257473017_newpeople_xlargeThis weekend I was approached not once but twice by men in a bar* who, upon eye contact , smiled with the radiance of a brilliant sunrise, came over, and said hello! I remember you!  I recognized the situation at once:

“The man coming towards me recognizes me from the past. He remembers me but I haven’t the foggiest who they are. Think fast, rabbit!

This is not a rare event. Sometimes they are patients**, but most of the time they are not. I have only a few seconds to decide whether to bluff my way long enough to connect the dots and recall who they are, or admit I’m at at loss. It is never the other way around viz. I recognize someone but they don’t remember me. I hope they remember some positive attribute rather than I made an ass of myself.  They don’t explain how or why they remember me and I don’t ask.

The first gentleman was a bartender from a bar where Someone and I used to go on Sunday afternoons to hear show tunes, before the bar changed generas. Considering we did not go often or drink much I fail to understand how he does this. In his defense he didn’t recall my name, but he remembered I was the one who wanted a ‘proper manhattan, no rubbish’.  So there it is.

The second gentleman was with his partner. He remembered me (of all things!) from a July 4th BBQ which occurred two summers ago. This is a tad unsettling for I have only a vague memory of being among a crowd of strangers and not saying much or staying long.  They were nice fellows; we exchanged information on the possibility to get together sometime.

I suppose I should be flattered, but it worries me. I can’t blame old age (yet) or memory loss from intoxication (hopefully) nor acting idiotic in public (hopefully not).  I wish I had better recall of people’s names, or at least that I have met them before. I hear tell you can take a course from Mr. Dale Carniege who assures me I will be a wiz at remembering everyone I meet at the next bake sale.

The other concern raised is a failure to keep in touch. Every time I encounter one of these types they remind me there was a brief attempt at forming a friendship but it fizzled.  After a decade of living in Arizona I haven’t been very successful at making local, lasting friends. I suppose this requires time and effort – and perhaps some sacrifice of other endeavors.

I plan to call the second gentleman caller and spouse and propose we go out for supper or a beer. It would be nice to be more than memory.



  • Not only did this double encounter occur in the same bar on different nights,  it is not in a gay bar either.

** Patient have the advantage they remember the ‘beard and bow tie’ combination, which are worn on most social occasions, like Saturday night.


After a week of non-stop work and long hours, I am spending this Saturday morning sitting in a medical conference. I am pow-wowing with my fellow wizards on the topic of opiate prescriptions. I don’t prescribe opiates or directly manage pain but I have a lot of patients who take medications for such conditions.  It’s important for me to keep abreast of the news.

The treatment of chronic pain is (pun intended) a pain in the neck. To be blunt, doctors don’t want to deal with chronic pain. It’s a complicated disease; despite its prevalence doctors receive little training on the topic. Patients with chronic pain are often needy and time consuming.  They come often with disability papers; they want pain medications. Thanks to unscrupulous physicians and bad-seed patients, prescribing adequate pain medications is bogged down with ever more regulatory restrictions making both the prescriber and patient feel like criminals.

So I am hear to today to try to sort out the science from the hysteria.

Sitting waiting for the lectures to begin, I sense negativity in the audience. The demands and paperwork and regulatory problems surmounting treating pain has made many docs who treat pain burned out.  I hear a few grumbling about ‘negative reviews’ patients have given them online about ‘inadequate or bad treatment’ when the doctor was sensibly setting limits or refusing to give out vicodin upon request.  **

It’s a complicated problem.

Many doctors feel a relief they don’t have to deal with mental illness, but I feel a relief I don’t have to directly treat pain. All the same, I need to know things; I am a physician first and a psychiatrist second.


** There is some evidence “patient satisfaction surveys” are raising the use and abuse of pain medications. If a patient gets a Rx for such they are more likely to leave a satisfactory review ‘they had their needs attended’ AND negative review if pain pills were not given.

