Please Ring Your Callbell

Ten minutes into a redeye on JetBlue to JFK, I pull out my earphones in the middle of Nathaniel Rateliff and the Nightsweats’ “Son of a Bitch” to ask my wife why she’s reaching over to ring my call bell. “They just asked for any doctor on board,” she explains. “You’re a doctor,” I point out. “Yeah, I don’t think any of these passengers is looking for an emergency mammogram,” she explains.

The senior flight attendant appears at my elbow. “You’re a doctor?” I nod. “What’s up?” I ask. “Do you have some proof? An ID of some kind?” Geez, this guy is pretty demanding. He scans my surgeon’s club card like a Manhattan bouncer. “Great,” he pronounces. “Follow me.” No problem, I think. I’ve done this drill a few times before. Almost every time, it’s a hyperventilating passenger with more anxiety than pathology.

Senior flight attendant introduces me to my fellow passenger, who is standing and clutching the seats on either side of the aisle in obvious distress. Oops, I’m thinking, this lady looks like a real sick person. She’s trying to breathe at about thirty times a minute, shrugging her shoulders with every breath. She looks scared; like a person who can’t breathe, scared.

“Hi,” I say. “I’m a doctor. What’s the problem, ma’am?”

“I–Can’t–Breathe!”

Got it.

“Let’s get you sitting down,” I suggest. Before you fall down, I don’t add. Because if this lady passes out in the aisle, it’s going to take me and about twelve of my fellow passengers to pick her up. Not gonna be a pretty picture.

“Can’t–sit. Can’t—-breathe.” She shakes her head. Okay then–let’s talk here. “What’s your name, hon? Marie? Great, Marie. Are you having any pain?” She nods vigorously in time with her rapid breathing. “Where is your pain?” She lets go of a seat to tap her chest, then grabs on again to keep from toppling over. “Okay, pain in the chest. Got it. Do you have heart  problems?”  She nods enthusiastically. “Diabetes?” She nods. “Emphysema?” She nods. Well, maybe she’s just agreeable. “Anything else?”

“Sugar.”

“Do you take insulin?” She nods. “Did you take your insulin today?”  She nods. “Did you eat anything before you got on the plane?” She shakes her head. Great. Not just  being agreeable, then. “Any other health problems, Marie?”

“Kidneys.”

“Kidneys?  Kidney failure? Are you on dialysis?”  She nods vigorously. “When was your last dialysis?”

“Weds–breath–day.”

Great. She’s probably on a Monday-Wednesday-Friday schedule. Today is Sunday. Which means her last dialysis was over 3 days ago. Which is a long time to go without dialysis.

So far I’ve diagnosed this lady as probably being in respiratory distress due to florid congestive heart failure, probably having an MI (heart attack), and likely to lapse into hypoglycemia at any moment.  I’m thinking anxiety is not the main problem this time around. I’m going to need to do some kind of real doctor-stuff, not just my usual professionally reassuring murmuring. Which is sort of a problem, because I’m a surgeon, not an internist. But I’m a general surgeon, and we all think we know everything about everything, anyway. So there is that going for me.

With flight attendants’ help we clear the back row and get my patient semi reclined and out of the aisle. Oxygen mask applied and helping–as in her lips are no longer purple. Reassurrance. But patient still expressing distress, feeling of impending death, invoking need for Jesus to save her; none of which are considered ‘good signs’ in this setting. Most important, she is still having chest pain. I break open the completely inadequate first aid kit.  The kit is composed of many, many sealed plastic bags with various drugs and things, poorly labelled and completely unorganized. A bag of saline with no catheter to connect it to the patient. Helpful.

I find the blood pressure cuff and get some vitals. It takes me three tries to convince myself that her pressure really is sky-high, as in ‘impending-stroke’ high. Her breath sounds are even noisier than the aircraft engines and her heart is going so fast I can’t tell if she has a murmur which is just as well because I was never any good at hearing murmurs anyway. My exam does reveal that she has a dialysis access fistula in her left upper arm which has a bounding pulse–which is good, I think.

