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Sorry! I have no time this week for blogging and other internet activities, for I am up to my ears in homework. The time I usually use to keep atop of the workload was consumed with hosting our out of town guest. He left today; I need to get cracking on catching up.  It looks like Friday or even Saturday before I can get back in the blogging saddle.

It is perhaps for the best, for The Muses have been quiet, not even an e-mail to their whereabouts. I haven’t anything on which to blog.  This afternoon when I should have been paying attention to a patient (who was whining) I almost thought of a topic, but it escaped me.

Please be patient. I will be back anon. And on and on and on.

Today’s entry is a brief one, for I have done it again: I went off to work and left the computer cord at home. In a few hours, there will be no more ‘juice’ in my laptop. It will be cold as a mackerel.

I write my progress notes as I talk to my patients. Happily I am a whiz at typing. This is one of the few areas where I can multi-task viz. type and listen.  Provided I remember to make eye contact, patients don’t seem to mind it – or so I think. I used to work with a physician whose patients constantly complained he never made eye contact with them while he used his laptop.  Hopefully I am not that bad.

A typed, detailed, easy to read progress note may be extra work while composing it, but it is vastly superior to handwritten rubbish for later on.  I am proud of my notes. I continually get transferred records from colleagues, whose notes are essentially worthless. Besides being usually illegible, they do not tell me ‘why’ things were done, but only the minimal what was done.  Bad documentation is an amazement to me, especially in this day and age.

I write my notes knowing medical records are about as private as Facebook or blogging – everyone is going to read them: the patient, other medical providers, insurance companies, attorneys, etc. I have to write tactfully as well as truthfully.  Sometimes more delicate topics have to documented with discretion.  If “Joe Smith” is in a workmen’s compensation everyone will soon be reading about his erectile dysfunction and his affair with the company’s secretary.

But not today;  the laptop battery is near its demise. I will write today’s progress notes by long hand, and then type or dictate them throughout the week.

On the positive note, I will save time today, for I will not be able to go on-line to read e-mails, check the news, etc.  Have you ever noticed when we are away from time – saving devices there is actually more time on our hands?

We had clement weather last weekend.  Our latest out of town guest (from the far off Kingdom of Chicago) was delighted to sit in full sunshine and temperatures in the high 70s. There is a sense of spring in the air, although it is not even March. We were able to eat outdoors a few times.

We don’t have daffodils, more’s the pity. I love them and what they represent viz. the awakening of the earth. The ground is too nasty for bulbs, and it never gets cold enough to set them.  I got out my floral tie.

Between the weather and work outs I am feeling ‘wound up’ as it were.  I appreciate that the sap still rises in this aging oak*.  All this spring fever includes wanderlust.

The tarot card for March is the Ace of Cups, which heralds new emotional matters. I wonder what that is all about, for spring looks to be more mundane: I need to start my taxes. I want to lose the five pounds gained since January.

The mentioned guest departs tomorrow, which leaves The Spo and Someone B&B vacant and ready to continue with house projects. The ‘To-do’ list doesn’t lack variety. There is a sizeable hole in the laundry room ceiling which should be repaired before the summer rains ensue (sooner than we realize).  I would like to sell or discard grandmother’s Hammond organ, taking up space in the guest room for 7 years.  Someone talks about painting the master bedroom.

So that is about all the news for the end of February.

*Yes, I know, sap is in Maple trees, not Oak, but I prefer Oak. Clever dicks and botanists needn’t bother to point out my mixed metaphor.  

I was going to try to be clever and write an entry of ‘oscar blog winners’, but I did that before. So I thought I would imitate those ‘5 on 5’ or ‘6 on 6’ or whatever number is it supposed to be.  Today is 2/26, and I only have seven photos, but they are fraught with artistic expression and meaning….

As you can see it is a depraved Sunday here at the House of Spo. It’s a dog’s life, to be sure, carrying on all this reprobate living. Just don’t tell Mr. Santorum.

Please ignore my right foot, unless you are good at giving feet rubs.This is the traveling attache for homework papers and chart. It may be my most difficult case, but I can get it to open up from time to time.

On to the kitchen…..

This is the Erik Memorial Rubber Duck altar. The fellow in the front row has on his chest the words –  “Syphilis Happens”.

My latest shirt; a work in progress. This one’s for George, my adopted Godfather, who likes to dress in African “regal” attire.

Someone is in the background, making lemon-lime sorbet with lemons from our backyard.

In the backyard I notice the pepper potted plants needs picking and pruning – pronto.

As you can see, the neighbors in the house overlooking our backyard can observe us from their upstairs windows. If they are a-peeping, they haven’t let on they are doing so. I’ve had no visits from police about complaints of indecency. Perhaps this is because I would inquire “Who is seeing this?”. I would ask not so much to tell them to stop peoping but to charge them my usual viewing fee.

