Life begins at the end of your comfort zone.

It’s official: Someone’s coworker made the phone call and our reservation is made. Urs Truly is going to check it off from his bucket list a ride in a hot air balloon.  I am excited and terrified.

Nearly every day at this time of year you can look out on to the desert and see several gaily coloured hot air balloons hovering on the horizon. They seem to be just floating there, serene and spectacular.  The bright bold colours are a marked contrast to the brown earth tones of the desert. I’ve longed to try one. I mentioned this at Someone’s work party. His coworker confessed she had the similar fancy. Now it is down for mid-October and there is no turning back.

I do not do well with heights. There is a part of me absolutely terrified to do this. Emerson says we should always do what we are afraid to do, and this is quite applicable to hot air balloon rides.  I am glad I am going with 5-6 others as I am less likely to cancel or go into hysterics.  Having a snort before departure may be helpful.  I am proud of myself for facing my fears to do this.

I haven’t been told yet what to wear or if we can choose the balloon pattern.  I want a balloon as colorful as one of my shirts.

I will keep Spo-fans posted on the details and the preparations leading up to the event. If anyone has been up in one, I am curious to hear if you liked it. I am grateful for any tips how to do it right without wetting yourself.


I don’t have time today to write a proper entry, so I thought I would share a prayer passed on to me by the late Alice Thomas Ellis, one of my favorite authors. It is a rather lengthy litany but well worth a read. In it, the subject is purging his/herself of the many sins and hurts received from others – and by the looks of it this is about everyone in the neighborhood.

I usually can’t get through it without breaking into giggles. It is nicknamed The Litany of Spite.




Whenever I am unhappy I read it or a part and I invariably cheer up. It never fails to entertain the supper guests.  Everyone has their favorite section but I like the  section on the clergyman. I don’t know the author, but I am guessing it was a bitter pious old church woman or a bitchy queen.  I remember in Sunday school learning The Lord’s Prayer with its simple “Forgive us our debts, as we forgive our debtors’.  I thought this a sensible and fair deal but it doesn’t hold for entertainment.

Forgiveness is a tricky and difficult endeavor. One of the first steps is the recognition we don’t really want to forgive; one of the last steps is letting go of negativity.  This clever litany looks good but is neither.

So that’s your entertainment this evening. I hope to have a proper post this weekend.

Meanwhile, I truly forgive my readers, who fail to leave comments, who don’t appreciate my artistry despite all I have to do. For the times they didn’t acknowledge they came by; for the times they didn’t praise me with lavish comments.  And for the times they didn’t share me in their links I forgive them.

The AC unit on the east side of the house has gone off. I am disappointed but not surprised. The unit has been running nonstop for many months; it’s amazing it hasn’t gone out sooner. I appreciate it waited until the temperatures finally started to become less fetid.  We are still having highs in the upper 90s but the early morning hours are in the upper 60s.  The intrepid AC on the west side remains operable so we are not too bad off. Someone set up a series of fans to blow the cold air from the east wing over to the west.  Unfortunately the cool dry air from the east collides with the west west air to create a storm front and it is now starting to rain in the foyer. Oh the embarrassment.  We need to get a repairman or somebody like him in ASAP. I hope the AC doesn’t need total replacement as that could cost several thousands of dollars.  Alas, our approach tends to be one if it breaks down we try to live without it – our house is filled with inutile objects – but no AC in AZ is not tenable. It must be done. Oh the pain.

Speaking of expensive breakdowns I finally got to the dentist at the local dental school. At one point in the consultation I had four people in my mouth, most of them throwing up their hands in horror at the work that wants doing. Apparently if I don’t get my gums attended pronto I may not have any teeth by sixty. More expenses!  If it becomes a Sophie’s choice I will go with the gnashers and not with the Goodman.  I could not be cheap and liquidate some mutual funds and get both.

I go to sleep tonight down in the dumps knowing I am surrounded by things shouting out ‘fix me!” I don’t have time or energy to be an autodidact but must call in others and hope it isn’t too outrageous.   This reminds me I am also in desperate need of a hair cut, which isn’t cheap either.  I may get Someone to give me a buzzcut heine. It doesn’t look too good but it is a bargain and in the heat of the house less hair the better.


