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I am nearly done reading “100 years of solitude” and I just started reading “Game of Thrones’ but I think I will abort it for something that doesn’t have a lot of relations. I enjoyed ‘100’ but seven generations of family – nearly all of them named the same – left me confused. GOT looks worse.

The Spo family is large, complicated and multi-generational too but happily we are not fighting each other and we have (mostly) unique names, so it is easier to remember who is related to whom. I used to know all my relations but now that the younger ones have youngsters of their own I am lost. I’ve turned into one of those elders who has to ask if you Tim’s daughter or Rachel’s girl etc.

Many Spos are on Facebook, which is a nice way to keep in touch with the ‘so what’s happening in your life these days” enquiries. Recently some of the more conservative Spos have posted entries on gun control and give The Orangutan in the Oval Office a fair chance. I don’t touch them. One cousin responded in his conservative way to my friend’s liberal comment and in response she gave him quite the tongue-lashing, the type my family all wishes to give him but can’t.

Happily no one is estranged or has shot each other. We genuinely like each other despite some differences. Every November my mother’s cousins who live in Columbus, Ohio and thems who went to the proper school in Michigan have fierce battles.

Thinking about yesterday’s entry, I should send some emails to the cousins whom I haven’t heard from in a while and find out how they are doing. I have three sets of cousins, many over four feet: two on father’s side, and one on mother’s.  The maternal cousins are frequent fliers on FB so that’s covered.  My father’s brother’s children are available via texts and emails.  It is my father’s sister’s children with whom I don’t have a close relationship. They seem to be forever traveling and living the rich life.

Ah, family. If it weren’t for families I wouldn’t have a job.


I just finished listening to a podcast on how to manage email. Apparently normal people are continuously inundated with the wretched stuff to the point it becomes a time-sucking entity in desperate need of containment. The teacher gave tips on how to write email to better communicate the ‘gist’ of the neutral words; she also gave ways to prevent endless emails from going back and forth like a pingpong ball. It was all most fascinating especially because none of was applicable to me as I don’t get any.

There is email at work but the staff never uses it. Like Charlie Brown hoping for a letter I look for something, anything in my inbox but I get nothing. The bosses seldom need to communicate with me, and when they do they use the EHR or call me. If I want to communicate to The Wonder Receptionist I only have to walk next door and speak with her. The therapists were told not to put patient matters into not-secure email; since this is the only reason really they would want to talk to me, none bother.

My personal email box gets maybe a dozen a day. Most of my time on email is to delete not read. Most of it is medical news, of which I read the headlines and into the rubbish with it. Spam is surprisingly minimal. A proper email from an actual person with real content are as rare as ravens.  I guess I am lonely; I want a letter telling me your news.  I get such but it arrives in texts or FB announcements rather. Email is becoming more and more just a nuisance.

Getting back to the topic of work email, what is blatantly missing is patient email. In Medicine (psychiatry no exception) patients are all for it while their doctors would sooner eat rats at Tewkesbury than have it. Imagine the daily email from hundreds of patients, many with poor boundaries and/or with the patience of a boiling kettle! Besides becoming the time sucking vampire mentioned in the podcast, there is the security factor:patient information zipping through the internet without security. * Then there is the tedium of making sure all email gets into the charts.

A colleague recently tried email with patients but soon abandoned the experiment. His made it quite clear email was not for emergencies or to renew prescriptions or for billing/scheduling purposes. Of course this is exactly what patients wanted and they ended up doing anyway. Patients become irate ‘they had emailed about needing valium and/or thinking of killing themselves’ and the doctor didn’t get back to them immediately. Apparently he checked his email box 2-3/week at scheduled times. He soon scraped the system and stated he doesn’t look back.

This week I will send some email to some long time chums whom I haven’t heard from in awhile. I have to think of something to say. I lead a dull life.

I am curious to hear from Spo-fans if they use much email at work or at home or do you not bother but still call people or write letters.