So at this point I tear open all the little plastic bags and start giving drugs to my patient. Glucose gel under her tongue for hypoglycemia, nitroglycerin for angina, aspirin for the acute MI. I’d love to start an IV but, again, no angiocath in the kit. Great.

The patient looks better but not great–as in, she now looks like somebody who may die soon rather than at any moment. I call over the flight attendant and mention to him that this lady may die at any moment. She is almost certainly not going to hang on like this for the five-plus hours it’ll take us to get to JFK, not to mention the additional half-hour taxiing to the gate. Time to land, buddy. He gives me his shocked face and mentions that maybe I should talk to the pilot. Good idea. He gets me on the little intercom thing and I introduce myself to Captain Pilot.  He asks me about my patient. I explain the situation and tell him in no uncertain terms that she needs to get to a hospital as soon as possible. To my chagrin, the pilot is not enthusiastic about my recommendation. He’ll check in with “MedCon” and get back to me. Really?

More drugs, more oxygen and Marie is alive but still having chest pain. Not good. Blood pressure is better, though. And her breathing is much better. At this point, helpful flight attendant informs me that I’m only allowed to use one more oxygen cylinder. “I’m sorry, why’s that?” Turns out that the plane only carries three cylinders and if I crack open the third one, I’ll violate safety protocol since the attendants need oxygen in case there is a decompression emergency. I inform him that if we are that fucked to have a decompression on top of what’s going on here, he’ll have to hold his breath. He doesn’t find this funny. So maybe, I suggest, he should get the pilot to land this plane like I said twenty minutes ago.

The pilot calls back to inform me that MedCon doesn’t feel the patient’s condition merits diversion. They recommend I continue current therapy, monitor vitals, and report back in thirty minutes with an update. I am pissed. I don’t know who “MedCon” is but I’m no fan. I inform Captain Pilot that if he doesn’t land this plane soon he’ll have a corpse in the last row of his plane. He promises to get back to me. I crack open the third–and last–oxygen cylinder. Flight attendant gives me a very concerned look.

Captain Pilot calls back twenty minutes later to inform me we’re diverting to Denver. Hallellujah! We’ll be down in 40 minutes. Hold it–what? Forty minutes? Captain Pilot lectures me that this is “not easy”, that Denver has “weather”, that it’s going to be “pretty damn bumpy” and he needs to get off the intercom so he can do pilot stuff so I should take care of the patient now, Bye. I’m hoping he’s smart enough to call ahead for an ambulance. Attendant assures me he is.

Half an hour later, I look past my patient and see lights out the window which is the first good time on this whole damn flight. “You’re going to be fine, Marie.” Woo-hoo! Celebration is short lived as pilot instructs everyone to buckle up for an unscheduled landing because the doctor in the back row is making us do this and by the way it’s going to be pretty damn bumpy because there’s a thunderstorm over Denver airport where we’re about to make an unscheduled landing so good luck with that. I’d be pretty pissed at the tone of the overly detailed announcement except I’m busy trying to keep my patient breathing and the last O2 cylinder has been on fumes for the last 3 minutes. I strap in and strap in Marie next to me across two seats and position myself to keep my hand on her pulse as the gear and the flaps come down and we’re bouncing all over the dark stormy skies of Denver, a flash of lightning illuminates the plane and I see a few folks from the back rows looking at me like, “If we crash and die, it’s all your fault, asshole.” So I smile except at that moment I realize that I can no longer feel a pulse on my patient. I attempt to discuss this problem with Marie but her eyes roll up in the back of her head and she slumps over as she stops breathing and proceeds to die.

“Oh, fuck! Really, Marie? Now you pull this?”

