Playing Doctor

Initial Visit?

Thursday, June 30

The Straits of Florida

My father's father died on Monday.

My mother's mother called me that evening when I was in the ED, which blocks mobile phones calls because they interfere with cardiac telemetry and other devices.

So she left me a very sweet message.

Wednesday, June 29

The Des Moines River

Yesterday I said that the only fishing advice my grandfather gave me was to keep my hook in the water. That wasn’t entirely honest, as evidenced by this photo.

‘When they take your picture with the fish, take a step back and hold your arm out with the fish directly between you and the camera.’

Would you look at the size of that fish!

Tuesday, June 28

Lake of the Woods

(My grandfather died yesterday. I am putting the Patriotism series on hold.)

My grandfather always had to remind me to keep my hook in the water.

I enjoyed his company and the quietness of being on the boat. We would go out in the morning, often way too early, dock at shore for lunch, and then go out for a few more hours in the afternoon. If we weren’t catching anything, I would often reel in my line and begin reading. My cousins and family could probably tell you some of his better fishing advice.

For me, it was pretty much limited to his gentle reminder to keep my hook in the water.

Monday, June 27

The Patriot Act: Scene One

When I was younger, I wouldn’t have considered myself a patriot.

Patriots were joiners. They flew flags and pasted decals. They maybe didn’t know too much about American history, but by god, they watched football and ate apple pie. They didn’t question authority and had nothing but respect for the president.

Aside from the apple pie, that didn’t much describe me, so I didn’t really consider myself much of a patriot. But something changed for me a few years back.

Part of it, to be sure, is living in a town with a large Naval base. In the hospital we train Special Forces guys. We teach them how to quickly throw in IV lines, triage injuries, control bleeds. More than anything, we let them see what trauma looks like so they aren’t as likely to freak out in the field when they are actually needed. When they leave here, they are dropped into hell zones. We’ve been doing this training for a little less than two years, maybe one or two hundred guys have gone through the program. Five have already died.

My friend, a cardiac nurse, has a son who shipped out just after Christmas in 2003. He was supposed to go for less than six months. He’s still in Baghdad. His picture is on the front of her locker. When I walk past it to get my coffee I see him—young and brave—smiling at his mother behind the camera.

When I talk to her about him, her eyes always water.

On her locker next to his picture is a decal of the American flag.

It’s easy enough to point out that such experiences should have a distancing effect on me: that kids dying at war should make me angry at my country or its leaders.

But my response—my actual, visceral response—is closer to jealousy. These kids loving my country so much that they are dying for her makes me realize how she’s wonderful. How she’s desirable. How she’s, frankly, magnificent.

I realize it’s not logical. I realize it’s maybe not even reasonable. But it was part of the foundation for my newly realized patriotism.

Friday, June 24

Later, We Can Practice French Kissing

This is the last Friday of June and thus the last of the summer games.

Today's category: Guilty Pleasures.

We're going to tread gingerly, somewhere above chocolate cheesecake (because-really-who cares?) and below rape. (because-really-I don't want to know that about you.)

So pick things that you actually feel guilty about, not just embarrassed by, but not so guilty that it keeps you awake at night.

Somewhere in the ‘I burned a hole in my friend’s fridge trying to defrost it with a candle and when he pointed it out, I pretended I had not done it.’ (The pleasure here was playing with fire, more so than destroying someone’s property.)

An appropriate follow to that turn, playing off the ‘t’ from ‘it’ might be: ‘I turned in my grandmother’s green stamps for a Parcheesi set when I was nine.’

As you can see, the guilt might be from transgressions needed to achieve pleasure or unintended consequences from partaking in them, rather than feeling guilt about the pleasure itself. I’ll let you be the judge of your own guilt.

To keep things interesting and more forthcoming, let’s turn the lights out: All comments should be anonymous.

Same rules apply:

1) First letter of your entry begins with the last letter of the previous entry. All entries should be a single sentance.

