Saturday, June 30, 2007

Tell Me Now How Do I Feel

"Can't you see that she's in a great deal of pain?" the woman yelled at me. I had just gotten report and I had walked into the room to do a routine morning assessment. The woman's daughter, a mildly developmentally challenged young woman maybe about twenty years old, sat on the bed eating pancakes and flipped the channel changer for the television.

"Hi," I said to the young woman, ignoring the brick out-house-shaped screaming harpie for a moment. The girl gave me a timid half-smile. "I'm your nurse for today. How're you doing this morning?"

"OK," she said, and then she asked me if she could have some more syrup and I said that I'd go get some.

"Anything else while I'm out and about?" I asked with all the chirpiness I could manage, and her mother blared "Yes. Just go get that pain shot and forget about the syrup."

The girl wilted.

In a moment I came back with a few packets of syrup and a handful of morphine. I asked the young lady how bad it hurt and she said that it didn't hurt at all.

Then the mother yelled at me again. "None of you people care. You just won't give her any pain medicine because she's, well; she's retarded."

Then I registered shock. The patient was obviously a fully competent young adult, perhaps with a learning disorder, but certainly nothing that would keep her out of Hollywood, nor Washington D.C., nor any productive and fruitful modern American life. She was okay. And that was part of this bizarre problem.



Munchausen by Proxy Syndrome.

The mother was teutonic of stature and in another setting could have easily carried off a costume that included hubcaps for breastplates. She was big, loud, and in my face. All within seconds of my entrance. And no wonder she was so fiercely protective. That was part of the profile.

"Munchausen by proxy syndrome (MBPS) is one of the most harmful forms of child abuse. It is also perplexing. MBPS involves an apparent deeply caring mother who repeatedly fabricates symptoms or provokes actual illnesses in her helpless infant or child. MBPS was first described in 1977 by Meadow; since then more than 200 MBPS related articles have appeared, the majority being case descriptions. Understanding the dynamics of this disorder is of utmost importance because growing evidence indicates that it is more common than previously believed and it is devastating if not fatal for the children and infants. It is also important to mention the effects MBPS has on others who become involved in this cases, particularly nurses and physicians."

This had been going on for decades for this patient. It explained why the poor young woman had undergone numerous exploratory abdominal surgeries and so many hospitalizations in her mere two decades springing the mortal coil. Damn. This person very likely underwent many surgeries just because her mother was a nutcase. No underlying illnesses had ever been determined.

I told the mother that if the patient refused the pain medicine then I could not ethically administer it, and she exploded in dramatic rage. Fake, I thought. Scripted. A load.

The patient herself maintained a neutral emotional distance from the fireworks and she concentrated instead on her meal and morning television news.

I knocked on my boss's office door and explained the situation to her, and she indicated that she was well-aware of it all because it had played out many times before.

Did I tell you that I was floating to that unit that morning, and did I mention that the other nurses were all familiar with this Grendel-mother, and that they figured new meat was better than old meat concerning the assignation of a nurse for them that day? Actually I didn't mind at all.

This was back when I was working in a community hospital. I was friendly with many of the doctors there. Small town, small hospital, all that stuff.

I did not want to see this young woman undergo yet another laparoscopy just because her bitch mother was a lunatic, so my boss called in the medical director. A meeting was arranged with the patient and her mother, the surgeon, the family doctor, the medical director, the director of nursing, and a few other administrators who felt a need to be there. What else was there to do?

Thank goodness they left me out of it, because I was at work, after all, and others needed my tending.

Later I heard that during the meeting the mother had decided to remove her daughter from our institution against medical advice and that they'd left. The bed remained empty until the end of my shift and when I got home I cooked and listened to Blue Monday. Loud.

"I thought I was mistaken
I thought I heard your words
Tell me how do I feel
Tell me now how do I feel"


Now every time I think of that song; every single day, several times a day, I see that young woman crumple in my mind's eye as an echo of her insane mother's voice rattles my frame.

Fucking MBPS. I think I was witness to a very bad example of it. But at least I sent it. Not that much good came of it.

