I Only Have Flies For You

Photo Credit: Jim Champion

In my humble, germophobic opinion, there is nothing more disgusting than the common house fly. I hate lots of other insects, such as mosquitoes or ants, but flies clearly bug me the most. Flies are dirty and slick.

A medical office is supposed to be clean...sanitary. Clinics are not supposed to have visible dirt, contamination, or flies. Medical offices did rank very high on my Blog series of the Dirty Dozen - The Twelve Dirtiest Places. Sure, an occasional, misguided fly might get sucked through the automatic clinic doors from time to time, but last week, our medical office had a Biblical plague of flies. They were everywhere. We had them on the ceiling, buzzing around our heads, getting trapped in light fixtures, and landing on every surface. The more we killed; the more flies that appeared. The staff was going crazy by cleaning everything. Patients were commenting. One even said this was like a Third World Country. This is not something you want to hear.

I did some medical volunteer work in Jamaica several years ago, working in a remote clinic. In the morning, we had chickens walking through. By the afternoon, the chickens were mysteriously gone. That evening, we were served jerked chicken. This WAS a third world country, and I did not notice any flies in that clinic, even though there were no screens (or glass) in the windows.

Our office sees many newborns and new parents are VERY conscientious about cleanliness. If a bottle touches a surface, they wash it. If a pacifier drops on the floor, parents will not use it until it can be sanitized again. They will take a new one out of a plastic bag. When I am seeing newborns, I scrub my hands over and over in front of the parents. I wash off my stethoscope with an alcohol swab. However, when you are examining a baby, you don't want a fly landing on them. Of course, several months from now, those same, carefully-protecting children will be crawling around eating flies. But, that is another story.

We all have our own little secret "skills". I am proud to say that I can consistently catch a fly in the air or on a surface with one quick sweep of my stealthy hand. I would then wash them down the sink drain as I washed and alcohol-sanitized my hands yet again. I do find the "catch and drown" method preferable to squashing a fly on the examining table in front of horrified parents, but there is really no good, acceptable and/or sanitary way to euthanize a fly in a medical office. I did modify my fly-catching technique by making a pocket using a paper towel in my cupped hand. I could still catch the fly, wad it up in the paper, throw it in the trash, and go on with my medical business.

Exterminators were called. They traced the problem to cracks or flaws in the outside of our building. Apparently rats crawl through these areas, die, and those rat carcasses attract the flies. The flies lay eggs and, of course, these eggs hatch out and our clinic is transformed into a garbage dump overnight. So, now we have rats, too. And, rat carcasses. Can it get any better? All I need now is for a rat to lazily walk by when I doing a surgical procedure, or hear a child saying, "Look, Mommy...a mouse!"

The exterminators wanted to fog the entire clinic with toxic gas and infuse all of the nooks and crannies with various poisons. Obviously, we could not allow this to happen, so we had to be creative. We left the rats up to the exterminators to catch, but the flies were left to us. They had no other non-toxic alternatives, but to suggest fly paper. Can you believe it? Would you go to a medical clinic that had a strip of dead fly-laden sticky paper hanging in the corner? I would not permit them in my exam rooms.

Another doctor brought in a low-tech method - a fly swatter. This was an effective method as long as you can stand on a chair to get the ceiling flies. Since most of our chairs have wheels, this became a disaster waiting to happen. The commercial bug zappers were out. It would be very distracting to hear and smell a fly being electrocuted during a medical encounter. Biological methods were not an option. Toads, frogs, and lizards eat flies but those creatures also lack a certain amount of appeal. The clinic in Jamaica had lots of lizards.

This was a fly emergency and it was every provider for them selves. I came in early, disposed of every one of the flies in my exam rooms to the point where the flies recognized and feared me. I then instructed my medical assistant to sanitize those rooms from top to bottom. The doors were kept closed all day, except when patients entered or exited. We remained at Fly-Con 4 for the rest of the week, and eventually, all of the flies were gone.

Photo Credit: nicolaitan

This morning, while sitting at my desk, contemplating my victory, thinking I was now the Lord of the Flies, I was bitten on the neck - by a mosquito.

