Ain't That America?

 



I heard the song "Little Pink Houses" by John Mellencamp a few days ago and it made me sad.  I may live in Central Pennsylvania, but I am not from there. I am from Ohio, and lived in Indiana for a few years. I really loved living in Indiana and felt very at home there. Driving in the country there always made me think of that song and hearing it recently made me feel a little homesick. When we lived here, my husband would complain about driving to work in a tunnel of corn to perpetuity, but the heartland will always be my home.

Fortunately, the mountains here are beautiful and places that are worth visiting are much more accessible than back in the heartland. The Midwest is landlocked and there are not that many interesting places to visit without a pretty lengthy pilgrimage.  I have always had a great love of travel. I am back at work and have very little time to write, so I put together some of my favorite pictures of some of the places I have visited in the United States.





 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

St Mary's Cathedral- San Francisco, CA. Absolutely beautiful, but an odd design that towers over the city and sometimes lends itself to the nicknames St Whirlpool and Our Lady of the Eternal Spin Cycle.

 

Nordstrom Shoe Department, San Francisco, CA- some of the most awesome shoe shopping available, and I am hard to please!

 

The Leapfrog Fountain at Epcot Center, Disneyworld. Kids still love to try to catch the stream of water on their chest and get soaked.

 

Sunset on Duck, OBX, NC. The ice cream shop owners had the right idea to set up shop on the boardwalk facing the sound. Every night, a huge crowd gathers for ice cream, photo ops and lots of oohs and ahhs. Always a great show.

The Big Bean in Chicago. I had no idea of the enormity of this thing until I saw it myself. I would have never thought that one person, let alone a couple dozen could fit under it.

 

Raystown Lake, Huntington County, PA. Man made lake from creation of a hydroelectric generating dam. Has now become a big local summer escape in central PA. It is a great place to watch the leaves turning in the Fall (but do not make me think about that little slice of Hell coming). Also a good bird watching site as there is a pair of bald eagles that nest nearby the dam. I got a great view of one last Fall.

Not the best shot of a double rainbow I have taken, but it is still a double rainbow, which is always a treat, so I included it. This one was taken at Seven Springs Ski Resort near Somerset, PA.

 

 

I love lighthouses and will visit

 them every chance I get. This on is the () Light along the Lake Michigan coast in Michigan.

 

The Chapel in the Hill is an amazing work of architecture build into hill in Sedona Arizona. The view is amazing. Quite an awe inspiring place to go to mass in.

 

I took this handsome young man to the Cherry Blossom Festival and learn about our nation's heritage for the first time when he was two. Washington DC is only about a 3 hour drive so is an easy drive for a long weekend and one of my favorite side trips. We were fortunate enough to be able to pose with the portrait of one of our heros- Stephen Colbert the "National Treasure".

 

The train in Strassburg, Pennsylvania is a restored steam engine from the 19th century. It is located in the heart of Pennsylvania Dutch country in Eastern, PA.

 

 

The Mohave dessert outside Las Vegas is far more beautiful to me than Las Vegas and was one of the highlights of one of my trips to Las Vegas.

 

 

Unlike the casinos, I also found Hoover Dam to be a quite interesting part of one of my trips to Las Vegas.  I actually thought that how the electrical wires were strung was fascinating.

 

Although the city was fast to clean up the tourist areas, years later, many parts of New Orleans remain abandoned. Areas the border along Lake Pontchartrain have sections where there is still an eerie silence when you drive through and although a few home have been rebuilt, every other property left is a total loss.

The Black Hole

In all my years I have heard my patients talk about the dark hole, the dark tunnel. Some permutation, used quite frequently, always similar in its base description but just slightly different when you ask them to give details. Not every patient will talk to you about that dark hole. Not every patient gets that depressed.  Some who come complaining about being suicidal have never put much thought into what they are truly saying. Perhaps attention seeking for some, but thoughts of suicide are a coping skill for many. “If life gets too overwhelming, I always have the realization that if I am dead, I cannot suffer anymore.”  

 

Black holes may not be universal but certainly a common theme. Many patients speak about it.  Why it is so frequent that one has the subjective feeling of being surrounded by darkness, distanced from one’s world when feeling depressed could be debated.  Is it due to a brain starved of serotonergic input? Perhaps the ever so slight lack of oxygen caused by psychomotor retardation affecting one’s vision along with ability to move? It is real enough to one who dwells within.

 

 I have no proof of this, but I wonder if “The Pit” by Edgar Allen Poe was inspired by a depressive episode. Purely speculative, I do not know enough about the author’s personal life to say. I do know that his writings spoke quite frequently of similar themes, being trapped in enclosed spaces, unable to escape. Of course the ever constant ruminations of death and misery are highly suggestive of a depressed mind.

 

One thing I know is no one can fully understand what it feels like at the bottom of that hole unless he or she has been there. Everyone’s hole is their own. Varying in depth, breadth, and feel, they are all unique but somehow have a similar thread. They all come with the same sense of terror looking up at the top, desperately hoping someone will send a rope down, but no one does. You try to call for help, but your lungs will not expand enough to let you draw in the air to scream. Like those nightmares where you can see the shadowy figure in the window outside the door of your house, but you cannot run, cannot call for help, you feel desperate and trapped.  Scared but not sure of what and feeling alone, very, very alone.

