Pinpoint Analysis

The Best Things

2011-12-14T23:45:00.001-05:00

The best things happen while you’re dancing

Just when the days are at their shortest, when the winter chill accosts me each morning and when you’d think that a nasty seasonal affective disorder should be setting in, I sit in my chair with my laptop feeling a very bearable lightness of being. Though close to the night before Christmas, it’s not visions of sugar plums dancing in my head that are lifting my mood. Rather, it’s Irving Berlin’s song from White Christmas, “The Best Things Happen While You’re Dancing”. The movie has been on TV every day this week. If you missed it yesterday at 9, you could catch it again at 11. I watched just enough of both showings to wake up this morning with that song playing in my head. And just like the TV programming, it’s been replaying all day.

Things that you would not do at home come nat’rally on the floor

Barbara and I took beginning ballroom dancing classes this fall. Waltz, foxtrot, swing, megengue and the cha cha cha. Irving, in his wisdom, did not say that the dancing would come “nat’rally”. It’s the other stuff that does. The touching, holding and smiling that are not the norm for any 50+ year old couple I know, just happen. As Vicki Baum said, “There are shortcuts to happiness and dancing is one of them”. Strangely, I really liked the discipline of formal dance our instructors stressed in their classes. Less flower child, more atten-hut. Even Patrick Swayze in Dirty Dancing taught the importance of a rigid carriage, holding the arms up to create a personal space in firm contact with ones partner, the rigidity allowing even minimal pressure to be transferred and communicated. He chided Jennifer Grey, “No spaghetti arms”. I repeated that same line to Barbara many times during our sessions and, thanks Patrick, felt so virile. While the male is leading and feeling so full of himself, the female has the more difficult task of figuring out what he is going to do before he does it. As Ginger Rogers said, “I do everything the man does, only backwards and in high heels!” And she looked great doing it.

For dancing soon becomes romancing

It’s no secret why orthodox Jews, reactionary Christians (think Footloose) and fundamentalist Muslims prohibit dancing between the sexes. Put a boy and a girl together, add some music, start them moving in concert and it’s only natural that biology take over. That is every bit as true for the restrained waltz as it is for the hip swaying cha cha. The male creates his space, the female hers. The tension between them sets the romance to an emotional simmer, a much better temperature for a tender, long lasting romance. George Bernard Shaw said it best, calling dancing “the perpendicular expression of a horizontal desire”.

When you hold a girl in your arms that you’ve never held before

I’m going to leave that line alone…it’s been so long I just can’t remember.

Even guys with two left feet
Come out alright if the girl is sweet
If by chance their cheeks should meet

While dancing
Proving that the best things happen
While you dance

Cute song. Cute story. Maybe a bit saccharine for my taste, but the holidays are almost upon us and what’s more, for the next three days I’ll be watching Miracle on 34th Street. I’ve got a ways to go before I’m ready for Natalie Wood’s “I believe…I believe…it’s silly, but I believe”.

Now for the ironic twist. The week after our dance classes ended BV had foot surgery. Despite the rumors, I did not break it, though I did upon occasion step on her toes. No cheek to cheek holiday parties or New Years tux for me. Talk about mixed messages! She’s lucky that I know that “faith is believing when common sense tells you not to”. Happy Holidays friends. Keep the music playing in your heads. Start tapping your feet. Stand up. Create some tension. The best things will happen. Just let yourself dance right into the New Year.

Getting In Touch

2011-10-26T21:37:00.000-04:00

“50/50” is an uneven movie that tells the story of an uptight 27 year old boy as he struggles with the diagnosis and treatment of cancer. Thankfully, it is not a sentimental tearjerker, but more an exploration of the protagonist’s relationships with his girlfriend, best friend, physicians, therapist, parents and other cancer victims. The unevenness is the fault of the writer, who in his semi-autobiographical script, wastes the skills of some very talented actors by having them play caricatures instead of believable people. Angelica Huston is the aggrieved mother but nothing more. “I only smothered him because I love him.” Seth Rogan plays the same vulgar, drug, booze, woman-as-object seeking character as in all of his previous films. He is much less believable as a best friend without his posse. He has nothing in common with his neat freak buddy and in the end we are supposed to like him because he reads a book (though not to the end). Ron Howard’s daughter, Bryce Dallas Howard, who played the villain brilliantly in “The Help”, is again cast as the bad guy, but this time just gets to show off her full lips, wet eyes, blazing red hair, avoid intimacy and get booted out the door. Who could even believe she and the cancer dude would ever hook up?

The cancer dude, Joseph Gordon-Levitt, does a good job acting out the stages of illness and portraying a stiff learning to recognize his feelings. He is helped by his therapist, played by George Clooney’s “Up in the Air” sidekick, Anna Kendrick. She is just another incompetent practitioner in a movie that stereotypes doctors as unfeeling assholes. She, however, has an excuse because she is a mere student therapist. As I mentioned in my “Death Lessons” blog earlier this year, medical students are in fact stumbling, fumbling, and potentially dangerous, but those flaws make them likable to patients. Emotional intimacy and trust are common. The therapeutic relationship in “50/50” begins with an awkward touch by the novice psychologist. The importance and difficulty of touch in the practice of medicine are well shown in “50/50". That got me thinking…

35 years ago I attended an old girlfriend’s massage therapy class in San Francisco. In order to work in a California massage parlor in those days you had to have a license. In order to get the license you had to take a course in massage. The class I had the pleasure to attend that day was therefore what my friend called “half hookers, half healers”—50/50 if you will. The hookers in their tight hotpants with their stiletto heels and nail files sat on one side of the room while the bearded or braless (or both my brother would say) Birkenstocked healers massaged each other. That room was a metaphor for the dichotomy of touch. And that ex-girlfriend was my 1980s definition of friends with benefits. Sex was sex, but a full leg massage after a 6 mile run was heaven.

Touch is an integral part of the practice of medicine. In our Physical Examination course we are taught to first warm our hands, and then initiate contact with a gentle, unthreatening touch to the arm. Every subsequent touch is preceded by a verbal warning, “I’m going to listen to your heart”, giving the patients the opportunity to prepare for the invasion of personal space and object if they want. After each part of the exam the physician should offer reassuring words, “Your heart sounds normal”. A good poker face is an asset. Worried looks and “Whoa, what’s that” are to be avoided. When examining the opposite sex or a child, a chaperone should be present. Nowadays every patient is a potential adversary with many lawyers ready, waiting only an 800 phone call away. Touch enables me to take a blood pressure and feel a liver. It also allows me to comfort the anxious, the ill and the bereaved. Mostly, it helps me build a physician-patient relationship with mutual trust. Think of the brisk, unexpected insertion of a cold speculum by a clumsy gynecologist and then imagine the opposite. I try to be that opposite. Some doctors never get it. A medical school friend once told me that’s why they have pathologists and radiologists. I might add psychiatrists too. Traditional psychiatry teaches therapists never to touch their clients.

Ofer Zur, PhD teaches an online course in continuing education for psychotherapists. In one session he discusses “To Touch or Not to Touch: Exploring the Myth of Prohibition on Touch in Psychotherapy and Counseling. Clinical, Ethical & Legal Considerations”. It is a major academic treatise. Some interesting points: 90% of analysts admit to being sexually attracted to their clients while 10% have acted on that attraction. The meaning of a touch intended by the therapist is not always the same as that perceived by the client. The perception of touch is influenced by factors including culture, race, sex, age, religion and many more. Societies place many taboos on touching others and oneself. Touch is critical to the healthy development of the fetus, infant and child. His bottom line is yes, touch, but following defined guidelines and only with training, competence and reeducation as needed. But realistically speaking, if you’re hoping for a comforting touch, go to the masseuse, not the shrink.

“50/50” ends on an optimistic note. Cancer-free dude and Psychie chick get together for a date. His hair is growing back. She is holding a pizza box. They smile and she asks, “What next?” Producers wanted an on screen kiss. Cast refused. End of movie. Tender touch to follow. I like it when the students stop their fumbling and feel good about being doctors. Even without the happy ending, medicine still has its rewards.

Art, No Refunds

2011-09-18T18:55:00.003-04:00

Do yourself a favor, save your $12.50 and stay away from this week’s new movie, “Drive”. IMDB rated it 8.8 out of 10 so I didn’t bother to read the NY Times review that I now know was lukewarm. Mistake. In brief: Ryan Gosling plays a getaway car driver who falls for a girl, does a job for her ex-con husband that goes sour, not only killing the ex-con, but leaving Gosling with a big bag of mob money that gets him a knife in the gut. End of movie, but good fodder for today’s blog.

The problem with this movie and many others like it is that some directors just don’t know the difference between art and entertainment. Art is something that gives you a strong, usually pleasurable reaction. It can be beautiful or awe inspiring. It is of significance, not just ordinary. Entertainment, by distinction, passes the time. It keeps your interest. It can amuse or sadden, but if it is boring or offensive you walk out and that’s where the entertainment ends.

Some examples: Auguste Rodin’s marble sculpture of Danaid is a work of art. It is beautiful in subject, form and material. It attracts the attention of thousands of visitors daily in Paris’ Rodin Museum. The visitors appreciate the beauty then walk by to see the next masterpiece. I guarantee you that if that creamy white form came to life and lifted her hair from the cool marble stream displaying her nubile figure, no one would walk away. They would truly be entertained.

Many think that winemaking is an art and that a fine wine can be a work of art. I’m not sure I agree, but they find pleasure in swirling their wine in a crystal goblet and watching the rivulets of liquid stream down the glass. They draw the scent into their noses, close their eyes and imagine I’m not sure what. Finally they take a sip and draw it over their palates. If it’s over $20 a bottle I’m willing to call it art. On the other hand, give me 2 or more glasses of the stuff, and we’ll both be entertained.

So where did “Drive” go wrong? I blame it on movie school. “Drive” had many scenes where long silences, montages and close-ups substituted for meaningful dialogue. It’s hard to have two actors develop a relationship on screen by talking to each other. It’s easier to show a soulful look and hope the audience buys it when they embrace. Overly long face shots are okay if it’s Ingrid Bergman in “Casablanca”, but Ryan Gosling with his close set eyes and 38 regular body made me wonder if I had time to go out and pee. Even Brad Pitt, who does have the goods, knew that his face alone wouldn’t cut it. In his breakout movie, “Thelma and Louise”, he knew enough to take off his shirt. Tom Cruise took his pants off in “Risky Business” and his shirt off in “Top Gun”. There’s no way plain faced Jamie Lee Curtis would ever have gotten to show off her comic brilliance in “A Fish Called Wanda” if she didn’t show off her large boobs first in “Trading Places”. Long before “Gypsy” entertainers knew that “you gotta have a gimmick”.

“Drive” was also terribly miscast. The movie’s strong silent hero was a wimpy Canadian kid whose mother took him out of public school to be homeschooled because the other kids bullied him. No stubby facial hair or imitation Stallone voice could ever make him Rambo. Even worse was the casting of Albert Brooks as the local mob villain who slashes one guy and then sticks a jeweled blade into Gosling’s gut. Brooks is a standup comic. He was the sweat soaked loser in “Broadcast News”. A proper villain would have been someone in the mold of Donald Sutherland who both wielded and embodied the perfect stiletto in “Eye of the Needle”. That director, Richard Marquand, succeeded in artsifying his film with brilliant phallic imagery, both impotent and virile, that turned a very entertaining film into one that you can watch again and enjoy even more. No, you won’t get me to say it is a work of art!

Finally, the worst film of the year…I lasted 20 minutes, the last 10 with my eyes closed. You don’t have to trust me, just read the disclaimer below, posted by Stamford’s Avon theater.

Dear Patrons,

In response to some customer feedback and a polarized audience response to last weekend, we would like to take time to remind patrons that THE TREE OF LIFE is a uniquely visionary and deeply philosophical film from an auteur director. It does not follow a traditional, narrative approach to storytelling. We encourage patrons to read up on the film before choosing to see it, and for those electing to attend, please go in with an open mind and know that the Avon has a NO REFUND policy once you have purchased a ticket to see one of our films. The Avon stands behind this ambitious work of art and other challenging films, which define us as a true art house cinema, and we hope you will expand your horizons with us.

Thank you.

Now that’s entertainment.

Death Lessons--I

2011-06-05T13:57:00.003-04:00

I was a fourth year medical student doing my neurology elective at Columbia’s Neurology Institute in New York City. It was an exciting time for me. I had a sublet across from the Blue Note Jazz Club. I took the bus to work by day and the subway to parties by night. The pulse of the city was a far cry from UCONN’s sleepy Farmington snore. I was happy to be there and eager to learn. Learning for a physician, clichéd as it may seem, is a lifelong process. It does not happen at a steady or predictable pace and can be about things you never saw coming. In the first two years of medical school it is force fed through lectures and books organized around subjects (anatomy, physiology) or organ systems (musculo-skeletal, cardio-vascular). In the third and fourth years, and for the rest of a doctor’s life, it comes from contact with patients.

Thirty years later I remember a patient I saw at Columbia. He was a 41 year old upper class New Yorker getting chemo and radiation therapy for an advanced brain tumor. His very attractive, but pale and anxious wife sat nearby as I interviewed and examined him. He seemed happy to see me. Hospitals, especially tertiary care hospitals, are cold and impersonal, and the waiting between contacts with caregivers can be so painful that medical students are almost always welcome. There is something very comforting about their clean white coats, insecure looks and plain ignorance. Patients often open up to medical students while holding back information from their more arrogant and hurried physicians.

Despite his brain tumor, my patient was awake, alert and it seemed, in complete control of his faculties. We talked about his illness, his work, his life. I didn’t really know all the questions I should have been asking, but we both had time and just kept talking. For some reason, one that I still regret today, I asked him about depression and whether he had thought about suicide. I didn’t even ask the question well. There was something about Hemmingway, I think. In any event, he gave me a big smile and started to answer, but his wife started to fidget in her chair, clench her jaw and glare at me. At the time I told myself that I had every right to ask a terminal patient about depression and that asking about suicidal thoughts was a doctor’s responsibility. I now feel that it was unnecessarily cruel to the wife and that as a student, not one really caring for the man, I did not have the knowledge or power to help.

