New turbine array near Altoona, PA getting ready to go live. ... on Twitpic

New turbine array near Altoona, PA getting ready to go live. ... on Twitpic

Clean energy is moving into the area slowly but local power companies are unlikely to buy to because this area is so connected to the coal industry. Coal is one of the top offenders in contributing to greenhouse gasses and needs to be phased out.

Early Winter Musings

It was a cold night in downtown State College when I left to drive home from a late appointment. Although the University was out for the semester, the streets were anything but deserted. Graduate students taking a break from their never ending pursuits of the almighty thesis sipped lattes in one of the many cafes that line the streets. Last minute shoppers were still roaming the streets trying to get those last minute gifts bought before Christmas and there were always a few students who remained for the season. The streets were brightly lit with Christmas decorations on the trees, lampposts, storefront windows. It was a festive sight. Normally I love Christmas, but was overcome with a mood I had not felt in years. I knew I should not be feeling this way, but emotions often override the logical mind. I am prone to getting depressed and was getting those dark moments again. They do not last long but certainly are not welcome visitors.

The fact that my husband lost a close family member just a few weeks ago only compounded an already somber mood. He went into the hospital with side pain and left with an unknown and incurable disease that no one had suspected. In just over two weeks of constant pain, he was gone. Every day the family vacillated between not wanting to lose a family member and not wanting to see him suffer, but we all knew his time on Earth measured in days, not months. We knew that his life involved more than anything else a great deal of pain and expedience in reaching an end was probably the best thing for him. When it was all over my husband was left battling with finding himself having to assume new role in the family that he never expected to play. I was left with a lingering fear myself about my abilities to be the person he needed to support him emotionally in that role.

But this is all a part of the grief process and completely normal. Nonetheless, it makes for a difficult start to the the holiday season. Thanksgiving spent apart. Our young son crying for his father. An eerie emptiness in the dining room for Thanksgiving dinner and nobody paying attention to football.

Back to the present scenario, I put my focus on the hour (more or less) drive home. It is usually a welcome period of solace. They are few and far between in my busy life, trying to maintain the balance between work and family. This one was just not a happy one. I had recently bought Pink Floyd's "The Wall" on CD, an album that had not been in my mind for some time. Had the son of one of the members not bothered to get himself arrested, it still would be. But while the miscreants of youth usually only attract the attention of persons close to us, those of us who have parents of note make headlines when they get arrested, even if for less than newsworthy offenses. Since reading that story, "The Wall" had been running through my head. Not just one song, the whole album. I decided that before I went through anymore undue emotional trauma, I had better just breakdown and buy the CD. Then I played it on the drive up, over and over, the end result being undue damage to an already low mood.

As if I were not being perseverative enough, I played the CD (well actually there are two) over and over on the trip home. I was on a roll and saw no reason to break my momentum. I returned in a very foul mood. Things at home were usually a relief so I knew this would probably not last.


Everyone needs to have a reason to get out of bed in the morning, and to my delight my son was still awake when I returned home. "I missed you Mommy" was all I really needed to cheer up my mood for the time. Even if he had been asleep, just seeing him sleeping seems to boost my mood. I have made the observation that no matter how horrific a child's behavior can be during the day, once asleep, he will always have the face of an angel.

That particular episode did not end up lasting very long and I was back to myself soon. If I have learned anything in this life, I have learned to allow myself those occasional spells of self indulgent pity- the crying spells in the shower that nobody else knows about, the tendency to play choice songs over and over in my car or on my Ipod when I am alone, the playing on the computer for hours so as not to have to deal with people. If I do, the noxious mood will pass, if not, it is going to hang around for a while. I have learned enough to know that in this area of the country, there can be some very long winters. Those really fun euphoric episodes do not show up until the bulbs start popping up.











I

The Real Meaning of Christmas

There is a small mountain that borders along the town I live in. It has a beautiful overlook of my city and the valley that comprises the metropolitan area of where I work. During the holidays, there is a single star that is illuminated on the top of that overlook that can be seen from most of the city. Since there is no development behind the cliff that the overlook stands on, the star is on a black background and appears to be floating in the night sky, as if it really were the Star of Bethlehem. I like the star, but my son who questions the star, has not been able to understand the significance of it yet. The story of Jesus itself is one that he is unfamiliar with itself, and the concept of the Magi seems too much for a child's mind to understand. In these days of GPS systems, even maps are considered archaic, let alone following a star?

Sadly, I am not as religious a person as I ought to be. Raised in the Episcopal Church and very active in church activities as a child, I went off to college to study in the physical sciences which turned everything I had learned on end. Since then I have been a proper dyslexic agnostic who lays awake at night wondering if there really is a dog. There is still a bit of Christian in me however and I respect the value of the Christian holidays at least. I am very offended by the commercialization and secularization of the Christmas Holiday. I do not say "Happy Holidays" unless I know the individual for certain is not Christian. I have even gone through spells of attending select churches, lead by certain priests that I feel have a particularly good message to relay. My battle this year is trying to convince my son that there is more to Christmas than Santa Claus and getting presents. They tell me the obsession with Santa Claus will be over soon enough so just let it go and I have done my best to heed this advise.

So why do I have much concern for the sanctity of Christmas? Why do I bother to attend church at times when I am so agnostic in my own beliefs? Simple. When one weeds out the propaganda, outside influences, medieval dogma and other outside influences, I feel very strongly that the message that Jesus himself had to convey carries great wisdom and is worth hearing. Some of the things that he said actually sounded quite similar to teachings of other religions that had origins in faraway places. Perhaps these are the real universal truths that are so actively sought for.



For me to be convinced a particular belief in Christianity is valid is knowing that it was one that was put forth by Jesus himself. There is a huge laundry list of conclusions that have been drawn from the writings of the New Testament that were never involved Jesus himself. In fact, the vast majority of writings included in the New Testament were written post mortem. Even if excluding the accountings in the Gospels of Jesus returning to Earth after rising from the dead, there is still very little of the New Testament that documented the actual life of Jesus Christ. An enormous part of the New Testament is written by a man who never even met Jesus and largely involved his interpretation of what he believed to be the message Jesus was trying to convey. If we do not accept second hand information today as reliable, why do we allow a religion to be based on it?

So much for my proselytizing. There is a great deal of wisdom that Jesus had to share and his message was actually very simple in complexity of things that he asked, but at the same time, extremely hard to follow. If everyone were able to follow his teachings, the world would be a better place. I am certain of that, but this planet is populated by a diverse group of people with their own religions, cultural norms, and belief systems and it would be unrealistic for this to happen. There are some things that Jesus himself said that have always stuck with me as having great enough value to heed whether I resolve my own doubts or not because they are so profound in their wisdom that they reach beyond the norm put forth by ordinary man.

Love thy neighbor. - This is not always easy when the guy's dog keeps digging up your garden and his kid throws beer cans in your front yard. People had been killed over trivial disagreements like this. If we cannot get along with our own people, who can we get along with?

I feel I need not mention love thy God. That is a given.

Love thine enemy - He meant it when he said it. Even the most corrupt, evil person in the world can love his neighbor. It takes a special person to love his enemy. We need to try to understand each other better. Love terrorists? Perhaps we need to understand why they came to be- Western interference with Middle Eastern affairs. The root of anger is fear. They are afraid of the power of the Western world and losing control of their lives. They just choose the wrong way to show it. A little more understanding between both parties would save a lot of suffering.

To reach the Kingdom of Heaven we must become like little children. - Really not that surprising when you consider it. It is a central tenet of Zen Buddhism. We are perfect at birth and become tainted with time. To fully be enlightened we must cast off this dogma and return to our pure state. Babies are not evil. They are babies, are pure, unadulterated. They are somebody's perfect little child with pictures being sent all over the globe on Facebook. Even the ones that grow up to be criminals and terrorists.

If thine enemy smite thee, turn the other cheek. - A hard point to swallow, but one cannot lose a fight that one does not get into. Sometimes the bigger man is the one who shows a little humility.
Let he who is without sin cast the first stone. - What gives any of us the right to judge another person when we are not perfect ourselves? We all do it, though and it is very hard not to.

Of course those who are Christians celebrate the birth of Savior each year to forgive our shortcomings. Every year I place candles in the window to welcome the baby Jesus to our home and there is a star on the tree to lead the way for the Maji (who arrived two years later, by the way). And that is the real meaning of Christmas, whether Wal Mart likes it or not.