 

Part of what keeps me going when I get overwhelmed by difficult patients, conflicts with the system or being overworked in general, it is knowing that I have a role in helping people out of that black hole. Yes, many of them will fall back in at a later date, depression is a frequently chronic illness but so is heart disease and diabetes, but you still treat it with the goal to get your patient  better.  It is possible to escape from the black hole, unlike most Edgar Allen Poe stories.

Antisocial Networking

I am still on medical leave and have always enjoyed my techno gadgets. Through the past few years I have wired everything with a computer chip in the house to our computer network and nurtured my little family of networked devices like it was a family. Once a new member was added to the family would then proudly announce to my husband and son about how they could now access one file on the new device rather than having to walk ALL THE WAY across the house to get it from the device it is actually stored on. Isn't that great? Huh? Huh? Then they would look at me that halfhearted "yeah, I guess" like Kip said to Uncle Rico in Napoleon Dynamite and go back to what they were doing.

Of course the real reason I like that feature is because I love the response when I send a file to print from my laptop unannounced to the desktop printer and someone is already on the desktop. The first time I did that, my son was at the desktop and his panicked response was hysterical. "The printer is printing!" He looked like he has seen a ghost. I think he thought a ghost was in the printer. Sadly, that still did not cure him of a bad addiction to Angry Birds, but it was worth a shot.

You can't teach an old dog new trick, though and old routers do not fare much better and our old router is rather antiquated. We usually end up needing to reset it about every 1/2 hour to keep our Internet connection. Now was a great time to update. So I ordered a new high speed router with better coverage, faster speed, and better security. It even was supposed to detect its own settings rather than being done manually upon set up. Just plug'n'chug. Like they used to tell us in Algebra II in high school. Wasn't that a load of crap?

After about three hours of plugging, unplugging, starting, restarting, and doing LOTS of bending and stooping, the old router is back on the computer. I am not supposed to be stooping or bending for four weeks post op. Now I see why. Which means we are having to cross the house and reset the router about every 1/2 hour again. The old router's green light mockingly blinks as if it were winking at the new router. "See, I told you she'd never be rid of me. Ha, ha, ha!" The old one sits in it's packaging lifelessly.

I must heal, but I will win this battle sooner or later. If I can conquer medical school, I can conquer a stupid router.

Happy Vernal Equinox

Well, technically it is Spring. The temperature has risen to above freezing, enough to melt the snow so it does not look so dismal but it still feels cold, especially with the wind in the mountains being so relentless this time of year. The upcoming week is not predicted to bring much relief.

My son is seven and still tends to believe those fables we tell our kids despite our admonitions that they are only stories. I would never tell him the truth about Santa Claus or the Easter Bunny (although I almost blew it with the Tooth Fairy, but that is another story), but he really does not need to believe in the predictive ability of Punxsutawney Phil if you ask me. Punxsy is only about 1 1/2 hours from here and on February 2nd he actually wanted us to drive him early on Saturday morning to go see them torment some poor rodent just for that ritual that he believes in. He should have just asked Momma and Daddy if we saw our shadows at 6AM on a Saturday morning when we were awoken so rudely.

Of course, Punxsy Phil did not see his shadow, and an early Spring was predicted. And my son was in tears because he wanted more time to go sledding. As before, my husband and I both could not convince him that regardless of the groundhog's keepers view of whether he saw his shadow or not (face it, the groundhog really does not give a shit) it does not appear that Spring was anywhere near arrival.

And so we took my son to a ski resort where he could go tubing. He got some sledding in too. Built a snowman. Ran around in the snow until his fingers were frozen and his lips were blue and still said he was not cold.


For me, I actually hoped the groundhog was right. I hate winter. I hate the cold weather, the long dark nights, driving to work in snow and slush and digging my car out of the same before going home. I get depressed to some degree every winter. Sometimes worse, sometimes less, but winter always affects me. I will stomp around the house every time we get another storm warning  shouting "Why do we live here? Why does anybody live here? Why would anyone have chosen to settle here 200 years ago. Why didn't they settle in warm places? Now we're stuck here. I hate it. I hate it. I HATE it!" Something like that. I wonder if snorting Wellbutrin would be more effective, or if it would just make my nose go numb and taste really foul. I have never tried it in case you are wondering. Yet.



But winter has persisted. Even my son complained that it was still cold today. "If it is Spring, why is it cold out? I am so tired of Winter!" Mr. Love the Four Seasons is growing weary of the weather, too.

But it is sunny today. Cold, but sunny. Maybe if I wear enough layers, I could tolerate it well enough to wallow in it and give my hypothalamus a jolt of energy. In terms of sunlight we are going to get more day than night for the next six months and cold or not, that is a start. Let the Sun shine in!

The World Comes Back to Life

It was been a long time since I have visited this blog. Time simply has not allowed for it and between writing this blog, spending time with my family and devoting time to my career, something had to go, and this was it.

Not that I do not enjoy writing. Thoughts come to my head that I truly feel are worthy of putting to paper but they are fleeting, and once the time comes when I can write them, the thought is lost. Perhaps that I why I like photography so much. It is easy to carry a camera and snap a picture while the image is still there. It annoys my husband at times. He ends up waiting for me frequently while I stop and "capture the moment" but even he admits that I can get some pretty good shots.

As it stands right now, I just had surgery and am off work for the next few weeks. With all the activity restriction I am on, I have a lot of time on my hands so I thought now was good time to reincarnate my blog. It was either that or eat. Considering I have a longstanding obsession about my weight, being told I cannot exercise is a bad thing. Eating out of boredom is, too.