The next day my preceptor told me that the patient’s wife complained about me, specifically my opening up the topic of suicide. She asked that I not see him again. I was not censured in any way. Senior physicians are very protective of their medical students and, at least on paper, I had done nothing wrong. He told me that the patient actually liked me. Sadly, the story did not end there. That night the young man, whom I today imagine wearing a tux out in New York society, went into a coma. His brain had swelled and herniated down his brain stem.

I left New York City with mixed emotions. I loved the Neuro Institute with its bizarre Movement Disorders ward—dozens of people even weirder than the ones who roam the streets downtown. I was proud of myself for braving the late night parties even though the women were way too cool for me. I was surprised and happy to receive an A and a glowing recommendation from my preceptor. Still, I was ready to get back to the normalcy of life in New Britain. On some level I still felt like I had caused a brain to herniate and a wife to be doubly distressed.

One month later I received a letter forwarded to me by my preceptor. It was from the young wife who had just buried her husband. She wrote to thank me for talking to her husband. He really did enjoy my company and conversation. She said that before my visit she did not realize how sick he was or that his death was a near term possibility. She said that my breaching the topic of death in some way prepared her and allowed her to project her built up anger, frustration and fear onto me. I don’t think she apologized for anything. She wished me luck and encouraged me to keep talking to my patients.

I said it already—you don’t always learn what you set out to learn. Sometimes the person you are caring for isn’t even your patient. Sometimes the things you learn are about yourself.

Get Up, Stand Up

2011-02-16T22:42:00.002-05:00

Valentine’s Day plus two finds me sitting at home in my chair soaked in the early morning sunshine that enters through the blinds left open by my wife to prevent me from drifting downward into a wintery withdrawal. Her intentions are good, but this American Jew is of Russian descent and enjoys the embrace of a long, cold, snowy winter. Imagine Zhivago at his desk in Varykino. This is exactly what I need, nature slowing my pace, touching me with a bit of sadness that when bathed in sunlight awakens my poetic muse.

Zhivago wrote love poems to his mistress, Lara, in the isolation of his wife’s country estate as a revolution ravaged his country. He is portrayed as a healer, lover and poet in sharp contrast to Lara’s husband who is a central figure in the revolution, a man of action and ruthless cruelty. Two other characters in the movie, portrayed by no less that Rod Steiger and Alec Guinness, show us different paths to take in life. One is corrupt, lustful and selfish. The other is quiet, reads others well and somehow comes out of chaos in a position of authority. Which one do I want to be today?

You say you want a revolution

Well, you know

We all want to change the world.

That was John Lennon’s view on things. Even two days after February 14th he would never leave us with “just another silly love song”. Thirty years after his death I remember his irreverence, his self-destructive years with acid, his using music as a tool of rebellion and his transformation into a man who stayed at home, cared for his son and asked us to “imagine all the people living life in peace”. He was an artist, not a fighter. Still, he inspired a cultural revolution. I wonder if ever, before his untimely end, he thought it was worth the tumult along the way or the risk (that he in fact predicted) to his own life. For the rest of us “life goes on”. Is revolution really worth the risks? My chair at home sure is soft and comfortable.

We’ve all been witnessing a revolution in the Middle East. I see the crowds of young people in Cairo’s central square and I am awed by their courage. I don’t think I would be so brave. As I watch TV I remember similar images from the 60s of American college students protesting the Viet Nam war. In that same era we marched and sat in to fight against racial inequality. We fought to abolish slavery in the Civil War losing more lives than in any other war. “Four score and seven years” before we rebelled against a foreign dictator and created a nation “conceived in liberty and dedicated to the proposition that all men are created equal”. Our nation was born thanks to the courage of a bunch of rebels. And to our credit, in every generation since, we’ve reawakened that spirit to put ourselves back on course to being a nation of freedom and equality. I say we but I am no Strelnikov. The 60s are now half a century ago. I wonder if my generation of Americans and I have become too comfortable to even recognize a cause that merits our attention and sacrifice.

This very thought has been bothering me and sitting in my subconscious as a slowly simmering blog for the past few months. It started when I listened to the lyrics of a popular John Mayer song, “Waiting on the World to Change”

     Now we see everything that's going wrong
     With the world and those who lead it
     We just feel like we don't have the means
     To rise above and beat it

     So we keep waiting
     Waiting on the world to change
     We keep on waiting
     Waiting on the world to change

He goes on to say that someday his generation is “gonna rule the population”. I felt like telling him that if he and his generation “keep on waiting”, someone else, maybe those courageous Egyptians, or well educated Chinese or enterprising Indians are going to be in charge, not him. But me in my chair, who am I to tell him anything. Don’t I share responsibility for my generation’s legacy, Enron and Iraq?

Then something happened that made me look at America’s younger generation in a new and much more positive light. A nine year old girl was shot dead in Arizona. She had been elected to her school’s student council and went to see her Congresswoman speak to learn more about government. Her death was tragic. Yet, somehow, I felt hopeful. I was confident that she was not the only nine year old out there with the drive to learn the principles that have guided us, and to fight to help us keep them strong. “You may say that I’m a dreamer, but I’m not the only one.” Christina-Taylor Green, five others in Arizona and thousands worldwide cannot have died in vain. We need to make sure of that. Whether by voting, singing, writing, marching, teaching, donating…whatever works for you, but not just waiting for the world to change. Time for me to switch to Reggae and Jimmy Cliff, and “get up, stand up” from this all too cushy chair. Who’s with me?

Getting Old (Lang Syne)

2010-12-29T16:06:00.001-05:00

I mean, 'Should old acquaintance be forgot?' Does that mean that we should forget old acquaintances, or does it mean if we happened to forget them, we should remember them, which is not possible because we already forgot?

So said Harry, Billy Crystal, in the closing scene of “When Harry Met Sally” with Auld Lang Syne playing in the background. After years of acquaintance involving on and off animosity, chance meetings, friendship and once awkward sex, he and Sally finally discovered and expressed their love for each other. They are by no means the only couple to get together many years after meeting in their teens. No big deal, but still, I’ve been wondering. What is it that makes us in our later years want to get back together with friends and lovers from high school and college?

The impetus for my musing was a phone call that I received last month from Karin, a Swedish woman who 45 years ago spent a year with my family as our au pair. She called from Stockholm and said that she wanted to see us when she visited New York for Christmas. The call came out of the blue and caught me totally off guard. 45 years ago I was ten years old. She was 19. To me, she was a nice memory. She was cute with many boyfriends, strawberry blond hair and more energy in the dead of winter than I’d ever seen, but still, just one in a series of women who helped take care of me and my four brothers. For her, it must have been different. We were her formative year. She went from being a schoolgirl in a cold family in a cold country to an independent woman in a houseful of adoring boys in a land of freedom and opportunity. When she left us she became a Pan Am stewardess, flew the world, married, divorced, got ill, got better, wrote a book. Now she teaches yoga and writes a yoga-nutrition column. And for some reason, she wants to see us.

Should old acquaintance be forgot? For Karin, the answer is no. She had the courage to make a new life for herself at 19. The idea of getting together with us probably helped her see herself again as a young, beautiful, spirited woman. Romanticizing our youth, nostalgia, that’s one reason to rekindle a relationship “old long since” as auld lang syne translates to from Robert Burns’ Scottish.

“Psychology Today” describes what I’ll call the auld lang syne phenomenon as a reaction to our baby boomer lives in which we move from place to place and job to job in search of opportunity. They say at some point we “crave familiarity. Someone who laughs at the same jokes, understands the same quirks”. Someone who knew us when. Is that why divorced couples often remarry or why a high school reunion can reawaken a first love? Or is it more a reaction to getting old, feeling stuck, being unhappy? My guess is that at some age we get to feeling it’s now or never. For those not used to testing the waters, a familiar port is inviting and considerably less threatening than the open seas.

Hmmm…Now I’m not so sure. Maybe it would be better to let those old acquaintances stay in the past. Regression and infidelity hardly seem like good answers for unhappiness. As Burns wrote,

We two have paddled in the stream,

from morning sun till dine [dinner time] ;

But seas between us broad have roared

since auld lang syne.

What’s to say things would work out with an old flame? If things aren’t going well it makes better sense to concentrate on understanding and fixing what’s wrong in the present, not risking a tenuous present for a glorified past. What did we really know at 19 anyway? Not much, maybe, but everything sure was more intense.

The answer for Burns, one that we embrace in song every New Years Eve, is to share “a cup o’ kindness yet”. Kindness would be a euphemism for Scotch whiskey. I’m no Scot, but I’d say that he means more than just getting drunk together. With that drink we are to remember our past, recognize the “many a weary foot” we’ve wandered since and respect each other’s present life with a handshake, and no more, as a gesture of friendship.

Friends, if I have forgotten you over the past few years, please consider this an apology. I assure you, it was not willful and had nothing to do with Robert Burns or “Psychology Today”. Me and Billy, we should remember but we just forget. Blame it on advancing age and too much caffeine free Diet Coke. Those chemicals got to be bad for you. Call me and we can share a real cup o’ kindness, for auld lang syne.

Bow Wow Wow, You Pronounce It!

2010-11-29T20:59:00.000-05:00

Do you remember how hard it was as a child to keep a secret? I can't say that I do. I do, however, remember my children filled with excitement, running and bouncing and ready to burst as the secret they were holding inside expanded and finally exploded from their smiling lips. It's a beautiful thing to see. I was reminded of this sheer excitement and joy not by my children. The things that excite them these days are more likely to make me scratch my bald head in confusion or just bite my lip and hope for the best. No, it wasn't the kids. It was my mother.

She called me and my four brothers last month and said that she wanted to give a party on the Monday before Thanksgiving. She explained that she chose the date because four out of the five brothers and their wives could attend. She said that as we could not all see each other on Thanksgiving, a Monday dinner would allow us to celebrate the holiday, early, but at least together. She insisted on hosting us at a local restaurant and called the dinner her "Thanksgiving surprise".

I accepted, of course. I would miss seeing brother #five, his wife and two year old son who live in California, but would see my other brothers who usually spend this holiday with their wives' families. An early Thanksgiving, fine, but what was this surprise? I didn't ask. From her voice I could tell that it was something good. And something good from (sorry Mom) an 80+ year old, at least isn't something like a broken hip, or worse, the sort of surprise that I fear and almost expect. My first thought was that she and her 90+ year old beau, after ten years of dating, were going to announce their engagement. I kept this thought to myself and waited for the surprise day to come.

As it turns out, I didn't have to wait that long. My mother, in her excitement, just couldn't keep her secret bottled up. She told brother #5 who wasn't around to spill the beans. But then she let it slip again to bro #3, I'm guessing because it felt so good the first time and, anyway, the cat was already out of the bag. By the time she called me, she assumed I knew already that she had sold one of her cello bows and wanted to divide the quite generous proceeds among her five sons as a holiday gift.

The dinner was perfect and the gift will be well spent. It's hard to imagine that a cello bow could be so valuable. Yet, I would be happier if my mother could still hold that bow in her now arthritic hand and play her cello. Some of you know the sound a cello makes in a concert hall but for me it was different. I was weaned on its songs in the resonant enclosure of my parents' study. I grew up listening to that sonorous alto voice every day of my childhood. It is the voice of the depths of emotion, of sadness and tears. Listen to any movie soundtrack and you'll find that whenever they want you to cry, they bring on the cellos. Its lower register is the moan. Its upper notes are the wail. Bowed in long strokes it is Saint Saens' graceful "Swan" gliding down a still lake in France:

http://www.youtube.com/watch?v=zNbXuFBjncw&feature=related

Bowed in rapid bursts it is Rimsky-Korsakov's "The Flight of the Bumblebee":

http://www.youtube.com/watch?v=g5GkX70hrzo&feature=related

My mother was a professional musician. She played in orchestras and taught college courses. She played quartets in the house. Rarely, she took on a student. Mostly, she practiced. And practiced and practiced. She says that growing up she never had to be told to practice. As the young wife of a physician, her hours alone with her instrument brought her comfort. As the older mother of five sons they brought her peace. Once a year she would bring her cello into my school classroom and put the Swan and Bumblebee on display. Twenty years ago I saw a book lying on a table in my parent's den, "Learning to Bow". I thought for sure that it was an esoteric tome about cello technique. My mother got a good laugh when she explained that the book, by my brother's friend Bruce Feiler, was about his year teaching English in Japan and that in this case bow rhymed with wow. Bowing either way is not so easy and does, in fact, take a life to master.

In this holiday season permit me to paraphrase Bing Crosby from Irving Berlin's "White Christmas":

     What can you do with a cellist
     When she stops being a cellist?
     Oh, what can you do with
     A cellist who retires?

What a silly question. We're still following her wherever she wants to go... and doing our best to keep up! Now that's something to be thankful for.

Dance 10, Looks 3

2010-10-08T20:52:00.004-04:00

I was walking down Summer Street Wednesday evening and passed a series of downtown restaurants with patio seating. I got half way past the first one and did a bit of a double take as I became aware that at every table there were only women. Next patio, same demographic—20-40 year old women in twos, threes and fours, stylishly dressed, eating, drinking and talking with smiles and animation. It was as if dozens of Carries with their posses as in “Sex and the City” had moved to Stamford. I continued walking to Eos, the new Greek place, for takeout pitas and got to wondering, why all women and why Wednesday? Barbara met me at Eos, and as we waited for our sandwiches, the women kept coming. She noticed it too. Now, Wednesday was the day of the first Yankee playoff game against the Twins. That could account for the men not going out. And as, forgive me for generalizing, most women prefer female company to sitting in front of a TV watching baseball, we agreed that this Wednesday was a perfect date for a girl’s night out.

By now, I hope you’re wondering where I’m going with this. If I knew for sure, I’d have told you up front, but mostly, it’s that this women thing has been on my mind. It started last month when the New York Jets were criticized by the Association for Women in Sports Media for their lewd locker room remarks to Ines Sainz, a Spanish language female sportscaster. They wrote:

AWSM, the NFL and Jets have been in contact since Saturday evening regarding this situation. Both the NFL and Jets were responsive to our concerns and are investigating the matter. We are awaiting the results of the investigation and further action from the NFL and Jets. AWSM remains steadfast in its long-standing commitment to ensure all women in sports media are treated respectfully, equally and professionally while working in the locker room. We will remain on top of this situation.

