulse, so she is referred to surgery. Multiple stents are placed through her femoral artery to open it up. Now deemed a high risk vasculopath, Mrs. Drain is placed on 8 different drugs, which make her tired and she is unable to work. She goes on medical disability full time by the age of 53. Her first heart attack occurs by 57, requiring further stents, and she is blind by 60 from the poorly controled diabetes. Retinal surgery with lasers is of marginal benefit. At the age of 63 she has another heart attack. She is brought into the hospital without a blood pressure and coded for 15 minutes. During this time, her brain received little blood flow and massive cerebral injury occured. After spending the next 4 days in an ICU, she is deemed to have little chance of a functional neurologic outcome. For the first time in more than 20 years her blood glucose reaches normal levels. Nevertheless, the breathing tube is withdrawn and she dies about an hour later.

The differences between Mrs. Peach and Mrs. Drain are myriad, but I'd like to focus your attention on their economic differences. Nothing more need be said.

Freedom

2006-05-02T11:43:00.000-07:00

[quote=Bush]I based a lot of my foreign policy decisions on some things that I think are true. One, I believe there's an Almighty, and secondly, I believe one of the great gifts of the Almighty is the desire in everybody's soul, regardless of what you look like or where you live, to be free. I believe liberty is universal. I believe people want to be free. And I know that democracies do not war with each other. And I know that the best way to defeat the enemy, the best way to defeat their ability to exploit hopelessness and despair is to give people a chance to live in a free society. [/quote]

Full speech [URL=http://www.whitehouse.gov/news/releases/2006/04/20060424-2.html]here[/URL]

I'm going to ignore one easy target: Bush is giving Iraqis a chance to be free, but he doesn't have people like Maher Arar in mind. For now, I'll also ignore the low hanging fruit that the last thing the US wants in Iraq is a democracy (so they can elect a theocrat), and that we must act to prevent that from occuring.

Instead, I'd just like to focus attention on Bush's theology. He says what he means. He bases foreign policy on his Christian notions of truth and he expects that reality will follow.

Some time ago I said that Bush's foreign policy is essentially religious: it is faith based and in no way contingent on reality (reality of Iraqi-911 ties, WMD in Iraq, sects within Iraq, questions of quagmires). Some people thought there was no evidence for this and doubted the case I was making. Well, here you go. Here is a man who bases the foreign policies of man's greatest nations on his notions of what his god thinks. And he has so little shame, so much arrogance, that he says exactly this.

No amount of bloodshed and death and destruction could ever convince him otherwise. No number of Coulberts could make him see his errors. The only thing that might help would be god himself in the white house living room. And then Bush would see her as a false god, clearly.

As an American, I hold my own liberty dear. But I'm not so arrogant as to take what I myself hold dear and make that into a universal constant. For that to occur, you've got to impose your values literally upon the fabric of the universe. And for that to occur, you've lost your sense of causal direction.

Because the universe has other ideas, as Iraq ought to be teaching us, as the Congo ought to have taught us.

The freedom of Iraqis is a moot point and always has been. What happens when the theocrats attain "a chance to live in a free society"? Well, Jihad is their word for it.

Youth

2006-04-29T18:44:00.000-07:00

Youth is beautiful nearly by definition. My wife and kids went to a party of some youths, one of whom invited us. They are all in their 20's, which is a difficult time for American no-longer-children. They're getting out of college, starting the first job, still thinking that they'll do this sort of job for a while before moving on. All to soon they will find themselves with a daily grind, a mortgage, perhaps children.

In the meantime, they are lovely. Twenty year olds these days have multiple tattoos, and some of them have detailed work. They call these 'ink,' and prestige is given to the most daring. Given the fact there is nothing to do to prevent this in my own children, I'll simply settle for something small.

And muscles. This is also very in. About half of the men spend serious gym time and perhaps even pharmacologic enhancements. I wanted to ask them if any had ever seen the Sponge Bob episode about anchor arms.

In your 30's you start noting the passing of time as etched on your face. In your 20's this is unthinkable. Skin is without wrinkles, tissue is plump with natural connective tissue, and eyes glitter with the wonder of the universe.

All of them are terrific. The women are so smooth, so different from my peers (Mrs. NOS can hold her own), that I nearly want to cuddle them as I do my child. The guys are handsome. The groove between the deltoid and the tricep is not only present, but looks as though it could give a nasty pinch. There is no ugliness yet: of body and of mind. There is only promise.