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Technorati Tags: flies, insects, germs, health and wellness

The Double-Edged Sword of Testimonials

I have been home all week recovering from the ravages of influenza, so I have been watching more of my share of day-time television. Although I have noticed health advertisements in the past, I am absolutely astounding by the sheer number of them. Nearly every commercial break is filled with important breakthroughs in the management of obesity, arthritis, or erectile dysfunction. Unproven and non-scientifically-tested herbal supplements share the same stage with patented, well-studied pharmaceuticals. Operators were standing by to take my order for supplements that cured just about everything (except my flu).

Library of Congress via pingnews

In the Old West, snake oil salesmen traveled from town to town hawking their various cure-alls and concoctions. A slick charlatan would stand proudly on the stage offering miraculous cures for cancer, rheumatism, tuberculosis, lameness, or alcoholism based on recent medical discovery of an ancient Kickapoo Indian recipe. For only a dollar, your medical worries would be a thing of the past. There was absolutely no doubt that this elixir worked, because there were people in the crowd who offer testimonial proof of its effectiveness.

An elderly man on crutches hands over his dollar and quickly takes a healthy swig of this life-giving elixir. Almost immediately, something begins to happen. Minutes later, he throws away his crutches and dances down the street, not having walked a step since getting polio - a true miracle.

For those who missed the show, there were flyers and books for sale extolling the benefits of this magic potent. There were excerpts from hundreds of letters from people all over the world contesting to the power of this miracle drug. These were testimonials from real people, like you and me. These were letters from grateful people that were now completely cured.

Dr. R.V. Piece, MD, President of the World's Dispensary Medical Association and noted author of The People's Common Sense Medical Advisor became a multi-millionaire in the early 1900's on the sale and distribution of worthless patent medicines. The cornerstone of his entire marketing strategy was based on testimonials:

Gentlemen -

I was troubled with boils for over thirty years to the point where I have not been able to walk for the last four years. I bought Dr. Pierce's Pleasant Pellets and took one after each meal. The boils soon disappeared and I have had none since. My headaches are gone too.

Respectfully yours,

William Ramich

This book (which I have in my possession) has thousands of testimonials from such grateful people as Lottie Clark, Belle Sweeney, and H.M. Holleman, Esq. Not one of them had anything bad to say about Dr. Pierce's Golden Medical Discovery, or Pink Pills for Pale People. We can laugh at these today. How naive can people be?

Guess what? Testimonials, no different than these, are still selling worthless products a hundred years later. The only difference is that the testimonials are on television, radio, and in magazines now. It is the same old stuff; only different packages.

Luther Garcia lost 27 pounds in six days eating anything he wanted (picture of Luther holding up a pair of pants he bought at Goodwill). Kristin's devastating acne cleared up after just one application. Jim's penis is so big now that he quit his job and stays home all day admiring it. Magazine ads show pictures of the actual person that was cured standing next to a distinguished man in a lab coat holding a chemistry beaker. These things must be true; otherwise, they couldn't have printed it!

I was trained in standard, allopathic, scientific, evidence-based, Western medicine. I have a very hard time with testimonials of any type. My patient wants a prescription for amoxicillin. Her aunt took two capsules yesterday and she is completely well. Another wants a vitamin B shot so she will have more energy. Yet, another stubborn and ill patient refuses antibiotics for an x-ray-proven pneumonia. He would rather increase his dose of vitamin C. Children are not getting vaccinated because their next-door neighbor's cousin's child got autism the morning after getting an immunization. A man in Upstate New York saw the image of the Virgin Mary in a piece of toast and now his cancer is gone. These are all testimonials; dangerous testimonials.

WebMD's Message Boards are "open boards" where members help members. Any member can post a comment if they have something to add. However, there is really no way for anyone to know the qualifications or agenda of the person making those personal comments. Health Experts and WebMD moderators constantly monitor the board for any potentially-dangerous advice or comments. Just because one person took mega-doses of vitamins and it seemed to cure their cold, in no way should they be standing on a WebMD platform, hawking this newly-discovered "cure" to others, even if the intention of their testimonial was good. Fortunately, this does not happen very often on WebMD. Other similar health sites are not as well-moderated.

