Greetings from South Carolina, Land of Humidity. *

We are having a lovely time walking around and seeing the sites, with frequent change in our shirts. I’ve had my first okra (fried, served with mayo).

I’ve not taken many photos and I will tell you why. I am beginning to prefer my own memories than those in a photograph. There is research on the subject to support my approach. People who quickly take a photo are less likely remember the experience than thems who look around and imprint their impressions using their senses. I write things down too, which helps jog my memory to recall the details.

On our first day in Charleston we took a bus tour. We sat up front on the right side of the bus; across the aisle sat another couple. They were well over four feet. As we drove by the points of interest, this quiet pair would get up quickly turn and click their phones to take whatever was whizzing by. Were they actually listening to the tour guide or merely taking photos at the cue there was something of worth there to see? A few times when their was something on the right side of the bus they would jump up and sort of lean over us (invading our personal zones) to try to capture the moment.   In contrast, Someone and I took no photos but listened to what was being said. We also asked questions, which the tour guide was happy to address. I hope said-couple enjoyed the tour. I wonder if ‘their way’ is good as our own at making the morning memorable.

Nowadays it feels a bit odd to walk up to a monument or lovely view and be the only one not wiping out their phone to take a photo. There is something old-fashioned about just standing and looking, but I don’t recall my grandparents complaining they could not remember what they saw or did on their travels.

With that said, we are not against photography. We took some photos, but not of the main things. Mine were of tangents. At Fort Sumter I took a close up of the brick wall. We were told the bricks were made by hand by slaves. The bricks had broken shells in them. I wondered who else saw them and why they were there.  Photographs of Fort Sumter – and good ones at that – are easily viewed and download via the internet. My quirky close up souvenir photos are good for what I want to remember.



* More accurate is to report on the dew point not the humidity. The dew point is 80F. Oh the pain.

draft_lens1615031module4595356photo_1211841208overpacked-bagThe Supershuttle picks us up in half an hour so this one will be brief. We are on our way to South Carolina!  

I don’t know anyone who can quickly pack for a holiday. I needs days to do so. I start a few days ahead of time by writing down on a list what things I may need for the trip. These are not the obvious like undergarments (although I’ve been known to forget these. Oh the embarrassment) but

the items I am likely to sorely miss. Choice examples: headphones, backscratcher, and the Kindle device.

Physicians are trained to do a physical exam in a particular order so there is less chance of missing something by doing things by rote. Urs Truly packs likewise.

Always first is the medications.  Out go the various blood pressure and cholesterol medications along with the vitamins (MVI and D) and whatever snake oil I am taking at the moment.  They go in little day travel boxes of white plastic. I’ve learned these go into the carryon lest the luggage lands in an alternative destination than my person.

Second: the dopp kit. Mine is a beat up black ersatz leather case the size of a small loaf of bread. It has several zipper compartments in which I am continually discovering lost items from previous trips.

The ghost bag is next. I envy people who ‘travel light” as I sure as hell don’t. In goes the laptop, my journal, a book or two, GAMES magazine, my wallet and spectacles, and (if there is room) whatever medical journals are at hand that I read and toss along the way.

Clothes are last as they are less clear. How much to bring is always the question. My Boy Scout training combines with my Midwest mentality to make me usually pack more than necessary. I do like a daily change of Spo-shirt (lest there is talk) and a daily change of underwear (lest I am in the ER and there is worse talk).

This is a good point for an aside to say Someone is fantastic at packing. He could pack a closet full into a carry on. If we are sharing luggage he does the packing.  Clever man.

After I gather all the clothes together I stand back like a show director in front of a group of applicants all after the same few jobs.  I try to whittle down to ‘the basics’ which is often far from basic. No one can accuse me of being spartan.

I always leave room in the luggage for the return trip. Dirty duds take up more space in the suitcase than clean items. Away on holiday I tend to buy things which demand their own space.  Someone tends to pack a full case to avoid the purchasing of knickknacks and bricolage.

For fun I sometimes imagine putting something ‘eye-raising’ in the bag just before closing, lest there is an inspection by the TSA fellow for him to have a heart attack for snooping around my undies.  But I never do.


