Happy Halloween

Halloween is one of those days I don't know quite what to do with. As a child creating a costume was always a chore. In the basement my Mom kept a box, down behind the furnace in a location more scary than anything else about Halloween. It would be one of those occasions where I would have to recruit my brother Dan and hope he would have the interest and nerve to go down there, crawl through the storage around that oil burningbeast and pull out the Holloween decoration box. And if we succeeded in that, we would open the box to find halloween costume parts. Instead of whole costumes we would find a few masks, some with their little elastic strings attached, others without; half a skeleton outfit; half a this, a part of that. That was one of the problems of coming along number 8 after 20 years of having kids-- there were a lot of scraps that the parents didn't really feel inclined to replace or upgrade.

When the "hobo" look came into vogue I felt a sense of relief. At least I could pull that off with little more that a sick with a bundle tied to the end and a handful of coffee grounds. Before that being a ghost was an option if there happened to be a sheet that was fully ready for retirement and had no further usefulness other than having a couple of eye holes cut in.

This year Ev declared he wanted to be a cowboy, a miner, and, for the Saturday trip to the local train museum Halloween function, an engineer. I did the best I could to match the theme. It's kind of refreshing that an engineer still calls up a train hat and red bandanna rather than glasses, iPad and a pocket protector. My friend Carol tells me she has a picture of me wearing a hat like this with a friend in grade school. She can rest assured some things never change.

Stay young and Happy Halloween.

Chicken Soup for the Cold

We have officially entered chicken soup season. Tam's stuffed up. Ev's sniffin' and blowin'. It's a viral war zone, a viral Occupy Mick's Street.

Years ago I spent a few months living with the Freemans. Dan had been one of my closest friends for years and, after finishing high school early, I worked and lived in LA until it was time to head back to Oregon for college. I lived fairly independently within the household but Friday nights always joined the family for Shabbat dinner. Mrs. Freeman, bless her heart, set a beautiful table, presented mountains of food, but could take a roast chicken within moments of total cremation. Her cooking was delish but the chicken should have come with a black box warning: best taken with a full glass of water. (The Manishewitz made it all better.)

Her chicken soup, on the other hand, was a work of art. She gave me the recipe at the time and I've unfortunately lost it over time. I remember it required 2 days to properly prepare and I miss that soup just writing this. My memory may be embellishing things but I'm inclined to think not. One bowl of that and you extended your life at least a good 2 to 3 hours.

So, as the cold viruses lowered the boom in our neighborhood I decided to fight back. I'm worried about a limited success, however. The version tonight was done and on the table in considerably less than 2 hours, let alone 2 days. But that's not what has me concerned. I had to use noodles. I'm out of matzo. Take it from a doctor: If you want to get serious about cold and flu season, re-stock the matzo meal now. In the meantime, I'll hope for the best in spite of my negligence..

An old friend of mine's sister died yesterday. I never knew her but I don't think she was all that much older than us. And I don't know anything about the circumstances other than she died owing to illness.

It doesn't seem right, or even possible. How can it be one of us dies? Our generation, a generation so rebellious, irreverent, so vocal, so young-- so forever young. Weren't we supposed to be the generation that would never succumb?

Time Bomb

Everyone around me is sick. Tam has a miserable cold. My medical assistant has been sick with a cold. In the waiting room and exam rooms one can hear a viral bomb going off every minute or so in the form of a cough or sneeze. They're trying to get me. I woke up this morning as Tam was trying to find her water and an Advil Cold and Sinus on her nightstand in the dark. I lay there thinking "I'm next. Is my nose a little stuffy? Does my throat tickle?" (Why is it called a tickle in your throat when it doesn't make you laugh but, rather, annoys the heck out of you? I don't use the term but I've never met anyone giggling about a tickle in their throat.)

I don't freak out when I get sick and it's a rare day that I'll miss work due to illness but, dang, I hate having a head cold when I have to fly. I have a trip coming up and I if I'm going to get sick I wish it would just hurry up and strike.  I'm like a poor tortured prisoner, "If you're going to do it just go ahead and get it over with! I can't stand it anymore!!"

I once knew a guy who, when he got sick, had to pin the blame on an individual. He was an airline pilot. It wasn't good enough simply to be exposed to an airliner full of bugs or a crowded waiting area at the height of cold and flu season. No. He always had the need to identify a single source to his illness as in, "Bill gave me this cold." Not me. I just figure odds are I'm gonna get nailed one of these days. I just wish it would hurry up and get it over with so I can get out to Phoenix without rupturing an eardrum!

Personal Hotspot

I like to think I'm not dependent on the internet. I like to think my iPhone is just that-- a phone. I like to think I've got plenty to do to keep me busy for the next 2 years of evenings at home without having to turn on a TV set. I liked thinking that, and I did think that, until the lawn guy ran over our cable the other afternoon.  Suddenly my home page won't load. No e-mail. Flip on the tube... more nothing. Maybe the lawn guy didn't tell us about running over the cable because he's seen how people react and knows it's better just to let them work through the emotions in private. Maybe he'll tell us in a week or so as in, "Oh, hey, by the way: I don't know if you noticed or not but I hit your cable line last week."

When I upgraded my iPhone a few weeks back I opted for the remote wireless option, a feature on the iPhone called the "Personal Hotspot." At first encounter I thought the name was pure hyperbole. After all, I've been in love with my personal hotspot for years, it's wireless, used for communication, and way more fun than even an iPhone.

Having my internet severed has cast a whole new light on my iPhone and its personal hotspot. As much as I hate to admit it, Apple's version has been of more use in the last 24 hours. As for all those projects I have to keep me busy for the next 2 years worth of cable free evenings? Maybe. But only if my hotspot fails me.