People want to believe in miracles and they want instant, easy cures. Who doesn't? People mistrust doctors who do not explain anything, but believe the person at the health food store who takes the time to listen to them. They take medical advice from well-meaning friends instead of consulting a legitimate medical authority. People like to help other people, but sometimes their good intentions can have very undesirable outcomes.

Perhaps, not all testimonials are bad, or even wrong. However, it is my firm belief that any testimonial used to sell or promote a product is more likely to be misleading and highly-biased. Otherwise, why include a testimonial in the first place?

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Technorati Tags: medicine, testimonials, health and wellness

The Generosity of People

We drove to Baja, Mexico last year - all the way to Loreto from Northern California. We petted some whales, ate some great food, and visited some friends that now live in paradise. Many people still have negative beliefs about Mexico, but it isn't like you see in the movies. The roads were fine,the gasoline less expensive (although we were cheated once), and the people were wonderful. Having traveled to Third World areas in the past, it saddens me to see the poverty, but I am always amazed that people get by relatively well with very little resources.

Photo Credit: Tia Foundation

Having grown up poor myself, I was particularly touched by the Mexican children. When I inquired how we could help, one of the requests was clothing. Many children only have one or two, hand-me-down outfits. There was a lack of shoes and a lack of light jackets. We had met a Canadian couple who spends the winter months in Baja helping out in the orphanages. He was a farmer with skills at fixing anything and his wife was a mother - an expert in holding and cuddling little babies. She also helped out with the macadamia nut processing, a venture that helps to support the orphanage. They said that clothes are needed, so this became our mission for this year. We are going back again in April and taking clothes.

My wife and I put out two big, plastic garbage cans in our lobby and asked our patients to donate any used children's clothing. Every day, we had to empty those cans, bulging with hundreds of outfits - baby clothes, blankets, socks, shoes, and even a few teddy bears. Last night, we started sorting them out and sizing them. In less than two months, the generous families in our practice donated nearly 1000 pounds of children's clothing, some still with the store tags on them. I don't think I will be able to get all of these clothes in my truck for the trip. I may have to take a trailer. Even after we removed the donation cans, the clothes kept coming in. I got another bag this morning. Another person tried to give me some money this morning since he missed the clothes drive. I declined, of course.

Some of the staff would like to continue the project all year long - providing clothes for the homeless shelters and food banks. I think this would be a great idea.

Years ago, one of my favorite patients owned a movie theater. He generously gave me the entire theater, popcorn and all, for a community fund-raiser. We offered tickets for donations only - money, canned food items, or wrapped gifts for children. We filled the theater and raised a considerable amount of money. Another patient started an organization called Christmas Promise that delivered thousands of new, wrapped gifts to children on Christmas Eve by a few hundred, appropriately-dressed Santas. I am proud to say that I was one of them.

When the economy takes a downturn, many people feel that donations will decrease as well. I have not found that to be true. It feels good to give and some people do give until it hurts when the cause involves children.

Our entire living room is filled with sorted clothes and I just brought in another several hundred pounds from the garage. We found a few "inappropriate" items, like a T-shirt with a stereotypical Mexican in a sombrero. I don't think I will bring that one through the border crossing.

I am waiting for a letter (in Spanish) from the community organization in Mexico that will be distributing the clothes. Hopefully, this will limit a bag to bag search of this clothing and explain to the federal officials that we are not bringing these to sell. Baja has some intimidating check points on the trip south, complete with men with machine guns peaking out of sandbag bunkers. My Spanish language skills are limited to medical terms, so unless the federal officials have some sort of disease, I am not going to be able to explain my mission. Being able to say "green booger" or "stick out your tongue" in Spanish is not that helpful. These are the times when I wish that I had the opportunity to take Spanish in high school instead of French (The only choice we had was French). If I ever decide to haul a ton of clothing into a French-speaking providence in Canada, I am all set.

This is going to be a wonderful trip in April. Not only will we be able to distribute thousands of articles of clothing to orphanages, churches, and community groups across Baja, I will be celebrating my 57th birthday somewhere along the road. This should be one of my better birthdays.

