The conference I am attending is very good. I am learning about the role of inflammation in mental illness (avoid such), how to read medical report statistics (tedious), and what is it about cannabis (avoid until you are 25 years old). So far I have not seen any Texans, just a lot of psychiatrists. However, my brain is full and my backside is sore; there will be no more lectures for this day.  After I publish this I am going to go bear-bait the pharmaceutical representatives in the exhibit hall, and then I am going to  walk on the River Walk.

One of the lecturers gave out the secret to the treatment for depression/anxiety, stress, pain, Life, The Universe, and Everything. It was just a quick insert at the end of the breakfast lecture. The panacea for all ills is worth a separate entry, so I will do it later. He told us to tell as many people as we could.

Gads, but I hate being alone in hotels. I wish Someone was here. Better yet, I wish I was home. Last night he went with some at-work chums to watch the Rocky Horror Show at the bar – jolly good fun. Tonight he hears Shostakovich #7 and I am mad-jealous. I’ve waited years to hear this symphony and its my dumb luck I am out of town. Despite me being in a brave new city I suspect I am turning in early this evening. I didn’t get enough sleep.  I fly all the way here and promptly fall asleep in lecture hall.


Last night’s sleep was ruined because of my reading. I am reading a non-fiction piece about a team of hikers who got lost in the Russian woods and when their bodies were discovered the campsite was quite a puzzle, a mystery never solved with satisfaction. The theories range from UFOs to the hikers going bezerk like “The Shining”.  It’s a page turner – and hardly conclusive for falling asleep alone in a dark strange room. Tonight I am going to reread today’s lecture notes on P-values and how to calculate The Number to Treat – I should be asleep in an instant.

texas-flagI am packing  this evening to fly to San Antonio tomorrow, to pow-wow with my fellow wizards at a medical conference. It will be my first time in Texas. (1) I feel like Margaret Meade going to the Bantus to observe tribal behavior.

In my life I’ve met only a few Texans; most of my knowledge about the state is from internet (liberal) news sites. I have the impression I will be among Bible-thumping, gun-slinging, GOP-worshiping Protestants. Poor Texas! According to The Weather Channel they freeze to death in winter, are blown away by tornados in spring and hurricanes in the fall, and in summer has more humidity than a steam room.  I wonder what Texans are really like. Perhaps I shan’t see any true Texans for I will be ensconced in a swanky hotel for 2-3 days.

I have a fancy to skip class and visit the Alamo, but I have my doubts. Unlike most Americans, I know some history. The story of the Alamo is a complex tale, the  accumulation of years of Spanish-Mexican-American tensions. The Alamo is not a simple black vs. white, good vs. bad, us vs. them story. (2)  I worry if I dare doubt the dogma some outraged person in the tour group will shoot me on the spot. (3)

Perhaps I will just stay safely indoors at the Hyatt and eat BBQ. The few Texans I know loudly boast BBQ from Texa is better than anywhere else (4).

Another ticklish topic I shall eschew is the subject of Texas cessation. I’ve heard rumors The Lone Star State wants to leave the USA and have another go at being a Republic. I don’t know what percentage of Texans actually want this. Interestingly I don’t hear what percentage of the other 49 wish to vote Texas off the island, as it were. (5)

Anyway, I am sure to keep Spo-fans abreast of the news as I vagabond about Texas.

I promised Someone I would not bring home any cowboy things.



1- In 2005 when we moved to Arizona we drove through the top part of Texas, but I slept through it.

2 – In the case of the Alamo, brown vs. white

3- The Alamo website instructs men to remove their hats when visiting, as if it were a sacred place, like a church. Same website assures me is OK for men to carry around a gun.

4- Come to think of it, they boast everything is better in Texas.

5- I am for all for succession if Texas take Mr. Cruz with them.

My amateur effort at housecleaning last weekend got me thinking about possessions, specifically, the lack of them. Concrete reasoning suggested to me the fewer objects I have the less I have to clean. Like the changing tide, my inner-Martha is on the wane and my inner-Angela ascends. It is high-time to throw things out.

I was recently reminded the average household has tens of thousands (!) of items under its roof, most of them doing no good. The speaker on the subject suggested a discarding one thing per day for a month. This will hardly put a dint in the amount of debris but it will give you a good feeling for having thrown out some rubbish. This virtuous habit could continue until the house is resembles a Martha Stewart photo:



My training in the treatment of OCD says the enemy to purging one’s provenance is the pernicious philosophy “Just in Case”.  You look at the box brimming with old cassette tapes, cords to who-knows-what, and clothes unworn in since the 80s, and you conclude to keep all of it –  ‘just in case’ – someday you may want them. The chances of this, of course, are nil. OCD patients are taught the “30 rule”: if you can replace a potential tosser with a new one purchased for $30 dollars OR you can drive less than 30 minutes to a store to get a replacement than the said item is toast.