I’ve fallen down the rabbit-hole; I’ve not had time (again!) to properly blog. I worry when I am away from blog-land all sorts of significant events happen of which I will discover long after the fact. The irony! I am usually always on time for everything. I suppose someone has to be at the end of the conga line of congratulations or condolences. I only wish it wasn’t always I who acts as caboose to the comments. 

When I have a time to write a proper entry (probably Sunday) I will tell you all the dirt and updates*. Meanwhile, here is a ‘back up’ entry:




Dante writes in his Inferno hell has levels, like Dungeons & Dragons. I like the concept. I fond of the expression ‘There is a special place in hell for…” for people who are particularly rebarbative or nefarious.

Here’s my choice list;  Spo-fans are welcome in the comment section to nominate their own special somebodies.

Special place in hell for:

Whoever invented strip malls

People who throw cigarette butts out or the car, especially in AZ with our drought.

Folks on cellphones going through a grocery checkout, making no conversation with the check-out person, and generally slowing things down as they are not focused. 

Her sister:  she gets to the end and says ‘Oh! One more thing” and runs away to find something way in the back of the store.

Insurance companies 

Gun lobbyists 

Whoever invented Black Friday sales


Telemarketers who call at supper time. 

Whoever thought “anonymous comments” was a good idea. 

Speed-bumpkins viz. people who exit the theatre only to stop right outside the door to gab, making the exit impassable.

Radio programmes who play “Don’t Stop Believing” every two-three hours.

Opera directors who think avant-garde settings are cool and clever (or who don’t drag Don Giovanni down to hell properly).

Whoever canceled “Star Trek the Next Generation”.

Most Fox News commentators. 

The woman in front of me in the airport security line who is shocked and argumentative  she has to remove her ponderous amounts of metallic jewelry.  

and a special place in hell for:

Whoever invented auto-attendent phone system.


* Actually not much. 

The death of Betty S. makes me think about making a difference. Many people are satisfied with accomplishing the basics: being a good mate, a good parent, and good family and local community member. Then there are the people who did more than the basics; they made a difference for many. History is full of such examples: Gandhi, Mandela, Aung San Suu Kyi, and Malala Yousafzai.  Their accomplishments often met with opposition from authority.  They were/are the true Warriors.

I wonder how many people want to truly make a difference. Some (most?) only want to get as much as they can out of life. I want to be more than a consumer; I want to be a contributor. I am not content with just being a good spouse, someone loved by family and a small network of friends.  I want to make a difference – somehow.

Some would argue I do make a difference via my job. After all I’ve spent over twenty years as a physician trying to heal mental anguish and restore meaning and direction to people’s lives.  But I don’t know if this truly counts for I get paid for it. Imagine Mother Teresa if she was on salary for helping the poor.

Betty inspires me to do more than be a good man and a competent doctor. She got involved; she made differences. When did I last volunteer, or join a protest, or assist in a clinic? Not in a long time I’m afraid.  I just go to work.  In my time off I do harmless introvert things.

I think my memorial to Betty should be more than a comment on FB and a yesterday’s blog entry. Perhaps the AIDS clinic she attended needs some help. Perhaps this Red States’ democratic party needs a volunteer. Where does Arizona stand in the battle of human rights?

It’s time for action; it’s time to make a true difference.

At my funeral I want more than ‘he was a good man/doctor/family member”.

I want to be remembered as“A friend of Betty.”


Today while reading my blog-list, I learned of blogger-buddy Betty’s passing.

Tributes are pouring in on FB, at Joe.My.God., and the blogs of people who knew her.

She was one of our Warrior Queens, and will be sorely missed by many.

I will not forget her; when my spine needs stiffening, I think of her and she gives me strength and comfort.

I feel oh so sad.




This evening I went to the local museum to meet Linda Ronstadt. In order to stay awake I drank a cup of coffee. This worked, but it was foolish: it’s past midnight and I am alert and there is no going to sleep. It gives me the opportunity to contemplate the cosmos or write a blog entry. I have no comment on Life, The Universe, and Everything, and I don’t have much upon which to write.  Being alert without inspiration is a cruel combination.