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Technorati Tags: donations, generosity, Baja Mexico

Too Sick to See Patients

Medical providers get sick, too. As a matter of fact, we often get sicker than the patients that we treat everyday. Our immune systems are constantly being challenged. People cough in our faces; they sneeze on us; little children whip "stuff" on us. Our immune systems work overtime when we are working. And, when germs do make it through our defense systems, we will become ill. Of course, that is happening to me right now.

A few minutes ago, I called my office to have them cancel my patients for today. I feel real bad about this, but we have other providers in the office that can see the ones that we were not able to contact. Last week, my PA wife was ill. When they called to cancel her patients, they simply informed them that she would not be in today and they would have to re-schedule. That is not enough information. Patients need to know the reason why we canceled their appointment. I told the medical assistant to tell them she was ill. People really do understand that we get sick, too, and will be much more sympathetic when they are inconvenienced.

I work 12-hour shifts and handle a large percentage of the acutely-ill people that call on the same day. Acutely-ill people are the most contagious, so it doesn't surprise me when this happens from time to time. I don't believe I have been sick for about a year.

So, why am I blogging? I am bored. I have a pile of tissues accumulating on my desk; I am coughing my head off, have a fever, body ache, headache, and basically, I feel like crap. I was up all last night doing the same; keeping the dogs awake. My wife decided to sleep in a different bedroom.

There is a good chance that I have influenza. I certainly saw enough laboratory-confirmed cases recently. This year's flu vaccine did not make the cut. Every year, a new vaccine is developed, anticipating the virulent strain. This is based on the flu strain the hits the Southern hemisphere about six months prior -- their flu season is opposite of ours. Most flu strains originate in China, like most of the stuff we purchase. Influenza typically comes from pigs or fowl (Pleasant, huh?), so agricultural societies that have a close, intimate relationship to these creatures are the first to get these mutated animal-to-human stains. Some years, the flu vaccine is right on, or at least the flu type was similar to a previous year. This year? Not.

Many people think they have "the flu", but most are probably wrong. Influenza is a respiratory disease; not diarrhea and vomiting. It causes high fevers, severe coughing spasms, body aches, headaches, sore throat, malaise, loss of appetite, etc. When you have the true flu, even your hair hurts. At first, you are concerned that you may die. At the height of the illness, you start hoping that you do. Of course, death from the flu is not a laughing matter. Every year in the U.S., tens of thousands of people die from influenza and its complications. About 90 years ago, during the Spanish Flu Pandemic, about 20 million people died. Visit an old cemetery sometime and look at the dates. You will see a lot of 1918's, involving people of all ages, including many, many children.

My first step today is to see if I have influenza or not. This requires a rapid test from a nasal swab. My wife will bring it home over lunch. If I have type A influenza, I will start Tamiflu today -- an effective antiviral medication that will shorten the course and severity, allowing me to get back to work and see the other people with flu. If my test is negative, I will just wing it. Based on the generalized symptoms that I have, the most likely culprit is a viral infection. Viruses do NOT respond to antibiotics.

Tomorrow is my normal day off, so I should (hopefully) be back to work the following day. Most people with viral illnesses are contagious a day before, and about two days later. I should be fine in that respect. Since I see many newborns and well children in my practice, too, I do not want to expose them. Viral illnesses are truly the Gift that Keeps on Giving.

Today, I will just do what I can. Get plenty of rest. Drink fluids. Eat some chicken soup. Take some anti-inflammatories for these body and headache. If I try and watch TV or read, I will fall asleep. Perhaps, my body is telling me something.

These winter months are brutal in a medical practice. It seems like someone is out sick every day, and the demand for appointment always exceed the availability. We have an "open access" policy in our practice. This means that anyone who would like to be seen today; can be seen today. The patients love it. We are not so enthusiastic some days when we get home at 10 PM. When you are ill, you need to have access to your medical provider. We signed on for that job when we picked the profession. It really ruffles my wrinkles when someone posts on the WebMD ENT board, that they are sick, but their doctor can't see them for two weeks! That's crazy.

