Willo Weep For Me

Older homes in historical neighborhoods can be architecturally attractive but are small, often come with repair issues involving plumbing and electrical wiring, and have become quite expensive.

"We put a lot into our home, but we feel confident it will sell," said Erin Benn, who with her husband, Jay, has listed a home in the historic Willo district for $335,000. They are moving to a bigger one in north Phoenix. "The run-up in home values have given us more options."

I like the Willo district. The streets are quiet and narrow, it's close to downtown work and shopping, the architecture of the homes is generally pleasing, the foliage is mature, and My Florist Cafe is just down on the corner.

We chose a home somewhat to the north. First we picked a school district, then after that roamed until we found a suitable dwelling.

Someday I will tell you all about my own home.

We probably could not afford to buy it at today's prices, and the historical district homes command far greater costs now. We were lucky to get in a few years ago before prices really exploded here. People like Erin, above, probably feel that they can get a much bigger home in one of the outlying areas of new development that surround greater Phoenix like distant asteroid belts, as James Howard Kunstler would say. So, like Erin, people are selling and moving.

"Barbara Parsons just wanted a bigger, cheaper house when she moved south of Queen Creek to Pinal County.

For her 42-mile one-way trip to work, she rises at 3:30 a.m. to hit the driveway by 5:30 a.m. at the latest for a "somewhat safe drive." Three hours a day trapped in her car battling one of the worst intersections, where Hunt Highway meets Ellsworth Road, has her considering moving closer to the metro area's core."

The situation that Barbara finds herself in is just the situation that Erin will sell her home to then aquire. Maybe they can just trade houses.

To continue from Carl Holcombe's January 22nd article:

"It will likely only get worse as huge planned subdivisions such as Anthem in Florence push Pinal County's current population of about 277,000 to 2 million in the next 20 years."

Actually, it will likely get worse than worse.

Let's do a little simple math with a hypothetical scenario. Assume a 42-mile commute each way, and two wage-earners making this kind of daily trip. Also assume that they drive large red-white-and-blue blooded SUV's which average about 14 miles-per-gallon. After all, a lot of commute time is spent idling or creeping along slowly, so that estimate is surely conservative, in the context of my scenario and argument.

So the two commutes consume 12 gallons of gas daily, not counting weekend trips and additional mileage for sidetracking off to soccer fields, stores, and the like.

Just today I drove by a station posting $2.48 for the low-test stuff. But let's suppose our couple has tanked up for a better price. Plug $2.40 per gallon into the equation.

Between two such people they spend $28.80 a day on gas going to and from work alone. That's $144 per week, or $576 a month.

But they saved a lot of money on their mortgage by getting a new home in Blandthem, so their mortgage is only about $1200 a month instead of the $1800 per month they were paying on their little remodeled $300K dollhouse in Willo.

Now we look into the crystal ball of Peak Oil where we clearly see that gasoline prices will continue to rise. In a few short years, unless mini-hybrid solar plastic automobiles replace their SUV's, the theoretical couple could be paying as much to fuel their commutes as they do on their mortgage.

Of course, the people of Pinal County have foreseen this problem coming for years now and have planned accordingly.

Poestenkill Question

Because this is such an old story, I cannot find any links. If there are minor faults in the narrative I provide, it can be blamed on my memory. As usual.

A young woman of highschool age was being routinely molested by her father or step-father, and it may have been established that he was raping a younger sister too. Same old story. Happens every day. Somewhere in this great land of ours, this is unfortunately probably happening right now; as you read, and as I type.

But in this story the abuse is ended. The abuser had pulled the car into the garage, but passed out behind the steering wheel sleeping off a binge. Dawn Cruickshank, the girl, got the family shotgun and went to the garage, where she confronted him and then blew him away.

I think she got twenty years in one of New York State's dismal prisons. She's probably been out of jail for some time now. She was a hero to many, a tragic figure to all.

I used to wake up at 6 o'clock in the morning when the local classical radio station began broadcasting, and I would read the Albany Times Union before riding off to highschool. Now with computers I can still read at least portions of my old newspaper-on-the-doorstep every morning again.

The Times-Union followed Dawn's trial closely.

Another infamous story from that place and era involved the Schenectady Police, who had arrested a woman whose torso was only partially covered. She had either been drinking or she was one of Schenectady's working women. As General Electric downsized and outsourced work way back then, people joked that prostitution had become Schenectady's second largest industry. Running drugs was considered the first.

The police didn't give her anything to cover up with, which was bad enough, but then one of them entered her cell and forced her to fellate him. She did not swallow his discharge. Instead she spit the spermatazoa into a folded paper cup and kept it. I think she summoned the jail chaplain and then told him what had happened, leading to the arrest of the officer.

This evidence and subsequent trial rocked the police department there. The offending officer went to an upstate prison for about eight years, the police force collapsed in corruption, and eventually even the mayor was forced to resign.

All that was very good.

As is this little gem, from the Letters section of today's TU:

Iraq being molded in America's image

First published: Friday, January 27, 2006

If we leave Iraq prematurely we might invite the rise of a president who would raise a large standing Army, squelch dissent, use intelligence services to spy on citizens, publicly "out" family members of those with whom he disagrees, torture those he captures, secretly try those his government accuses, invidiously discriminate against the poor, conspire with rich corporate interests, stack his country's highest court with judges who will yield to his will, and routinely invoke the name of the Almighty while doing so.

Who would want to live in such a country?

JONATHAN E. GRADESS

Poestenkill

Indeed. Good question.

Where to End It

Grosse Fugue by Beethoven, for string quartet played by the Quartetto Italiano. Blinding in its passion.

The Lamb Lies Down on Broadway by Genesis with Peter Gabriel.

The Grand Wazoo by Frank Zappa and a large group.

Horowitz Plays Rachmaninoff for his transcendent December 19th 1968 Carnegie Hall explosive performance of the B-flat minor Sonata.

O'Neal's Porch by the William Parker Quartet. Jazz is still this good. The best jazz you've probably never heard of. Piano-less quartet. Parker leads from the bass and talking drum.

Hear also Curves of Life by Steve Coleman and Five Elements. Jazz meets acid jazz in a 2+2+3+2 Bartockian riff with three rappers channeling the origins.

John Dunstable Sweet Harmony, Masses and Motets, Tonus Peregrinus group singing. Dunstable is the guy who decided 600 years ago to add 3rds to harmony. Which leads us directly to:

The Beatles "White Album." I used to have a vinyl copy of this that was stamped into white 12-inch. Sounded great.

Opera Proibita sung by Cecilia Bartoli. She's in great voice right now, the best mezzo ever, and she continues to explore rare repertoire that suits her amazing vocal flexibility.

Modern Music by BeBop Deluxe. Bill Nelson. Hear also The Love That Whirls. "October Man" features the best solo rock guitar stuff. Jimmy Page must lay awake at night wishing he'd played like that.

Jazz by Ry Cooder. Stuff from the 1920's reverently interpreted.

Poco with the oranges on the cover. God bless Ritchie Furay.

Pink Moon by Nick Drake.

Iberia by Isaac Albeniz, played by Alicia Delarrocha. She owns this stuff.

Yr by Steve Tibbetts. Recorded in his living room, but sounds like he recorded it live at Stonehenge during some cosmic guitar festival.

Washing Machine by Sonic Youth. Yes, they are getting old. Der.

Bameli Soy by M'Bilia Bel. Her voice "floats like gossamer." Afro-pop never gets better.

Anything by "Solace."

Del and the Boys by the Del McCoury Band.

Funeral by Arcade Fire.

Kambu Angels by Samite. I know his sister.

Stop Making Sense by The Talking Heads.

Geistliche Gesange by Hildegard Von Bingen, performed by "Sequentia." Barbara Thornton, who has unfortunately passed away from us due to breast cancer, was a wonderful singer of this 12-century music.

Bartok's String Quartets performed by the Emerson String Quartet. Frightening. Beautiful.

Enough for now.

shrimplate Moment Number Eleventy-Whatever-Three

The reviews were very good, the location was too convenient to ignore, and the weather was perfect, so after dropping off the Young One Who Can Hear Around Corners with a sitter, we stopped in for dinner. A three-piece with a singer was setting up on the outdoor area, a patio within the stores enclosing a retail/bistro outdoor square. Very cool, actually. A touch of the Mediterranean in Sonora.

The menu suggested martinis as preludes, and though I am somewhat naive, these seemed right. My spouse had Margos with fresh lime, as this is Southwestern cuisine. The singer did Gershwin and Van Morrison, while the threesome swung loosely behind her. I had a totally good osso bucco and the spouse tore into a great lobster tail and filet mignon combo with warm cilantro tortillas on the side. Nice meal, smart music.

I tipped the members of the band as we left, twenty bucks a piece. Inspired by the gin in the martinis, no doubt. The band leader thanked us and the singer, his daughter, asked us to come back to party with them later when the gig was up. Cool. Very appealing idea, I thought. Surely the kind of people I'd like to hang out with, anytime.

We didn't though. Instead we went shopping at one of those Danish European furniture places before we headed home.

Eighty bucks.

I tip well, but that was a bit over the top for me. I blamed it on my inability to stop at two martininininis. Number Three was the ringer. Serves me right for overdoing it. No wonder they invited us back later. They probably thought I had money or something.