So if you are Christian have a Merry Christmas and I hope you are able to celebrate with family and friends. If you are not, I hope you at least get some time off to enjoy your family and friends.

Peace to all.

Card Sentiments That we Really Need

I am not a typical woman, sending soppy greeting cards for even the slightest event in one's life. You know the kind- the covers are usually graced with butterflies, sailboats in the sunset or still lifes, most often with kittens in the foreground. On the inside, they have VERY long verses, so long that they have to be written on both sides of the card's interior. Face it, no one reads that. Usually the nausea starts kicking in too strong halfway through the first side for the reader to go any further and the rest is skimmed to the ending to see the business end- what the card is trying to convey - Happy Birthday, Congratulations on your new baby, etc and who sent the card. I do not send those cards. That said, I do not send fart joke cards either. I have some degree of taste. I will send humorous cards, just not Delta House frat boy cards.

There are cards that I would have liked to have sent, but did not for reasons of family unity, world peace, decorum, etc. I know there are some who will send those "I can't believe he did it" kinds of cards, I have seen it happen. A friend in college sent a sympathy card to a friend who married a woman with a case of raging borderline personality disorder. Was it the right thing to do? Probably not, but it was funny as hell and none of us in our social group got along with his new spouse very well. We hated to see him suffer and new that as long as he was with her, that was what was going to happen to him, so it did seem appropriate.

There are a lot of card sentiments that really could be put to good use by those of us who are gusty enough to send them. If only they could just divert the poets long enough to write them. For example:


Congratulations on your new baby...

-Too bad he/she is so damn ugly.
-I think he looks like the mailman, how about you?
-Maybe this one will beat the odds and have brains.



Congratulations on your Marriage...

-we wish you the best, but he is sleeping with your maid of honor so we all know were that's going.
-maybe this time it will last.
-It had better last considering the washcloths on your registry cost $90.



I'd send you flowers on Valentine's day but...

-I think you're and asshole.
-But I figured we might as well skip the dying flowers and get to the point so I sent condoms.
-I sent them to yo mama.



Happy Birthday!


-Try not to puke in your designated driver's back seat this year.
- You don't look a year older than 100!
- Don't forget to check your blood sugar before you eat that cake. Remember how you ended up in the ER last year in diabetic ketoacidosis.



Happy Father's Day


- I got you your favorite- cheap beer and generic cigarettes!
- even if you did beat the crap out of me and mollest my sister whenever Mom went to visit Grandma.
- I hope you enjoy your card because if you do not stop whining about the condom breaking, this if the last one you will see.

Happy Mother's Day

- to the Travel Agent for Guilt Trips of the Year.
- even if you did like my brother better.
- I liked you a lot more when you were still in the State Hospital.

Card Categories that should exist but do not

Rather than
-For the Happy Couple
try
-For the Unhappy Couple


Instead of
-New Baby
we need
-New Crack Baby


Instead of
-"Sweet Sixteen" birthday party invitations
we need
-"Sweet Sixteen" 10 Kegger While the Parental Units are in the Bahamas invitations



Instead of
-Baby Shower cards
we need
-Unplanned Baby Shower cards



Instead of
-Wedding invitations
we need
-Shotgun Wedding invitations



Instead of
-Mother's Day cards
we need
-My Baby Mama Day cards



Instead of
-Father's Day cards
we need
-My Baby Daddy Day cards



Instead of
-Generic "Happy Holidays" cards
we need
-I hate the F#&*ing Holidays cards



Instead of
-Ridiculous "Happy Hanukkah/Christmas/Kwanzaa/Chinese New Year/New Years Eve/Some vague Catholic Saint that no one has ever heard of day cards
we need
-Let's All Go Act Like Douche bags for Two Weeks at the End of Every Year for World Peace cards

Instead of
-Valentine's Day cards
we need
-I Bought You This Card Because You Would Think I'm a Dick if I Didn't Day Cards.

Instead of
-Happy Sweetest Day cards
we need
-Happy Increase the Profit Margin for Hallmark by Creating Another Stupid Holiday Card.

Next entry- card sentiments that we really need rather than that soppy Hallmark poetry crap that no one had the patience to read.

A Child's Love

In our busy days we sometimes forget the innocence of children. My son knows that I am a doctor and I have tried to explain what a psychiatrist is, but it is certainly hard to explain what depression or psychosis is to a four year old who has not experienced it first hand. He has been up to the staff lounge where I work briefly, but because of confidentiality reasons, not to mention safety, he has never been on the actual unit proper. He has no idea what an inpatient psychiatric unit looks like. All he knows is on weekdays, Mommy goes to the "hosipal" to help sick people who are sad. He also knows there is a helicopter outside Mommy's window and that is pretty cool.

Fortunately, with the exception of the month he spent in the NICU after he was born, he has never been admitted to a hospital. He has visited some very nice ER's though, where he gets stickers and people tell him he is cute and a very brave boy and he gets to lay or sit on a special bed with bars with Mommy or Daddy. Once, he even got "a big pill up my butt", a fact that, rest assured, he will tell you about. In all three of those visits, he was sent home with more stickers and people telling him he was a brave boy. It never occurred to me that he did not realize that people stay in the hospital as inpatients.

I discovered that earlier last week, the last time I had to take call. I took a call from the ER about a potential admission. Business has been good and we have been running full. "Do we even have a bed?" I asked. Once that was clarified, I accepted the admission. My son overheard the conversation and his response was not what I expected. He gave me a quizzical look and asked "We have a bed upstairs?" Of course we do not. Our house is a ranch house without an attic and I could understand his confusion as he does not always separate telephone conversations from the one in the room. I explained that I meant, do we have a bed on the psychiatric unit where I work, which is upstairs from the ER. He still seemed surprised by this and had to tell my husband. "Daddy, they have a bed upstairs at the hosipal!" followed by the question as to why we kept beds in the hospital. I explained that these were for the patients to sleep in when they stayed there. "They stay there at the hosipal?" I did not realize that he did not know that patients stayed at the hospital. His only experience with hospitals that he would remember are the ones above. He had never been exposed to a situation where he had to experience someone as an inpatient. This idea was all new to him. I got a good laugh about this and went to work with a new "my son said something this morning that was so cute" story and went about my day.


I thought maybe I should show him some pictures of his month long ordeal in the NICU when he was first born. He had been told he was a "preemie" and spent a month in the hospital before but never paid much attention before. I asked him if he recalled being told about being in the hospital for a month after he was born which he really did not have much memory of. This time was interested to see the pictures. I showed him pictures of the warmer he stayed in at first, then the small crib where he was kept tightly swaddled to help with muscle development in a premature baby. He saw all the tubes, heart monitor leads, oxygen monitors. I told him that we came by three times a day to feed him and that the nurses fed him with a tube the other times. I showed him the feeding tube. That's when his response really moved me.


We probably felt worse leaving our son than he did being left behind. Preemies in general cry when they are disturbed too much. They have important things to do, like grow, so they do not mind being left alone. The mind of a four year old is different. When I told him that we came three times a day to visit then went home, he started crying and said that he missed us when we left. It was very touching. I reassured him that babies that little do not have that kind of awareness but he insisted "but I really loved you guys and I didn't want you to leave." Of course at his age, it is hard for him to process having feelings any different than the ones he has right now, but I also know from his response how much my husband and I are loved by our son. That means a great deal to me.

Money can buy you things that might make you happy at times, but a child's love must be earned and will bring more than happiness. It will give you a reason to get up in the morning every day.

Why I Changed My Name

Artistic license only goes so far in medicine and I have run into a road block in that arena. The dilemma I have run into is that the powers that be have concerns about the content of my blog possibly compromising patient confidentiality and have put limitations on what I may write in the blog. While I understand their side, it does put fairly strong limits on what I am able to write about. I am fearful of writing anything that could offend them. The end result is the vast majority of things that I write about do not have anything to do with psychiatry at all. That or if there is any psychiatric content, it comes out more like a textbook than anything of much interest.