At work I often encounter patients who have extraordinary circumstances or just bad luck between appointments. I call this “The Helen Syndrome”, which is named after a patient or mine who was named – wait for it – Helen. Helen seemed to have the worst luck. I kid you not I would see on January 1st and we would start a medication, let’s say Prozac.  She would return on February 1st and I would ask how the medication is going. She would reply it was hard to tell for on January 3rd the house burned down with all their possessions and they had to move in with that bitch sister-in-law who I can not stand and iI am so close to knocking her teeth out and oh by the way I got pneumonia about mid-February I was so sick I had to be hospitalized.  She  would finish she had only been discharged home a few days ago and the bitch sister-in-law still hasn’t done anything in her absence and now the insurance company is doubting the story.

“So you see, Dr. Spo, I can’t tell if the Prozac is doing any good.”

Oh the pain.

When this happens I change over from listening if the Rx made her feel better to Helen despite it all did you go off the deep end and crack up?  She admitted she hadn’t gone postal on the insurance agent and she hadn’t axed her sister-in-law. Normally she wigs out in hospital, but she took it in stride. Perhaps the Prozac was helpful after all.

The Helen Syndrome happens a lot. People are forever having unexpected events most unpleasant occur while they are out and about.  One patient astutely questioned the phenomena. “Gee doc, isn’t what you are calling The Helen Syndrome, just, you know.. life?”  Good point.  Life is full of random actions and surprise appearances. One definition of mental health is how well we deal with life’s surprises and roadblocks.  However, it’s the humdinger happenings that really test our mettle (and the meds).  Interesting: most patients  who worry they had snapped a tether since that random comet annihilated their house are comforted by my feedback they did OK under the circumstances. Seldom do they want ‘more meds’ but are willing to see if the next month is a bit more mundane.   This follows the sage advice of Hippocrates who defined all of Medicine as the careful craft of entertaining the patient while the body heals itself.

Neurotics don’t trust good times; they just know the shoe will drop soon and they are not wrong. What they don’t consider is during Helen Syndrome-like down times it is equally true the shoe will pick up.

It is a bit giddy for me to forever wonder what is going to walk in my door next, a patient spitting blood or one worshiping my intervention ‘you saved my life mister’.  The Helen Syndrome and Life itself keeps me on my toes. It is never dull. It sure beats cardiology.


Note: I wrote this entry mostly as an exercise to help me focus into consciousness a set of emotions on a topic that is bothering me. This process of expanding the subconscious is called ‘amplification”. It doesn’t make for a comical or interesting entry.  Spo-fans and cranky Board Members have been warned. 🙂


I like to talk about The Journey, which is the Jungian archetype about ones passing through life. It highlights the elements of Self-growth and development for the time one has between cradle and grave. Sometimes I am am talking out of my other end on the topic for I don’t any clue what is my Journey.

Mind! There is no written script on what constitutes The Journey. There is nothing preordained. Indeed, having thought out yours like a AAA triptych is not Journey at all. What makes the gods laugh most is when you tell them your plans. By definition, The Journey is what you encounter when you remain open to what may happen. Frodo Baggins said it best “I will take the ring though I do not know the way”.


All the same, I want some sort of guidance. The Cheshire Cat’s assurance if I walk long enough I will get somewhere is at times no comfort.

So what’s missing? The answer: future goals. I pepper the months of each year with events and things to look forward. These include the traditional holidays, away-from-home seminars, and vacations. In contrast there is nothing in the bigger picture such as what I want to accomplish by 60 or 70 or where I want to retire (if I should achieve such) or even what do I want out of life.

Spo-fans know I inherited from The Lovely Neighbor several stacks of cooking magazines which I am slowly rummaging for recipes. I tear out the interesting looking ones and tuck them away for a nebulous ‘some day’. I recently got all of them out from the accordion file and I sorted them into categories. There are scores of them, ranging from appetizers to vegetable dishes. My first emotional response at surveying the piles on the dining room table is even if I were to start right now I could not make all of them in my lifetime. So, when am I going to make them? Is this my future goal, my Journey?  If so it is it seems a bit mawkish and uninspiring. The point here is these piles tickle that itch to have more Purpose and to refine The Journey. I don’t know yet what to do but I sense I need to do something.

Maybe that’s what the Cheshire Cat is assuring me: not what is The Journey but which steps to take first.