  • Articles and Pronouns do not count. (Ignore ‘the,’ ‘I,’ ‘my’ or ‘a.’)
  • If you want to add a special description, add it as a second line or in parenthesis.
  • Spell out numbers and symbols, example: ‘1 legged hooker’ would be appropriate for the letter O for ‘one.’

2) If you want to critique someone’s choice, start by playing your turn. But I’ll delete any post that judges anyone else’s pleasure.
3) You can place as many entries as you want, but someone else has to go between each of your entries.
4) If two people post a turn off the same entry, the first post will be the path taken. The second post will be ignored. If it gets missed and people start playing off the second post, then just keep the game moving.
5) If someone makes a wrong entry, ignore it and take your turn.

Rachel, is that you touching my leg?

Thursday, June 23

Antoine de Saint-Exupéry

I can see the nurse is visibly upset when the elevator doors open. I think about taking the stairs, but instead I step into the elevator. I give her a brief closed lipped smile, trying to telegraph the stiff upper lip of a ride I am hoping to have.

I am, apparently, terrible at telegraphing my desires.

She tells me that a family member of a patient threatened to have her killed. She does not know if she is willing to come back to our hospital and endure this kind of treatment from the people we serve.

‘I wouldn’t worry about it.’ I say. ‘These people have no ability for follow through.’

‘I don’t think that’s funny,’ she says. ‘How would you feel if one of your patients threatened you?’

‘I wasn’t joking,’ I say, ‘but I have been threatened, repeatedly.’

She vents about the experience for the remainder of the ride, and she seems to be serious about not coming back to the hospital, so I decide to demonstrate something.

We walk into the ED and I point to a fifty-two year-old man sitting in a stretcher.

‘You see that guy over there?’ I ask, ‘I worked with him for about an hour last night, less than four hours ago.’

I take off my white coat and my stethoscope, hand them to her, and, wearing my green scrubs, walk over to the man in the stretcher.

‘Hello sir,’ I say, ‘are you feeling better?’

‘A bit,’ he says, scrunching his nose at me, perplexed.

‘Oh, I’m sorry sir,’ I say, ‘I think I may have the wrong patient. What’s your doctor’s name?’

‘I don’t remember, I think it began with a P’

‘Big guy with glasses?’ I ask.

‘Yeah, that was the guy.’

I walk back to the nurse without either glasses or a big frame and retrieve my coat and stethoscope.

‘The guy who threatened you didn’t threaten you he threatened the nurse. We’re invisible behind the role we play. We’re ciphers. Go home and rest, then come back tomorrow. Your work is—You are—valuable.’

Wednesday, June 22

seven hundred twenty-nine... seven hundred and thirty... seven hundred thirty-one...

Today marks the two year anniversary of my arrival to this town. It’s also the halfway point to me leaving here.

I feel like I’ve been holding my breath on the ocean floor for all this time. Sometimes, I try to imagine I can hold my breath forever…

sooner or later

Tuesday, June 21

Eight Polaroids for the Purpose of Triangulation

When I was 13 my family made our annual trek from Iowa to Miami and we stopped for dinner in Chattanooga at a greasy spoon situated in a larger structure’s parking lot—a JC Penny’s maybe—and I was so hungry from the long car trip that every bite was an emotional relief.

I made a ridiculous comment that night, haunting me for years after I made it; my family hardly lets an opportunity go by without reminding me of it: ‘These green beans would make a great addition to any meal.’

It was the first time they realized my gift for pastiche, which is not to say panache.

When I was 22, I got a couple of weird crank calls from a girl who purported to know me. I suspected she was lying so I asked her to describe me.

When she said, ‘Well, you’re very good looking,’ I gasped, thinking: ‘She does know me! Who is this girl?’

The other day, my friend Dan got in my, admittedly messy, car.

There were towels and sweaters, papers and journals, even an unopened bag of Oreos. (Which was a gift for one of the administrative assistants, but he didn’t know that.) He looked around and said, ‘Erik, what’s the deal? Are you practicing being homeless?’

One summer, a college friend visited my family. I don’t remember exactly—frankly, at all—what she was trying to get me to do, but we were in the living room and she was talking about her long drive and how it would be really nice if, if—well, whatever she wanted from me, it escapes me now.