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Technorati Tags: flu, fever, aches, influenza, vaccine

Valentine's Day - Past and Present

My first Valentine's Day was probably in first grade. Miss Rider pasted out a mimeographed list of the names of everyone in our class. We were told that we needed to send Valentines to everyone (everyone!) in class to be distributed on Valentine's Day? Who is this Valentine guy and why do I have to send cards to Lorraine and Blanche, the nastiest girls in class. Maybe I will be sick that day, because I was sort of sick at the moment.

I took the list home and my mother counted the names. She determined that I needed two boxes of cards. These were small, one-sided pictures of a naked baby with wings, hearts, little white girls holding flowers, and little white boys holding a heart-shaped box of something. These were not your Hallmark cards here.

In 1957, there were no cards that portrayed African-American children (like Lorraine). And, we were supposed to give these same, mushy, girly cards to boys, too.

"Dear Ed, Will you be my Valentine?" No, that ain't gonna happen.

As instructed by Miss Rider, I meticulously wrote the envelopes to everyone in class. My next task was to pick the right card to go in the envelope, picking the lesser of the evils for my best friends, and purposely did not sign my name on the back of Lorraine and Blanche's card. I did NOT want to be their Valentine, nor did I want them to get the wrong idea. I wrote my friend's name on those. Let Terry deal with it.

We did have a few good looking girls in our class that would surely enjoy getting one of these hand-picked masterpieces. I would sort through the stack of strange Valentines, trying to pick the one that would win her heart. On the day we distributed them to our classmates, I would make sure there was an extra heart drawn on that one. I would watch my "real" Valentine open it up, look in my direction, and smile. She's mine, baby!

So, every year in grade school, we had to go through this mandatory ritual of sending Valentines to kids we did not particularly like and to teachers that fell into that same category. You were forced by peer-pressure to give a bigger Valentine to your teacher. This madness stopped by the time we hit 7th grade.

I only had two girlfriends in my entire grade school years; Joyce in kindergarten, and Beverly. Everyone loved Beverly. She had a pack of boys that walked her home every day. We bought her rings (ten cents) and other trinkets. In high school, Beverly showed me her ring collection that she had saved since grade school. She had hundreds! Basically, I had no chance. She liked one of my best friends, Jim. Oh, well, I could always live vicariously through Jim.

Valentine's Day became more serious in high school when you were in a relationship. You actually had to buy them something nice, such as a charm for their charm bracelet or a necklace. A card, even a Hallmark card, isn't going to cut it. This meant you had to plan in advance, save your money, and actually go shopping. Gifts to girls had to be wrapped. They could not be presented in the store bag with the receipt inside so she would know how much you spent. In guy-thought, the amount of money spent is equal to the amount of love you had to offer. A carefully orchestrated gift could really pay off big time. Of course, there was always one guy in class the really spent some money on his girlfriend. She would walk around showing off her Valentine's gift, making us feel like mindless cheap-skates.

As I am writing this Blog, I have to admit that I have not even thought about Valentine's Day for my wife of 25 years. She already gave me "one of my gifts" last week when I was complaining that I had nothing good to read. She gave me a John Grisham novel she bought at Costco. I pretended to be excited, but I am not a big fan of reading lawyer books. I get too ticked off. It is sitting on my bedside stand, but I really don't want to read it. Buying a book for someone is very personal and you really have to know what the person likes to read. Apparently, my wife is clueless in that department. Maybe I will buy her a dress! That'll teach her.

So, I haven't bought anything yet. Taking her out to dinner and a romantic movie (chick flick) is a tried and true Valentine's gift. She loves good wine. So, a nice meal, lots of wine, a good love story, and she will definitely be in the mood for the final gift of the evening. Enough said about that. She would love if I took her dancing, but I absolutely hate dancing. I was born seriously rhythm-impaired, so I am not permitted on the dance floor.

Flowers are nice, but way too expensive for what you get. Technology really helps last minute partners since we can order bouquets on-line. Jewelry is always a good stand-by but again, we have differing tastes, but perhaps I will check eBay anyway. I once bought her a pair of earrings that were actually little ears! She never wore them.