Good Fortune

Kels sent me an e-mail the other day. It was a "BTW my account says I still owe $1245. I think it's for my meal plan and it's due by the 31st."  As much as some parents gripe and complain about school expenses, we're a lucky bunch, those with kids who want to be in school. With all the expenses we face, all the options available to draw down one's bank account, there is no better way to spend your money, no greater success, than to usher on the success of your kid who has stayed the course and found her way forward. (Well, a new pair of boots might rate a close second.)

The way my measly investments are performing she may well have to pay it forward and finance my room and board in a nursing home some day. With prices what they are for long term care you would think they would at least throw in a class or two. Maybe offer a graduate degree after 4 years of residence? Hmm...that might be something to work on. In the meantime, I need to start convincing my daughter there is no greater success than providing for one's elderly Dad.

Perfection

Monday evening I walked home from a hospital board meeting. I stepped out of the hospital and into the most beautiful evening-- cloudless blue sky and the sun still a few inches above the horizon. The wind was blowing and the lacy gold and yellow patchwork that remains in the trees moved in a botanical dance both striking and sensuous. And in that breeze one could smell all the good of the year that is winding down. In the glow of that setting sun I could recall all the warmth of the summer just past-- it's friends and family and travels and enjoyment.

Maybe it's my work or maybe it's my age but when I step into such an environment I get terribly sentimental. I have to wonder: Is everyone paying attention? Can everyone find the richness in this moment? Do we all know how good it is to be out here in our comfortable lives? Can we all look forward to more?

I don't know the answers for anyone other than me. For me it was a perfect moment at the end of a good day at the far end of the year. I hope for many more and I promise: I'll be paying attention.

Fashion Flashback

One of the great things about having a little guy is getting all that great little guy clothes. One of the difficult things about having a little guy is all that great clothes he gets to wear and I don't. So many of his outfits are A.) Super cool and B.) remind me of just how many articles of clothing are now so far, far removed from anything I will ever wear again.

Case in point: A whole shipment of overalls just arrived from Oshkosh B'Gosh. Evan was planning on being a miner for Halloween. He seems to be waffling on his Halloween decision but the overalls are here to stay.

So, you ask, overalls? Overalls were on the menu? Yes. Where were you in 1975? (Don't answer that!) It doesn't seem so long ago my friend Danny used to strut around in his overalls, bare feet, sans shirt. How cool was that? I had mine, too. Hickory stripes. Needless to say those days are long gone. If I wore overalls today I'd be looking like a contestant in a Mr. Green Jeans contest. I wouldn't even pass for a tradesman.

But the kid? He's definitely got it goin' on. Check 'm out:

Student Driven

Driving around town this past week I've started to see the Student Driver vehicles out on the street. Usually this provides a smile, simultaneously condescending and sympathetic. The students don't make me nervous. I figure they're more freaked out than the experienced drivers around them. We all provide wide berth for the student and they let us past.

I have little memory of driver's training other than thinking I wouldn't want my instructor driving me anywhere. Not that I had ever driven with him. No, much worse: He had been my lousy high-school tennis coach, history teacher, and vice principal. (It was a very small high-school). Nonetheless, he was the guy who signed off on my driver's course work and enabled me to proceed to spend time behind the wheel with Mom and Dad. I guess it worked, I've had less than 3 moving violations, never caused an accident (that I'm aware of), and have never been in a serious accident-- except for that raccoon I smoked one night a few years ago driving to the airport. All in all, I think I learned to drive with some success.

There is a t-shirt I've seen that says, "If You Can Read This Thank A Teacher." It seems strange that an occupation that is so critical for the development and maintenance of a free society is so trivialized in ours. I look at that poor bastard riding shotgun next to that 15 year old student driver and I have to think he is an all-star. In retrospect, even my own lousy tennis coach was doing what he was supposed to, what was required, what someone had to do.

Teaching is one of the great professions but is never given its due. Think about the many teachers who've touched your life. Chances are, there were some great ones and their influence continues to live with you today. Thank a teacher. Fight for education.

The Sermon for this Sunday

Walking past a magazine rack last week I noticed an issue of Oprah's magazine. Her magazine caught my eye because it had in bold print, something like, 9 Ways To Improve Your Life.  I actually grabbed it and glanced through the contents but could not find anything within that seemed to pair with the title.  Magazines that splash those catchy titles across the cover and then leave you to wander through page after page of high end clothing, accessory, and fragrance ads in search of the promised article drive me crazy. And pretty much insures I will never pick up another copy. In the present case, I even sat down and tried again a little while later and still to no avail.  It's not that I'm looking for change or improvement in my life. Rather it's just that I find these types of self-help/advice articles curious and wonder what people consider good advice. I think the reference in the magazine was to a series of biographical sketches which were meant to inspire the reader to engineer a breakthrough in their own life.

Thinking about it, I've decided that what most people need to concentrate on is what they have. They need to know to appreciate, enjoy, and invest in themselves. Consider these few "life changing discoveries" that, effective as they may be, I hope you will never have to face: 1.) Discovering your spouse of 23 years is leaving you. 2.) Contracting a life threatening illness. 3.) Losing the ability to walk. 4.) Learning you will, more likely than not, be dead in less than a year. 5.) Losing your job of 26 years at age 54. I'll leave my inspirational list of "Ways To Change Your Life" at 5. There are others one could experience but they get too grisly.

As terrible a list as that may be, for many people, every day, one of these items becomes a reality. I hope never for you. The fact is, more people face change because of unwelcome and unexpected events than those owing to good fortune or choice. But maybe realizing the hell that can rain down in a person's life can provide the incentive needed to assess one's assets, forge a change where needed, and live life like the gift it truly is.  Examine the lives of others to take inventory of your own, appreciate what you own, the potential within, and all that remains for you to accomplish.