Explain In Your Own Words


Dan Frazier and his T-shirts have attracted the attention not only of the Arizona State Legislature but also the American Civil Liberties Union. I am a little surprised by this only because I am as yet unaware of any legal proceedings against Frazier stemming from his business and the new law meant to suppress it. It was my understanding that the ACLU was going to enter the fray only from the moment Frazier was actually charged under the freshly-minted statute.

Here is something from one of the best letters I've ever read in the usually execreble Arizona Republic:

"My heart went out the parent of the serviceman killed in Iraq who was enraged that a T-shirt maker would capitalize on the deaths of our sons and daughters in Iraq."

As does my own.

"We respond with horror when events like the Nazis marching in Skokie or the T-shirt guy capitalizing on our dead children come into our lives. We want to silence them.

But what makes us Americans is a principle much bigger and nobler and more important than either of those events. I just wish all of us - and our Legislature, which responded with a knee-jerk reaction - understood that better."
- Richard Marmor,Phoenix

You have probably seen late-night-television hosts in segments where they roam the streets asking random passers-by to point out Armenia on a map, to name their Senator (or any Senator for that matter,) or to comment on a snippet like The First Amendment, which is often then derided as "too liberal" by the unsuspecting citizens caught on video. I've seen shows in which Leno does such things and I've slapped my forehead purple in astonishment and laughter.

The members of the Arizona Legislature are probably just clever enough to recognize Constitutional phrases left intact, but I wonder how many of them would continue to approve of the Bill of Rights if they were presented with a version in modern language; words that carry the meaning of the Amendments but phrased differently from the original.

You can easily imagine how some of the Russells and Karens would be deeply offended by the sentiments expressed in their own governing principles.

"The Senators and Representatives before mentioned, and the Members of the several State Legislatures, and all executive and judicial Officers, both of the United States and of the several States, shall be bound by Oath or Affirmation, to support this Constitution; but no religious Test shall ever be required as a Qualification to any Office or public Trust under the United States."

After dialectization:

"Zee Seneturs und Representeteefes beffure-a menshuned, und zee Members ooff zee seferel Stete-a Legeesletoores, und ell ixecooteefe-a und joodeeciel Ooffffeecers, but ooff zee Uneeted Stetes und ooff zee seferel Stetes, shell be-a buoond by Ooet oor Effffurmeshun, tu sooppurt thees Cunsteetooshun; boot nu releegiuoos Test shell ifer be-a reqooured es a Qooeleefficeshun tu uny Ooffffeece-a oor poobleec Troost under zee Uneeted Stetes. Um gesh dee bork, bork!"

Friday, June 29, 2007

Swedish Chef - Meatballs

This is a great way to prepare a delicious meal while honing your tennis forehand.

Evaporative Cooling





Tuesday, June 26, 2007

"J" Friday

Hats off, gentlemen, a jenius. That's right. With a letter "j." It's mo'better that way.

In today's fishrag, E.J. Montini relates the sad story of a lone man up against the big guys, standing tall with nothing but the United States Constitution, quaint old snippet of parchment that it is, to defend him in his efforts to express his personal dissatisfaction with the Bush war against Iraq.

E.J.Montini. The "J" stands for "jenius."

This is a remarkable piece of writing, it is. Truth unvarnished by principle. The whole story uncolored by petty concerns about our little First Amendment thingie-thing. Solid reporting perfectly unhinged from any regard for values.

It's just so perfect.

Dan Frazier is an entrepreneur who Montini refers to as a "hyena." Frazier's main claim to fame is that he prints the names of soldiers killed in the Iraq war under the words "Bush Lied." On T-shirts. There are too many names for bumper stickers anymore.



Montini plays the story straight, just like a good little boy should. No patriotic appeals to free speech from this guy. Nope. He works for a newspaper. The biggest in the state. Forget about silly defenses of First Amendment rights from E.J.

That's not what he does. Just the facts, ma'am.