Much of OCD hoarding focuses on throwing out unneeded things but not much is said about the new things flowing into the house. One must be always on guard for nefarious items creeping slowly in and accumulating until you are drowning in unnecessary plastic objects and refrigerator magnets.

In the House of Spo (and Someone too) there is no lack of unused items; we could fill the Goodwill bins with our discards.

I am going to take up the thirty day once a day throw-out challenge – if I can for Someone is a bit of a Just-in-Case type of guy. It would be just my dumb luck to discard the moss-covered three-handled family gredunza only to have Someone suddenly want it and ask its location. I think I will start in the garage with the snow shovel or the inutile walk-man. Even my inner-Martha won’t object.


house-cleaning-11688-570x403I woke Sunday morning to see the sunlight reveal a thick layer of dust on the dresser clock and the dresser as well. I couldn’t recall when last the house was cleaned. Someone was to work all day, so I decided to spend this day of rest doing some housecleaning. By 6PM I was quite tired –and the house was only half cleaned. I am not experienced in housecleaning. I suspect someone with experience can do this in a fraction of the time and much better. Being an autodidact is nice but I felt gipped of a weekend. Someone says he will clean the other half of the house on Tuesday. By then the first half will have started to collect more dust. This stuff never ends.

I hoped in my industry to have found a missing blue sock. I have the other one; it’s been floating around without its fellow for some time. I keep putting it back in the laundry hoping time/space and dryer will magically reunite them but no such luck. As a consolation prize I found several coins under some appliances. Alas, the total is not enough to purchase as new set of socks, which is Someone’s recommendation.

I unplugged the icebox freezer for it had accumulated enough frost to do so. Happily nothing was lost. All its contents fitted nicely into the new fridge. In among the frozen chicken breasts and mystery meats were several Tupperware containers of frozen something-or-others. I had completely forgotten about them. I should label these things for my system  of I will remember what this is” has been a complete failure.

Although I was quite pooped, I had the mild satisfaction the house is better than it was. Some sinister-sized dust bunnies were evicted from under the bed. One can no longer write naughty words in the dust on the coffee table. I suppose with practice I will improve my productivity but I think it is high-time to put my foot down and hire a maid or butler or somebody – anybody – to do this for me.



For sometime now my back has been intensely stiff and my fingers sore. The differential diagnosis list is long (1) but there is one possibility I thought of only this morning. I have not taken CoQ10 for a few weeks. Maybe the snake oil supplement really does work after all.

Urs Truly is very skeptical of over-the-counter supplements, herbals remedies, and nostrums.  The same people who demand purity and quality spend billions of dollars on products with no indication and no regulation. Patients continually announce they are starting some sort of fad remedy their friend is taking. Why? ‘to be healthy’  What’s in it? Don’t know.  Nearly always they take it for awhile, become bored with it, stop it (with no overt benefit) and go onto another one.

I use The Spo rules when considering remedy, whether prescription, herbal, or supplement:

1- Why am I taking this? (is there a specific goal). 

2- How am I going to measure its success?  (other than just feel better)

3- How long do I take it before I determine it is a bust and stop wasting my money. 

If these three questions can’t be answered/measured, the chances of staying on something is not good.

Which gets back to the CoQ10.

My internist in the 90s suggested I take it when I started medication for high cholesterol. He stated the statin would deplete my body of its CoQ10, enough to support taking a supplement of such. Normally I pounce and ask where is the data to support this as coQ10 is very expensive; I didn’t want to shell out mega-bucks for rubbish. But this was coming from the physician, so I assumed his advice was good.

I’ve been on the supplement for decades. Every time I buy another bottle I wonder if it is worth it. Under the adage ‘if it is working don’t tinker with it” I have kept it going. The successor doctors never said to stop it. (2)

Having no time to get to Costco provided me with a hiatus off of coq10. For a few weeks I had forgotten about it other than when packing the weekly pill box.  As stated, in the past week I’ve gotten a lot of aches and pains – due to lack of coq10?

I should buy another bottle and see if there is a correlation. (3)

Until I get my lazy self to Costco I may try some simpler remedy: stretching. Now there’s a thought. It reminds me of a recent patient who announced she was going to take some sort of monkey gland concoction for weight loss when I thought ceasing stuffing herself would work better.


(1) Mosquito-borne illness, tertiary syphilis, exposure to colder air, and old age.