A Taste of Autumn: Leaves fall, Weight rises.

People who live in moderate climates sometimes find it peculiar, and even annoying, how we of the northern climates so often let our thoughts and comments go to weather. Really, it's quite easy to explain and hard to understand if you've never experienced submersion in a harsh environment or lived where the seasons come and go with pageantry. I get it. That's where I live. And as bad as it can get it can also get just that good.

Autumn is one of those seasons of major transition. If climate were a stage play we'd be headed for the intermission. Everything changes. People's energy levels change, pounds start to creep back on as the summer activities get packed away, the wardrobe changes require a costume hand.

The weight gain that frequently accompanies the coming of cold weather is becoming easier for me to understand. I didn't buy it at first. Many people here in Michigan remain active indoors in the winter with basketball leagues, volleyball, indoor tennis, dance. It requires more effort but they're out there-- or in there, I should say. No, it's not activity. It's diet.

The evening before last I came home from the office to the wonderful aroma of a pumpkin cake. I've never had a pumpkin cake before-- but within a couple hours of getting home I'd had the better part of a third of one. The fall and winter menus are fabulous: Chili and stew and chowders and roasted this and that. Adios dinner salad, hello hearty soup. But that's just the entrees. Now comes pumpkin pie, pumpkin rolls, this murderous pumpkin cake, gingerbread, ginger cookies, and a landslide of holiday cookies just weeks ahead. Good God, take cover! Someone pass the Crestor!!

Maybe all these fall treats are less appealing in the warmth of the southwest. Maybe I should move for my own good. I'll give some thought to heading out to Arizona...as soon as I polish off that pumpkin cake!

Retail Revelation

I'm a little excited. I just finished going through the new Orvis catalogue. I don't even know why I'm on the mailing list except via the credit card information whores. Nonetheless, I'm stoked.

As embarrassing and politically uncool as this may be, I love retail. New shoes, new pants, new shirts...more stuff. Not that I'm acting on this impulse. I'm trying to learn restraint and fiscal responsibility so that, one day, I can retire if I so choose. Besides, it's late as I write this and I'm not about to walk all the way out to the kitchen to dig out a credit card. But I do love clothes, especially this time of year.

What was especially exciting about the catalogue, however, was not the numerous items for sale. What excited me was the number of items made in the USA. The text even included a reference to the reemergence of the textile industry in New England. I love reading that and only hope the resurgence is substantial and not just a go at a marketing niche.

Over the past few years I've been in an Orvis store or two. I'm not a fisherman but I like their stores. But Orvis, like Ralph Lauren, J. Crew, and damn near everyone else out there, annoys the crap out of me when I see their products with top-dollar prices and manufacturing labels from China, India, Vietnam, Chile and the like. Top dollar. At the top end every bit in line, price and quality, with favorites of mine like Bill's Khakis which are made in the U.S. The higher price on the other guy's imports equate solely with greater profits, not greater quality.

I guess I'm just weird about all this but I like to think that when I purchase an item made in the US it somehow helps out the home team in a more substantial way than just being a good consumer. Like shopping locally owned rather than big box. I live where unemployment is high, where many manufacturing jobs have been exported, where small stores have long been snuffed out by Wal-Mart and the like. The effect is demoralizing on the individuals as well as the community.

If you happen to see the Orvis catalogue laying around somewhere, or if you find one in your stack of junk mail, check it out. And look for the items marked "USA." It's just nice to see after such a long absence.

Rain

Wednesday is my commute day. It's my equivalent to living on the westside and commuting downtown. 18 miles to the next little town where they have a hospital and I do surgery every couple of weeks. Just like elementary school, I try to run back home for lunch in the time between OR and office.

The drive this noon was made beautiful by a soft falling rain. So many people hate the rain and, I'll admit, I did for years. All through high school I thought the rain was just one more dimension of the indignity I had to endure moving from L.A. to rural Oregon. That all melted away after meeting Miss Right who happened to love a rainy day, loved to walk in the rain, loved the Oregon Coast on a stormy day.

Now as I drive along I love seeing the big gray clouds hanging low.  I love to see the fall colors and the lights of passing vehicles reflected on the wet pavement. Most of all, I love getting home with Tam-- having chili for lunch; cozy in sweaters. It could only be better if I didn't have an office full of patients at one o'clock.

Rain asks you to stay in and get your work done or get out and walk through a puddle. It allows you the opportunity to disconnect from what nags to be done and reflect on all the great things accomplished-- and fun to be had. Rain asks you to hold still and enjoy the day. Not liquid sunshine. Liquid opportunity.

Someday I want to assemble my "Rain" playlist. For now, enjoy this classic by Paul Simon, sung by Eva Cassidy.

                                   

Happy Anniversary, Baby

Saturday was our anniversary so that night we took turns... getting up with Evan.  First, I got up at 1. Then Tam got up at 4. Then I got up at 5 when Evan awoke again, this time finally walking into our room-- dog, bear, and blanket all in hand. That evening he'd pooped out around 7 not feeling well so I had feared it might be a short night.  "I'm hungry. I'm really hungry!"

It is so very easy at such times to just say no. At 5AM  my charity cup is empty, "my give a damn is busted." Especially so when the night has already been twice interrupted. Slowly, reluctantly, painfully, I got up and volunteered to get him some breakfast. And breakfast I did: Hot cereal on the table within just a few minutes. Within just a few more minutes, however, it became apparent he still wasn't feeling well. One bite, tears and, "my stomach hurts."

For the next three hours we cuddled in a chair along with his trusty Giraffe blanket. As much as I hate having to get up early on a Sunday morning I realize just how lucky I am to have this little guy, perfect in so many ways. Even when he's not feeling well and gets me up at 5AM.

