This is a quick one for I am dictating charts……….

I got a compliment today all at the gym. I was at the sink area in the locker room. A fellow was across from me packing up his gym bag. I washed my hands only to realize the paper towel dispenser was empty. I looked across the room; the dispenser at the other end of the row of sinks was empty too. The man shook his head with  schadenfreude. I said to him  “Well, if we are out of paper towel, I guess that’s a sign men are washing their hands”. He nodded. I took my sweat towel off my right shoulder, and explained not to be worrying for  I am the proverbial Boy Scout and this will do.

Just as I was drying my hands another man came into the washroom area. When his attempt to extract paper towels from the dispenser failed, he explained out loud in anger “What a fucked up shitty gym!” and went across the room to the other dispenser, where he again cursed for the lack of paper. He  stormed away.

My sink fellow, who had witnessed this dudgeon, turned to me and said “You know mister, you have a good attitude in life.”

I would like to say he transformed into my fairy godmother and gave a reward of twenty dollars (or better yet, a buss) but there wasn’t anything like that. There is nothing more. But I did have the quiet satisfaction I had taken the positive approach, and in the eye of my peer I was seen as a gentleman.

And I wasn’t truculent jerk like Mr. Potty-mouth.  :-)



nri0115I recently read an article on the salubrious benefits of cold showers. Urs Truly is rather sensitive to cold; I am used to hot showers. Translating over to cold ones would be a challenge indeed. Rather than going from one extreme to the other (and risking a stroke) I figured acclimation was the answer. My problem is trying to find some cold water. The water heater is located in the garage. Nowadays the lows are in the upper-80s. “Cold water” is approximately the temperature of a glass you send ask the waitress to please put in some ice.  Well, it’s a start. By winter I hope to get more butch.  So far I haven’t seen many benefits although my skin is less dry and flaky.

I like showers, and bathing in general. After all, I am a Cancer, a water sign. The ablution of cleansing is a lovely one that goes behind the prosaic of removing the day’s grime.
My shower is rather lovely. It is a walk-in shower with dark green tile and silver faucets. It is sans tubside so there is no need to step over something. Nor does it have a nasty curtain that billows like Ms. Monroe’s skirt as you try to adjust the water to find this oh-so-elusive virtuous cold water. The shower wall, which is the size of a large door, is made of glass brick.  Its only drawback is over-zealous scrubbing causes water to splash out on to the bathroom floor. Nevertheless the shower is quite capacious and I invite as many Spo-fans to town and experience one with me.

In contrast to the chic shower are my cleansing materials. Prudence is my middle name; I bring home the leftover soap cakes and shampoo bottles from hotel trips and I use them rather than buying proper bottles.  I also have a small yellow plastic scrub brush. The hispid hexagonal brush is used for scrubbing the scalp or anything else that wants scratching.

“Joy to itch in a minute” is what I always say.

By the way, this is a good as time as any to say I do not sign in the shower. I think rather. As a younger man I thought along the line “This is one of the world’s most beautiful bodies”. Nowadays my thoughts are more  “You know I should put a plastic mat down in here before I trip”.

 Hey ho! I am enjoying a lovely weekend in New Mexico. I haven’t had time to read/write blogs.  So, here’s an entry I’ve been meaning to post for some time.  


Patients sometimes ask me what is the point of living.  What they are asking really is what is The Meaning of Life. Does Life have meaning?   I will share what I tell them.  It is apropos for today is Carl Jung’s birthday.


“The Meaning of Life” – as seen by Urs Truly. 


We start in our infancy with the capacity to experience Joy in everything we experience, down to the simple things like sunshine or colour. Alas, this sense of wonder about Life dissipates as we grow; the awareness of Death begins to infiltrate Life and slowly erode our joy and idealism. We see injustice, pain, and death everywhere; we lose faith in ourselves and Man.  Life feels meaningless.

Choice-less, we are given the choice: make meaning or go without.  We become bitter or better.

The most terrifying and sad fact about Life, the Universe and Everything is not that they are hostile ,but that they are indifferent. There is no ’42’.

