Pushing the President off a Virtual Cliff Isn’t an Answer

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This is my Greenville News column from August 1. I forgot to post it to the blog until today.

http://www.greenvilleonline.com/story/opinion/2017/08/01/pushing-president-off-virtual-cliff-isnt-answer/514120001/

Have you seen the charming computer game that allows you to push President Trump off of a cliff, into a volcano or to some other unpleasant location? It allows tolerant, caring individuals to vent their spleens against the man who they typically say is ‘not my president.’ Of course, it’s only the faintest tip of the iceberg, beneath which is a large mass of angry, violent, eliminationist rhetoric.

Not to be outdone (and certainly not new), I recently saw a similar game that allows players to do terrible things to a virtual former President Obama. In fact (in a search that I hope won’t draw the attention of the fine folks at the Secret Service) I found an entire page of terrible ‘kill Obama’ games.

Of course, there are always fringes; I hope it’s the fringes. But I fear this is becoming an increasingly mainstream behavior. I would like to say I’m surprised, but I’m not. Politics is the new religion, and every religion has its heretics. And what do we do with heretics? We kill them! Everyone used to know that was a bad thing, when it actually involved belief in the supernatural. And we’re still shocked when we see horrific tales from groups like ISIS and the Taliban, where you can still be physically (not virtually) tortured and killed for believing or saying the wrong things.

Now, even in the good old US of A, there’s an underlying rage and disdain that leads some people to harm those who disagree with them. (See the shooting of Rep. Scalise or assorted violent protests on campuses). At the least, that anger allows Americans to publicly fantasize about harm against people whom they consider, thanks to their political position or ideology, sub-human.

Of course, the venom often starts with a Tweet, Facebook or blog post, online comment or speaking engagement. Someone demonstrates that they don’t agree with the latest political or cultural trend. They are called out for their thought-crime, and instantly attacked, threatened, and shunned by a community that points righteous fingers and shouts ‘Shame! Shame!’

Discussion is further shut-down by describing the ‘enemy,’ the ‘other,’ in casually launched terms like racist, sexist, homophobic, transphobic, hateful, intolerant or any number of pejorative adjectives that help put the cross-hairs in more stark relief. (In the old days it was Catholic, Protestant or Pagan!)

The righteous can then proceed to acceptably wish harm on the heretic, as several have recently done (for example) towards Sen. McCain in light of his position on ACA repeal. ‘Should have died in Vietnam,’ one said. Others hoped his tumor would kill him more quickly.

In a post-Christian, rationalist, and scientific world, where we are told we needn’t rely on some deity to hold us to ridiculous and uniform standards of behavior we have come round again to acceptable, post-modern fantasies about killing people who make us uncomfortable.

Admittedly (and as I alluded) people of faith have often led the charge of violence towards the heretic. But for a while, we seemed to be rising above it. At least until the church of politics became the equivalent of the Church of America. (Separation clause aside!)
What strikes me, though, is that the Jesus of the Bible (not the Jesus of modern politics) said in Matthew’s Gospel, ‘’But I say to you, love your enemies and pray for those who persecute you.’

He also said all sorts of other pesky, kind things about greed, caring for the sick, the poor and the prisoners. He even said, as he was being crucified, ‘Father forgive them for they don’t know what they’re doing!’

Christianity teaches us that we’re all ‘works in progress.’ That God will, if we desire, remake us bit by bit, sin by sin, into something far better than what we are, both in this life and in the next. That however bad we are, and He means that, He will forgive if we admit we need it; admit we need Him.

We need to try and see everyone as potential saints, not contemptible demons. Wishing, or doing ill to our opponents is not rational, scientific, libertarian, constitutional, progressive or modern. It’s pre-Christian and un-American. And it harms the hater most.
So stop pushing people off of virtual cliffs. And start praying for all the heretics, however you define them. Turns out, we’re all heretics to someone. That realization alone should open our eyes and thaw our hearts.

Kicking North Koreans Down the Bloody Road of History

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I don’t think that anyone really wants a war with North Korea. The potential use of nuclear weapons on either side is the stuff of nightmares; but even without nuclear weapons, the death tolls from conventional munitions such as artillery, small arms, non-nuclear missiles and air-strikes would be extraordinary.

Thus, many have been shocked that President Trump has seemed openly hostile to N. Korean Supreme Leader, Kim Jong-un. They have blamed him with escalating the conflict, with prodding the rogue nation to the brink of nuclear conflict.

In the end, it sounds as if North Korea were a gentle, quiet land of rural majesty that just wanted to be left alone, when along came Donald Trump, who started being mean to the cuddly Teddy Bear president of exotic, far-off North Korea.

And yet, we forget. We forget that the Korean war of 1950-53 began when North invaded South and that it ended in an armistice, not a peace treaty. That war cost an estimated 1.6 million civilian casualties and some 1.2 million combat casualties. I’ve met veterans of that nightmare. It was a horrible war, and would be again.