I do have to find a nice card and write something in it (other than my name). Since my brother recently retired from Hallmark after 30 plus years, purchasing an expensive card helps to support his pension plan. They have some new cards that play music and my wife loves those commercials. She will cry even if I describe a Hallmark commercial. It would not be considered romantic to just send her an e-mail love letter. Besides, she is not a person that even opens her e-mails more than once a week. E-cards are definitely out the question, too. In the past, I have made her a card with Photoshop and she liked it.

What else could I do to show my love and appreciation? I could get her a tree to plant in the yard, but I will end up digging the hole, so that is out. I could do that dishes, make the bed, run the vacuum, and pick up my junk (this term refers to anything that is mine) that day. She may really like that, but of course, that would set a bad precedent.

I do love my wife. We have made it all of these years; through thick and thin (What does that means?) We have successfully reared five children to adulthood and they are doing much better than our friend's adult kids, some of which are still living at home. We have a nice house and drive nice cars. We basically have everything that we need. So, why then, do I have to go buy her a gift for Valentine's Day? 'Cause I love her and she will be mad if I don't.

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Technorati Tags: Valentines, love, romance, health

Getting Older - Being a Pre-Senior

Every day, in one way or another, I am reminded about getting older. I "feel" young, but chronologically, I am 56. I am about 20 years older than my father was when he passed away. Someone told me that I am "middle-aged". Unless I live to 112, I think I am a bit past the middle. My older brother retired a few weeks ago and is enjoying his idle time. At least two of my closest friends are now retired, or close to it. I have about nine more years of working my butt off before I retire, although I do think about it every day as I live vicariously through those that have made it.

I was prematurely grey, so people always thought I was older. Now, I am prematurely white, so there are few mysteries to my age. I married a woman five years older than myself, who looks five years younger than me. I have developed a few health concerns common to older people, like arthritis and high blood pressure. My little patients often call me "Grandpa", which is really okay, since I am a grandpa.

At least ten years ago, I was given a senior discount at Taco Bell. The pimply guy behind the counter was really sweet.

"You people deserve it," he said. I accepted his offer of the one dollar discount.

When I was fifty, I qualified for AARP. Remember, my wife is five years older, so I was able to join through her. This week, I found out that I could get a 5% discount on my car insurance if I completed a Mature Drivers Course. I did it. It was quite an experience.

Age 55 is the earliest one can take this course, so it is appropriate for people 55 to 105. It is designed that way. This thing took nearly 8 hours to complete on-line. This was my choice since I did not want to sit in a classroom all day with really old folks like Earl or Mildred. They would most-likely be asking the teacher to speak up, or tell long, boring stories about driving their father's Model A or something. Being new at being old, I didn't think I would fit in with the classroom setting at the retirement village (where it was held). I do not need additional reminders that I am getting older.

Some parts of the course were really interesting; others were not. I was particularly amused at the pre-driving check list that included the ability to look over the steering wheel or to have enough distance between the belly and the steering wheel for the air bag to deploy. Even with my pot belly, I qualified. It did make me think of all of the slower cars on the road that do not seem to have a driver. As you pass them, you often see a little, white-haired head peaking out over the lower edge of the window. I don't know how they can see the road at all. Other check list items include making sure you have gas, or that your tires are inflated. This is basic information, but important nonetheless.

Reaction time slows as we age. If someone rudely cuts me off now, I still want to flip 'em the bird, but I don't. Not only would this obscene gesture incite road-rage, they may be one of my patients. In my mind, however, my finger has proudly risen.

There is a lot of debris that ends up on the road, such as tire skeletons, boxes, fireplace logs, or chunks of metal. My reaction time must have always been slower, since I have hit my share of these things. Just last year, I hit a large chunk of scrap metal that fell off of some goober's pick-up truck. It caused some considerable damage and could have killed me if I swerved. Twenty years ago, I hit a dining room chair standing prominently in my lane as I traveled through a tunnel. Being younger then, I chased down the truck with the other three, poorly-tied chairs to make them pay for my car damage. Surprisingly to all of us, the wooden chair that I hit did not cause one scratch on my car. When the people denied it was their chair, I told them to count the ones left in the truck, and handed over a piece of matching wood still hanging on my bumper. I accept their apology for being idiots.