As she was doing her convincing, my dad came walking through the living room and, without breaking his gait, said: ‘If you’re trying to get Erik to do something using guilt, don’t bother. We figured out a long time ago it doesn’t affect him. You might as well try to make a stapler feel guilty.’

‘Thanks, Dad,’ I called out as he turned the corner into the kitchen. ‘Love you, too!’

Monday, June 20

Okay, We Get It: YOU’RE YELLING.

My workroom in the ED is next to the triage area for the Fire-Rescue guys. When the ED is backed up, the stretchers pile up like a grocery store checkout lane with guys in blue buying the injured and the infirm.

Usually when this happens, it’s a straight forward annoyance of maneuvering around them to get to the workroom. But sometimes the people in the stretchers are singularly annoying. Such as the fellow who was brought in by Fire-Rescue and the Sheriff’s office.

‘I’M GOING TO KILL THE FUCKING CRACKER WHO FUCKING STABBED ME,’ he said, continuing on his rant for awhile.

‘Pipe down.’ I told him as I walked around his stretcher and into my room.


By that point I was trying to read the nursing notes in my chart, and he was rather distracting.


And with that, I closed the very nice sound proof-ish door, and I continued my work in peace.

Friday, June 17

Game On: Favorite Foods

This week I told you about my favorite sandwich. So for this week’s game, why don’t you tell me your favorite foods? Snacks, desserts, entrees, whatever you call your favorite foods can qualify.

The more specific the better: don’t say ‘pizza,’ say ‘the Arugula and Gorgonzola pizza from Pizza Rustica in South Beach.’

Give recipes or simple descriptions if you want, for example, my favorite fifth-grade after school snack was ‘Saltine crackers smeared with Skippy peanut butter and dipped in Country Time lemonade mix.’

Tell me what you enjoy, what pleases your mouth.

Same rules apply:
1) First letter of your entry begins with the last letter of the previous entry. You must count the food as one of your favorites.
  • Articles do not count. (Ignore ‘the’ and ‘a.’)
  • Brand names can be used, so can personal names such as ‘Aunt Sherry’s Roadtrip Turkey Sandwiches.’
  • If you want to add a special description, add it as a second line or in parenthesis.
  • Spell out numbers and symbols, example: ‘1 cup cream’ would be appropriate for the letter O for ‘one.’

2) If you want to critique someone’s choice, you have to start by playing your turn, not a suggestion for what their turn should have been. I’ll delete any post that doesn’t move the game forward, vous bâtards.
3) You can place as many entries as you want, but someone else has to go between each of your entries.
4) If two people post a turn off the same entry, the first post will be the path taken. The second post will be ignored. If it gets missed and people start playing off the second post, then just keep the game moving.
5) If someone makes a wrong entry, either by not naming a food item or not beginning with the last letter of the previous, ignore it and take your turn.

행운을 빕니다!

Thursday, June 16

Seat #29E

If the text is too small for you to read, click on the image for a larger version. (This means you, Dad.)

My cousin emailed me this tale. I cannot speak to its veracity but thought it was funny.

Besides, this blog has been pretty dry lately. Working nights and sleeping days—with tinfoil covering my bedroom windows—have brought out my pedantic nature.

Such a fine word ‘pedantic,’ from the Italian pedante by way of the Middle French…

Wednesday, June 15

Uncynical Wednesdays:
You Said I’d Be Lying If I Said It Wasn’t Easy

I was evaluating a seventy-five year old black woman who was found living in filth and unable to get off the floor. Apparently her neighbor called fire-rescue and when they arrived, she threatened them. They had to forcibly remove her from her home. I got called to admit her into the hospital for urosepsis and dehydration.

When I met her in the ED she was combative, threatening to call the police on me if I didn’t leave her living room. I asked if I could listen to her heart, and when she said nothing, I placed my stethoscope on her chest. Her hands were restrained—tied—to the stretcher, but she had enough leeway to grab my stethoscope and pull it—and my ears by extension—close to her.

‘Ptew,’ she said.