I felt that considering this situation, it would be best that I change the name of the blog to one that is more suited to what I am really writing about. This will allow me to write my posts without the pressure of trying to find a completely neutral topic in psychiatry but end up with one that is not very interesting. There is plenty of things to talk about in my life here. I am, after a big city girl who is essentially stranded in a small to medium size town in the middle of nowhere with very limited access to Nordstrom, true fine dining and cultural activities. What they do have is hunters with guns. There are also monster trucks with deer head decals on the back windows and rubber testicles hanging from the trailer hitches. There are critters here that we do not encounter in Ohio, like bears and bobcats, some of which tear down birdfeeders and poop all over our lawns during the Spring and the Fall and the people here just accept that as the way it is. There is also another fine selection of critters to dodge on the roadways, not the least of which is skunks. I could go on and on about the differences of the area in which I reside and the area in which I grew up but suffice to say that there are a lot of things to talk about. Which is why I have chosen to change the focus of the blog. Therefore I give you...

Lost in Central Pennsylvania

An Old Home Dies

On a busy corner of a main street in my town there sits a blighted house. Not much different from all of the hundreds of other blighted houses out there, but this particular house sits near a friend's shop and I drive by it quite frequently. Devoid of all exterior coverings that one would expect to find on a home, it is particularly hideous in appearance.

She tells me that it was reputed to have last been occupied by drug dealer. Once he was caught, the occupants disappeared and the house has been vacant ever since, at least by official occupants. Empty homes are a magnet for rats, pigeons and mice. Not to mention unwelcome human visitors who find such homes a good shelter from busy eyes, therefore useful for drug dealers and "shooting galleries".

Not that the house is totally without value. When I drive by, I see pipes, wires and windows, all which could be reused. There are two Satellite dishes that appear to be in good condition mounted on the side of the home. The pipes could be stripped and sold for scrap metal. Some of them may be reusable. The windows appear to be recent installations, albeit done shoddily in plywood nailed onto the original window frame. It is possible that they could be reused. If not, the glass could be recycled, as could the metal frames. The house is obviously quite old and on the interior there could be some quite beautiful light fixtures, hardwood flooring and other pieces that might be reusable. Of course those sorts of reclamation type demolitions take money. Old walls bear lead paint. Old tiles and insulation have asbestos. But eventually, that house is going to have to come down.

As do probably a couple hundred other blighted homes. It bears a red condemned tag on it as do all of the condemned homes. Most of the red tags posted on homes like these have long faded to pink or even near white. The owners are supposed to bear the burden of bringing the homes back to code or demolishing the building, but the cost to tear down the structure is greater than the cost that the property would sell for. In some cases the owners have simply died of old age and their children, if they had any do not want anything to do with the property and simply abandon it. The city is supposed to give the owners every opportunity to reclaim their property before razing the building causing even more delays. Federal stimulus money did have some benefit to the community in allowing several houses long awaiting demolition to be brought down and cleaned up. But the hundreds more waiting have yet to be touched.

The number grows every day. The area's long standing Republican representative does not live in the city proper and never sees the decay that his constituents see every day. Riding in on the coattails of his father, his long time tenure as Representative to Congress has done nothing to improve the economy in the area and the layoffs in the area grow daily. This is a working class community to begin with and many of the homes in the city are of little value on the real estate market. Certainly nothing worth fighting for when the foreclosure notice comes. The end result is another home is left to decay.

The recent removal of some of the blighted homes in the area of the city surrounding the downtown area has removed a few of the eyesores around town but it is only a drop in the bucket compared to the growing numbers that remain. The holes they leave look like the gaps in a line of poorly cared for teeth. This always leaves the question of what to do with the property. For the adjacent owners, the property would probably be a welcome addition to the anemically narrow lots they survive on. Homes from this era were built with little more than a few feet for a walkway to pass between them. The problem is that most homeowners in the area are either slumlords who do not care or poor homeowners who cannot afford to buy this land. The areas are too run down to redevelop without tearing down the entire area. The end result is displacing an entire neighborhood of people who can barely afford what they have. In some areas, local businesses have bought some of the properties, largely to pave over as parking lots, but the land does not go unused at least.

In one area where a large enough strip of land was cleared to be useful, the city made the decision to convert the area to a park. This, on the surface sounds like a good idea. To someone who has seen this before, it is a terrible one. I have lived in a big city long enough to see what happens in a small park surrounded by a decaying neighborhood. The children do get a playground to play on but the drug pushers quickly find a new whole new location in which to pick up customers. Get them young while they are too naive to know better and they become your slaves. Driven to dealing themselves to support their own habit, an entire new and growing network of addicts is born. There are always abandoned houses to hide in to shoot up.

I know what this city needs. We need jobs. But bringing jobs in is a lot easier said than done.

Can this city be saved?

Things I Tell My 4 Year Old that Nurses Tell Our Patients

-Put your underwear on!


- If you are not going to wear clothes you are going to have to stay in your room. Nobody wants to see you naked.


- Stop playing with your penis in public.


- Don't use your sleeve as a tissue. That's what Kleenex is made for.


- You need a shower/bath. .... No you are not clean. You stink. And it does not count if you do not use soap. I know if you haven't used soap so do not try to sneak.


- Dinner is here. WASH YOUR HANDS before coming to dinner. I don't know where those hands have been but I know it is somewhere pretty disgusting.


- If you are going to yell like that you are going to need to take a time out in your room. (NB: 4 year old's who refuse get privileges revoked. Some patients get prn medications if they get really bad so there is some difference here.)



- Pull those pants up. Your underwear is showing. (Of course the 4 year old's reason for droopy drawers is the more benign thin body build while the adult/adolescent patient is just trying to play the "gangsta" role.)


- Stop picking your nose/butt at the dinner table.


- No biting!


- Watch your language!

-When was the last time you took a brush to that hair?

-You need to brush your teeth. Your breath is disgusting.

Internet Party Tonight

"TV party tonight
TV party tonight"

"Don't want to talk about anything else.
We dont wanna know
We're gonna watch our favorite shows."


The song resonates through my head as clear as day. Like I was listening to the grainly old tape itself.


"Be back soon! We are down due to connection issues. We are sorry for the inconvenience."


That was the message the greeted me at the top of my ISP's home page when I sat down for my evening ritual of computer time. I have little time to use the computer and the brief time after my son has gone to bed and before I do is my time to catch up on email, Facebook, my blog and Twitter. Until this unwelcome visitor greeted me above.


Is is a tacit assumption that most readers are not familiar with the Black Flag song "TV Party" so I will explain the lyrics above. The song surrounds a group of pathetic losers who have essentially no lives and do little with their day but "watch TV and have a couple of brews." Their lives are totally devoid of any value and they take great efforts to avoid dealing with the reality of the world. When the TV breaks, their lives fall into chaos and they are forced to actually talk to each other, something they have never had to do before and are at a total loss on how to survive.


When I saw that notice about the internet being down, my first inclination was to actually play video solitaire rather than do something of real value. I realized then how my addiction to the computer and the internet, especially Farmland, had overtaken me. I have been able to cut back my use of Facebook and Twitter to a low roar, but Farmville is a consistent addiction. I HAVE CROPS TO HARVEST, FRIENDS' CHICKENS TO FEED AND GIFTS TO SEND! I need to stay on top of this as I need 2 MILLION COINS to get the HUGE farm. Whithered crops are just wasting money and that just will not do.

My mind pleads for mercy- "My Lord! How have I offended Thee?"

I think his response would likely have been "Do you want the whole list or just the top 10?" Fortunately, I was not that high up in his priority list to warrant a response.

So I am a pathetic loser. I could write these thoughts down now and transcribe them later (which obviously I did). I have done it before, I can do it again. There are always other things that need tending to either way that are of far more importance that electronic solitaire.

Then a light turned on in my head...

...I can still access the internet from my IPod and at least harvest my crops.

And another display in my mental Hall of Lame is opened.

"We stay tuned to the TV set all night-
and every night.
We don't go out into the world at all-
it's such a fright.
We've got nothing better to do than to watch TV and have a couple of brews."
Lyrics: Greg Ginn Performed by: Black Flag

Obamacare and Illegal Aliens

I realize the Healthcare Reform Act has been very controversial. Some love it, some hate it, some support the idea but feel it needs revision. It is certainly being brought up a lot in the current campaign year. People have the right to their own opinion, but what really irks me is the constant misrepresentations of what the bill actually says. Political ads constantly bombard the public with half truths and sometimes outright lies to sway the public towards their candidate. Since so many people make their decision on those ads alone, and not on the reality of the candidate's true record or principles, I wanted to throw in my two cents on a few points as an example of how the truth can be distorted.