The last part of the Mature Drivers Course involved knowing when you are too old to drive. Many elderly drivers are in denial and end up hurting themselves or someone else before they give up their license. At 56, I should have another 25 or 30 years behind the wheel before this becomes an issue. Unsafe drivers come in all ages, of course. When you hear about an elderly man driving through a crowded intersection, you realize that it's everyone's responsibility to inform our aging friends or relatives that they are no longer safe behind the wheel. I wonder who is going to tell me some day.

I am not a true senior citizen yet, but I will accept those senior discounts when offered. As an honest man, I won't ask for them until I am age-eligible, but I will certainly not turn them down if someone thinks I deserve it. A buck is a buck.

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Technorati Tags: healthy aging, senior drivers, AARP, retirement

Movie Reviews: I'm ALL EARS

Movies are a great day-off distraction after a busy week at the clinic. Since this was Super Bowl weekend, we thought it would be a good opportunity to see a few newer movies. Unless the Steelers are in the Super Bowl, I am not the least bit interested.

Photo Credit: dizznbonn

My wife picked the first movie to see - Juno. Since she is a PA in an adolescent health clinic, she was very interested in the movie about teen pregnancy. Apparently, she is not getting enough of those at work (not!).

My Review: Juno was absolutely fantastic. I enjoyed every moment of this unique film. It was both poignant and funny, and definitely reflects our adolescent clinic population. While it is sad that recreational sex often results in an unwanted pregnancy, this film shows that teenagers, while reckless and irresponsible at times, are surprisingly intelligent and very, very sensitive about these issues. Our culture predominantly blames the sperm-makers for teen pregnancies, but in this film, he was a passive (albeit, enthusiastic) recipient of random sex. I laughed and even silently cried during this wonderful picture. I can see why it was nominated for four Academy Awards, including Best Picture.

I had a 15-year old in my clinic this week that requested birth control pills to regulate her irregular menses that were interfering with her competitive basketball. Her mother was against it for "moral" reasons. She did not want to give her daughter permission to have sex by allowing her to take the pill. I reminded the mother that her teenage daughter did not need her permission to get birth control pills, nor do teens routinely ask parental permission prior to having sex. When I informed her that she was entitled to a confidential visit to discuss these issues, she jumped at the opportunity. No parent wants their teenagers having sex, getting a sexually-transmitted disease, or having an unwanted pregnancy. Abstinence is always best, but unfortunately, unreliable in many cases. In confidence, this 15-year old was NOT having sex and had no intention of having sex anytime in the future. I believed her. She just wanted to stop having periods three times per month.

The second movie that we saw this weekend was nominated for 8 Academy Awards and had Daniel Day-Lewis - There Will Be Blood. Damn, it had to be good. I was expecting it to be twice as good as Juno. Wrong. I must be missing something, but this stinker was among the worst films that I have ever seen in my life. The musical score was perhaps the most annoying part of the film. It was loud and caused my tinnitus to go crazy. During the rare quiet scenes, when that crappy music was not blaring, I fell asleep a few times. The other dozen or so people in the theater did not even notice when I snored. I suspect they were sleeping too. Three teenagers behind us walked out half way through the film. They probably went to see Juno again.

The only poignant part of the film was when the main character's son suddenly lost his hearing from an explosion and was shunned by his uncaring father. As I impatiently sat through this 2 and a half hour movie, I found myself wishing I was deaf, too. My ears were ringing terribly from that strange score and I was getting nauseated. The movie title was There Will Be Blood, but I didn't think it referred to my own ears.

Photo Credit: Matt MacGillivray

The only thing that stunk more than this movie was my other "job" this weekend. I had to dispose of a real skunk that suddenly died when I shot it. Before you judge me, I have to say that the skunk was very sick and acting strangely. It was just sitting there in the rain all day and not moving when I tried to frighten it away. I suspected it had rabies, so in order to protect my pets, I had to do the humane thing. The skunk of course, did what skunks normally do, and sprayed everything in 100 yard radius. It is going to take days to get the smell out of the yard and out of my nose hairs. I buried him deeply. There were no kind words said.

