Feel like that damn cat in Alien. You know, at the end? Not a good feeling. And you, buddy, are no Sigourney Weaver. Just saying.
Jack the Bulldog
The Problem with God
by Evan Geller
That Cat in Alien
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The Contenders – Lewis Hamilton
For my fellow F1 followers, the following (and no, I won’t be reblogging anything about Rosberg):
GP2 Testing, February 2006
GP2 Media Service
I’d expected him to look older. I suppose its only natural with someone you’d been reading about for years, but he’d been such a constant part of the motorsport landscape for such a long time that I’d imagined he’d already be the finished article. He’d been a mini-megastar in England since his karting days. Even as a child I remember seeing his face on TV, on the news, on ITV’s karting show with DJ David ‘Kid’ Jensen, Blue Peter, through the pages of Autosport and Motoring News. He was a future world champion. That’s what we’d always been told. That’s what we’d always believed. And here he was, this future F1 superstar. I’d expected him to be taller. I’d expected him to be broader… I’d expected him to look older.
But there he stood on the pitwall in his ASM F3 overalls, a…
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Doctors Parking
I’m old enough to remember when physicians in general–and surgeons in particular–were held in high regard. I mean, we used to have our own parking spaces and free coffee in the doctor’s lounge. I remember when I was a resident in surgical training being taken to lunch between cases by my surgical attending at the hospital’s designated doctor’s only lunchroom, served a steak and fries by a waiter, then encouraged to finish my drink before running back to the OR to get the next patient ready for surgery. And this was an inner city, midwest academic hospital! Table cloths and linen napkins! I’m not making this up–it was the eighties. Now that I’m an attending surgeon myself, I usually find myself wolfing down an Odwalla bar with cold coffee between cases. So I’m sensitive to the situation when one of my surgical colleagues is bent over the hood of a car, in handcuffs, with several guns pointed at him. How did we get to this?
Because, I hear you saying, you guys act like greedy, pompous dicks. And while you are right (see “Mommas, Don’t Let Your Babies Grow Up to be Surgeons” for a start), that’s not the exact explanation. Doctors used to run the hospital–literally and figuratively. In the twentieth century, successful hospital administrators were either grey-haired physicians who realized that the most important thing a hospital did was take care of patients, or no-nonsense nuns with MBA degrees who wouldn’t let anybody die in their facility, goddam it. By the turn of the century, however, hospitals became “Medical Centers of Excellence” with “Program Initiatives” and extensive real estate investments, even the occasional shopping mall amidst the medical campus. The CEO had bigger concerns than relieving suffering and curing disease, he had a big bottom line and a board to answer to. That patient care stuff was delegated to a third-tier hospital administrator who could be found cowering in a windowless office, apologizing to the Chief of Cardiac Surgery for not getting his shiny new hospital wing finished on time, begging the surgeon not to make good on his threat to bankrupt the hospital by taking his skills across town. Now the third-tier hospital administrators take home million dollar salaries as they lay off all the experienced nurses in that same, now careworn cardiac wing, because of the need to “trim the service line overhead.” The center of power has shifted, you see. Today, the Chief of Cardiac Surgery finds that his ID badge doesn’t even open the doors to the administrative wing. And that’s where the nice cafeteria is.
Not so many years ago, I used to make a habit of leaving the hospital on my way home by walking out through the Emergency Room. You learn after a decade of being the Chief of Trauma Surgery to look for trouble on the way out, because otherwise you had a pretty fair chance of getting called back in half an hour. So on the way out I’d walk through the resuscitation bays and exit through the ambulance dock. On one occasion, I was walking out this way when I noticed that a number of hospital security personnel were surrounding an individual, guns drawn. The university had only recently granted our security personnel permission to carry weapons, and it wasn’t unusal at this time to see them working through the particulars of just when to employ their new, shiny Glocks. It was dangerous to drop a candy wrapper in the lobby or complain too vocally about the lack of parking spaces. So on seeing this little armed tableau, I just kept walking, somewhat ignoring the guy bent over the hood of his car, screaming obscenities. I stopped, however, when I recognized the man’s voice. That, I recall thinking, sounds like my colleague Mark. Mark was a busy and talented surgeon who operated at several hospitals in the area. I looked over. Damn, I thought to myself, that looks like Mark, too. I walked over to see a man struggling and cursing as he was bent double over the hood of a black Mercedes, being handcuffed by hospital security. It was Mark.
“Mark,” I said, “what’s up, buddy?” I noticed at this point that the big black Mercedes, Mark’s car, was parked on the helipad.
“Please stand back,” one of the security guys with his gun drawn admonished me. “This is a dangerous situation. I have to ask you to please step back, sir.”
“Geller, is that you?” Mark asked, his face being pressed into the hood of his car.
“Yeah, Mark, it’s me.”
The security guard waved his gun. “Step back, sir. Last warning.” I’m not sure what he meant by that, so I stepped back. He had the air of being the man in charge.
