I don’t usually talk about specific patients here. I will do so now.

Today I learned a patient of mine died earlier this month. It was not a shock. I knew this day was coming.  He was in hospice care with terminal cancer. His passing produced a deep sadness in me. He was a sad man himself. He had a depression that was based on his perception his life had had no accomplishment. He felt himself a failure.  He hadn’t written a great novel or powerful paper. He hadn’t established himself in any particular field. There was no hospital wing or building with his name on it. He felt responsible for not saving his first marriage, many decades ago. His current marriage was also deemed a failure in ways. He felt his life had been a meaningless one

I tried (with little success) to get him to discard the past with its perceived ‘failures” and focus on making his present life is meaningful as possible. He didn’t “buy it”. He felt the parade of life had passed him by and what he could accomplish at his age was mawkish and meaningless. Then he got cancer; his days were numbered. I took the approach to get him to sum up and make what time he had left have meaning. As his health failed these goals shrank to keeping him pain free and ambulatory. I don’t know how he died exactly, but I surmise if he was conscious at the time his last thoughts were how he had failed.


I don’t see ‘success” in life as he did viz. leaving a legacy or achieving fame or peer esteem.  I have known countless patients; they have taught me a “good” life isn’t necessarily long or fabulous or ‘successful’. The key was having meaning.
I feel sad for the passing of my patient, that he went to his death feeling he had accomplished nothing. He was stuck upon the things he hadn’t done rather than take joy/satisfaction in what he had done, even if this wasn’t notorious.


As the new year begins I wish to sit down and contemplate the meaning in my life. I hope I am brave enough to do a shake up if it comes up deficit.  A person who had no meaning in life might live to be 100 and think his life but a brief one.


I implore those reading this entry to seriously consider their lives: does it have meaning?  I don’t care about your income or accomplishments; I want to know if your life has meaning. If it doesn’t, please do something about it.

Note: this entry has been held up for some time by The Board of Directors Here at Spo-Reflections as they can’t make up their minds if it is clean or even what it means. Dry, tongue-in-cheek humor often bewilders them; they see it as truth when it is parody.  It finally got the ‘OK” as it is Krampusnacht.  They figure if it is naughty I will be hauled away in a wicker basket.

It is quite frustrating to have a high desire for reading without much time or outlets to do so. It is sort of like being a perfectionist who can’t get anything right. Yesterday The Other Michael suggested we go to the library to read some books. This sounded jolly good fun for I haven’t been to the local library in ages. Alas, after our strenuous 1.5 hour-long hike and lunch we sank like rocks and took long naps rather. No books were read, alas.

I miss leisure reading. I have an app for downloading books (as it were) but who has the time for that. On occasion a young bibliophile says hello via the app and wants to know what I like to read and would I be interested in loaning him some literature. Alas what these youngsters like to read sounds mostly rubbish and they never have compatible times or proper places one could go to read in peace. The fact I like Dickens scares them away

The Other Michael is an avid reader; it is enjoyable to hear what he is reading these days. All I get these days are my medical journals. I have a Kindle which allows me to read a bit when I am by myself. I read exciting things others are doing and I dream of writing something similar.

I am not a picky reader; all reading is a pleasure. I enjoy a variety of reads from lofty novels to cheap penny-dreadfuls. I enjoy old classics and contemporary literature. I hope to do a lot more reading in the new year.


020ec4a458325fd5f6ed2c43ba63d839The Other Michael is in town; he is well over four feet. Usually he tempts toward vice but this time (so far) he’s tempting me towards virtue. TOM is a runner. He is very good at it. He’s run marathons and makes good time. I’ve been contemplating running as an alternative exercise to elliptical and gym stairs so over dinner rather than a proper chin-wag I interviewed him on how to run. I felt such like Barbara Walters.

Urs Truly was a runner once a upon a time. I haven’t done so since High School. Nowadays I feel as fast and graceful as a parade float; I wonder if I can actually run at all. It would be nice to be in better shape and ‘have a goal’ as it were. I don’t fancy running a marathon but it would be nice to run a half-bit.  Some day.  Well Naples wasn’t re-built in a year. It’s always good to start at the beginning some wise woman said.

I have two nagging neurosis about this. I am notorious at starting things with great enthusiasm only to fizzle. I worry too there is a ‘proper’ way and doing something otherwise is wasting my time. TOM tells me there are instruction books with “recipes” as it were on how to get going and what to do (I do like structure). However his advice is a simple: put on your shoes at get going. I can do that.

As Edina Monsoon says: “Oh darling, if it were that simple, every one would do it” .

Phoenix has bad air and it is worse in winter. The inchoation may have bad timing viz. getting in shape now is correlated with cold air and COPD. In my neighborhood are several’ washes’. They have lovely trails sans traffic (that means without) provided I run in the day so I don’t trip or encounter javelinas I should do OK.

Today is Sunday and Someone is working: I am in charge of entertaining TOM. I doubt we will run, but we will share a cup of coffee (rubbish I fear) and contemplate the day. Perhaps there will be vice to counteract all this virtue. Balance is the key to life – including running.