The Blogosphere was all a-Twitter with talk of appropriate female dress in the workplace, sexual harassment, locker room behavior and mostly, Ms Sainz who really did look hot in her “painted on” blue jeans and lacy low-cut top. She defended herself by saying that she dressed the way she likes to dress and that her clothes were in her size. From her website pictures, it is clear that she is proud of her appearance, and as a TV personality, right or wrong, that appearance is an important asset. Val from “A Chorus Line” said it best:

Dance: ten; Looks; three.

And I'm still on unemployment,

Dancing for my own enjoyment.

That ain't it, kid. That ain't it, kid.

"Dance: ten; Looks; three,"

I’d like to die!

Left the theatre and

Called the doctor for

My appointment to buy...

Tits and ass.

Bought myself a fancy pair.

Tightened up the derriere.

Did the nose with it.

All that goes with it.

Tits and ass!

Had the bingo-bongos done.

Suddenly I'm getting nash'nal tours!

Tits and ass won't get you jobs

Unless they're yours.

Maybe not politically correct with the ASWM who would probably favor business suits and a brains 10, looks 3 attitude, but I’d say Ms Sainz and her bosses know their business and their audience well enough to make their own decisions. No one had ever heard of Sainz or TV Azteca before. Now they are, albeit fleetingly, front page news.

AWSM are hardly innocent in the Sainz affair. They, not Sainz, raised the stink and went after the Jets players and organization. They are also not above sexual innuendo with their outrageous concluding statement, “We will remain on top of this situation.” This form of aggressive feminism reminds me of the group of female students in my medical school class who sat together in the back row and hissed and booed whenever a professor offended their credo. They actually had a breast surgeon called to the dean’s office where he was forced to defend himself for his lecture in which he showed explicit pictures of breast pathology. The professor, like Sainz, was trying to be provocative. It’s hard to keep from being provoked, but the response to provocation is in our control and is a responsibility that we all share. It was right to remind the Jets how to behave in their locker room. A more gentle reminder would have been nice.

So back to Wednesday and Summer Street. Barbara asked if it bothered me to see all of those women out together without men. No it did not. I liked it. What’s not to like? Haven’t I mentioned in this column that I like women? And I like the idea of women getting together and enjoying each other’s company. It’s good. It’s healthy. We men sure aren’t solving any societal problems in front of our TVs or at the poker table. Maybe the women are figuring it out for us. No, not on their Wednesday night out. No matter. They looked happy and that’s enough. If we’re all a bit happier, Mars and Venus won’t seem so far apart.

Oh Boy, New Math!

2010-07-27T23:35:00.003-04:00

I’d like to continue the theme from my last blog about comedians and their role in bringing us the news, albeit with a certain slant. But first humor me with a brief departure, still in the realm of popular culture, to this season’s premier of TV’s Mad Men. In this episode the creative director of a new, breakaway advertising firm blows an opportunity to promote his company in a magazine interview. When he defends himself before his board by saying that his work speaks for itself, he is told, “turning creative success into business is your work and you failed”. I took this harsh criticism personally and wondered if by writing a blog “with no agenda”, I am in essence failing. Samuel Johnson, a great writer and a man of many quotes said, “No man but a blockhead ever wrote except for money”. To me, unlike to admen and pundits, it’s not that black and white. Admen love to force us into clear cut choices, their brand or brand X. One of the best ad campaigns ever, the one in the 70s for Miller Lite, took two choices and pointed them both to their product: “Tastes great…Less filling”. It was a heads I win, tails you lose angle that caught on and led to America’s acceptance of light beer. Interestingly, the advertising firm responsible for the campaign, McCann Erickson, was also the firm that, in Mad Men, made the hostile takeover at the end of last season. No takeovers here. I plan to keep writing without monetizing or expecting anything in return except your (mostly) kind comments.

In 1964 David Frost imported a comic news hour from England, That Was The Week That Was. Despite a solid core group of comics plus guests such as Woody Allen, Steve Allen, Bill Cosby, Mike Nichols and Elaine May, the show only lasted one year. Instead of using skits as SNL would later do, TW3, as it was called, used songs to comment on current events. The main songwriter was a Harvard graduate and math instructor, Tom Lehrer. He got his start as an undergraduate where he wrote “Fight Fiercely, Harvard”. He entertained classmates, performed at clubs, eventually recorded an LP and had 300 made for sale around Harvard. (This was just like Bert and I at Yale. See 11/09 blog, Cay-ent Get They-uh From He-uh.) In 1955 he was drafted and served two years at the NSA. His big contribution to army cryptography was the invention of Jell-o shots. He continued his songwriting and performing but never gave up his day job. His songs were clever, in the vein of Cole Porter or Yip Harburg. When he heard that TW3 was looking for songs he wrote one for National Brotherhood Week:

Oh, the white folks hate the black folks,

And the black folks hate the white folks.

To hate all but the right folks

Is an old established rule.

The TW3 regulars performed this song and 8 others including his best known "New Math":

http://www.youtube.com/watch?v=mNCUuh8_VhE

When TW3 ended, Lehrer was left with enough proven songs to make a second album, That Was The Year that Was. This was released by a major label, promoted nationwide including appearances on the Tonight Show, and made it into the Benjamin household where it joined Allan Shermans’ My Son The Folk Singer and Nut in our collection of comedy albums.

Though both Lehrer and Sherman sang funny songs, they were very different. While Lehrer was clever and precise, Sherman was Hamish and a bit of a slob. He was an LA TV producer who wrote humorous lyrics to popular tunes and performed them for his friends. He lived next door to Harpo Marx, whose friend George Burns heard Sherman’s songs and got him a record contract. His themes were those of 1960s American Jewry. His first album, My Son The Folk Singer, parodied our imperfect assimilation into American society where we retained our old world speech patterns, strong family ties, boorish manners and thrifty ways:

Shake hands with your Uncle Max, my boy

And here is your sister Shirl

And here is your cousin Isabel

That's Irving's oldest girl

And you remember the Tishman twins

Gerald and Jerome

We all came out to greet you

And to wish you welcome home

The juxtaposition of these lyrics and Sherman’s accent with the melody of an old Irish tune was hysterical. It was pure side splitting shtick when he replaced “Meet Branigan, Fannigan, Milligan, Gilligan,Duffy, McCuffy, Malachy, Mahone,” etc. with

Meet…

Merowitz, Berowitz, Handelman, Schandelman

Sperber and Gerber and Steiner and Stone

Boskowitz, Lubowitz, Aaronson, Baronson,

Kleinman and Feinman and Freidman and Cohen.

His next album, with its hit song "Hello Muddah, Hello Fadduh" made him a star. Even JFK went around singing his songs. Sadly, he died at the age of 48, having too well assimilated into a life of overeating, smoking and booze.

So, what was it for me as a kid, Lehrer or Sherman? Yankees or Mets? Flintstones or Jetsons? Tastes Great or Less Filling? Vicki’s Manhattan or Marty’s Brooklyn? The answer? “Oh, Boy!” I liked them all. That was the real new math, “So very simple, That only a child can do it!”

You Can't Beat That

2010-07-21T12:01:00.002-04:00

Chevy Chase spoke last week at a 25th anniversary screening of his movie Fletch. During the movie, he sat with the audience, squirmed in his seat, made uncomfortable faces and tried his best to show his discomfort with the attention and exaggerated adulation given by the Avon Theater’s pretentious artsy audience. After the screening he owned up to not being an actor in the vein of Sean Penn or Robert DeNiro, and said that he just tried to be himself in his films, making wise cracks, improvising, falling down, basically doing the same things he had done from Elementary School to Saturday Night Live to get laughs. When an audience member stood up, mike in hand, and took five minutes to comment and finally ask a question, one whose only point was to show how knowledgeable and perceptive he was, Chevy was brilliant. He rolled his eyes, stuck his finger down his throat, hanged himself with his tie, and when the question finally came, answered it with a quick quip and moved on to the next question. It was a merciless strike at pomposity that made us all smile. It reminded me first of Woody Allen’s coup with Marshall McLuhan in Annie Hall:

http://www.youtube.com/watch?v=bBtXfBdEXEs

It reminded me second of why I like Chevy Chase. It’s not because he’s a great actor. In every one of his movies, all lightweight comedies, someone else was always funnier. Sure, he’s a comedian, but more for falling down (his classic SNL parody of Gerald Ford) and smirking than for quickness and wit. Though many thought he’d inherit Johnny Carson’s job as host on the Tonight Show, Johnny said of Chase, "He couldn't ad lib a fart at a baked bean dinner". Johnny missed the point. Chevy was surrounded by the best ad libbers ever. He was hired as SNL’s head writer for the likes of John Belushi, Gilda Radner and Bill Murray. He played straight man for Richard Pryor in a racially charged skit that included the N word and ended with a bug-eyed, boiling over Pryor hissing, “Dead Honky”:

http://www.youtube.com/watch?v=Bl9I7IUFKu4&feature=related

YouTube won’t even show the original. It’s too hot. Chevy never had to be the funniest guy on stage and never could. And he never tried to be. We liked him because he was willing to be the tag along, second fiddle, prat-falling straight guy. His line, “I’m Chevy Chase and you’re not” wasn’t directed at Belushi, it was aimed straight at us. He was the dumb schmuck lucky enough to be up there on stage with greatness. He was one of us. While Belushi and Pryor have crashed and burned, Chase has grayed, gained some weight and rolled back onto TV for NBC in some sit-com that I’ll likely never see.

If Chevy was great in any comedic role, it was as host of SNL’s Weekend Update. In the tradition of Laugh-In’s Look at the News, he satirized the week’s news stories. Even better, Update introduced editorial comments from the likes of Roseanne Roseannadanna, Emily Litella (“Never mind.”), John Belushi (”But nooooo...”) and many other cast members and guests. When Jane Curtin took over Chevy’s role in 1976, she added Point/Counterpoint which immortalized her as everyone’s favorite “ignorant slut”.

News today is even worse than in 1976 and it is not surprising that most of our 16 to 30 year olds get it from Jon Stewart’s Daily Show. Despite being a comedian, Stewart has been voted our most admired and trusted news anchor. He has a keen nose for political hypocrisy and probably invented the technique of using video clips to catch politicians making blatantly contradictory statements. He, like Chevy, says nothing and instead, rolls his eyes to make his point. He lacks Chevy’s physical presence. He is short, slim and a bit of a Nebbish. Of course, it follows that he is a Mets fan. While Chevy is a New York blue blood, descended from the Mayflower, Stewart, nee Leibowitz, grew up in New Jersey, proposed to his wife in a crossword puzzle, at times sucks up to guests and has socialist leanings. His gift, more than his razor sharp wit or his willingness to let his righteous anger show on stage, is his heart. After 9/11 he showed that heart at a time when he knew we were not ready for comedy:

The view... from my apartment... was the World Trade Center... and now it's gone, and they attacked it. This symbol of American ingenuity, and strength, and labor, and imagination and commerce, and it is gone. But you know what the view is now? The Statue of Liberty. The view from the South of Manhattan is now the Statue of Liberty. You can't beat that.

No argument here. I’m happy my kids get their news from Stewart. As Chevy would say, “Good night and have a pleasant tomorrow”.

Amazing Grace

2010-06-06T13:31:00.003-04:00

Armando Galarraga, a fourth year pitcher for baseball’s Detroit Tigers, was robbed of a perfect game last week by an umpire’s bad call at first base. Galarraga was one out away from being only the 21st pitcher in baseball history to pitch to and get out 27 batters in a row when the umpire called a man safe at first. Instant replay, not allowed under these circumstances in Major League Baseball, clearly showed the batter to be out. The umpire later admitted that he had made a terrible call. In the heat of the moment, Galarraga, a 28 year old Venezuelan, smiled, waited for his manager’s confrontation with the umpire to end, went back to the pitcher’s mound and calmly got the last out. In post-game interviews, he said that he held no animosity toward the umpire because umpires are human and like us all, make mistakes.

In the hundreds of media commentaries that followed this imperfect perfect game, the word most often used to describe Galarraga was grace. The word seemed to fit, but the more I thought about it, the more I wasn’t sure exactly what it meant. I understand graceful. That’s a big reason why I like watching sports…the play of a shortstop can be as beautiful, graceful as the moves of a ballerina. But grace is not graceful. Grace carries with it strong Christian overtones that I, as a Jew, just did not have ingrained in me as part of my upbringing. As Alexander Pope said, “To err is human; to forgive divine”. Were baseball’s pundits comparing Galarraga to God?

I went to the dictionary and looked up grace:

elegance or beauty of form, manner, motion, or action.
a pleasing or attractive quality or endowment.
favor or good will.
a manifestation of favor, esp. by a superior: It was only through the dean's grace that I wasn't expelled from school.
mercy; clemency; pardon: an act of grace.
favor shown in granting a delay or temporary immunity.
an allowance of time after a debt or bill has become payable granted to the debtor before suit can be brought against him or her or a penalty applied: The life insurance premium is due today, but we have 31 days' grace before the policy lapses. Compare grace period.
Theology.

the freely given, unmerited favor and love of god.
the influence or spirit of God operating in humans to regenerate or strengthen them.
a virtue or excellence of divine origin: the Christian graces.
Also called state of grace. the condition of being in God's favor or one of the elect.

moral strength: the grace to perform a duty.
a short prayer before or after a meal, in which a blessing is asked and thanks are given.
(usually initial capital letter) a formal title used in addressing or mentioning a duke, duchess, or archbishop, and formerly also a sovereign (usually prec. by your, his, etc.).
Graces, Classical Mythology. the goddesses of beauty, daughters of Zeus and Eurynome, worshiped in Greece as the Charities and in Rome as the Gratiae.
Music. grace note.