Yesterday I walked in the locker room where I heard a man talking loudly to another. I walked around the corner only to discover he wasn’t talking to anyone there but with someone via a device. He didn’t stop with my approach; he continued his dialogue as if I wasn’t there. Standing next to him I couldn’t help but overhear; he didn’t tone down his voice. He was talking about lizard people. As I could only hear his side of the conversation it was not clear if he was trying to educate only or persuade his listener there is a race of lizard type people infiltrating the world governments. Normally when I encounter a man talking to himself about such rubbish I prescribe depot antipsychotic medication but he didn’t sound schizophrenic but barking mad.
When I got home I looked up ‘lizard people’ only to find this is a theory held by many. And what a theory it is! Apparently many politicians are lizards in disguise. Many crowned heads are implicated including Hair Furor. The notion Mr. Trump is actually a disguised alien, hell-bent on our downfall, has some logic to it. I may become a believer.

The lizard people conspiracy websites are somewhat vague what you are  supposed to do if discover your mayor, president, prime minister etc. is a reptilian alien. There isn’t much advice on how to effectively approach a government official and tear at his face to reveal green scales underneath sponge rubber.

The reasons to impeach Trump now seem rather tame compared to the hypothesis he is a Slitheen from beyond the Oort Cloud.

Tomorrow I am going to start to be on the look out for tell-tale signs The Current President has lizard-like attributes. I would write my congressman about it but he’s probably a lizard too. Oh the pain.


Do any Spo-fans have reptilian aliens as their governmental representative?

This week’s calendar reminds me on Friday Someone and I leave for our annual August holiday. Normally we take a long week to travel to Canada but this year we go to South Carolina (Charleston) and Georgia (Savannah). Up until now I’ve not been too excited as it was all rather abstract.  However, a bit of snooping around on the internet has raised my hopes.


This trip crosses off a few of my Bucket list items. First: I can say I’ve been to South Carolina, which is one of 5-6 states of the union I have not visited. Second: I get to visit a tea plantation. I figured I would have to travel to India or China to do this one, but it turns out North America’s only tea plantation is located in South Carolina. I don’t know if it is a ‘proper’ plantation (or if the tea is any good) but hey they have real Camellia sinensis so that counts. Third: I see a Fort Sumter.


We planned this trip months ago. We did not consciously do so but we will be in Charleston the day of the eclipse. Hot puppies! If the weather cooperates we will have a front row seat!*

I think it terribly tedious to bore ones friends and relations with too my photos and details about ones travels but I plan to do so this time. Other than these three or four hopes** I don’t have any pre-expectations. It is a proper adventure holiday with no plans and make-it-up-as-we-go-along.  And I get all the shrimp I can eat. What’s not to like about that?


*Alas the forecast doesn’t portend success. It looks to be a good chance of rain each day of our visit, with obscene dew points. Oh the disappointment.

**Charleston appears to have some lovely local distilleries so that may be the fifth horse of my apocalypse.


I don’t have much to report, so here’s a new set of fabulous words Urs Truly is trying to get to land and stick to his lexicon flypaper.


Brummagem – (adj.) cheap, showy, or counterfeit.

Cadge  – (v.) to ask for get something to which one is not strictly entitled

Chicanery – (n.) The use of trickery to achieve a political, financial, or legal purpose.

Euphonious – (adj.) pleasing to the ear.

Harridan – (n.) a strict, bossy, or belligerent woman.

Noisome – (adj.) having an extremely offensive smell.

Prolix – (adj.)  Using or containing too many words; tediously lengthy.

Sapiosexual – (n.) a person who finds intelligence to be sexually attractive.

Sequacious – (adj.) lacking independence or originality of thought.

Tetchy – (adj.) bad-tempered and irritable.



A Gowpen is the cup formed by putting your hands together to make a bowl.  A Yepsen is the amount you can hold in your Gowpen.


I am beginning to doubt my self-perception I am not a vain person. The 2016 Elanta gets a tune-up today, so Someone gave me the other car to drive to work. I’ve just parked the 2001 Honda Accord next to The Other Doctor’s bright red shiny new Porsche and I feel like white-trash. I look down at my ten-year-old mouse pad to see it is quite frayed around the edges. The cuffs on my khaki pants, quite dog-eared and thread-bare, suddenly seem a problem. I look like a tatterdemalion. Oh the pain.

In our house we tend to hold onto things as long as possible before replacement. This means we have lots of worn-down far from stellar (but still functioning) things such as the 270,000 miles Honda with its scratches and dents and a closet-full of undergarments stained and hole-y. When does parsimonious Midwest virtue translate into being a tightwad?  Do patients look at my jalopy, compare it to the Porsche, and deduce The Other Doctor must be better?

Perhaps in the end we are not so much penny-wise Midwesterners but cheap. Someone doesn’t give a darn the Honda looks long in the tooth. He is content it keeps running and we don’t have to shell out money for a new car. Replacing my Dockers because the cuffs have some rough edges and loose threads strikes me as wasteful.