The next day I went to Trader Joe's to get coffee and stuff. When I stepped out of my car my foot came up against a wad of cash. Five twenties. A cool one hundred. But when I went into Trader Joe's I just got the usual $3.99 Bay Blend that we always get.

You can't hang on to these things. So I wrote a check to the animal shelter and put it in the mail the next day. I was afraid to do otherwise. I needed to give them something anyways, as it had been a year since I last made them a donation.

Tamarindo

Any child born today in America should have the same health care insurance coverage as that of Karl Rove.

Why not? We can't afford this? But, we can afford Shock and Awe, so why can't we afford to cover tonsilectomies and measles here in Lubbock, in Springfield, and in Peoria?

Perhaps you know what kind of health care coverage Fred has. I do not. I haven't asked him, and I am not likely to. It's a boundry issue.

"There is no health care shortage, and the actual "Code Blue" is the individual failure of not making personal health care insurance a top priority, a failure that is aided and abetted by social welfare advocates. In other words, people have been conditioned to care about their health care needs, but not care enough to give up their toys and luxuries for them."

Man, that's harsh.

If you are an uncovered infant born into this world from an oncovered mother, the preganancy a product of incest, rape, or "bad choices," no matter to Fred. You see, people who have no healthcare coverage don't care enough to give up their toys and luxuries to obtain proper healthcare.

Fred is an interesting guy, I suppose; and I can only suppose, having never met him.

Didn't the Air Force provide health care for him, and now that he's retired, doesn't his insurance tab fall on the taxpayers? Like me? I'm a taxpayer. Aren't you, too? Funny that. I dunno. Maybe he has Pacificare. Whatever.

Let's start.

Well Fred, you're wrong. There is a healthcare shortage.

Firstly, we need nurses here. When he insists that there's no shortage, this defies reality in that regard. There also seems to currently be a shortage of doctors in this state. And hospital beds are also in short supply.

Retired healthcare administrator?

Oops.

So when Fred says "there is no healthcare shortage," he's blowing smoke out of his ass and up yours. How else can I say this? Tell me. Please. I'm a good listener. It's just plain nonsense. Nice word, that. Nonsense.

The point is, there is a shortage of healthcare here. Even if you've "made good choices" (as Fred probably thinks he has, no doubt he's not on a waiting list for any treatment at the VA at this time,) there are not enough nurses, doctors, and hospital beds available to accomodate him, master of good choices, let alone the rest of us mere mortals and our unfortunate offspring.

Fred goes on to wildly proclaim:

"Now, suppose the government (taxpayers) did provide health care for all who supposedly can't afford it. The result would be a financial and quality disaster."

Yeah, kinda like the way the government handles national defense. Total bloody hell. Freakin' disaster that, especially under Republican administrations. 9/11 under Bush. The Marines who died in Lebanon under Reagan's watch, in a vulnerable onshore hotel instead of offshore safely in a ship.

Sheesh. There's more, poor Sylvia. Can we bear it?

"The first thing we would see is huge increases in people who allegedly can't afford health care, greatly swelling the rolls and taxpayer cost.

• That's catastrophic enough, but likely exacerbating the calamity will be employers' incentive to terminate their health care plan contribution for employees, adding them to the public rolls.

You must understand that to Fred, the 40 million-plus people who currently have no healthcare coverage are invisible, and they will only become apparent if we decide to give them some sort of humane coverage.

What the duck?

It would be catastrophic for small businesses to find that their employees had coverage that came at no direct cost to their employer? Tell me, laundromat, retail, and gallery owners, that this would present to you a catastrophe. We all want to share this pain.

Fred offers further enlightenment:

"• There will never be enough money for public health care and pay increases, but government won't have any control over pay. Health care workers will strike to get more pay because they will have all the leverage. Health care would have to be cut (delayed or rationed) to meet worker salary demands."

Ah.

The Law of Supply and Demand.

What a bitch. Sheesh, I wish we could somehow artificially control healthcare costs by suppressing the earnings of those who provide it. Oh wait... been there, done that. That's one of the reasons we have a doctor shortage, actually. Funny that.

Scare word, scare word!

Socialism.

What that word really means, and this is the reason why people like Fred have been trained to be afraid of it, is democracy. We The People need healthcare, and our attempts to provide this for ourselves are of course socialistic. That's what government is for.

But for some reason, Fred and his ilk repackage this in fear:

"Contrary to socialist blather, any present health care Code Blue results from individual priority and choice. However, if we let the propagandists dupe us into socialized medicine, we'll all be screaming "Code Red" for health care."

Propagandists? How about realists. These are the people crying out and working for change.

Mango? Tamarindo? Pina-Pineapple? What flavor of kool-aid does Fred drink? Sheesh. I think maybe he drinks it all.

Is that mean?

Almost All the News

We all knew him, because he came in a few times a year. He was a chef, apparently of some repute, but I was unfamiliar with his cooking. He was polite, quiet, and he had good veins.

He had been with us a couple few days already this time around. Basically we gave him a lot of Demerol. Sickle-cell flare-ups are said to be very painful so the doctors had ordered fluids and 150mgs. of intravenous demerol to be given as needed every two to three hours.

Now we know.

Janelle, an older nurse who had worked there for years, brought the patient his lunch tray, and he had asked her for his pain medication. She gave it in the dose noted above and checked on him maybe ten minutes later before she herself went to the hospital cafeteria.

Dr. Andrews was telling people at the lunch table a story on me and my dog. I was jogging down the main street sidewalks the day before and had stopped at the news shop to check out the newspaper headlines. They always put up a rack of out-of-town papers like the Boston Globe, the Toronto Globe and Mail, the Sacramento Bee, and such. While I was comparing headlines my dog took a long hard wizz all over a bunch of papers on the lower rungs.

After gently cussing out my loyal jogging partner I gathered the steaming odorous newsprint and went into the shop, explaining that I had no cash on me and apologizing for my dog's political opinions. Dr. Andrews was there and he thought this was just totally hilarious, and he paid the shop-owner for all the papers my dog had soaked.

I had gone to the hospital cafeteria cashier and paid up for a week's worth of free lunches for Dr. Andrews for bailing me out that previous day, but he enjoyed the story and rubbing it into me for weeks after that. Janelle sat with us as he finished his retelling of the tale with his nerdy laugh, which was as unique and oddly charming as the classy little old-fashioned bow ties he wore.

A little while after I'd gone back up to work I saw Janelle outside the sickle-cell chef's door down the hall. I could tell just by the way she looked into the patient room, then dove in, that something was up, and seconds later they called a code.

What a mess. He had seized while eating his lunch, which was bad enough, but by the time we got through with him the room too was a disaster area. Janelle blamed herself entirely and Monique, the charge nurse, hauled her out of there.

Jack and I were "volunteered" to do the clean-up, because we were all caught up and could spend a little time away from our own assigned patients. If we had hurried we probably could have wiped up the food, vomit, and post-code garbage more quickly, but the longer we were in there the better. We stretched things out until shift change and Janelle went home without having to face the situation head-on again.

Coroner case. We bagged the patient with the endotracheal tube still in.

Janelle was better by the next day.

Demerol toxicity. The stuff is junk.

Things happen quickly in hospitals, and a day is as good as a year for those of us who work in these places. Whatever situation is presently at hand renders the day before to the distant past, so it seems.

And the hospital beds do not grow cold.

The elevator doors opened and I saw the sickle-cell chef's sister step out and walk toward his room. I called out to Jack to go get Janelle while I ran down the hall after the woman. She was already peering into the room at another patient; the patient who replaced her dead brother in that bed the day before.

Nobody had told her, so I did.

Chinese Cherry

You hear stories, and a couple years ago a nurse who then worked in a well-regarded east valley hospital told me about a cardiac patient in their emergency room.

They gave the patient aspirin and started a nitroglycerine intravenous infusion, which reduced the patient's chest pain. Then, because they needed the room in the E.R., they sent the patient back out to sit in the lobby, there to presumably either wait for a hospital bed in an intensive care or telemetry unit, or to infarct completely and code in a chair.

Lately Rebecca has been doing a good job of regularly demolishing the not-so-brilliant letters-to-the-editor often gracing the Arizona Republic. We must commend her for taking on such a task, and doing it well. I also personally thank her for apparently saving this one for me. So writes Bob from Prescott Valley:

"Regarding "Code blue for health care" (Republic, Jan. 4):

I find it hard to believe that 81 percent of 602 registered voters polled want universal health care."

I don't.

What's really hard to believe is that so many people still relish the idea of paying exhorbitant insurance premiums, skewed upwards by the fact that those must cover not just the insured and his family, but care for all those who remain without the blessed grace of high insurance costs: 45 million uninsured fellow Americans.

Let us remember that your premiums pay me to care for the uninsured as well as you.

"Are they ignorant of what has transpired in Canada and Great Britain since they instituted health care provided by the government? I have read about the waiting lists for heart surgery and other necessary operations. Also, research and development are stifled by lack of competition. "

Well, for elective surgeries, people wait a little here in the States, too. And if you don't have insurance at all, are you on a waiting list? Not here. But in Canada you are. Unless it's an emergent situation, then surgery is performed immediately. And it's paid for. Free. Ha-ha. Free.