I unbuckle and stand up so I can lay my patient across all three seats. Helpful flight attendant yells at me that I must remain seated, we’re landing. Yeah, right. I start doing CPR which of course causes everyone in the last four rows of the plane to start screaming, which makes it tough to hear the automatic external defibrillator announce that “No, your patient does not have a shockable rhythm so, sorry, I’m not going to be much help. Just keep doing the chest compressions. Click.” Which I do while alternating breaths with the Ambu bag hooked up to the empty oxygen cylinder when a very pleasant young lady appears next to me as the plane jounces onto the runway and she asks, “What the hell are you doing?” I explain that I’m doing CPR, are you a doctor?” “I’m a family practitioner, can I help?” “Well, yeah, lady, where you been the last few hours or are you an Leprechaun Family Practitioner that just magically arrived on this airplane?” “Sorry, I was asleep, I didn’t know.” So she starts doing compressions so I can give drugs. Of course, I don’t have a working IV so I shoot an amp of epinephrine transtracheally into her windpipe and shoot another one into her fistula followed by an amp of bicarb because, well, what the hell, it can’t hurt and just might help. Mr AED still isn’t going to shock anybody but there is a pulse which is a definite improvement. Late Arriving Family Practitioner and I alternate doing chest compressions as several of our fellow passengers helpfully record our efforts on their cellphones. A kid leaning on the back of his seat keeps asking if that lady is dead and I’m impressed by my colleague telling him to shut up and go back to playing video games. At this point, the plane arrives at the gate and quite suddenly a squad of EMT’s arrive and somehow get not-entirely-dead-Marie on a gurney and up the aisle to the concourse. Well-Rested Family Practitioner and I follow and see that Marie really does have some type of rhythm on the monitor just before they package her up and speed away towards Denver General. Vaya con dios, Marie!

Well, that was fun–not!  I walk back to my original seat next to my wife and realize that my hands are shaking. I’ve done surgery for over thirty years, including a lot of pretty crazy trauma stuff, and I’m sure that this is the most shaken I’ve ever been after taking care of a patient. I was planning on discussing these feelings with my empathetic and supportive spouse, but I’m shushed by her so we can listen to the pilot announcing that, no, we won’t be taking off shortly to continue our voyage to JFK. Rather, he explains, this emergency diversion required by the doctor sitting in seat 6B has eliminated any chance of making it to JFK to be home with your loved ones or to make all those connections to lots of fun places because the doctor used up all the oxygen and the crew is traumatized and not allowed to continue so we’ll all be spending the rest of the night here in Denver International and we’ll try to get you seats on a plane in the morning to New York or somewhere, probably. Thanks for choosing Jet Blue!

At this point there is a general groan and many pointed stares pointed pointedly in my direction.

As we all gather up our carry-ons and make for the exit, I see Captain Pilot leaning against the doorway to the cockpit. I stop to chat. I introduce myself as the doctor who was on the other end of the intercom. “Oh,” he says without a smile. “That was you.” I agree that was indeed me. Just because I’m curious and still a bit pissed off, I reveal to Captain Pilot that I was surprised that there was such reluctance to land the plane even though it was my professional opinion that his patient was going to die otherwise.

Captain Pilot looks at me with a steely gaze and, in that Southern pilot drawl that they all have, says, “Doc, you got one life to worry about back there. I gotta worry about 186 lives. You do your job, I’ll do mine.”

I guess that’s pilot talk for “thanks for your help.”

 

 

From: Choosing a Specialty: A Letter to a Medical Student

Society punishes those who improve it. Emerson observed this fact when he gave up a promising Christian ministry career to instead minister to all of mankind. Don’t expect awards and accolades from the psychiatric profession for bettering it. The awards go to those who maintain the status quo, not to those who change it. Freud never won a Nobel prize; they gave it to the fellow who introduced frontal lobotomy.

Nassir Ghaemi, MD, MPH

You Drive Like a Sodding Slugfuck

This post was to be entitled, “You Drive Like a Dick,” but hey–it’s the holidays.  And in case you haven’t noticed, people drive even more dickishly (copyright, ERG) now than at other times of the year.  Hence, the new title.