(http://www.cnn.com/2013/06/28/world/asia/korean-war-fast-facts/index.html).

However, we also forget that since that truce, North Korea has constantly provoked South Korea with infiltrations by special operations soldiers, with naval and border clashes, assassinations, terrorist events and artillery fire. We forget that North Korean operatives have kidnapped citizens of South Korea, Japan and other nations. (Many of whom never saw their families again.) Go through the list in the link below. It’s not stuff we hear much about, but it’s truly shocking. And the list only goes to 2007.

https://fas.org/sgp/crs/row/RL30004.pdf

Beyond that, we in the West (and particularly college educated Americans) have a stunning ignorance about the singular delights of the land above the 38th parallel. We forget that North Korea, that undying zombie of Communism, is a land of terrible cruelty, torture, imprisonment, starvation and sorrow. As we in the West decry oppression in all its real and imaginary forms, the people of North Korea understand it in full. Over the decades of North Korean tyranny, since 1948, hundreds of thousands have died at the hands of their own government in prison camps and reeducation centers. Attempted defection to China usually results in either more abuses, or return to North Korea with further torment. Starvation, beatings, rape, forced abortions and executions are tools of state, and entire families are punished for the transgressions of one. (I suspect no small number of those crushed souls would say today, ’bomb it, bomb it all; it really can’t get a whole lot worse for us here, eating bugs and rats, and hoping our children aren’t murdered.’)
If you think I’m confabulating, follow the links below.

https://www.hrw.org/world-report/2017/country-chapters/north-korea

http://victimsofcommunism.org/north-korea-under-communism-1948-2014/

So it’s all well and good for us to oppose nuclear war, and to oppose war in in general. But the sudden discovery that North Korea was a super friendly place until Donald Trump? That’s not historically accurate or intellectually honest.

If it all cools off and calmer heads prevail, North Korea will still have hundreds of thousands of citizens living in conditions that rival those of the Soviet Gulags, or the Nazi concentration camps. They will survive day to day, eating starvation rations, being beaten or raped, tortured and murdered; the lucky ones exported abroad as wage slaves.
Those not in the camps, even the true believers, will continue to live in the constant fear that they’ll be arrested. And in the knowledge that their success, their survival, depends on showing unwavering devotion to Kim Jong-un and his family’s dynastic brand of tyrannical thuggery. Political opponents, religious believers, families of those suspected of dissent, all will fear the government or be punished by it. Because that’s how it goes down in the Democratic People’s Republic of Korea.

Assuming, again, that the war clouds pass, free people can wipe the sweat from their furrowed brows and allow the horrors of North Korea to go on, safe in the knowledge that diplomats will continue to talk as nuclear weapons and delivery systems continue to be developed in North Korea. All funded by the slave labor of untold, unknown citizens. And as men, women and children continue to suffer and starve.

What a relief that will be! And those who say ‘not my president’ can meet in safe cafes and discuss how ‘that crazy Trump’ nearly caused a war with a country that has been provoking free nations, and torturing its own citizens, for over 70 years. Safe out of the view of sensitive American citizens who oppose oppression.

I also hope we’re all prepared for what we see when, and if, the DPRK ever falls and the West has access. Because when we go in at last (hopefully through diplomacy or some miracle), when we see the camps and hear the stories, and witness the broken lives and weeping, gaunt faces; when we at last grasp the misery and sorrow that generations of people endured under that regime, we’ll be ashamed. And it will take decades for those people to escape the toxic cloud of imposed fear that enveloped them for so long.

But then, the world let it happen in exchange for the comfort of empty discussions and endless sanctions as we (the West and China) kicked North Korea and her people down the bloody road of history.

God forgive us when we see what that ‘peace’ cost.

Vacations early and vacations late

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I write from the large, quiet beach house where 21 family members have been enjoying one another, and the various delights of vacation.  I write from the solitude of the large dining room table which, this morning, was full of adults and children, from six to eighty, basking in the joy of breakfast, the smell of bacon and eggs, the delight of one another, the impending pleasures of a new day’s adventures.

Vacations come in two flavors, I see today. Early vacations in Spring are full of ‘what if,’ and ‘what shall we do,’ as well as ‘how wonderful to be together!’  They are powered by the kids’ freedom from the confines of schedules; they are super-charged by the joy parents have in being liberated from the homework and activities of their young.  Early vacations are made more delightful because not everyone is free yet, the traffic isn’t gridlocked and because (even on Southern coasts), the evenings are breezy and cool and the bed is chilly not from air-conditioning but from nature.