With the help of dictionary.com, especially the second and third bullets under 8 above, it becomes clear that when a human is severely wronged and is able to smile, remain calm, not attack his offender, finish the job at hand and then forgive, many of us see the inner beauty as coming from God. Maybe it does. Aren’t we all made in God’s image? If so, image is not enough. Go ask Serena, John McEnroe or that Pakistani squash player from my February “Schwing!” blog. They showed anything but grace in their outrageous court behaviors. Galarraga not only had grace, he had grace under fire. For some, like Gandhi or Martin Luther King, that quality did come from a spiritual strength. I know nothing about Galarraga’s faith. To me, he just seems like a happy guy. For some reason, Venezuelans are, by World Value Survey, among the happiest people in the world. I think that one cannot have grace under fire without an inner peace, whether from religion, spirituality, a Caribbean “don’t worry, be happy” mentality or even Prozac. No matter…Galarraga’s perfect game with its asterisk is more perfect than any other because of his grace.

“The weak can never forgive. Forgiveness is an attribute of the strong.” Gandhi

"We must develop and maintain the capacity to forgive. He who is devoid of the power to forgive is devoid of the power to love." Martin Luther King, Jr.

“When I was a kid I used to pray every night for a new bicycle. Then I realized that the Lord doesn't work that way so I stole one and asked Him to forgive me.” Emo Philips

A Parent's Blessing

2010-05-16T11:26:00.001-04:00

Graduation season is upon us in the Benjamin family. It’s a season full of so many thoughts and emotions, it’s hard to sort them all out, let alone make any sense of them. And that’s just for me, a proud parent, one slowly, reluctantly, resignedly further loosening the ties and hoping the prodigal daughter will find her way in life.

Dustin Hoffman was The Graduate, and coincidently, was also a Benjamin. The idea for this blog post came to me last month as I watched The Graduate on television. Hoffman’s Benjamin character, in the movie’s defining moment, burst out of his car and ran in the drenching rain away from Mrs. Robinson, to her daughter Elaine to tell her about his affair with her mother. As Benjamin leaves the screaming and hysterical Elaine, Mrs. Robinson, physically diminished, cowering in the hallway with dripping hair and running mascara verbally rises to put the knife into his emotional wounds with a cruel, victorious “Goodbye Benjamin”.

I wasn’t afraid for Benjamin. I’ve seen the movie at least 20 times and know that he recovers from this trauma, finally sees a future for himself, goes for it and gets the girl in the end. Like any parent, I did give a thought or two about how the graduate got himself into such a mess. On a completely different level, I recognized the brilliance of Mike Nichols, specifically the movie’s water imagery. The cleansing rain, the womb-like depths of Benjamin’s suburban swimming pool, the naked exposure of the opening scene’s fish in their tank. No doubt about it, The Graduate is a great movie, one of the best ever. When my mind stopped wandering, I was left with one thought: What is it to be a Benjamin?

Clearly, you can’t dismiss us with a “Goodbye”. We’ll take that as a challenge and end up with the girl and the last laugh. Is our attitude that it’s All About the Benjamins? I don’t think so (though some wives and in-laws may disagree). I never even saw that movie. Having a couple Benjamins in your pocket is a good thing, but for us, it’s not about the money. We are a tribe, descended from the youngest son of Jacob and his most beloved wife Rachel.

Benjamin was originally named Ben-oni, “the son of my sorrow” as Rachel died giving birth to him. Jacob renamed him “the son of the right” which most interpret as meaning strong and virtuous, as in right hand man. Benjamin was a full brother to Joseph who’s other brothers sold him into slavery and who went on to be advisor to the king of Egypt. Benjamin was held captive by Joseph and used to trick Jacob into coming to Egypt. When Jacob died he blessed each of his sons. His blessing for Benjamin was, “Benjamin is a ravening wolf, in the morning he devours the prey, in the evening he snatches a share of the spoil” (Genesis 49:27). This was a blessing, not a curse. Benjamin went on to live a life that was so blessed that it is said he was one of only four men in eternity to die without sin. There’s good in being strong, self-sufficient, self-sustaining and grabbing for what you feel is rightly yours. Yeah, that sounds like a Benjamin.

Wolves are not always loners, and as I said above, we are members of a tribe. The tribal mentality carries with it the connotation of fierce loyalty. The tribe of Benjamin was attacked and almost completely wiped out by the other eleven tribes in Biblical times when they refused to surrender a group of rapists and murderers to justice. 600 Benjamins survived and took wives from the other tribes. They went on to give birth to the first king of Israel, Saul, who was a Benjamin. Mordachi and Esther were Benjamins. In the Bible it says we taught our sons to fight left handed in order to have an edge in battle. We are strong, selfish, clever, insanely loyal and enduring.

So, graduate Benjamins, in conclusion, I leave you with a word. No, it’s not “Plastics”. Had Benjamin taken that advice he’d only have had a job. I said it already. It’s not about the money. The word is family. We gave birth to you. We raised you. We taught you tricks to get ahead. We are in your DNA. We will fiercely defend you. We will let go and know you will sustain yourself and grab for your share. Go with our blessing. Find out what makes you laugh out loud like Benjamin and Elaine in the back of that city bus. Your happiness is our happiness. That is family.

A Doctor's Week

2010-03-21T20:30:00.002-04:00

I had a good week at work this past week. In the world of medicine, that’s a rarity these days. Not that I don’t feel good about what I do. As a physician, not a day goes by when I don’t help someone. I earn a good income and feel good about providing well for my family. I exercise my mind with diagnostic challenges and do endoscopic procedures that, like any good video game, are still fun after 25 years. Sadly, the meddling of insurance companies and government and the poor state of our economy have combined to ruin the doctor patient relationship. When caring and trust are replaced by indifference and mutual mistrust, practicing medicine is like any unpleasant job where you are just happy to have the week end.

My week ended with a funeral. I don’t normally attend patients’ funerals. As a specialist, I don’t usually form close, long-term relationships with my patients. I see them once and maybe again 5-10 years later. Also, if there’s a funeral, someone, including me, is going to think that if the patient’s dead, the doctor is somehow to blame. When I was ready to back out on attending this funeral, Barbara reminded me that even though I only knew the woman for one month, I have known the family for many years. She says funerals are for the family. I went to high school with one of her sons in law and have stayed friends over the years. I have seen his family grow, and have gotten to know and like his wife and her family in a hello at poolside kind of way. I never met her mother until she arrived from Florida and ended up in the Stamford Hospital ER with GI bleeding. I was consulted to diagnose and treat the bleeding, but once I read the medical reports the family brought up from Florida, I knew that the bleeding was only one manifestation of a widespread, rapidly growing and soon to be fatal malignancy. Over the next month I helped the patient, a retired nurse, and her family anticipate, understand and deal with issues such as nutrition and pain control. When other physicians promoted aggressive therapies, I made sure the patient and family stayed focused on realistic expectations and goals. When I made a house call last week I sensed a calm sadness in the patient that was mirrored in her two daughters. I was not surprised that she passed a few days later. I was surprised, though, to receive the news in a tearful bedside phone call from her daughters and husband. They called to thank me for my medical expertise and human kindness. They thanked me again at the funeral, the husband with a very public bear hug and a card that he put in my pocket. It was good to see a family so full of love, to know that I helped them and to be recognized and thanked for what I do.

Usually there’s no love and no thanks. It’s up to me to know I do it well and do it right. Earlier this week I did not give into pressure from a hospital internist and oncologist and refused to surgically put a feeding tube into the stomach of a terminal esophageal cancer patient. His problem wasn’t that he couldn’t eat; his esophagus was kept open by a stent. He was just in too much pain from a spine that had been replaced by tumor. I felt good about recommending high dose pain medication and Hospice care.

Midweek I refused to prescribe a new medication over the phone to a patient who I hadn’t seen in a year, who had stiffed me for her copay, who said she was out of work and couldn’t afford to see me, whose insurance wouldn’t pay for her old medication and who needed medication “now!” because she was going on vacation. I got her to come into the office, pay her year old copay and make an appointment. In return, my secretary gave her samples of her old medication to last her a week. I’ll likely never see her again, but got a kick out of her chutzpah and 20 bucks to boot.

At the end of the week I performed a difficult colonoscopy on a bleeding 73 year old, located and stopped his bleeding and saved him from having half of his colon removed. Despite being a working professional, he had little insight before or after as to the significance of his bleeding. He expressed no gratitude afterwards, only irritation that I had him admitted to the hospital for observation. Still, I know that I did good.

Some career choice, huh? And that’s what I call a good week! No regrets. I like what I do. So, can someone out there tell me how we got into this healthcare mess? Let’s talk about it sometime, say over a game of tennis. I like the weekends too.

Schwing!

2010-02-28T19:53:00.003-05:00

The Vancouver Olympics end today after the men’s ice hockey finals this afternoon between Canada and the US. It’s been a wonderful two weeks for me with TV coverage on three different networks that I recorded on DVR, scanned at super fast forward and either viewed or erased. No ads, minimal fluff, no 10,000 K cross country skiing, but some amazing individual and team performances. To the credit of NBC, they kept the jingoism down, and though they are probably obliged to highlight the accomplishments of the US athletes, they gave plenty of time and credit to the host nation, Canada. There were two bits of fluff that I actually liked. The first told the story of Gander, the small town in Newfoundland that on 9/11/2001 took in all of the passengers from US bound flights that were diverted to eastern Canada when US airspace was closed down. The 10,000 citizens of Gander took in 7,000 passengers and crew, housed them, fed them, gave them emotional support and accepted no money in return.

The second was a piece on Canada’s many outstanding comedians. There’s Mike Myers, John Candy, Jim Carrey, the first for me; Dan Aykroyd, and loads more. Some say that the long Canadian winters induce a form of insanity that produces comedians. Others theorize that it’s the authoritative society that creates rebels that fight back with humor. I don’t buy that one. How many really funny people come out of Switzerland? Part of the answer, at least since 1977, is Lorne Michaels, the founder and producer of Saturday Night Live. He is from Toronto and no doubt sought to promote the careers of fellow Canadians. He didn’t make Rick Moranis and Eugene Levy funny but he did give them a forum for the development and broadcasting of their talents.

Despite the Olympics and all the hype surrounding it, the biggest sports story for me in the past two weeks came right out of New Haven, CT. The US collegiate team squash finals took place in a match between Trinity College and Yale. Trinity, the number 1 team in the US for the past 12 years, was led by senior, Baset Chaudhry, a 6’5’’ player from Lahore, Pakistan. Yale’s top player was a 5’8” freshman from Singapore, Kenneth Chan. Chaudhry has been the best player in the US for the past three years. He was undefeated this year and beat Chan handily in their previous meeting. According to his coach, he is an excellent student and a popular figure on campus. His parents came from Pakistan and were in New Haven to see his last team match. At the end of the match, which Chaudhry won in straight sets, he had a Serena-esque meltdown in which he physically confronted and verbally attacked his defeated opponent. The outburst was caught on tape and featured on ESPN’s Sports Center:

http://sports.espn.go.com/ncaa/news/story?id=4949438

The ESPN piece was presented by Merril Hoge, an ex-NFL running back, cancer survivor and motivational speaker. Hoge presented the frightening incident with a smirk and joked about the towering Chaudhry’s intimidation of Chan. As his co-commentators chuckled in the background, he quickly and condescendingly explained away the game of squash, and then went on to talk about buttocks seals and verbal spraying. The only reason the sport of squash received any national coverage was because one of its top players acted badly, one might say like a football player. Whereas antisocial behaviors such as fighting and trash talking are condoned or encouraged in many sports, they are not a part of squash which actually has Ethics Guidelines. To his credit, Chaudhry, once past the heat of battle, apologized to every team and coach in collegiate squash and ultimately punished himself by withdrawing from the national individual tournament, giving up his last chance to defend his two time championship. ESPN did not report this in follow-up.

Merril Hoge may see himself as a motivator who can help us “Find a Way” in life, but he and ESPN missed the boat on this one. We need to decide as a nation if the way to success includes behaviors that injure others and whether such behaviors such as drug use, bullying, trash talking, robbery, rape and murder are excusable in those who have achieved great success. Maybe we should just be a bit Canadian, include good deeds in our definition of success and learn to tell a good joke. Schwing!

I’ll Bring the Kleenex

2010-02-14T21:01:00.004-05:00

I hope you readers took the time to view the last YouTube clip in my “What a Dog” blog. It showed the ingénue, Cameron Diaz, in the role of a nightclub performer who dropped men’s jaws and induced howls and whistles. An actress only gets to be an ingénue once, and Cameron made the most of it. I tried to divert your attention from her clinging, shimmering gold sequined dress to the sexily dubbed singing voice, but once she let her fingers play down the right side of that dress, who could notice the voice? Perhaps ingénue is not the correct word as it implies naiveté and innocence more than newness to acting. Lauren Bacall, 50 years earlier, was a similarly sultry ingénue in her first role as Slim in “To Have and Have Not”. She even taught her man, Humphrey Bogart, how to whistle:

You know you don't have to act with me, Steve. You don't have to say anything, and you don't have to do anything. Not a thing. Oh, maybe just whistle. You know how to whistle, don't you, Steve? You just put your lips together and... blow.

Diaz and Miss Bacall had similar beginnings. Cameron left the beaches of Southern California at the age of 16, signed on with an agency and spent the next five years as an international model. Bacall began modeling in New York City at the age of 17. She appeared on the cover of Harper’s Bazaar, was noticed by director Howard Hawk’s wife Nancy, was invited to Hollywood for a screen test and the rest is history. Nancy Hawk helped her develop her style in clothes and her trademark seductively low voice. Miss Bacall lured Humphrey Bogart from his wife all on her own.

Cameron went from temptress in The Mask to angel in the Charlie’s Angels movies. She played a ditzy blond on screen and began to play the potty mouthed bad girl off screen and in the Tabloids. I’m sure for her it seemed the right move, but can a woman who used Ben Stiller’s semen as hair mousse (Something About Mary) ever be taken as a serious actress? To her credit, when she doesn’t have to appear in a film, she does a great job. She is a perfect Princess Fiona in the Shrek movies. Sweetness with an edge, and a tolerance for us donkeys.