Angry Cat Driver

In keeping with the holiday spirit, it is my considered opinion that people are now driving worse than ever.  Both of the regular followers of this blog know that I have a bit of a petulant streak when it comes to my fellow drivers, e.g.., “Overcourteous Assholes Like Me.”  Last year, I was irritated.  This year, I fear for my life.  This year, a new classless class of drivers has appeared, a class that adheres to the following three point credo:

I.  The rules of driving apply to you, not to me. 

II.  Get out of my way.  

III.  My car/truck is a two ton steel weapon on wheels which I am willing to use to injure, maim, or kill if you slow me down or generally do anything that pisses me off.

I refer to this new class of driver as “sodding slugfucks.”  But not to their face.  This is why I don’t refer to these people as “sodding slugfucks” to their face:  Detroit Driver Shot in Face in Road Rage Incident.  If you have ever been tempted to get out of your car to discuss driving etiquette with someone, this article will surely disabuse you of that silly notion.  Please don’t.

It has come to my attention that otherwise reasonable people can and do behave like sodding slugfucks when they drive.  I know this, because I live on an island.  When you live on an island, you occasionally find yourself in a situation of being assaulted by a sodding slugfuck while driving, only to subsequently realize that both of you are driving to the same destination.  On one occasion, that destination turned out to be our mutual place of employment.  We parked next to each other.  Somewhat awkward. On another occasion, the sodding slugfuck cut me off, tried to hit me, then screamed at me through my window before we both ended up in my neighborhood, only to realize that we live on the same block.  Even awkwarder.

With the foregoing in mind, perhaps it would be a holiday mitzvah to point out the type of activity that may lead to the realization that even you may be acting like a sodding slugfuck.  So you can stop.  As kind of a public service, I offer the following:

–Over the last six months, I have witnessed several guys who, in the middle of the day and at a busy intersection, decided that waiting for a traffic light to turn green was for losers, so they proceeded to just sprint across the intersection against the light. This causes every other driver to screech to a halt, wondering what the hell just happened and whether civilization as we know it has come to an end and nobody told us.  If you were one of these guys, and you didn’t jump the light because your wife was in active labor at a nearby hospital, then you, sir, are a sodding slugfuck.  Don’t do that anymore.

–I still pull over when I see an ambulance, lights flashing, come racing up behind me.  Call me old-fashioned, I know.  Other drivers may just drive faster to try to stay ahead of the ambulance, but last I checked that was kind of against the law.  What I’ve noticed now with frightening regularity, however, is that once the ambulance has passed, some sodding slugfuck (sometimes a whole string of sodding slugfucks) is chasing so closely behind the ambulance that I’m nearly killed when I try to pull back into my lane.  Unless you are related to the poor sap in the back of the ambulance, if you don’t let me back into my lane because you’re speeding behind the ambulance, you are a sodding slugfuck.  Or an ambulance-chasing lawyer, in which case you are also a sodding slugfuck.

–It appears that many drivers incur physical pain if they are required to use the brake while driving.  This must be some type of new epidemic, because I witness this ailment at least a half dozen times a day.  The symptoms are evident when a car slows to make a right hand turn and the car behind, instead of braking slightly to let the guy turn, swerves around him into the left turn lane.  Or in my recent experience, across the double yellow line to nearly hit me head-on, requiring me to veer off the road and almost hit a tree.  Main Street in my little hamlet is not the Nouvelle Chicane in Monaco, okay?  If you do this, please stop being a sogging slugfuck.   You’re going to kill someone.  Maybe me.

I could go on, but it’s the holidays.  I’ll save the rest for next year–like how your horn doesn’t make all the cars stuck in traffic ahead of you magically disappear.  Really.

Happy Holidays.  Don’t Drive Angry!