First thing, is I do want to make comment on the journalistic abilities of Fox News. It is not just because Glenn Beck is on my top ten list of men in the world most deserving of a thorough ass whooping, but I have issues with the station as a whole. Fox News was bought by noted conservative newspaper man, Rupert Murdoch solely for the purpose of pushing a hard core right wing agenda. They have no interest in the truth or providing non-biased information and often broadcast information that is blatant lies. If one is looking for the most objective reporting available, The Christian Science Monitor has long been noted for this, surprisingly enough. Even Oscar the Grouch's grouchy girlfriend on Sesame Street said she was going to watch Fox News because "now that's some really trashy news." I played that over numerous times on the TiVo to make sure what I was hearing was correct, and yes, the writers at Sesame Street went that far out on a limb. They helped to propagate the whole "death committee" rumor which never existed to begin. If done in error this shows the signs of very incompetent journalism. If done on purpose it is apparent this was reported with a great deal of intent of malice. The rumor initially propagated by a republican politician whose name escapes me put forth the statement that Medicare recipients would be required at regular intervals to meet with a committee to discuss their plans on how they intend to shorten their lives and prevent unnecessary medical expenses. There was never anything close to this proposed, but when Fox News and Sara Palin got word of this work she wrote to the story and ran with it. What really was suggested was to offer Medicare recipients "end of life" counselling, but it was never mandated. End of life counselling addresses issues such as designating a power of attorney, writing a living will or advance directive, etc. These are issues that do need to be addressed, and probably long before someone reaches the age where one can qualify for Medicare. Many families and providers have been put in a quandry when an incompetent patient without a power of attorney demands to return to an unsafe situation. Most famillies do not have the thousands of dollars needed to hire an attorney to start the process to declare a family member incompetent. Either way the process takes weeks, forcing providers to send these patients home. Many patients die as a result. Having a designated power of attorney to speak for the patient may result in the patient placed in a safer setting. In the long run, this could end up costing the system more, not less as implied by the "death committee" principal. I am not sure if the end of life counselling was dropped from the final product but do believe people are often too quick to act and make assumptions about something without really reading what the clause actually says. This type of behavior can have dangerous consequences in the long run.


My biggest area of contention is the constant barrage of political ads that distort that truth of a given candidate's opponent by taking certain clauses out context and twisting them to mean something completely different than the truth. I have seen far too many ads recently that stated that supporters of the Health Care Reform Act are giving out millions of dollars in health care to illegal aliens. Much of this stemmed from the initial version that did not have a clause in it that specifically stated that illegal aliens (or undocumented persons, or whatever term is the term du jour) were to be excluded in this plan. It did not state that illegal aliens were to be included in the plan either. It is very easy to take the phrasing of the act out of context and state that supporters of the bill are throwing dollars at illegal aliens for health care. That does not make it true.


I work in a setting where a large percentage of our patients are uninsured and have lived in area of the country that played host to large populations of migrant workers at certain times of the year. Tuberculosis runs rampant in these populations as does diabetes. Dental problems are a huge issue. HIV and syphilis are an increasing problems. With the exception of dental caries, these are communicable diseases that could get passed on to American citizens. But they are not monsters, they are humans, and yes, they too need medical care sometimes. These people do not receive health insurance from their employers. The American people need to stop bickering about who is giving money to illegal aliens for health care and who is not and face the fact-


We always have covered the cost of healthcare for illegal aliens, we continue to cover the cost of their care and as long as they are living in this country we always will. These people simply do not crawl in a hole and die when they get diabetes, they go to the ER. They do the same for TB, pneumonia of any other malady they suffer from. There are some areas where clinics have been set up to address their health problems but for a large percentage of them, they end up as high end utilizers going to the most expensive place possible to receive health care because it is the only place they can go when they do not have the money to pay for their care- the ER. Federal law forbids hospital ER's from turning patients away just because they do not have insurance. If they need inpatient care and there is a bed available the hospital must admit the patient or the hospital faces some hefty penalties. If there are no beds, the hospital pays at its own expense to send the patient to the nearest hospital that does have a bed. That law applies to every patient who walks in the hospital doors, citizen or not. Even without those laws, the Hippocratic oath does not only apply in cases of resident aliens and citizens and any physician who refuses to care for a patient because that patient is an illegal alien should have his license revoked.

Of course, the other issue is that doctors never walk into the exam room with the patient and start out the interview with "So Mrs S, are you an illegal alien?" I have never asked a patient of mine if he/she was an illegal alien and would put down good money nor has the vast majority of the practicing physicians out there. We do not know, we do not care. We do not treat "Green Cards". We treat people.

So who pays all those ER bills? You do. Personally, I would rather pay for a $40 office visit to a family doctor but that would be "throwing millions to pay for medical care for illegal aliens." Those that oppose the Health Care Reform Act may have a lot of good reasons to be opposed to it. There are a lot of stipulations that are not popular and some things that may not be the best option for the nation. Not wanting to pay for medical care of illegal aliens is not a good one. Repealing the Health Care Act would result in the taxpayer covering a $600 ER bill rather than a $40 clinic bill. Why? Is it because one does not want it "on the books" that illegal aliens can access health care. Doctors and hospitals are still going to treat our patients, whether they are illegal aliens or not. We have an ethical duty to do so and a federal statute (EMTALA Act) that requires it. Let the Tea Party say what they will. We would still be paying for health care for illegal aliens, just a WHOLE lot more.

Things I Just Do Not Understand

Thongs on really heavy guys.

Men driving cars with Tinkerbell seat covers. Especially if the gear shifter has a skull for a handle.

Really ugly tattoos that look like one's skin is rotting off.

Glenn Beck

Women who bleach the top layer of their hair white and leave the rest dark so they look like a skunk.

Country music. Apologies to my brother, but we made fun of country music as kids, and I am not going to change now.

What the hell a Tarheel is?

Why they had to put this sign up at New Orleans Airport's security scanner. And why they did not notice that they wrote children twice?

How anyone would think that handpainting flames and putting a 2x4 as a spoiler on the trunk of his car is going to make it more attractive.

How 5'2" women with 2 children can justify owning a huge gas guzzling Chevy Suburban just because they have those 2 children and "need the space."

Who Justin Beiber is, and why he is such a big deal on twitter.

What a breakfast burrito is, and why anyone would eat such an aberration? Gross, sorry, but gross.

Why people pierce their tongues, lips, nipples, genitals, etc. It is sort of like the anti-dress for success. Like saying to an employer "Don't hire me. I'm on drugs and will steal your money and sleep with your daughter."

Why anyone would want to wear really huge ring dilators, except in the case when these are use to hide heroin or cocaine.

People who get hooked on heroin and meth despite knowing what it will do to them.

People who have children at 16 years old because they are partying so much that they make bad judgements.

People who neglect and abuse their children because they are too interested in their addiction to deal with them.

People who get so hooked that are driven to trafficking heroin to support their habits and still do not want to quit.

People who have watched all their friends die of heroin OD's but continue to shoot it.

People who have 2 and 3 year old children who are still children themselves who die of heroin overdoses because they could not choose their addiction to heroin over the lives they created.

I would rather put up with Justin Beiber.

Top 10 Songs to Wallow in a Sea of Your Own Misery To

Autumn is traditionally a time people with seasonal affective disorder dread. The days are getting shorter and they know that they are going to start getting depressed. A lot of people are actually affected quite a bit by the change in the length of the days. The advent of artificial lighting has done wonders in creating depressed patients to fuel the mental health industry. I can discuss that in another post. In honor of the oncoming season, I present my favorite ten songs that I find particularly good at listening to over and over and over when I am feeling down. I apologize that most of the songs are rather dated, but since I have been working in small towns and did not until only recently acquire a satellite radio, I have been out of touch with "real music" as it were. Rest assured, though most of these are oldies, they are goodies:



10

"People Who Died" - The Jim Carroll Band

A song enumerating many friends of the writer who died, several through drug use. The sad point is driven home if one aware of the fact that this song is true. These were actually real people who died, and there were quite a few.