Late vacations are also wonderful.  All time together, laughing, floating in the pool, kickign the soccer ball on the beach, all of it is a sacrament of love.  But this morning, lying in bed, I watched through the window as heavy rain rolled over the side of our rental house; it was a gray dawn, with high dark clouds, and reminded me that Summer is not half over, but sometimes still hints at Autumn.  That Summer is a roller-coaster that runs faster and faster, and its cars are driven ever faster by the return of school, the heat of the season and by the advancing ages of the children we try so hard to keep young and nearby.

This is a late vacation; and an odd one.  Several of two of our children and one of their cousins cannot be here.  One is working, one is looking for an apartment, one is traveling in Ireland.  One will leave for college in a few weeks. They are doing what they should; in the Spring of their lives, in their twenties, life is busy.  But their absence punctuates the reality that all vacations, like every single year, change.  In a sunny homage to Heraclitus, ‘you cannot step onto the same beach twice,’ as it were.  Kids grow up, adults grow old and things move on to jobs and school; as they have and as they should.  The alternatives are for our children to be stunted forever like pets, or to die.  Better they should miss vacation.

The house is quiet, except for the dryer and the occasional young person scrounging for food and saying, ‘good night Papa!’ Or, ‘good night Uncle Ed!’  They make me smile, They inspire me.  And every year, we return to do so many of the same old things, to hold the form and shape of vacation even as the substance (mostly the children) move in and out.  And thus there is miniature golf, and bike rides; pizza night and games; throwing football and Frisbee on the beach.  Even having overpriced ice-cream too late and after too much food.

These are scaffolds that remind us of the past, and on which the young will perhaps build their own future times, or (when the times are right) bring their own loves back into our rickety traditions to enliven them.

This late vacation is drawing to a close, and I will miss it.  But we have a deep trove of memories, all of us, and we have build not only the frame but the solid foundation of love upon which families, this family, can stand for generations to come.

Tomorrow it will be hot and muggy.  But we will run on the beach with reckless, joyous abandon.

Nothing can take that from us as we drain the last drop of joy from this pitcher full of love and tradition.

 

Electronic Devices Shouldn’t be Used as Comforters (for Frightened Children)

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Electronic Devices Shouldn’t be Used as Comforters (for Frightened Children).

http://www.greenvilleonline.com/story/opinion/2017/07/19/electronic-devices-shouldnt-used-comforters/484325001/

After years and years of practicing emergency medicine, I’ve seen and treated thousands of children for everything from beads in the nose to leukemia, ruptured spleens to sprained ankles.

A father of four myself, I take great delight in interacting with the kids that come through my workplace. I consider it a personal challenge to make them smile whenever possible and to put them at ease.

I’ve learned a few things over the years. For instance, when examining sick infants, it’s best to let mom or dad hold them as long as possible. Stethoscopes work just fine when mom is standing and rocking the baby back and forth. Likewise, when moving towards sick children, it is wise to move like an old, arthritic hound. Children are easily startled by the sudden movements of adults. Especially those carrying tongue depressors. It’s also helpful to speak softly, even in stressful situations.

I do my best to smile, a lot, at infants. I compliment, or find some commonality, with verbal kids. We talk about their cat, their toy, their favorite super-hero. Older children like my Captain America watch. For the most part, I’m successful. Maybe it’s because I spent so much time connecting with my own family.

However, much of the ease of my work depends on parents. Parents who are confident in their role, who have good relationships with their children, make my job much easier. Some parents are great at this! They understand the wonder and mystery of childhood, and it’s obvious they have a deep, purposeful connection to their little ones.

But as I’ve watched parents and children over the last few years, I’ve seen a very concerning trend. And it’s the tendency exhibited by far too many parents to allow electronic devices to do all the comforting, all the distracting, all the conversation and casual education that in days past would have been their responsibility. And indeed, would have been their joy.

I’d say that the majority of small children I see at work are playing with a cell phone, tablet or computer. Either their parents’ or increasingly, their own. While mom and dad are busily texting or playing games on their devices (everything and everyone else being obviously so much more interesting), the little ones are watching a cartoon or playing a game.

What isn’t happening? Conversation. Simple games like ‘I spy.’ Reading books or magazines, talking about colors, singing songs. Anything where the parent looks into the face of the small child and imparts either love or information. The device and the Internet have supplanted those apparently mundane jobs.

Now, I know that ER’s are often places of interminable waiting. And I’m certainly not opposed to folks using those phones or other devices to pass the time. But what I’m thinking is this: ‘people, interact with your kids!’

Children need to have lots of words spoken by parents into their dirty little wax-filled ears, and from there into their growing, learning brains. They need to see comforting facial expressions, and learn the pronunciation of new words, read or spoken to them by their parents.

When they are endlessly bombarded by the voices of strangers on devices, when they are deprived of their parents’ voices, they are robbed. And when poems, songs, prayers, scriptures, fairy tales and nursery rhymes are displaced by computer programs, they are technologically impoverished and neglected.

