I am still recovering from a nasty cold, so this year’s thanksgiving spread at the House of Spo will be a modest one.  All I really want tomorrow is to sleep. If Someone wants to make dinner all power to him.  He said yes, so there it is.

Earlier this week we found in the freezer a turkey – much to our surprise as neither one of us remembers when it was purchased. A few days ago Someone pulled it out but remains obdurate as ice. I don’t know what he plans on doing about it. I have never cooked a turkey so I am of no help.

He has a desire to make my mother’s cranberry relish, so I called home to get the recipe. It consists of merely chopping up cranberries and a naval orange in a processor along with some sugar and that’s that. It seems a disappointment that that is all there is to it. However, I am not surprised at its simplicity. Midwest cuisine is never fancy or nuanced.

Someone enjoys making pumpkin pies, which he makes via the directions off the Libby’s can. This year he has taken to try a bourbon pumpkin pie. This is a bold endeavor given he doesn’t like bourbon. I wonder if this is to get me to eat more pie and him less. Usually I eat one modest slice and he ends up consuming the rest.

I like the green bean casserole with the fried onions; Someone does not. If I were to make said dish he might eat a ‘no thank you helping’ only and leave me the rest – most of it going down the wastepipe. To avoid waste will do Brussel sprouts. We want something else than the traditional Midwest approach to vegetables which consists of boiling them to extinction.  I found a recipe in my accordion file titled “Kung Pao Brussel sprouts” with chilies, ginger, and chili paste. We will try this one.

I like mashed potatoes; Someone prefers sweet potatoes. As he is doing all the cooking we get the latter. I tend to not like things too sweet so I hope he doesn’t add too much sugar or (worse) marshmallows. It will be a reverse of the green bean casserole if he does.

We agree on the wine: Gewürztraminer. It is a varietal of white that goes well with turkey.  Prior to dinner I may have a good snort of Travel Penguin’s gift of Mt. Vernon rye. Oh how lovely.

For small chocolate cone, Someone likes whipping cream on his pumpkin pie whereas I like mine with cheese – Edam cheese to be precise.  A proper Edam cheese from The Netherlands is my last remnant of childhood Thanksgiving time and I shan’t give it up. I have my slice all ready.

If my appetite is still weak tomorrow I plan to stick with the simpler items of wine, bourbon, and Edam cheese.



The Board of Directors Here at Spo-Reflections just came back from their holiday in Sweden and they almost immediately sent me a text of remonstrance (this there any other kind?) exclaiming in broken English/Norwegian and several nasty-looking emojis they didn’t like at all the tone of the recent entries, what with their thoughts of death and ill health. * They told me to write something jolly or else. I texted back I have a bad cold and I am in no mood to write something whimsical.  They got nasty so I blocked them.  I’ve learned there’s no lasting damage to do this as they don’t hold grudges. Either that or they drink and black out and don’t remember these things.

Today I was awaken from my flu-slumber by a call from the medical insurance agency. Some youngster- minion proceeded to flog a home visit from a nurse who would go over my medications and take my blood pressure or something. I daresay she was reading off of a script, for when I varied from it she didn’t seem to listen.

(Minion): May I schedule you for your home visit?

(Urs Truly): I work Monday through Friday 7-5. It will have to be on a weekend. 

(Minion): Excellent sir! Can I put you down for this Thursday at 9AM or 1PM? 

I tried to explain The Good Doctor does as fine job at taking my blood pressure etc. and I have no questions about my meds so there wasn’t any point or need.  She wasn’t going to take ‘no’ for an answer. It was probably the fatigue of the flu because I succumbed and said yes, OK Florence N. can come visit – on 12/31 (Sunday) at 1PM.

I felt a bit perturbed afterwards. I must remember to be civil and not act out such as greeting her at the door dressed in boxer shorts and bathrobe, unshaven, and exclaim “Won’t you come in my dear, I’ve been expecting you!” Rather I will be the gentleman Spo,and offer her tea.  However, I plan to be ready. I will know my meds by rote with their doses and mechanisms of action. I also plan to call out on any nonsense that isn’t backed up with evidence-based research.

Two final thoughts on this pending home visit:

1 – I fancy calling back to request a male nurse –  a lumberjack type if they have such as thing.  I saw this in a movie once: “Home visit health care II”.