9

"Everybody Hurts" - REM

Until the release of Automatic for the People, REM's music was largely upbeat, and at times rather silly. Lyrics were most notably incomprehensible much of the time and this was a signature feature of the band. Not to mention their refusal to print the lyrics on the liner notes. This album changed that tone notably. This song, intended to cheer up the broken hearted missed the mark with its slow pace and melodic tones that had not been heard from Micheal Stipe previously and only made people feel even more alone. That said this was one of their best, if not their best album ever made. Then they started to suck. (Sorry boys. I love you, always will, but the truth is the truth and new REM is just not old REM.)

8

"The Rat" - Dead Confederate

One of the few contemporary songs on the list. Anyone who has ever felt brushed aside or labeled as insignificant can sympathize with the rat killed in the song because it is viewed as vermin to humans. Even worse for the rat is that it is brushed off at the Pearly Gates as well so even in death gets no respect.

7

"Every Day is Like Sunday" - Morrisey

I hate to use the Smiths/Morrisey more than once, but Morrisey is by far the best depressing music writer ever. Lacking the talent of guitarist Johnnie Marr, his solo music did not have the musical quality as the Smiths. Despite that, the depressing tone of the music lasted. Only Morrisey could successfully portray the image of being miserable while on vacation in a resort town. And to tie it in with imagery from the movie "The Beach" where the Australians are awaiting the nuclear dust cloud to come and rain down on them after WWIII and slowly kill them- absolutely brilliant!

6

"Misplaced Childhood" - the entire album, minus the last song- Marillion

Being so desperate for love one man falls in love with a prostitute. Then buys her a ticket to England expecting her to meet him there and actually get on the plane. Not surprisingly, he gets stood up and totally breaks down into a miserable heap of self pity. This concept album by one hit wonder Marillion must be heard in its entirety to fully get the entire range of emotions. The down side is the last song turns it all around and makes everything better, spoiling the whole effect.

5

"Wish You Were Here" - Pink Floyd

Written as a tribute to former (and now deceased) member of Pink Floyd, Syd Barrett. In many ways, an attempt to apologize for kicking him out of the band. Not that it did not need to happen. Barrett's bizarre and unmanageable behaviors interfered with his ability to perform as a musician. Ironically what was initially believed to be the result of excessive drug use turned out to be severe mental illness. Anyone who has been separated from a loved one can identify with this song and it is very useful to play it repeatedly, at least 10 times to really get one's mood down.

4

"Heaven Knows I'm Miserable Now" - The Smiths

Enough said.

3

"Grapevine Fires" - Death Cab for Cutie

Just the name of the band is morbid. A song about a couple, presumably in California, sitting in an elevated graveyard drinking wine while all of their worldly possessions burn to the ground. The woman's daughter dancing happily through the gravestones. Could there ever be a more peaceful sight? The lyrics, the pace of the song, everything, leaves this very solemn feeling of doom and destruction that hangs with you for hours. Great way to really feel blue all day long.

2

"How Soon is Now" - The Smiths

Not to be perseverative, but these guys are by far, the masters of misery and unhappiness. The Smiths have perfected the depressing song to such ridiculous heights that they actually become humorous. This one is a six plus minute long masterpiece of whiny lyrics, whiny sounding guitar licks, whiny everything. And it drags on long enough to really drive home the point. Most songs cut out after 3-4 minutes and do not have the chance to really sink in and ruin your day. This one has just enough time to do that without the endless droning of those songs produced by 70's acid rock bands that just got annoying after a while. The lyrics are indescribably depressing: "...so you go and you stand on your own, and you leave on your own, and you go home and you cry and you want to die." You simply cannot beat that.

and finally....

1

"The Wall" - Pink Floyd

This includes the movie and the album. The entire two record long album, for those of us who were lucky enough to have survived the years living with roommates without it getting stolen. Even the writer was miserable when he wrote it. The majority of the album was written while Roger Waters was going through heroin withdrawal in rehab. The theme of the story is semi-autobiographical in that the main character, like Waters, lost his father as an infant while away at war in WWII, developed a terrible heroin addiction and had a lot of unresolved emotional conflicts. It helps to see the movie, but only in a good movie theater or at least a home theater system with a good surround sound system, and it helps to watch the movie a good three of four times. At first it seems rather incomprehensible. It takes a couple viewings or the explanation of a veteran of the movie to understand what is going on. What is quite certain is the main character, Pink, is quite miserable, and spends the vast majority of the movie pondering the terrible experiences he has had throughout his life and really does not like to be disturbed while he is busy being miserable. If you do not want to go so far as to see the movie, the album is still pretty depressing, but the story is not as clear. You might best to well to listen to "Hey You" and "Comfortably Numb" over and over again until your roommate whacks you over the head with the turntable that you worked so hard to hunt down so you could play that two album set that you worked so hard to keep from getting stolen.

Now for the instructions on how to wallow in your own misery:

Pick out your favorites, and I am sure you know many of your own, download them onto your IPod shuffle, lock yourself in your room with too much ice cream/cake/cookies, pop, beer, Red Bull, whatever makes you happy and play over and over and over and over and ...... Ignore the rest of the world. Blow off your roommate, especially if you do not like him. Or family, SO, etc. Repeat.

In the end of it all, after you have had your few hours of crying in your beer/energy drink/diet pop, eaten three gallons of double chocolate chip ice cream and missed the biggest party of the year sitting locked in your room burning out your IPod, it is time to realize that while it is good to have some time to let the pain out and stop internalizing your feelings so much, that life goes on and you need to break out of it. If you find yourself following this ritual every night, there is a problem and you need to seek help. More people than you might realize do, including many of the musicians that wrote the dreary depressed music above because they were, after all, depressed when they wrote it. That did not mean they were unable to write after being treated, but the tone of their music was different. Besides, you have been hogging all the double chocolate ice cream and I want some, too.

Objects in Your Mirror are Larger Than They Appear

"It's just a bug." That is what the social worker on the unit told me the other day when I related the heroing tale of my treacherous drive to work. Normally I would agree with him. Most bugs do not bother me, nor do spiders or snakes for that matter as long as they are not pit vipers. Even in Pennsylvania, we have a few species of those. But this was no ordinary bug. This was a monster, by far the largest dragonfly I have ever seen, and I have been in the rainforest in Costa Rica so I have seen some pretty big bugs. This thing did not belong in the Eastern Allegheny Mountains. But it was there, and it was IN MY CAR AND IT WAS GOING TO GET ME! NO REALLY!

Actual size photo of a different man eating dragonfly.

To begin the story, it was any normal Monday. I was driving along my usual road with the once polluted river on the left. There was the strange house with rusty farm equipment and a chicken running loose in the front yard on the right. There was an SUV in front of me, a pickup truck behind me and we were all going 10 mph too fast. Any normal Monday. We all turned right on the US highway and made a fast left on the two lane road that is badly in need of widening. There we all tried to drive 10 mph too fast, but were as expected slowed down by a school bus, dump truck carrying gravel or some old guy who just does not get the point that some of us have somewhere to be at 08:00 and drives 15 mph too slow just to piss us off.

It was somewhere in that transition between going too fast to too slow that I heard the loud buzzing noise in the back of my car. It did not take too long to identify the creature that was making the loud buzzing noise looking in my rearview mirror as it was a HUGE BLUE DRAGONFLY WITH A FUZZY TAIL THAT WAS A BIG AS A WOOLLY WORM. I am not exaggerating this. I am not the kind of person that would normally fear a dragonfly. This was the sort of nightmarish creature that only appears in B rated science fiction movies from the 50's with names like "Attack of the Killer Dragonflies". This abhorrent monster was keeping me company on the way to work while trying desperately to get out of the back window by pounding on it with sheer force and not succeeding. So there I was on a busy road in a line of cars being deprived of any reasonable chance to arrive at work on time and there was nothing I could do about it. I tried the usual interventions. Open the rear windows, no bites. The dragonfly briefly strayed from the base of the window to the top so I tried opening the sun roof thinking maybe it would continue its upward ascent. No go. The monster went back down to its point at the base of the window where it had been on guard most of the trip. I should point out that it was about 55 degrees outside and opening the windows was not exactly pleasant, especially at speed greater than 40 mph. It was a sacrifice I was willing to make if it would get this creature out of my car but it never did work. I had that bug in my car the whole trip and worried the whole time that something awful might happen like it might fly in front of me and get in the way of my view or poop on my leather upholstery or worst of all...