Later that day he was all better, his UNO game back in top form. I know it won't be much longer that I'll get away with holding him on my lap for a bit, let alone an hour or two. So, for now, I'll count my blessings and realize every event is an opportunity--- an opportunity that won't be available forever. For better or for worse.

Just Say Yes

Do you remember not getting what you wanted? I mean, it still happens to me and, quite frankly, I don't like it any more in my fifties than I did at 5. I cry less even if I do pout the same. But, no, I'm referring to that time as a kid when that seemingly reasonable request was just flat out denied. A request that seemed so benign but didn't even warrant a "we'll see" response. I'm not talking about a request to see "Hair" at the Dorothy Chandler as a 12 year old in 1969. (Denied: Nudity.)  I'm talking about "no" to white tennis shoes vs. black. (Denied: Undeclared.)

Like so many mysteries of childhood, age and parenthood provide the insight to reveal just how these snap denials came to be; and how unreasonable such decisions can be and might have been back then. Case in point: Light-up shoes. If you have contact with a child under the age of 8 you should have at least tangential knowledge of the subject. If not, light-up shoes are sports shoes with little lights incorporated into the soles that light up with each step. In short, when wearing them the kid looks like a priority one ambulance running down the sidewalk.

Tangential knowledge is where Tam and I had hoped our encounter with light-up shoes would end. Evan wanted, wished, and (politely) begged to get a pair. "No." All the kids at his pre-school have them. "No. We'll get a new pair of Pumas." "But I want light-up shoes."

After a few weeks of this it became quite obvious to me that a.) both his mother and I hate those freakin' light-up shoes and b.) our objection and denial had no basis in substance.  In short, we had become the "no" parents.  In spite of the fact we both recognize the value in not getting into fights over trivial clothing choices; in spite of the fact we both recognize the value in not getting in fights over bedtime books; in spite of the fact we make a conscious effort not to get wrapped up in battles of no consequence with a 4 year old: here we were putting our foot down (intended) over (those annoying, cheap, stupid) light-up shoes.

Evan has had his light-up shoes now for just about two weeks. His feature the character Lightning McQueen and are wired with enough lights that cars would pull to the shoulder should he be seen walking in the rear-view mirror. So far he is not showing any signs of tiring of them. Nor is he tiring of demonstrating their function by stomping his feet for the casual observer.

This was definitely a proper yes. Ev loves his new shoes. We'll get over this. We'll survive light-up shoes. Personally, we hope he gets over them pretty soon as well.

Monday

Monday morning.  When will Monday morning ever stop hurting? Where did the weekend go?

Monday morning is when I wake up and realize just how poorly I've managed my time in the last 48 hours. This is when I wake up to my alarm wishing I had slept more over the last two days when time permitted such frivolity. This is when, just before I drag my butt out of bed, I take a few moments and ask myself why I did what I did instead of what I should have done, like hang the pictures in Ev's room, or any one of a half-dozen other projects that need to get done, always get relegated to the weekend, and somehow never get addressed. This is when I ask myself: to what degree could I modify my standard of living so as to retire in the next few weeks?

I'm not sure that retirement helps. Even with no particular agenda I still think Monday morning is going to be that punctuation mark in the week that makes you pause and evaluate how well you've used your time in the last few days. Maybe so. But if I'm retired I would hope I could at least kick my noisy conscience out of bed and get back to sleep on a Monday morning.

It's a moot point for now. Time to get to work. Five more days and I'll have another go at time management. Have a good Monday.

More Fall fun

Yesterday Tam and I were fortunate to witness one of the great fall traditions here in Michigan. Thanks to the generosity of my partner Joe, we found ourselves in East Lansing, Michigan to witness the annual University of Michigan vs. Michigan State University football game.

It's a long day starting with the 30-some mile drive to East Lansing followed by lining up in miles of traffic to find a spot to park; then traversing a campus populated by students who seem to have no problem initiating beer management well before noon.  (Who needs a Bloody Mary when you've got a cold Miller Lite?) All that to arrive bright and early at that black-top social institution, the tailgate.

The tailgate is well known to most football enthusiasts. I suspect it is not well known to the rest of the country that finds itself doing anything but watching sports on Saturdays. If you don't know tailgating you need to know this: The tailgate is the Thanksgiving of picnics. The tailgate is the family reunion open to all members of the extended family that loves college football. The tailgate, for many, is college football. Like any great reunion, this event is filled with friends and faces you're happy to see. Bundled up on a blustery fall day to enjoy food, drink, and an ocean of friends, old and new. What's not to like?

The star of yesterday's performance was my partner, Joe. To look into the fully loaded cargo space of his mid-size SUV is a wonder-- packed from stem to stern, floor to ceiling with a full bar, food, fold-up tables and every utensil, cup or plate one might need-- including the MSU canopy to pull out and cover it all. Think gypsy wagon here. Thirty minutes later he's set up and ready for the business of feeding and watering a steady stream of family and friends. All of that but you won't see is the biggest item he has to serve: Hospitality. In a parking lot filled with hundreds of tailgates and thousands of fans, you won't find a bigger more generous soul than Joe. I always joke and say the most enduring non-blood relationship in my life has been my partnership with Joe. On a day like yesterday it's easy for anyone to understand why.

My daughter's Wolverines suffered a long and painful loss. By the end of the day we were tired enough that the drive home would have been better in a bus or limousine. But it was all worth it and couldn't have been a better day. It's just one more thing to love about October in Michigan.

Manly Time

Manly days are upon us once again here in the mid part of the Great Lakes State. Bowhunting deer season started the first weekend in October. It's not an exclusively male domain by any means. I have a partner who always takes the first weekend in October off so she can head up north to her rustic cabin and climb her tree stand in the hope of killing something with antlers.