‘Ma’am?’ I said, a few inches from her face. I could have freed myself from her weak grasp, but might have hurt her in doing so.


‘Ma’am,’ I said quietly, ‘you’re going to have to let go of me.’


‘Let go sweetheart.’

‘I’m trying,’ she said, ‘to spit in your face.’

‘I know, honey.’ I cooed, ‘but you haven’t fed yourself in days; you’re drier than sand.’

She let go and I walked into the nurse’s station.

‘Can we get some fluids into that poor darling?’ I said, writing orders for a two liter bolus. ‘She can’t even spit in my face.’

Tuesday, June 14

My Favorite Sandwich

Buffalo Chicken Sandwich


French Meadow's Men's Bread, 2 slices
Blazing Buffalo Style Chicken Breast, Sliced
Celery Rib, julienned
Maytag Blue Cheese, crumbled
Miracle Whip
Alfalfa sprouts
Buffalo Sauce

Slather the Miracle Whip onto a slice of bread, arrange the celery onto the Miracle Whip, crumble the Maytag Blue cheese on top, and then layer the chicken on top of that. Spread a handful of sprouts on the chicken and squirt the Buffalo sauce into the sprouts. (The sprouts act as a medium to hold more sauce in the sandwich) Place the second piece of bread on top.

Enjoy with an Ice Cold Budweiser.

Monday, June 13

Paging Doctor Frankenstein

Two weeks ago, you may recall, I told a story of bringing a woman back from the dead.

I want you to see the attending’s comments about my performance during the code. He said that I was ‘outstanding during a difficult, prolonged & successful Code Blue.’ I share this because I want you to understand the difference between what I can do and what I ought to do—the difference between my capacity to thwart death and my fealty to sustain life.

The part of the story that I didn’t tell before—the part that is important to understand now—is that she never made it off the vent.

When she was down—when she was dead—her brain went without oxygen. When she came back she had continual seizure-like activity. Every 10 or 20 seconds, her eyes roll back into her head, her head lolls up and to the right, her arms shake and her feet extend down for about 2 or 3 seconds, then she goes back into her baseline sleeplike state.

That evening, her family decided she’d been put through enough; that we were no longer extending her life, but prolonging her death. They gave us permission to take her off the vent and she expired quite quickly.

This was the result of my outstanding performance during a successful code.

I’m told that 80% of codes on television bring the patients back to life. In reality, only 5% of Code Blue patients survive to hospital discharge.

The morning after the code, before the patient’s family had made their decision, I saw them in her room. I thought about what I had done to them. I wondered if they were pleased that they got to see her before she died or angry that they had to make the decision to pull the tube out and allow God to finish what he had already started.

I confessed my umbrage to the administrative assistant.

‘What would you do if I introduced myself to you as the doctor that brought your mom back to that?’ I asked, gesturing to the family, watching as their mother writhed and then went limp.

‘I’d punch you in the jaw,’ she said.

‘I know,’ I said, looking at my shoes. ‘I’d do the same.’

Sometimes I’ll hear people talk about patients who are on vents and emergent dialysis with cardiac pressors and internal pacers. They’ll actually say, ‘It’s in God’s hands now.’

Let me clarify something for you.

I have done everything possible to take it from God’s hands. If God has issues with shoplifting and sodomy, I cannot imagine his affront to this usurpation.

I am Daedalus offering waxen wings to Icarus desires: I’ll give you your loved one back.

‘Behold, I can restart their heart; I can take over their lungs, their kidneys. Their mind might be gone, but they’ll be warm, they’ll possess the penumbra of life! Come! Feel their hand! It’s still pink, is it not? The blood courses yet! Don't let go! Want to see more? I can give you more. When their gut no longer works, I’ll put their nutrients right into their veins.’

Of course, the real conversation is always the opposite. Me explaining that I have the capacity to do these things, but should not do them. But try explaining this to a family when their mother is dying.

‘We’re hoping for a miracle,’ they’ll plead. ‘We want you to do everything.’

They have no idea what everything entails. No idea at all. And I have no way to really explain to them the horrors that I am capable of, all they will hear is that she will not be dead.