This seems to occur most often because their parents are also chained to the devices (and a child playing with electronics leaves time for parents to do the same), and because it’s easier to say ‘play with this,’ than to interact with the little humans they brought into the world.

I’m often ignored when I walk into the exam room, as the patient with abdominal pain has to finish a text or call. I get it. I made them wait and they’re trying to finish what they were doing.

But people, please give the kids more than electronics! Parent and child alike will benefit from putting down the device.

The Dangers of Summer

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This was my most recent column in the Daily Yonder.  Unfortunately, the Yonder website is down or I’d give you a hot link.

It’s Spring now and all across the land things are bursting with life. Flowers are in bloom, yards are bright with new grass and the sun is high in the sky. My car was, for a while, covered in a thick, green coat of pollen. Carpenter bees are still turning my log-house into Swiss Cheese. It’s pretty out, the sky is blue and the days are warm. Blah, blah, blah. I for one don’t really like this time of year. And it’s mainly because warm weather brings me patients with all kinds of injuries; some of them pretty nasty.

In rural America, there are dangers that seldom occur to people in more populous, metropolitan areas. Ironically, though, rural folks often assume that life in the city is more dangerous. And indeed, murder rates are higher.

However, according to the CDC, deaths from unintentional injuries are 50% higher in rural than urban areas; https://www.cdc.gov/media/releases/2017/p0112-rural-death-risk.html. These differences in death are due to several causes; rural citizens are further from necessary health care and are closer to large lakes and rivers, use dangerous equipment and firearms. Doubtless there are many factors involved in the difference.

Of course, some of the perils of rural life are just the result of living in close proximity to nature and all her deadly charms. In Spring and Summer, we encounter creatures that bite and sting. Just last year, while mowing our lawn, we must have run over yellow-jacket nests at least half a dozen times. By the end of the summer I just let the grass grow. ‘You win!’ I screamed to the little jerks, hiding in their holes. Whether it’s scorpions, hornets, wasps, centipedes, spiders or some other tiny monster, we simply encounter such creatures more in the warm months. And their various stings and bites, while rarely fatal, can cause dangerous allergic reactions. And make your spouse want to leave the area and move to a condo.

Fortunately, deaths from allergic reactions of all sorts are rare, and around 99 deaths per year in the US. https://www.aaaai.org/global/latest-research-summaries/Current-JACI-Research/death-anaphylaxis. Still, If you or your loved-ones are afflicted with such allergies, please talk to your physician about what to keep on hand; hopefully epinephrine injectors will get cheaper. And there are some other brands besides the ‘Epi-Pen’ that should be less costly. They just hurt a lot (the Black Widow) or make ugly wounds (the Brown Recluse).

Poisonous reptiles (Copperhead, Rattlesnake, Cottonmouth and Coral snakes) are also a feature of rural life in many areas. Those who ‘ooh and aww’ in city zoo reptile houses rarely have the singular delight of encountering these wonders in their own yards or whilst walking through the woods. But these creatures, while important to the eco-system, can deliver nasty wounds and in rare cases can be lethal. They’re certainly dangerous to your finances given the cost of anti-venin to treat the bites. So be aware as you go about working and playing in places where snakes are also enjoying the summer sun, or cool evenings.

Remember also that at least in the US, many snake bites occur because people are 1) intoxicated and 2) trying to mess with the snakes. And yes, ladies, this is a peculiar affliction of men that starts with ‘hey, betcha’ I can catch him!’ Actually, I have it on good authority that snakes don’t even like the taste of drunk people and would like to be left alone, thank you very much.

Now, other dangers of rural life have to do with the necessity of power-tools. In my own life, the chain-saw, weed-trimmer and lawn-mower are absolutely essential to keeping nature from simply over-running our house. But as the dear reader knows, these are things to be treated with great respect. Please use appropriate protective gear, like safety glasses, gloves, appropriate clothes and heavy shoes. Of course, those who work on highways or farms use much bigger types of tools and heavy equipment and have to be ever watchful. This is probably more true in Spring and Summer because that’s when farms are busy, roads need to be fixed, bridges repaired, pipes laid, power-lines connected, houses constructed and all the rest. God bless all those folks who make our lives better by doing hard, dangerous work on the hottest of days.

And of course, warm weather brings assorted recreational dangers. Hiking and camping are delights, but someone always manages to fall off of a waterfall or cliff-edge, break an ankle, sustain a laceration or encounter said biting and stinging creatures.
Bicyclists and motorcyclists look forward to warm months so that they can enjoy the open, dry road. But helmets really are important as is appropriate protective clothing, reflective material and good education. I’ve seen patients who left their tanned skin on 50 yards of asphalt. Nobody enjoys that.