 

Mammographic Misery and the Plight of the Perpetual Patient

Mammograms save lives.  Despite several controversial studies over the last couple of years, there is no question in my mind or that of most other health care professionals that annual screening mammography for women over age forty has completely revolutionized the treatment of breast cancer.  Those studies can’t claim that people regularly receiving mammograms don’t have better rates of survival or cure from their disease–they claim, with mixed success, that providing a large population of women with mammographic screening is not cost effective.  What price a life, you ask?download

When I began performing surgery for patients with breast cancer in 1982, the typical patient presented with a mass she had felt herself.  By the time she came to me for surgery, her cancer was often in a relatively advanced stage.  Surgery involved complete mastectomy, usually with the removal of large numbers of her underarm lymph nodes, too often leading to disability and disfigurement.  This was followed by chemotherapy and radiation therapy. Worst of all, survival rates in this group of patients rarely reached 80% for the five years following surgery.

Fast-forward to my current practice.  Over 90% of women referred to me for surgical treatment of newly discovered breast cancer are now presenting with a lesion found on their annual screening mammogram.  Almost all of these lesions are about the size of a pea or smaller, having been discovered years before they grew to a size that could be felt on examination.  These early cancers have not spread to the patient’s lymph nodes or anywhere else in her body. There is no need for mastectomy to achieve a complete cure from this early stage of cancer.  Indeed, I can reassure patients that equivalent cure rates for such small cancers can be achieved by a small lumpectomy and a sampling of one or two lymph nodes, a procedure that takes less than an hour.  The patient is home later that morning and experiences minimal discomfort.  Newer forms of radiation therapy permitted by such early diagnosis expose only the localized tissue and can be achieved in five days, rather  than the whole breast radiation therapy over 4 to 6 weeks required in the past.  Most significant of all, this minimal therapy now provides cure rates well over 90% in these early stage patients.

All of this revolutionary success in the treatment of breast cancer has been made possible by earlier diagnosis due to routine screening mammography.  So don’t buy the hype–there is no controversy amongst practitioners over mammography:   A mammogram once a year can save your life.

But that’s not what this post is about.

Let’s talk about what happens after:  After that excruciating moment when I tell you that the biopsy showed cancer.  After the discussion of what we need to do, how soon we can do it (“Sorry, not yesterday”), what happens after the surgery.  Surgery for the treatment of breast cancer is safe, straight-forward, and relatively painless.  To be honest, surgery for breast cancer is the easiest operation I do.  Patients usually are surprised by their rapid recovery.  They come back to my office a couple of weeks after surgery feeling great.  Over the next several months, I see the patient as she completes her recovery and any additional therapy that’s recommended, usually a short course of radiation therapy and a daily estrogen-blocking pill.  By six months after her diagnosis, she’s feeling great and has her life back.   And then reality sets in:

The reality being that you are not really convinced you’re cured of cancer until the moment you die of something else.

We’ve moved from a paradigm of the valiant patient bravely battling her cancer to the successful breast cancer survivor–who now must live forever with her diagnosis.  It’s not a battle with cancer.  Battles are fought and won, and then we can move on. You don’t just fight cancer–you survive cancer, and then you live with having had cancer. This is a burden that few who have not experienced the diagnosis, or lived with someone who has survived cancer, can appreciate.  It doesn’t matter how great you feel, or how many times the doctors say that you’re doing great, or how great your spouse or friends say you look–you worry.  You worry every day.  Because you remember feeling pretty darn great just before the doctor told you that you had cancer.

Of course, we all worry about getting some disease or another.  We worry about that dark mole on our arm that might be a little bigger, particularly after we hear of a young friend recently diagnosed with melanoma.  We worry about heart attacks, because we get chest pain every time we eat Taco Bell or palpitations at the gym.  It’s not the same. It’s not the same because you’ve never been told by the doctor that the biopsy is positive, that your worst fear when you walked into the office was true.  You’ve heard of Post-Traumatic Stress Disorder?  This is Post-The Test Was Bad And You’re Totally Screwed But Now You’re Finally Better Stress Disorder.  And it’s every bit as bad. Maybe you didn’t experience faceless bad guys shooting bullets at you in Iraq, but you experienced some pretty heartless machines shooting xrays at you every day for a couple of months, or smiling nurses apologizing as they stabbed the needle in your vein for the third or fourth time, or watched the strange colored fluid dripping into your body knowing that in 24 hours you’d be doubled over the toilet vomiting because that’s just how this stuff works.  Cancer sucks, and it doesn’t stop sucking just because everyone tells you that you’re cured.