I will sit and look them in the eyes. I do not cry. My voice does not break. I am Prometheus, keeper of fire and not dispensing it, but trying to withhold it with compassion. I hold their hands, and often enough hug them.

‘God’s calling her home.’ I say, in a language that they can understand. ‘If God wants to perform a miracle, he doesn’t need my permission. Or my help. It’s time to let her go.’

Friday, June 10

You’ve Got Game: Cool Dominos

We had a lot of fun with cool this week, but remember: Don’t try this at home; Cool is the third rail of cool. We had trained professionals (Meg White, Martin Amis, Catherine Deneuve, and Berry Goldwater) standing by at all times. Albeit, mostly just to watch as I electrocuted myself.

So let’s have a little more fun with cool, shall we?

This week’s category is Music. You can choose an artist, album, or song, so you have a fair amount of leeway.

But we’re going to bring the difficulty up a notch. Same principle, one entry’s last letter is the next entry’s first letter, but this time each player makes two entries. The first entry is something that falls within the standard boundaries of cool, the second falls outside its bounds. The trick is that the player is attesting to liking both choices.

For example, I could not use ‘Belle and Sebastian’ for my entry, because I only like ‘If You’re Feeling Sinister’ and ‘Tigermilk.’ Conversely, I shouldn’t use ‘Beautiful’ because, well, I like a lot of Christina Aguilera.

This game should be fun because you will, in part, be playing with yourself. For example, if we start with ‘N,’ here is how the first few rounds could go:

Doctor_Erik: ‘Nick Drake / Every Little Thing She Does Is Magic (The Police)’

Elina_Andreou: ‘Coldplay / Yanni

AltFratGuy595: ‘It’s Hard to Find a Friend (Pedro the Lion) / David Gray

The Rules:

1) First letter of your entry begins with the last letter of previous entry. Every turn consists of two entries; the first entry is what you think people will consider ‘cool,’ the second entry, ‘uncool.’ You must like both choices. Separate the entries with a slash.
  • If you are using a song or album, put the artist’s name in parenthesis. (This is only for clarity; it will have no role in what letter is played.)
  • Articles do not count. (Ignore ‘the’ and ‘a.’)
  • Spell out numbers and symbols, example: ‘#1 Hits from Motown’ would be appropriate for the letter N for ‘number.’
  • Unsure of a correct spelling or full song title? Go Here.

2) No Repeats, but if someone has listed a song or album, and you’re willing to expand the category to the full artist, that will count.
3) If you want to critique someone’s choice, you have to start by playing your turn, not a suggestion for what their turn should have been. I’ll delete any post that doesn’t move the game forward, you sons of bitches.
4) You can place as many entries as you want, but someone else has to go between each of your entries.
5) If two people post a turn off the same entry, the first post will be the path taken. The second post will be ignored. If it gets missed and people start playing off the second post, then just keep the game moving.
6) If someone makes a wrong entry, either by using a repeat, not making two entries, or not beginning with the last letter of the previous, ignore it and take your turn.

I’ll go first with:

Thursday, June 9

Economies of Cool

You might like your aunt, but she’s not cool. Cool’s like cash. Its value’s imposed, not intrinsic. Liking something doesn’t give it value.

Well, that’s not entirely true. You can give something your coolness to make it slightly cool. But you can’t do it with just anything, or you’d give away all your coolness. That would make you uncool.

Giving away some coolness is not a bad thing, as hoarding too much of it will give you the dreaded title of Hipster, in other words: Counterfeit.

In order to be cool, you have to give some of it away.

Let’s admit it, being cool is conflicted.

For example, knowing is cool, but learning is not. Looking cool is mandatory, but trying to look cool is very, very uncool. Talking about cool is admitting to the drudgery of one’s uncoolness, so it’s impossible to understand how or what cool is, except intuitively.
Cool is in control.
Conformity is not cool. Being an individual without being a freak is the finest of lines to walk. What makes it tricky is that—to the uninitiated—coolness is freakiness.