The fact that tomorrow is the day that the world, at least from an astronomical standpoint, comes back life is only a coincidence with my reintroduction of this blog. Not that it feels like Spring. When I look out the window, it certainly does not look like it. The schools let out two hours early again yesterday due to snow, just to prove it is not quite Spring. There goes my son's education. I know somewhere in this world it is warm and sunny right now. Sadly I am not there. They probably have lots or Tequila and Rum, too. Sadly, I do not have any of that, either. I have a lot of snow and my rampant fantasies that I am in one of those sunny places. This is the Gulfo de Papaguyo in Costa Rico. It comes highly recommended.

But sooner or later it will get warmer. Sooner or later I will go back to work. Sooner or later that surgeon will let me do normal things like pick things up and go to Zumba class. Or drive. Or drink Rum and diet Coke. But for now, I am not allowed to drive a car or even take a leisurely walk. Hopefully I will not get fat.

My thoughts on Bin Laden's death

There has been a lot of talk flying on the media about the death of Osama Bin Laden from should they show his picture to was it fair to shoot an unarmed man to blah, blah, blah. I posted one comment on Facebook and it set off a nationwide (literally) debate between people that have never met and lasted for days. Not that I like to set off that much conflict, but I was kind of proud that my single thought could spark that much interest.

Obviously much of how our society has functioned over the past ten years has been strongly influenced by this man and I know I had given up hope that he was ever going to get caught so this event has certainly taken my by surprise. Some that I have spoken to are of the opinion that we are safer with him gone. I am not so easily convinced. I am certain that Al Quaida will continue on. Any organization of such power has built in backup systems in case its leader is lost. The US Government is the most obvious example that comes to mind. Bin Laden was not a nice person, but he was not dumb enough to assume that he was invincible and I am sure he had some kind of "in case I go on to my 67 (0r whatever the number is) virgins in the sky" plan in place for a replacement to take over.

The newest opinion I read was that the death of Bin Laden should have been kept secret for a certain period of time to allow the military longer time to evaluate the material in his compound. The writer of this editorial felt that the rapid announcement was only a way for Obama to gain popularity points. Now he is withholding the photographs of Bin Laden for his own gain as well. My guess is that the writer is not an Obama fan and needed to find something to criticize him on. Tell the public now or tell them later, they will get the news, and this is the kind of news that they have waited for a long time.

Personally I think that it is a silly thing to worry about. There are too many other things going on in the world to worry about minutia. I still maintain we are not safer as I mentioned above. Al Quaida has strong holds in Yemen and Somalia and do not need orders from Bin Laden anymore. The world is not a better place. There are something like 6 billion people on the planet. Killing one bad person is not going to make that much of a difference. Maybe I feel better that he is gone, and I know that a lot of people certainly do but if we let one bad person have too much influence on our life, we will let him win.g

Continued Bath Salt Rants

The number of admissions to the psychiatric unit here continues to be a fairly steady rate of 2-4 a week caused by psychosis secondary to MDPV, or bath salts (as they are commonly called) abuse. In some cases the patients have nothing else wrong with them and if it were not for this, would not come in contact with the mental health system. Some of them have other comorbid conditions. For a patient who has bipolar disorder, adding a hefty dose of "Blizzard" can set off a psychotic manic episode in no time. Not that one has to have a history of psychosis to get psychotic on MDPV. Most of the patients admitted do not have any psychiatric history. The common factor with all of these patients is that they are grossly psychotic.

And addicted. Many have turned to stealing to find the money to pay for their addiction. This stuff runs at about $35-40 a packet and the version sold around here, Blizzard, runs around $50-70 for a small jar. Break ins have been reported in areas that never had to deal with them before because of the presence of a "head shop" that sells MDPV. This is all to pay for a legal substance, not a so called "street drug". At these costs, the price is simply too high for most people to sustain their habit without resorting to illegal means to pay for it.

I am not sure about the weight or volume that is in a jar of Blizzard, but I know this is about enough to keep one person doped up on an out of control speed binge for about a weekend. It goes further than crack certainly, but still not cheap. In other words, enough to keep someone awake for three days straight and end up so flagrantly psychotic that one is either going to end in the hospital or dead. Much longer would cause the heart to give out from tachycardia (racing heart). That or the delusional patient ends up running into the street fleeing an imagined assailant and gets hit by a car. That or the person just dies of an overdose.

Although the user will come off such a long binge swearing he or she will never go through that experience again, they inevitably do. By now the user is addicted. The withdrawal symptoms make the user miserable and the actual experience of a binge is not always pleasant, but the drug's effects are stronger than the intellect. I have talked to people who have been fighting this battle for years.

And there are still people who think that legalizing drugs will solve the country's problems. I just hope that if a store decides to sell this product, that this store is in their neighborhood and not mine. If they want legal drugs, they can have them. I do not want them in my, or my family's (especially my child's) neighborhood.