Sure, they say you’re cured.  But you don’t really believe it.  You don’t believe it because we keep sending you for more tests and more mammograms and more CAT scans and more PET scans.  If there were a PUPPY scan or a CUTE FUZZY BEAR scan, we’d send you for that, too.  If I’m cured, you keep wondering, why do we keep looking for it?  And every time you have to go for the test, it’s an opportunity to relive that special feeling you had that time when the test came back bad.  You relive that feeling for the week before you take the test, while you’re in the machine trying to breathe during the test, and for every single second until the doctor calls to tell you that it’s okay. This time, you think.  It’s okay this time.  The elephant steps off your chest–but he doesn’t leave the room, he just steps behind you for awhile.  Until the doctor says that it’s time to do another test.  And there is always another test.  If I’m cured, you think, why do we have to keep looking?

So here we are:  Surviving today.  The test was good.  Enjoy it.  You can run faster than any old elephant.

 

 

 

Magnificently Overrated: Whale Watching

My wife and I spent the day “whale watching” last weekend.  She had been anxious to pursue the great, wild whale ever since our last outing two years ago.  During that previous high seas adventure, we failed to spot the elusive, majestic whale.  This despite many, many hours tossing about the Atlantic Ocean, accompanied by seasick shipmates and an entourage of dolphins that made fun of us for even caring about whales.  No whales that day, alas.whale

On this sunny Sunday, however, we were successful.  We spotted a dozen whales!  Which was surprisingly similar to not seeing any whales at all the last time, just with more whales.

It became all too evident as we bobbed about the wide Atlantic Ocean, chasing from one sighting to another for hours, that these are not professional whales.  These guys are the ones that just happen to be lying about when the boat pulls up.  It’s as if you took your friends visiting from the Midwest into the city by driving for hours in hot, rush-hour traffic in your car with no air conditioning and four broken windows, but when you finally got into the city you decided not to take them to see Les Miserable or The Book of Mormon like you promised, but instead took them to a karaoke bar that was popular with taxi drivers recently emigrated from Eastern Europe.  Lack of stage presence is being kind.  Forget jumping over the boat in an arcing trail of crystalline spray.  No tail pirouettes or lunging jetes, either.  Those are the actions of the elite, highly-talented whales, it seems.  These guys were more circumspect.  More “log-like.”

The cruise was  narrated by a marine biologist with bubbling enthusiasm for all things whale.  This loud, incessant narration was piped over a battery of tinny, scratchy speakers set next to all available seating areas.  Some adjectives used by the marine biologist to describe the whales:  majestic, enormous, magnificent, playful, friendly, endangered.  Adjectives that crossed my mind as I stared at the same whales the biologist was pointing at:  grey, might-be-dead, abandoned-car-ish, and, again, grey.  Dr. Marine Biologist had names for all the regular whales, cute names like Susie and Eddie.  On this exciting cruise, however, two new whale friends were found and needed names, which the good doctor solicited from our ranks.  Sadly, he did not select my recommendations of “Roadkill” and “Old Rubber Boot,” preferring the much less apt “Pete” and “Pauline.”  He also did not invite me to become a volunteer marine biologist, though he seemed to encourage pretty much everyone else on board to do so.

The pedestrian whales such as we encountered were fairly limited in their entertainment skills.  The occasional sneeze, dramatized by the appearance of sneeze vapor wafting across the boat.  Sometimes, they slowly sink.  Every one of them totally ignored the  potato chips I threw their way.  Pretty aloof, actually.  A glaring lack of people skills.  Majestic?  Is a half-submerged Volkswagen beetle majestic?  Then, no.