In my house, Cameron Diaz is best known for one of her lines from Charlie’s Angels, “I love tickets”, which she delivered in response to a potential suitor’s line, “I’ll get tickets”. Though endlessly repeating movie lines is a decidedly male annoyance, even the women in my family will almost smile when I respond, “I love tickets”. And I do, both repeat the line and love tickets. Have you noticed that many of my blogs make references to movies?

Some of my love of the movies is genetic. My father grew up in the pre-TV era and would spend all afternoon Saturdays at the movies for a quarter. The Brooklyn theaters would have serials, Flash Gordon and the like, newsreels, a double feature and contests with prizes for the kids. My maternal grandfather, Julius Davis, loved movies and would laugh and weep audibly, a strange sight for a ten year old me to witness in a public Manhattan theater. My grandmother Florence, who was a very controlling and in control woman, explained that he cried because he had strong emotions that just came out at the movies. Their's was an old world marriage. He practiced medicine, sat in his chair and read newspapers and journals. She managed the home, help, children, social calendar, vacations…basically everything and everyone else. She was always very protective of him. We had to be quiet during his daily nap. We couldn’t sit in his chair. My aunt Dorothy wouldn’t eat lox because my grandparents threatened to put locks on the door if she kept going into my grandfather’s office. After his second heart attack Florence stayed home with him for three months. When she finally thought he was well enough to be home without her, she went out to join her sisters for their weekly card game. He was not home when she returned. A panic followed. The police found him that night in a city hospital morgue. He had been found dead in the back row of a Broadway movie theater. We’ll never know the whole story. No doubt he took advantage of my grandmother’s afternoon out to take a walk on a beautiful summer day. One possible scenario: he developed chest pain and ducked into an air conditioned movie theater to sit down and rest. A second scenario: he liked movies but the one he chose was too much for his weak heart. Either way, he died in a place where his feelings could be freely and openly expressed. I express mine there too. Join me sometime. You can buy the popcorn. I’ll bring the Kleenex.

What a Dog

2010-01-31T19:13:00.000-05:00

Have I mentioned that I like to sing in the shower? Perhaps not. It’s not something I tell everyone. It used to embarrass my kids. They’d insist that there be at least 3 closed doors between my shower and their ears. A lot of good that did—they both know my whole repertoire, down to the third verses. Shower acoustics make all of our voices echo with a resonance that most of us can’t create with our limited breath support and vocal skills. The humidity helps too, along with the hot water that relaxes tense muscles, and the privacy and nudity that disinhibit and free us to experiment and let loose. So what, you say. We all sing in the shower. Granted, but you don’t sing what I sing, and I’d like to share some of that music with you. Relax; I am not extending 6:30 AM invites to anyone. You don’t have to listen to me either. Just take some time to check out the real singers on YouTube using the links below. Smiles and surprises, I promise.

Miss Peggy Lee was born in 1920 in North Dakota. From small town radio to Hollywood clubs, she made it to Benny Goodman’s big band as his featured vocalist. She acted, wrote music and lyrics and continued to perform into her 70s. She has been compared to The Great Gatsby’s Daily Buchanan; “she brings others close to her with the softness of her voice. There’s a creamy warmth to the tone of her voice that gives it a sensually conspiratorial quality”. (Discovering Great Singers of Classic Pop By Roy Hemming and David Hajdu; Newmarket Press, 1991). For me, her voice is cream, honey and sex. Everyone has covered her seminal Fever, including me in the shower. I like to deliver the line, “Julie, baby, you’re my flame”, in a voice that’s a mix of Charlie the Tuna and Andrew Dyce Clay. He’s a Tramp from Disney’s Lady and the Tramp is another of my Peggy Lee songs. She wrote the lyrics and was the voice of that bushy tailed junkyard vixen who made all the male dogs howl (don’t miss the link below). I change “He’s” to She’s and “rover” to big tease. It works for me. She also wrote the Siamese Cat song and was the voice of both cats. I don’t do that one. I’m more of a dog guy.

Another Peggy Lee classic that I don’t do is Why Don't You Do Right (see link). As a guy, there are some songs that just don’t cross over, unless you’re willing to go Outrageous! (classic flick) and do the drag thing. I admit, I do sing Johnny Mathis’ When Sunny Gets Blue and Misty, but I still prefer Jessica Rabbit’s shape to Roger’s. Jessica, by the way, covered Why Don’t You Do Right (see link) vamping to a gape-jawed Bob Hoskins. My jaw dropped too when I discovered who gave Jessica her voice. Believe it or not, it was Amy Irving. She was, you may remember, the girl in Carrie, Yentyl, and Crossing Delancy. She also happened to be married to Steven Spielberg in 1988 when Who Framed Roger Rabbit was released. Spielberg founded Amblin Entertainment. Amblin made Roger Rabbit. I don’t think it was a coincidence that she got the job. And I am absolutely sure that Amy Irving sang in the shower. Not good enough, though. They divorced in 1989.

The last link is for those of you who prefer the real thing to cartoon characters. Cameron Diaz knocked everyone’s socks off in her film debut, The Mask. The body and moves are hers, but the voice belongs to Susan Boyd, a journeywoman singer and actor who you can see in reruns of Happy Days. The wolf in the audience is Jim Carrey who is a cartoon character with or without the celluloid.

Enough words. It’s time for you to get a taste of the Indomitable Miss Peggy Lee and Jessica/Amy/Cameron/Susan doing their thing. Then, if you really want to laugh, picture yours truly singing Miss Lee in the shower. “Fever ‘till you sizzle. What a lovely way to burn”.

http://www.youtube.com/watch?v=cO3hrVaVzP0&feature=related

http://www.youtube.com/watch?v=jdqvX-n25gs

http://www.youtube.com/watch?v=yy5THitqPBw&feature=related

http://www.youtube.com/watch?v=WfjuZVG4wGM&feature=related

With A Capital T

2010-01-18T17:10:00.003-05:00

I volunteered to give a Grand Rounds talk to the Stamford Hospital Medical Staff on a topic that is hot in Gastroenterology and has been bugging every GI doc in the US for the past year. The topic is the use of anti-acid Proton Pump Inhibitor medications (Prilosec, Nexium, Protonix, etc.) along with Plavix, a blood thinner that is used, among other things, to prevent clotting of coronary artery stents. Last year a French study said that PPIs could interfere with the anti-platelet effect of Plavix and possibly cause coronary stents to clot off leading to heart attacks and death. That single study, which was done in test tubes, not lab animals or people, was publicized by the news media, embraced by cardiologists and pharmacists, and has caused many doctors to have their patients stop taking PPIs. It has also caused many patients to stop taking PPIs on their own or at least question their Internist, Cardiologist and/or Gastroenterologist. Last November the FDA got into the act and now recommends against the use of both Prilosec and Nexium with Plavix.

I am in the process of deciding how to approach my talk and hope to use you, my readers and friends, as a sounding board to help me focus and organize my thoughts. Let me jump to the bottom line first. Although some PPIs do interfere with the activation of Plavix in the test tube, in real life prospective studies published in the past year, done on people, there has been no increase in heart attacks or death in those co-treated with PPIs and Plavix. The only increase in morbidity (bad stuff happening short of death) or mortality has been secondary to GI bleeding from stopping the PPI. PPIs have been proven to heal ulcers and protect against GI bleeding. If someone has an ulcer or some other GI lesion that could bleed, drugs like Plavix make the bleeding much more severe and difficult to stop. America’s foremost Cardiologist, Eugene Braunwald, the Harvard guy who writes the foremost Cardiology textbook, wrote a paper saying that we should not stop PPIs in our patients who are taking Plavix but rather get back to thinking about preventing GI bleeding. Still, I get calls daily about my patients being taken off PPIs because they have been told the whole class of drugs will cause them to have a stroke, heart attack or die.

Am I the only doctor reading the literature? No, I’m not. I’m going to try not to let my anger or frustration get in the way during my talk. The studies are out there and I’ll present them. That, however, is not enough for me. I’d like to open a discussion on how we doctors do or should respond to new medical studies, all of which these days appear in newspapers, TV news, talk shows and the like. Do we give in to mass hysteria? Do we wait for corroboration or expert opinion? Do we act based on how it affects our income?

Last spring I gave another Grand Rounds, along with a panel that included a cardiologist and hematologist, on the use of blood thinners in patients having GI endoscopic procedures. The PPI/Plavix issue had just started and I was asked for my opinion. What I said was that more study of the topic was needed, as in fact was recommended by the original study’s authors. In the interim, because of the serious question of stents clotting off, heart attacks and death, I said that it would be prudent to use another anti-acid medication if possible and to make sure if a PPI was to be used along with Plavix, that it was being used for a strong indication. Now, a year later I’d like to practice evidence based medicine and tell my patients not to stop their PPI even if they get a new stent and are put on Plavix. Unfortunately, with Cardiologists and Pharmacists, not to mention the FDA, still saying to stop the PPI, I can’t, without creating discord and setting myself up for potential litigation if a bad outcome would occur. I’m facing a tail wags the dog situation where the established untruth trumps evidence and expert opinion. That’s what I’d really like to talk about.

There are billions of healthcare dollars being spent on unproven procedures and treatments. Even when expert guidelines and recommendations exist (remember my mammography blog?), public opinion and inertia and fear and greed rule. I wonder how popular a theme that would be for grand rounds? Better, I guess, to be a team player, give the public what they want and let me and my colleagues keep selling you stuff you don’t understand and can't use—to use a Music Man analogy, expensive musical instruments that you teach yourselves to play by concentrating, Professor Harold Hill’s think system. Friends, we got trouble right here in River City. That’s Trouble with a capital T that rhymes with P and that stands for PPIs and Plavix.

Harold Hill: A man can't turn tail and run just because a little personal risk is involved. What did Shakespeare say? "Cowards die a thousand deaths, the brave man... only 500"?

http://www.youtube.com/watch?v=s60hOgqLFGg

2010, Looking Up

2009-12-24T20:30:00.004-05:00

“The best way to have a good idea is to have a lot of ideas.” This Linus Pauling quote was the solution to a recent New York Times Sunday crossword puzzle. I knew when I read it that it would be the inspiration for a blog, I just didn’t know what the blog would be about. As I set out now to write, I still am not entirely sure. You see, I am no genius. For whatever reason, I just don’t have as many ideas as Pauling, a Nobel Prize winner for Chemistry and Peace. Albert Einstein agreed with Pauling. He was passionate about imagination and said it was more important than knowledge. It was his ability to be persistent, and be willing to imagine and fail 99 times that allowed him to be recognized as a genius when, on his hundredth attempt, he succeeded. The more you read about Einstein, the more you’ve got to like him. My joke about sex at 60 is that I’m for it, but you should at least pull over to the side of the road first. Einstein said the same thing in a different way: “Any man who can drive safely while kissing a pretty girl is simply not giving the kiss the attention it deserves”. I wonder what the first 99 girls were thinking.

I do have some ideas. Usually, they come to me at 4 AM. To those of you who have been faithful to PinpointAnalysis, you may remember my Naybob Bobblehead doll. Now that was a great idea. Can’t you imagine how many parents would buy one with their face on it for their kids in college. I’m sure it would be a big seller, especially if it contained an audio chip with a recording of the parent’s voice, “No, no, no!” I’d follow it up with one for the college freshman to balance out the parental advice with some that spoke more to the id. For the guys, there’d be the YeaMeg doll. It’s head would bob in the yes direction only and the recorded voice would be Meg Ryan’s from the Deli scene in “When Harry Met Sally” (see link below). An orgasmic yes, yes, yes, yes would do it for me. For the ladies I’m still not sure. It would have to be a multidirectional bobblehead, one that could be pushed in any direction. I think I’d leave the audio chip out, you know, keep him strong and silent, or just plain dumb. There would have to be a changeable face option, Antonio Banderas one day, Brad Pitt the next. The problem is that it might be nice to leave out the face altogether, a la Xaviera Hollander’s zipless sexual encounter. I haven’t yet figured out how to make a bobblehead with no face and a tight ass.

Another idea of mine is the Backapplicator. This invention is a long rectangular shammy towel designed to allow sunbathers to apply suntan lotion to their own backs. Utilitarian and feels good too! Imagine kiosks at the beach where you could either buy a Backapplicator or lie down on a massage table and be lathered up like a shoe getting buffed. I’d start this one out in California.

With the New Year approaching some of us reflect on the year, or decade, that is ending. Others look forward to the year to come and make resolutions of all sorts. Einstein said that our main problem is that we have perfected our means to get things done but are confused in our aims. For those of you who are reflectors, I think you’d have to agree. I’m more of a look forwarder. This coming year I’m going to follow the advice of two great Americans, Satchel Paige and Pat Paulsen. Baseball legend Paige said, “Work like you don't need the money. Love like you've never been hurt. Dance like nobody's watching”. Paulsen never won a US presidential election despite trying six times. Still, I’ll aspire to follow his campaign slogan, “I've upped my standards. Now, up yours”. A very happy and healthy New Year to you all.

http://www.youtube.com/watch?v=F-bsf2x-aeE&feature=PlayList&p=0C96102F6BAD11D0&index=0&playnext=1

Falling Out Of Bed

2009-12-10T23:21:00.001-05:00

This blogging gets tougher as the days get shorter. The news media do not have the luxury of a warm den, a leather chair and a hi-def TV with cable and DVR to wallow in (like I do) as the season takes its toll on their affects. They must produce copy to meet their deadlines, deadlines that in the age beyond CNN no longer wait until five PM, but rather exist in real time, ever ready to shake, jolt and revolt us. I have no such constraints and I readily admit, my readers, that it has been two weeks since my last blog-fession.