I have returned after a much needed vacation in Costa Rica. It has been one of the most beautiful places I have ever been but in talking to the people there, I have found that it;s outward beauty goes more than just skin deep. Costa Rica is the only country in the world without a standing army which I had known, but not why until this trip. In 1948 there was a civil war and after the end of this, the president felt that violence was not the answer and that government money could be better spent. The army was disbanded so that more money could be put towards education and medical care. Since that time, the country has instituted compulsory K-6 education, and free education for K-12. There is talk about increasing the requirements from K-12. The standard of living has improved enough that teenagers are not needed to be working to support the family nearly as often as in the past. Medical care is growing in availability and there is universal health insurance through the government. Clinics and hospitals are not as widely available as is probably ideal, but this is slowly improving with time. What is more important is the fact that both areas are a priority of the government and that both areas are slowly improving in availability and quality every day. Another positive effort made by the government was to limit greenhouse gases and pollution and now 95% of the electricity that the country uses is generated by renewable means.



They still have their struggles. Battles for land from developers threaten the coastline, but the money generated from tourism is a large part of the country's income and to turn them away would threaten that source of income. The other large income generator, exportation of fruits and plants demands large areas of land risking loss of rainforest land to agriculture. About 60% of the rainforest in Costa Rica has been lost to agriculture and rainforest land is very poor in quality once the actual rainforest has been removed from it. The tourism industry itself puts the fragile ecosystem of the rainforest at risk with tourists coming to see the rainforest in increasing numbers. The government has been paying attention to this more now, but this is a more recent development and some things cannot be taken back. And while the country is not out trying to generate adversaries, they have no army and are essentially unguarded if another country were to decide they wanted the land. Nicaragua is just to the north and the political instability there has affected Costa Rica.

Striking a balance between "progress" and conservation is not easy. Trying to maintain the viability of the "ecotourism" industry without damaging the fragile ecosystem is tricky. Many governments that rely heavily on tourism pay too much attention to the needs of the tourists and neglect to realize the impact that this has on the people of the area. Big new highways that make it easier to get the beach take land away from family lands and pollute the surrounding areas. I have travelled to a lot of countries seeking respite from the cold air and for the most part, these countries are fairly impoverished. Some seem to be working towards pulling out of that position, some seem stuck. Costa Rica is by far the most forward thinking of all of them.

People who I would most like to kick in the ass if I could.

We all have people on our s#$t list, many likely to stay there for a while. The marjority of mine are only temporary visitors, however. Most of us have a supervisor that we can get along with most of the time but have their "Midol Momenents" and really piss us off. I have some coworkers that I really like but because we have fairly intense personalities to begin with, will go through spells where we are constantly at each others throat. And then you come upon the inescapable celebrity gossip. Try as I might, I cannot avoid that drivel. It is everywhere and the more I am forced to here about the Kardashian sisters, the more they piss me off. Who are there chicks anyways, and what value have they contributed to society? After dealing with your personal list, do you not start having fantasies of wanting to just kick some of these people in the ass? Jessica Simpson- The issue of whether or not she has gained weight or not does not warrent the designation of "controversy". No one is that important. Just go away already. Paris Hilton - The only thing worse than a tramp is a rich tramp. Tom Corbett (R) Governor of Pennsylvania - If you lived here you would understand. The person on the high end sports car show who said that all Audi drivers play golf. Do not, have not, and likely never will play golf. But I do drive an Audi. Dick Cheney - the name says it all. The Kardashian sisters - Since I mentioned them, I have no idea who they are but the people at work tell me that they have a reality TV show about them. Why they deserve such an honor I do not know. The tabloids seem to talk a lot about them fighting about who has the biggest butt and who has the biggest loser boyfriend so I guess if I were single, had a big butt and dated a loser boyfriend, I would get to have a reality show too? I have a lot of patients who fit that description and they do not have TV cameras following them everywhere. It has nothing to do with looks. The pregnant chick is downright homely. I will wait until the baby is born to kick her ass. Glenn Beck - No smarter than Sarah Palin and a lot less attractive. Rupert Murdoch - The one who made Fox News what it is today and revived the little gem above after his tenure ended (thankfully) at Headline News. Then he bought the Wall Street Journal and is in the process of spreading his right wing propaganda via this medium. Mohamar Khadaffi - If not for the impossible to spell name, for those nonsensical rants he goes on where he rambles about some kind of issue that seems important to him and does little but confuse the rest of us. ...and speaking of nonsensical ramblings... Sarah Palin - Ex Governor Palin, no one knows what you are talking about anyways, so please just do us a favor and SHUT UP ALREADY!

Bath Salts Revisited

The knowledge of artificial bath salts is working its way across the country although I am not sure how far it has spread. The compound, with a very long chemical name formally is shortened to the name MDPV. There are other similar designer drugs that have appearing on the scene fast enough that governmental control has been unable to keep up with their emergence. MDPV is new to the United States but had been around for a few years in Europe. Another similar compound, mephedrone has been blamed for significant loss of life in England. Some states in the US have already banned MDPV and others are considering bans. Considering the significant effects it has had on communities in Pennsylvania, it is likely it will soon be banned here. A measure to ban it has already passed the State Senate, and is pending in the House.

A recent incident that illustrates it's potential dangers occurred a few days ago. The police were dispatched to a call on a domestic disturbance where a man was tearing the wiring out of the walls of a woman's home. Upon attempting to subdue the man, he became combative, was tazed twice and still put up a fight, tearing the pocket off one officer's uniform. In the end, several police officers were injured. The man had been shooting up bath salts. He is facing numerous charges at this point. He is one of the lucky ones who lived through an overdose of MDPV but many have died. These cases of PCP like strength are not unusual. We frequently see patients showing up in the ED acting like this that we strongly suspect are using bath salts. The problem is, we cannot prove it and even if we could, there is nothing that can be done to stop it. As of a few weeks ago, 22 admissions to this hospital were estimated to be caused by complications of bath salts and those were only estimates. I know of three admissions this week to psychiatry alone that we are fairly certain were motivated by bath salt induced behaviors. That kind of number rivals alcohol and outnumbers opiates on an average week.

