Monday, March 30, 2009

Bad Match

He was a frumpy-looking dour middle-aged guy with a gray sack of those freebie newspapers that are all advertisements, going from house to house, tossing the things onto the doorsteps of each. We were walking the dogs.

I had been listening to Sunday Baroque and sipping coffee. They had begun to broadcast a recording of Bach's d-minor keyboard concerto. Great stuff, but I've heard it many times. I have several recordings, and I once even heard it performed live by the late great Igor Kipnis.

Some music just gets into my ears and stays there and I can carry it along with me. So that was was a good time to walk the dogs. The morning was young and beautiful. But the paper-delivery guy was not so. Definitely not.

A man opened his door to collect the paper deposited there. He then yelled out to the deliverer "You know, some people would call that littering."

For a moment I thought he was ribbing the other guy, the one tossing the newspapers. But the energy between the two men wasn't one of playfulness. No. It was fucked up.

Bag-man yelled "What?" and the guy from the house reiterated "I call this littering."

Bag-man replied "Well I call it work," and for emphasis he spelled it out, loudly, "W-O-R-K," the letters resounding throughout the morning air, floating above like psychedelic Peter Max style bulletins, only instead of being colorful and fun, they were drab and leaden.

Grown men delivering papers on a weekend morning. That used to be a job for boys on bicycles.

Bag-man later got into his dirty old car which had been parked at the end of our usually quiet block. The wheels had no hubcaps. And they didn't match.

Friday, March 27, 2009

Decorative Grate

Links in comments

Tuesday, March 24, 2009

Twigs Both Thick and Thin

Repo Man:

Otto: "Lobotomy? Isn't that for loonies?"

Parnell: "Not at all. Friend of mine had one. Designer of the neutron bomb. You ever hear of the neutron bomb? Destroys people - leaves buildings standing. Fits in a suitcase. It's so small, no one knows it's there until - BLAMMO. Eyes melt, skin explodes, everybody dead. So immoral, working on the thing can drive you mad. That's what happened to this friend of mine. So he had a lobotomy. Now he's well again."

Revolutionary war statesman James Otis:

"My dear sister, I hope, when God Almighty in his righteous providence shall take me out of time into eternity, that it will be by a flash of lightning."

In 1778 Otis was standing on his front steps looking at the rain when he was struck and killed by a bolt of lightning.

Ann Coulter:

"Anorexics never have boyfriends. ... That's one way to know you don't have anorexia: if you have a boyfriend."

That could be a confession.


"Three o'clock is always too late or too early for anything you want to do."


"If we knew what it was we were doing, it would not be called research, would it?"

Wednesday, March 18, 2009

Everybody Should Have Goals

If you are walking down the street and you see people waiting in a line, join it.

Listen to your pets. They have been thinking a lot and they have formed essential opinions about many things.

If you have a favorite recipe for a savory meal, change it to sweet. Or the other way around. Sweet to savory.

Go north.

Collect pebbles. Or new words. I made up a new word once: tagerectaphobia, which is the fear of having the tag inside the back of your shirt collar sticking up in an embarrassing manner so you keep checking on it to push it back down.

Saturday, March 14, 2009

Just A Few Minutes

These Hohokam petroglyphs, quite typical for those found in the Phoenix area, are located on a low flat knoll off the northeast shoulder of Lookout Mountain. We stumbled across them while hiking Friday. I suspect that astronomical alignments are indicated here. I'll have to go back there this summer to check it out.

A line drawn from the circle figure through the sun glyph might indicate solstice sunset; it seems to point in that direction generally. Of course these markings could also be just decorative.

Tuesday, March 10, 2009

Twenty Minutes

Dani walked up the hallway to the desk and told me that the patient in room 10 wanted to leave "against medical advice."

"You mean the chest pain guy with the GI bleed?" I asked.

"Yes," she said, "He doesn't want the tests."

"But his cardiolyte [stress test] was positive and he's got an active bleed," I said.

"Maybe you could talk to him, shrimplate," said Dani, but I had a feeling it was a lost cause. The patient was a little belligerent when he came up yesterday. All he did was complain.