We are in the midst of Tiger frenzy. A friend asked me to comment in my blog. Pinpoint Analysis is what he may have hoped for, but I’m thinking, these days that, like my brother Bill joked, my postings tends to be not at all analytic, a bit obtuse and written (who said it?) by a pinhead. What, me worry? Heck no. Here goes…

Hiding Tiger, Revealed Transgressions is nothing more than an ancient Greek tragedy. How the mighty have fallen and all of that. It’s Oedipus with his eyes out or the Emperor with no clothes. We elevate our modern heroes up on 90 million per year endorsement pedestals and delight in their falls. For some of America Tiger was more than a king or hero, he was a god. There was a website tigerisgod.com. Forgive me, but I can’t go on without playing the race card. Tiger was revenge. He beat the white guys at their game. He proved yet again, the physical superiority of blacks. He took the white guys' trophies, prize money, endorsement contracts and even their blond Viking goddess. For white America, he made us feel less racist. Corporate America showed us how colorblind they could be… when there’s profit to be made. They turned him into a billion dollar brand. No matter what bad consequences may come as a result of Tiger’s infidelity, if rich blacks, Asians, Jews and women can now be members in formerly white only clubs, I’d say Tiger did good. Without Tiger (and Oprah) there’s no way Obama would be President. They showed America’s power brokers that a black product could be packaged, sold, return a profit and inspire along the way. A shake up like this forces us to face the wide racial divide that still exists in America, and that is good too. Amid comparisons between Tiger and OJ, SNL skits and all of ESPN’s self-righteous pundits telling Tiger how to live his life, my favorite quote was from a black 20 something, who when interviewed on the street, said that he would never have voted for Obama if Obama had not been married to a black woman. That thought had never occurred to me. Of course not, I’m white.

For Tiger and his family, I wish them the best. No one really wants to be, or live with a god. For the rest of us, there’s still a lot of work to be done as a country, and as we all must admit, behind our own closed doors too; as husbands, wives, children, parents and friends. Before the year is over please, someone, get me up out of this leather chair. There’s some holidays and a new year coming. If there’s work to be done , let’s do it together.

Tigger: There's no difference between plunging 10,000 feet to the jagged rocks below and falling out of bed.

Piglet: Oh, really?

Tigger: Sure, haha! Except for the splat at the end they're practically similar.

NEJM -- On Mammography -- More Agreement Than Disagreement

2009-11-28T15:44:00.002-05:00

NEJM -- On Mammography -- More Agreement Than Disagreement

This week’s blog is serious. Please take a few minutes and click on the link above to read the New England Journal article on mammography in women between 40 and 50. Before you start reading, take a moment to recognize and acknowledge your biases. After you have read the article I’d like to discuss some of these issues with you. The issues that come to mind for me are breast cancer, cancer screening, women’s health, health care rationing, the health care crisis, the government’s role in health care decision making, technology and its limitations….there’s a lot to talk about.

In order for an online discussion to take place, you have to use the comments area at the bottom of the blog. You can use your name or be anonymous. If this format works, we can use it to discuss other issues in upcoming weeks. If not, it was worth a try.

Some food for thought:

• In 2009, some 192,370 American women will be diagnosed with breast cancer, accounting for more than one in four cancers diagnosed.

• In 2009, an estimated 40,170 women will die from breast cancer; only lung cancer kills more women. This corresponds to 25 deaths per 100,000 women, down from 35 in 1989.

• Data from 2006 -- the most recent statistics available -- showed that about 2.5 million American women have a history of breast cancer. Most of these women were cancer-free. Others were still undergoing treatment.

• From 2002 to 2003, there was sharp decline in breast cancer rates, particularly for women aged 50 to 69. This reflects the drop in hormone replacement therapy by menopausal and postmenopausal women that began in 2002. Breast cancer rates have remained about the same since 2003.

• Since 1990, breast cancer death rates have dropped steadily. The decline has been greater among women under 50 (3.2 percent per year) than among women over 50 (2 percent per year).

• From 1997 to 2006, breast cancer deaths dropped by 1.9 percent a year among white and Hispanic women, 1.6 percent a year among black women, and 0.6 percent annually among Asian-American and Pacific Islander women. Death rates have stayed the same for American Indians and Alaska Natives.

“The choice is not between health care rationing and some undefined alternative, since there is no alternative. Rather, the choice concerns what principles we will use to ration health care. In the United States, we have traditionally rationed health care in the same way we ration expensive cars: those who can afford to pay for them are those who can have them. The alternative currently being considered in health care reform would involve a shift to other principles, such as those rooted in considerations of fairness, efficiency, and efficacy.” Robert D. Truog, M.D. From the same NEJM issue as the article above.

17% of Congress are women.

The Republican National Committee’s health plan covered abortion for its employees beginning in 1991. When feminists pointed this out this year, the Committee Chairman withdrew the coverage.

Among uninsured women, only 30 percent had a mammogram during the past two years, compared with about 70 percent of insured women.

I am interested in what you have to say!

Cay-ent Get They-uh From He-uh

2009-11-15T22:24:00.001-05:00

Dr. PETER AMES GOODHUE, M.D.

Announces His Retirement from

THE PRACTICE OF GYNECOLOGY

Effective January 1, 2010

So reads an announcement on page 7 in Sunday’s Stamford Advocate. An announcement, paid for by the doctor himself. It seems sad, and wrong. In another era this would be front page news with a two inch banner headline. There would be a feature story and additional commentary with testimonials from his thousands of patients, not to mention from the thousands of children he delivered over the past 50 years. But Stamford is no longer a small town and the Advocate is no longer locally owned or beholden to the community. Stamford is a far cry from the back country Maine that Peter loved and brought to the rest of us with his storytelling.

When I began my medical practice in 1987, Peter Goodhue was the President of the Stamford Medical Society. The Society was an organization that met four times a year in local restaurants. There was a brief business meeting, an occasional outside speaker and then a dinner. If there was a speaker, the presentation was always short, sometimes educational, sometimes political but never so intrusive as to distract from the primary purpose of the Society, doctor sociability. Before Christmas there would be a silly card game where winners got free turkeys. Once a year there would be a dinner dance with spouses invited. That era, along with the Society, has passed. Doctors are too busy or ill-tempered to want to socialize with each other. The rubber chicken dinners can’t compete with ritzy drug company seductions at the best restaurants. We have too many other responsibilities and too large a community to relax or be collegial. Peter, however, remains to this day the epitome of collegiality.

He is handsome with a full head of silver hair, a ruddy complexion and an easy smile that brings a sparkle to his Paul Newman blue eyes. He is always well dressed with a trademark bowtie, usually bright colored and flowered. And he speaks slowly in that Maine sort of way. As President of the Medical Society, he would begin his meetings with a story. If you have never heard a Mainer story I encourage you to do so. They are unique regional Americana at its best. They are told slowly with the distinctive “they-uh, he-uh” Maine accent and a Bob Newhart deadpan. Think the opposite of Henny Youngman with his one liners and you have Bert and I—the comedy team that brought Maine humor to the mainstream.

Amazingly, neither Bert nor I, Marshall Dodge and Bob Bryan, were from Maine. They were Yale undergrads with connections to Maine from summer vacations, great ears for dialect and a talent for low rent sound effects. Their original album, recorded for family and friends, went on to sell more than a million copies. They inspired the storytelling of Garrison Keillor (Lake Wobegon Days) and were forerunners to other styles of regional American humor such as southern redneck, as perfected by Jeff Foxworthy.

Excuse the digression, but what native New England story would be complete without one. Peter’s stories went on and on and, if there was a punch line, he never got to it in the first fifteen minutes. The audience of doctors would groan, and then try to hurry him up, and finally shout and heckle to get him to stop so we could eat our dinner. It was of no use. Peter would finish when he was good and ready. Now, after 50+ years of practicing Obstetrics and Gynecology I guess he is good and ready. He is retiring. One story ends and the next one, hopefully just as long and rich with that same Mainer spirit, begins. Q: Have you lived in Maine all your life? A: Not yet.

Sample Maine storytelling at:

http://www.islandportpress.com/BIwhichway.html

A Thing and Two

2009-11-10T11:26:00.000-05:00

The sun sure did shine, and I wanted to play,
Still we sat and we sat on that beautiful day.

I sat there with Barbara, we sat there we two

We were waiting for Himes, our new congressman who

Was to talk to us doctors about a new bill

Being bandied about up on Capitol Hill.

We doctors grew restless, we bided our times,

Just who does he think that he is this Jim Himes!

We heard he’d been talking to town halls of late

He was dealing with folks spewing venom and hate.

Though he was a freshman, of little import

Fear mongers set out free discourse to abort.

I cut him a break as I sat and I waited

He just tried to listen and ended up hated.

A bit late and flustered he entered the hall

He looked like an intern who’d just come off call.

He said he was sorry, yes friends, fancy that

A humble young man, not no Cat in the Hat.

He was a bit slim with an oversized collar

He was poised, I believe he had been a Rhodes Scholar.

Retired real young, he said those were the facts.

He made all his millions at Goldman and Sachs.

Now some would not trust one so young and so wealthy

To keep us in health and to make health care healthy.

But me, I believe that a man who’s patrician

Is less apt to be a corrupt politician.

Our own Constitution was drafted you’ll note:

A Pres’dent gets in by Electoral vote.

So back to Jim Himes, what did he then do?

He pulled out of his tall hat Thing One and Thing Two.

No kidding, he said it. He said that Thing One

Was though smoking and drinking and eating were fun

They were bad for us one and thus bad for us all.

And in order to get healthcare spending to fall

It was up to us doctors to somehow arrange

To institute effective life style change.

Thing Two then chimed in with a screech and a shout

Saying docs, pretty soon all our money runs out.

If we don’t all spend less getting sick people cured
We’ll be unemployed and we’ll be uninsured.
Great Britain’s care’s cheaper, Canucks they pay less
It’s spending and costs got us into this mess.

I listened to Himes going on with offenses
And sat on the fence not yet come to my senses.
Did he think that changes in base human nature
Could come from a bill he and his legislature
Would magically cook up and somehow then pass?
Was he bold and enlightened or foolish and crass?

My friends, I’ve no knowledge of mirrors and smoke.
I’m a doctor and sometimes I tell a good joke.
But big steps, they scare me. Small steps they seem wiser
And if to Obama I was an advisor
I’d say be more cautious. Don’t go risking it all.
Take it small step by small step or you and we fall.

MRB 1924-1994

2009-11-06T16:37:00.000-05:00

Eulogy delivered to the Stamford Medical Society on December 13, 1994. For his Yahrzeit November, 2009.

Martin Robert Benjamin loved medicine. From Brooklyn, N.Y., the son of a clothes manufacturer and a housewife with a heart condition, and from the University of North Carolina, he went to Flower Fifth Avenue, the New York Medical College, where he got his MD. From there he went to Bellevue where The elusive blue breasted seersucker he completed his training in Internal Medicine. Bellevue, my father told me, was a lively place even back then. As often happens when working in the trenches,a camaraderie developed among the residents. Marty got to know an attractive female resident who happened to be married, but told him that she had a sister at home just like her. She introduced him to her identical twin, Vicki, and Marty and Vicki soon married.

In 1954 Marty, Vicki and their one year old son, Dan, made the adventurous move to the suburbs. Marty put out his first shingle on Summer St. at the Mayflower Gardens, with the
young family living upstairs. Those early days were a struggle, but Marty did what he had to do. He covered for many of the well established doctors in town, taking their night and weekend
call, and through their kindness received referrals as well. Marty wrote a story about his first New Years Eve in Stamford. It was 3 AM, cold and raining, when he got a call from one of the busiest doctors in town, someone who had never called him before, a real SOB to those who knew him, but, of course, the doctor to his patients. Marty was told to see an immigrant tailor with CHF who was short of breath. Before long, Marty was climbing up to the third floor of this tailor's tenement. He was let in by two policemen and stared down by a tiny man in obvious heart failure. The man said nothing, but took Marty's coat lapels and ran the material between his fingers. He then turned the lapels over to examine the stitching. Now, Marty always prided himself in his dress. He took to heart the advice of Polonius, "In thy dress be rich but not gaudy," paraphrased in Brooklynese, "Dress British, think Yiddish". Even after his stroke, when it would take him 45 minutes to dress, he would walk out to the family room to have us check his ensemble. He called himself a public figure and always had to maintain that professional appearance.

But how was that little tailor to know that this was the only winter jacket Marty owned. When he got through fingering the material, he told Marty, between coughs, "Big shot, vat do you know". He just couldn't trust such a young doctor with such a well made jacket.

Mayflower Gardens soon got crowded with the practice downstairs and the family, now expecting a second child, upstairs. Marty moved the office south on Summer St. where he rented space from Dr. Leo Heimovitch. His first break, an ironic one, came soon when Dr. Heimovitch had a heart attack. Marty took care of the older physician’s practice and from there his own practice took off. I don’t have many vivid memories of my father in those days. I know I was busy with school and football and baseball. He was busy with the practice. That seemed okay to me…except when my friends’ fathers would throw a baseball with us or take us swimming, or just be around the house. I guess I was so used to not seeing him that I didn’t really notice when, in 1961, at the age of 38, he had a heart attack. My older brother and I visited him once in the hospital. The two younger brothers, there were four boys then, never did. As soon as his doctor would allow, Marty went back to work. He was in Hanover Hall on Bedford St. then. Dr. Michael Browne had the office to the left and Dave Widrow the one on the right. Dave’s consultation room was through a thin wall from Marty’s. That, Dave tells me, is how he learned all of his dirty jokes. Marty would call them stories, “true stories”. He’d tell them and then laugh louder that any of us.

Marty loved his patients. He was a kid from Brooklyn. They were mostly blue collar workers, West Side immigrants, cops. He just hit it off with them. He’s listen to them, they’d confide in him. We were never hurting for cookies, cakes, sweaters, wine; you name it at Christmas time. We couldn’t walk down the street in Stamford without someone stopping us to say hello. They wouldn’t even let us pay the 25 cents at the Greenwich tolls. The toll taker would take my father’s quarter and return 25 cents in nickels to the kids in the back seat. I remember one call at night at home. My parents were out and my father had signed out to another doctor. The man was calling about his wife. She was sick, but not the kind of sick that a covering doctor could help. He told me this, and then told me, a kid, maybe ten years old, that my father was a special man. That he listened and cared and meant more to people than just a doctor. My brother Fred tells of another middle of the night call, on the kid’s telephone. My father, head on hand, elbow on knee, listening and listening, and finally putting the phone down. Fred said, apologizing for getting dad out of bed, “The man told me it was important”. Marty replied, “To him it was, and that’s enough”.