This week I am going to pick a day and turn off my phone and leave it at home. I will without it for 24 hours. 

I sense Spo-fans clutching their pearls, their eyes popping out at the mere notion.  Oh the horror.

I’ve always had the rationale to keep my phone on and near by 24/7 , even at bedside (and in the bed) in case there is a crisis and I am paged by a patient who needs my instant attention to talk him off a ledge before he jumps. In twenty years of carrying a pager or cellphone this has never happened. People determined on killing themselves do not call their doctors. The pager system can always call me at work in the day and at home in the evening. So the ‘worse case scenario’ is covered – and blows away the sham I have to have one on a continuous basis.  I can’t remember when I last received an email or text so urgent it couldn’t wait.

Truth is I spend a lot of ,y time checking and rechecking my phone mostly for frivolous things like Facebook. I really don’t need to continually know if there is a new comment or what was just posted on WordPress or a podcast is sending me a new episode. I don’t ‘need’ a phone.   The world spins quite nicely without me continually checking CNN to ascertain if this is so.

All the same I suspect the no-phone Thursday will be uncomfortable.

I am curious to see if I show signs of withdrawal. Will I constantly looking for the phone not there, and feeling anxious I am missing out. The lack of texts etc. may create a quiet I might find unsettling rather than soothing.

I am curious to see how much time is regained from not continually poking around on the thing.  Will my work day go more smoothly? Will my work out be more streamlined and/or more tedious (imagine I will have to sit and do nothing between reps!)

I remind myself I lived forty years or so without a cellphone. I have a vague warm-fuzzy memory I did quite well without one and life was not boring nor disconnected. Indeed, I remember reading  a lot of books and eating dinner with people who talked and made eye contact. I also recall there was more nocturnal past times too.

This all sounds splendid actually. I may do this on a regular basis. I may not turn the cellphone back on if it goes really well.

The Firesign Theatre had a comedy album “Everything you know is wrong.”  This axiom turns up again and again throughout my life. Going to medical conferences is no exception. Medicine is an ever-changing field. What was true one year turns out to be not so the next.  Some people see this as a sign of a sham but it is a truism of science.

For example, I was trained in the 80s/90s thems who smoke marijuana were all pot heads and nothing good could come from smoking the stuff.  Yesterday I heard the latest scientific-backed evidence-based data to negate all my training and beliefs.**

I prefer Truth to Dogma, so I try to throw off held-fast beliefs when there is good evidence to support such.  This is not as easy as it sounds as we like steadfast truths. To have the rug constantly pulled out from us leaves us with little firm to stand upon. Most people are uncomfortable without some fixed beliefs.  You might have noticed thems who believe Obama was born in Kenya or deny climate change or think the earth if flat are never swayed by reasoning and evidence; they just dig into their beliefs more.  There are few at ease with moral ambiguities (hey it sings) so they pretend they don’t exist.

As a doctor I can’t ethically do this. Imagine I learn after hundred of years of prescribing bloodletting it turns out to have no value but MDs decide their years of experience with it and ‘it has always been that way’ trumps evidence (pun intended) and they keep prescribing it.   Alas, this happens more often than not. Lots of doctors continue to do things which have little scientific backup.  Deny and discard is more often done than not. I try not to be one of them. I know myself well enough I do and prescribe things

I go back to work on Monday with  new perspectives and an up to date knowledge base – some being 180s to what I used to say and do. Some patients will complain ‘you guys can’t settle on what is right and wrong” but I know I am following the path of science – test a hypothesis and discard it if the evidence doesn’t support it.


**There is ‘good’ and ‘truth’ to the possible use of cannabis in the treatment of mental illness yes, but it is not at all what my patients believe.  More on this anon if Spo-fans are interested.

I am grateful for my scientific training and mentality for they help cut through the humbug and dazzle that are presentations provided by pharmaceutical programs.  Urs Truly is only partially listening to a pharmaceutical sponsored breakfast in which a product is being flogged. As is the wont, the data/graphs are are jolly and they seem to imply the medicine is safe, clean, efficacious, and preferable to what’s already on the market.  What isn’t being addressed is the Rx is:

This is a repackaged medication of something already on the market in generic form.

The drug is not superior to anything already on the market.

It costs ~ 2,000$ a month to take.