"In British Columbia, more than 400,000 hospital-based surgeries and treatments are performed each year. If you need surgery or treatment that is not an emergency, you will be placed on a wait list. An individual who needs emergency surgery does not go on a waitlist; they receive treatment without delay."

So while you are sitting in a local emergency room, titrating your tridil drip yourself to reduce chest pain and maintain a systolic blood pressure of at least 90, you can kill some time waiting for a hospital bed by reading about Wait Times in Canada by clicking on the link.

Carping about wait times for surgery is ridiculous in light of the millions of uninsured here for whom the only waiting list is the one we are all on: to heaven's gates, with a stop at the E.R. to run up a bill first.

The issue is a canard, and has been debunked many times over, but Rush and rest of the well-insured propaganda slime machine bobble-heads keep repeating the same nonsense anyways, so no wonder the poor guy who wrote this LTTE finds himself repeating it. That's what happens when you drink the kool-aid.

I should stop saying that. I used to really like kool-aid when I was a kid. Now we drink seltzer. Hardly as nostalgic, but sucrose-free.

The letter-writer goes on to spout more parroted lies and untruths:

"We have to quit looking for the government to provide for our needs from cradle to grave. We know from recent history that the government cannot do these kinds of things without making them more expensive."

What a hoot! Of course if we turn over American healthcare to Halliburton through a no-bid government contract then the costs will be even more astronomic, but that will never happen because sick people have no large reserves of petroleum.

The opposite of what the letter claims is really true: Medicare overhead and administrative costs are far lower than what is found in the private insurance industry. Here is a typical article outlining the real numbers.

"Currently, Medicare incurs only 2% for administrative costs and does not need to advertise or pay commissions. According to Bernstein, private insurance spends considerably more on advertising and management. Administrative costs run as high as 30% because providers and insurers have to employ large staffs to cope with thousands of different plans for billions of billings a year. Similarly, federal and state public needs-tested programs must determine whether applicants meet the different programs' eligibility criteria, and these administrative costs run about 7% above Medicare's."

I thought everybody knew that.

From that same article comes this in the next paragraph, and perhaps it explains why so many of the people in that poll say they want universal healthcare:

"Medicare-for-All would eliminate the need to ascertain eligibility for billions of billings," Bernstein says. "Shifting employer, federal and state funds already earmarked for medical care to the new plan would provide huge savings and coverage for the uninsured."

The article also goes on to note that if healthcare were universal here, even your automobile and home insurance premiums would go down, because you would no longer need liability insurance medical care coverage. I'll bet the letter-writer had too much Rush-slush in his head to think of that.

Do the math, Bob, and try Google. And for pete's sake, stop drinking that kool-aid. It rots the brain.

What We're Not At

Below is a critical excerpt. I like to keep the whole thing bookmarked here. I have a paperback copy that I keep handy, and I've also downloaded it to my PDA.

You never know when it might be useful.

"Section 8 - Powers of Congress

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

To borrow money on the credit of the United States;

To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;

To establish an uniform Rule of Naturalization, and uniform Laws on the subject of Bankruptcies throughout the United States;

To coin Money, regulate the Value thereof, and of foreign Coin, and fix the Standard of Weights and Measures;

To provide for the Punishment of counterfeiting the Securities and current Coin of the United States;

To establish Post Offices and Post Roads;

To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries;

To constitute Tribunals inferior to the supreme Court;

To define and punish Piracies and Felonies committed on the high Seas, and Offenses against the Law of Nations;

To declare War, grant Letters of Marque and Reprisal, and make Rules concerning Captures on Land and Water;

To raise and support Armies, but no Appropriation of Money to that Use shall be for a longer Term than two Years;

To provide and maintain a Navy;

To make Rules for the Government and Regulation of the land and naval Forces;

To provide for calling forth the Militia to execute the Laws of the Union, suppress Insurrections and repel Invasions;

To provide for organizing, arming, and disciplining the Militia, and for governing such Part of them as may be employed in the Service of the United States, reserving to the States respectively, the Appointment of the Officers, and the Authority of training the Militia according to the discipline prescribed by Congress;

To exercise exclusive Legislation in all Cases whatsoever, over such District (not exceeding ten Miles square) as may, by Cession of particular States, and the acceptance of Congress, become the Seat of the Government of the United States, and to exercise like Authority over all Places purchased by the Consent of the Legislature of the State in which the Same shall be, for the Erection of Forts, Magazines, Arsenals, dock-Yards, and other needful Buildings; And

To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof."

So simple, really. I marvel at the clarity and essence of the language finalized by those that conjured this document.

That's one of the reasons why I decided to post it today. Also, it's not the most popular section of the Constitution. It certainly gets less face-time than the Bill of Rights, which is of course the "prom queen" of the Constitution. So let us feature it today.

I must also comment that I see absolutely no biblical heritage evident in the words of Section 8. Often ones hears members of the political religious right (who I suspect are for more fundamentally right-wing than they are truly religious) claim that our laws are somehow all basically derived from Judeo-Christian precepts. I see nothing of that in Section 8. If you do, please tell me. No snark intended; I honestly just don't see it.

But my foremost reason for posting Section 8 is this: We are not at war. Congress may have authorized Bush to use military force against Iraq, but it has made no declaration of war.

Yeah, I know. Picky, picky.

Would be so hard for Bush to go to the sheep herd that we refer to as the Republican-led Congress and persuade them to declare war against, oh, I dunno, maybe Iran, or Syria, the Kennedy cousins, or a bunch of 4th graders from Lake Worth Florida? They'd just do it.

But they haven't.

So the next time one of your winger friends insists that we must trash all of our civil rights because "we're at war, you know," please politely remind them that such is not the case.

The 9/11 attacks did not change everything, despite frequent assertions otherwise. The Constitution remains the same. It is indeed an unfortunate sign of our present times that this reminder is constantly necessary.

Paper Sun

These were her present choices: Get clean, stay in a program so that a clean lifestyle could be documented, and then maybe with some luck and a lot of hard work she would get a new heart. Somebody else's.

Which she needs rather desperately. Ejection fraction of ten percent. Well, that depended on who you asked. Some people said it was only six percent. A tenth of normal.

Try driving to work in a tenth of your car. Try maybe this: Notre Dame takes the kickoff from USC, but with one-tenth the players.

She has one-tenth of a heart. Dobutamine does the rest.

Methamphetamine sucks. That's not the only thing, the heart weakness, because she still has that keen every-cell-in-her-body craving for crystal going again. Nothing else in her life, not her child's warmth, not the taste of Godiva chocolate, not her boyfriend's erotic caresses, will ever feel good at all. Only the draw of crystal will ever entice her to pleasure, of any kind, ever again for a very long time.

Yet her personality is not yet completely ruined. She's still herself.

Not a drug-seeking machine-whore, like the Washington talking heads we see nightly on Fox news and the other mainstream television channels. Talking heads that have somehow supplanted the humans; round speaking pixellated visages spouting off in two-dimensional propaganda festivals in between regular feedings. Hannity. Savage Wiener Dog. Man Coulter. Bat Boy Malkin. Scary bunch.

One can maintain a kind of hope for her yet, because it's not too late. She's still human and can maybe get over it someday.

Or, if she foregoes the program and lapses yet again, no new heart. No waiting up late for her daughter to return from her Senior Prom. Just that sour and frail connection, and an early death.

I am so looking forward to voting this year. Is it too early to send in my paper ballot?

The Mines

With no crystal ball at hand, I cannot claim to have any vision of the future. But certain things are certain.

Untreated progressive illnesses, by their very nature, will worsen. So President Bush will continue to escalate in his untreated and chronic alcoholism, even if he somehow manages to avoid the drink.

He has already elevated (escalated) himself above the Constitution, trashing the Fourth Amendment in the name of the War On Terriers. No need for warrants now. Warrants are now in fact a betrayal of imperial... oops., I meant to say, Presidential power.

More Constitutional protections will fall by the wayside. Quaint as these are. Hardly useful in The War, which has not been declared according to the very Constitution which now falls away like so many tourists before the December tsunami.

What will we have left?

Nothing. Nothing except the poetry of the soul of our nation.

"We, the people, must redeem
The land, the mines, the plants, the rivers.
The mountains and the endless plain--
All, all the stretch of these great green states--
And make America again!"

Langston Hughes.

Dona nobis pacem Langston.

From nothing something must be built

Thank you, Charles.

The mines. Damn it, he knew. Damn it, we all knew. What's next?

Don't Mention It

Once again, I am left asking why is it that the word is so unmentionable? It must have the power, like Tolkien's ring, to drive people absolutely out of their power-crazed minds. Because that is literally what it's all about. Power.

Not political power, not the power of the pen, not the sword, but just plain combustive power.

Gasoline.

That, and peak insanity.

In the Long Island Newsday newspaper, Raymond L. Keating writes about the great things that suburban sprawl has done for the people there, and he asks:

"But why is "sprawl" a dirty word? It shouldn't be. Sprawl is about people fulfilling the dream of owning land and a home. They work, save and borrow to reap the rewards of the suburbs, which combine many conveniences of the city with elements of rural life, including trees, gardens, grass and more space."

