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I am going to Chicago, said in my best Bette Davis voice, to attend a medical conference. It is really an excuse to visit The Windy City. I lived there from 1989 to 2000. Some of my greatest memories both good and bad come from my Chicago days. 25 years later it seems unreal I had ever lived there – was it all a dream?

One of the problems of living in a city and moving away is when you revisit the place you want everything to be just as you left it. It makes you feel sad to see some of your favorite places are no longer there, but it also makes you happy to see some of them have survived – just like you.

The medical conference is on the magnificent mile, downtown, so I will be able to walk about and see the sights – not that I will have much time. Classes are Wednesday through Saturday 7AM to 5PM. I like to learn so I will be happy therein. But what will really be good is meeting friends after lecture for dinner, drinks, whatever. There are more friends than evening times.

Tuesday Someone drops me off at the airport; I fly Southwest to Midway. I am not looking forward to the plane trip. Flying is usually a hassle but SWA sounds like a cattle car. I plan on wearing a mask and plugging into my headphone and do not disturb. I will take the L downtown. I will enjoy that. When I lived there, the L took me everywhere; no car was needed. I am staying the first night with The Other Michael. We will go out to Cafe Babareeba! Patience above! It’s still open! I might get emotional. I can’t get too wild for Wednesday is a school day. I move into the Marriott as lectures begin at 7AM.

I am certain to write on this as nothing inspires writing as ‘going home’ and seeing old places and old friends – some I haven’t seen in 25 years.

4. What brings you the most joy right now? What about as a child?

I’m guessing most grandparents would answer the question with ‘having a normal bowel movement’. As we age joy narrows to simple things like not falling down or not wetting ourselves. If a grandchild should ask the question, chances are granddad and grandmama will say what brings them joy is ‘you’, which may or may not be true. Alas, Babylon! I have no grandchildren but I will do my best.

What brings me the most joy are hedonistic endeavors done without a time constraint. I like going to a resort or a hotel located in an area where I don’t feel obliged to go out at the crack of dawn to see the sights. Rather, I can do what I please, making it up as I go along. If that ends up as ‘nothing’, so be it. This indolence is accompanied by good food and drink – no rubbish types, consumed without the rush that are my present meals to get through it in order to get to something else. This setting comes with traveling companions, good company with whom to play cards and games or simply to talk away the hours. When one isn’t footling around there are books, lovely books, books that I am reading because I want to and not to advance my education or to look smart. When in doubt: get horizontal viz. take a nap if one wants to or go to bed early rather than feel obliged to go out and paint the town red until the dawn.

If I lived in a temperate zone, I think answer would include the joy of gardening – especially vegetables with heirloom tomatoes. I miss this.

My childhood joys were legion; they certainly didn’t lack for variety. Was there anything I didn’t find joyful? There was school, games, books for fun or learning. There were travels with my parents to see cities and the relations. Holidays and seasonal foods thrilled me. Back then I loved TV and comic books and thunderstorms. I found joy in just about everything – other than sports. They did nothing for me – although I loved family tailgate parties with the food and the various relations who came to them.

Life now is a series of losses and disappointments – my life anyway .The simple joys still do their magic. I extract joy in the mundane, such as the warmth, aroma, and taste of a freshly brewed cup or tea or in a particularly beautiful sunset. It is enough for now until they wither away with age. Then I will have the joy of their memory.

It is rawther hot here, temperatures over 40C (104F). Too hot for walking whether Spo or Harper Hound. I don’t envy the roof-men although perhaps they are used to it and take frequent water breaks etc. They delivered the new tiles while I was at work so I didn’t see them. They were like Santa although the prizes are still up there; I can see the boxes. Next week I fly to Chicago so I won’t see them working; I come home to a new roof. I wonder if I will even see the difference.

The only good thing about the heat is it hight enough to make the first batch of solar tea I love it so. I found the glass container and put it out along with four tea bags (Barry’s Irish breakfast, no rubbish).

Someone (bless his heart) gave up trying to put together the entertainment system. It’s time to call in The Geek Squad (or someone like them) to do it for us. Electronics are so damn complicated these days, worse than neuroanatomy, and one needs a specialist. I have a terrible intuition when it is all set up I won’t understand how to work it and end up never using it like the last entertainment system. Oh the embarrassment.