Humility is cool. Assuredness is more so. Humbled assuredness is always the goal. Another impossible line to walk.
And being cool is about never walking a line. Any line at all.
Mockery is not cool.

Well, mocking someone can—in certain rare circumstances—be cool.

Arguing that—say—the US would not be liberating Iraq if they didn’t have oil is irrelevant and uncool. Arguing that the US is only pretending to liberate them to steal their oil, well that may or may not be cool, depending on how annoying the person is while making the argument.

(If the politics are too distracting, you can substitute ‘the US’ with Erik, ‘Iraq’ with Mary, ‘liberating’ with ‘helping with algebra,’ and ‘their oil’ with ‘her virginity.’)

Quoting people is not cool. Interpreting their meaning can be cool, if you avoid words like discursive, pluralities, paradigm, and transgressive.

Calling attention to the surface of things is uncool. But differentiating between surface and substance—differentiating between hip and cool—is quite difficult. Like religion, if you genuflect at the right times, sing the right hymn, and know the right prayers; it’s impossible to know what resides in your heart.

Taking the safe route—being ironically uncool—is not only uncool, it’s an insult to both yourself and what it means to be cool.
Cool is always honest, but rarely forthcoming.
It can sometimes be cool to align yourself with things that are particularly uncool, if it’s genuine. This alignment can work like what investment bankers call ‘a short,’ which is—essentially—selling a stock with the idea that you’ll buy it back when its price lowers.

This is similar to what we talked about earlier, but with this technique you are not making the object cooler: You are admitting a lack of coolness, which makes you cooler. This is a specific application of the maxim that taking risks is cool. Embracing what you love, despite its uncoolness, is cool. I don’t know exactly why, it just is.

Maybe it’s because of the central truth about being cool: it is indefinable. Any attempt to do so would only prove the uncoolness of the attempter.

Especially if the whole ‘Cool, Not Cool’ thing is a cheap rip-off of King Missle's Gay, Not Gay. (Streamed, Not Streamed)

Tomorrow: Cool Dominos

Wednesday, June 8

Uncynical and Cool

How did it come to be that cynicism is thought of as cool? This’s something I’ve thought about before, and though I’ve got a good idea what’s going on, I’ve never figured out how to articulate it.

I was going to Venn it out, but—believe it or not—some things don’t lend themselves well to Venn diagrams.

But since you took to the Venn’s so well, and even sent me your own diagrams and pointed me to Venn’s on the web, I thought I might try to explain it using an algebraic matrix.

People, settle down!

I never said there wouldn’t be any math involved. Just relax, I’ve fudged some of the math concepts here, so this shouldn’t be too difficult. And we’re going to start at the end, working our way forward to make it easier.

Now—admittedly—on the surface, cynicism can seem cool, as evidenced by the following matrix, which shows how coolness and cynicism can appear the same to the outside observer. This is also the solution of the equation that we are going to work through. We’ll call it Solution1:

Laconic Confident

But we can dig beneath the surface using a matrix grid to understand what’s really going on here. These are the core distinctions between traits that only appear similar at first glance. Take a look:

No to Low Tolerance for Inconvienence Knowledgeable

Matrix of Cynicism, or Cynical1:

No to Low Tolerance for Bullshit Savvy

Matrix of Cool, or Cool1 :

Now these traits interact with people exactly the same way numbers ‘interact’ with each other in a matrix, so here we have the subjects who may interact with these traits, or Subjective1:

Stranger Co-Worker or Customer

Now what is noteworthy about this equation is that:

Cynical1 x Subjective1 = Solution1

and that:

Cool1 x Subjective1 = Solution1


Cynical1 x Subjective1 = Cool1 x Subjective1

Thus explaining the confusion between being cynical and being cool.

It is extremely important not to make a rookie math mistake and believe that because these equations are equivelent that therefore Cynical1 is the same as Cool1. This would be the same as believing that because -12 = 12 that therefore -1 = 1. We know that is not true, and this is the same concept, just a bit more complex.