I spent my formative highschool years trapped in a suburban wasteland, and believe me, if it was a dream it was a bad one. Sure my family "owned land." I mowed its grass, raked its leaves, and shoveled snow from its paved driveway. I groomed the non-native plants that lined its narrow concrete walkways. Our pets eliminated their bowels there.

My father was a modern-day provincial Lord of the Manor. I was combination Groundskeeper, Carpenter, Stonemason, and Keeper of the Hounds.

But as kids we rarely played there. It wasn't big enough. We played in the open lot on the corner, until it was fenced in, and we played in the woods that separated us from the civilized world of the town nearby.

Later I put in a small garden and a canopy of grapes. People ran away from me when the zucchinis produced. Over-produced, for our household and circle of aquaintances. Some people put in pools, or had little areas for outdoor dining that were used maybe a couple-few times a year. Yards were really just unused outward displays of conspicuous waste. But everytime I mentioned that to my father, the brief conversation ended not with his enlightenment but with me mowing the lawn again.

I did not like it. I learned nothing from it except that its costs outweighed its benefits in our neighborhood microcosm. Despite the widely-held misconception that local families actually desired to retreat daily into their own little monad-like properties, we regularly carved out civic spaces in which we could be. That corner lot, the street, the distant town library, the distant park with its fabulous Depression-era architecture, tennis courts, and Victorian lawns and pools. Back in the day it was a trolley ride from town.

Keating spends a good deal of his article writing about "Sprawl, a Compact History," by Robert Bruegmann. You can look at an excerpt here. I've not read the book, as I just learned of it upon reading the Keating article. But like the Keating article, the excerpt makes no mention at all of gasoline.

That is what I find to be so strange.

Admittedly, Bruegmann mostly busies himself with the history of city expansion as it occured before automobiles infested the planet. As if that has anything to do with the post-World-War-II suburbanization of America. So the excerpt, by its design, does not much concern itself with petroleum-derived fuels as a factor in suburban growth. How convenient.

But the only reason I grew up in a suburb is because my father rather fancied the idea of living there as opposed to someplace closer to his work, which was then 30 miles away. And he didn't take a bus or train to get there and back. Suburbs are all about driving cars.

Keating goes on to write:

"After debunking most justifications for opposing sprawl, Bruegmann hits on three key driving forces behind the anti-sprawl movement: change, home values and aesthetics. Anti-sprawlers, as we see locally, have reactionary aversions to change, understand that limits on developing land boost existing home prices, and want their kind of planners to dictate living arrangements for others with "less taste and good sense." Indeed, much of the anti-sprawl effort focuses on using government to impose one group's preferences on others."

Incorrect. "Anti-sprawlers" are not averse to change. We are loudly crying for it, in fact. And we know, due to peak oil, that change will come regardless of our collective readiness for it. That's why we're screaming at the tops of our lungs.

Hear that sound? No? Oh well. I grow hoarse.

What Keating says about Bruegmann's second "key driving force behind the anti-sprawl movement" makes no sense at all to me. Land development itself, rather than limits imposed upon such, would seem to me to be boosting home and property prices very nicely. At least around here, where inner-city condominium prices typically break the seven-figure mark. Similar home square footage is much cheaper in the suburbs, which is a point that Bruegmann makes for their origin and justification to begin with. So I just don't get that one.

Maybe we anti-sprawlers do believe that we know better than corporate home-builders when it comes to civic planning. I don't know. Maybe we do, maybe we don't, but at least it should be up for discussion. Before gas prices go into double-digits.

You think?

Not After That

It wasn't the first time that I'd worked with this little girl. She came in several times a year, around holidays when school was out, but not always. Her mother would accompany her, as did her younger sister, who was about half the age of the girl herself. She was maybe twelve years old then when I last worked with her.

Her sister was about six but suffered a developmental delay. She had a little PEG tube in her belly because she could not swallow. She also could not walk and she was small for her age despite chubbiness. They wheeled her about in a baby jogger.

We used to have a really nice baby jogger for our little one, but at about age four she was too big and she could outrun us, anyways, so we gave it to a neighbor.

This twelve-year-old always came in with the same complaints. Stomach upset and vomiting, her mother would say. I asked the girl if she had been sick a lot and she would say "I don't know."

"Any pain?" I'd ask her and she would reply "No, not really."

Dr. Fisher, the general surgeon, decided we needed to put down a nasogastric tube to see if there was anything interesting in her stomach. I had started an IV on the girl and she took that very well, tiresome and uncomfortable as that was for her. Dr. Fisher decided to stay around and help put down the little 12-French tube, all the while silent as a stone in moonlight.

He didn't talk much. I was used to this, but the mother of the girl had a thousand questions. Not spoken questions, but the kind of questions that you can see on a person's face.

We inserted the tube and I knew the placement was okay because we could easily aspirate a little nice green bile stomach contents from it, and it auscultated appropriately for position. On behalf of the mother, I asked Dr. Fisher "what is that?" and he replied with one word: "Fluid," which did nothing really to allay the mother's concerns. I wanted to ask him if he could be just a little more vague.

We ran tests, did abdominal films and an ultrasound, and a day or two later the girl would feel better and we would send her home. Happened every time. We'd find nothing really wrong, but a few weeks or months later they would come to the hospital again.

I would ask her if she was sick again and she'd say, "I don't know," or "not really" but her mother would affirm that she had been vomiting at home and maybe at school, too. The little sister would sit in her baby jogger sucking on a pacifier. We would do bloodwork and films again, hold her for a day or two of IV fluids, then send her home again.

Then it happened.

This time it was her younger sister that was sick. Fever, vomiting, dehydration. Poor little sweetie. We had her bedded down quietly in the intensive care unit. At 2 a.m. she developed some respiratory distress and we suctioned her and called the doctors. Then her color turned dusky and she got sweaty but cool. Her blood pressures went down.

When the doctors arrived we were coding her and hanging fluids and calculating vasopressors for her slight weight. The E.R doctor had difficulty intubating her. Due to her developmental idiosyncracies, her airway was crooked. But the vascular surgeon Dr. Riley, who just happened to be up, got one in quickly enough. Not that it did much good.

We never got her pressures back up, and her blood gases were crappy, and eventually her rhythm decayed. It was a long code. One of the other nurses had called her family. When they all arrived, mother, father (it was the first time, over all the years, that I had met him,) and sister, it was approaching 3 a.m. and we were going at it tongs and hammers.

The attending doctor stepped away and talked to the parents while the surgeon, the E.R. doctor and all the rest of us bagged and pumped and gave drugs. It came to a moment when I asked if they wanted more epinephrine and the doctors said "no."

I heard the mother sobbing, and one of the other nurses cried along with her. Through the windows out into the main part of the unit I saw the older sister clinging to her crumbling parents. We quickly cleaned everything up. I left the room while they entered to say good bye for the last time.

After they all left and we had taken the girl out, we spent the last couple hours of the shift in an exhausted fog. I went home and slept for a while but I was awoken by the sound of rain around noon so I did laundry.

The older sister never came to the hospital again after that. Once in a while I would see them at the grocery store or the library, and we'd exchange hellos.

Every Two Hours

Once he looked me straight in the eye and raised his right hand to give me The One-Fingered Salute. "Hey!" I said, "I gave you pain medicine, didn't I?!" before turning and positioning him.

He was a big dude, over 350 pounds I guess, because he wouldn't fit in our scanner, but if I yanked on his waffle mattress I could cram a few pillows under one side of him just by myself without taking up the nursing assistant's time.

Less than 20 years old, he'd been a passenger in a rollover a little while back. He probably would have grown up (as if he wasn't "grown" enough already) to be an offensive lineman. But now he'd be lucky just to be able to someday sit up in a chair.

That wasn't practical right now, due to the external fixation of his left femur and tibia. Neat piece of hardware, that. Unfortunately the wounds around the pins cultured up oxacillin-resistant colonies of bacteria. And he had a vancomycin resistant enterrococcus strain, but that had subsided enough that the hospitalist gave me an order to pull out the rectal tube.

That was probably the nicest thing I've done for anybody since Christmas.

The hospitalist also let me take the telemetry monitor off the patient. He was tachycardic, probably due to low-grade fevers secondary to all the bugs roaming his body. He was on four different intravenous antibiotics, plus Diflucan through his PEG tube. It wasn't a cardiac problem. He probably never needed the telemetry at all.

Little things like that mean a lot. I always point these out to visiting family members, as signs of progress. One less tube, one less intervention, one more step towards the door out of there. It's visible, even if it doesn't represent a whole lot of progress really.

His visiting uncle, a wonderful man, would ask the patient to point to things. He couldn't talk and his damaged side was paralyzed due to the sub-arachnoid bleed he suffered in the accident. Sometimes the patient would indicate yes or no with finger gestures, so we knew there was somebody home, so to speak.

His uncle said "We're Catholic," and added that he "played drums for the Lord." He was wearing an AC/DC T-shirt.

Care for this patient was a little difficult due to his size, but very routine. I've mentioned this kind of thing before. Turn and position, run the antibiotics, medications and feedings through the tube, a little hygiene, and repeat every couple hours. Pin care, mouth care, change the Tegasorb dressings on his buttocks bedsores (it takes three nurses to do that, two to hold him over and one to wash his backside and place the dressings.)