If we can come to terms with these two truths and accept the challenges of Life, then our existence – as a person, tribe, or species – can have fulfillment with genuine meaning. With  strength, courage, and consciousness we can arise from the ashes into a rebirth of Life’s thumos.

For those fortunate ones who manage somehow to cope with mortality then Life is worth living.  Paradoxically the meaningless of Life forces us to create our own meaning.

You can’t regain the purity of wonder you had in your youth, but you can create something far more deep and enduring.

In the universe of silence we have to create our own Music.





I’ve received a truculent text-message from You Know Who. Apparently they are being besieged by upset emails and PETA-folks about yesterday’s entry. I am told to write something more convivial or I will be the next Shanghai luncheon special.

Someone and I drive to NM tomorrow evening for the annual trek to the Santa Fe Opera.  This serves several needs:

Get out of 110-115 temperatures

Attend the Santa Fe Opera.

See chums

Eat peppers

Purchase another bottle of local gin infused with SW herbs.


We drive to Holbrook AZ (Land of US-66 relicts) for the evening and then we drive Friday morning to Santa Fe (Land of pueblos). It is going to be lows in the 60s – lovely. We will have some proper NM cuisine*.  We even have an evening free to ‘do nothing’ for which I am looking forward.

The opera we are attending is “Dr. San Yat-sen“.  He was a colleague from the early 20th century.  When he wasn’t practicing medicine he was overthrowing nearly 300 years of Manchu rule of Imperial China. **  I don’t know if the opera focuses on his establishing The Republic of China or his rather-intriguing personal life.  This sounds a  far more interesting night at the opera than “Fidelio”.

I am damned determined to stay awake for this one, even if it means drinking a pot of coffee or pilfering a patient’s Adderall. ***

Well, I am off to pack my traditional Ghost-bag of paper work, puzzles, and sundries of reading materials for the long car ride. Sleep tight my dears.  And don’t eat no cats.





* No cats, no snakes, and no rubbish.

** Apparently he didn’t have all the paperwork I have. Imagine how history would have gone if he worked for Blue-Cross.

*** Note to the APA secret police: this is a joke!!

sushi-cats_2 I was searching on Youtube for postings on the history of the Chinese Republic when I saw a ‘you might like this link’ to something called “Cats as food”.  It is a five-minute long documentary on the Chinese custom of cats not as pets but for cooking. She showed via hidden camera cats in cages next to the chickens, ducks, and piglets. They were handled with tongs. The authoress of the video made it a shocking documentary:isn’t it ghastly cats are being used in as cuisine. At one point she was assaulted by a Chinese merchant, who told her to f*ck off. He called her a meddlesome westerner and to get out of his shop. She went on to explain how popping pussies into pies is a long time delicacy in China. She let the cat out of the bag it is perfectly legal to buy and sell cats as produce, so it wasn’t like people were breaking the law or deceiving the lunch crowd they were eating chicken.

I found myself curiously sympathizing with the Chinese merchants and customers. She did come across as a meddlesome “food police”. I noticed she wasn’t objecting to the other caged animals destined for the butcher. I wondered how she would react at home if some outsider from India barged into her dinner demanding she stop eating steak as cows are sacred.


I’d sooner eat rats in Tewkesbury than cats in Canton, but who am I to criticize another’s diet. If I didn’t like the notion of sweet and sour feline how do I justify eating any meat?

Another emotion I have to analyze: the notion of cat food (pun intended) makes me wrinkle my nose in disgust but eating dog is another matter. I would be as outraged as she. I would be trying to free up the dogs destined for kung pao.

I hope Spo-fans aren’t reading this while eating supper. My point here is how much right do we have to condemn or even ban what others eat and drink if we don’t want it ourselves. What about ‘bad food’ like fast food or fried bits? Can I nag others on the excuse I am a physician?

It is food for thought.


I continually struggle with making eye contact. I grew up a shy boy; making eye contact with someone I thought superior was hard for me to do.*  This ingrained bad habit still pops up a lot. I need to be on my guard. Of course, making eye contact is important both as a man and as a doctor.