Lakes and rivers are warm, and filled with persons who typically want to be dragged at high speed behind a power-boat while skiing, clinging to a large inflatable item for dear life, or kneeling on a wake-board. Likewise, fishermen head to their favorite spots (either in tournaments or alone for peace and quiet) and other aquatic persons kayak, canoe and raft the rivers that draw so many to rural America for vacations. All of which is fantastic! But remember to learn to swim, always wear life-jackets and follow local laws when doing all of the above.

Obviously there’s always the danger of heat exhaustion, heat stroke, dehydration and sunburn. We all have to remember to be careful to stay hydrated and remember that beer and caffeinated sodas don’t help. Also be reasonable about sun exposure and wear sunscreen to hep protect against skin cancers.

And if the gentle reader wishes to avoid painful foreign bodies and sutures, here’s another bit of advice. Wear shoes all; all the time. Simple and to the point.

Spring and Summer are glorious in rural America. But the dangers are many; I’ve only skimmed the surface here. Please remember to be safe, think before doing, follow the laws, don’t drink and boat, drive, ride, ski, pick up snakes, work with power-tools or do just about anything else. If you’re going to drink, find a chair and sit in it. That bit of advice would keep many an ER quiet all night long. Also remember that everything I said you shouldn’t do when drinking is something you shouldn’t do while taking narcotic pain medications.

I hope everyone has a great summer, free of emergencies. And that you can still be around when that first breath of cool air dips down from Canada and a proper season comes back once more.

Just please, please, be careful out there, OK?

(If you’re interested, here’s another link to a nice discussion of the unique injuries common in rural America. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448517/)

Welcome new physicians! Watch where you step…

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Today is the day that new resident physicians begin their training all across the United States.  Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a side-line) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school.  Anxiety-filled and debt-ridden, they will embark on four to seven (or even more) years of training to make them knowledgeable, technically proficient physicians.

I will occasionally wax poetic and philosophical for their benefit.  But not today.  Today there are practical matters.  Today I want to give them a few pointers, to ease their transition into the maelstrom of post-graduate medical training.

1)  Any flat surface that holds still, is free of gross body fluids and not used as a walk-way or cook-top will serve for a quick nap.  Practice sleeping in odd positions:  sitting upright, reclining at various angles, lying sideways or with your head cradled in your hands.

2)  In my day (always wanted to say that!) we filled our fresh, white lab-coat pockets with review books, algorithms, reference manuals, scissors and calculators.  And candy bars.  You, doubtless, have a smart-phone of some incarnation, which contains all that we had, as well as the Web.  Which means, where we had to play video games in the lounge and find answers in giant, antiquated things called attending physicians and books, you can look up fun facts on hyponatremia and instantly play Angry Birds, whether you’re on rounds, in the cafeteria or hiding in the call-room, pretending you didn’t hear ‘code blue.’

3)  Eventually, you may decide the lab-coat isn’t worth it.  Don’t be surprised.  Your kids will eventually wear it for Halloween.

4)  If you keep the lab coat, what with the extra space in your pockets, carry extra candy bars.  Or protein bars, or whatever it is you crazy kids snack on these days.

5)  Watch where you step.  Trauma patients and cardiac arrests are exciting!    But there’s almost always some body fluid on the floor when the shouting is over.  Try not to get too covered in blood early in your call night.  It’s sticky and gross.

6)  You know so much.  You don’t know anything.  Keep those two ideas in constant tension.  Odds are, your command of modern evidence-based medical research is extremely impressive.  Eighteen years after residency, I can still leave you in the dust when it comes to making decisions and knowing who is sick and who isn’t.

7)  See above.  Learn, as quickly as you can, who is sick and who isn’t.  Hopefully medical school helped; but don’t count on it.  If you know this simple thing, you will know when to go for help, when to panic (or not) and what to tell your upper level residents and attending physicians on rounds.  And you will become that greatest of commodities:  useful.

8)  Look professional, develop your own style.  Be comfortable.  My friend Sherri used to wear pearls on call, with her green scrubs.  They always made her appear elegant, no matter how much pediatric vomit had been hurled her direction.

9)  Patients can be frightening.  But remember what they told you at camp, about bears, raccoons and snakes.   ‘Don’t worry, they’re just as afraid of you.’  This is kind of true.  Except patients really aren’t afraid to ask for pain medicine or call attorneys, whereas you are afraid to do anything since you can’t believe you know anything yet.

10)  You may be more frightened of physicians than patients.  But remember, the people assigned to train you are smart, capable and experienced.  And they put their tentacles in their pants just like everyone else.  Ask them questions, listen and watch.  And remember what I said above:  be useful.  My surgery resident was fond of saying, ‘Help me, don’t hurt me!’

11)  You will soon have a thing called a paycheck.  It will have a stub that shows how much the government is taking from you.  Do not be surprised.  This happens to everyone.  It’s just that you owe a lot more money than most people.   Cheer up!  Everyone expects you to be rich someday, so they can complain about the fact that your rich.  (Whether you will be or not remains to be seen.)  Remember that no matter how little or much you make, never tell a contractor or car-dealer you’re a physician.  Tell them you work in customer satisfaction, or something nebulous like that.