And I gave him pain meds once in a while, just because. He had hardware.

I always talked to him, a lot, maybe too much. That could be why he gave me the finger that one time, to get me to shut up. And I made sure there was something interesting on the television, music or something stimulating.

Anything to break up the routine.

Meme of Four

This has been going around and I was reluctant to do it myself, but Gail over at the ever-beautiful website The Arizona Eclectic Webzine has prompted me.

Four Jobs:

I was actually a pinboy in an old 6-lane manual bowling alley underneath bar or Moose Club something-or-other once for a few weekends in my college years. It was the most athletically demanding work I've ever done. My grandfather had done the same thing back in the 1920's. I vomited from exhaustion after my first night on that job.

For many summers I was an usher captain at a significant summer music festival, where I saw and heard the New York City Ballet and Philadelphia Orchestra many many times as well as rock concerts and jazz festivals. My best pre-career job.

Restaurant Guitarist- fun but less lucrative than dishwashing.

Various registered nurse jobs, med-surg, geriatric psych, general ICU, and my favorite: telemetry.

Four Movies I could watch again and again:

Citizen Kane for the depth-of-field camera work, Farinelli for its historical-piece beauty, Jesus of Montreal for its modern retelling of an old story, and of course Repo Man for its contributions to existential philosophy and classical dialogue.

Four Places I've lived:

Woodstock (my parents didn't let me go to the festival because I was only 11 or 12 years old,) but it was and still is a lovely mountain village. Saratoga Springs, probably one of the nicest "towns" ever, with beautiful people, architecture, and a great summer scene. It is no random fact that James Howard Kunstler chooses to live there. The Adirondack Mountains were equally beautiful but somewhat miserable weatherwise and economically/culturally. And the Valley of the Sun, where I've lived both once as a child and now as a bigger older child.

Four TV Shows I'd love to watch if the television were not dominated by the young one:

Nothing specific, Food TV, the home shows, comedy, occasional snippets of (gag me) news or movie-channel stuff.

Four Vacation Places I have liked:

Quebec City is probably the most beautiful city in North America, in the summer that is, with its ancient walls and streets, and Boston is nice although I've never really "vacationed" there except when running in April. California beaches are very hip. I could vacation forever in Santa Fe but I'd go broke in the galleries.

Four Websites I visit daily:

bartcop.com, Newslink, and Eschaton have been my regular stops for many years now, and Atrios' blogroll is something I pick from all the time. I visit all the sites on my own blogroll nearly daily, and browse several online newspapers via Newslink similarly. The first "local" website I began reading daily years ago (and still do) is the venerable Heller Mountain.

Four of my Favorite Foods:

Fusion, like the Mediterranian-Southwestern-Asian things are happening all over now. Ethiopian, sushi, India, and anything of the fair-trade, slow-cooked philosophy of cuisine.

I grew up in a steak-and-seafood restaurant in New York. In the spring, the boats would harvest shad out on the wide creek that fronted the establishment; diners could watch out the big bay windows as the fisherman brought the fresh catch up to the dock. Minutes later we would serve up the roe.

My mother cooked home-made Italian, Mexican, and Chinese way back in the days before there were food trends. The explosion of micro-brews, regional cooking styles, and "fusion" gourmet cooking is the happiest of modern American cultural developments. In the kitchen there's little distinction between Jews and Palestinians, blacks and whites, immigrants and natives. It's all family and friends in the kitchen.

Four Places I'd Rather Be:

This time of year, one of them is right here, in my lovely little home enjoying the Sonoran "winter" with my spouse and The Young One. But I wouldn't turn down opera tickets, or some ski-lift tickets, or a chance to participate in a groovy cooking class.

Thank you, GailOnline for getting me to think about this. It was fun. I'd really enjoy reading about others, too. If they haven't done so already, I wonder if Enviro Hanky, Just Deserts, or even the ever-drooling demented goofball behind the obvious parody LiberalismisaMentalDisorder (no link, just because) would care to share.

Pssst! Pass it on.

Did anybody else read about Narnia walking out on the World Trade Talks?! Thanks to Vern for getting this out locally.

The news services that fell for it seem to have scrubbed their mistakes. I wish the people who own and work the major news outlets were only smart enough to admit how stupid they can be. The world would be a much better place.

Fresh Coffee

Every spring there was a kind of minor population reversal that took place in the mountains. The locals, all screaming-bonkers with cabin fever, would head out for warmer climes, while vacationers would trickle into the bed-and-breakfast places and hotel resorts.

The lakes would have thawed well enough for boating and fishing, the trails just patchy with ice and snow could be hiked before bug season took hold, and the south-facing cliffs so prominant around there would attract early-season climbers.

Local doctors especially would take off, kids out of school, so the operating room did few electives. One surgeon, my very favorite Dr. Riley, always stayed around because he was from John Hopkins and life was slow and vacation-like for him here just about all the time.

It was a weeknight and there were only three patients in our little eight-bed intensive-care unit. I had a fresh carotid endarterectomy done by Dr. Riley, and she was having some of the usual blood-pressure concerns. I was watching her arterial line and giving her the occasional dose of hydralazine or labetolol.

Nikki had a vent patient with pneumonia who wasn't doing great, but hanging on well enough.

My other patient was riding his bicycle down the highway hill by town hall when a local drove by towing his fishing boat. The trailer hitch failed and the boat swung out and struck the bicyclist. He had a fractured pelvis and some other breaks, and he'd lost some blood so I was giving him transfusions. But he was basically okay. Okay for a bicyclist that got hit by a boat, that is.

Nikki and I cruised through the early evening hours of the night shift, chatting a lot about this and that. We had actually worked together at another hospital years earlier, when I was a nurse aide, so we often talked about those days.

Once in a while Jane, the night nurse supervisor, came through to see how we were doing and to tell us that the emergency room was as quiet as expected. That was good, because if we got loaded up with new arrivals there weren't any additional nurses to come in. People were out of town, and in that remote region there just were no such animals as agency nurses who could be called in if demand required more working bodies in nurse uniforms. We weren't much worried about it, though.

Janie called at about 10:30 to tell us that there was a crash and patients were coming in. A family of five from Canada had a head-on collision into a pickup with an elderly local couple in it. When they hit the ER she'd have a better idea of who would go where, but we could expect a little action.

A little action. In a few hours the unit would be full.

The father/driver smacked his chest into the steering column and his R-waves were tiny, plus the chest scan showed maybe a little tamponade so he needed to be monitored. There were three girls, a teen with a fractured clavicle and some bad cuts, a twelve-year-old who would need to be C-spine cleared but not until morning, and an eight-year-old with a broken arm and some bruising, also clavicular. They were all wearing their safety belts. You could tell from the bruises. Like stripes.

The mother had a nasty broken leg and enough blood loss to require monitoring. Nikki took the mother and the oldest girl, and I took the father and the two little ones. They weren't really "critical" but Janie thought it would be better to keep them with their parents.

Our little hospital had no pediatric unit. Just us. A kid shows up, and presto! You're a peds nurse. None of the floor nurses had taken a PALS course, probably anyways.

The husband and wife in the pickup died at the scene. They were unrestrained and they also had a bunch of unsecured stuff in the back of their truck. Like a chainsaw, some cut wood, and a plastic container of kerosene. The saw had smashed through the back window of the truck cab, and the kerosene tank had ruptured and its smell was all over.

There's no trauma like head trauma. It was probably pretty quick for them.

But it was a little rough on the squads that came out. They're all volunteers. People you see at the grocery store. People you buy furniture from. Not hard people.

We did our transfusions and gave pain meds and dealt with the shock of it all. The twelve-year-old kept asking me if "the police were going to take her dad away for killing those old people," and I just said "no, it was an accident." But Janie said he would probably be cited for some violation or other. Lane crossing.

The eight-year-old asked me to sign her arm cast.

The hours flew by. Nikki and I were exhausted, but doing okay, a little proud of our efforts really. This is my "once I had five patients assigned to me in the ICU so stop your whining" story. We sort of liked the stress of it all.

Morning approached. Time for coffee, but neither of us had drank much of the last pot, and it had been hours. The coffee at the bottom of the glass carafe had evaporated down to a syrupy brown sludge. I couldn't stop to make more because I was so busy going from patient to patient, and neither did Nikki, but she was desperate.

It was after 5 a.m. and she couldn't go on without an immediate caffeine fix. I was bleary, too, but I did not imagine what she did next. It was as real as the chair I'm sitting in right now.

Nikki ran the hot water from the sink, and swirled a little into the muddy bottom of the coffee carafe, reconstituting the remains. She poured this into a cup as I looked on, stunned.

"You're not going to do that," I said hopefully, and she said "Oh yeah, well just watch me!" and she stirred in some sugar and creamer.

The cup contents turned ashen gray, like some chalky volcanic drool. Then Nikki took a long hard drink of it.

"Not so bad," she said.

"Liar," I replied. Back to work.

Janie had persuaded a couple day shift nurses to come in a little early to help us out. We were so glad to see them come rolling in. We were tired and hungry. The first thing Anne did when she arrived was to put on a fresh pot of coffee.

She took a whiff from the carafe and said "Yuck, this stuff is disgusting. How old is this?" and I said that Nikki had just made it.