Cynical1 ≠ Cool1


Tomorrow: Economies of Cool

Tuesday, June 7

Everything I Ever Really Needed to Know I Learned in Junior High

So let’s talk a bit about what we all know about cool.
Cool is insightful and suggests wisdom without repeating half-assed truisms.
Scars, both emotional and dermal, are cool. Spielberg demonstrated this all too well in Jaws, one of his three cool movies, when Roy Scheider and Robert Shaw escalate a show of battle scars while the uncool Richard Dreyfuss looks on. The movie got it so right and made it so obvious, that scars lost their coolness for a while and thus the advent of Disco.

Coolness has to remain partially hidden; If too many people are in the know, it becomes uncool.

For example, last week I heard someone say, ‘This stapler has jumped the shark.’ By which she meant, this stapler has reached the point that it will never be as good as it once was. A cool concept, as evidenced by the ultra-cool Rachel and Todd. But it was about a stapler. I thought, ‘Jumping the shark has just jumped the shark.’
Cool can be catlike or doglike, but tends to be catlike.
While it’s uncool to be arrogant and elitist, coolness itself can be arrogant and elitist. Don’t ask me how that works, it just does. It forces itself underground and is always slightly transgressive. It’s like pornography in that respect.

A few years ago, porn started becoming non-transgressive. Ron Jeremy and Jenna Jameson became household names, pornstars had walk-ons in sitcoms, and the AVN Awards were covered by Entertainment Tonight. It did what it had to in order to remain transgressive.

Similarly, sometimes coolness will become violent to protect itself from domestication—think Rumblefish and the brokenhearted, heroin-addict Cassandra who says to Matt Dillon’s Rusty-James as she touches his blackened eye, ‘He only broke your arm? I wish he were that kind to me.’
It doesn’t care what you think, but sometimes will do things just to piss you off.
But this, to use popular parlance, is the dark side of cool. Anger can be cool, but remember: Anger works for only so long.
Cool can have flashes of passionate intensity among prolonged episodes of disaffected indifference.
Caring what is cool is so very uncool. Even deciding what is cool—being its arbiter elegantiarum—is not cool.

Being cool is a risk to your health, as smoking—unfortunately—always was, always is, and always will be cool. (As is heroin, but not cocaine—which can sometimes be hip, but never cool.)
Cool is funny and inventive.
Also unfortunately, giving up is cool, or maybe just recognizing your limitations is. Being a winner—or getting accolades for winning anyway—is uncool. This is because mumbling is cool, while calling attention to yourself is not. The important corollary is that while melancholy and loneliness are cool, self-pity and desolation are not.

Living your life, playing the hand you were dealt is cool; Cowardice and excuses are uncool.

Dying for something you believe is the epitome of cool, but a technique that must be used sparingly.

Tomorrow: Uncynical & Cool

Monday, June 6

Cool Week

After last Friday’s game—Thanks for playing, everybody. I don’t know about you, but I saw a bunch of movies I either wanted to watch or wanted to watch again. My Netflix queue went up by about ten movies—It got me to thinking about what is and isn’t cool.

Let’s start with the admonishment ‘Be Cool,’ a reminder that you are braking the bounds of cool, a shorthand version of ‘Don’t be uncool.’

It can be used correctly, as in:
  • Stop calling me four times a day
  • Put down that knife
  • Come to the party
  • Don’t throw a punch that’ll get our butts kicked
  • Go down on me

It can be used incorrectly, as in:
  • Help us knock-over the liquor store/steal a car/bury a dead boyfriend
  • Give me the answers to the geometry quiz
  • Buy beer for us underage kids
  • Jump off a structure with a bungee cord
  • Go down on me

Tomorrow: Everything I Ever Really Needed to Know I Learned in Junior High

Friday, June 3

Would You Like To Play a Game?

I seem to be watching a lot of retro movies about punk rock lately, and saw Hard Core Logo this week.

It was billed as a ‘darker, edgier Spinal Tap,’ but really it was more interesting than that. I guess it was an easy way to bill a psuedo-documentary about a faded punk band. It’s a shame because who really needs a darker, edgier Spinal Tap? This movie was better than that. And it wasn’t terribly funny, so it must have disappointed those people who were looking for that.