(2) A trade secret: when a doctor hears a patient is taking a supplement they usually keep silent on the subject. Unless there is a danger or a drug interaction, most docs know patients like taking supplements; it makes them feel good to do so. So why tell them there is no evidence to support its worth? The placebo effect is a a powerful thing indeed.  Let’s not knock it.

(3) Of course, if the muscle stiffness is from the pravastatin without Coq10 then another experiment is to stop the statin.  I feel sheepish to do so as it is without MD approval. My patients do this all the time and it makes my eyes cross. I don’t want to be a bad patient.

1 – What is your favorite movie to see at Halloween?

“The Haunting”. It is a tribute to the truism less is better. Is the house haunted or is it all part of people’s paranoia? No monster; no blood. Just the uncanny fear something is in the hall……

2- What was your favorite Hallowe’en costume as a child?

I have always went with the scary “death” costumes like skeletons or specters, keeping in touch with the original notion this was a day for being in touch with the dead.

3- Given enough money what would be your fantasy Hallowe’en costume?

Pan, with the goat legs and horns and all. I would play the pan flutes and evoke erotic desire in all who hear me.

4 – What is your favorite Hallowe’en candy?

Out of nostalgia, I like Sweet Tarts. Nowadays I prefer gummi-bears. I do not like coconut. Toffee-flavored penny sweets are right out.

5 – What is your supernatural fear?    Possession by evil spirits.

6 – Your ‘creepy-crawlie’ fear?   Tarantulas!

7 – Your ‘that’s gross” fear?    Trypophobia.  It makes me cringe!

8 – Have you ever heard a ghost or heard something go bump in the night?

Once upon a time when I lived in Chicago I awoke at 2AM to a very loud explosion from downstairs. My first thought was someone had smashed a window or shot a gun in the house, it was that loud. I ran downstairs to investigate. Nothing was out of place or askew. Even the cats were asleep as if nothing had happened.

9 -Are you a traditionalist or a creative carver of you Jack-o-Lantern?

I carve several pumpkins each year. One must have a scary face to frighten away the bad spirits. The others are creative, and getting more and more artistic as the years progress. I’ve been pleased with my artwork. However, Arizona living may stop this. Pumpkins shrivel literally overnight and the details go quickly. I may have to stay with simple patterns now.

10 – Do you know have a favorite ghost story?      Yes, I do. The Upper Berth

11 – Do you know someone who is “Anti-Halloween”?

I used to work with a woman who would not decorate her area as the others, nor would she even touch the candy and treats brought into the office. Even the trail-mix with candy corn was off-limits. I give her credit. She did not explain or defend herself, nor did she execrate others. It was a mere ‘no thank you’ – good for her!  I guess her strict Protestant sect thought it all Satanic.

12- Do you decorate the house at Hallowe’en?

As a kid I used a lot of store bought plastic stuff. Now I channel Martha Stewart. The inside and out of the house is tasteful but lavish.  My favorite decoration is to open a pumpkin from the bottom, clean it out, and drill it all over with holes. Then insert a light bulb. The dotty glow is both spooky and whimsical.

13- What do you want on your Tombstone?       “Finally Stopped Worrying”

For fun here is one of my favorite Halloween tunes from my youth. I worry now if it  has racist overtones. But as a boy I thought it innocent and absolutely delightful.  


I woke this morning disconsolate from a horrible dream. It was some sort of post-apocalypse scenario in which I was trapped, likely to die, and unable to get back to loved ones. An elderly friend died in my arms. Even as the morbid drama unfolded I was asking myself how on earth is this arising. I blame the news. Thanks to a continual exposure to world events and American politics (dominated by Mr. Trump and his shenanigans) my soul is poisoned. It feels like a binge diet of junk food and gummi-worms. It’s time to turn off CNN, Huff Post, and Yahoo! News for a more bland diet of Saturday morning cartoons on Youtube. I need cheering up.

At times my boundaries are not too watertight. Sometimes another person’s sorrows get to me. Like tuning forks in synch the world’s woes make mine vibrate. The worst cases are the dog/cat shelter commercials, for which I have no boundaries. Seeing these with the doleful music and lamentable looking animals makes me go into hysterics.  I don’t do well with violence and nasty confrontations; I am known to leave the room when Someone watches “Law & Order”.  He says I am too sensitive, and I daresay he is right.

When my aegis fails I often go to the bedroom and withdraw into the inner compartment of my mind away from the general lunacy of my fellow humans. I am not one to have a snort in these scenarios but a nice hot cup of tea and some comfort tunes are most salubrious.

I am not one to sleep when vexed, but I am tempted to take a Rip Van Winkle-like potion to induce enough sleep to wake up after election day. Alas, I would miss my favorite holiday: Hallowe’en. I must stiffen my spine and be less porous to the morass of endless gunge coming from the boob-tube.  Avoid curried snacks is my motto. This is expanded to include CNN.