As absurd as this may sound to normal human beings such as you and me, E.J.'s article expresses no concern at all for the implications of this story. The Arizona Legislature passed a bill outlawing Frazier's T-shirts and Montini tells this tale without passion, without depth, without larger context, and most of all without offense to anyone who might in the least way support the ridiculous and malignant status quo that gets our soldiers killed every day in Iraq.

Good job, E.J. If there were an award for malignant mediocrity you'd be getting it.

Now there's an idea.

Sunday, June 24, 2007

Emily Hearts Zeno

Her grave is not obvious; in fact, I am not sure if it is discernable at all. But her house is. I wasn't allowed inside because the college uses it as a guest home for visiting dignitaries, but I viewed the beautiful lilly gardens in their full bloom of early summer.

When I came down the long steep hill into town I stopped my vehicle at the little chamber-of-commerce booth to get a map. The sweet old man inside, upon hearing of my itinerary, said to me "She's not there." He was a sly one. I wouldn't have bought a used car nor a timeshare from him.

Emily Dickinson (1830–86). Complete Poems. 1924.

Part One: Life

XXVII

I ’m nobody! Who are you?
Are you nobody, too?
Then there ’s a pair of us—don’t tell!
They ’d banish us, you know.

How dreary to be somebody!
How public, like a frog
To tell your name the livelong day
To an admiring bog!


In an old episode of thirtysomething the Gary Shepherd character played by Peter Horton, is in (Ken Olin) Michael's office and the phone rings while Michael, the business guru, is out.

Gary is not part of the firm. The other person on the line asks him who he is. Since he is unmoneyed and not part of Michael's business, he says he's "nobody."

Nobody is nobody.

Not anybody.

Saturday, June 23, 2007

What Pith?

To be, or not to be: that is the question:
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them? To die: to sleep;
No more; and by a sleep to say we end
The heart-ache and the thousand natural shocks
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd. To die, to sleep;
To sleep: perchance to dream: ay, there's the rub;
For in that sleep of death what dreams may come
When we have shuffled off this mortal coil,
Must give us pause: there's the respect
That makes calamity of so long life;
For who would bear the whips and scorns of time,
The oppressor's wrong, the proud man's contumely,
The pangs of despised love, the law's delay,
The insolence of office and the spurns
That patient merit of the unworthy takes,
When he himself might his quietus make
With a bare bodkin? who would fardels bear,
To grunt and sweat under a weary life,
But that the dread of something after death,
The undiscover'd country from whose bourn
No traveller returns, puzzles the will
And makes us rather bear those ills we have
Than fly to others that we know not of?
Thus conscience does make cowards of us all;
And thus the native hue of resolution
Is sicklied o'er with the pale cast of thought,
And enterprises of great pith and moment
With this regard their currents turn awry,
And lose the name of action. - Soft you now!
The fair Ophelia! Nymph, in thy orisons
Be all my sins remember'd.


What he's saying is that Cheney's vice-presidential office isn't really part of the Administration, except when it comes to funding. Then it gets a fair share of the Administrative budget, Secret Service protection, and free daily blood transfusions accompanied by pacemaker/automatic-internal-cardiac-defibrillator battery recharges.

Friday, June 22, 2007

Wednesday, June 20, 2007

Fred Hot Monkey Love

Everybody has at least heard of this guy, Fred Phelps, who rose to national prominence when the Westboro Baptist Church picketed the funeral of Matthew Shepard, who was brutally murdered in a bizarre hate crime.



Fred Phelps is even worse than you thought, and his church (the members of which come mostly from his family) would by comparison make the most extreme violence-worshipping Middle Eastern madrassas look like girl scout gatherings.

A few years ago the Topeka Capital-Journal did an important series of articles about Phelps and his "church" of 51 of his very best friends and fellows. You can also start at Exposed! and follow links to the whole gamut of articles or just take in the synopsis.

I read the whole lot of it sometime ago. Afterwards I felt like drilling a hole in my head and pouring in bleach. Just to freshen up.

But alas. There is no bleach strong enough.



But there is great strength to be found in ridicule, humor, and snark.