Last week work was noteworthy that several patients brought gifts. One brought me a zuni bear; another gave a bow tie.  I am not supposed to receive anything from my patients lest the APA secret police bust down the door and drag me away for violating contemporary professional standards. You tell me how to tell a patient to take it back.   Speaking of work, next weekend I attend a seminar on pain pills. There are new draconian laws about prescribing opiates. I fear the audience will be in ill-tempered and resemble an orchestra of scorched cats as the remonstrate they and their patients are being treated more and more like criminals.

Speaking of gifts I sent the nieces and nephews (AKA the niblings) some Hallowe’en treats but only one of four sent a thank you. I don’t expect a handwritten note (although that would be nice) but an email/call/smoke signal would fill my need for proper manners.

Speaking of Hallowe’en I am slowly getting out the props. I have a small tree designed to resemble a black dead oak.  Every day I hang a new ‘halloween ornament’ making it an advent calendar.  One of my relations is telling one and all via FB Hallowe’en is Satanic and/or Papist (she gets these confused).  I personally don’t see the connection between giving M&Ms to 8 year olds dressed as princesses and sacrifices to Beelzebub.

Which reminds me, I need to find the Hallowe’en costumes and trimmings to see if I want to show up to work dressed as one of the Directors Here at Spo-Reflections.  The repeat patients won’t mind but the ‘first timers’ could develop heart failure.


Spo-fans should stop sending emails and texts, the answer is “No!” Mr. Kim Jong Un is not on the premises. It’s understandable tongues are wagging as he’s been missing over a month, but the hypothesis he is in my guest-room is incorrect. To be certain, I’ve gone through the rooms and cupboards and there is no sign of the rascal. The only suspicion is somebody has been eating the Hallowe’en candy which was up to now hidden away in the freezer. Harper can’t eat chocolate and Henrik never touches sweets. Mr. Un is legendary for his appetites.  I am considering putting up a hidden camera in order to catch him in the night as he consumes the Milky Way bars.   It’s bad enough having a drip of a ghost but an overweight totalitarian dictator snarfing the sweeties is really too much.

Mr. Un needs less sugar and more discipline, and besides, the candy is for Hallowe’en. The culprit is fond of the “B” candy*

Mr. Un would be better off lurking around my office, not creeping around the hallways. Not that he would do much there either. He seems to have quite a nasty narcissistic personality, which (according to Dr. Fisher, my professor on Freudian psychology) has the same prognosis as advanced cancer of the pancreas.  Prozac is hardly going to help, although come to think of it, Skittles is the panacea for all ills.  Perhaps I could advance the unification of Korea merely by putting out some bowls of candy. This is on the proviso he is indeed lurking about.

I will try to keep you up to date on Kim spottings and the status of the Baby Ruths.




* Also in the freezer is the “C” candy: pumpking-shaped gummy treats. He won’t touch them.


Quick! Is there an entomologist in the house? I want to identify the species of demonic mosquito causing Urs Truly no end of grief. We’ve had two great rains, which have bred some sort of nasty blood sucker; they’ve sprung up like  maggots from dead meat. I can’t quite catch one to observe its nuances, but I’ve deduced: it is small; it works in a group; the bites are very small but itch like hell; they go for the calves (mainly); they stop at nothing.  I am not used to mosquitoes. Alas, they are legion.

It’s cool enough to open the windows but these bastards, who seem to squeeze the smallest cracks in the screens, make it impossible to let in some air.

I suppose itchy calves and a disturbed sleep are minor complaints compared to more sinister mosquito-borne woes. For bug-bite hysteria de jour, West Nile virus is ‘out’ and chikungunya is ‘in’.  Few people seem to be complaining about the rise in this local production of “Them”.  This is likely because everyone is barking mad over ebola.