Granted, I am a clinician, not a movie critic. If one overlooked the overall stink of the film, Daniel Day-Lewis did a wonderful acting job portraying someone that we would all hate. If this film gets Best Picture over Juno, I am not going to go to the movies for one year in protest. I will just stay home and rent select DVDs, adjust my own volume levels, and eat cheaper popcorn, freely sharing with my dogs.

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Technorati Tags: movies, Juno, There Will Be Blood, Oscars, ears

Something in the way we move

Photo by Randy

There is nothing I hate more than when I have to move. Moving to a new home or a new office is way too stressful for me. For me, life has been an endless series of moves.

My first big move was from the hills of West Virginia to San Francisco -- a culture shock of untold dimensions. Fresh out of college, my possessions were few, but my enthusiasm was high. I packed (seriously over-packed, actually) a U-Haul trailer and pulled it behind a four-cylinder economy car that barely moved itself. I had things tied to the top and packed tightly inside the car as well as the trailer. For most of the 2300 mile trip, I had to remain in third gear because I couldn't get up enough speed for the highest gear. I was a slow, mostly-uphill trip but we made it in four long days.

Five years later, we had a house full of stuff, including two children. We were preparing for a move from the Bay Area to Sacramento. After a few garage sales to lessen the load, we commandeered several friends and their vans to accompany the U-Haul truck. It took a few trips, but most of our growing number of possessions made it unscathed.

Five years later, we were doing it again. Do you see a pattern here? This time, we were moving to a bigger house. My family had grown by three more children; total of five. This time, we stayed about a dozen years, allowing our children to complete high school with minimal disruption. When the last child was headed off to college (Yes, we had to move their stuff), we sold the bigger house and moved to a new neighborhood across town. We remained in this new house for several more years before we undertook another big move again. This time, it was across country to Michigan.

The medical climate in California had gone into the toilet in the 1990's. HMOs were going bankrupt right and left. My PA wife and I just happened to work for one of them. Before we both lost our jobs, we decided to leave the state for greener pastures. I was leaving clinical practice for academia; going from the heat of California to the freezer of Central Michigan. Thinking I would not return, I took everything that wasn't tied down, and a few things (like a spa) that were. I gave away furniture and donated our third car to a charity. This time, someone else loaded up the truck. We took the precious things, including the parrot and the dog. The cat was adopted by friends at the request of both the parrot and the dog.

After moving about 25,000 pounds of "things" to Michigan and buying another house, we only stayed 18 months. The job (and the weather) was not to my liking, so we sold this house, packed a few tractor-trailer loads and headed back to California again. We still had our old house that we could not sell. It was rented (sort of) by someone that decided paying rent was optional. He left owing a few months back rent, but we had our home back again -- a bit dirtier and trashier than when we left, but our home, nonetheless.

Over the next few years, our former neighborhood had changed. There were new neighbors (noisy); more traffic; and more vandalism. I attributed the regular toilet-papering of my trees; the spray painting of my lawn with someone else's name, and egging of my garage doors to misguided teenagers. My next door neighbor was a Junior High teacher. It was time to move again.

My wife was not enthusiastic about moving, yet again. She had a five-minute commute and suggested that we put up a sign on the front lawn that pointed to our neighbor's house that said, "The teacher lives here". That may have solved the graffiti, but not the noise and traffic. I desperately wanted the quiet of the country and a few acres in which to putter. Mindless, purposeful puttering is important to men.

I found a wonderful house on three acres with an unobstructed view that extended hundreds of miles. It had just been reduced in price and it needed some puttering. My wife didn't even want to go see it, but she did. Much to her predetermined stance that she would not like it, she loved it. So, we moved.

Although we have debrided much of our things over the years, a vacuum was obviously created. I think we now have more stuff than ever before. I even had to build another garage to store it. Another move would be out of the question. I suspect my last move will be to the grave. When that day comes, I want to be cremated, put in a file box, and placed on one of my garage shelves, so someone else will have to move me...someday.

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Technorati Tags: moving, change, home, office