My job has trained me to gather information and formulate a treatment plan in fifteen minutes or less. Given a knowledge of my patients, a good sense of the gestalt, and a keen intuition, I can accomplish this most of the time. There are a few downsides of this technique:

I quickly ‘get it” which means extra data is not necessary. I often interrupt circumstantial conversations to get people back on the topic at hand ala Dragnet “Just the facts, ma’am, just the facts”.

My listening is mostly ‘goal oriented’ rather than listening for listening sake.

While these tools are efficacious for getting the job done and staying on time (to the delight of patients and bosses) they are lousy for social intercourse outside of the office setting.

Someone suffers the most. Bless his heart, he is working now, and he comes home with many tirades and tales about his day. He is a good narrator; he tells a good story. Often these vignettes involve impudent convention attenders or rude old people at theatre where he ushers. I have to focus and really listen and not cut him off or ‘give structure’. He is not a patient, after all!  The nasty customers and co-workers he describes often make my blood boil and I want to knock heads together. However I know he is not asking for advice; he is asking me to listen.

I don’t know where this is going but I think it is a reminder to me not to bring work habits home. At home I can eat without rushing and listen without guidance or problem solving. At home I don’t have to be ‘on time’.

The late Barbara Holland wrote about the wisdom to hold on to the mawkish pleasures in our lives. Indulgences and dissipations are being continually execrated she warned.  Out of guilt and shame we are forsaking lovely things for oh-so-practical joyless endeavors. I thought of her this morning while I munched a large slab of buttered homemade toast made from a loaf of white bread I made in my bread machine.  That’s right: bread. Worse, it is white bread. It has gluten and carbs for days. It has no fiber or whole wheat , nor was it organic. I might as well have ate ground glass in the eyes of many.  But it was absolutely delicious thank you very much, and a more enjoyable breakfast could not be found.

We seem to be more aware of the dangers of junk food and poor nutrition, of which I am very glad, but there is a Shadow side to it all.  We are throwing out the baby with the bathwater.  What our grandparents adored we are being taught to despise:








A few months ago I was in San Diego at a conference which served a luncheon lecture. Although this was free eats, many at my table remonstrated to the poor overworked wait-staff their critique of the meal. I remember a few: the vegetables had been cooked in chicken broth and the bread was not gluten free. There is a creeping sense of something called ‘orthorexia’ which is a sort of political eating disorder where someone eats only ‘proper’ food which vary but all have in common strict standards that if deviated from conjures up in the person repellence, political activism, and condemnation.  The polite inquiry “Would you like some pork?” is no longer replied with a simple ‘No, thank you.’ but with a catalog of declarations why the receiver never touches pork and why the server should not be serving or eating it his or herself.

Mind! I continually watch my intake of high GI items, fried foods, and junk. However, I will continue to make toast and fry eggs and drink whisky (no rubbish) and eat pasta that isn’t made from gluten-free organic whole wheat picked at 3AM by Amish of three generations. Maybe not all the time.  But when I do, I will enjoy them without guilt as some of life’s little pleasures, thinking of Ms. Holland as I ask for more butter.


I am a consultant for the local medical board; I evaluate cases for potential violations of standard of care. I will spend a great deal of today examining a complaint filed against a colleague. These cases consist of a patient or a patient’s family  who have written a letter of complaint against a doctor.  I opine if the complaint has merit.  These cases are complicated by the fact the patients doing the complaining are mentally ill and not always sound in their thinking. It can be a daunting task. I try hard to be as neutral a judge as possible.

Stripped of the legal words and medical mumbo-jumbo the majority of these cases can be distilled down to a simple story: the patient feels the doctor was a jerk and he (nearly all are male) didn’t explain things. The patient has hurt feelings.

Alas, the conclusion to these cases is often the doctor didn’t do anything ‘wrong’ per se but reading between the lines he was a jerk. How do I tactually write a report stating if he hadn’t been an a-hole none of this mess would have happened?

The doctors against whom complaints or lawsuits are filed often say it is the system that is the problem or it is greedy patients and dastardly lawyers. Yet who is sued/complained against is not random –  most complaints are against only some doctors.  These doctors are some what different than the doctors who are not.  In the research it turns out the desire for remuneration is not as important to patients as wanting to be informed/heard. Studies show doctors who spend time explaining things are far less likely to be sued or have complaints against them.

In summary:  more friendly doctors are less likely to have complaints filed against them.

A study in 2010 supported the notion if doctors apologized the chances of lawsuits went dramatically down.