BERJAYA

Mr. Bezos (the dear!) sent me a six pack of Moxie. I was about to call it ‘Moxie cola’ but I am not sure it is a cola or even sure what it is. I’ve heard about the drink from thems who live/d in New England. I’ve been meaning to try some; it’s been on my bucket (small b) list for some time. So I finally got some. It’s nothing I’ve had before so its taste is off-setting as it tastes like a bad root beer or perhaps a cola that someone put something in it. I am not certain I like it. I have five more cans to determine so. I texted my friend DougT who grew up in Massachusetts but lives in Chicago that I have tried it. He replied he never liked it much but only knew it from bottles. I said I could bring him one next Tuesday. We saw some irony in this it is I who is bringing him a Moxie.

This being Father’s Day I will call Father and wish him a good day and then we will look for boats via the The Great Lakes webcams. I do this with most everyday already. The rest of Sunday isn’t much. I will do some preliminary packing for my trip and drink iced tea. Happily I am caught up with blogs, a relief. Stay indoors and try not to go out. Hugs.

BERJAYA

La Casa de Spo doesn’t look so good at the moment. Someone is putting together the new entertainment system, connecting it to the relatively ‘ancient” speakers throughout the house. He’s a clever one and he is making progress, but it is a slow process. The living room floor looks like Christmas morning after the children have unwrapped their prizes. There are boxes and electronic items strewn everywhere. Not too far away is a rawther large pile of ironing – nearly all of it Someone’s. In his defense he has bigger projects to manage than ironing. I’ve calculated if he should actually do it, there are not enough hangers for all the shirts. I thought of getting more hangers, but he thinks to get rid of the shirts. I am half-tempted to do it for him, but I would probably donate a shirt he hasn’t worn in years only to have him suddenly want it and inquire to its whereabouts. Oh the embarrassment.

Harper is in her old age is having accidents. Every time we come home we hold an inspection if she’s had any. There was talk of hiring a professional carpet cleaner but as this problem isn’t likely to stop, we will clean up as they happen. Someone does a better job at this, but he is easily triggered to retching so I am Stain Master and Effluvia Master as well.

Last weekend I started making lists of what needs doing about the place, a note for each room. I stopped after three rooms as it was already a long list and rawther discouraging. The roofers (or someone like them) bringing over the dumpster today. Someone is at home this morning to instruct where to put it. “One war at a time!” said Abraham Lincoln, so the roof and stereo system take precedent. The terribly threadbare kitchen chairs will have to wait yet another day.

Soon starts the weekend and that means dusting and delayed daily doings like the dishes. Would that I was Merlin who waved a wand and said ‘tidy up’ and the pots and pans did so on their own. Alas, Babylon! At home not only am I Stain Master and Effluvia Master but I am also Dish Master and Dust Master too. Then again what are weekends for other than fighting filth?

Every once in a while Father would announce to us boys we are going to the library. We would shriek and jump up and down as if we had won the lottery. We had to quickly take inventory of what books we had at home and were they ready to return and if not finished to better get cracking before we went. My brothers often had a list of ‘to read’ which they would ask The Librarian* if they were available. I often took a different tack, as I will tell you.

Upon entering the hallowed halls of The Library, we immediately hushed although it was often hard to curtail a squeal of delight at finding out the book you have longed to read is finally available and waiting at the counter. While Father went directly to the fiction section looking for Jack Ryan novels, I went to the large wooden filing cabinets and randomly picked a bin (‘Ma-Mo’ perhaps) and pull it open by its brass knob and finger through the index cards to come across a title that grabbed me. It was like a treasure hunt. With the dewy decimal clue in my head I would go find the book, and if it was there, would it be as wonderful as I wanted it to be. Perhaps it wasn’t there – a disappointment – but just a few books down from the gap on the shelf was another book waving its cover at me. What I wanted to find was a magical tome all but forgotten that when opened it would reveal a marvelous tale or perhaps lead me to a faraway land. Sometimes this happened.

Wandering through the stacks looking at titles at eye level (mine) sometimes this didn’t come up with anything. No fear, there were always the ‘favorites’ that were read and reread. You had to sign your name on the lender log in the front of the book. There was my name, taking up four or five lines in a row sign with some upstart stranger’s handwriting breaking the run. I would pay a lot of money to have some of those books again.**

It seemed then people were quiet and they were there to read or study. The common denominator was reading, which everyone took seriously like a religion. There was no talking but some moved their lips while reading like a priest does when he reads the prayers Secreto.

If you didn’t like the library then you didn’t go – and left us superior reader types to our books.