Sunday, June 17, 2007

Without Mothers There Would Be No Fathers



You're

Clownlike, happiest on your hands,
Feet to the stars, and moon-skulled,
Gilled like a fish. A common-sense
Thumbs-down on the dodo's mode.
Wrapped up in yourself like a spool,
Trawling your dark, as owls do.
Mute as a turnip from the Fourth
Of July to All Fools' Day,
O high-riser, my little loaf.

Vague as fog and looked for like mail.
Farther off than Australia.
Bent-backed Atlas, our traveled prawn.
Snug as a bud and at home
Like a sprat in a pickle jug.
A creel of eels, all ripples.
Jumpy as a Mexican bean.
Right, like a well-done sum.
A clean slate, with your own face on.


Sylvia Plath

This poem appears right next to the horrific "Daddy" in the collection Ariel and Other Poems codged together by Ted Hughes for publication after Plath's death.

With Butter and Garlic

I am so cooked.

Saturday, June 16, 2007

Check 1,2,3

When I heard the screaming I thought that somebody was having a root canal like in the 1976 Dustin Hoffman movie "Marathon Man," but it was just some jerkwad of a patient yelling at their doctor.



It was awful. The nurse (not me thankfully) was sick of the verbal abuse, name-calling, and continual hints at threats of lawsuits.

It is very difficult to maintain composure and develop a therapeutic relationship with some asshole who is threatening to sue you for everything you and your great-great-grandchildren will ever have.

I've run Boston. That's easier than putting a smile on for this particular sort of personality-disordered patient. The Newton Hills? I laugh at those. Newton can bite me. But these sorts... rut-roh.



They came in with a gastrointestinal bleed. No transfusions required, hemoglobin and hematocrit steady at 10 and 35, some black tarry stool that was clearing up... the GI doc wanted them out of the hospital and back for a follow-up esophagogastroduodenoscopy in a week or so.

Why would anyone ever spend more than no-time-at-all in a hospital if they didn't have to?

They didn't want to leave. They wanted their EGD right now. And they cussed a lot. By "cussed a lot," I mean they used more foul, despicable, imaginatively obscene and bizarrely profane language than myself and Linda Blair combined.

If we didn't have a tube down their nose or up their ass then we "weren't doing anything," claimed the patient.

(Assuming that criteria, how many of us are ever really all that busy?)

The initially consulting GI doc washed his hands of all this and refused to suffer any more verbal abuse from the patient. He wrote that the patient should be discharged with follow-up from any gastroenterologist later next week, except himself, of course.

He had also advised the nurse to not enter the room unless accompanied by security, lest the patient escalate.

Another GI doc reluctantly came on board, quickly ordered and did an EGD, finding esophageal varices resolved and not bleeding, and then ordered the patient home. This doctor also said that "nobody should have to take kind of abuse" in reference to the patient's continual verbal aggression.

The doctor told the patient to stop drinking alcohol or his varices would progress. For that, the doc got cussed out. Or rather, he got fuckin' cock-punched. Verbally.

Pardon.

The significant other was pretty bad, too. They insisted that the patient needed intravenous fluids, despite the fact that the patient had a good blood pressure, was taking foods and fluids well, and refused IV fluids in no uncertain terms. That is to say, they stated that they "didn't need no fuckin' IV from some stupid-ass cunt nurse."

Okay then.

In this business they were what we call "a nice couple."

Wait until the patient gets the notice from their insurance company that the EGD was non-emergent and not covered. These companies tend to hire people who like to say "no."

And as you know, they also like to record phone calls for quality-control purposes.

Friday, June 15, 2007

Of Mice and Coelacanths

From an unsigned question-and-answer format article appearing on the editorial pages of today's local fishwrap:

"Didn't the Legislature do something?

Yes. In 2002, lawmakers told the state's universities and community colleges to set a goal of doubling the number of nurses being graduated.

Lawmakers didn't provide any money with the mandate, though. The deadline for doubling is this year, but the goal won't be met."


From the deep well of the veritably miraculous, natural-law-driven, and red-white-and-blue Free Market comes... nothing. That's why the market is nowhere mentioned in the article. Just the lack of a legislative rescue.