What Makes It

The car driver had smashed into him while he was motorcycling, circled around to view the damage, then sped away leaving the patient down on the street. The sharp ends of fragmented tibia and fibula sprouted like long nasty thorns from his pulpy lower leg.

Man, that is cold. I marvel at the meanness of so many people. I would think that eventually I would become numb to it all. After all, what that hit-and-run driver did was really no worse than what the Bush administration has done to New Orleans.

Recurrently bombarded with meanness. All of us. Daily.

But I do not go numb. Instead I am resolved, despite my inner sloth and zen-like moral indifference, to work. That, and play classical guitar music. We all need some kind of release, and I'm getting too long in the tooth for marathon running anymore.

It wasn't bad for a Friday that was to begin a holiday weekend. But then I walked into a room to announce that a patient had been formally discharged, as her repeat labwork was fine, when their spouse said that they had to get to their pharmacy by 5 p.m. closing or the patient wouldn't be able to get their Lovenox prescription filled. It was 4:50 by my Casio.

I rushed to call their pharmacy while the spouse hurried over there, only to find out when the pharmacist called back that the medication was not covered. The patient was your basic charity case who probably had been surviving on doctor's office medicine samples and mercy care for quite some time.

Trouble. This would be a hassle. Lovenox is so pricey that there was no way they could purchase it out-of-pocket.

The in-house on-call case manager didn't return my page, and when I tried to page the daytime case manager they also were unable to get back to me. The resident for this patient, one of my very favorite doctors, did take my calls even though he was out of the hospital.

In the midst of this 5-minute period of great hassledom, two of my other patients had called out for pain medications. The leg guy obviously needed this frequently and regularly. But I had just given him 6 milligrams of morphine 40 minutes ago. The other patient was known to be threatening to staff if he did not get what he wanted when he wanted it. I had been getting along with him perfectly well and I did not want to spoil that therapeutic relationship by holding him up on a little Dilaudid.

Busy times three.

Then the grand-daughter of my other patient down the hall came up to me, while I was on the phone with the resident about the foiled Lovenox, to tell me that "her grandfather had blood on his diaper."

Whoopee.

I followed her to the room to find him amongst a pile of bloody Attends and hospital pajamas. Though incontinent, he was fairly independent, but apparently he had pulled out his running intravenous line while freshening up. He'd had a bit of a stroke way back when, so his mentation was just a little off, too.

Four places to be, one nurse.

Blood.

I think when he bled all over the fresh brief and pajamas, he just put on another set, which subsequently got bloodied, and then he would change out to another set of briefs and clothing, only to have that get red and messy, too, not realizing that his arm continued to drip blood from the intravenous site.

He just kept changing clothes, probably for all of about ten minutes. But a little blood goes a long way, and as he moved his arm to pull up his clothing, the intravenous site pumped a little blood instead of clotting off.

There were probably four or five bloody briefs, bloody hospital gowns, and bloody pajama bottoms lying on the bathroom floor around him. Bloody towels and washclothes, too. His left side was painted red in blood from his chest down. Like I said, a little goes a long way, and a lot can happen in ten minutes.

All nurses know this feeling. Waiters and waitresses call it "in the weeds." A mad rush to be in four places at once.

Well, stopping the bleeding is usually a good place to start.

So I did that, then went to get a bunch of linen and IV supplies for Mr. Red. Another nurse offered to medicate one patient, while I mixed a cocktail for the other, then I cleaned up Mr. Red and got him tucked into bed.

The resident called in the meantime and gave me orders to hold the discharge on Lovenox lady, because without it she would be at risk for tossing a clot. She had a history of having done that before, hence her lack of toes on one foot. Both feet, actually, but it was just the one that had no toes at all.

I just now see some irony in these two particular problems: one patient bled while the other was a clot risk.

Sometime in this madcap half-hour I had lost my composure. I took the Lovenox lady's chart to the charge nurse, urgently explained the problem, and said that I didn't have time to address it immediately because these other little problems were "pissing me off."

She naturally offered to help, but I couldn't really expect her to sort it all out. She did help type up the discharge paperwork, but that turned out to be a waste as the patient ended up staying.

Another night in the hospital probably goes for a good grand. Half that would pay for the Lovenox she needed. Oh well. It's the best health care system in the world. That, and Halliburton is the best food provider on the planet.

Within the hour I had replaced Mr. Red's intravenous line and everything else slipped into place as the next shift started to trickle in. Pain under control for those two, Lovenox lady merrily ate her supper, dinnertime insulin coverage for everyone. Day three was coming at last to its end.

I saw Andre walking in, and went to give him a hug. I'd known him for years at work in another hospital. When I asked him how things were he said "not good" and I could see the moisture welling up in his eyes.

His significant other, with whom he'd been living for the better part of a decade, had just decided to leave him after he had spent time and money supporting her through school. He was taking this hard. We all would.

She was even seeing, among all the other people she was now rotating through her life, someone who worked here, and she was also a good friend of Mr. Pulp-Leg, and Andre feared she would come to visit him but with a new lover in tow. Not pretty, that.

And Andre then told me his doctors had just found a lung tumor, after he explored his developing shortness of breath. He was not told of its size, and he was worrisome about having to wait weeks for more follow-up diagnosis and treatment.

Plus, his ex-lover's sister had come to live with them, but after the break-up she had taken Andre's second car and a cell phone and disappeared into the big city swirling masses. $600 cell phone bill in Andre's name, then he had it turned off.

I had been having a good day until it all broke loose at 5 p.m. Then it fell together.

Andre had been having a good life until recently, but it is against all hope for it to resolve as easily as my piddly troubles did.

I do not go numb. I am humbled and chagrined at my break with composure in the face of self-pity and stress, but I remain resolved.

Never give up, even if everybody else does.

Andre and I talked, him tearfully, for a half-hour. That's eons in "nurse-time." Then he was called by his patients, interrupting us, and I finished up my documentation, leaving an hour-and-a-half after my shift ended.

Dudley Don't-Right

From his early business failures with Arbusto and Harkin, through his scandalous leap-frog admission to the Texas Air National Guard in which he protected the southwestern skies from Vietcong attack, to his failure to show up for a Guard required physical, on through his driving-while-intoxicated incidents, up to his Florida vote-counting fiasco, then his failure to protect our country from terrorist attacks even though he was expressly warned of just such hijackings, he has throughout these passings always been regularly rescued by powerful friends.

Now that he has assumed the most powerful political position in the world, he has no more friends who are more powerful than himself, and no one to rescue him from the jams in which he has put himself and our once-noble country.

I've said it before but I find myself saying it again: as an untreated alcoholic, he will worsen and escalate without required intervention. But as he has little, if any, insight into his problems, there will be no intervention, unless we the people remove him from power and see to it that he is properly institutionalized.

There is no other effective treatment for him.

He has imprisoned American citizens without due process of the law. He has trashed duly-made foreign treaties which by the Constitution are the law of our land. He has spied upon the private communications of Americans without regard for Constitutional protections and without warrant.

He has failed to protect out citizens on home soil from terrorist attacks, and he has failed to protect our servicepeople abroad from a difficult insurgency; an insurgency that he himself had a hand in creating, as it did not exist before he foolishly declared war on a weak and hardly threatening third-world secular dictatorship.

(I heard a kool-aid drinker on a radio call-in show a day or so ago who decried that "Saddam fired upon our planes that were enforcing the Iraq no-fly zones." And just how many of those planes were hit by this fire?

None.

Our planes bombed Iraq radar and anti-aircraft positions almost weekly, and never suffered from an Iraq strike. Some threat, that.)

He has failed to guard the economic surpluses built up by his competent predecessor, instead creating a deficit greater than the world has ever seen.

He failed to prevent the drowning of New Orleans, after failing to appoint even a remotely-qualified person to direct the agency that was supposed to manage such emergencies. The nation watched on television as the bodies floated by in the floodwaters and he himself clumsily held a supporter's guitar. He can't even do that right.

His failures continue to escalate. The brakes are off.

So what next?

More failures, more escalation, more disregard for our treasured Constitution.

Where will it end? Nuclear war? A total economic collapse? Martial law and the suspension of future elections?

These are this man's trajectories.

Who will come to the rescue?

Happy holidays!

Tree Link

Iris and Fern will show you how to set-up and properly maintain your Holiday Tree in Tree Decorating 101.

1001 Days

If it were a pole, it would be large enough so that somebody could run a big patriotic American flag up it. Sometimes people do so. But it isn't a pole, it's an eye-mote. A blindingly effective one.

A common theme fails to emerge from three recent items in the Arizona Republic. "Crucial freeways crippled," by editorial writer Kathleen Ingley appeared a couple weeks ago. In this she decries the gridlock that affects Valley highways, and she has some suggestions, such as "better planning," for managing this adjunct to sprawl.

"Nearly round-the-clock gridlock on I-17 and I-10 may be inevitable. But the economic toll would be so immense that we should pull out all the stops to avoid it.

Inevitable. Okay then.

As a counterpoint to Ingley's piece, James Hahn replied later with "New freeway will only lure more cars." His point of view is that gridlock is not only inevitable, it's a sign of "stability." More housing developments will require more highways to serve them, which will foster the growth of more sub-divisions, and around and around the Maypole this circle dance will continue to go, so to speak.