I hear tell libraries are shutting down mostly from indifference and lack of use. Fewer people go to the library these days; if people want to read or research something they do that online or on their Kindles. The index card filing cabinets are all gone – I wonder what happened to them. Libraries, once a quiet realm, are under siege from @-holes who want to ban books – not that they or their children go to libraries or actually read. It is all about control; if people read and became knowledgable thems in power would lose control.

If there is a hell I hope there is a special level for book burners and book banners.

There is a local branch of The Phoenix Library not too far from La Casa de Spo. I have tried going but it is a disappointment. The place feels oddly bereft of books. Rather there are video and games to rent. The librarian (who doesn’t look or sound at all god-like) will looks things up on their screen to see if said book is here or somewhere else and would I like to order it to be sent here? Somehow this takes all the fun out of it. All the same when I go which is usually on a Saturday morning among the few browsers there is often a parent with some youngsters who look as excited about their books as I was. It makes me smile to see them and the sight gives me hope thems who read and thems who go to libraries will endure.

Do you go to libraries?

Is your library in trouble from lack of money or vile sorts wanting their will imposed on them?

*Librarians were perceived to be gods, all knowing and worth our reverence. One did not talk louder than a whisper to these sage goddesses.

**One of them was titled “Red Letter Days” which gave some history of the various holidays. I forgot how I got it but there it stands on my shelf, its dust jacket quite worn and ripped some. What a treasure.

BERJAYA

Thank you Spo-fans and blogger buddies for all your recent comments and texts, wishing me well. You are all dears! Spo

What’s top of my mind: Work. Patience Above! Athena, who is the new EHR, arrived yesterday in a flourish not too vengeful. The anxious and overwhelming emotions are due to it merely being unfamiliar and more complicated than the old familiar one, and in time will dissipate. I felt like a juggler familiar with his four ball routine suddenly thrown three more and a rubber chicken and a small sword too boot and don’t drop anything and stay on tempo. All the ‘first notes’ had to be cut and pasted from the old system; the patient pharmacies didn’t travel over either, worse luck! Every encounter can’t start until a handful of drop boxes and consents are checked off. Oh the pain. Once each chart is established it should be easy thereafter, although this will take a few months as the patient slowly check in with the new system.
The worse matter was I can’t write any prescriptions based on some vague problem at The Overlords who haven’t made me qualified to do such. This needs to be cleared soon.

To lighten things up I ordered pizza at lunch for the office; it lightened the mood.

Where I’ve been: The neighborhood app. I am in need of a several servicemen, particularly a knife sharpener, a hot tub repairman, and someone to get rid of the rubbish items in the backyard. I normally avoid The Neighborhood app as it is mostly a morass of endless gunge from the stay-at-home house-sorts who have too much time on their hands. Requests are quickly responded to by several who laud their man; merchants themselves reply as well. This is what the app ought to be – not for reporting on spotted hooligans or white vans in the neighborhood driven by non-white folks.

Where I’m going: Chicago. Next week I fly to Chicago for four or five days of medical conferences, pow-wowing with my fellow wizards. This is really an excuse to get out of the Arizona heat and have some sort of ersatz summer vacation. Mind! I will be in lecture hall from 7 to 5 but the evenings will be free to see old friends. I am looking forward to that.

What I’m watching: The new TV. Someone is slowly putting together the new TV system. So far he’s managed to get the basics going that he is back to watching his shows on ‘big screen’ now. I haven’t had time to watch anything myself, but it looks “OK”.

What I’m reading: Ice. I enjoy books in which the author takes an item ( salt, cod, tea, curried snacks) and illustrates its history how it influenced mankind and history. It is hard to imagine this ubiquitous common place item as once upon a time a luxury commodity only the rich could afford. Can you imagine a time when drinks and storage didn’t have access to ice?

What I’m listening to: Cher. She is a dear; please don’t feed her buns and things.

What I’m eating: Hamburger hot dish. Last weekend I wanted to make something out of what ingredients were at hand. With what was available I could make a good-ole Midwestern hot-dish minus the noodles or frozen tater tots for there were none. I found a recipe for a ‘low carb’ variety that uses for carbs a minimum of rice. It turned out fair; I had made a 9×11 sheet pan of chili. It seems macaroni or frozen tater tots are essential to make a proper hot dish. Do not dare to question this.

Who needs a good slap: She who must not be named. I have to be careful what I say about The Overlords as the new contract has vague but menacing clauses suggesting if I grumble or bad-mouth the place in public I am out on my ear. One of The Overlords didn’t tell me something resulting in a near-disaster. In the good old days when I had a problem I would talk to the bosses face-to-face. Now it is all about emails to faceless people who are overall not looking out for me but for the company.