“Tell these assholes who I am, Evan!” Mark yelled.
“Do you know this man?” security guy asked.
“Maybe. What’s going on, officer?” They love to be called officer, because none of the security guys are real cops, you see. They really, really, wanted to be real cops. The guns helped. New cars with the flashing lights also helped.
“Is he a doctor?”
“Might be a doctor,” I said. “Why, what’d he do?”
“He tried to kill one of our officers,” the security guy explained.
“I just needed to park, so I could do a case!” Mark yelled over.
As I was later able to put together, it turns out that Mark was called to take care of a young patient with appendicitis. When he got to the hospital, however, he couldn’t find a parking space in the ER lot or the designated doctor’s lot. Being Mark, he elected not to pay to park in the visitor’s parking structure, deciding instead to park his black Mercedes 500 on the helipad. This, it turned out, had made it rather difficult to land the helicopter with incoming trauma patients, so security had been called. Mark finished his case and came out to see his car about to be towed so, being Mark, he got in his car. Being Mark, he assumed that this would resolve the problem. ER security guy stepped in front of his car. It seems that security guy, gun drawn, had decided that the goal was not so much to clear the helipad for the transportation of incoming trauma victims, as it was to make Mark pay for his effrontery by having his rich doctor car impounded. At this point, Mark decided the wisest course of action was to drive away and hope everyone would just forget the whole silly episode, but unfortunately this involved nudging the officer gently with his large, black Mercedes. Which quickly escalated to a lot more security guys with guns drawn deciding to arrest Mark’s rich doctor ass.
Once I understood exactly what happened, I had to explain to the security guy that no, I don’t think I know the guy after all. Looked familar, but not the guy I thought he was.
And that’s kind of why things have changed for us doctors.
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?
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.
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:
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.”
Writing Doesn’t Make You a Writer
Pleased to reblog the thoughts of Jason Smith:
Don’t Do This. Ever.
Okay, maybe once.
Blog Tour: Therin Knite’s Othella
It is a pleasure to host the blog tour of Therin Knite as she promotes her new novel, Othella.
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Book Description:
Georgette: Pulitzer Prize-winning journalist Georgette McClain can’t resist a juicy tip. So when a rumored crazy ex-CEO gifts her evidence of a vast conspiracy involving the world’s premier scientific community, Arcadian Heights, she sets her sights on the story of a lifetime. And all she has to do to grab it by the reins is sneak into the most secure facility in the world—and expose it for the slaughter house it is.
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Marco: Tech company CEO Marco Salt has it all. Fame. Fortune. Family. But not long after Marco’s beloved genius daughter is invited to join Arcadian Heights, a rogue agent reveals to him the horrifying truth about the revered scientific community. Forced to flee for his life, Marco finds himself on the run with a deadly secret in his grasp and a single goal in mind: destroy Arcadian Heights.
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Quentin: Quentin Belmont has been the Arcadian Heights spokesman for the better part of two decades, and his singular motivation is to keep the community safe at all costs. So when an internal incursion leaks vital information to an outside party, Quentin preps a “cleanup” without a second thought. But what at first appears to be a simple task turns out to be anything but, and Quentin comes face to face with the unthinkable—a threat that could annihilate the community.
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About the author, Therin Knite:
Therin Knite is a 22-year-old recent college graduate who occasionally writes speculative fiction and has the odd delusion of literary stardom. Knite lives in a humble little place known as the Middle of Nowhere, VA, where she spends most of her days reading books and writing what may possibly qualify as books.
Knite is a graduate of the College of William and Mary and holds a BBA in Finance and English. In August 2014, Knite will begin work as an underwriting analyst at a large insurance company, where she intends to stay for the foreseeable future.
Knite, who’s been writing seriously for seven years, is an avid book reviewer, blogger, and the sort of person who spends far too much time imagining epic sci-fi battles in her head. Knite intends to publish 3 to 4 novels per year, ever year, until she runs out of ideas…which is highly unlikely, so she’ll probably be writing forever.
Finally, Therin Knite has a simple writing philosphy you may want to know before you pick up one of her books:
“50% Dark, 50% Snark”
Purchase the paperback: http://www.amazon.com/Othella-Arcadian-Heights-Therin-Knite/dp/1499551258/
Purchase the kindle version: http://www.amazon.com/Othella-Arcadian-Heights-Book-1-ebook/dp/B00L7DCTA8/
Website: http://www.therinknite.com/
Blog: http://knitewrites.com/
Twitter: https://twitter.com/TherinKnite
Goodreads: https://www.goodreads.com/author/show/7760963.Therin_Knite
Amazon Page: http://www.amazon.com/Therin-Knite/e/B00HRL0CXA/
Facebook: https://www.facebook.com/pages/Therin-Knite/663841677010575
I invite you to explore Therin’s excellent blog or try the sample of this new novel available on Amazon.
Best of luck to Therin on her new novel.
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.
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
the Goat Rodeo blog 