2- I may call and cancel and ask them to not provide the service but with the money saved how about lowering the cost of my medications.




*They liked the entry written by the dog. 

cartoon sick

One of the drawbacks of being a doctor is a constant exposure to sick people. I started coming down with a virus last Friday and by Sunday  afternoon the bug was in full blossom. It has the usual  symptoms of headache, congestion, cough, aches, fever/chills, upset bowels, and personal guilt.  “Nothing to be done” says Estragon in “Waiting for Godot”; there is nothing really efficacious enough to speed up recovery than common sense items of time, rest, and whatever palliative over-the-counters one feels does you some good.*

Unless the saints provide a miracle cure by morning I plan to stay home today. This is quite sensible but it makes for a bad day for The Wonder Receptionist. She will have to call and cancel everybody, some of them have been waiting months to see me, poor things. Most cancellations feel a disappointment but also have empathy. Some will be remonstrative if downright truculent over my selfish move to not come in to take care of them.

A sick day always sound charming but really one feels dreadful.  One can’t do those put-off tasks. Even reading is a tiring task. I can put on some podcasts but naps and delirium mar my attempts. Nope. One just sits and naps and takes something and waits.  Nothing to be done indeed.

Thanks to electronic gizmos I can continually check in with The Wonder Receptionist to write prescriptions and put out fires so I won’t come back to a pile. Calling back those ‘urgent calls’  will be curious as my voice is that of a frog’s. Patients either feel guilty for bothering me OR they get cross and complain they had to reschedule. I remember once having the flu and the patient told me over the phone I didn’t sound that sick as if to imply I was faking it. Probity prohibits me in return to prescribe something out of spite just to make them worse but it is a delicious sinister thought.  I can always blame the fever and the meds – everyone else does.

Urs Truly has to shun decongestants as they raise his blood pressure, worse luck. My proboscis is closed tighter than the North Korea border.

Harper 31

Hello Harper here

The Other Dog not feeling well. The Friend Beasts with horned hats and loud voices funny smells tell me to tap on the metal plate. They say some one needs to do so and they do not do this.

The Other Dog sleeps a lot and in my spot but I let him as he sick. I take him on walks to get him into sun and sniffs but he likes to drink funny water out of bottles for cough. The Friend Beast is OK he works a lot so I am home to help The Other Dog. I give him licks and warm him lay next to him he get better soon.

The Friend Beast and The Other Dog make meals out of boxes smell nice but many without meat no good for me I beg but there is nothing but plants no wonder he is sick. He needs chicken and beef and oh so tasty cheese. I get some too!  The Friend Beast says The Other Dog should not do so he says this is a ‘trickle down theory’ but it works it work.  Yesterday The Friend Beast got out of the cold box a turkey but it is frozen I hope soon for proper treats from the table no plants.

“It’s a dog’s life” says The Other Dog when I sleep and walk and eat yummy treats and cheese. It is a good life yes.  Some times I hear intruders over the wall and bark bark bark bark but The Friend Beast scolds for me doing my job.  The Other Dog says I am a nuisance what doe that mean.

Anyway The Friend Beasts with horned hats and loud voices funny smells tell me to tell you The Other Dog taps on the metal board soon and not to worry if not better I take over too bad as this is silly do I get a bacon treat for this I hope.


There will be no performance of “The Red Shoes” this evening: Urs Truly has a touch of bronchitis.

It is hard to channel The Muses during dyspnea.

The Board of Directors Here at Spo-Reflections sent me their personal Druid (a total quack) who has ordered me to cancel all activities including writing.

See you soon.

Meanwhile, here is a rerun. I rather liked it.

Every morning I when I wake I say a little prayer along the line being thankful I was given another day.  I often don’t know to whom I am saying this Secreto; often it is not so much a prayer as a pregnant pause for me to realize neither myself of the world died in the night. It is a moment of inserting a dose of Death into the day.

I try to reflect on Death on a daily basis. This is not a morbid matter but a sort of meditation seen in the writings of Buddhism and in Catholicism viz. the cognizance of Death helps us keep Life as something precious. I am kept conscious to make each day meaningful and something marvelous. It makes me not sweat the little stuff; I am not as quick to go into a swivet over petty things.