He’s no fun. he falls right over.

This year I took all the Christmas music and combined them into one playlist, pressed the ‘Random select’ and there it is. Apart from a few horrid tunes*, I generally like Christmas carols. Over the years I’ve collected a lot holiday CDs ranging from the sublime to cheap Christmas trash.

It’s curious to have random generated Christmas music if only to hear what next arise. One moment there might be a tasteful Noel motet followed by Elvis having a blue Christmas. Loreena McKennitt’s soothing Wexford Carol exits and Pentatonix Dance of the Sugar Plum Fairy enters (jolly good fun).

I suppose the sudden change in mood and genera is a bit jarring. It is sort of like going to a banquet where the first course is an exquisite delicacy only to have the second coarse be fries and catsup.

After the novelty wears off I will stick with albums, one at a time, as my moods wish. Albums tend to be more homogeneous in taste, volume, and style. Random tunes make for strange and uncomfortable bedfellows. Jessye Norman doesn’t go well with The Partridge Family. Eartha Kitt wanting Santa Baby to bring her goodies jars with the spirit of “In the Bleak Midwinter” (of which I have six versions).

I have approximately three weeks to get through all my CDs although I think I will skip the Beach Boys and the Lovely Lennon Sisters (gads but they sound white) and focus on more on soothing Narada-like verisons of hohoho.

In all my years of knowing Someone I don’t remember him once putting on a Christmas CD or any music for that matter.  He likes TV not music. I listen to Robert Shaw Chamber Singers; he watches Law&Order.

Neither one of us likes The Little Drummer Boy.



The following make me sick up, shoot reindeer, or release the Krampus:


Rocking around the Christmas tree.

Grandma got run over by a reindeer.

The Christmas Song (chestnuts roasting on an open fire)

The Sleigh Ride song (truly horrible).

It’s the most wonderful time of the year (Andy Williams version is the worst)

Have yourself a merry little Christmas (Judy Garland’s version drives one to drink).




It’s International AIDS day. I should say something profound and inspirational but nothing leaps to mind other than the day reminds us HIV is not ‘beat’ but still around and we musn’t grow weary from attrition. It is the task of the living to make meaningful the ordeals of the dead. I pause on this day to think of patients and friends, past and present, who have/had AIDS/HIV.

Insanity1st December is the start of the annual hysteria about Christmas; I’ve done little to nothing in preparation for it. Alas, I am one of those who doesn’t see gift buying and exchange as a pleasure but an anxious task with an ominous headline. This year is it complicated by travel to MI. Do we buy the Christmas prizes there, or ship them ahead of us, or pack them in our luggage?  I need to corner Someone to clarify our battle plans.

Yesterday I came home to find all the furniture turned up and onto the beds; Someone did the annual shampooing of the rugs. The house has a clean soapy smell to it – cool too, for the ceiling fans were on to dry things up. We three had to all pile into the guest room bed as the master bedroom was wet. I did something I haven’t done in a long while: I woke at 2AM wide awake and could not go back to sleep. I daresay it is the emotions about the news. I worry my mental health is going to pop a tether in the next four years. There is some comfort I am not alone on this.

thSpo-fans may be interested to know I signed up for Twitter. Turns out I already had an account but I forgot about it. I signed on in 2008!  I am now getting fustian words via Haggard Hawks tweets and I am pleased as punch.

Twice I have made crockpot Vindaloo (one pork, the other lamb). These turned out OK. I haven’t gotten the recipe down to the type I get at the restaurants. I feel assured to branch out into more Indian cooking soon. This is fun.


Going to work involves a lot of packing. Looking at me loading the car you would think I was going somewhere for a long weekend. I have my briefcase, my gym bag, a lunch bag, the inter-office box (nicknamed “My Most Difficult Case”), and a beverage cup (thermos in the cool months; a plastic glass in summer).  The briefcase has patient files, paperwork, something to read, my pillbox, work keys, and what not.   I look and feel like the Ghost of Jacob Marley hauling this hoard around.

Needless to say, it’s a rare day when I remember to get everything right. There is always something left behind. The gym bag may be missing proper shoes or My Most Difficult Case is bereft of some charts I took home for homework.*

Today I overslept and forgot the gym bag and the lunch bag – a rare event to forget two things let alone major ones. Sometimes Someone will bring forgotten items to work for me. The Wonder Receptionist, who is used to this, still finds it funny; I dare say she and Someone swap sardonic stories about me as he drops off the keys, the Most Difficult Case, or whatever was neglected that day. Today’s major bungle I’ve interpreted as a sign from the gods I don’t have to go to the gym today, having gone regularly for the past several days. I may have subconsciously acted out by forgetting lunch as it is more leftover turkey and I am tired of it.  If I have time today I can run out and get something hot, cheap, and quick, like my men.

Lepers periodically do a something called a vital assessment survey (VAS) to make sure they haven’t injured themselves. I suppose I could a sort of VAS by making a little list to check off each morning to diminish lost objects.