12)  Crazy people, even really crazy people, are sometimes terribly ill.  Pay attention.

13)  Ill people, really ill people, are sometimes very crazy.  Pay attention.

14)  Medicine is inexact.  I promise you will make mistakes. Don’t live in fear, and don’t let error define you.  No one in medicine, or law, is capable of perfection.  Except for being perfectly insufferable, of course.

15)  If you poke things that look like they are filled with blood or pus, they will explode into your face; if you tend to hold your mouth open when you focus, well you know what will happen.

16)  Scalpels really are sharp.  Pneumonia and HIV and TB and Hepatitis really are communicable.  Psychotic patients really will try to choke you.  Medicine is dangerous.  Be careful out there!

17)  Human beings are really frail, vulnerable and hurting.  Be gentle and kind whenever possible.

18)  Have fun!  Don’t think of it as residency, think of it as a chance to spend most of your waking and many of your sleeping hours in a huge, cold-building where people are dying!

19)  Everyone is proud of you.

20)  Pay attention to what the nurses say.  They aren’t always right.  But for quite a while, they’ll be right more than you are.

21)  Only three to seven years to go!  Hang in there.  Remember, it’s no different from Boot Camp.  It just lasts much, much longer.

Barbie the Zombie Cat Walks the Day

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Barbie the black cat has lived with us some ten years or more.  A transgender cat ahead of his time (and through no actions of his own), he was a Christmas present to our daughter Elysa in a season when cats were few and far between (an unusual situation to be sure, given the reproductive tendencies of cats).  Elysa wanted a girl cat, but only a boy cat was available.  He was named, therefore, Barbie. That was during our daughter’s ‘Barbie phase.’  Since that time, Barbie has been the subject of any number of debates over pronouns.  He?  She? Him? Her?  Maybe if we had had the currently vogue zie or zir, it would have been eaZier.

At any rate, Barbie came with a matching cat, a brother gray with white paws, who was named Socks.  He belonged to Elysa’s brother, Elijah.  Socks, like Barbie, was extremely devoted to his child-master and often slept the night standing guard at the head of his bed.

Socks, alas, had a propensity to wander through open doors.  Once we found him in our woods, high in a tree and calling out in his most pitiful cat voice for rescue.  Jan talked him  down and ultimately he returned.  Several years ago, he wandered out again and was not recovered.   We mourn Socks to this day, good egg that he was.  We hold to the hope, faint as cat whiskers, that he will return one day, king of the forest, with the look of one gone on extended adventures.

Barbie, however, lives on.  And on.  Barbie has likely burned through at least nine lives and perhaps nine more.  You see, Barbie’s teeth fell out years (and years) ago. He/she has claws like well-honed sabers, but not a tooth to be found.  I dreamt, one night, that her/his teeth had grown back.  But it has not happened.

Some time ago we noticed that Barbie was losing weight.  Pick him up and he was a furry bag of bones, purring loudly but a wisp of a kitty.  A trip to the vet, with fears of cancer, feline AIDS, leukemia or worms, and I was informed that our cat was hyperthyroid.  That’s right, Barbie burns through calories fast enough to make a Sumo wrestler anxious about gaining weight.

As a consequence, Barbie is on medication.  Every day we shove a pill down his toothless gullet and he purrs like a madman as we do.  But because of his endless calorie burning, he learned long ago to eat.  And eat.  And eat. He eats non-stop.  Downstairs in the morning?  He sees humans and paws the glass back door frantically, as if to say, ‘Hello!  Hyperthyroid cat here!’  Jan has said we should put little cleaning pads on his paws and we’d have sparkling windows.

I feed him, we feed him, multiple times a day.  Cat food and scraps, all day and all evening, and still an open door leaves him frantically running for the house.  His ability to juke between human legs and come inside is the stuff of soccer legends.  His co-cats (later arrivals, half-Manx maniacs named Leo and Frodo), have no trouble gaining weight.  But they have learned the frantic food pursuit from Barbie and as soon as he begins to panic, so do they.  Despite the fact that together they could probably take down a deer.  (If you’ve had a Manx, you understand.)

So we have a cat of some 11 years at least, who lives in the yard and on the porch of a house in the South Carolina Blue Ridge foothills.  He is surrounded by any number of creature would should by all rights have eaten him by now.  (He is guarded by five dogs of increasing sloth but who still bark and smell doggish to predators.)   Said cat is nearly weightless and fully toothless.  And yet, he remains.

I think, sometimes, that he stays for Elysa. She is a rising junior and they love one another. Perhaps, he waits for his brother.  Maybe Socks said, ‘wait here, I’ll be back,’ and went to a foreign land to hunt mice and get rich.  Maybe he’ll bring back cat dentures of gold and diamonds.