In 1967, at the age of 44, Marty had his second MI. This time his doctors told him he couldn’t continue to practice medicine. Marty had Vicki, now five boys, the youngest just one, and the practice. He became depressed. After he recovered from the MI he spent six months in a Westchester psychiatric institute. I was twelve. I remember this very well. I hated seeing him sedated, moving slowly, smiling slowly, walking among the splendid trees and the green grass of this institution. I saw him only twice in that six months, but when he came home he looked normal, walked normal…smiled and told jokes…and went back to work. He said he had to work half time. But we all knew what that meant.

I noticed a real change after that. Marty did spend more time at home. He was home for dinner with the family. And I liked that. Dinners at home with the family were great. Every time my mother got up to go to the kitchen he’d tell us another dirty joke or “true story”. We were turning into teenagers and he wanted to be a part of it. “Did you get lucky last night?” he’d ask me. At sixteen I was pretty tight lipped in my replies. But by eighteen, after my freshman year in college, I knew I could go to him when I needed some penicillin. And I’m sure to this day he never told Vicki.

Marty practiced another 15 years. He put a lawyer, a doctor, a rabbi, an MBA, and a young Hollywood exec through college. A lot of pressure, a lot of worries. Vicki tells me that he started to voice a lifelong conflict. “I’m sicker than most of them,” he’d tell her. He resented when, after praising him, deifying him, they left him after his illness. But there was a good side to this. The practice became almost like work and his important relationships grew with us. He became co-owner of Ben-Paul Stables so he could sit in the owner’s box at Belmont. He travelled, read, gardened. He was the life of the party with his violin on birthdays and holidays.

I was an intern in Philadelphia, doing my neurology rotation of all things, when I got a call. He had a stroke. Despite a dense hemiparesis, he felt he’d again return to work. He worked hard at the physical and occupational therapy. He learned to walk, to dress himself, to drive, but he never practiced medicine again.

Some have said over the years, that it was medicine that caused his heart attacks and strokes. But he never did. It was his family history, high cholesterol and hypertension that did it. It was medicine that kept him going. He never lost faith in medicine or in his fellow physicians. When he could no longer practice, he began writing, mostly about his days as a practitioner. He continued to go to medical conferences and, along with Monroe Coleman, developed the Physical Diagnosis course for second year medical students. He read and read about the history of medicine, and delighted students with the wisdom of Osler and Freud.

For his sons and many of his nephews, nieces and special friends, he remained a sounding board. He still wanted to listen. Something about the way he listened made others sure he cared, and this caring became addictive. In the end Marty was not ready to die. He still felt he had something to give.

This last year was a recurring nightmare for us. Marty didn’t remember what hit him, but we told him. I was angry at the indifference, incompetence, insensitivity of some fellow physicians, but not Marty. He was thankful. Among our community he had his heroes. He spoke of Mike Parry as a clinician, Noel Robin as a teacher. In his word processor I found a letter of congratulations to Bill Hines.

In the end, he wanted to come home. He never made it back to his study, his music, his gardens that he loved so. But he died where he labored…in Stamford.

If there is a message to us physicians from Marty’s life, it is his sons. We have all achieved some measure of professional success, but every day we go home to our families, and play with our children, bathe them, feed them, talk to them, listen to them, or just spend time around so they’ll know we’re there for them. Marty Benjamin loved his family, and we miss him very much.

House and Holmes

2009-11-01T16:56:00.000-05:00

I’d like to wrap up my Holmes series this week. It seems the history thing has not been too popular with my readers, at least judging by the lack of response to my recent columns. As for Sherlock, I won’t get into the upcoming Robert Downey Junior film, but will point out that the TV evening soap, House, is a cheap knockoff. The protagonist’s quirky personality, his drug habit, his musical instrument fixation, the detective bit…and just in case you didn’t get it, his apartment number 221b happens to be the same as that famous address on Baker Street. At least they got it right bringing him back to his archetypal state, physician.

Why does history bore us? I wanted to tell you how OWH Sr. started a monthly literary magazine that, of course he named, the Atlantic Monthly. His monthly column related conversations from the breakfast table at an inn of his creation. His persona, the Aristocrat one year, the Professor another, would talk with other guests at the inn. The conversations were witty, humorous, and were at times the same stand up routines he had given on his lecture hall tour years earlier. He was really not too different from George Carlin. He just came a century earlier. But who cares? No one, I think, unless you're a really old dude.
It took a most Excellent Adventure for Bill and Ted to get into history. It’s the same for me. I went through my years at Yale without ever taking a history class. I couldn’t read the stuff. History writers can’t write. Three weeks ago on a mountain in Great Barrington, MA I had my own most excellent adventure and discovered history. For me, it’s the same as learning medicine. The reason medical education takes place in the clinical setting is, in large part, that there it becomes alive, is understandable and is remembered. Once you see a case of say, subacute bacterial endocarditis, it becomes real for you and you want to go to the textbooks and read more. And when you read with interest, instead of laboring over the words, you become alert and absorb the material. Do medical writers write better than historians? Keats and Holmes aside, probably not.

I will never forget bacterial endocarditis because of a Delaware VA Hospital patient who came in with shoulder pain and chills. We talked. As it turns out, he lived next to a racetrack and every evening would walk his dog around the stables. Had I ever heard of Streptococcus equi? I’m sure it was in the books I read for cardiac pathology, but come on. After his blood cultures came back full of horse bacteria I went back to those books, learned about that obscure bug, yes, but also learned everything I could about SBE. I may be a gastroenterologist, but I still come across SBE, and get a big kick out of beating the interns, residents, medical attendings and cardiologists to the diagnosis. Our Infectious Disease guys, I admit, get there with or before me.

As Dean of Harvard Medical School, Holmes wanted to admit women. The overseers would not let him. He admitted three blacks, but withdrew the admissions, succumbing to pressure from students and administration. He resigned as Dean but continued to teach until the age of 73. “Life is a fatal complaint,” he said, “and an eminently contagious one.”

“It is a good thing to save a few lives, but it is better to infuse a new life into our language.” So said Holmes as he found new life and went on to worldwide fame as a poet and author. And that’s history. You can read about it, or better yet, do as I did…take a hike! Or do like my father and go birdwatching. (That translates to the racetrack.)

The crack-brained bobolink courts his crazy mate,
Poised on a bulrush tipsy with his weight.

Dr. Holmes, Part 2

2009-10-28T23:17:00.000-04:00

The brilliant Sherlock Holmes is certainly the most famous detective, for that matter character, in all of literature. The Guinness Book of World Records lists him as the “most portrayed movie character” of all time. Over 70 different actors have portrayed him in over 200 films. We are of course dazed by his wealth of knowledge and unequalled sleuthing skills, but we are mesmerized by his personality and presence—his self-absorption, his addiction, his passion and his egotism. “Excellent! I cried. Elementary, said he” is Watson’s correct account of that famous conversation with his friend, the one that lives on in movies in its misquoted form, “Elementary, my dear Watson”.

The real Dr. Holmes was the Parkman Professor of Anatomy and Physiology at the Harvard Medical School in 1847 when one month after Halloween the school was closed by a coroner’s jury. They spent the next week gathering evidence in the form of Dr. Parkman’s dismembered body. They found his jaw with its teeth and an identifying gold filling in the furnace of Dr. John Webster’s lab. Dr. Webster, a chemistry professor, was heavily in debt to the wealthy Parkman. In those days a professor was paid from the receipts of tickets bought by students to attend his lectures. Apparently, neither Dr. Webster nor his subject was too popular. His murder trial and the precedent it created in case law, however, were sensational. When Charles Dickens came to America he asked to tour the crime scene. The conviction on the basis of circumstantial evidence is part of American legal history.

Unlike the unfortunate Dr. Webster, Dr. Holmes was a masterful lecturer. His craft took root in his days as a Harvard undergrad where at 5’2” his sport was lively conversation. He joined the Hasty Pudding Club where he wrote and performed comedic poems and skits. His wit followed him into the lecture hall. He added spice to Anatomy and Physiology with puns and poetry in the form of mnemonic devices, at times of a ribald nature. When the four month term was over he would take his act on the road. Every city and most small towns had a lyceum. In the Age before movies and Comedy Theater, speakers like Holmes would tour the country and provide entertainment for the locals. His favorite topics were poetry, especially Byron, and homeopathy, a practice he railed against. “The causes of disease,” he said, “have been less earnestly studied in the eagerness of the search for remedies.”

Doctors in the 1800s still used bleeding and cure-all elixirs for any and all ailments. Holmes was schooled in Paris in the French methode expectante, a sort of therapeutic nihilism that instructed the physician not to do harm and to keep the patient going long enough to allow the body to heal itself. He was taught to observe. This training led him to collect hundreds of cases of postpartum infection into an historic paper, "The Contagiousness of Puerperal Fever". His claim that doctors and midwives spread infection to mothers giving birth was not accepted by mainstream medicine for another twelve years. His recommendations that practitioners involved in infection cases stay away from future deliveries saved many lives. His scientific method was a model, that when applied to other ailments, saved many more.

Holmes was an educator and an entertainer. He did not pretend to be a genius or scholar. “Nothing is so commonplace as to wish to be remarkable,” he said. He did not invent the use of ether in surgery but he came up with a name for it, anesthesia. He was no Keats, but his simple rhyme, “Old Ironsides” inspired mainstream America and helped save the USS Constitution from the scrapheap. His unwillingness to show proper reverence to religion or to take sides with “moral bullies” like the Abolitionists in the pre-Civil War years got him in trouble in the press. “I don’t want to be bullied into heaven by the pulpit—neither do I wish to be called hard names to make me better or more humane.” For a public figure, he was certainly naïve. He just preferred to see the good in people, humor in difficult situations and be a conciliator. Not surprisingly, University politics did not suit his temperament. Next week, his transition to 19th Century blogger.

The Real Dr. Holmes, Part 1

2009-10-21T22:00:00.000-04:00

Barbara, Alison and I pulled off Route 7 just north of Great Barrington, MA on a brisk, clear New England morning. We parked the car at the base of Monument Mountain in front of a stand of red pines. Amid the pines stood our guide, grizzly gray beard, layered clothes, leather knife case attached to his belt. As he stood there silent, our senses sharpened and tuned into the autumnal Berkshire setting before us. I felt the soft cushion of pine needles under my hiking shoes. I smelled the air, heavy with pine, but also with the mustiness of fallen leaves. There was no mist and through the trees I could see the hint of a white faced cliff.

We started off on our trail, in skiing terms a blue slope. It rose gently, winding around the side of the mountain instead of attacking it head on in double black diamond fashion. It was one of several trails used over the years by Mohegan Indians, loggers, horse drawn wagons, charcoal makers and local pleasure seekers. The most famous of those pleasure seekers was a group in 1850 that included Herman Melville, Nathaniel Hawthorne and Oliver Wendell Holmes, Sr. The outing that August morning made such an impression on the adventurers that five out of ten of them wrote about it in letters or journals, preserving the day in history and giving us, 159 years later, an accurate account of their actions and impressions.

Herman Melville was in the process of writing a nautical adventure. The inspiration for the book came from the profile of Mt. Greylock, a whale shaped mount to the north of Great Barrington. He was behind schedule with his editor who was encouraging him to befriend Hawthorne, a shy New England author who had just completed The Scarlett Letter. The two of them hit it off so well, that according to Melville, the advice and encouragement he got from Hawthorne that day put him back on track, and shaped the rest of Moby Dick. The odd man out was a third author, Dr. Oliver Wendell Holmes. He however, brought the champagne, and was happy to pass it among his comrades. It seems that the good doctor kept a healthy dose in reserve for himself, and when the group reached Squaw’s Peak, he acted like the Harvard undergrad he once was, leaning out over the cliff’s edge, scaring his friends. We climbed that peak and I can tell you, it’s a long way down from the top.

Most of us know the name, Oliver Wendell Holmes from the doctor’s son, OWH, Jr., the “Great Dissenter” who served on the U.S. Supreme Court from 1902 to 1932. Holmes, Sr., though, is the one who intrigues me. He did more than just hang out on that limb. He was a great American in his own right. His medical writings presaged the discoveries of Pasteur in germ theory. As Dean of the Harvard Medical School he challenged the white establishment by admitting 3 black students. He was a poet, inventor and leading thinker of his time. Next week I will tell you more about his life and explore my growing kinship with him. I hope he will inspire you as he did another physician and author, Sir Arthur Conan Doyle, whose brilliant detective, Sherlock Holmes, was modeled after the real Dr. Holmes.

http://www.thetrustees.org/what-we-care-about/history-culture/hawthorne-melville.html

Take That!

2009-10-15T21:21:00.000-04:00

William Safire died last month. He was best known as a speechwriter in the Nixon White House, the one who armed Nixon’s attack dog VP, Spiro T. Agnew, with alliterative phrases like “nattering nabobs of negativism”. I’m sure it delighted him, a man that boasted about being a college dropout that he could send us all hunting frantically for our dictionaries in order to understand the insults hurled our way. Though I now know that a nabob is a person of wealth or influence (initially a Mogul governor), I still see one as a bobblehead doll that somehow nods “no” when jiggled. If such a doll did exist, I would have one made of me, just to send to college with my kids. Whenever that devil would pop up over their left shoulder trying to lead them astray, they could consult me with a mere tap of the bobblehead and get my counsel, “NO. NO. NO”.

I used to look forward every Sunday to Safire’s New York Times Magazine column “On Language”. It was unique and clever, only at times espousing his conservative political views, but always letting the reader know who was right—he was. I asked him once to help me find the origins of the phrase “I keep the ends out for the tie that binds” from Johnny Cash’s “I Walk The Line”, but he never wrote back. Now I’ll never know.

George Carlin died one year ago. He was my other favorite word maven. He was also self-educated, a New York high school dropout and, like Safire, proud of it. Many of his stand-up routines revolved around words and their meanings. Most were crack-a-smile humorous like “If crime fighters fight crime and firefighters fight fire, what do freedom fighters fight?” Others were more over the edge like his “Seven Words You Can Never Say On Television”. That one got him arrested many times but never convicted. You can read the routine on line as it is quoted in the Supreme Court Decision of FEDERAL COMMUNICATIONS COMMISSION v. PACIFICA FOUNDATION, 438 U.S. 726, 98 S.Ct. 3026 (1978). Read it at http://www.georgecarlin.com/.