It’s time I write about Madonna. I hear the howls of Spo-fans near and far.  Bear with me; I need to get her off my mind…..

My first boyfriend Paul (from the late 80s) adored her. He continually played her music. He had an autographed photo in his room. He lovingly referred to her as “The Tramp”. Whenever I hear “La Isla Bonita” I still think of Paul. This is probably why I don’t listen to Madonna that much.

I remember a couple of queens at a party coming near to violence whether Patti LaPone or Madonna had the better recording of “Evita”.  I forget ‘who won”. It was rather entertaining hearing the logic of their arguments.

“Material Girl” is a jolly tune. I have it on my ‘gym” playlist for the half hour on the elliptical machine. I’ve learned not to squeal and shout along, for it evokes odd looks.

Last month a nephew vented on Facebook about Madonna being the half-time entertainment. He complained about this ‘old people’ type of entertainment. He added the barb ‘it is so gay”.  Someone and I confronted him on this crack. He back-peddled and explained, well, you know what I mean (no, we didn’t). While were lecturing him severely, FB friends were posting ‘Ooh! Isn’t this the gayest thing?”

This week we learned Her Majesty Madonna is coming to Phoenix in October. I announced a fancy to get tickets. Someone was flabbergasted as if I had announced a desire to join the Moonies.  I guess it would a good for supper invite. “Did you know we have tickets to see Madonna?”, that sort of thing.  If we go – a big if – I want a ticket way in the back, with the other aged queens. I will bring along a pointy bra and my ear plugs.

I recently read an article about some sort of “Facebook rating” companies allegedly use when screening applicants for possible employment. This makes me wonder: in my line of work there is a lot of emphasis on “Evidence based Medicine” viz. scientific data to support the use of this or that treatment. If this “Facebook rating” exists, I would be keen to see the “Evidence Based” data on its efficacy.

I am on Facebook and I write this blog, so my privacy is basically thrown out the window. Hopefully I write nothing of which I am ashamed (after all, my relatives and patients read this stuff).  Despite my attempts to keep things “PG-13” I suspect nobody is going to hire me now. I fear my Facebook rating must be a low one.  I probably don’t have enough friends (only a lot of relatives), and/or I don’t say the right things.  It is my curse in life to always on the “B” list.

Some of my blog links lead to sordid and scandalous sites, but they have ‘Content warning’ admission sites.  If anyone should complain, I will take the Mae West approach and tell them they could have turned it off.  I am not ashamed of these associations, but I admit I can’t run now for public office.  Oh how disappointing.  But it is a small price to pay for artistic freedom and being a smart-ass.

Being an unemployed anathema is a probably a “neurotic what if”, for I don’t know of any unemployed doctors. I continually receive job offers (steady work is nearly certain when you are making a living off of human suffering).  I only hope future hirers will find my Facebook and WordPress postings at least entertaining before they tell me in some euphemistic way to shove off.

On Wednesday I was surprised and alarmed to re-experience an ‘aura’, a shimmering distortion in my vision like ripples on the surface of water. The fancy word for it is ‘scintillating scotoma’.  It can herald a migraine. I immediately took some Motrin.  Happily, no migraine developed, possibly from my quick intervention.

I had auras starting in childhood, when I was fascinated by the patterns they produced. They were very infrequent. Even more peculiar : only once did they evolve into actual migraines. For one week in 2003 I had daily migraine headaches for the first  – and only time? – in my life. The medical side of me was fascinated. “Wow!” I thought “ I have studied and treated migraines and now I am experiencing them from the inside!”

This scientific excitement was contrasted by the emotional side of me in so much in pain I was down on the floor in a fetal position, in tears. I have never felt such pain. It was the ice cream headache from hell; an ice pick between the eyes. Then, mysteriously, they never happened again. I did not have another aura until today.

I vaguely remember attending a lecture on migraines in which I learned the reason we have them is due to some sort of evolutionary advantage gone haywire.  I thought this great nonsense: possession by demons slam dancing in my sinuses is a far more likely and sensible explanation for the etiology of migraines. At least this was the belief once upon a time.

St. Theresa of Avila apparently had frequent migraines and thought them demonic. She also had great ecstasy in her pains. In her writings she wrote about an angel impaling her with an arrow:

“In his hands I saw a large golden spear and in its iron tip there seemed to be a point of fire. I felt as if he plunged this into my heart several times, so that it penetrated all the way into my entrails. When he drew it out, he seemed to draw them out with it, and left me totally inflamed with a great love for God. The pain was so severe, it made me moan several times. The sweetness of this intense pain is so extreme, there is no wanting it to end, and the soul is not satisfied with anything less than God.”