One of the most recent stimulant compounds to be banned in the US was ephedra. Popping ephedra in the past was a bad idea and there were people who died from complications from it. Cases of psychosis or heart problems did occur, but nothing to the extent that this, substance has caused and the highly addictive nature of it makes it an even greater danger. MDPV is a far greater threat, producing a high compared to cocaine and Ecstasy and similar to Ecstasy in structure.

For those that advocate legalizing drugs as it is a "victimless" crime, I hope they stop to see the thousands of dollars of property damage a bath salt user on a binge can cause. I hope they stop to talk to the parents whose only child just died of an overdose of what they thought was a "safe" high since it was legal, after all. I hope they see the people who are involuntarily committed to psychiatric units and forever have their records marred by the commitment because they were floridly psychotic from excessive bath salt use. And I hope they see the medical and law enforcement workers that are injured trying to restrain a violent and irrational user on a wild binge. I see lots of victims here.

I hope that Sen Charles Schumer pushes ahead with his drive to ban MDPV as even though there are multiple agencies that must be involved before a national ban can happen, the sooner it happens, the better. Which will not be soon enough.

Random Thoughts

There are always times when I have neither the time nor the inspiration to think of anything worthwhile to say. I have hit one of those impasses and have chosen to fill the slot with some of those random ideas and musings that one encounters that warrant being documented for history's sake but are not that lengthy enough for a whole post. Some of those follow.

If you ever really want to annoy a guy named Doug, go up to him and ask him why he does not spell his name Dug rather than Doug. The same goes for Phil and Fill.

If you look at this really closely, you can see a tiny Ben Roethlissberger chasing a terrified woman in this.

If you can tip a stripper with cash by sticking a dollar into his/her thong, why can you not install a card reader in his/her butt cheeks so you can swipe a credit card and give a tip this way?

This is just wrong. This is a Volkswagen Beetle- with a dragon painted on the side! VW Beetles have bud vases standard! Not marijuana buds you smart asses- flower buds! The very same Beetle had an Ed Hardy steering wheel cover with bulldogs with fangs showing and spiked dog collars. VW Bugs are available with such options as flower covers for the rear tail lights. These cars are not intended for such violent images. If you really look closely, you will notice that the VW symbol on the rear wheel cover is missing. This is nothing short of blasphemy for VW fans. VW bugs have always had all of their VW symbols in the hub caps. ALL of them. Not SOME of them, ALL of them. VW bugs are about peace and love and happiness and this bug has images of anger and violence and is just WRONG. I am going to have to kick some major ass over this one. This REALLY PISSES me off!

This is a Dodge Viper RT/10. It is the finest piece of street legal automotive engineering the Americans have ever mass produced. There is nothing funny or obnoxious about this car with the exception that is not MY Viper. (For those of you who would argue that the Shelby Cobra a better specimen of American engineering, I would remind you that the true name of the Shelby Cobra is the AC Cobra and is not, in fact, 100% American. It is, in fact a Ford motor on an AC {ie British} chassis.)

Why is the local news I am currently watching about to show a news story about a new gas station opening? Even a real ugly mullet sighting would be more newsworthy. No, I am not making this up. They once covered a Wendy's opening, too.

Look, twins!

OH MY GOD!, the new gas station story just played! You can get a FREE COFFEE OR CAPPUCCINO just for stopping in! No wonder they covered it on the evening news! I feel so much better now.

The Fashion World Must Be Insane

People who know me know that I expend an exorbitant amount of time trying stay in step with the fashion world. This is probably an overreaction to having spent the majority of my life being deprived of the opportunity to actually be "in style" having grown up in the Midwest where unless you live in Chicago, you are by definition, behind the times. In the modern area of Amazon.com, Zappos.com and the like, anyone with access to a computer can get pretty much anything they want, anywhere in the world. The result is one does not have to live in New York to look like one lives there. I have never even been to New York but will always aspire to cultivate this city's unique look. Despite my interest, there are some aspects of the fashion world that have me convinced that the people who run it are not fully reality based. I have always wanted the chance to vent these frustrations because those of us that support the system should have the right to have our views heard.


1)Refusing to put pockets in clothes. This is apparently based on the idea that putting things in your pockets makes you look fat. I am not sure how, but somehow a tube of lipstick and a pen have the capability of transforming a model thin woman to a candidate for bariatric surgery in seconds. It is not enough to simply not use the pockets for the "thin obsessed." I read in one magazine that rather than risk the danger of being helplessly compelled to put things in one's pockets a woman must take her clothing to a tailor and have them removed! Fortunately the fashion world has been thoughtful enough to save us a few dollars by making clothing with "faux pockets" to keep us safe from that risk. Okay, it is true, I am thin and do not worry about whether or not I look one pound heavier by carrying a pen in my pocket, but come on, I am a real woman, in the real world with a real job. I want and I need real pockets.