‘Think global and act local’ is a motto I interpret as drain the puddles and kill as many bastard bugs as possible.  There is a grim satisfaction finding one of these bitches resting on the wall and squishing her to smithereens.  Boom! Crush!  They make a small bloody mess which has to be cleaned up. There is a mild trepidation she was destroyed only after having bitten me.

I would like to install a bat house for little brown bats consume their weight in bugs every night, but Someone won’t have it. He finds bats even more horrid than mosquitoes.  I only hope things dry up soon and the mosquitoes go back to hell or wherever they respite when the desert is dry.  Meanwhile I wear long pants even though it is still in the 90s and I scan the environment for small buzzing things.

It’s halloween; the only blood suckers I want to encounter are eight-year-olds masquerading as vampires.

journalwritingIn the spirit of Hallowe’en I recently reread Washington Irving’s “The Legend of Sleepy Hollow”. I enjoyed the story but more so his writing style. Mr. Irving has an elegant way with words. When I read the works of a good writer it inspires me to do better.  I want the lexicon of Dickens, the wit of Ellis, the prosody (and pith) of O’Connor combined into the humor of several to create something all my own and just as satisfying.

I’m contemplating taking a writing course, for I want to become a better writer.

After all, the main reason for blogging is to scratch the itch I have to become one. I do not want to be a professional writer, but I desire to be decent. I’ve been scribbling out various types of prose here at Spo-Reflections since 2006. While I am pleased with the sometimes satisfactory prose I would like to see improvement.

Tonight I saw a preview of a play about a collection of writers coming together work on improving their work. The director of the play asked how many people have at home in a drawer some unfinished piece of writing they’ve not shown anyone. Most of the audience raised their hand as did Urs Truly.  Indeed, tucked away in my personal files is the outline of a story I’ve fancied fleshing out if I only knew how to do it properly.  I fear if I did it now it would be fair at best or (worse) derivative. So it remains uncompleted after years if not decades, waiting for me to have the skill to master its conclusion.

Each time I write a blog entry I hope to see improvements. Perhaps (like getting to Carnegie Hall) all one really needs is practice; is it as simple as that? All the same, I desire a mentor, a prose-personal trainer, or teacher to give me some tips of the trade and make me better. Sometimes I fear good writing isn’t learnable but an innate talent which you do or do not have (and I don’t). Nevertheless I’m keen to find out. So this month I will see if any of the community colleges offer ‘Writing 101”.  The professor may not be able to make a race horse out of this sow, but I am hoping at least he/she can make me a very fast pig.

Walking the dogWalking the Dog is always a pleasant and popular type of entry……

It’s that time of year when the 530AM and post-prandiol supper walks are done in the dark. It will be this way for many months. The temperature in the morning is cool enough to wear a light sweatshirt; the strolls at gloaming remain in the 90s. Worse, the PM strolls have a lot of bugs. This is unusual. I suspect our recent rains have brought forth a hoard of nasty mosquitos. We come back with bites on our calves. They are small but they itch like billy-oh.

Someone is on a mission to lose weight and exercise regularly; he’s joined us for most of our walks. Harper is thrilled. When we leave the house, she literally pushes Someone down the sidewalk to get him going. Sometimes we talk; sometimes we listen to podcasts. Either way, Harper is pleased as punch to have him.

It’s the first weekend in October; we are already seeing some Hallowe’en decorations up and running. Someone is in the camp that wants Hallowe’en props and lights to go up no sooner than the 30th and down they go on November 1st. I’m for having the whole month of October a celebration of All Hallow’s Eve.**

Harper is fastidious she poops in only certain spots. The city provides us with black plastic bags and drop-off sites. Until recently Someone was the only one who can open these damned bags.  I finally got the ‘trick’ of it. We always pick up after Harper. Not everyone in the neighborhood does likewise.


** Curiously we are reversed at Christmas. He likes some things up soon after Thanksgiving; I am OK with doing things maybe a week ahead of the arrival of St. Nick.  The tree goes down on Epiphany or prior to 1 January – depending on which one of us ‘wins’.

Sponsor Harper for AIDSWalk

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