(snip) "The roads are bad and getting worse, true. But consider what would happen if they suddenly got better: Commuting and travel times would go down and it would become more attractive for new developments, more Anthems, to be built.

And once they are built, presto! Road conditions will degrade again as new residents fill the roads. Back to where we are now.

(snip)

Other forces must come into play to quell the growth. Perhaps it will be higher housing costs or the limits on water. But improving road conditions won't solve anything in the long term.

I think we are stuck in a stable system, and thy name is gridlock."

Other forces. Right.

And today, on the 1001st day of our latest Iraq war, we find the Robert Robb essay "False anxieties fueling new China syndrome." He argues that China's growth is nothing we need to fear, because at present their economy is really much smaller than ours and it will be some time before that country can compete against us as an equal. Even though we owe them a great deal of money.

"Even if China continues its current pace of growth it would only have an economy about a quarter the size of the United States' by 2025. China's ambition is to have per capita GDP in just the $3,000 range by mid-century.

To get even that far, China must overcome some fairly significant obstacles. Right now, China's economic growth is largely export-driven. To truly develop the domestic economy will require extensive liberalization and the establishment of a non-political rule of law. Right now, China ranks very low on the Index of Economic Freedom published by the Heritage Foundation and the Wall Street Journal."

Significant obstacles. Yuppers.

All three of these writers fail to address the one main thing that is at the heart of our issues of sprawl, highways, economic growth, and competiveness in world markets:

Gasoline. (Click for chart.)

We won't need more freeways to relieve the inefficiencies of gridlock, per Ms. Ingley, if the price of motor fuel becomes prohibitively expensive, but I do not think that Mr. Hahn was thinking about that exactly when he wrote of "other forces" that might adversely affect suburban growth. And Mr. Robb entirely ignores the real fuel that will power China's economic growth. Like every other modern economy, theirs will depend on cheap petroleum. They will compete very strongly against us as fellow customers for oil.

None of the three pieces I've cited above even mention the word "gasoline."

Well, Ms. Ingley touches upon the notion of using a "gas-tax" for something-or-other, but she ignores the term as it relates to fuel. The words "oil," "gasoline," and "petroleum," though, actually do not appear in these articles. Amazing.

I suppose most people, like these three, do not consider much that oil is a finite resource. Well, maybe James Howard Kunstler and a few other voices screaming from the concrete and blacktop jungles of peak-oil edge-city wilderness. (Here, shrimplate leaves the computer to perform a horrific minute-long lung-collapsing Yoko-scream, then returns to the keyboard.)

I did send a polite and very snark-free e-mail to Kathleen Ingley shortly after her editorial appeared, but I've gotten no reply from her.

"Dear Ms. Ingley,

Your recent editorial concerning valley highways was interesting and raised many important concerns, but you completely left out the most vital consideration:

Gasoline.

What will the traffic on our highways look like when the price of fuel goes up to $5 per gallon? Or $10 per gallon? Many people are already paying $5 to $10 for their daily commute. What will happen to edge-city development when that same commute costs $30 to $40 per day?

The era of cheap fuel will end someday. Perhaps quite soon. It would be prudent to consider planning for that inevitable day. Why aren't we?

Thank you for your time,

shrimplate"

Maybe she doesn't like being called "Ms."

Mirecki

Here's a photo of Kansas University Professor Mirecki before the beating, and in this you can see how good he looked shortly after he was ambushed by two alleged supporters of "Intelligent Design" being taught in schools.

The local sheriff's department is investigating.

He said he was not pleased with the sheriff’s investigation because he had been “treated more like a criminal than a victim.”

He said he was interviewed by officers several times, “once for five hours straight. They keep asking me the same things over and over. They seized my car; they entered my office and seized my computer. They said they need them for their investigation but it didn’t make any sense to me.”

Mirecki was going to teach a course at Kansas University that compared I.D. to other creation mythologies. He was the head of the department of Religious Studies there until recently. He still holds his tenured position as a professor, but he has "resigned" his chairmanship.

Mirecki had made some indelicate comments, under a pseudonym, to an online opinion board.

In the e-mail message to a listserv, Mirecki said of intelligent design: “The fundies want it all taught in a science class, but this will be a nice slap in their big fat face by teaching it as a religious studies class under the category ‘mythology.’ ” Mirecki said he was “doing my part” to upset “the religious right” and signed his posting “Evil Dr. P."

Of course, after being outed, which in itself is rather creepy, by a conservative gadfly bass-player with attention-deficit disorder, Mirecki apologized. But it had all really hit the fan by then. Then he got beat up. The university says they will continue with plans to offer the course, but Mirecki will not be teaching it.

His health insurance would probably drop his coverage if he did teach that class. It's Kansas, after all. Things happen there.

What We Mean When We Say Waste

We can all think of people, maybe we never knew them personally, who had great talent and potential and they just chucked it all by living very badly. Kurt Cobain was probably one such person. Robert Downey Jr. may yet snuff himself out, but so far he's proven he can outlast some of his problems.

One of my favorite examples of this type of person was Jaco Pastorius, bass guitarist for the seminal fusion-group Weather Report. He literally revolutionized the use of that instrument, changing it forever. Not too many people do things like that. But he succumbed to heroin and died violently, at too young an age.

"What a waste of life," people say.

Sometimes I get a pretty close look.

A short time ago this patient overdosed on methamphetamine, developed a hypertensive blood-pressure crisis, and with that a parenchymal bleed into the ventricles. There may have been a stabbing or a gunshot along with the overdose scenario.

Drugs and trauma. Oh, great.

The nice neurosurgeons put a hole in their skull and drained away that, but a lot of life got drained away with it. The patient had this wierd decerebate posturing with their left arm, preferring to hold it straight down their side with the fist turned outwards. They could move their right arm and leg some, always pulling at the tube that supplied air to their tracheostomy collar.

Their tongue deviated left.

Aphasic, but I did not know if that was global or just expressive, meaning: they could not talk, but did they understand what was being said in within their hearing? I hope not much.

Easy patient, really. Suction every couple of hours, turn and position, wipe up their crap, feed them through the PEG tube inserted into their stomache, dangling like a long, thin, latex umbilical cord. Come back later and repeat.

That's all there is for this person for the rest of their life. And they were young, as in not as old as I am. Not halfway through an average American lifespan.

Suction every couple of hours, turn and position, wipe up their crap, feed them through the PEG tube inserted into their stomache, dangling like a long, thin, latex umbilical cord. Come back later and repeat. Empty urinary catheter bag.

Suction every couple of hours, turn and position, wipe up their crap, feed them through the PEG tube inserted into their stomache, dangling like a long, thin, latex umbilical cord. Come back later and repeat.

Transfer patient to long-term-care facility, where they will spend their lives trapped in that looping paragraph, until a bad case of pneumonia or urosepsis finally kills them.

Aside from having to confront that gloomy existential abyss of a life on and off during the day, it was otherwise a pretty good shift. That's the horror of it. It's too easy.

All Doing Stuff

Wherever I am going and whatever I am doing, deep down inside I am really just Blackberrying.

  Blackberrying
 
Nobody in the lane, and nothing, nothing but blackberries,
Blackberries on either side, though on the right mainly,
A blackberry alley, going down in hooks, and a sea
Somewhere at the end of it, heaving. Blackberries
Big as the ball of my thumb, and dumb as eyes
Ebon in the hedges, fat
With blue-red juices. These they squander on my fingers.
I had not asked for such a blood sisterhood; they must love me.
They accommodate themselves to my milkbottle, flattening their sides.

Overhead go the choughs in black, cacophonous flocks ---
Bits of burnt paper wheeling in a blown sky.
Theirs is the only voice, protesting, protesting.
I do not think the sea will appear at all.
The high, green meadows are glowing, as if lit from within.
I come to one bush of berries so ripe it is a bush of flies,
Hanging their bluegreen bellies and their wing panes in a Chinese screen.
The honey-feast of the berries has stunned them; they believe in heaven.
One more hook, and the berries and bushes end.

The only thing to come now is the sea.
From between two hills a sudden wind funnels at me,
Slapping its phantom laundry in my face.
These hills are too green and sweet to have tasted salt.
I follow the sheep path between them. A last hook brings me
To the hills' northern face, and the face is orange rock
That looks out on nothing, nothing but a great space
Of white and pewter lights, and a din like silversmiths
Beating and beating at an intractable metal.

Sylvia Plath
23 September 1961

I just love the sound of that.

Snap Smack

Once in a while we will see a patient who has been fighting cancer and the pain that goes along with it. They don't come to people like me for that. But maybe they've had a little chest pain and we want to rule them out for an infarct.

If indeed their cardiac enzymes are negative and the echocardiogram and stress test results look okay, I guess you could say that they "outfarcted."

I didn't even walk into the room without dilaudid in hand. Early the first of my two lovely days with these people, we had the doses adjusted upwards. The spouse questioned every pill and injection I gave. I always came in with the meds in their little packages and opened these at bedside, naming and explaining each one.

The spouse always said that I could "just leave them there" and that they would "help" the patient take them, but since I suspected the spouse had the same kind of drug problems that the patient had, I always stayed and assured myself the pills were properly swallowed by the patient. Spousie had their own little stash of various pills and talked sometimes of their own stupifying pain issues and their heroic efforts in dealing with it.