For me it's not the hunting biz, it's the clothing. I was reminded of this the other day seeing a man in his 40's and anxious to get out in the woods. He was dressed for the part even if his leg was not healed enough to permit.

This is the season of nice heavy flannel shirts, well worn jeans, and a good pair of field boots. Ball cap and Carhart coat if needed. It doesn't matter if you're shopping at Ralph Lauren or Wal-Mart-- in this state they're all appropriately stocked. All things considered, though, you might be well advised to pick up your outdoor clothes at the local farm supply. The outdoor experience here gets authentic in a hurry, especially in the coming weeks.

If you dig the look of the rugged outdoorsman we've got your number; and the accoutrements  to indulge your woodsman fantasy. So, if the mood strikes you, come on out. Grab those old jeans or a good pair of field khakis, pick up a heavy flannel shirt and pull on a pair of Red Wings. We'll go for a walk and crunch some leaves. Sorry, my Mom got rid of my bow and arrow years ago.

Houston We Have A Problem

Houston, we have a problem.  Pre-school and daycare have been a part of my son’s life since he was an infant.  Our pediatrician is one of those socialist eastern European types that do not believe in raising a child at home. No. Children benefit from daycare and a communal upbringing. It’s good for the immune system to have that exposure as well as for developing a strong social competency. Check. Our guy has been at daycare since she gave us marching orders at his 3 month wellness visit.

So far I can vouch for the immune benefits. Ev gets exposed to every bug in the county and seems to handle them with an admirable degree of immuno-competency. Not that his parents fair quite so well. Some of the crud that moves through a community daycare should require those kids to be kept in individual zip-lock bags for 10 to 14 days. Those kid-bugs seem to get special pleasure in taking residence in the adult upper respiratory tract.

The real problem rests with the social development.  I'm a public school kinda guy. I like heterogeneity. I like it, that is, until that heterogeneity starts influencing my kid to come home and talk in this deep guttural satanic voice. I like it until my kid comes home talking about bombs and guns and blowing people up. Just because my brother and our friends were playing war, shooting stick guns, and having dirt-clod fights by the time I was 5 doesn't mean it's good for the flesh of my flesh.

The dilemma we face is this: How do we steer our kid away from that rotten little bad citizen who is destroying our sweet little boy? I've tried explaining to Evan that someday little Johnny will be his client. That is, little Johnny will be his client if Evan chooses a career in criminal law. So far we haven't broken the spell this little future meth-dealer has on our kid.

I know I'm blowing this out of proportion. We'll calm down. After all, I guess all one can do is lead by example, emphasize the good, and extend a world of opportunity in the hope your child will find his proper place. All of that and maybe a visit to the gallery of the county courthouse.

Pack Up the Trailer

As previously reported I have any number of patients in the course of a week belonging to a group best described as "dissatisfied elderly." Many of these people are not particularly disabled. Many of them remain quite active and continue to live independently-- even alone. They make it but they have problems; problems that interfere with their ability to enjoy life as they did in previous years. Medical, physical, emotional. The disgusted comment always starts, "Let me tell you, the golden years..."

The other day I saw a man who broke his hip a few months back. He is slowly progressing in his recovery but appears to have weakness which might be explained by a pinched nerve.  He is frustrated by his impairment so I suggested we set him up to see someone for a nerve test. "When?" was his immediate response. He seemed anxious to get at the root of his trouble. I proceeded to list any number of options over the course of the next 2 to 3 weeks, all of which he shook his head in the negative. "Doctor's appointment." "Biopsy that day." "Have to see my dermatologist."  "Lab draw that day." His calendar was literally riddled with medical appointments. I laughed and told him I now know why we retire: So we'll have time for all of our doctor's appointments. With a look of defeat he laughed in agreement.

No problem. There is no urgency at this point. He can make an appointment at his convenience. "How about November?" I asked. "Hell no. We leave for Florida in 3 weeks." At least he's got his priorities straight. Like cholesterol pills, restricted diets, smoking cessation, and a half dozen other medically imposed restrictions placed in the name of health and longevity; at 80 you just need to say "screw it!" Pull the plug, pack up the trailer and head for Florida.

Think Outside the Box

One of the phrases I most dislike is "think outside the box."  It is beyond lame and terminally overused.  So much so, I can only hope the term really isn't used any more except among small groups of uninformed "stakeholders" who are being "engaged" by two-bit consultants. Translation: such snippets of corporate speak are the stock and trade of the medical consulting industry.

A small community hospital is fertile ground for just such abuse.  It is the bane of our existence, our dirty little secret, that at board and staff meetings we are still implored to "think outside the box."  Having had to hear the phrase overused for so very long I now finally realize what it means: Make a suggestion, discuss, and then prepare to hear what has already been planned and is about to be implemented. Bottom line? Think outside the box means:" Get out of your box and climb into mine."

Of course, one must never "think outside the box" unless they have "drilled down" into the available data prior to thinking outside the box. I always balk at "drilling down," however, as I fear I may strike an electrical line or other hazard long before I strike oil. For now I think I'll just look into a matter through research and logical evaluation of the available data. Then, I can come to a conclusion. Or, if you will, "wrap my mind around it."

There's a good one.  The last person I saw who wrapped his mind around something was a motorcycle rider. Needless to say, he was dead. Maybe the phase is a reference to warping your mind as in getting stoned once too often or looking at too much porn. For my money, I'd rather wrap my arms around something. That would be a physically plausible analogy, allowing me to embrace or contain the thing.  Hmmmm. Makes sense.

I'm just ranting here, I realize. But I get a little "pissed off "(that's orthopedic for upset) about all the money and time spent with consultants who constantly hide their often very simple ideas in layer upon layer of complex nonsensical wordsmithing bullsh*t.  I get so I think the only point to their crap is self-preservation: If you pay for advice you can't possibly understand then maybe you'll pay to have them stay around and explain it. Hey! Wait a minute-- maybe these guys are pretty smart!