Anyway, at one point in the movie they played the same road game that my family often played during those long drives from Iowa to Miami. Someone named a country and then the next person named another country whose first letter was the same as the last letter of the previous country. You probably played it too, remember?

England…Dominican Republic…Columbia…then the run of countless countries whose names begin and end with the letter A.

But instead of countries they played with cool movies.

So I thought maybe we could play here, using the posts.

Here are the rules, with a few arbitrations to prevent fights later on:

1) First letter of your movie begins with the last letter of previous movie. Articles do not count. (Otherwise, we’ll have a glut of A’s and T’s.)
2) No Repeats! No Do-over's!
3) Movies have to be cool by your standard, not anyone else’s.
4) If you want to critique someone’s choice, you have to start by playing your turn, not a suggestion for what their turn should have been. That included stuff like ‘I LOVE THAT ONE!’ I swear to god, I’ll delete any post that does not move the game forward, you sons of bitches.
5) Yes, porn titles do count.
6) You can place as many entries as you want, but someone else has to go between each of your entries.
7) If two people submit entries simultaneously, the entry that appears first will be the path taken. The second entry will be ignored. (Better Luck Tomorrow!) If it gets missed and people start playing off the second entry, then just keep the game moving. The first responder will get his reward in the next world.
8) If someone makes a wrong entry, either not naming a movie or not beginning with the last letter of the previous, ignore it and take your turn.
9) Numbers and symbols would be spelled out. 12 Monkeys would be appropriate for the letter T.

I’ll start the game:

Thursday, June 2


This post has a soundtrack. You can stream it or download it.

Last night, I began the first of a month of nights.

I go into the hospital from seven in the evening until eight in the morning admitting patients into the hospital, running codes, and helping the intensive care and cardiac care service.

Last night we brought a woman back from the dead. That was kind of exciting. She cycled through nearly every known arrhythmia, from asystole to bradycardia to pulseless electrical activity to ventricular tachycardia to ventricular fibrillation, even into Torsades de Pontes—the most French of the arrhythmias. Halfway through the code the senior attending started laughing at me.

‘It’s like she’s testing you—making sure you know how to deal with everything in the book,’ he said.

I admitted two or three crack chest pains. This is typical for a night. Cocaine causes coronary arteries to spasm and about twenty percent of our cardiac patients are there because of crack.

As the ED folk like to say, to laconic effect, ‘Crack Kills!’

I had a few straight forward admits, and then I had the big guy.

A member of the 500 club, weighing in at over 500 pounds. His feet were so hugely swollen that he didn’t own shoes that would fit him. It didn’t really matter, because he couldn’t really walk much anyway. He stank of fungus and mildew, because the saprophytes feed on the oils and sweat that accumulate in his fat folds.

When he started to crash, thankfully, I was somewhere else, and someone else had to intubate him. When I got there though, I placed the Nasogastric tube because the nurse said ‘good luck with this,’ and handed the tube to me. I placed it through his nostril and—kids don’t try this at home, I had him paralyzed—stuck my fingers down his Jaba-like craggily-tooth orifice of a mouth, and guided the tube down into his esophagus.

When his blood pressure started to drop and we needed central venous access, I had one nursing student pull his right breast out of the way, while I applied a tremendous amount of pressure to the fat around his clavicle and drove the needle into his subclavian. I had to bury a four inch needle through his fat all the way to the needle’s hub, compressing the fat as much as I could, just to reach the vessel. This is typically an easy inch and a half journey, with minimal compression needed.

The worst part is I had to use such a tremendous amount of pressure to the fat that I could not remove my left hand to place the guidewire. When I tried, the fat bounced up and I lost the vessel and had to rebury it to find it again. I tried this three times before I got another physician to act as my left hand, so that I could continue holding the fat down while we secured the access.

My arms still hurt. But he’s alive.

I return home to a bath and a mug of warm milk and fall into a deep—admittedly tormented—sleep. I feel like Batman.

I just wish I was an affable millionaire during the daytime.

Wednesday, June 1

Uncynical Wednesdays

Medical Records

Season Three

Season Two

Season One