Try telling this to my colleagues.  They feel patients who file complaints/suits are doing it for the money.  In contrast  the patients when interviewed say they are doing it for negligence based on poor communication. Yet efforts to appease complaints continue to focus on trying to make it harder for patients to file complaints.

Poor communication remains the problem – and the norm, alas.

One reason why doctors dislike ‘on-line reviews’  which places them among restaurants and plumbers and other service work is the unconscious reminder stripped of our fancy training we are in customer service.  The key to less negative reviews in customer service is better service, especially in the forms of bedside manner and explanations.

Before I begin my silly scribbling, I pause on this day of thanksgiving to acknowledge my gratitude for Spo-fans, far and wide. Thank you.

frustrated-chefThis morning I cooked bacon and sausage. The former is for a bean recipe for today’s dinner next door with The Lovely Neighbor; the latter is a traditional breakfast treat I allow myself on major holidays. Neither came out well. The patties were burned on the outside and raw inside. I fear I have no knack for cooking.  I hope this is merely from lack of practice. Someone has literally or figuratively cooked for me all my life, so I don’t have much experience. This is a pity for I like the notion of cooking. I’ve often said my retirement plan is to cook something new and different everyday.  I suppose if I am going to realize this goal, I better start practicing – now and often.  Someone is an intrepid cook who makes the same things over and over; I like new and adventuresome dishes. Another incentive to learn how to properly chop onions and sauté vegetables etc. is to better guarantee I get what I want.

I made a run at the rolls last weekend and while they were okay in taste they were heavy has hockey pucks and got no better with time. System analysis reveals I did not like them ‘prove’ long enough, whatever the heck that means. I think the next batch will be better.  My other dinner task is to bring beans. I hope green beans aren’t too bungle-prone.  “The Joy of Cooking” suggests a simple boil in salt water with a peeled onion will produce a good-enough dish, hot, simple and tasty – like my men.

So wish me luck. I am off to the kitchen to check once again the recipes and keep calm and cook on.


There is a lot of lunacy running amok these days, and not only in the noggins of my patients.  Certain politicians are saying the most outrageous things, the sort I normally read in the headlines at “The Onion” or I  treat with heavy-duty antipsychotic medication prescriptions.  I am not too well-minded myself.  This morning Someone gave me specific instructions to drive with him to the car shop. While he was walking Harper I mindlessly drove to work. I knew in an instant I had f-cked up when he called asking where the hell was I. Not only did I forget to drive to the Honda dealer, I drove to the old clinic location.  I was temporarily flabbergasted to see it was a pile of rubble; then I realized it was scheduled to do just that.

Perhaps it is my cold or the distraction of Thanksgiving that has marred my mentality.(1)  Alas, the Wednesday roster consists of several ‘holy-roller’ patients  who are guaranteed to make mischief or suck the essence out of me.  It’s Drama-Queens vs. the Dementors. Fasten your seatbelts it is going to be a bumpy ride indeed.  The holidays are generally not good times to make major medication changes; between mid-November and early January most of my job is sheparding people along to keep things as is and batten down the hatches and take things one day at a time and let’s get through it somehow. (2)  I will probably be a wreck by day’s end. Then I have to face Someone about the missed car arrangement.

Tomorrow there is no work. Perhaps I can sleep in after tonight’s  dose of Nyquil. (3) If my cold lingers I will forgo going next door tomorrow to The Lovely Neighbor lest I give all the oldsters my bug.  Someone is working tomorrow, so I will be “home alone” with no Thanksgiving.  Don’t feel bad for me:  curling into a ball and sleeping all day sounds quite delightful and far preferable to a 3,000 calorie dinner.

Let’s first see how horrible the day goes and what grinning Fury does me in: the patient roster, the cold, or the wrath of Someone.  I will write a post-script this evening and tell you the outcome.  Bets are open until race time.

P.S. at 9PM – it was a nasty day. I don’t think it is worth telling. It’s over. Good night.


(1) Or I am just a ditz.

(2) Hippocrates once defined Medicine as the art of entertaining the patient while the body heals itself.

(3) Or Highland 18.