At the other end of the spectrum are the folks who regularly replace their possessions at the first sign of a blemish. And then there are thems who replace things not because the car, the shirt or what have you is torn or looks bad but because – gasp – they simply want a new one. I don’t think I have ever done that. Will the gods who dwell in faraway Michigan strike me down for vanity and extravagance?

I think this weekend I will be so bold as to put away the trousers with too many frayed cuffs and indelible spots. The Honda is a lost cause until it needs a repair so costly as to make it not worthwhile. I’ve been hoping for that for ten years with no signs of such. Like the rocks at Stonehenge nothing knocks it down.

Spo-fans – How soon do you replace things? What is the decision point to do so? I am particularly interested in the Spo-fan Warrior Queens (A.K.A. the ladies) when do you replace your clothing ?

When The Lovely Neighbor moved away she left behind a computer monitor the size of an IMAX screen. Alas I couldn’t use it at either of my offices for it blocks my view of patients (and everything else). I gave it to The Wonder Receptionist who loves it so. Apparently she has poor vision and this large screen is superior to the previous one. She is pleased as punch.  If she is happy the clinic is happy.


Rumor has it the bosses hired a nurse practioner so there will be three pill pushers on the premises. Let’s see if she shows. Hiring a third prescriber has been a challenge; at the last minute the change their minds and don’t show up. My experience with psychiatric RNs is not good but I am going to keep a neutral opinion on this new one. The past ones often lauded ‘they are just as good as the doctor’ but when they were faced with a challenge they told the patients ‘Oh, I am just a nurse you need to see a doctor’ and give them to me.

The current crop of pharmaceutical representatives has arrived. They come and go so quickly here. It looks like the pharmaceutical companies haven’t done their research well as this lot doesn’t have any particularly handsome ones of the sort Fearsome Beard would post on his blog as “Beard of the day”. The 401K man recently came to visit, bringing with him a companion. They weren’t bad on the eye. Alas I have no legitimate excuse to have him back for a private examination of my mutual funds.

After years of threats from the Boss-man he vows it is really going to happen viz. his plan to knock down my office wall to divide the room into two. This will allegedly happen when I am away later this month. I don’t mind really. My office is quite capacious and I prefer a more cozy setting. I retain the better half, the one with the windows and the view.

The Mesa office refrigerator remains messy and cluttered with leftovers long forgotten and other things hard to identify. The users are 95% female; I thought women were more fastidious than men.  My Swiss-German genetics wants me to clean it all out and perhaps I will.


I am signed up to attend two conferences: I go to New Orleans in September and in December I go to Lost Vegas.  Normally I attend medical conferences on my own but this time Someone will go with me to both . I am pleased as punch that he will do so.  Some people like traveling alone but I do not. I prefer the company of others.

Medical conferences can be lonely trips. After the afternoon lectures adjourn there is nothing much more to do. Left to myself I end up staying in the hotel rather than poking about the town. I eat better with a travel companion. I eat out of a fast food places rather than pay to sit down alone in a restaurant.  Imagine going to New Orleans and eating chain-food fodder!  With Someone at my side I can plan on a few proper dinners – and they are tax deductible!

Medical conferences usually happen in swanky cities and resorts as the doctors usually travel with their spouses. A bedazzling city gives these intrepid mates things to do and see while their doc-mates pow-wow with their fellow wizards learning the latest.  Someone jokes as a doctor’s wife his job is to sit poolside wearing expensive jewelry. Most of the time he gets a bored waiting for my seminars to end, so he often doesn’t want to go on these shing-dings. I daresay he prefers staying home in the peace and quiet of my absence.

Another perk of my Sancho Panza escorting me to the psych-congress is libations. When I travel alone I find it creepy to go to a bar to sit and read a book and drink alone.  He’s also more clever than I at arranging the rental car or shuttle and getting luggage there and back again without mishap.

There are some disadvantages to traveling with ones mate. I will be trapped in a hotel room with the TV; at home I can go into the other room.  Someone likes evening entertainments such as Lost Vegas shows when I often feel too tired to go out. After all it is a school night for me.

Alone in a hotel room, a stranger in a strange land in a resort city my mind is a recipe to stray towards wickedness. Having Someone at my side keeps me virtuous.  I won’t go out at night an prowl and bring back to my hotel room any nasty chips.


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