The nursing shortage is not only still with us after decades of dire concern, it is going to get much, much worse. And the healthcare market is doing all it can to exacerbate the problem, being "profit-driven" as it claims (if there are fewer nurses to pay then there's more money left over for the middlemen and women.) By its own design it is contributing to this critical problem. While self-destructing, of course.

Actually there are no "profits" in healthcare. Just subsidies, from which takings are maximized by limiting the provision of healthcare itself. Quite the opposite of "building a better mousetrap." Flimsier and cheaper mousetraps provide more "profit" to the big fish.

Appeals to the Arizona State Legislature have also been predictably near-useless, of course.

Before a species goes extinct its population dwindles. It is farcical to think that the number of nurses could ever become so small that they are unable to produce enough "offspring" to continue the profession, isn't it? Can we be sure about that?

From N=1 at "Universal Health":

"As a nurse who has been on the front lines of hospital overcrowding, of too many traumas and not enough trauma bays and trauma nurses, I know full well that nurses will carry the motherload of work, of agony, of sacrifice and of loss in a flu pandemic. Ogilvy PR staff willl be cozily sheltering in place, as will the HHS honchos, while nurses will be on the front lines of mass suffering, death and of loss. It will be nurses who run from patient to patient doling out limited oxygen supplies, who after running out of N95 respirators, will continue on and give care while they put their own lives at risk. And it will be nurses who remain with patients as others stay in the safe havens and shelter in place."

Just as disease can bring the remaining members of an endangered species to the brink of extinction, nursing as it is now practiced could very possibly take a hit from which it is not prepared to fully recover.



Maybe nurses are members of a dying species.

Streisand and Redford 1973

Olive Riley of Australia is the world's oldest blogger at age 107, but she has company. She is joined by Maria Amelia of Spain, who is 95 years young.

Eric Shackle of Sydney, Australia writes:

"Maria Amelia had been ill with pneumonia and various complications which left her weak, so she decided to go to a resort in Brazil for 15 days to recuperate.

Despite her illness, she was determined not to miss the trip, but worried about the long travel time. The trip took 20 hours, but soon after she booked in to a five-star hotel, she took to the dance floor!"




Please, a gracious tip of hats to Eric Shackle, who cued me in about Maria. Judging from Life Begins at 80... On the Internet, he's no spring chicken himself.

One of the really great things about being a nurse is that you get to meet and talk to people from other generations. It's not just that some of them have interesting things to say, and a way of interacting with people that reaches back towards more mannered times... it's, well, that they're old. They used to be young once, and in some ways many of them still are.

Maria Amelia says she started blogging when her grandson, who she describes as "cheap," gave her a blog for her birthday.

Bedroom Balcony





Thursday, June 14, 2007

Cabezas de Pescado

Witness tampering?

From the Office of Inspector General of the United States Justice Department to ranking members of the Senate Judiciary Committee:

"In your letter you referred to Monica Goodling's testimony before the House Judiciary Committee on May 23rd, 2007, in which she stated that she had a meeting with the Attorney General in which the process leading to the removal of certain U.S. Attorneys was discussed. You asked whether our investigation includes this matter.

This is to confirm that the scope of our investigation does include this matter."


TPM Muckraker has the story and that's where I got the link to the copy of the letter. My mind reels in anticipation of the inevitable spin.



The Justice Department is investigating it's own boss!

I think this calls for a non-binding resolution, don't you?

Wednesday, June 13, 2007

Ocean's Immigration Reform

This past weekend The Great One Whose Room is Actually Slightly Neater Than Baghdad went to a sleep-over, so spousie and I sped off to the movies. Since my job brings me into a realm of those who would routinely attempt to perpetrate fraud, exploit others for personal gain, and subject helpless people to humiliating bodily intrusions, I just wanted to see something that was fun.

So no Kevin Costner for me. We saw Ocean's 13.



It was a great and stylish caper movie, fully in and reverent of that wonderful film tradition that goes all the way back to Rififi, which I've heard is undergoing a remake with Pacino in the lead.