We theorize that he has a happy dementia.  Some of us have postulated that he is actually dead, or the Walking Dead.  A cat who passed years ago and simply forgot to die.  Barbie the Zombie Cat sounds like a B-rated horror movie to be sure.

But utimately, Barbie is just a reminder that life is good. No matter what nature throws at him, he rolls with it.  He is full of joy in his few small joys.  A bit of turkey, a cup of milk, a bowl of cat-food or even his medication and he is dancing on cat toes, tail high and happy.  But a little cradling in Elysa’s arms and he purrs like he has loudspeakers.  Hold him and he reaches up with his blade-embedded paw, not to strike but to caress as surely as any human ever touched another.

Life is hard, for people especially but also for the small creatures of this world.  But we should all be as satisfied, as joyous, as Barbie the hyperthyroid, toothless Zombie cat.

Long may he purr.

 

The Canine Pain Verification Team

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We’re all familiar with the dogs used by the blind, and more recently with dogs used to comfort those with PTSD. There are even dogs that identify low blood sugar in diabetics!

What I want is a ‘pain scale dog.’  Physicians who treat pain in the emergency department and elsewhere are often confused and frustrated by the pain scale, by its inherent subjectivity and by the abuse to which it is subject.

That’s why I want the Pain Verification Dog.  Let me illustrate.

21 year-old-patient presents to emergency department ambulatory.  He is healthy appearing but grimaces, saying ‘I pulled it at work.’

Me:  ‘What’s your pain scale, sir, if zero is no pain and ten is the worst pain in the world?’

‘It’s a twelve!  No kidding, maybe a 15!’

Me:  ‘Nurse, call the Canine Pain Verification Team!’ Dog enters room.  ‘I repeat sir, what’s your pain scale?’

‘Now it’s a 20!  I have to have some, what is it, it starts with a D and it’s all that ever helps!’

Me:  ‘Sir, that’s Axon. He’s highly trained and very sensitive to pain scales and he feels that you may be overestimating!’

‘Dude!  Get that dog off me!  I’m serious!  OK, OK!  It’s, it’s a ten!’

Me:  ‘Sir, I appreciate your situation; but Neuron disagrees.  What do you think?  Is it really a ten?’

‘I’m serious, I’m scared of dogs!  My back hurts and this is making it spasm!  OK, OK, it’s, it’s maybe a three, OK?  A three!  Can I get a Tylenol or something!’

Me:  ‘Sir, the pain scale dog team leader, Decem, says “good boy!”  Here’s a list of exercises and an Aleve.’

Now those are useful service dogs!

 

Good Fathers are the Ultimate Safety Net.

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This is my latest column in the Greenville News, published Father’s Day. Dads, we’re relevant at every point in our lives as fathers!  And even beyond…

http://www.greenvilleonline.com/story/opinion/2017/06/16/good-fathers-ultimate-safety-net/381733001/

This Father’s Day is a good time to remember that we fathers sometimes drive you kids crazy. We hover. We give unsolicited advice and undesired help. We say things like, ‘nothing good happens after midnight,’ or ‘please be careful out there!’ We view your love interests with suspicion, even if we greet them kindly.
Sometimes, we load your car with stuff you don’t want. A box of tools we think you might need or food you used to love (even if you don’t anymore). We keep your things for the sake of nostalgia, long after you have forgotten them.
We try to intervene when you’re in trouble; by calling your teacher or posting your bail. We would stand in front of you if you were being attacked by a bear or insulted by a stranger.
We are hard-wired to teach and protect you. We want you to succeed and be independent. But this desire lives in dynamic tension with our deep, aching hope that you will still need us all your lives.
For all of this and more, you should love and honor your father today. He has worried about you, hoped or prayed for you and provided for you for years. The slightest hug and kiss, the minimal ‘thank you’ note, the kind word of genuine appreciation, these are our paternal treasures.
But dear fathers, let me now reassure you that you are always relevant to your young. This is obvious when they are small, and bring you cards scribbled in crayon, clamber onto your lap for comfort in a storm, or hug you to ‘pop your head off.’ When they cling to your hand in crowds, ask you to read puzzle books for hours, or say ‘I love you big more.’
Over time it’s harder to know. The children become busy shedding their old selves, and some of their old emotional displays, so that leaving is easier. But you are always in their hearts.
You see, brothers, even when the toys are packed away, the videos taken, the photos saved, the tassels moved, the rings exchanged, the cars packed for leaving, the apartments and colleges and careers and deployments accomplished, you fathers, all of us fathers, still have things to do.
We can model love by showing them that our love for them is not contingent on their presence, their gifts, their cards; even their acknowledgment. This is love, that persists and simmers even when it is ignored, and is ever ready to rise up like a hot fire in times of need.
We can stay with their mothers. We can show them that marriage is about raising children, but also more than that. That the love that made them is the love that remains. That as long as we live, we are a unit; mom and dad, deeply in love with one another and with our progeny.
We can show them the power of purpose. That whether in work or retirement, life has meaning and joy, especially in service. That age need not be empty or dull. We can work, and volunteer, and give ourselves for the good of others so that they learn the lesson by watching, and one day emulate us.
We can give them, in our words and actions, the powers of a personal faith so that they can deal with loss, struggle, mistakes and suffering long after we exit stage left. And so they know that in a great, wide universe that there is meaning, forgiveness and redemption.
Finally, as regards our inevitable exits, we can show our children what it means to grow weak, and sick, and then to die, with grace and honor. This is the last lesson we can model for them, but one of the most vital. We can teach them, if we believe it, that there is reason for hope beyond this life, and reason to live this life well to the end. Others, who do not believe, can teach them that to look back on the good of their lives, and to know that their love and memory will live on in the lives of others they have touched.
In so doing, we not only teach them, we protect them from terror and despair when life’s final darkness passes over.
Children, love the old man and remind him of his importance. But dear old men, dear fathers, never for a second think that you no longer matter. You matter to the end and beyond.