'Til Death Do Us Done

A friend of mine's mother died recently.  It was unexpected but she died peacefully-- took a nap on the couch and 'woke up dead' as I say. He and his family are well known long time residents of our small town.  Several of the kids work in highly visible public jobs, they're active in their churches, and they have a history of being active in community service. The death of this woman was news and precipitated a fair amount of grief and talk.

Another woman I know just lost her mother. There was nothing peaceful or compassionate about the experience. It was one of those awful events in which a person smolders and then, suddenly, bursts into the painful and all consuming flames of metastatic cancer. It didn't take long but it was a miserable journey for both the patient and her family.

I am always amazed at how death impacts people.  Not the family so much as others. The talk is always about how sad and how difficult it must be. And sometimes that's true, like in the case of the woman who lost her mother to a painful, merciless, unrelenting disease. On the other hand, I am around aging people all day, many of whom wish they were dead. Worse yet, many of them are dying, but slowly and following a road pocked with the cracks and potholes of failing mind and body. It's becoming a miserable fact of increased longevity: We're not just living longer, many of us are taking longer to die. Way too long for some. Where's that couch when they need it?

Until such time when we get to choose the day and the hour I guess I'll hope for the best for myself and others.  My heart goes out to those who will suffer. In the meantime I'm going to see if, when the time comes, there's a way to get in line for a nap on that couch.

From the Heartland

More tales from those late night travels in rural mid-Michigan: Driving home from the airport last night we were reminded once again what it means to live in this neck of the woods. Heading north on the two-lane, after we had slowed to safely pass the two horses and pony running loose on the shoulder of the highway, we started to smell that fine light fragrance of...dirt. It doesn't stink. It's sweet and organic and reminds you of where food comes from. And just a few miles after that we see the dust and find the source of what we smell: Combines working late into the darkness to get the crop off the field. According to the weatherman they'll have a couple more days to get those soybeans off before the rain comes and spoils the opportunity.

Not even 5 miles further north came another rural aromatic calling card: Somewhere, out of eyesight, someone was burning leaves and brush. That smell is enough to make you want to stop the car, grab your marshmallows, and pull up a folding chair. A big moon, 62 degrees, and a bonfire. It's a simple pleasure and, oh, so hard to beat.

Of all the things one may go without when living in rural mid-Michigan, it's things like these that remind me of just how lucky we are. For the rest, we have an airport.

There, But for the Grace of God

It's Sunday so I have some license to include a reference to God in my blog. Unfortunately it's not the prettiest story but it does allow me to preach a bit.

I had to go in to the hospital last Sunday because I was the on-call guy for my group. While there I learned there had been yet another substance related death that night. This time it involved a 35 year old man who had been found drunk and face down in our local river.

The broad Shiawassee River is quite picturesque as it winds through town. This time of year it is especially so with the big trees starting to add highlights to their heavily leafed branches. It is also especially shallow this time of year, maybe 3 feet at its deepest. Not a white water monster.  Nonetheless, in a community with its fair share of Saturday night drunks, more than just a few people have found themselves stumbling along it banks. Thankfully, it's pretty infrequent that anyone doesn't make their way back onto dry land.

Talking with one of my colleagues about this latest episode it was one of those sad and unfortunate events. Attempts were made to resuscitate but to no avail. And we both had to say, there, but for the grace of God, go I. We both had to admit we have each had our misadventures which could have ended up quite badly. We both acknowledged our good fortune in never having had to end up in a hospital, a cop car, or on the wrong end of a "bail me out" call.

As much as we all grow older and, for the most part, seem to learn from our mistakes, it amazes me that we seem so incapable of successfully passing that information along. Whether it's as simple as the wisdom in not procrastinating or as critical as the necessity of not drinking and driving, it seems others just don't want to embrace the lessons to be learned from the experiences of others. As the saying goes, experience is the best teacher... and best learned from the experience of someone else. The worst of it is the concrete wall which seems to obstruct any possible transfer of the elders' combined wisdom to the inexperienced offspring. Take Mom's/Dad's advice? Right.

We all suffer the same stupidity. We all seem to re-plow the same unforgiving fields. Those of us who are truly fortunate end up, one day, sitting in our comfortable homes thinking about it. And hoping against hope our children will safely manage life's many, often self-made, obstacles as well. Say a prayer.

Why This?

In my family it's definitely the wife who wears the pants when it comes to football. It's the reason we have a big cable-connected flat screen where there used to be none. It's the reason her phone has ESPN and NFL apps where my phone has none. Even so, in the course of the past 6, almost 7, years, she has slowly sucked me into the fold.  Now it's me sitting up late on a Saturday night to watch the final quarters of the west coast college game. Now it's me thinking about sports menus with features like ribs, chips, dips, sliders and dogs.

With that as a background I ask the audience to acknowledge, yes, Michael P. Schmidt does realize female football fans do exist, are real, and are legitimate. Thank you.

Having established my credential, now let me ask: What's up with all the female sports announcers these days?? Not the sidelines types who've been around a while, although that's weird too. Mostly I'm referring to the women populating the Sports Center desk. They strike me as out of place. Like having your mother make the food and pass the trays at your bachelor party--I'm sure she may have wanted to, and she may have had a legitimate interest, but it just would not have worked.

I'm not a big sports guy but it does seem to me that football is all about men beating their chests, flexing their muscles, and clobbering the other guy so that they can ultimately, well, get the girl, whether literally or figuratively. Somehow having women turn up in the male bastion of football, or, for that matter, whatever other man-sports are qeued up, it just strikes me as too weird. It's just too p.c., like modifying Cookie Monster's diet to include fruit and veggies. I mean, really. Remember that scene in the movie Steel Magnolias where Olympia Dukakis reports from inside the men's locker room? I'd be embarrassed as hell and calling myself out here as a sexist bastard in all this if it weren't for one thing: My wife agrees. And in an informal poll of sports geek women in the OR, they agree as well. It's weird.