I give faceless supervisors three slaps.

Who gets a fist-bump: Britt from Athena. Yesterday for the ‘first day’ Athena sent one of her handmaidens to help us maneuver the system. She was indeed a godsend; she explained and fixed problems. What a relief and a joy it was to have a ‘real person’ right there for consultation.

What I’m planning: Several dinners with chums. Next week plan when meeting up with chums I hope to have some splendid dinners at old favorites – provided they are still there.* One of them, a tapas bar, is still operating and better yet still making my favorite: goat cheese cooked in tomato base. I might get emotional.

What’s making me smile: The light in the pool. Having a dip in the cement pond at day’s end is a nice way to cleanse off the day and cool down but I don’t like doing this in the dark. Doing so gives me the creeps. Jenny Greenteeth is down there, waiting to pull me down to my doom. I texted The Pool Man can he fixe the light. He sent a terse-sounding text to just turn on the switch in the electrical box. Lo! It works! Now when I have my evening dips they are done in ever-changing colors that light up the pool and scare away JG. I stay out there longer and lay back and look at the stars. On the negative the light on means the neighbors can see me. Oh the embarrassment.

*The restaurants, not the friends.

There will be no performance of “The Red Shoes” today and perhaps for a couple of days. Today Monday is the last day of the old EHR (electronic health records) and tomorrow heralds the arrival of the new one, courtesy of the great goddess Athena (the dear!).

It feels like ‘Y2K’ times, as we try to save things lest tomorrow they go may all go poof!

Tune in again on Wednesday or so; I will let you know of there were any casualties.

SPO

It’s already rawther hot here, already hitting temps above 40C which aren’t normally seen until early July.  Vampire-like, my evening walks are done after sunset lest I turn to dust.  

Happily, there are no lack of indoor things to do. I need to download my at-work note templates and finish all paperwork before ‘The Great Change’ on Tuesday. It reminds me of Y2K getting ready for a crash and inability to do things. There are signs already of problems. We are supposed to have our electronic signatures established but this hasn’t happened and emails calling for help get a vague and impersonal autonomic reply from IT (or someone like them):

‘We have received your request and someone is working on it.’

Not at all assuring. I am told by The House Manager I am the only one ‘not freaking out’ by all of this. This is somewhat out of wisdom but mostly from my habit if someone is carrying the beachball of anxiety I don’t have to hold it myself. 

Speaking of soon-to-be shenanigans,  The Roofer (or someone like him) is dropping off on Monday a very large iron rubbish bin in anticipation of starting The Great Roofing Project. The container sounds to be the size of a small freighter. I hope we don’t have to park on the street for the duration of the voyage. 

Speaking of freighters, a proper one recently sprung a leak while transiting Lake Superior. Reports have it the boat ‘hit something’ and soon afterwards started taking on water. The Coast Guard and a nearby freighter were summoned and the freighter hauled itself to the nearest harbor hoping to get there before it sank. It made it, but it does’t look good. The rear of the boat (the stern) is definitely lower in the water as it should, and it looks like if you put a marble on the front part of the boat (the bow) it would roll back at a 30 degree angle. Oh the horror. Bad for the boat but the boat nerds have something to talk about. There hasn’t been such drama since the Edmund Fitzgerald.  Rumors are already circulating (or course) on the speculation of what did it hit – probably a sunken ship or an uncharted shoal but the more loony-tunes explanation are soon to follow. 

Speaking of shipwrecks La Casa de Spo has its usual messes to attend to like laundry and the changing of the sheets – no Coast Guard to my rescue. This morning I am on the look-out for The FedEx man (or someone like him) to deliver some sort of cable needed to connect the new screen to the new receiver. The back of both having enough holes and connections to rival a large airplane.  It reminds me of the YouTube “The Onion” clip titled “Sony release stupid piece of sh-t that doesn’t f-cking do the g-d thing it’s supposed to”. I would provide the link but WordPress won’t let me. 😦

Someone picked the fairest in The Judgment of Paris endeavor for a roofer. The first of the three was chose because he responded quickly, gave a good show, and felt ‘a good click’ – like my men. The second had to be called a few times to remind him we are waiting for his estimate and the third one seems to have disappeared, so there it is. It is hoped Mr. Roofer and his minions start working before the first rains arrive. But first they want our money – 20K or so – which means I have to sell a lot of oxycodone prescriptions online quickly ho ho ho.* The thought of a bunch of burly bear-chested roofers overhead is a heartwarming spectacle but really I vote for the “Shoemaker and the elves” approach they do this while I am away and I come home to see it done.