2)Cheeky underwear. What misogynist invented these? All the discomfort of a thong, all the visible panty lines (VPL for those not in the know) of standard panties. All in one package. Now widely available but originally produced by Victoria's Secret, the marketing geniuses who made the thong a household item. Not to rest on their laurels, they had to come up with an item even more uncomfortable and more impractical. Knowing that they are always on the hunt for new ways to make underwear uncomfortable, several women at work and I came up with the MOST ULTIMATELY UNCOMFORTABLE PANTY IN THE WORLD design. I will decline to describe it. We plan to sell it to Victoria's Secret and expect a healthy cut of the profits. Not that any of us would buy it. We will leave that to the 20 year olds in New York that seem to think this kind of thing is sexy.


3)Ridiculous clothing design. I was given a very nice pair of black pants with a short tab belt made out of leather in the center. Those two pieces that constitute the belt are no more than 2 inches each, but since they are leather, the entire pair of pants must be dry cleaned via leather process which runs around $50-$75. All for two 2 inch pieces of leather. Had those two pieces been mounted on snaps so they could be removed, I could have the pants dry cleaned for around $12. Is there any reason those two pieces could not be mounted that way? No. In fact, I took those pants to a local seamstress who did just that. I did that about four years ago and have not had a problem since, but I am paying a whole lot less to have those pants cleaned. The people in New York? Probably are paying $75. As far as to the age of those pants? Are they out of style? No, they are just black pants, they never go out of style. By the way, they do not have pockets, either.


4)$400 haircuts. Do I need to elaborate?


5)Miniskirts 2 inches below the crotch. Considering the popularity of "going commando" recently, these things are not a good idea to begin with. Not to mention, why would anyone want to wear something so short that she cannot bend over, sit down, walk, reach her arms over her head, etc without running the risk of flashing the whole room. Did these things not used to be reserved for strippers?


6)6 inch high spikes heels for work. Fashion magazines will show "work appropriate" outfits that are as on the mark as Lady Gaga is conservative. They invariably feature a pair of shoes that are so high one needs an oxygen tank to breathe. I wear heels at work, more so than most of my cohorts and get teased for doing so by some. My husband is probably my biggest critic in regards to my excesses. But my obsession is shoes in general, be they flat, medium or high heeled and the majority of the time, my heel height is a moderate height which is the most comfortable level for me. One thing is for certain, if they hurt, they do not get worn. I am on my feet all day and the idea of wearing something so toweringly high that I am limping by mid-morning is ridiculous. Any serious career woman knows what I am talking about.


7)Size 12 is a "plus size". In the 80's the average woman weighed 120 pounds and wore a size 12. Since that time, the weight of the average woman has grown as has the average size. It is also true that as years have gone by, what an article of clothing that is considered a size 12 is larger than it was 25 years ago. That said, plus sizes start at size 14 at the smallest, and to hire models that are smaller than that is just an insult.


8)5'4" is short for a woman. Actually it is the average height of the American woman. It is the models that are freakishly tall. So why are average height clothes cut for woman the height of models?


9)Ultra low rider jeans. There is a reason women's waists are thinner than their hips- so their pants do not fall down. Up until a few years ago, that is where we wore our jeans- at our waists. If we wanted jeans that rode low, we borrowed our boyfriend's. Then they gave us our own low rider jeans. Then to really ramp up the refrigerator repairman effect, they gave us ultra low rider jeans. This way, it was impossible to find a pair of uncomfortable Victoria's Secret panties that did not pop out over the top in back and a rising moon was certain to be sighted several times a day.



10) Saying anything so ultra-trendy that it will only be in style for one season, yet still costs $5,000 is a "good investment". Unless you have the money of Oprah Winfrey, this is more money than most women can pay for an outfit they will use for the rest of their life, save three months.



It is a shame that all of the people behind the scenes in the fashion world not be required to have a psychiatric consultation before embarking on their careers. If they were more reality based to begin with, a lot of us would suffer a lot less in the end.

On the Issue of Bath Salts

I am embarrassed to admit that I fell for the ruse (briefly) like many others that the drug that so many kids were getting high from that was said to be a bath salt is not a bath salt. The same product is marketed as a plant food as well. This was a ruse to cover its real active ingredient. It is a highly addictive amphetamine known as MDPV for short. It has been banned in England and many members of the European Union already. Louisiana and Florida have banned it, and it will not be long before Pennsylvania does. We have had many rather tragic stories and at least two direct overdose deaths end up at the hospital here. I have not posted in a while as my time has been occupied working on a presentation relating to some of the results of this drug and have not been doing much on my blog.

Well, maybe I have a bit of writer's block.

But putting in work on the Blizzard, Powdered Rush, Vanilla Sky, call it what you will, epidemic has taken up a lot of time and certainly has interfered with the time I might have spent farting around coming up with ideas to write (more accurately, type) about.

Desperately Seeking Spring

If you are a follower of the woolly worm form of winter weather forecasting you have probably noticed that they were way off last fall. The ones we saw had a black front band that was moderately wide. The middle was mostly brown and the back tip was black. Instead, the entire winter has been cold and snowy. We live in a valley and were spared the depth of snow that nearby communities have endured, but we had snow nonetheless. And it was very cold and windy. The entire winter. According to the woolly worms, the early winter would have severe weather and snow for a while then a mild middle followed by a brief blizzard at the end of the winter. So much for the woolly worms.