Anyways, a strand of the twisty plot involves infiltrating a remote Mexican desert maquiladora where dice are made. One of Ocean's guys foments a worker's revolt at the plant creating a diversion, to let them load the nascent dice, which then of course end up at the rigged craps tables in the Vegas casino they intend to plunder.

There's a discussion back in Vegas about the arrangements that must be made to pay off the striking workers for helping out. An Ocean accomplice says something like "They want $36,000." One of his buddies then says "well, there's about 200 of them so, doing the math, we need to come up with another $7 million."

"No," the first guy says. "Just 36 thousand dollars."

"For the whole bunch?"

"Yeah," says the first guy, adding that this amounts to a raise of about 5% per week for the factory workers.

"Hell," says another,"We'll cut 'em a check right now."

Sunday, June 10, 2007

Loving Spoonful 1965

Here's another fine example of the wonderful effects of the "invisible hand" of free-market economics:

Students frustrated with waiting lists for nursing programs.

"Statewide more than 2,000 qualified applicants, those with the necessary prerequisite courses completed, were not admitted to nursing programs in 2006."

[snip]

"With hospitals offering bonuses and increased pay to nurses, recruiting faculty for clinical and classroom instruction positions is a challenge.

"We don't really have that ability to compete with their salary and incentives," Mesa Community College nursing chair Peggy Fridell said."


That's a royal pisser, as my old friends from Long Island would say. We do not have enough nursing instructors because hospital nurses get better pay than the people that teach them to do their jobs.

You might think that the good old laws of supply and demand would come into play here, with demand wrenching up pay for (and the supply of) nursing instructors, which in turn would help fill the demand for staff nurses in hospitals.

But that is not happening.

You don't have to pay a nurse who isn't there. Those nice people who have completed all their prerequisite courses and who are patiently waiting for positions to open for them in nursing schools are not on the payroll. They do not eat into the profit margins of healthcare providers.

The nursing shortage helps to maximize the takings from the subsidy system that funnels profit to healthcare companies.

Sometimes you just have to look at what's actually happening from the point of view that such is the way things are really meant to work. By somebody. As if it was no accident that there's a shortage of nurses, as if nursing instructors are intentionally underpaid, and as if consumer demand has nothing at all to do with market supply.

Then of course there's the little matter of the forty-some-odd-million people in the U.S. that have no healthcare insurance coverage.

You Know, That Story


Cinderella, by Anne Sexton

You always read about it:
the plumber with the twelve children
who wins the Irish Sweepstakes.
From toilets to riches.
That story.

Or the nursemaid,
some luscious sweet from Denmark
who captures the oldest son's heart.
from diapers to Dior.
That story.

Or a milkman who serves the wealthy,
eggs, cream, butter, yogurt, milk,
the white truck like an ambulance
who goes into real estate
and makes a pile.
From homogenized to martinis at lunch.

Or the charwoman
who is on the bus when it cracks up
and collects enough from the insurance.
From mops to Bonwit Teller.
That story.

Once
the wife of a rich man was on her deathbed
and she said to her daughter Cinderella:
Be devout. Be good. Then I will smile
down from heaven in the seam of a cloud.
The man took another wife who had
two daughters, pretty enough
but with hearts like blackjacks.
Cinderella was their maid.
She slept on the sooty hearth each night
and walked around looking like Al Jolson.
Her father brought presents home from town,
jewels and gowns for the other women
but the twig of a tree for Cinderella.
She planted that twig on her mother's grave
and it grew to a tree where a white dove sat.
Whenever she wished for anything the dove
would drop it like an egg upon the ground.
The bird is important, my dears, so heed him.

Next came the ball, as you all know.
It was a marriage market.
The prince was looking for a wife.
All but Cinderella were preparing
and gussying up for the event.
Cinderella begged to go too.
Her stepmother threw a dish of lentils
into the cinders and said: Pick them
up in an hour and you shall go.
The white dove brought all his friends;
all the warm wings of the fatherland came,
and picked up the lentils in a jiffy.
No, Cinderella, said the stepmother,
you have no clothes and cannot dance.
That's the way with stepmothers.