In the home office is a Tlingit Cedar Bent box, in which will someday reside my ashes, prior to their being spread. On the refrigerator hangs a photo-magnet of the Point Betsie Lighthouse. I’ve often fancied having my ashes spread there. Every time I open the fridge I see the lighthouse for a quick reminder it is waiting for me.

To wake with the feeling of more life and to go to sleep with the gratitude of having had another day: what a gift this is. I hope I never forget to do so.



When I came to the Mesa office today I was greeted with an appalling chemical smell, as if someone had just finished the walls using a cheap brand of paint. When the staff arrived they explained the next door office yesterday sealed their floors with epoxy and the fumes are coming in via the air system. Apparently Monday the Mesa office air so toxic many counselors called and canceled their Tuesdays.  The boss-man set up a series of fans to blow the bad air out one door while the outside pollution of Mesa was sucked in through another. Overall this did little good; by noon the two receptionists had called it quits leaving Urs Truly to and two intrepid counselors to fend for ourselves.

While I am writing about toxic work environments I might as well mention the fridge. The staff at Mesa are mostly female. I have long thought women were more fastidious than men but lord love us they leave lots of dirty dishes in the sink as if someone is going to clean them. Worse, the fridge is full up with have consumed leftovers in paper bags and white take-home boxes.  Today a saw the Boss-woman had taped on the freezer door ala Martin Luther a collection of theses tersely telling people for heaven’s sake clean out your crap your mother doesn’t work here.  Fat chance of that.  My Swiss-German genetics took this as permission to adopt a scorched-earth policy and take charge. I first limited my toss-outs to things with brown and green fuzzy growths on them and containers with expiration dates of 2016. It’s a slippery slope and soon I had most unmarked half-consumed totes and bottles out and into the rubbish. As the staff were too sick from asphyxiation no one really noticed.

I am in the Phoenix office tomorrow and the cupboards are calling. The drawers are full up with napkins, plastic utensils etc. leftover from endless pharm-rep lunches just waiting for Urs Truly to clean house andput all the spoons, forks, and Splenda packets in taxonomic order. No one will thank me and I dare say it enables the problem but I will feel much better.

If someone should question my sanity I can blame it on expoxy exposure.

Walking the dog

I haven’t done one of these in a while. The Board of Directors Here at Spo-Reflections is away at Askersund so they are not minding the store. Chances are they won’t even notice this when they return.

It is November; all morning walks are done in the dark. It’s also cold enough to require long pants and a sweater (for me). These morning walks are a shorter due to the weather. At 5PM the winter constellations are high above us. Orion and his dog Sirius light up the sky paralleling our situation down here on Earth.

I try to vary each morning’s walk to a different direction but Harper has her favorite – towards the park. I suppose that is where she finds the best smells. Walks are mostly about sniffing the sights than for exercise. I am wary of the park at 5PM lest there are coyotes or javelinas, so in winter months I stick to more well-lit areas. Sometimes Harper cuts the walk short as to imply disapproval of the route chosen.  Sometimes I wonder if she just wants to go home as the walks all end with a dental stick. She loves treats. As long as we’ve had her she always takes these sticks away to eat them out of sight. All my other dogs would eat it right then and there.

Sometimes Someone gets up at the same time to get ready for work. This confuses Harper for she assumes he is going on the walk with us. It is a hard-sell to convince her he ain’t going. It is a disappointment. This supports my hypothesis she doesn’t see me as the second master but the second pet and we are better off taking our walks with proper supervision.


A Spo-fan some time ago asked me to write how does the brain think. I’ve been putting this off for it is a lofty topic. A promise is a promise so here it is. Spo-fans afraid of the learning-kooties should skip this one – although to do so would be ironic given the topic and conclusion.  So pay attention and learn, dammit. 

The thinking brain model is divided into two modalities with the unimaginative names of System I and System II.  For my little  lecture I will refer to them as “Spo” and “Michael”. I will also use myself as the model although this applies to all people.

“Michael” nee System II is my conscious self. He is who I think I am.  He is in charge of conscious decision . If you ask me to multiple 367 by 2 without a calculator Michael is the one to do it. Michael is lazy; Michael slow; it takes effort for him to do anything. If there is something to do he likes to conveniently vanish.  Thinking is an uncomfortable task;  it takes effort. It’s easier to ‘think’ quickly and make fast conclusions rather than stop and work. However he is the careful one capable of catching error.