Punxsatawuny, PA is about one hour away from where I live so I hear all about the Groundhog Day festivities. Since the woolly worms blew it my hope was maybe Punxsatawuny Phil would be right. It is certainly my I hope now since he saw his shadow and ran back in. An early Spring is predicted. We actually had a few days above freezing over the weekend and that was the first time in weeks. I was almost disappointed that is was not going to snow having gotten so used to this particular weather pattern.. I wanted to take my son sledding one more time, anyways.

But all things considered, I would welcome a respite from my car being covered with salt, the biting wind and being stuck inside. I notice the Sun rising a little earlier each morning and the days getting longer in the evening. I really miss dinner on the back deck after work and playing ball with my son in the yard. The melancholic mood that develops over time during winter grows old and it is getting time for this season to move on.

I am rooting for you Punxsatawuny Phil. I need a dose of Spring euphoria.

To Stop or Not to Stop

"So how do you stop?"

That is a question that should never have been asked about a sledding hill. Sledding is not about stopping, it is about adrenaline. The goal is to find a good hill that provides the ultimate excitement with plenty of opportunity to get injured in all sorts of unpleasant ways. One with lots of jumps, twists and snow banks offering cushioning from sledders sent airborne. Messy details like how to stop can be worked out later, but anyone who insisted stopping in some form of "safe" manner is likely to get written off as a woos. When I was a child, our favored means of stopping usually involved trees or for the more daring, rusty barbed wire.

My husband knows this, but parenthood does weird things to people's brains. So when we stood at the base of "Double Dips", a local sledding haunt, he had the audacity to ask this question. We had only that day been made aware of this hill and had driven by to check it out. Our son is five now and it was time to initiate him into the world of real sledding. He had gone down small slopes in our yard but these were the equivalent of sledding bunny slopes. He was not ready for the hard core X Games version of sledding yet, but it was time for more than this. The Double Dips were actually not that dangerous at all. If they were, the city would not have gone to the length of actually blocking off the two city blocks that comprised the slope to traffic every year with saw horses. This was a decent place to take a kid sledding but how to stop should not have been a concern in my eyes.

This hill was set up with a long stretch at the end of the hill for one's sled to slow down. We took our son sledding and his plastic saucer just drifted to a stop. Fine for young children. But I still long for the days of my youth when we were always in pursuit of "extreme sledding". This was far before the X Games were conceived and no one used any trendy terms like "airs" or "gnarly" to describe our self destructive behaviors. We never knew there was anything that could be viewed as a sport to our activities. We just knew that if we could find the biggest, most dangerous, scariest hill to go sledding on, we had succeeded in our quest.

For us the kind of sled that was used was almost as important as the hill. The old fashioned wooden sled had the advantage of control so it could be used on the more tortuous slopes or on the more treacherous side paths that a simple toboggan could not navigate. Of course having a total lack of control had its own attraction as it significantly increases the danger element. Toboggans lack control, but inner tubes are far superior as they raise the center of gravity making the fall off the sled more dramatic. The best ones are the real ones intended for use in a tire, especially an old one with a bulge on the side that guarantees it will not go straight and one will end up running into a tree or other obstacle

Which goes back to the question of "How do you stop?" Easy, roll off the sled before you hit the barbed wire fence at the bottom of the hill. Run head on into a tree. Steer into the snow bank at the bottom of the hill and hope that you do not get buried. Take your chances with the barbed wire. Sure, you can do the spin out maneuver with a wooden sled if you know how, but the above options are scarier, riskier and far more gratifying. The goal is to get a thrill and scare the Hell out of Mom, not be safe. Safe is for dorks.

Which brings us back to the hill where we brought our five year old son. My husband is not a wimp when it comes to sledding. He knows all about sledding into barbed wire and hairpin turns with a wooden sled. It is just that he is the worried parent now and is not ready to face his son sledding straight into a snow bank. At least not yet.

A Pigeon by Any Other Name...

My recent journey to Pittsburgh gave me the opportunity to visit the National Arboretum. This was perhaps at my family's own peril as this was dangerously close to Heinz Field, home of the Pittsburgh Steelers and even in the morning there were throngs of Steelers fans, ticket scalpers and memorabilia vendors that had gathered for the evening's festivities.

I love the Aviary. It is set up in a manner that allows the birds to move around freely in much of the display. In many cases the birds will roam into the walkways where the visitors move through the aviary. It allows the visitor a unique opportunity to encounter the birds' behaviors up close.

The birds in these photographs are pigeons. Very exotic pigeons with fancy head feathers, long legs and bright colors, but pigeons nonetheless. Known as Crowned Pigeons or Gouras, they reside in New Guinea and are close to the size of turkeys. Normal American pigeons are more prone to run away and fly off when threatened, but these birds will lie down and play dead. I had the opportunity to observe this behavior several times while on my visit there. There were two pigeons on an elevated walkway that ran over their display who, despite the constant disturbance by humans, refused to yield their ground. They would stand there displaying their beautiful plumage and whenever someone would come just a bit too close would lie down and "play dead". Sort of like a possum, except less annoying and less likely to get run over by a car in the rainforests of New Guinea.

On the job with the boss looking- human world.

On the job with the boss looking - pigeon world.

Now do you not wish that when your boss (or whomever else) was getting on your nerves, that you could just lie down and play dead as a means of defense?

It's Playoff Time

I have been swallowed by a sea of black and gold. It is a bit of a drive to Pittsburgh but this is definitely Steele rs country. Since the playoffs are going on, that fervor is driven to new heights.