It will be a bitch to get it approved for all these reasons.

Pharm reps are often not allowed to answer what I really want to know.  They are not a good source for knowledge. I’ve learned to hold my tongue asking intelligent questions which poke holes in the data, and my bear-baiting makes them uncomfortable. Rather, I nod and be polite and try not be a jerk about it all.  Still, it makes my eyes cross to see spectacles.

Mind! If you ask any doctor if they are swayed by the razzle-dazzle of pharm-rep symposiums they will say no way.  In my head I hear the host of one of my favorite podcasts “You are not so smart” telling me I am probably led by the nose more than I realize.  One must be always on guard for such.

It’s good to ask questions and be skeptical and take everything with a grain of salt, whether it is a pharm-rep pushing pills or a politician trying to convince you of the need for building a wall and Mexico will be paying for it. When it comes to Hair Furor and his minions, I believe nothing. Someday he might actually say something true and I am likely to miss it as I am so used to dismissing anything he says as rubbish.

Last week while doing an intake evaluation I had a sudden anagnorisis and for a second I had total clarity about life, the universe, and everything only to lose it when the patient across from me asked a question causing me to focus again and the theophany disappeared and now I can’t recall what it was. Just hate when that happens. The gods give you grace and when you weren’t paying attention long enough to scribble it down on a post-it it’s gone. I suppose the gods or angels or Board Members frequently come a-calling at my cranium but I don’t seem to hear the doorbell much. Tidbits from heaven are more readily noticed when one is quiet and sitting still and not listening to Youtube or podcasts.

For some time I’ve been meaning to take ten minutes from my evening activities to sit still/do nothing and see what comes to me. I am a democratic drawbridge that goes down for anyone but there doesn’t seem to be any traffic.

Asking heaven for insights and clarity isn’t as jolly as it sounds. Anyone who has read the prophets and saints knows they seldom receive anything they really want. Rather you are told to drop everything and do things you are not  all comfortable to do. Consulting the oracle is quite unsettling.

I remember from the Old Testament some one (Amos?) who was quite content with his mundane life when The Lord decided to com a-calling.  When he realized what he what he was being told to do he tried to hide out in a barrel or something, hoping it would all blow over. Nowadays theophanies are more subtle and more readily drowned out by the Kingdom of Noise what happens in our heads and in our headphones.

All the same, I would be curious to rehear what The Answer was. I suppose I could call the patient back in. I won’t worry about it; my experience with Truth is if you missed it or ran away it tends to come back until you ‘get it’. Perhaps it is on Youtube or in my podcasts, which would be ironic if not convenient.  I will keep you posted for any revelations.

Urs Truly is in New Orleans at a medical conference, pow-wowing with his fellow wizards learning new things to become the best shrink possible.  Sitting still and listening to lectures x 3 days is not an easy task. Alas the pharmaceutical booths are not giving out free samples of Ritalin, more’s the pity.  It also doesn’t help The Muses or The Graces or some of that crowd is flooding me with inspiration. Bitches have bad timing and/or a wry sense of humor. I should be focused but my brain is bouncing about blog bits.   When the conference is concluded I may write a bullet-point highlight for Spo-fans of mental health tips.

The first conference is about opiate and canniboid receptors in our brains and why is it we like to take drugs rather than eat broccoli.  Apparently our monkey brains have certain buttons that light up like a christmas tree when pushed with smokes, gin, doughnuts, or that pick up from Scruff.  Our hard-wiring responds to greasy goods and intoxicants.  The “Just say no” approach hasn’t a chance against millennia of evolution. Oh the pain.  Happily, wiring is not destiny; we can do something about it rather than always pulling through the Dunkin Doughnuts or Beer Stop on the ‘what the hell” approach.  I should know more by lecture’s end.

Updates! Bottom line headlines! 

It turns out there are some actual uses of marijuana as treatment in Medicine, but it is not what everyone thinks or wants, but there is something not nothing (as I was trained). 

Inflammation plays a major role in mental illness. Inflammation is probably the key factor in treating depression/anxiety etc. 

Mindful meditation can increase endogenous pain relief so well if you give a opiate-blocker to someone trained in such their pain will return.