IT MIGHT TOUCH ME! Bug germs! Ewww!

By the time I got to work, the dragonfly had wedged itself between the glass and the shelf below and I was not ready to have a dragonfly carcass decorating my rear window. Like it or not, I was going to have to extract the monster myself. My first attempt by trying to scare it out with a pen made it dig in even deeper into its hole. By then all that stuck out was the tip of the tail which looked surprisingly like the stinger of a scorpion to me. A bigger woman would have just grabbed the tail and pulled the dragonfly out herself. I am not a big woman. In a panic, I dived into the front seat to extract a tissue from my ever present tissue box that resides in my car for my ever allergic sinuses and with that, I grabbed the dragonfly/woolly worm tail and extracted it.

The dragonfly, apparently finding itself under attack, turned around and attacked back, twisting its body around on its tail 180 degrees and attaching to the tissue with a steel grasp. Up until this point, I had not realized that dragonflies had flexible tails. But apparently, the Mothra species does, and this one turned quite readily. I was at least able to get the tissue out of the car along with my radioactively altered friend who had decided he did not want to let go of the tissue and clung to it for dear life as a shook it like a madwoman trying to get it off. Thankfully when it finally did let go, it did not go back into my car but took off into the strange environment it had been transported to. Sadly, the "big city" is mostly concrete and urban blight and this creature came from a mostly wooded area. It may not feel all that comfortable in the blocks of row homes it will find here. Perhaps there will be enough trees to survive in the cemetery across the street from the doctor's lot. (How's that for irony?) I honestly wish the dragonfly no harm. I just do not want it serving the role as my new navigator.

One thing was for sure. I was not going to offer it a ride home.

Shanksville

With it being so close to 9/11, I hear a lot about Shanksville. I do not live all that far away from the city since moving here, and it seems to be a fairly sleepy town for the most part were it not for the tragedy that happened that day. I thought of Shanksville writing my last post as the site where the plane crashed was actually near an abandoned strip mine.

Every crash site from 9/11 seems to have taken on a different symbolism in American culture. "Ground Zero" will always be know to Americans as the former site of the World Trade Center and have a strong association with firefighters and emergency workers who lost their lives charging into the building trying to rescue survivors. This is sometimes taken to a fault as the multicultural nature of the building was lost in the tragedy. People from many places in the world died, probably some from countries that are sympathetic to terrorist causes. The World Trade Center was the WORLD Trade Center. It was not just Americans who suffered that day but people of many countries and this seems to be a neglected fact.

The Pentagon was the military site, regimented and organized. The loss of human life was kept to a minimum. The military does not leave itself vulnerable. The frightening thing was that there was loss of human life. They were hit totally unprepared and the fact that they were was scary. It meant that we were not as safe as we thought and the bad guys could come and get us when our scouts were not looking.

Shanksville was the site of the common man. There was still a crash and a terrible loss of life, but the terrorists failed in their objective, apparently to crash into the White House. This was the only plane where the passengers had the courage, stealth and fast thinking to be able to overcome the terrorists before this happened. As a result the airplane crashed in Shanksville, essentially in the middle of nowhere. Sadly none of them survived. Had they crashed into the White House, none of them likely survived either, but the loss of life and chaos that would have resulted might have caused irreparable damage to our nation. They saved our country.

They are a symbol of what average people can do when they get together and try. It does not take great strength, intelligence, wealth or power to achieve things if people work together.

While there is work being done on what will certainly be an elaborate memorial at Ground Zero and a very elegant memorial has already been built at the Pentagon, lowly Shanksville is just beginning to start on their memorial. They still have yet to raise the funds to pay for it. One of the hold ups was getting land owners to agree to sell their land to make the memorial. This is a conservative area of the country and people are very devoted to their little piece of the Earth. This is the only place I have ever lived where people regularly talk about living on "the family homestead." This is an area with pockets of Amish, Mennonite and Brethren communities that live off the land and simply are not used to this kind of attention. The "memorial" today still is a makeshift hodgepodge of ribbons, flowers and notes left by the visitors to the site. In a lot of ways more moving and bearing the pure emotion of the people who left these items.

But maybe the people on the plane who lost their lives would have wanted this anyways. Something more human, less exotic and more in touch with the real world. Something that represents them.

GPS and the Coal Mines- part II

I left you at the point where the pavement disappeared. We started to question if the road was going to disappear altogether, but that continued, in the form of a gravel road. We had gone that far and survived enough adventures that we figured it was worth continuing. Besides, the little box on the dashboard said this was a road. Must obey the little box.

So the road continued over a slight rolling hill and it reached a point where it certainly did not look like there was any more road ahead, but the GPS said to carry on. The road started withering away into mostly dirt at that point and was largely indistinguishable from the ambient dirt if it were not for the tire tracks. The tire tracks let us know that some humans had driven there at some point. Otherwise there was no sign of human life here. No farmland, no road signs, fences, nothing. Just a dirt road and a GPS that indicated that a road went through this space.

Even my husband had serious questions as to whether or not to press on at this point. I felt that since we had gone this far, we had probably reached the point of no return and needed to press on. "Are you sure there is a road up there?" was his response. I reminded him that he had put his faith in the GPS so far, he was going to have to suffer the consequences of the results now. So we continued on the vague scars on the dirt that comprised a road over this hill. At the bottom of the hill, we finally found signs of human life, just not what we were expecting.

"Oh, look Mitch!" I said to my four year old son. "There's some dump trucks. Your favorite." And there were dump trucks. BIG dump trucks. The kind that one has to climb a flight of stairs to get to the cabin dump trucks. The ones that are so huge that they have to be built on site because they are far too large to be driven on a street.

The kind that are used in mines. Strip mines, generally, and in Central Pennsylvania, this is coal country. And we were driving right towards the entrance of a coal mine.

That @%#ing GPS had just navigated a suburban family in a midsized SUV into a coal mine. A white SUV to be exact. Not that the color should mean that much, but really. It was obvious to all present that we did not belong there. Remember that Garmin commercial where it suggested that a Garmin GPS would prevent the disaster of getting oneself stuck in the middle of a coal mine or other unsavory place? The commercials they show at Christmas where they totally cheapen the Christmas carol in order to sell their product? If you do not, wait a month. It will be back on the TV soon enough. So Garmin, hey! WTF?

That said, there were no "No Trespassing" signs, gates or other markings to say that we could not drive down the road that passed the coal mine, so we kept driving. We had already violated the inner sanctum. We might was well go whole hog and drive right through. Every few feet the constant question of whether or not the road was going to continue on to some sort of paved type state route came up, and surprisingly, the road did continue onwards. The problem was that as we drove on, we came closer and closer to those really big dump trucks that are not allowed on standard roads. We also moved closer to really big front end loaders that could pick up ten of our horrifically bourgeoisie SUV's and dump us into one of those really big dump trucks. If the drivers of those front end loaders knew how much I dislike the coal industry and how supportive I have been of their nemesis, wind farms, some located in clear view of the mine, one of them just might have done that. Probably the scariest part is when one of those really big machines decided it needed to go somewhere else in this barren landscape, it drove out of the mine proper and right past us on the minimally visible dirt path that the GPS sent us down.


"I can't believe you drove us into a d.....arn coal mine!" was stated more than once and had a four year old child not been in the back seat, the commentary would not have been nearly so G-rated. Yes, it was a struggle to censor that commentary. "We're gonna get arrested or killed or something!" My husband's response was basically we ought to just move as quickly as we could but that there were no signs saying that we could not drive on the road so he hoped no one would give us a problem.


My response to anyone who would tell you that there is such a thing as "clean coal" is bull&%#. Coal is not clean and anyone who has ever driven a white SUV through a coal mine can attest to that. Although the ordeal of actually driving past the actual strip mine probably only lasted 5-10 minutes, the coating of black soot that covered the car was amazing. This was not just dirt from driving on a dirt road. That dirt is light brown and hazy. This was pitch black and literally coated the entire car. My husband had to scrub down the rear doors for fear that our four year old would touch it and spread black hand prints on everything in Somerset County. The car looked like it had been passed through a cloud of volcanic ash and the residue rather had the consistency of ash.