“Spo” A.K.A System I is Michael’s quick counterpart who processes all the information flooding into your senses. Spo has to be quick for he is dealing with a lot.  Quick as a quarter-note Spo discards the irrelevant bits (which is most of them) for the deemed needed stuff.  Spo works without Michael knowing he is doing it.  The quick and unconscious Spo makes up his mind even before “Michael” attends to the matter at hand.

Spo is made possible by your long term memory.  “Michael” is my working memory, capable of working with a few things only at a time. Example: a string of random numbers or two tasks to do at once.

Michael wants to pass things over to Spo for long term reference, but to accomplish this Michael has to work consciously and repeatedly (and that takes effort!) to get Spo to accept into his realm that matter.  At its onset it is tedious to memorize a poem or learning how to chop an onion, or they directions to the dentist. When Urs Truly was learning to dance, I had to consciously memorize what steps went where next until it became an effortless flow done without thinking. ‘Getting it into my muscle memory’ my teacher called it. but it really isn’t going into the muscles but into Spo.

Michael and Spo make a good team. As Michael has limited capacity and needs time and effort Spo has to be doing the majority of thinking.  Think how much your typical day’s doings are done ‘without having to think about it”.

On the downside, Spo quickly tells Michael what to do based on quick intuitive conclusions that may not be right at the moment.  To Michael’s ear what Spo says sound reasonable and the lazy bum will go with it without checking on it first.  Opps. This can be a bad thing.  Ironically by making something a tad difficult or complex makes Spo upset enough to pass the problem onto Michael who is obliged to ‘stop and think’ – and more likely make the right decision.

I see a lot of “Spo” mentality in politics. Simple incendiary statements don’t evoke “Michael”  to stop and think and what was said is truth or rubbish.  Alas, I like to stay with ‘what I already know’ so I don’t have to think – which is time-consuming, slow, and uncomfortable.  The paradox is by being out of my Spo-run mentality and making  my Michael work is the only way to learn and enrich my Spo-based knowledge base.

I developed HTN (hypertension) in my early 30s. High blood pressure runs in the family so I fairly certain it was a matter of time until I got some of my own but I was surprised – and a little annoyed – it started so early. Like most people told to take medication,  I tried to weasel out of it through non-pharmeceutical endeavors, hoping to ‘prove’ to my doctor I didn’t have to take no stinking meds. Despite my exercise, the no-added salt diet, and ‘zenning’ every time I stopped the HTN Rx I nearly had a stroke so back on meds I went. For twenty years by blood pressure has been fine and stable – thanks to a daily dose of felodipine.

A month ago the dentist deduced the medication was causing gum inflammation.  It was changed to lisinopril and that did the trick. Alas, my blood pressure hasn’t been good ever since. The diastolic pressure was over 100 and I was getting daily headaches and malaise.  The lisinopril dose was raised to no avail. Preferring bloody brushing to a stroke, I went back on the felodipine.  The Good Doctor now has me trying BP Rx trial #3 (a combination of lisinopril and HCTZ). I am supposed to take my blood pressure to see if it is working.  Someone did the research and I am now the proud owner of a blood pressure monitoring device.


I show my age to remonstrate I am highly suspicious of the accuracy of a machine. Back when I was in med-school (just before the internet and right after blood-letting) the taking of BP was a precise ritual many did poorly.  This HAL Jr. techno-gizmo comes with several pamphlets and app connections I am supposed to read and do prior to sticking my arm in and starting. This alone is enough to raise my blood pressure, so already the reading is marred.

My first reading is 135/80;  normal BP is 120/80. This is very good considering I had just spent fifteen feckless minutes trying to set up the app to no avail while Someone was in the other room cursing out loud and frustrated with his own on-line endeavor.

In the past few weeks my various readings at the clinic and in the pharmacy stores have been ~ 160s/100s.  Today’s OK-enough reading is correlated to being back on a week’s worth of felodipine.

Today I start my new combo-Rx and monitor its efficacy.  I am going to need a decent BP if I am to reattempt the Kafkaesque instructions to connect the cuff to my iphone. Apparently this will generate a colorful chart for my amusement and send all my readings to my doctor (as if he really wants to know my daily reads). It will probably send my information to FB too so Mr. Zuckerberg can flog salt-free or stimulating products depending on which way my pressure blows.


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