My Midwestern malady is aggravated by my hummingbird mind which flits around from one shiny object to another. Poor habit and ADD joined electronic health records into a sinister cabal which makes eye contact too readily none. It is way too easy to stare at the screen while I listen to patients. I could get by with no eye contact at all (which on many a occasion I have done).


Curiously, the complaint ‘he/she doesn’t make good eye contact’ has lessened since the introduction of computer screens into the examining room.** People have grown not to expect much eye contact from doctors – or anyone else for that matter, probably because screen-staring is ubiquitous. We all do this to some degree. It’s another case I’m afraid where poor service is considered the norm.


I try to remember to stop my typing from time to time and look them ‘straight in the eye’, especially if they are men. There are some exceptions to the value of eye contact: paranoid patients, women with histories of abuse,and borderline personality cases often become more unsettled with too much eye contact.


“Eyes are the window into the soul”. One can learn a lot about a patient by their eyes. Not only physical conditions but subtle emotional elements. “the eyes don’t lie” as it were.


I keep working on this need for eye contact, both professionally and socially. It isn’t easy for me.





*As I felt nearly everyone was better than I, my eye avoidance was pretty well with everybody.


** I used to work with a doctor in Michigan who made no eye contact at all as he typed into his laptop while he talked and listened to his patients.  It was one of the chief complaints why they would transfer to me.

The Weekend Guest arrives tonight. This was incentive to tidy up the backyard.  At this time of year we don’t get out in the yard much, other than to make a beeline to the pool.  The backyard is in disarray and wants attention. Most of the plants have died, victims of relentless summer.  Desert dust get onto everything.  While Someone swept and dusted the furniture I tended the plants.

I try to keep herbs and perennials but it is just not humanly possible; I’ve learned to stick with succulents. Xerigardening has its hazards. Just about everything in the yard has prickers and nasty big pointed teeth. Heavy gloves are a must when pruning pickers or pulling pups. Transplanting cacti are particularly tricky; it requires wrapping them in blankets prior to transfer. I stick manage to get one or two pricks. Once in they are recalcitrant and as immovable as the rocks at Stonehenge.

The backyard is presently past the point of being an embarrassment. It is feasible for outdoor entertaining if The Weekend Guest fancies it. Alas, as I sit, I continuously scan the horizon making a mental list of things still to do. It feels feckless; nature is against us.  There is a continual dropping from the mesquite tree; the monsoons brings in more layers of dust. There is no end!  Ah well.


The pool and hot tub are ready if The Weekend Guest wants a dip. That’s the most important matter. I am in charge of lighting the tea candles and ‘circle of friends’ if we sit outdoors. I sense we will merely just go to bed – aren’t we the sybarites!

Tonight I will sleep with the quiet satisfaction the agaves and cacti are tided up and I found no triffids.

When I have a patient who speaks Spanish, an interpreter is required for I speak little Spanish. Although I sign, my deaf patients usually have an ASL interpreter along.
I have an English patient**. When I am with her I wish there was such a thing as a British-English interpreter. It’s not her choice of words like ‘petrol”, ‘taps’, or ‘nappies” (gasoline, faucets, and diapers) that confuse me. Rather, it is her charming but unrecognizable expressions which leave me bewildered. I either pretend to know what she was saying or I stop the interview to ask for a translation.

Being a closet Brit I admit I enjoy them and I later try to use them myself. Most of the time I sound silly saying “Pull the other one!” in my Midwest accent with its pseudo-Canadian diphthongs.

Here are a few of my favorites. I hope you find them jolly good fun as I do!

It’s monkeys – apparently this means it’s very cold. It derives from ‘It’s cold enough to freeze the balls off of a brass monkey. It’s a fun but relatively useless idiom for living in AZ where the temperatures regularly get up to 40-45 centigrade.

To have a butcher’s – is ‘let’s have a look at it” I don’t know the origin of this one.