Sugar looks to be the worst evil for our well-being. Avoid it at all costs

Opiates can actually cause pain; opiate-based medication can worsen chronic pain especially in fibromyalgia, arthritis, and lower back pain. 

Taking care of you microbiota (the wee-beasties in your bowels) may be the most important ‘job’ you have to manage physical and mental well being. 

There are 5 simple things you can do to make your health so much better – they are easy to do, measurable and have science to support them all.

More anon. 

Never trust trust.

David (the dear!) suggested I answer a few questions he thought would promote writing and be entertaining. The Board of Directors Here at Spo-Reflections unanimously voted this as a splendid idea. That’s quite a compliment to David for they seldom agree on anything, usually resorting to fisticuffs and swordplay to clear things up.  They proposed I tackle the questions in a series of entries, so here is the first batch. Unfortunately these ancient and austere Norsepersons wanted to add a few questions of their own. I’ve interspersed them with David’s.

Spo-fans are encouraged to answer the questions themselves in the comment section.

What was the most brilliant idea you had last week.  I realized if I save signing off on sent prescriptions to the end of the day I can do that in one step, rather than a series of piecemeal sign-offs.

Who did you fight last and what damage did you do them.   I had a FB row with a cousin about Hurricane Harvey and whether or not this is G-d’s wrath.  No one was physically harmed in the battle.

Who was the kindest person.  Domani Dave, who sent me a book.  I was quite touched.

What made you laugh.  My new favorite podcast “The Magic Tavern” . For thems who don’t know this marvelous podcast, it is a cross between Firesign Theatre and Dungeons and Dragons.

In the past week which public building have you torched.   The Supreme Court in Washington D.C. but it was only virtually damaged.

What made you angry.  Hair Furor and his constant shenanigans and outrages.

What inn did you last pillage.  None, but this weekend I am staying at the Marriott in New Orleans, so I may be able to kill two birds with one stone but pillaging and torching it afterwards.

What made you want to cry.  Human ignorance, hate, and folly.

Where did you see attend the last blood eagle.  Does hearing about one listening to The Great Courses count?

Where are you/where do you want to be.  I am at work, goofing off during a ‘no-show”.  Where would I want to be? : under Jake Gyllenhaal.

Practical Parsimony (the dear!) suggested I expand on my 37 1/2 thing about myself list which is a truly most excellent idea. One of 37.5 is my parents have been married for 50 years but they just celebrated year #57, so the list is 7 years old.  It could you a face lift and tuck.  I plan to add to the original list new imperial tidbits but first here’s some updates on things you are dying to know.


So far as I can tell I am still descended from English/German/Dutch and Canadian stock and both family lines have been in North America for over 12 generations. Recent genealogy has dug up no skeletons to say otherwise.

I remain the oldest of four brothers but I now have six niblings. Six seems enough and quite the family to provide for at christmas time.

As for health: Alas, I am still trying to flatten my stomach. My  blood pressure and cholesterol are in check but the ADHD isn’t and that seems to be worsening with each year. Someone, driven to distraction, will likely divorce me over it and get a new spouse one who listens and sits still.

Tea and whisky remain at the top of the list of Urs Truly’s favorite libations, although coffee quickly climbed into the top ten and seems to be staying there.

I haven’t collected any recent artwork; my nickels go to house repairs. Oh the pain.

I was shocked to discover my soulmate Liebchen Gustav Mahler and I are not 100 years apart. This is so disappointing I think I will continue to say it is one hundred as no one will stop to do the math to question it.

I still haven’t smoked anything or hit anyone but I know of several heads I would like to knock together.

Thunderstorms, a good back scratch, hot water, and noodles remain some of life’s greatest pleasures, as is rolling down grass hills. Alas, none of them are much around anymore in my life more’s the pity except the hot water, which remains lovely for tea and such.

I remain well over four feet but not as tall as I used to be. My tessitura has gone from husky to hoarse and there is hair growing out of my ears. Oh the embarrassment.

Blogger buddies remain the best thing about blogging.

I still can’t operate the home entertainment system nor do I want to

I still stammer and stutter and I can do this in German as well. I am learning Spanish which really brings out the stammer.

I’ve seen a tea plantation but not Ireland or the northern lights.

And I can’t spell calendar.

Finally – the picture that surmounts this entry was taken over seven years ago and I haven’t changed a bit.

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