Not too much longer after finally clearing the danger of the huge coal mine machines, we actually did get to the road that we were looking for as promised. The GPS did actually get us to the resort without a hitch from that point on.


Our lungs are hopefully not too scarred from the experience and the car was able to be restored to its original color eventually after a thorough scrub down. I am sure the boys at the coal mine got a laugh at their befuddled suburbanite visitors that day. And at least I can say that I can add "driven through a coal strip mine" to my list of interesting experiences, and I am lucky as I have had quite a few. I imagine that if we put our trust into that little brainless box too much in the future, we will probably have more. The problem is I am afraid to find out what.


At least I cannot say "set the cake table at my wedding on fire and had the firemen show up" as one of my direct adventures. I was witness to that event but it was not my wedding. That honor goes to my cousin, who also has a blog on Blogger. I will leave it up to her to choose whether or not she wishes to divulge the details of that little adventure. That's a pretty good one, too.

GPS and the Coal Mines- part I

I admit it. I love technology. I grew up in that cusp between giant mainframe computers that took up a whole building and Blackberry's with more memory than the original Macintosh computers. I took the usual computer programming course in high school, learning BASIC on TRaSh 80's. I learned about binary numbering systems. I watched the Macintosh revolution. I even know how to program the time on my parent's VCR. I have saved both sets (they are divorced and remarried) of parents from the horror of having to hook up a DVD system and actually get sound out at Christmastime. I do not have every gadget that comes out the second it comes out, but I have a lot.

But I love technology with one caveat. Machines are dumb. They do not think. Computers are machines and they do not think. I like technology to the extent that I am in control of it, it is not controlling me. Which is why I do not have a GPS system in my car and am hesitant to use my husband's GPS when he offers to loan it to me. That machine definitely does not think, and using it requires that one allow a snotty little voice be the boss.

I like maps. I like to look at maps. I always have. When preparing for a road trip, I would pour over the maps, plotting out the most interesting, the fastest, or most scenic route to take. My excitement for the trip growing daily with every little turn I figure. I know how to read a map. I can tell a four lane divided road from a small by-road. I can tell roads that are likely to be curvy motion sickness barf-fests by looking at the map and where the road goes. I can tell when a side road is likely to have a lot of delays by looking at the map. That is why I have AAA. So I can always go and get the most up to date maps. Roads do change with time so one has to prepare for this inevitability after all. They are not perfect, but I like them. Maps do not think but I think. I am in control.

So I really do not like my husband's GPS that much. That little box has caused more trouble in our life than a bevy of gremlins (not the AMC kind) could. In one particular instance, the road map showed clearly that one could not turn from Union Ave to 8th St as it was an overpass. The GPS did not see that. It saw an intersection and told us to turn onto 8th St. It gave us a lot of grief when we did not turn off the bridge on to 8th St, hurtling 20 feet or so down to an almost certain death. After it threw its little hissy fit, it "recalculated" and told us how to get to our destination. I have never had a map try and kill me before.

Our most recent escapade with the GPS involved a trip to the local resort where we discovered the previously mentioned most totally awesome AMC Pacer Wagon in existence. My husband was the one who wanted to take the side trip to the tallest point in Pennsylvania before checking in. He likes to go to really remote places that require driving on a lot of curvy roads that take you to scary places where people do not have running water or teeth. You can hear the sound of banjos in the distance. The curvier the road the better, especially if it has a lot of pot holes because I have problems with motion sickness and it really makes for a fun trip when Mommy wants to throw up and gets a terrible migraine. Puking over a guard rail is one of those things that I really do not aspire to put on my list of experiences that I am proud to say I had before I died.


So we went up a lot of curvy roads to get to a nice enough state park where there was an observation tower that gave us a beautiful view of lots of trees. No breath taking view over a valley, no mountains in the background, just a lot of trees. Not worth puking over the guard rail. So we headed out to our final destination to the mountain resort on more curvy roads.


But the GPS directions were confusing, sending us on overlapping roads so we could not tell which road we were supposed to be on. We ended up on the wrong road. So we tried to figure things out with the map. It did not take us very long to figure out that we were going the wrong direction on the highway and needed to make a 180 degree turn. No problem, just turn around and it would take us to the road we were trying to get to. That would have been the smart way to go. I had the map and a handle on the situation at that point. I knew exactly where we were going.



But NOOOOOO!



My husband wants to let the GPS give directions since it has more detailed roads in its files. He turns off the road before we were supposed to on the original directions. "Are you sure about this? This road looks like a pretty minor road. Maybe we should go back to the main road." was my response. He responded with "This looks like it is shorter and will get us back to where we are going more quickly. The GPS says the road will take us straight there."


So we drove on the minor side road for a short time. And it got a little narrower, and we reached a point where it was obvious the road was not used much, as the edges were crumbling. Then all of the houses disappeared, then the farms, then signs of human civilization.


Then the pavement disappeared.

That is where I will leave you in the tale, but the good part comes up next so check back.

The Week in Review

Not much time, so I thought I would summarize the interesting events of the last few weeks at work for you.

-I met a patient who thought that the rock singer Billy Idol was the Messiah. I would hate to see who she thought was the anti-Christ. Personally, if I were in the position to pick a rock star as Jesus, I would think more like Bono or Peter Gabriel, or someone else who has put a lot of work towards improving the Earth/Human condition, etc. Somehow the pseudo pop punk sneer just does not do it for me. I have been hearing a lot of songs from my youth in my head as a result. I am sure I do not like it.

- I was flipped off in a new and even more creative way than all the past creative ways that I had been flipped off by a patient. He even had the style to deny that he was flipping me off, stating he was just showing me how swollen his middle finger was since he broke it years ago. It was the wagging both middle fingers around trying to compare them that pushed it over the edge. I will have to keep that maneuver for my extensive "flip off" repertoire. Some of those gestures come in handy, you know?

- We have had a mysterious underwear burglar on the unit. Some of the patients (all female victims so far) have been fairly polite about the whole thing, but some have not been as so gracious. The worst part is hearing a description of the kind of panties your patient wears. The best part is knowing that your patient does in fact wear panties.

- Morning team rounds got off track one day, straying from a patient's eating disorder as a way to cover up her poor self esteem, to why would anybody want to buy a set of underpants that makes one's butt look bigger? The name of said product was something like "Booty Buddy". I have this suspicion that I will get a pair at my next birthday which is coming up in a few weeks. I take a lot of torment for my rather slim build and I do not expect that to change.

- We have one patient who thinks everyone but one patient and me are trying to kill her. That one patient thinks she is trying to kill him. One patient who things everyone is out to get her. We have one patient who talks to God, one who preaches the word of God. One who has had a case heard in from of the Supreme Court and is preparing to have a case seen in front of "Federal Court". Then we have one really depressed guy who just tries to stay sane.

- None of our patients were caught in any drug busts, but one was hauled in on assault and battery charges.

- And the staff sits in the back and tells politically incorrect jokes about booty buddies trying to keep themselves sane.

Peace.

Wind Turbines and the Coal Mine

One thing you may find about me is that I have a lot of concern for the environment. That may surprise you with my obvious love for cars, but the majority of our carbon emissions actually come from electric producing coal plants and cars can be made more fuel efficient. It does not matter what the industry says, coal is pure carbon and when burned it makes carbon dioxide and carbon monoxide. There is no such thing as "clean coal". Or as a work colleague of mine pointed out, it was clean in the mesozoic era, when it was in the form of dinosaurs and plant life. Now it is just carbon. Oh, and sometimes sulfur and other contaminants that create acid rain.

But the problem is that I live in central Pennsylvania which is Coal Country with a capital C. It is ironically a very good place to develop wind farms and the two industries make for strange bedfellows. They do not like each other, that is for certain. There is a lot of anti-wind power propaganda in this area. So much that they have even been able to convince the Audubon Society, of all people that wind power is bad and kills birds. What, and global warming does not? I have watched those wind turbines daily and they go so slow that only the sickest or most inept of all birds would be likely to get entangled in their blades.


The actual building of the turbines is something that one could have an objection to. The blades themselves are enormous, being longer than a standard truck trailer and requiring an oversize load carrier to be transported. There is a facility that stores them very close to where I reside and when they try to bring one through town, it makes for some sticky traffic snarls. The engines are no better being just as bulky and difficult to transport.