Chin-wag – a gossip.‘Lets have pour s wine and chin-wag and get caught up on the news’

Bob’s your uncle! - meaning presto, or right away.

He knows his onions – The fellow knows what he is doing or what is going on. I think of The Best Friend when I hear this expression, for he once gave me this tune with this title.


But my favorite?  Hands down < ‘Away with the fairies’.

She explained it means to be not focused, daydreaming.Oh sorry, I was a away with the fairies or Don’t mind Spo, he’s away with the fairies today’.



And – as a bonus – “Sooner I’d eat rats in Tewkesbury”. Contrary to what Spo-fans think, I did not make this one up. I think it comes from Shakespeare; I can’t quite right remember.  However, I am proud to be the one to keep the legacy alive and kicking.



rat-alone**The details are altered to protect the person’s confidentiality.


The Board of Directors Here at Spo-Reflections would like to apologize to everyone in the world for these latest blog entries.  The author was instructed to write “something serious”  along the line of the mysteries of statistics or how to fix the drains or a commentary on the history of Middle Ages (overall a more friendly period) but instead he produced a threnody which is not at all what we want here at Spo-Reflections lest the readers begin to channel “Werther” or turn to strong drink or start voting Labor.  Rest assured the author is not at all clinically depressed or wholly pessimistic but was having a bad hair day after watching too many news reels involving Sarah Palin and Dick Cheney which caused him to be a little upset so please don’t write in he is going to cheer up (or else) and the world is knee-deep in buttercups and daisies the good times are coming if not we have given him a brochure on “The Institute for Incompetent Bloggers” which is profusely illustrated and he won’t find a dull page in it. We would also like to point out the recent entry titled “Meet the Directors” has a myriad of embellishments and many of the descriptions are quite stretched if not outrageous and not to be trusted any further than Sven can kick a lemon pie so again please don’t write in we are all perfectly happy and Herbert is really a nice fellow really now that he is taking his medication as directed.

Michelangelo_Buonarroti_027It’s been one of those days; I am in a lugubrious state.  It seems the country – nay, the world – is barking mad a kennel of mad dogs. I get chest pains at the rampant ignorance running amok these days.


As a boy I was told I was ‘too sensitive for I seemed to have a genius level of feeling. Because of this heightened empathy I was easily affected by hurt, sorrow, and stupidity. In response, I developed a habit to avoid things and crawl into a hedgehog hole and pulling the door shut.  Every once in a while I try to be more brave, ‘man up’, conure up my inner ‘Warrior”, and face the Demons of Ignorance.


Unfortunately the internet is the ultimate Pandora’s box which releases the world’s sorrows and zanies in one sockdolagar of an onslaught. There is no end to what drives me to distraction and despair: Fox News, The GOP, The Tea Party, religious zealots (of any persuasion) – the list goes on and on. Like any sane person I despise cruelty, so why is it The Yahoos are winning? Education, science, reason – and good manners – are all rejected in favor of shouting and pushing one’s way to get what one wants. I recently viewed some ASPCA documentaries on puppy mills and abandoned dogs; I am ready to take gas. Even as I type my fellow Arizonians are organizing an armed protest against a busload of refugee children. These are the same who lament on Sunday we are not a Christian nation. We are the only civilized nation who doesn’t provide some sort of reasonable health care to its citizens. The prison system is broken; the politicians are in the pockets of the Koch brothers et. al.

Look no further than Maricopa county where Sheriff Joe is repeatedly re-elected. That sums things up nicely.


What my inner-child wants, of course, is the equivalent of Mother who used to put her arms around me and assure me everything will be all right, for God watches over us and cares for us and blesses those who hunger and thirst for justice (while she gives me something nice to eat like a homemade brownie). Alas, Mother isn’t here now (as they sing in “Into the Woods”) and we can’t seem to kill the Giants.


I guess I will turn off CNN, Huff Post, Yahoo, and the TV, drink my wormwood and crawl under the covers. Perhaps tomorrow there will be enough Warriors who will keep fighting the good fight. I hope the demons of Ignorance haven’t eaten them all in the night.

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