At work there are so many happenings it make my head spin. Next week is the arrival of “Athena” (speaking of goddesses). One of the NPs left this week leaving behind her patients. I will absorb them Borg-like as I have done with all the other prescribers who have come and gone from the place. It reminds of the scene in “Young Victoria” where the queen dowager reminds the young queen “prime ministers come, ministers go – you stay.”

Health problems: I have pulled a muscle in my left arm, which is my writing hand (lefties: only the best, baby!). It pains me to pick things up. Happily us southpaws are good at using the right hand when they have to. This is not true the other way around: if a righty can’t use their right they may as well be without any. I still have bouts of intermittent fatigue of unclear origin. I hope this is due to being out of shape or perhaps it’s the heat (it’s already over 40C). It may be simply ‘getting older’. Whatever the origin it is a nuisance but I have learned to lie down for a few rather than push through it.

This weekend we hope to connect the new TV to the even newer ‘receiver’ which Someone bought the other day when the 2024 screen refused to couple with the 2006 receiver, worse luck. The new TV comes with a new remote of course. I have a big basket of remotes; I think they total eight. I have no idea what they are for or how to use them (admittedly I never did). I would like to toss them don’t dare do so lest one of the other devices like the CD player requires them – although we haven’t used any of these in over a decade, La Casa de Spo is wired for the receiver to play music via speakers into several of the rooms including the patio. They seem quite quaint nowadays although they must have been ‘trendy’ in the late 90s. I was too but no more.

To finish the frets and features is fabulous fabric. New stuff arrived – nothing like a new frock to brighten up your day. 🙂

*Notice to The APA Secret Police: don’t be a dimwit; that was a joke.

BERJAYA

Thems with mental illness often use drugs, alcohol, or nicotine. It is often hard to tell ‘which came first” and most of the time it no longer matters to sort out cause and consequence: get everything better is better called for.

I used to work for a psychiatrist who was well over four feet and a stickler. If he found out the patient was using cannabis, the patient was told they had to stop completely or else he would not work with them. If drinking was a problem, the patient was obliged to abstinence and AA meetings – often with written proof of attendance. Many patients wouldn’t or couldn’t do this or sometimes their drug of choice was continued as just ‘socially’ viz. on occasion they might smoke dope or still have a drink. This was still enough to be kicked out of treatment. More often than not the patient just lied they weren’t using any.

This is seen in other specialties. Someone’s cardiologist told him to have no alcohol ever – not because Someone has a drinking problem or had elevated liver functions but ‘in principal’ to better his cardiovascular health. Once upon a time dermatologists lauded absolutely no tanning. To avoid STDs the recommendation was total abstinence outside of a marriage.

I used to take this route – we all did really. Over time I realized it wasn’t realistic and to refuse all help because one area wasn’t seemed almost a cruelty. For example, it is common for thems with ADD/ADHD to do drugs and drink. Treating the ADHD – often with amphetamines – actually brings down their drug and drinking use. I’ve had many patients come in a mess of depression/anxiety and drugs/alcohol problems. If I can get a toe in somewhere somehow with counseling, medicine, and perhaps their cutting down on their habits leads to improvement. A person with a drug/alcohol problem is more likely to abstain if their pain, depression, and social strains are assuaged.

It is more the norm for people with drug/ETOH use to keep using to some degree. This is called ‘harm reduction’ viz. get the detrimental habits down to a dull roar rather than to abstinence. Any doctor who treats diabetes knows no one is going to be so pure they will have absolutely no sugar for the rest of their lives. You manage what you can and keep encouraging diet tips.

It is also the norm for my patients to never have ‘no more anxiety or depression’. Patients with insomnia: the goal is to sleep better than not, more nights than not – NOT 8 hours nightly as they often see the goal.

I often sense I wish my patients were better viz. less depressed, less anxious, using no street drugs and cannabis. Interesting in contrast to my disappointment and let down is their ‘thumbs up’ how much better they feel for being less symptomatic – and if they have a drink from time to time or eat a doughnut or do pot with their friends I am OK doctor.

It’s a paradigm shift I struggle with but I am getting better.

Have you ever been told by a practitioner you had to stop ‘X” or they wouldn’t treat you?


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