Graduation, When we Shoot Arrows at The Enemy

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http://www.greenvilleonline.com/story/opinion/2017/05/25/its-time-launch-our-arrows/343820001/

We have a quiver full of arrows in the house. Over and over again, the kids and I have used the target arrows it holds. Many of the arrows are worn and dinged, and some fletchings have come loose. (I have no idea how many rest beneath the grass or are stuck into trees in the woods.) The remaining arrows are sentimental to me, but still see use now and then as the mood strikes us.
Since yet another of my children prepares to graduate high school, I found myself thinking of Psalm 123: that says ‘like arrows in the had of a warrior are children of one’s youth. Blessed is the man who fills his quiver with them.’ Jan and I are about to launch another ‘arrow.’ But not at a target. Our son Elijah is being launched into the great battle of life. And as I heard a preacher once say regarding that passage, ‘what do you do with an arrow? You shoot it at your enemy.’
I am unapologetic about the martial metaphor. We live in a time of conflict, contention and danger. And no matter what one’s political, cultural or spiritual alignments, the fact remains that our children go forth into difficult times.
There are physical dangers, of course. The cowardly murders in Manchester, England remind us that violence lurks in the world and no amount of lovely colored buildings or candlelit, hug-filled marches will impede those who find its use expedient.
Cruelty is timeless and knows no borders. Slavery is still widespread, in the world at large and even in the US in the form of sexual and financial exploitation. Women of every race and creed are treated horribly in many lands. Globally, children die of starvation, dehydration and assorted diseases that we can easily manage in even the lowliest American hospital.
War continues to raise its endless Hydra-head. Gang violence robs necessary, beloved young people of their potential and their lives. Domestic violence and child abuse are rampant; especially in SC, sadly enough. Addiction is an entire war in itself, demanding aggressive action to save lives and families.
There are also political dangers. On both sides of the political aisle, there is fear that the glorious traditions and safeguards of the Republic may be imperiled. Each thinks the other is wrong. But each is concerned about something; each side has a sense of unease.
There are many battles to fight. Some compassionately advocate for equality of groups marginalized by race, gender or sexual orientation. Others battle for preservation of freedom of conscience, for the precious right to believe and act based on faith and tradition rather than cultural trend.

There are battles for abortion and against abortion, for open borders and for more regulated immigration. Climate change pits economic interests against environmental, both making important arguments for the future. Behind each lies the war of objective truth versus the cheap manipulation of spin and emotion.
Hardly a pep-talk for graduation, is it? But that’s the lay of the land. Graduation is beautiful and thrilling and all of us try to stifle our tears and cracking voices as we applaud our young people and give them hope.
But I want to give all of them, my own incredible son included, more than pretty images and vapid platitudes about ‘following your dreams.’ I want to say this: ‘It’s tough out here; we’re ready for reinforcements so get with it. Welcome to the team. Keep your heads down.’
I find that a more useful and thrilling thing than what graduates are all too often told. I want to see them launched at the problems of the world, in the full knowledge that it isn’t safe, that it isn’t easy, that they have a purpose in all the struggles and that they are needed. We need their courage, their insight, their creativity. We need their brilliance, their success, their strong backs, their loving hearts.
We live in a culture of increasing self-interest. Young and old spend too much time reflecting on their own wounds, victimization and identity politics. These things pull us apart rather than uniting us in the fray.
Dear graduates, look up and look around! Show us how to rise above ourselves and live well, how to glory in the struggle, how to win (or lose) with compassion and love, and also with ferocity and risk when necessary.
We loose you, dear arrows at the various enemies we face.
Strike true.
And congratulations, Elijah and all.