I know all this didn't just happen in the last 2 months and I'm not sure what it's all about-- and I'm not really sure I even give a rip. But, whatever the motive, there is some real entertainment value to it: Having a woman commentator sitting along side the football or NASCAR guy announcers really seems to irritate the hell out of those men. It's just below the surface, but I see it. You gotta love a good competition!

Smart Shopper

In the last year or so I've become a big breakfast cereal guy. I don't sit and read the box like I did years ago. Now I catch up on e-mail, this thing, and check out the news. There must be an awful lot of reading that goes on while Americans eat their cereal.

I picked up a box of Smart Start cereal the other day. I tried it a year or so ago because the box said it was full of anti-oxidants and what not. I liked it but somehow dumbed down and wandered away from this delicious and useful breakfast product. Trying it again, I think they've made a change: The flakes appear to be coated with a lacquer to prevent sogginess. This recalls National Lampoon's Christmas Vacation in which Clark W. Griswold, Jr. reminds his boss of the cereal lacquer he had created for the company to do just that. So I'm thinking...did Kellogg's get the idea from the movie? The flakes in my cereal are hard as stone chips even after a good five minute soak. And then, would this product do to my little snow sled what it did for Clark's??

The other thing this new cereal reminds me to think about is the American consumer. Does anyone really buy a cereal thinking that Smart Start will be just that, a smart start to the day? I'm thinking it does, in fact, work that way. To the contrary, however, I don't feel or perform any smarter after Smart Start than with granola, Grape Nuts, or Raisin Bran. My mouth and teeth might be a bit sensitive but I'm no smarter.

Now, if they offered one called F'n Good Lookin' I might have a go at that.

Blueberry Buckle

Wednesday was Evan's day to bring a snack to pre-school. It was supposed to be a "B" word snack like banana, banana bread, baked beans. So I had the bright idea we should do blueberry buckle. We threw in Banana Bits and milk (Bovine Breast Beverage, duh).

Tam is the baker while I'm the cook. Thus it fell to Mom to make the buckle. I knew there was such a thing as blueberry buckle because it comes in baby food jars and adults love it. So, with a substantial collection of cookbooks here in my kitchen, Tam did the reasonable thing: She promptly opened her laptop and Googled blueberry buckle. Presto! More blueberry buckle recipes than you can throw 3 pints of blueberries at.

As it turned out, the one she selected smelled heavenly baking here in our kitchen. So much so that I suggested I run to the store and grab a bag full of Butterfingers for the pre-school and we'll demolish the buckle right here at mi casa. No deal. The buckle went.

This experience has left me to wonder just what we might be missing in the age of Google. Leafing through several cookbooks in search of a recipe allows the happy coincidence to occur. Like when looking for buckle you mistakenly open to a page featuring a chicken or vegetable dish that piques your interest. Or, even just looking through the index, you come across names of dishes or ingredients you have forgotten or have always wanted to visit or revisit.

With Google, the index itself will soon be nothing but a mystery to an entire generation because Google is just that: a giant index. Will it be 2 years or ten before a 12 year old doesn't know how to navigate a printed reference? Perhaps you think it doesn't matter but I think it does. I would wager coincidence has been responsible for the birth of more than just a few good ideas as one thumbed through the pages of a book, its table of contents or index. The most likely way that will happen when Googling is if one mistakenly omits or transposes a letter or two. But be careful, you may have some explaining to do.

For now, Google "blueberry buckle."  Take your pick, or try this one I Googled. Make your belly smile and your house smell good.

It's the Most Wonderful Time of the Year

Being a native Oregonian I've always had a place in my heart for the great evergreen forests of the Pacific Northwest. Hiking on trails inches deep with bark and fern mulch, inhaling the sweet pungent fragrance of the cool damp air filled with Douglas-Fir, rhodies, ferns, and assorted underbrush is a treasured memory. Even on the many gray days with a low cloud ceiling and mist in the air, it is invigorating and one of the great places to be.

Moving to Southern California as a kid, and now having a part time residence in Arizona, I have come to also treasure the brilliant sun, a desert landscape punctuated and bordered with peaks and mountain ranges, and the beautiful cactus and palms. The desert environment is far removed from that of the Northwest and Michigan but offers much to recommend the experience-- especially December through May in Arizona.

This week, however, belongs to Michigan. If you don't have evenings with clear skies and temperatures in the 30's; if you don't have brilliant crisp clear mornings where a sweater and jacket are in order; if you don't have sunny afternoons with a high temperature of 70; if your home is not surrounded by hardwood forests where the red, orange and yellow of fall are beginning to paint the trees-- if you can't say yes to all that you don't have a thing to talk about this week. For a state where we suffer through months of sub-freezing weather, snow and ice; for a state where the peak of summer is often accompanied by percent humidity which matches the high for the day; for a state with more than it's share of economic ills-- this week we own it all and can feel fortunate to be Michiganders.

I See the Moon

Driving home from Ann Arbor the other evening it was late. As we passed through the many miles of farms and countryside the sky was dark enough to see a multitude of stars. Even so, the quarter slice of moon was brilliant and made the most beautiful nightscape image as it illuminated a solo wisp of cloud in the sky above it. Such a common sight and yet it was really breathtaking, an image simultaneously austere and spectacular.