Eat shredded coconut – it makes me ill.

Invite a vegan to a pig-roast

Read comments in a news article. Oh the pain to see such rampant ignorance, rude manners, and poor grammar.

Telephone conversations with insurance companies to defend what I am doing for patient care.

Sarah Palin talking about anything. I get enough word salad ramblings from my patients.

Wear a wife-beater T-shirt out in public.

Tell a tryst I wish it were bigger.

Write my own prescriptions.

Tell Someone what he should do to improve himself.

Drink lite-beer.

Having hot sex with a parsnip

Fox News

Eat food fallen on the floor. There is no ‘five second rule’ folks!

Confessing I still like to watch old Saturday morning cartoons from the 70s.

Breaking wind as I meet a new patient.

Project Runway

Rush Limbaugh

Write using dangling modifiers

Raw fish


Write a blog entry about that time I was put in jail for public indecency, nor divulge the name of the youth organization to which the others belonged, nor the shop where we bought the equipment.




I remember as a boy at Christmas time going to Hudson’s in downtown Detroit, where the merchants had set up a sort of store within the store for youngsters to shop for their parents. It was the first time I was ‘on my own’ to shop. Before me was a plethora of items and I soon became boggled-down sorting through the many variables and items.  I could not make up my mind what to buy. Faced with too many options and too many factors – and a sense there was ‘the right one’ – I froze; left the store without spending a dime.

My purchasing neurosis continues to this day. Buying something as inane as breakfast cereal becomes as complicated as a Hari Seldon Plan. Price, volume, and nutritional contents combine with political matters, recyclable (or not) packaging etc. conflate to the point I often don’t buy any cereal at all or I buy something shiny at eye-level. Either makes me feel fatuous.

Worse when I do make a decision to buy something based on my research this doesn’t leave me with a satisfaction of success but raises doubts I missed a vital variable, thus invalidating the purchase as the ‘right one”.

Someone does our travel arrangements. He obtains our airplane tickets, rental car, and hotels. He does this thoughtfully with research. I wonder how on earth he wades through all variables to come up with the final decisions and purchases.  Perhaps he doesn’t take in as many factors; perhaps he looks only at ones with the most weight.*

At work I’ve learned patients dislike being told what to do viz. “no choice” but they equally dislike too many choices. Two or three choices are satisfactory for a person to grasp and feel good enough about making a decision.

I need to become more at ease at letting go of decisions. Picking out the toothpaste need not be as scrutinizing as reviewing scientific paper published in JAMA. The gods won’t strike me down for making an “error”; Consumer Reports isn’t going to laugh at me for not getting ‘the best buy’.  How nice it would be to purchase some brand of crackers, have Someone question the purchase, and reply in east “It sounded good, I just wanted it”.


*Perhaps I am just a neurotic ditz.


While rummaging through the desk drawer looking for some scissors I found a bronze paper clip. Its circumference is about 3-4 inches, about the size of a coaster. At first glance it resembles a set of castanets. The clip is covered with scenes from Minoan Crete. On one side is the nobleman pictured above; the other has a bull. My grandparents gave me this upon their return from one of their trips. The gift goes back to the early 70s or perhaps even to the late 60s. I didn’t know I still had it. It was an amazing find.

I remember many times in my youth eagerly waiting in the airport with my parents for my grandparents  to return from a world-wide excursion. In hindsight I had the erroneous belief they constantly traveled and always to exotic places no one has ever heard or been to before.

I was most excited about what they were going to bring me; there was always something in their pockets or carry-on given out soon after the hugs.

This paperclip must have come from some trip to Greece.  I once received a little matador bullfighter cap. There was another time when it was a fish flag from Japan. My favorite item was a carved troll, probably from Denmark or Norway. I didn’t think any of these have survived until I discovered the clip. My favorite was the troll. He had a face lit with the smile of a brilliant sunrise. He hung on a string. I carried him everywhere, wondering what sort of world he came from.

These souvenirs were seen as magical, unique – as awesome as relics. Now I wonder. The Minoan-based paperclip looks mass-produced. I wonder too did my grandparents get these things on their way to the airport, stopping at some convenience tourist shop to grab something at eye level – quick, cheap, and thoughtless? Who can say.  In my mind’s eye these were gifts of love and invitations to someday travel myself.

Nowadays I am not so sure. I am a timorous traveler. Is it synchronicity this clip suddenly appear as I wonder about when if ever am I going to travel?  It seems to say seek out my own souvenirs, and go find the trolls.


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