One young man actually asked me for my advice given that he's graduating from college: what should his next step be? But he phrased it incorrectly as a comparison to what I did after college, so I was forced to answer: med school. No help to him, and then the moment was lost. But if I were to render advice, it would be this: attain and climb, climb and attain. After college, you've got to attain. You've got to climb. You've got to enter the work force and find something that you can do well, that pays well, and that will be fun. Don't put all the effort into one thing (which I did when I was in medical school), spend some of your effort in high risk areas (boy, do I wish I had learned something about computers and the internet in medical school instead of useless biochemistry!). It takes luck and personal characteristics and the ratio favors luck by a lot.

Best of luck.

Teaching Case

2006-04-23T10:51:00.000-07:00

78 year old guy who has a 50 year heroin habit (quit for last 5 years). I've met some people with long habits before, just not ones who've quit on their own volitition. He had just finished telling me about helping to build skyscrapers in NYC, so I ask him, eyebrows raised in some amount of disbelief, "You built skyscrapers while using heroin?"

"Yep." He looked pleased with himself.

"Well, how did you do that?"

"Carefully. Very carefully."

There's a lot to learn from that.

This guy goes into my "toughest guys I've known" category. First of all, anyone who survives a 50 year heroin habit is nails tough. Sure, luck plays into it, but 50 years starts to negate luck. Second of all, he looks tough. This guy is 78 and although he looks it (even his face is grisled), he's the sort of guy that, even now, I wouldn't particularly want to get into a fight with. He's fireplug strong looking. His blunt face has a Roman nose that looks to be broken a few times. Scar tissue covers both eyebrows. His arms have jail tattoos, which have their own tough stories. Well, let's hope they've stopped making his destructive model, but I can't help but admire the way it was put together. Like seeing one of those old F150s with 500000 miles.

Another Lesson

2006-04-19T11:03:00.000-07:00

The chief complaint, they teach us in medical school, is the portal to the patient. Like the window to their soul. All else should follow from there. It makes some sense, in that at very least, one needs to address the patient's main problem, and that you shouldn't ever loose sight of that main problem.

However, like all dogma, it breaks down in the chaotic system called reality.

I had a woman with a headache. That was her chief complaint. OK. But on exam, she shows more than the usual vagueness. She has had headaches all of her life, but she can't describe them at all. In fact, there's something clearly wrong with her story because there's clearly something wrong with her. She's completly confused. So I abandon the chief complaint and focus on the real problem.

Which is something that comes with great difficulty. It actually goes against all the medical dogma. I'm in uncharted waters. I'm the religiomaniac who reads and understands Darwin. This makes good sense, yet it must not be. One mustn't ignore the chief complaint.

So I send her to the ER, where labs show she is in renal failure. Dogma falsified becomes... Tradition?

Elementary

2006-04-17T20:39:00.000-07:00

The unknown diagnosis. It's like a friend you've just met: you're smitten with possibilities. Then you start in on it and it'll turn out to be something or other, another normal disease, just like your friend will turn out to just be a normal person.

But right at takeoff it's still open. And that's where I am with one of the patients. This one is highlighted by the fact that I'm leaving and won't do the follow ups that'll seal the diagnosis, for better or for worse. But on this one I'll get the rest of the story.

I find the most interesting cases are always slightly outside my comfort zone, which is exactly what makes them interesting, they are not routine.

2006-04-14T09:39:00.000-07:00

I don't usually read the Nation, but I heard an excellent argument by one of their editors named David Korn as he helped to destroy Christopher Hitchens (who at one point said that the absence of WMD in Iraq is proof of their existence. And no, I'm not making that up.). Hitchens is a pompous idiot blowhard. I'm ashamed he's an atheist. The link is a long discussion, I rec downloading it to an I-pod/whatever, then going for a run.

So thank you David Korn, for making me check out The Nation. It is entertaining and the articles are excellent. And I urge you to check out the latest Kevin Philips article highlighting exactly the people to whom Hitchens has sold out to.

Liar

2006-04-12T20:18:00.000-07:00

Today I caught a patient in a lie. Well, not so much me, but when I discussed the matter with a third party, we honed in on the lie. He essentially lied about what I told him in order to get what he wanted. It regarded a test that I said was useless. He got off the phone and ordered another doctor, "Doctor NOS wants the test now."

Getting what we want. That's the thing we all want, isn't it. But sometimes you can't get it. Sorry. Particularly in medicine. We do not run a Walmart (and even in Walmart I doubt you could find everything, like Rhino Jerky). Your doctor will usually get a reasonable test that she doesn't think will help if you stongly want it. But few doctors care so little that they would get a useless test.

"What's the harm?" He asked me, more than once.