Next week:  We go to a Mets game.  Woo-hoo!

DRONES ATTACK IN CENTRAL PARK!

We have seen the future:

A1a-1SQ-Quadcopter

Drones Mug Tourists in NYC

“My buddy and I were walking across the park, you know, and two of those drone copter things just came down right in front of us while we’re walking.  You know, those quad-copter things you see on Youtube.  So, we’re just walking but these two copter things keep buzzing right in front of us, so Steve kinda swats at one but it just dances away and gets right back up in our face and says, ‘Hey, asshole, don’t do that.’  Yeah, it called Steve an asshole, which we thought was pretty funny until the things stop right in front of our face and it says, ‘Give over your money and wallets.’  We didn’t even know what it was talking about, but every time we try to get away the things get in our face, you know?  Steve told the thing to fuck off, we’re not giving you anything and then, bam, the copter in front of Steve hits him square in the chest with a TASER!  Yeah, fuckin’ crazy, right?  Steve goes down and is screaming and the drone thing in front of me says I should take his wallet and his money and his phone and put it in the basket thing hanging under the copter that just TASER’d him.  I mean, the things menacing, you know what I mean?  So I did it.  Then I had to give it my phone and shit, too, and then they both just zoomed up over the trees and were gone, man.  Crazy, right?  That’s what the cops said.  They thought we were high.”

Anniversary of a Tragedy

In memory of those lost one year ago today, I reprise my earlier post:

Superman is a Myth

It was a classic Superman moment. A train of seventy-two railroad cars filled with highly flammable liquid was poised precariously on a hill above a sleepy town filled with innocent Canadians. It was dark. There was no driver or attendant to witness that the airbrakes preventing the train from slipping are slowly draining pressure. The train begins to slowly roll downhill, picking up momentum as it ponderously but inevitably begins to roll faster and faster towards the center of town, disaster looming–but wait! Here he comes, streaking out of sky! A red and blue caped blur, a powerful hand braced against the lead locomotive, a grimace and then, with a squeal–all is saved, disaster averted.Minolta DSC

Only it didn’t happen. No Superman. Instead, disaster, death, and destruction. Innocent lives lost. The classic Superman moment, one I had witnessed in comics and onscreen since my wide-eyed youth, went horribly wrong. No Superman.Minolta DSC

At first, I hoped and believed that Superman could not save the day because he was otherwise occupied achieving even greater goodliness, saving even larger populations of threatened innocents. But I checked–it seems that North Korea had not simultaneously launched a nuclear tipped missile aimed at a New York museum at the exact moment that Lois Lane was visiting with her little nephew’s fourth grade class. The only other possible explanation, that Lex Luthor had Superman incapacitated under a geodesic dome made of Kryptonite, was also disproved by a quick Google search. No Superman.

How could it be that Evil had triumphed? How could the sinister forces of darkness and malevolence succeed, unchecked by our heroes? Such a situation is contrary to the workings of a moral universe, would require the balance beam of justice to be bent beyond all reasonable fairness. Not possible; the Fates are not so cruel.

But, hold on a second. Deep investigation reveals no Fates, cruel or otherwise, in the immediate vicinity at the time of the accident. Reviews of salient radar logs show a sky clear of evil, flying monkeys. Overhead satellite imaging clearly indicates that a demonic miasma did not dissolve the critical feedlines to the airbrakes. Not at all. No Evil, either, it seems.

No, upon further investigation it appears that a well-meaning crew of volunteer firemen, responding to a fire on the train, skillfully extinguished the blaze. They did their best, including following the protocol which required them to shut down the engine to the burning train. The engine that provided the pressure necessary to maintain the airbrakes. And then they went home.

No evil. Not even an absence of good intent. But no Superman.

It makes me sad.

My heartfelt sympathy to the families of the victims of the Canadian railway tragedy.

Requiem en pace