There is a posthumous Halloween hex on the house. What else explains so many unfortunate events happening around the place? Last week late at night I woke to a phone call from Someone who quickly assured me he was all right but he had been in an accident on Highway 51. Being told “I am all right’ assuages nothing. A spinning car smashed into the passenger door. Someone was OK, but he caught a dreadful cold waiting for the police or somebody like him to show up and do whatever they do under the circumstances. A few days later I was caught between two cars on same Highway 51 forcing me to run over a shard of tire. Now there is a scraping sound under the Elantra and we are fearful to drive it.  A few days later – same highway – I nearly ran over a ladder lying in the middle of the road. Come to think of it perhaps it is Highway 51 and not the house which is possessed. Meanwhile I have caught Someone’ cold which threatens to cancel Thanksgiving.

Yesterday my Christmas pudding came out of the steam kettle as a crumpled mess of half-cooked gunge. After six hours of labor it was quite a let down. Being a scientist I am conducting a system analysis to figure out what the hell went wrong. I have plenty of time to make another but I am not certain if I will do so. I hate throwing out food, so the pudding crumbles are being slowly consumed with vanilla ice cream. This may satiate my appetite for pudding come Christmas time. Perhaps I will think differently in a better mood after the cold clears

If things happen in threes, I’ve made my quota with an unholy trinity of cars, head cold, and pudding flop. I suppose the repairman can fix the dents and the odd things that go bump in the night under the tires. The head cold will pass with sleep and hot toddies.  That leaves the pudding. I still have leftover suet and what else can it be used for besides pudding I wonder.

I feel compelled to write something for I have not done so for a few days. That happens when I get busy. It is Sunday night; I am rawther tired. I had a long and productive weekend. There is nothing remarkable to tell; I merely accomplished a lot.

I am sad to report my second attempt at making a Christmas pudding was a bust. I suspect the container I used was the matter. I felt despondent for cooking the damned thing took over six hours, only to have it come out a disappointment. Happily I have four weeks to try again, this time using a different container than my great-aunt’s. Family heirlooms are nice but not if they put out inferior puddings.

The fit-bit tells me I walked over 16,000 steps today, which is nearly 7.5 miles. Most of this happened by flitting between the kitchen and the office and the laundry room for I was in a perpetual waltz, doing paperwork (office), checking on the pudding (kitchen), and doing the laundry (guess where).

Mr. Fitbit confirms what I have known all long: I don’t sit still very well. I burn a lot of calories via fidgeting.

Speaking of kitchen adventures I had jolly good fun hauling out the bread machine and making dough for a trial run at dinner rolls for Thursday. They turned out fair. I thought they tasted well enough but I found them quite heavy. They were like mini-loaves of bread than dinner rolls. I have a few days to figure out how to make them lighter or else I break down and buy them at the grocers.

Speaking of grocery stores, I traveled across town today to the butcher shop where I found the suet for Pudding #1. Alas, they were closed on Sunday. The local Albertson’s had a very nice young man who ground up a pound of beef trimmings to make me some suet, which he did at ‘no charge’ on the grounds it was going to be thrown in the rubbish anyway.  Since Pudding #2 was a flop, I now have to go back and ask him for more.  I worry he will think me either a nuisance or a wicked old screw trying to cruise him.

Come to think of it he was a handsome fellow, so the dark cloud that was my ruined pudding may have a silver lining after all.

Fearsome Beard inspired me to write this post.

In “Citizen Kane” the narrator is trying to figure out what or who was Rosebud. One of Kane’s friends advises the reporter Rosebud could be something so small as to miss scrutiny. It is the paradox of power: what looks small is large and what seems large is small. He tells of a chance encounter that haunts him:

“A fellow will remember a lot of things you wouldn’t think he’d remember. You take me. One day, back in 1896, I was crossing over to Jersey on the ferry, and as we pulled out, there was another ferry pulling in, and on it there was a girl waiting to get off. A white dress she had on. She was carrying a white parasol. I only saw her for one second. She didn’t see me at all, but I’ll bet a month hasn’t gone by since that I haven’t thought of that girl. “

Everyday we run into countless people in what seems like random meetings. We get next a stranger on public transport or while waiting in line at the grocery check-out or riding the elevator. We make eye contact perhaps; sometimes there is a brief formal intercourse.

Does any of this mean anything? Do these manifest chance encounters have significance?

I work in a service-type job. I see people all day long, some of them I will encounter only once. Will our forty-five minute interaction really change anything?

I don’t know if the theory ‘People come into our lives for a reason’ is a truism. However I believe our influence on others is far more than we realize. I have an intuition the brief and seemingly unimportant encounters are the ones which turn out to be the most cosmic. In the musical “Into the Woods” there is a song about ‘No one is alone”. In it there is a chilling line among the comforting ones

“Careful ! – no one is alone.’