Do you remember who was the first host on Saturday Night Live? It was George Carlin. He came back from the future in “Bill and Ted’s Excellent Adventure” and down from heaven in “Dogma”. “Scratch any cynic,” he said, “and you’ll find a disappointed idealist.” That attitude probably led him to be the original conductor on “Thomas the Tank Engine and Friends”. He inspired the likes of Richard Pryor and Howard Stern but was able to calm his demons early in his mid-life and never burn out (up?) or become ugly. Without him and Safire my Sunday night forecast is “dark,” but like George knew, “turning to widely scattered light in the morning”.

Before I sign off I’d like to leave you with a word and a phrase. The word is tennis. It is derived from the French “tenys” meaning “take this” or “take that”. The origins of our modern game of tennis are in a 14th Century game played by French monks. Apparently the game involved a lively repartee and, a la Monty Python’s medieval knights, the monks would often hurl insults at each other along with the ball. Ergo, “take that”.

The phrase is: give and take. It’s a lot nicer than the in your face, “take that”. There are any number of aphorisms about giving, but my favorite came to me from my mother-in law, JoAnn, who died before Barbara and I met. She said that in every marriage if you’re not giving 95%, you’re not giving enough. Now, even though at times I choose to take it as “okay, I only have to do 5% of the work around here” or “if I’m giving 10% I’m exceeding my wife’s expectations by 100%,” I usually take the advice to heart and give it a try.

As we head off to a joyous family wedding my thoughts are with the soon to be married couple and my wish for them to choose and use their words wisely, often and with a sense of humor, and to give and take, always giving, always taking and never forgetting the flexible give and take.

Special thanks to Valerie Byrnes, a genius of bobblehead.

In-Goo We Trust, PLEASE!

2009-10-09T23:59:00.000-04:00

Henny Youngman arrived early to the theater. He needed to go backstage to get ready for his act and asked a stagehand to find seats for his wife and friends. “Take my wife, please” was the innocent remark he made, but the stagehand thought it was a joke and laughed. Did Sadie blush? Did she laugh with the stagehand or cut Henny a dirty look and give it to him when they got back home? What about the friends? Did they laugh or were they embarrassed for poor Mrs. Youngman who said nothing but meekly allowed herself to be led to a seat? Maybe the remark wasn’t as innocent as Henny claims. In any event, he used the line in his act for the next 40+ years, along with many others, much worse, that would test the limits of any marriage. He and his wife stayed together until she died after over 60 years together.

Rodney Dangerfield and the mother of his two children had a much shorter and stormier marriage. He gave up on the comedy business in his twenties to work selling aluminum siding. He tried to provide for his young family but went broke anyway. He gave comedy a second go at 40, but by that time he and his wife were history. Despite the lousy marriage, Rodney’s jokes, unlike Henny’s , were not at the expense of his wife. His humor was self-deprecating. He was almost always the butt of his own wife jokes. “My wife likes to talk to me during sex. The other night she called me from the motel.”

Henny would work and then work some more—he was known to do a big show, then go to his hotel and try to find a bar mitzvah or some other private party to entertain for 15 minutes and 150 bucks. His credo was the Yiddish for “Get the cash”. Rodney was happy to make the bigger bucks too, but he would blow it on alcohol, drugs and women. His jokes were funny, but his big attraction was his persona. Of course he got “no respect” because after a cruel childhood of neglect and his struggles with marriage and career, he didn’t feel he deserved any. He fought depression and got high every day of his adult life. His trademark bug-eyed look of confusion, head to the side, hand pulling at his open collar and tie was born when he forgot his lines on stage at the Ed Sullivan Show. Ed thought it was brilliant and it was. We laugh at his discomfort like we laugh when Curley is hit by Moe or when Laurel cries at Hardy’s verbal abuse.

Many of us small folk try to get a laugh from time to time, not always with success and at times with unforeseen bad repercussions. A freshman at Tufts tried his hand at comedy and suffered for it at the clenched fists of every politically correct organization on campus including the school administration. It happened this year during a campaign for student office. A female student of Chinese ancestry put up a poster with her picture and the phrase, “Small stature, big ideas”. In-Goo Kwak, himself of Korean origin (but perhaps Daily Show suckling), put up a poster next to hers with his picture and his slogan, “Squinty eyes, big vision”. In-Goo apologized and avoided suspension. The student body was divided, but many rose in his defense and in an expression of anti-PC-ishness actually elected him to the school’s ethics board. Go figure. They like him. They like him.

If they like you, like they say in Chicago’s Razzle Dazzle that I referenced last week, you can “get away with murder”. Take Bill Clinton. He had W.C. Fields' smile and George Burns’ cigar, screwed around, lied to Congress, got impeached and rode it all the way to the bank. Now he goes around trying to act presidential. That makes me laugh. God forbid Hillary should ever try to tell a joke. She’s smart enough not to.

So I got this problem. Every now and then I try to be funny. What could be wrong with that? Let me tell you. First, look at that picture—the stiff in the suit. Nothing funny about him. Second, you may not really like me. I act too serious and am one of those doctor types who knows a bit too much and does some uncomfortable sounding things. Third, maybe you’re not like Sadie, shy and totally devoted. As Carly Simon said, “You probably think this song is about you”. I know what Lenny Bruce would tell you…but I’m no Lenny Bruce. Friends, it’s not about you. If anyone is to be the butt around here, let it be me. Q: What’s a colonoscope? A: A medical instrument with an A-hole at both ends. ,PLEASE!

And All That Jazz

2009-10-03T14:30:00.000-04:00

Thank you, friends, for your encouragement, support and critical comment on my new creative effort. The comments have been varied, from “WOW” to “Gotcha” (a clever play on my “I get you” plus “I’m wi’cha”), to “I don’t read blogs, take me off your list”. One professional media type liked my writing. Another former editor advised me to stick to topics in which I had some expertise—as in, who wants to hear about tennis from an over the hill suburban swim and tennis club weekend hacker? Once my dander got back down I got to thinking. Did my column reveal an obvious lack of expertise on tennis, or am I unqualified because I was never a tennis professional? Does having a father who loved to tell jokes and a Jewish mother give me the street cred to get up on stage and try my hand at a High Holiday, half asleep Jewish joke/holiday greeting or do we all have to stick to Seinfeld reruns? In this era of reality TV we see examples daily of delusional clowns who really think they have talent. As standout talent is rare, the major entertainment value of the shows is not in the discovery or display of real talent, but rather in the spectacle of us mortal folk reacting to harsh criticism and ridicule. It’s not easy. Still, I’m not delusional. Though I still fantasize about being a star professional baseball player (Sorry ladies, that’s what your men fantasize about too), I know the difference between a job and a hobby. I take a small measure of personal satisfaction in having more maturity and insight than say, Michael Jordan. He was the best basketball player ever and he left it all for what? Baseball. Then there’s A Rod. Now he’s got a real problem. You see, he’s already a baseball star. So what is he to do when he gets bored with his day job? You got it. He’s got to fantasize about sex. How else do you explain that Madonna thing?

So, there are jobs and there are hobbies. I’d like to be able to write about both, and maybe even about stuff I know nothing about. If I have fun writing it and you, the readers, are entertained, does it really matter if I’m no expert? If it does to you, don’t read the blog. I’d be happy to take you off the list.

Humor me a bit longer. I’ve still got this bug up my ass about expertise. What is it? Can it be objectified, rated, certified and licensed, and if so, who gets to do all that? Once the experts have spoken is there any voice left for us little people? Sorry. This is getting a bit heavy for this humble country doctor’s fledgling blog. I may be a gastroenterologist, but in my family I’m not even the most expert on bugs up the ass—that title would go to Lindsay, staff researcher for TV’s Monsters Inside Me.

Some random favorites and then I’ll sign off…

Wizard of Oz: They have one thing you haven't got: a diploma. Therefore, by virtue of the authority vested in me by the Universitartus Committiartum E Pluribus Unum, I hereby confer upon you the honorary degree of ThD.
Scarecrow: ThD?
Wizard of Oz: That's... Doctor of Thinkology.

D.A. Jim Trotter: Now, uh, Ms. Vito, being an expert on general automotive knowledge, can you tell me... what would the correct ignition timing be on a 1955 Bel Air Chevrolet, with a 327 cubic-inch engine and a four-barrel carburetor?
Mona Lisa Vito: It's a bullshit question.
D.A. Jim Trotter: Does that mean that you can't answer it?
Mona Lisa Vito: It's a bullshit question, it's impossible to answer.
D.A. Jim Trotter: Impossible because you don't know the answer!
Mona Lisa Vito: Nobody could answer that question!
D.A. Jim Trotter: Your Honor, I move to disqualify Ms. Vito as a "expert witness"!
Judge Chamberlain Haller: Can you answer the question?
Mona Lisa Vito: No, it is a trick question!
Judge Chamberlain Haller: Why is it a trick question?
Vinny Gambini: [to Bill] Watch this.
Mona Lisa Vito: 'Cause Chevy didn't make a 327 in '55, the 327 didn't come out till '62. And it wasn't offered in the Bel Air with a four-barrel carb till '64. However, in 1964, the correct ignition timing would be four degrees before top-dead-center.
D.A. Jim Trotter: Well... um... she's acceptable, Your Honor.

http://www.youtube.com/watch?v=Rn5-VN3SH1o&feature=fvw

“Long as you keep ‘em way off balance, how can they spot ya got no talents?” And all that jazz.

New Year 5770

2009-09-22T15:57:00.000-04:00

So there were these three Jews, one orthodox, one conservative and one reformed. And they were sitting around on Rosh Hashanah evening. “Joe”, I says, “What did your rabbi talk about in his sermon?”

Joe thought a minute, smiled, gave a sheepish laugh and answered, “I forget”. So much for orthodox oration.

Vicki was next. “My rabbi missed his son. You could see it in his face…”

“Mom,” I says, “The sermon?”

“Oh that. He said Israel and Jews are being threatened by Iran and that Iran is evil. And that we should try to do more good deeds.” Timely, touching on the political, with a cloying aftertaste of conservative ethics.

It was my turn to give a report of this year’s reformed rabbi’s message—usually the punch line in any decent Jewish joke. I always try to fall asleep during the sermon. This year I almost did, twice. But each time I was about to drift off I caught a couple of words that sent me into an AllieMcBeal/Scrubs-like imaginary funk. The rabbi said that we should make a strong and consistent effort to know each other. He said that one of the greatest expressions of friendship and love is to be able to look at someone and say, “I get you”.

Well, that did it. I found myself in a Hollywood producer’s shabby office with Harry Zimm (Gene Hackman) sitting behind a desk in front of a window, blinds open, lights shining into the eyes of his guest, Ray “Bones” Barboni (Dennis Farina).

Harry: “Ray, look at me.”

Ray: “Why don’t you take a look at this?”

You know the rest. Harry got the crap knocked out of him. You see, Ray wasn’t really in the mood to bond emotionally.

And then somehow I find myself between John Travolta and Robert Deniro. John’s got his arm around my shoulder and says, “I’m wi’chu”.

“You’re with me?” I ask.

“No, I’m wi’chu. I know you. I get you.”

Then there’s the rabbi again. He’s saying that there’s a lot of things we don’t talk about that we should talk about because talking about them will make us both feel better and bring us closer together. But that it’s hard to be the first one to bring it up but that we should. And that whenever a shepherd lost a lamb and that lamb returned, the shepherd could take a seed and put it into a sack, but only if he really knew that lamb well. Hey, don’t laugh. This is reformed Judaism and we don’t take things literally. It’s all metaphor. We might as well be Freemasons. Good. Now you don’t have to read Brown’s The Lost Symbol. I did. Don’t waste your time.

I have learned after many years, that when talking to my mother, I should keep it short and keep it simple.

“Our rabbi’s sermon was the same as last year’s. He never talks about politics. He just tries to get us to be better people.”

Not a bad sermon. Happy and Healthy New Year to all.

American Idol?

2009-09-19T07:27:00.000-04:00

Serena Williams, in her post-meltdown news conference, revealed that one of her idols in tennis is John McEnroe. I was shocked and a bit unsettled. Did she mean the tennis brat famous for his immature tantrums, tirades and threats? “Are you serious?” Did she even know about the young father and Hollywood hobnobber who was no innocent bystander to his druggie wife’s cocaine laced high life? Or did she mean the divorced father of three who overcame accusations of controlling and bullying and bravely took custody of his children? She probably does know that he has profited greatly from tennis, becoming one of the richest in the sport. And we all see and hear his commentary during the US Open where year after year he shows himself as the most insightful analyst out there. I loved John McEnroe most as a fiercely competitive and gifted winner on the tennis court. Even when he lost a match, as he did to Bjorn Borg in arguably the best match ever played, his intense effort and racket artistry made him and us, his awestruck audience, winners. So Serena, which John is your tennis role model?

Serena was being pressured by great tennis from Kim Clijsters. She was down a set and behind 6-5 in the second. She was on serve and had already fought off four match points. She was hitting the ball hard and deep, but the balls were coming back just as hard and deeper. Several of her forehands failed to clear the net. Her serve was keeping her in the set. She was acing Clijsters on the ad court with a flat, wide 112 mph bomb. At 15-30 she stepped up to the baseline, fired her second serve and was blindsided by a line judge’s call, “foot fault”. And she lost her cool. F this f that, down your throat, code violation, point to Clijsters, game, set, match. Do you call a foot fault at a crucial point in a marquis US Open match? Yeah, you do. Why? Well, not only because it’s the rules. Just as much, because, just maybe, it was the unrelenting pressure from Clijsters that told Serena she needed to hit a really good serve. That subconsciously nudged her toe forward to touch the service line. That ultimately made her snap and not default, but lose to Clijsters who did not slide into the finals but won.

So Serena, which John do you want to emulate? You’re already the most gifted women’s player out there. How about the John who has turned his life around and looks back at his past with a smile of bemused embarrassment, the rewards of a champion, the pride of a father and looks ahead every day, richer for that past, to be a good person and live life. Do you have what it takes? It’s in your court.