Cinderella went to the tree at the grave
and cried forth like a gospel singer:
Mama! Mama! My turtledove,
send me to the prince's ball!
The bird dropped down a golden dress
and delicate little slippers.
Rather a large package for a simple bird.
So she went. Which is no surprise.
Her stepmother and sisters didn't
recognize her without her cinder face
and the prince took her hand on the spot
and danced with no other the whole day.

As nightfall came she thought she'd better
get home. The prince walked her home
and she disappeared into the pigeon house
and although the prince took an axe and broke
it open she was gone. Back to her cinders.
These events repeated themselves for three days.
However on the third day the prince
covered the palace steps with cobbler's wax
and Cinderella's gold shoe stuck upon it.
Now he would find whom the shoe fit
and find his strange dancing girl for keeps.
He went to their house and the two sisters
were delighted because they had lovely feet.
The eldest went into a room to try the slipper on
but her big toe got in the way so she simply
sliced it off and put on the slipper.
The prince rode away with her until the white dove
told him to look at the blood pouring forth.
That is the way with amputations.
They just don't heal up like a wish.
The other sister cut off her heel
but the blood told as blood will.
The prince was getting tired.
He began to feel like a shoe salesman.
But he gave it one last try.
This time Cinderella fit into the shoe
like a love letter into its envelope.

At the wedding ceremony
the two sisters came to curry favor
and the white dove pecked their eyes out.
Two hollow spots were left
like soup spoons.

Cinderella and the prince
lived, they say, happily ever after,
like two dolls in a museum case
never bothered by diapers or dust,
never arguing over the timing of an egg,
never telling the same story twice,
never getting a middle-aged spread,
their darling smiles pasted on for eternity.
Regular Bobbsey Twins.
That story.


Sunday poetry blogging.

Friday, June 08, 2007

Screened Porch





Wednesday, June 06, 2007

Athier marshmallows

When school got out at 3:30 p.m. I'd be there. On Tuesdays and Fridays mostly; my usual weekdays off.

A stop at Haagen-Dazs for cones and coffees would eventually lead us to the fountain for people-watching and the usual hanging out; then a trip to the bookstore.

I noticed this one thing at the bookstore: they had a section of some of the latest best-sellers by Dennett, Dawkins, Harris, and now Hitchens, and there was a little sign over the display that said "Atheism."

Wow. They have their own section now. That's something else.

Maybe I'm not "an atheist." But surely I am "athier" than most people. I do not like defining myself in terms of negation. "Material positivist" might be suitable, but likely to never have its own book display.

So it is interesting that there are multiple best-selling books concerning atheism out there now. But what is even more interesting to me is just how many religious folk in the media express their own feelings of being threatened by the belief, or rather non-belief, systems of those who are, after all, merely other people.

Some people roasting marshmallows on a stick over an open wood fire actually allow the sweet to burn and carmelize just a little before using their breath to exinguish the flame.

Are not those marshmallows the best?

Monday, June 04, 2007

Intersense Modalities 64

When playing black I deploy something like a Najdorf or Dragon variation of the Sicilian defense against white's P-K4. I almost always use the Grunfeld against Queen pawn openings. The King's Indian and Nimzovich are also very interesting to me, but I love the Grunfeld kingside bishop and an early P-QB4 break by black.

With white I always play P-K4 except with people who know me, and I almost never play people who know me. When I vary by playing P-QB4 I do not rely on my Sicilian habits. Instead I like to steer things into a Catalan.

When playing online I generally find it to be more satisfying to play open games, so I rarely get into a complex positional Ruy Lopez, even though the majority of online game room opponents answer P-K4 with E-5.

Too bad. I like playing both sides of the Ruy Lopez, both open and closed. Spassky's Breyer lines particularly interest me.

With my kid we've been exploring the Giuoco Piano.



It can lead to a fun open game like many played by Paul Morphy one hundred and fifty years ago. He did very well defending with the black pieces.

But it also can lead to positional manuevering and modern combinational blow-outs like Tarrasch versus Alekhine 1925. (Click and play.)