Last weekends game was quite the nasty one. Steelers fans really HATE the Ravens so that game was a nasty one as expected. The upcoming game against the Jets does not carry the same kind of animosity, if only because the dislike of New England around here is so intense that anybody that can pull off an upset against them, especially in a playoff game, must be okay. Personally, I do not care. I do not like the Ravens only for the reason that they used to be the Browns and abandoned Cleveland. I am okay with the Jets because they took on Boomer Esiason when Cincinnati realized that they sucked and did not deserve him. Otherwise, I am not that rabid of a fan. I guess I will root for the Steelers.

So who do should I root for? Well I am from Ohio (state motto: During the Presidential Primaries we are actually relevant), which you may have guessed from my defense of Cleveland. Actually I am from Cincinnati and have grown up with the long, proud tradition of hating Cleveland- aka- the mistake on the lake, the armpit of the midwest, etc. Despite that, it is in Ohio and you do not betray fellow Ohioans like that. I did at one point support the Bengals when they played professional football. I am not sure what they play now, but it does not look like professional football to me. Professional teams do things like score touchdowns and defend their quarterback and have defensive lines. The Bengals have not incorporated these elements into their game since 1989 when Boomer Esiason was quarterback and they went to the Superbowl. Cleveland is out as a team I could root for since they are the rival team of the Bungals (take that Mike Brown!) The Browns have not been the same since being re founded so pretty much both Ohio teams are out.

Prior to living here, I lived near Indianapolis and that was where I found a real football team- the Colts. They had the advantage of both being a good team, and they had Peyton Manning who played for University of Tennessee where I had been a student briefly. He was a cool dude to boot. Besides, Indianapolis was a lot like Cincinnati, except much hipper and larger. So I became a sworn Colts fan. Whenever there is playoff game that the Steelers are in, the hospital allows staff to wear team colors of the involved teams. I am sure to show up in white and blue, even if they are not playing against the Steelers. Sure, I look like a douche bag, but if you cannot look like a douche bag amongst trusted friends and colleagues, who can you look like a douche bag in front of?

This weekend, I just so happen to be spending in Pittsburgh, which I am probably going to regret considering there is going to be a playoff game on Sunday and the city is going to be a zoo, but I planned this weekend first and am holding firm. It does not matter that a winter storm just dropped 5-6 inches of snow in the city and the high temperature is running below 20 degrees. The fans are going to come to the game. And I am going to be rooting for the Colts. Except when a Steelers fan is watching. They are not so forgiving about the lack of allegiance in the city proper. With that in mind...

Go Steelers (unless the Jets win)!

The Forecast

There have been plenty of stories about newer legal drugs floating around that kids have been getting into so they can subvert the system. K2 and Salvia are the ones I have heard the most about, but I am sure there are more. Like Ecstasy, it will only be matter of time before they are outlawed but a lot of people are going to be harmed before that happens.


The newest one I have heard of around here is called Blizzard. It is apparently a no more than a bath salt that has fallen into favor in the drug crowds. For the time, it is legal and can be bought at large chains that sell bath products. For their benefit, I will not mention any names. As the form Blizzard which is very finely ground and packaged in small jars labeled as such, this is probably more likely found in head shops, but it is not hard to get a mortar and pestle to grind up the legitimate version if one does not have access to such an establishment. I would have never heard of it either, but word of this sort of thing worked its way to me via my patients, like so many other tidbits of information. The recent story on the death of a Blizzard IV drug user has increased its notoriety since then. I have been told that some states have become more aware of this becoming a problem and are making steps to ban the product. Much like Ecstasy, K2 and Salvia, these compounds will have their heyday before being recognized and regulated. The compound is not harmless and more people are sure to die from use of this product.


While it is not funny, do you not just want to say "are you completely stupid, or just mostly stupid?" when you hear that someone shot up their veins with BATH SALTS? Still I wonder since it is a cleansing type product is the user less likely to get an infection than, say a heroin user? At least they will smell spring fresh.


Of course there was the bath salts as a drug discussion that came up at lunchtime the first time that Blizzard was introduced to the psychiatric unit here. How is it used? Are there different scents? It is not that our lunchtime discussions do not reach the lowest common denominator of poor taste to begin with, but since this is likely to hit the teenage set out of its sheer accessibility, we pondered if were likely to be used the way high school students use to get drunk during school- the vodka enema. Useful if one can squeeze really tight for a long time. Unfortunately, this form of alcohol delivery has been implicated in a good number of cases of alcohol poisoning. Nonetheless, it is easier than trying to sneak a bottle of vodka into school so the practice continues. Would not a bath salt enema be a great way to pull off a buzz, avoid track marks and leave one's colon smelling fresh? They might even expand the practice into one of those colonic type spas where one could choose the size of the buzz- flurries, light accumulation, a clipper or the full blown blizzard.


So that was the main topic of discussion during lunch in the conference room yesterday- bath salt enemas. I do not wish to make light of the tragic loss of a young person's life, but if people are stupid enough to do something as stupid as shoot up bath salts, we are going to joke. Our jobs are stressful enough that we need a break sometime.

They kind of look like Devil horns don't they? on Twitpic

They kind of look like Devil horns don't they? on Twitpic

They kind of look like Devil horns don't they? on Twitpic

They kind of look like Devil horns don't they? on Twitpic