One of the biggest complaints offered against wind turbines in this area is the damage caused construction done on the tops of the mountains. To this I respond, it is better than scraping the tops off and dumping the remains in the valleys below causing certain environmental disaster and a flattened mountain in its place. This is a practice known as mountain top coal mining. Through a loophole in environmental regulations during the GW Bush years, this practice increased exponentially causing massive damage to homes, mountains and forests in West Virginia ever since. Yes, there will be damage to the environment to build the roads up to the top of the mountains, but this is no less damaging than that damage caused by roads built to put up cell or radio towers.

Certainly the question of aesthetics has been put forth. Wind turbines are no worse than all those cell phone towers they are putting up and nobody complains about those. Those cell towers are an ugly scar against the sky. The wind turbines are actually quite elegant in the way they slowly sweep though the air.


In the aesthetics debate, wind power still trumps coal power. If you saw my earlier post, you would have seen my first hand account of what it is like to drive through a strip mine, and no, it is not very pretty. And to reiterate, it is not clean.



There are other arguments about noise, light blinking causing headaches, and other distractions for local neighbors to the actual turbines. Much of the responsibility of being a good neighbor rests on the hands of the power company. The newest array of wind turbines going up is very visible from the city, but they went to great lengths not to build near enough to populated areas that they would be disturbed by them. People have had their lives disrupted by having wind turbines plopped down in their backyards. People have had their lives disrupted by coal mines, landfills, nuclear power plants, and strip malls, also. These are things that happen and people need to turn to their local government leaders for ways to work with this, but this does not mean that an entire industry as a whole should be rejected.

Coal and wind power are at odds largely over jobs. Coal was always been here and certainly does not want to give up its market share, but wind power companies have seen a market that is ripe for the picking when it comes to locations, available workforce and room to expand and have a newer option that sooner or later is going to have to become more of a mainstay. Coal power is one of the number one producers of greenhouse gasses currently and the survival of the planet depends on us moving away from coal as a mainstay and towards cleaner options. The sooner the better.

After the Hurricane

I was riding the bus to my exam destination and it first had to stop at Charity Hospital and drop off some candidates scheduled to complete their exam there. I looked up at its towering presence, aging cement walls with somewhat art deco designs on them. The harsh environment that was New Orleans was evident as I looked upon the enormous towering monolith. Dripping down from the top of the building was the blackened soil of years of urban smog, oil wells and decay. It covered the top of the building and streaking down probably one third of the upper part of the building in ever thinning streaks, like streaks of chocolate syrup on a sundae. Only this did not have the appeal of ice cream at all. I looked up at that building and it gave me the creeps. I was thankful that I did not have to go in it. Something about it just made me uncomfortable.

At the time, I had no idea what fate awaited Charity Hospital.

That was in 2004, the year I took my American Board of Psychiatry and Neurology Board oral exam, the final step in the process of becoming fully board certified. The process is a tedious process and the exam is only administered once or twice a year at one site at a time. Every candidate in the country is expected to fly in from wherever they are to the designated location for what is ultimately a one hour long exam. As far as exams go, it has been very criticised for being very subjective, with results varying on the willingness of the patient being interviewed by the candidate to cooperate, the nervousness of the candidate, the mood of the examiner, etc. It is indeed a very nerve wracking time for a board candidate.

The oral portion is in fact, being phased out, but I was one of the "lucky ones" that got to endure the torture of an exam that has a 45% failure rate. To be honest, I did not pass it my first time, or my second. I passed one portion, but not the other, both times. I needed to pass this time. By now, I had relocated to a job where I had more colleagues to help me practice and felt better about the exam going in, but still nervous.

Through the whole process, candidates are loaded into buses and shipped throughout the city to various hospitals and outpatient psychiatric centers where we examine a live patient as part of the exam process. The first stop my bus made was at Charity Hospital. I honestly did look up at the grimy towers of the hospital and the building gave me the creeps. Perhaps it was my nervousness, perhaps the knowledge that this was not a safe part of town, perhaps just the whole feeling that there was a lot of suffering going on in this part of the city that got to me. I was glad I was not taking my exam in that building. It just made me uncomfortable.

I did not know at the time that it was the only hospital in town that treated uninsured patients. I now know I judged the hospital unfairly.

It is not in a good area of town, sandwiched between two interstate on ramps and surrounded by decaying slums. Location wise, Charity Hospital is not really all that near Lake Pontchartrain and the area that was most noted to have been flooded so badly. It actually was closer to downtown and the French Quarter, so I would not have expected it to have taken the hit that it did. Just that fact that the facility was damaged as badly as it was is a testimonial to the extent of the flooding that occurred. Charity Hospital is further away from the lake than the Super Dome. It now sits, fenced off with chains to keep people from entering. The building is considered a total loss and is somewhere on the long list of buildings that are scheduled to be demolished. The sordid tales of doctors and nurses euthanizing patients who they felt would not survive the ordeal continue to plague this facility, but I do not believe them in the least. One more ghost to haunt this facility.

To this day, there is a part of me that feels like my initial dislike of the building somehow played a role in its eventual demise. Like if I had not thought that it looked creepy, somehow it would have survived the flooding. Of course, the logical side of me knows that this is ridiculous. The city was going to flood regardless and the building is very old and outdated. It would not have taken much to render the building unusable. I know I am not the only person to look upon the dripping grime and soil on the towers and feel uneasy. My husband felt the same way for one. I am sure there are others.

I paid Charity Hospital a visit this New Year's to pay homage to the once so important institution in this city's history. Partially to make peace with myself that I was not the cause of the demise of the facility but also to honor any institution that cared for so many who had so little. The closure of Charity Hospital left a lot of people out in the cold. The gaps are slowly getting filled but like the lower ninth ward, the gaps are still larger than the areas that have been repaired.

My hospital cares for the uninsured quite a bit itself. It puts a big financial strain on the system, but people need care and they are human beings, not numbers. Sometimes I look up at the white cement tower at the hospital here, and it looks a little creepy, too. I have learned to see past the grime and look at the people inside.

Hurricane Katrina

"New Orleans is below sea level and if a serious hurricane were to hit them, they are all like sitting ducks. It's only a matter of time." - Former resident of New Orleans speaking before Hurricane Katrina hit.

It was five years ago today that Hurricane Katrina changed the lives of a lot of people. It was a day that I remember well. I was pregnant at the time and already emotional and easily teary eyed over sad things. I remember hearing the news reports on the radio at work saying that the roof of the Super Dome was starting to make strange noises and they were fearful that it would give. I have been in the Super Dome before and it is big, very big, and if the roof came down, countless lives would have been lost. I had this worried feeling but I cannot even begin to imagine how it must have felt to be in there. Fortunately the dome held although the chaos that occurred in there afterwards was almost as disastrous. I am not sure that anyone could have imagined the chaos in the city that ensued after that.

I took my psychiatric oral board exams in New Orleans and passed them so the city will always have a special place in my heart. We spent some extra time there just exploring the city and taking a mini vacation afterwards. We talked to people there and there were several people that came home with us in our memories. The patient I had to interview certainly stuck with me. There was an owner of a small store in the French Quarter that we talked to. And a worker at Cafe Du Monde. Sometimes I still wonder if these people survived, and if so, did they return? I tried to find the shop in the French Quarter when I was in New Orleans over New Years and could not find it. It is easy to get lost in those square grid streets so I will never know.

What I do know is that I knew real people, so they were more tangible, not just a demographic or number. I worried about those people I met. I felt badly for them. I still worried about those that I did not maybe becuase it was easier to extrapolate from the ones I did know. I got choked up when they showed women with sick babies or parents separated from their children, especially anything about mothers and babies. That was all the pregnancy thing, mother/child bonding, lives shared, blah, blah, blah. Only women can understand. Sorry guys. I saw a lot of real people suffer a real lot. Nothing was going to be able to stop the levees from breaking at that point, but the rescue efforts were pathetic and inexcusable.

So why did I not do more myself? I wanted to. My employer was allowing people go help out with rescue efforts, but like everywhere else in the country, there were not enough psychiatrists on staff for me to leave on short notice. There was no one to cover for me. And I was pregnant and it was not safe for me to be there. So I gave my money to the Red Cross and prayed for a miracle. The miracle never came. But the people of New Orleans are a hardy bunch and had continued to rebuild despite the disaster.

I salute you.