For this reason I try to be conscious of keeping up good manners, smiles, and positive interactions whenever I encounter others.  We are not privy to see the outcome on our influence.

I wish at times I could be utterly without influence, but  I am not. I am not an island. All I can do is hope every interaction I have has its heart a grain of positive energy that will grow into a pearl I won’t see.

Home life news seems popular with the Spo-fans. I find this strange. I lead a dull life but it brings in the readers. Whenever I have nothing to write TBDHSR prods me to report on things mundane and quotidian. 

I was appalled to come to work today to discover the radio station that fills the clinic hallway with wretched classic rock started their Christmas tunes. Their cheesy upbeat secular holiday tunes have not changed an by a snowflake. There was Andy Williams’ “It’s the most wonderful time of the year” and Michael Jackson telling us Santa Claus is coming to town interspersed with several renditions of (oh the pain) the Sleigh ride song. My impulse was to pull down the speakers but I am not so tall. Normally I leave my office door open between appointments but today I barricaded myself in Achilles-like vowing to not come out until 26 December.  Apparently I was not the only trying to avoid snapping a tether as nearly everyone had their doors closed. By noon someone had changed the station. It’s a reprieve but I know next week they will be back.

My “War on Christmas”  has two fronts: content and timing. Mine is better named “War on Christmas Crap” which targets kitschy cheap Christmas trash.  The timing element is no carols or decoration until after thanksgiving. Like Napoleon, my two-front assault is probably doomed. I don’t now how right-wing Protestants can be so paranoid about the alleged annihilation of Christmas when Christmas seems to expand each year further back into the calendar to the point it now overtakes Halloween.

On the home front I purchased my bread ingredients for a ‘roll-run’ this weekend. The neuveau boujealois just arrived and I wish to purchase a few bottles provided the Black Friday shoppers haven’t already piled up in the parking lots to block my entry to Total Wine. I’m told this weekend is the proper time to make my Christmas pudding but I fear I won’t have time to do so. There is opera and symphony on Saturday and I think I am scheduled to be abducted by aliens on Sunday. I  hope they don’t have any Christmas music going. If so I vote for the anal probe.

A final home tidbit: there was a Henrik sighting the other day. As is his wont he vacates for months at a time to the point I think he’s scrammed or he was just the figment of my imagination then lo! there he is. While I was walking in the hallway I was quickly passed by a shadow seen in my peripheral vision. I felt a slight cold breeze as he whizzed by. Normally Henrik creeps so why he was in such a rush is a mystery but it was comforting to know he’s back. I sense he is fretful about something so I offered to talk to him while I made a cup of tea but I sensed he has skidoo-ed. As a haunt he is a rather a disappointment.

I’m rather knackered and it’s past my bed time but I feel obliged to post something lest you-know-who send me one of their bellicose emails threatening bodily harm if I don’t ‘put out’ as it were.



The Lovely Neighbor has invited us over for Thanksgiving. I am glad as otherwise I would not have had any. Someone is working that day and no one invited me otherwise. I would be home-alone. I asked her what may I bring for dinner. She requested I bring dinner rolls. I was surprised at this, for I thought she would ask for an appetizer or a bottle of bourbon. I would feel stupid to merely fetch remade rolls from the grocery store, so I will get out my bread machine rather and make some dough for crescent rolls.

I miss my bread machine. It is a boxy white appliance that resembles a sort of easy-bake oven. It makes a square block of bread the size of a small box of wine.

I have always loved bread, but when carbohydrates became ‘bad’ I felt guilty and stopped using it. Someone does not eat bread, so I had to eat the loaves myself and quickly too before they became hard or fuzzy.

There is a quiet satisfaction to hear the machine churning in intermittent grinds and whirls. At the end of the baking the house fills with the redolence of freshly made bread.  How can something so marvelous be so ‘bad’ for us?  Isn’t bread the staff of life?  Did not the French revolt for want of bread?

I tried making bread from scratch but found it a lot of work and the end-product wasn’t that good or worth the effort. My bread machine is good enough for my needs. I’ve made loaves of rye, wheat, and some with cheese or egg or yogurt in them.

I plan on making a trial run of dinner rolls this weekend to work out any bungles or disappointments.  If a success, I plan on keeping the machine out for a bread baking revival. I still believe a thick slice of buttered homemade bread remains the food of the gods – or at least the demigods. If Thanksgiving is canceled at the last minute, I will be thankful enough to stay home and eat dinner rolls.  Oh how lovely.


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November 2015
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Spo-Reflections Years 1&2


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