 All I will say is, if this is divine love, I have experienced it frequently.

Today is Ash Wednesday. I like the concepts integral to the day viz. a time for penance and meditation on one’s mortality.  It is good to pause in formal ritual to remind myself I will be someday be ashes. The rhythm of solemnity followed by celebration is appealing;  I like things in balance.

I also like ‘giving up something’ for Lent. A conscious deprivation or abstinence is cleansing and calming.  I started doing this as an adult, for I grew up Protestant. Then, “giving up something for Lent” was looked upon as Papist nonsense.

When I first took up the practice, my choices were bad. I would give up concrete items like candy, which carried no spiritual benefit (and seldom kept anyway).  Once or twice I tried to give up a few things I won’t write out lest my relatives are reading this, but this failed sooner than the candy. I recall giving up essentially useless items, along the line of “I vow not to smoke more than one cigar at a time”.

Lately there is encouragement to take up good actions rather than giving up something. Daily prayer or good deeds like helping others seems more sensible than abstaining from gummi-bears.

This Lent I came up with two things.  #1 – I am going to abstain from booze. This fits the criteria of creating a more austere lifestyle, and it would be something I would actually miss (unlike the cigars, which I have never smoked). The Personal Trainer has been nagging at me for some time to curtail the calories, so the lack of a snort won’t harm my figure any.

#2- I  am going to give up negativism. Too often I bitch and vent about the negative aspects of my day or life. I go with the ‘ glass half empty’ approach more than I should.  So, in this Lenten season I will say only positive things rather.

Someone, who was raised Baptist,  thinks my “Popery” practices nonsensical, but he is surprisingly supportive about choice #2.

I will greet Easter 2012 sober, positive, and perhaps a bit trimmer.

Memo to the Easter Bunny: Never mind the chocolate eggs this year. Bring me a bottle of Hendrik’s gin. 

A few weeks ago a Spo-fan asked me to answer  ‘What does being neurotic mean?”.  I sense the question wasn’t so much about getting a definition, but what to do about it.  I will do my best to summarize this lofty topic into a few take home points.

“Neurosis” is an old-fashioned term no longer used in modern psychology. It is a hangover term from the analytical days. Once upon a time being neurotic meant having an anxious thought or action resulting from unconscious conflicts.
If you were out of touch with reality, you had ‘psychosis’; if you had some screws loose but could still discern reality from delusion, you had ‘neurosis’.

I define “being neurotic” as the tendency to view the world or a situation in an unpleasant, threatening way.

How do you rid yourself of neuroticism? Ironically it is NOT about wallowing around in childhood issues like that time when you were six years old and didn’t get enough brownies. Intellectual neurotics can do this until the moon goes blue with cold and they remain as neurotic as usual. Intellectual insight cures ignorance, not neurosis.  Although this approach does follows the motto there is nothing wrong with you that an expensive analysis can’t prolong, and it does enhance a neurotic’s vocabulary with some eloquent psychobabble.

The other mistake dealing with neurotics is getting them to learn “coping skills” which are really avoidance techniques.

A more useful treatment is teaching people to be with their neurotic discomforts, and not run away from them.  What allows problems to take hold are all the desperate attempts made to protect yourself from emotions that make you feel bad.  For treating a neurosis, this means fixing the patient’s attention on what’s actually happening and not on the scary or threatening things they are imagining. You feel it and ride it out. The discomfort ends. You survive.

This is the treatment of neurosis, greatly summarized.   It feels like telling you the plot of “Madama Butterfly” is:

Madame Butterfly is set in Japan. An American sailor named Pinkerton buys a Japanese bride named Butterfly. He takes off, she has his child, and nobody has the guts to tell her he’s remarried in the States. She finally finds out and  kills herself”. 

Now my winter holiday is concluded; Life doesn’t look too interesting for awhile. There is nothing scheduled that is extraordinary until July. This gives me five months of “Life”, defined as those mundane things you do while waiting for something spectacular to happen.

And I have plenty of Life. In the next few months a few friends may come to town for a day or two; this would be most pleasant. I want to return to the gym after a week of eating/drinking and not much exercise.  Someone and I have a long list of household ‘to-do’ items. The taxes need doing; laundry needs ironing. I have a shirt I want to do for a friend’s birthday. Perhaps I can give up the iphone for Lent and read some books.

Most people don’t recognize when Life happens until after the fact. “Oh, I was so happy then”. Yet if they time traveled back to that time and asked themselves “Are you happy?” the answer would be “What are you talking about? I am too busy right now cooking dinner and there isn’t time for anything else”.

Apart from the unexpected, I hope there is plenty of Life for the next four to five months.  This makes lousy Facebook material, but I hope to sleep well.

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