For example, he said that he wanted to eat but refused his insulin because his blood sugar was only 290 and that "wasn't high for him." And he was using 70/30 insulin at home on some kind of weird sliding-scale, the way people use Novolog or regular insulin. The doctors here had ordered a regular insulin sliding scale but the patient wouldn't have anything to do with that. He said that it would "kill him."

I had talked to him then and figured out at least what he did at home; though I didn't agree with it, it made sense to him and we managed to get that one issue temporarily out of the way.

Today, he wanted to go home because he was "all through with us." Hmmmm....

Abnormal stress test.
Bloody stool.
Poorly controlled diabetes.

Sounded to me like he was just beginning: A long, slow, expensive spiral into further hospitalizations, heart failure, renal failure, and eventually a miserable death.

I explained that the cardiologist wanted to do a catheterization to fix the clogged blood vessels in his heart, but we wanted to first make sure he wasn't losing blood from an ulcer in his digestive tract.

See how simple that is? Just one little sentence. Does that make any sense to you? It does to me. I couldn't make it any plainer than that. We'd have him patched up and in a day or two he'd be just like new. New for him anyway, whatever that's worth.

The patient scoffed and said that I was talking down to him. "I didn't get to be 68 years old without knowing what's going on with me," he coughed out.

"So then, what do you think is going on with your heart?" I asked, and that set him off even though I was using a polite tone of voice.

"Nothing!" he barked, pulling on his pants. He was dressing himself in street clothes as we had our little chat. He added that further testing would just stress him out and his body couldn't take that. As if internal bleeding and cardiac ischemia provided his body with pleasant rest and relaxation. Oh well. That gave me what I needed to chart on him leaving AMA.

Then the GI resident came in; she asked me to leave so that she could talk with him. I said that I just wanted to ensure that the patient was making an "informed decision," and she asked me to leave again. I went to get the against-medical-advice form for him to sign.

I returned and set the paper on the bedside table between them. He looked up and said "what's this?" and I just replied "It's for you." The resident said that I could finish talking with him in a moment and I said that I was all done.

He left twenty minutes later.

That was yesterday. Chances are pretty good that he's had recurrent chest pain since then. It doesn't go away untreated. It just eventually gets worse. He's probably in another hospital. Maybe right now, as I write, he's pulling on his pants again.

Sunday, March 08, 2009

At Twenty Paces Turn and Fire

Janacek is getting busy!

Saturday, March 07, 2009

Not Even Curly

Just Moira.

Friday, March 06, 2009

Wide Screen Domestic Battleground

Soprano Patricia Petibon
Bach organ tablature manuscript
Jesse Owens 1936 Olympics

Wednesday, March 04, 2009

A Cover of Coots

Life is short. Work is long. Time is long, too; infinitely so. But it's always running out. There's never enough of it.

I'm rarely in the mood to appreciate that. It royally pisses me off, actually.

Cats, unlike dogs, do not wag their tails because they are happy to see you. On the rare occasions when they do so, it's because they are smarter than you.

You can't see around corners, at least not without using a mirror. But with practice you can learn to hear around corners.

Everybody knows what the outside of the Sydney Opera House looks like, but not many would recognize a picture of its interior. I probably wouldn't.

There are never no more questions.

Like humans, birds tend to name their songs.

Sunday, March 01, 2009

Bow Down

Queen Moira, slayer of all things beyond the walls. All Hail!

Would You Like a Moment?

Dani is from England and she is working here as a registry nurse. I first met her while I was on staff at another area hospital. I've known her for years. She's very knowledgable and funny, and she has her nursing chops down.

"So Dani, we were driving home from shopping the other day when we pulled up behind an SUV that had this weird license plate. It just had "96" on it. Some lady was driving it, " I said to her.

Sometimes I'll have these little "drive-by" conversations as I'm passing through the nursing station, the medication room, or wherever. My hands will be busy doing something- pulling a chart and transcribing orders, pulling meds, putting out a page to a doctor, but that leaves the mouth free for a moment of talk with coworkers.

"Just the two numbers?" Dani asked, and I confirmed.

"Maybe it's an Irish sexual position," she said, and I laughed out loud. I set them up, and she brings them home.

Carpopenaeus callirostris