Looking back at the image I was reminded of a children's song my nieces taught my daughter years ago. It was probably during one of several trips we took together out to the southern California desert where one often sees the moon shine over the surrounding mountains. The song goes something like, "I see the moon and the moon sees me. The moon sees the one that I long to see....." It's a great little nursery rhyme/song that lets a child feel connected to the greater world and, especially, connected to an absent loved one.

Walking up to the hospital early that next morning I saw that same moon as it made its departure for points west. Still beautiful in the pre-dawn glow I had to think: All over this world there must be people admiring the beauty of this moon, its brilliance in the clear night sky. Somewhere there must be people in a world at war who wish for nothing more than to enjoy that moon in peace; people who don't care to die over religious beliefs; who don't care to die for petroleum; who don't care to kill because some remote leadership demands it. Somewhere in the world there must be too many people who want only to enjoy the beauty of that moon without the burden of their desperate hunger, their poverty, their illness. Somewhere in a world so large there must be people who want nothing more than to be able to enjoy the simple beauty of a moon without fear. If only we could all agree that our greatest achievement would be to provide for everyone to see that moon and enjoy its beauty in peace and comfort. Such a dream on a moonlit night.

Too Cute

Dateline: Owosso

Cuteness awards were handed out over the weekend here in mid Michigan.  Once again, Evan Schmidt swept all categories after his performance in a local restaurant. In an embarrassing repeat of his previous performances in the competition he knocked his parents, er, the judges, off their feet as they quickly came to the unanimous decision that Evan is, in fact, cute as heck.

The surprising decision came early Friday evening when Evan, while exiting an Italian eatery, had to give a wave of the hand to each table as he passed, saying goodbye. When the hostess inquired if he was on his way home, Evan replied, "No! I'm going to the train store!" Then, after opening the door and entering the vestibule to exit he turned as he held open the door and sang out, "Who, who, who, who let the dogs out?!!" The decision was immediate, unanimous, and uncontested.

Welcome to My Life

As happens with a fair amount of frequency, I bumped into one of my old patients the other day. I think it was in either the coffee aisle or the bread aisle. He stopped and turned toward me, paused, and then asked "Are you Dr. Schmidt?" I'm never sure what will happen next but, casting my reservations aside, I answered in the affirmative. "Oh, ya. You fixed my daughter's arm a few years ago. She's the one who was kicked by a horse." The funny thing about that encounter is that, in my practice, being kicked by a horse puts you in a group of patients, not a class by yourself. I have at least one or two every year. And a cow injury or two. Here, being injured by a large farm animal is not a unique identifier. Welcome to my life.

The very next week, same store, peanut butter aisle, I bumped into another couple of patients, a husband and wife. He was wearing a sling because he had his shoulder operated the week before by another doctor. "So how ya doing?" "Okay" he answers. "This is gonna drive me nuts though 'cause I can't shoot my hand gun!" This guy is not a cop. But it gets better: "ya," he says, "I went out shootin' with my pastor and a couple of the deacons from my church last week and they were smilin' at me the whole time. I know why they were smilin' too. They were hopin' I'd have to sell 'em my hand guns because of this shoulder! I'm not sellin' my guns!!" This gave him a chuckle and a big ol' smile. It's not every church parish where the Sunday announcements might include something to the effect of, "The pastor and deacons invite all interested church members to join them in a handgun shoot next Saturday. Bring your weapon and a dish to pass." Welcome to my life

I don't have horses and I don't have any use for guns. Be that as it may, I enjoy having this close rapport with my patients. It can be a nuisance but, more often than not, it is satisfying to run into happy patients at the grocery store or in a local restaurant. The stories may be weird but that's half the fun. Welcome to my life

Beep Beep Beep Beep Beep

The other day my beeper went off at 4AM. As it turned out the ER doctor just had a quick question about a broken foot we'll probably see in the next few days. I didn't even have to get out of bed. Shoulda, coulda, wish I woulda, gone right back to sleep. I don't get paged that often in the middle of the night and that's one of the advantages of working in a small town. We're not the kind of town where people get shot; unless they're not wearing orange in November. We're not the kind of community where people drive around at high speed late at night. We're the kind of community where people go to bed at night, sleep, and stay put. Including me. Even so, the beeper remains a fact of life although many docs are giving them up and relying solely on their cell phones. I still prefer a beeper because it gives me a head's up before I get on the phone.

Years ago I remember when the neighbor across the street, an intern at UCLA, got his first beeper. It was a voice audible device that basically beeped and then you heard something like, "Paging Dr. Freeman. Dr. Freeman, please call the hospital." Once he arranged to have the hospital operator page him during Shabbat dinner so his mother could hear her son, the doctor, get paged. I think she cried she was so overcome with pride. And I'll admit, at 16 or so, I thought it was pretty cool as well. (As I recall, the young intern thought it was extremely cool!)

Like a whole lot of docs in this country, I'm getting too old for that beeper crap. Not that I have a choice. It's part of the shtick at my hospital: "Wanna work here? Grab a beeper." Problem is, often times when my beeper goes off at 4AM I can't get back to sleep. Instead I lay there and think of this thing or that. The worst of it is when I have a particularly difficult case I'm struggling with-- bad injury, bad outcome, bad attitude, bad vibe-- somehow it's then, at 4AM, that my head decides to start the internal debate about what to do, should have done, will do next, will never do again, and so forth. It's particularly maddening because my own brain starts practicing willful disobedience and disrespect towards its owner. I tell it to relax and go back to sleep. Ha! I tell it we will do something about it after a couple more hours of sleep, Double ha! I tell it there's nothing wrong and everything will be fine. Nothing but sass!

For now the beeper has to stay. But if it goes off at 4AM again any time soon I think I know how I'll handle that disorderly bed-partner brain of mine. Next time I'm gonna reach over to the night stand and grab my copy of Strunk and White's. That'll get the noisy bastard back to sleep!