Well, that sounds like a reasonable question. But it is not the proper question. The proper question is "What's the benefit?" And if there is no benefit to the test, then there is no further need to ask about possible harm.

He didn't like that. That's OK. I don't particularly like him.

Bush and Clancy

2006-04-09T18:52:00.000-07:00

I know this is a tangent, but I recently read a Tom Clancy book (one of the Ryan books that they haven't (yet) made a movie out of). About a quarter into the book, when all the chips start lining up, the following thought hit me: thank god we don't live in Clancy's world. And then this thought followed me through the book. The fake presidency of Jack Ryan is required to determine what other nation states, and in this case, a scism within a nation state, are up to, then act accordingly. They need to combine intel with wisdom with ferocity and with mercy.

Bush doesn't do that. Now, I know this is silly. Clancy writes fiction, this is a silly tangent. But I can't help but think that if you'd put team Bush into any of those situations, they'd fail miserably. After all, they've failed in Iraq, they've failed in North Korea, they've failed in Latin America. The simple things that Clancy writes about: the good management of information and resources to win the day, is missing from Team Bush. They don't do things like that. What they do is go off half cocked and mess things up badly.

Anyway, present day Iran is scary, especially because Team Bush managed to remove their main enemy from the stage while America has been keeping Iran's coffers full. However, I find the Bush reaction to Iran to be the really scary part.

Psychologically, right now Team Bush is like a surgeon who's just messed up bad. They don't, can't, even admit this to themselves much less the public, but there've gotta be some dark nights when it hits them how horribly they've screwed up in Iraq. How there haven't been any flowers. How freedom, democracy, and capitalism isn't sweeping through the region. Just like that surgeon who inflated the catheter to stop the bleeding, but cathed the spine and stroked the cord. There was a complication and it's terrible. Now that surgeon is looking at malpractice, and his place in history. Then its time to over-react. Anybody see this phenomenon before? It's bad stuff.

Sometimes these things have a way of snowballing. Check out S. Hersh.

Bush Lies.

2006-04-06T21:26:00.000-07:00

Nearly two years later and we're pretty close to knowing that this was a lie.

Let's not forget what he said.

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

March 18, 2003

Dear Mr. Speaker: (Dear Mr. President:)

Consistent with section 3(b) of the Authorization for Use of Military Force Against Iraq Resolution of 2002 (Public Law 107-243), and based on information available to me, including that in the enclosed document, I determine that:

(1) reliance by the United States on further diplomatic and other peaceful means alone will neither (A) adequately protect the national security of the United States against the continuing threat posed by Iraq nor (B) likely lead to enforcement of all relevant United Nations Security Council resolutions regarding Iraq; and

(2) acting pursuant to the Constitution and Public Law 107-243 is consistent with the United States and other countries continuing to take the necessary actions against international terrorists and terrorist organizations, including those nations, organizations, or persons who planned, authorized, committed, or aided the terrorist attacks that occurred on September 11, 2001.

Sincerely,

GEORGE W. BUSH

Badness

2006-03-31T10:27:00.000-08:00

Another bad Bush/GOP week in review. I'll probably miss some of the top stories.

Bush censure hearings. John Dean, who knows a little something about political corruption from his stint as Nixon's lawyer, calls Bush's wiretapping actions worse than anything Nixon did. Ouch.

Immigration. This is a point that divids the GOP against themselves. Some want to continue to exploit illegals. Some want to expel illegals. Bush is in the first camp, and perhaps he's correct. I think the best case can be made for sealing the border and giving out permits to those already here. At least that doesn't ignore the realities of the situation. But Bush's base isn't interested in realities: they either want to exploit or expel.

Bad news from Iraq: sectarian violence continues. It is time to face facts regarding our failure. Iraq is suffering the ending that everyone feared: sectarian violence and a failure of political leadership. Instead, local warlords, each with a militia, have control on the ground and national leadership needs to deal with them - not citizens. This dooms our involvement.

Rice says we've made "thousands of errors," in Iraq. Her full quote is "I know we've made tactical errors, thousands of them, I'm sure." This is a bit like me saying the same thing over the dead body of one of my patients. Or, more aptly, if I were a surgeon.

Tony C. Rudy, one of DeLay's aides, pleads guilty to some charges and agrees to cooperate in a lobbying fraud investigation. Watch yourself when you eventually go to jail, pretty boy.

Finally, I did not know this: Bush has never gone to a funeral for a soldier killed in Iraq. Never. Hard to prove a negative, but a search through the internet: not one. And we all know there've been plenty of chances. Another one of Bush's personal failures as a leader and as a man.