Being a bit of a ditz runs runs in the family. I remember grandmother, who lived in a large house. As she aged, doing the stairs became a task only to do twice a day at most. She would try to ascertain she had everything she needed for the day before coming down the staircase. If she realized she had forgotten something, she would not go back upstairs but either go the day without it or buy a new one in town. Works for me.

*TMDC is also used to transport dirty dishes, lunch bags, and tea things.



The Other Michael is coming to town and we are excited to host. Apart from the pleasure of company, visitors get us out of our mundane daily grind and into a higher plane of living.

First, the house must be tided, and not just the minimum but a proper cleansing. We must expunge away the morass of endless gunge that has accumulated over the months. Someone says he wants to shampoo the rugs: this portends a more detailed house job is going to happen. For once we will have a clean place. I dare say we may even change the bed sheets in the guest room.

Out-of-towners also inspire the preparation of better meals. Rather than rotating through the same three or four ‘fuel food’ items we pass off as supper we will have proper dinners (no rubbish) and a few eat outs at restaurant (lovely). TOM enjoys a cocktail so we will have fun and adventuresome libations to boot.

Next month Someone is doing a lot of evening, so keeping TOM entertained in the evenings won’t be difficult. I forget what shows we are seeing but it doesn’t matter much. It will be jolly to step out and see some theatre.

The major question facing us is whether or not to get out the Christmas trimmings ala “We need a little Christmas”. At least we should put away the Halloween things which are still sitting in the dining room in their black and organe bins and boxes waiting to be put away in the garage. Thank goodness TOM is coming to town as these would probably sit until Easter.

Last week at Thanksgiving The Lovely Neighbor and her relations were shocked when I announced I had never had mincemeat pie.  They figured the Renaissance Man that I am surely would have had some in his life. Alas, the truth is no.* It got me thinking of the scores of things I have never experienced in life and are they worth pursuing.  Some things like mincemeat pie I figured would come my way eventually; I was in no need to speed it up.  Other untried items would require more active intervention if they are to become reality.

Spo-fans are welcome to comment if I am missing out or I should not bother.



Christmas Hard Candy


A professional football game

“Rocky” movies

A baby shower




Alabama and Mississippi

Tom Clancy novels


Make my own beer

Run a half-marathon


Morris Dancing

Angry Birds

Learn contract Bridge

Beef Bourguignon (made or consumed) 

Hot Air Balloon ride


A day of drinking


Get at tattoo

Attend The Bayreuth Festival

Write a politician


A Redhead


Every once in awhile I make a plain one-coloured shirt and surmount it with a yoke made quilt-like from scrapes of previous projects.  These are the leftovers from shirts I have made for others. The yoke becomes a sort of encyclopedia or list or what I have done.

This way I get to wear a piece of shirt made for others, shirts I no longer have. I can look at the yoke are recall what I have done in life.

Some Spo-fans may recognize bits from previous posts, or even shirts they possess.

I am not so certain about this one. There is something I don’t quite like about it. The yoke turned out OK. It is the colour I suppose that isn’t agreeing with me. I was going to make the shirt fuchsia but decided to go with red as I don’t have one.

Oh well. Perhaps it will grow on me. At least the red matches my eyes.



My medical mags often have articles warning about “Physician Burn-out” and how to avoid it. They are fascinating reads. I am frequently tired by the end of my work day (age) and I often lose interest by 3PM (ADHD) but I don’t have burn-out.  Despite the endless paperwork and time  consumption of my profession I genuinely like my work and I go to it feeling good.

All the same I want to keep tabs on advice to prevent such.

The recent article suggested some salient solutions: going part time, saying No, and getting young people into your life.

I went into the living room where Someone is ensconced in his chair watching Law&Order (as is his wont). I announced I go part time to avoid burn out. He let out a snort most unsupportive. I then proposed I get some young people into my life. He pointed out I tried that before and it didn’t work out. I could see conversation was a feckless endeavor while the court scene is happening.  So I said No and we haven’t spoken since.

If I can’t go part time to avoid physician burn-out I will have to do something about getting young people into my life. The article didn’t say ‘how young’ but at my age 30-40 could be considered such. I think the article suggested lads in their 20s, tyros still with spots nevertheless with ebullience and ideals that only young people have. Sounds good. Alas, I tossed the article before I read the fine print on what I am supposed to do with young people to prevent physician burn-out.  All I can think of is manhandling and light housekeeping; these activities sound quite salubrious as a preventative. JAMA also didn’t mention where I can find the prophylactic youngsters . Last night at the bar where we go on Fridays for happy-hour there wasn’t a soul under forty years old.  Afterwards Someone and I ate at a place specializing in enchiladas. The eatery was packed with working lads in their 20s, who were quite ready to attend to me but limited their service to what sort of sauces I wanted and was that with or without fried egg (with). Although I had had two gin and tonics I held my tongue;  I didn’t ask if they would like to help prevent physician burn-out.

I guess I will have to continue to work full time sans young people (that means without) and just hope for the best. If I should develop physician burn-out I will blame Someone for saying No.

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