We increased the MS Contin dose from 100mgs twice a day to three times a day. That amount of morphine, alone, would probably adequately sedate a classroom full of hormone-crazed junior highschool students for a day or two.

Let me try to give some idea of how I think morphine is typically dosed, very generally speaking:

If you are having a heart attack, 2 to 4 mgs of morphine (which dilates the cardiac arteries a little, too) usually eases the pain, in conjunction with aspirin and nitroglycerin, which in themselves are not pain medications. If you fall off the roof and get all trauma-like with broken bones and stuff, 10 to 15 mgs of morphine will help you deal with it enough to probably forget about it. I'm just guessing.

Spousie asked me to call the doctor to get that dosage increased every time I went into the room, armed as I was with only 4 mgs of intravenous dilaudid. That dose is likely to translate to maybe about 20 mgs of morphine, I would guess, as dilaudid is about the strongest stuff legally allowed in this country. Maybe Fentanyl is more concentrated. Heroin is not prescribable. I didn't bring it up. They had enough ideas of their own.

Every two hours, on the even hours, within a minute or two of the hour, I knocked on the door with my bundle of Dr. Roberts intravenous elixer. Half a minute late had spousie on the call system yelling at the secretary to get the nurse to their room immediately.

But wait... if you order now, you'll get the Ginsu knives.

Yes, also a complete set of anti-anxietals were prescribed. Klonopin 2 mgs and Xanax 2 mgs each every 8 hours, ("Keith Richards" amounts) with additional doses of Ativan occasionally ordered by the medical doctor, just so I could get spousie to shut up with their constant demands for more drugs for the ailing patient, I guess.

You don't always give medications to treat the patient. Sometimes you give it just to make their family shut up for awhile.

The patient had back and knee pain. Allegedly had a broken foot, too, according to spousie, but they still walked out to the patio to smoke regularly.

The neurosurgeons wanted to immediately excise an abscess (somehow I found time to give the patient intravenous and oral antibiotics, too,) and do a laminectomy, but the patient wanted to wait until they paid their rent. Otherwise they'd be too nervous for the surgery. It was all our fault for making them so nervous, and that made their pain worse, too.

Couldn't we see that?

Since they were from another state, they of course needed to finalize a rental apartment and get a new bank account here, too, so they needed to postpone surgery a few days for all that. Case Management arranged to have a bank clerk come to their room so a a local account could be set up.

The other state's health insurance did not cover their stay with us, naturally. I suspect they had come to our own fair city to avoid legal troubles in the Land of Arnold. They were told that if they continued to refuse the surgery we could arrange to transfer them to a hospital in their home state, a conversation which escalated into yelling and demands for increased pain medications and anti-anxietals, every time.

Spousie even called hospital management a few times, ranting on about how awful we all were for insisting on doing surgery that the patient both needed and wanted, just not today. First they had to have their medication doses increased.

On the one hand we wanted to kick them out for refusing non-elective surgery, but on the other hand, the patient needed it so it wouldn't be nice to do that. The patient and spousie "fired" a series of neurosurgeons, residents, nurses, and managers who tried to persuade them to do something besides sit in the hospital soaking up narcotics like a bog on a foggy day.

I just went in every two hours and delivered the dilaudid and then got the hell out of there, so they loved me. I was their best bud. They said they would write letters about me.

How nice.

Anyways, there are only about two ways you can get to tolerate taking these drugs at these doses: cancer with its often accompanying metastatic pain, and heroin or cocaine addiction.

The patient did not have cancer. Dying cancer patients usually don't need that much morphine, anyways. But then, they don't have this patient's problems.

Post-Carbon Patsy Cline

In my humble opinion:

No analysis. No examination of underlying facts. No consideration of the future. No anticipation of change.

That's the crux right there: No anticipation of change. Is that not the stupidest of all things? What, pray tell, could be more stupid? The word OIL is not even mentioned. Stupidity beyond my own imagination. I need help to be that stupid. No, even with help I am incapable. God knows they, the Goldwater Institute, have tried, but I still remain less stupid than they themselves, despite their grand efforts and media access. They try harder, admittedly. Credit where credit is due, as dad always said.

Nice office space, though. No link. Because they suck. Oh well. Too bad. But just for fun, here's an example of their think-tank product. It has to be seen to be believed, it's so granitic in its stupidity:

Sprawl is a dirty word in Phoenix these days. According to one Arizona Republic columnist, "Limiting sprawl and turning development back into our cities would go far to addressing a host of ills, including Balkanization and destructive competition."

(snip)

As the author notes, among the great cosmopolitan centers of the Western world, London's population density peaked in the early 19th century, Paris in the 1850s, and New York City in the early 1900s. Before and since then, expanding economies with increasing incomes have exhibited what I will call the inexorable centrifugal force of growth.

She does not mention oil at all. Not at all.

Nor does she specify "the author." It's a need-to-know basis kind of thing, I guess. Heck, it's a freaking newspaper, not a scholarly article. So who needs standards? Or even information? The print articles are just there to fill up space between store advertisements.

She later goes on, however, to cite the feckin' "invisible hand" of Adam Smith. Very impressive. Almost as impressive as "the inexhorable centrifugal force of growth." That's called "cancer" in the real world. And it kills and there is no cure. Oh well. Everybody dies sometime. Might as well die stupid.

Loser. Pathetic. I have to tell you, history has shown that Adam Smith's hands were plainly visible to all who knew him. Not invisible.

They weren't oily. Not much, anyways. Maybe that's why she fails to mention it. Or maybe she's an idiot.

What will happen to people who live in homes that are oversized and too far from their places of work when petroleum prices normalize according to the laws of supply and demand? Gas goes to $10 per gallon. Inevitable. It's a finite resource. Only a matter of a little time. After all, Bush basically doubled the price of gas in his few short years of economic demolition. And he's not done yet.

The cities of Europe developed suburbs when the locomotive and automobile made transportation quick and cheap. Those days are soon coming to an end. And just who, of all people, is the truest herald of the post-carbon cheap fuel age?

Patsy Cline.

"I Fall to Pieces" will well apply to suburban living soon.

Unable to afford the high prices of heating/cooling huge 3500-square-foot edge-city homes while commuting 45 miles per day, each, to and from work, two-job families will soon find the suburban lifestyle unsustainable. Their yards will not be big enough to grow the "victory gardens" they will need to supplement their food needs, due to the excessive cost of groceries as transportation costs multiply the prices at the local supermarkets. Supermarkets they can't afford to drive to frequently.

As Patsy Cline admonished us decades ago, many of us will soon be Walking. After midnight. To work, if there is any, and to stores, school, medical care, and other areas of social need, because driving will be prohibitively expensive.

Suburbs will die, and inner cities, as well as rural farms, will become the places where people eek out lives, jobs, and commerce. Cannondale stock may actually become listed on the NASDAQ again. If there even is a NASDAQ.

Maybe the Goldwater Institute can afford to pay people to be stupid, but I seriously doubt that we can base our entire future economy of that concept.

The House of What?

Non-representational art has always come easy to me. Since ever I was quite young I've liked the paintings of de Kooning, Jackson Pollack, and especially Kandinsky.

Our household will probably never be able to afford original artworks by any of those painters, but we do have some things like this painting, but by different elephant artists, for example. We also have things done by actual humans who are not even close relatives of ours.

Good and enjoyable art doesn't have to represent anything. It can be like music.

This aesthetic, however, does not at all apply in American politics.

I hereby proclaim that we call the House of Representative the House of Abstract Expressionists, especially in light of recent polls. Like this Harris survey taken a week or so ago.

This scientifically-conducted poll taken by one of this world's premier pollsters concludes that 63% of the Americans who were asked favor pulling our troops out of Iraq in the coming year.

Well, somebody, like Becca maybe, should set this winger straight:

"Congratulations to House Republicans and Arizona Rep. J.D. Hayworth for finally standing up and making the anti-war Democrats put up or shut up.

On Nov. 18, the Republicans forced the House to vote on a bill that simply said it is the consensus of the House that we immediately remove our troops from Iraq. It was very plain to see on C-SPAN that the Democrats were hopping mad to be forced to choose between their rhetoric and what is best for the country. They wanted this as an issue and did not really want a real solution, but the final vote was 403-3 to keep our troops in Iraq."

(Snip)

That is just so pitiful. Poor thing.

Hey, wait there just a dog-gone minute. Becca already did straighten out this issue, and in the same exact newspaper in which this guy had his letter printed, but hers was up the day before!

(Snip)

"To be accurate, the 403-3 votes were based on a wholly irresponsible and blatantly partisan GOP reinterpretation of Rep. John Murtha's remarks. That it came to such a shattering defeat says more about the GOP's ability to rewrite the views of Democrats in their own image than it does about the Democrats' ideas."

(Snip)

I guess the guy must have missed that.

He probably misses a lot of things. Like reality.

Anyways, a 403-3 vote. Sheesh. Just who are these people representing? I don't think they are "representing" anything. Certainly not the 63% of Americans who are currently maintaining their sanity.

Paintbrush-wielding elephants would be more responsive to the current political leanings of the American citizenry than either our own House or the people who write the loopy pro-Iraq-war letters to newspapers.