Classic. Intense. Like a Mozart piano concerto as realized by Stravinsky. Like Van Gogh realizing Japanese still-lifes. The dark outlines of the background trees are so Vincent. Yet so Nipponese.



Chess is very musical.

I am your nurse today. Do you have any pain?

Though I do not say so out loud, the word-bubble over my head holds "Bush is a fucking drunk and a lying asshole." And I try to reconstitute, in my mind's eye, the web address where the guy set up targets and demonstrated that Cheney lied about accidentally shooting that friend in the face.

Music from Olias of Sunhillow sounds loudly in my dream ears. It repeats.

I retrieve my science books from my locker. I am in the hallway of my highschool. Friends laugh and express wishes to buy a fish license.

Sunday, June 03, 2007

If It's Sunday This Must be McLean



Plath wrote this poem in 1961, and it's rather simple to discern the experiences from which it is derived.

"The Hanging Man"

By the roots of my hair some god got hold of me.
I sizzled in his blue volts like a desert prophet.

The nights snapped out of sight like a lizard's eyelid :
A world of bald white days in a shadeless socket.

A vulturous boredom pinned me in this tree.
If he were I, he would do what I did.



This first appeared in Plath's second collection, the amazing Ariel released in 1965 after her death at age thirty. She herself did not include "The Hanging Man" in the list of poems she compiled for Ariel. It was added by her surviving husband Ted Hughes when he put out the book with the poems in a different order; adding some from those left uncollected by Plath, and deleting others.

Plath had read a book or a few about Tarot and probably had a Rider-Waite deck, as that was probably one of the few available back then.

And of course, there was that little thing with the electroconvulsive therapy.

Saturday, June 02, 2007

Smack Shoot Smash

As far as I know, I have never had morphine. Maybe way back when my tonsils were taken out, but that's just a guess. Certainly in my years of nursing I've administered probably a few metric tons of the stuff.

Well, maybe not quite that much.

Morphine has developed a pretty good track record. After all, it's been in use for about six thousand years.

[Snip] "It is unknown exactly who, when, or where opium was first used or discovered, but the date can be narrowed to around 4000 BC. It was used to relieve anxiety and pain. It was also used to induce sleep and give a feeling of well being and peace. The first recorded use of opium for medical purposes was in 200 BC.

In the 16th century, a Swiss physician name Paracelcus experimented with the medical value of opium. He decided that its medical value was of such magnitude, that he called it Laudanum. Laudanum comes from the Latin word "laudare". Laudare means "to praise". He did not know of its addictive properties.

1803 can be seen as the true "birth date" or discovery date of Morphine. In 1803, Serturner, a German pharmacist, identified and isolated the main ingredient of opium, Morphine. He called this alkaloid "Morphia" after Morpheus, the Greek God of Dreams. The name "Morphine" is now used instead of Morphia because of the standard that all alkaloids end in "-ine".



It's basically very cheap, especially when compared to newer drugs (and they're all newer drugs!). Morphine can be manufactured for a penny per milligram or two. Contrast this with the antibiotic Zyvox, which could run you about $70 per tablet.

It also basically "burns clean," in the sense that morphine is unlike, say, Demerol, in that it does not leave a boatload of harmful metabolites in the body. Of course it's a little more complex than that, and you can read here and here if you want to start down that long and difficult road. What it means to me is that a chronic user of morphine, like a cancer patient, can just take more as they develop tolerance to the drug. Under a doctor's supervision, of course.


Though presently named after the ancient Greek god Morpheus, the drug itself predates the mythology by many centuries.

It's also a rather potent venous vasodilator, which is why realtively small doses of 2 to 4 milligrams are typically used for chest pain, and it slows the heart down a little. Too much can adversely affect breathing, but that can be pharmacologically reversed if absolutely necessary.

We usually keep some Narcan close at hand for patients who are using patient-controlled analgesia pumps, just in case they get too much.

Anyways, I did not intend to be a bore by going on and on about this. I just wanted to give you some idea of what I tell people when I'm smashing them up with powerful opioid drugs.

Friday, June 01, 2007