I am told this can be fixed somehow, but the bosses are not willing to shell out the money for such.

“A sobering thought: what if, at this very moment, I am living up to my full potential? ”

Jane Wagner

My life is an ongoing struggle between ‘proper’ and ‘good enough’. Sometimes I want to do something right or not at all, and sometimes I seem to settle on sufficient.  I continually strive for perfectionism but seldom achieve such.  It’s sort of like being an optimist who often falls flat.

This afternoon I am going to try (for the umpteenth time) to make onion soup. I have grown despondent over the years of making a proper at-home version of this most delectable potage.  The ‘proper’ side of me thinks (and fears) there is a precise formula for French Onion Soup, a magical precise incantation of heat, ingredients, and cooking process that if missed by an inch makes the soup fail creates failure. The other approach, the ‘good enough’ philosophy says so long as the soup doesn’t come out putrid that makes it OK. All this precise nuance isn’t necessary; cooking is not a complicated password that if missed by an iota won’t open.

Cooking is one example of good-enough vs. just-right; weight-lifting is another. I have an uneasy sense there is a right combination of diet, frequency of lifts, timing etc. that translates into success and anything else is the equivalent to wasting my time.  On the other hand, some gym seems better than no gym, right?  Besides, it’s jolly good fun.

Ironing shirts and trousers definitely falls into the ‘good enough’ category, although Someone would disagree. As a rule he irons his own clothes (and he does do a better job I must say).

“Proper” cocktails are the rule for ’good enough’ manhattans, margaritas, martinis and non-M libations are immediate recognized and rejected by my persnickety tastebuds. I’ve learned in dive bars and with suspiciously untrained bartenders not to order such potations but stick to can’t-go-wrong bottles of beer or just straight whisky (proper lager, no rubbish).

Rolling down grass hills is any form, style, and duration is always “good enough” and better than none at all.  I thought pizza was likewise until I had PizzaPizza in Toronto which was quite the exception to the rule.

Today I will go to the gym, tidy the house, fold the laundry, and iron some shirts settling on ‘good enough’ without disappointment.  As for French onion soup, I am going to try a ‘no-brainer’ crockpot version.  Proper cooks may sneer or groan but I have my fingers crossed it will be ‘good enough’.  This one calls for beer, which portends it will be quite good enough. Now I have to worry about getting a proper beer, no rubbish.  This nonsense never ends.


I had a prodromal essay on the subject of integrity but it seems to have disappeared. This is most curious for I had three versions of it on three different computers (home office, work, and laptop). They have been all absconded, perhaps Hair Furor and his minions have deleted them as it is a now-forbidden attribute. So as not to let down the Spo-fan who requested said entry, I will be succinct to the point in this remake.

Integrity is what we do when no one is looking. It is doing the right thing even when you know you could get away with it. Some examples:

Stopping at the stop sign late at night when no one is around to see you.

Obeying the highway entry traffic light even when you know you can get away with it.

Not taking a small item when the gas station attendant has their back turned to you.

Keeping promise seven when certain the others have probably forgotten all about it.

Some would argue integrity is even more defined about what you WON’T do despite what everyone else is doing. People who see others blowing through the mentioned highway ramp entry signal are more likely to do likewise along the line what the hell everyone is doing it.   It is a common phenomenon when folks see cheaters getting away with something they follow.

Honor and Integrity are not synonymous. Integrity is a ‘within me” matter while honor is something bestowed on you. Honor can be horizontal (given by peers) or vertical (given by minions and underlines). Most of the time honor and integrity are highly correlated but not always. One can lose honor for having integrity and one could be honored for tossing integrity. I once had a patient of a certain background who told me in his culture to not steal when possible would lose honor.

Thanks to my Midwest Protestant upbringing Integrity is rather ingrained. I am one to do things one should do even when no one is looking – I think. There are exceptions. I don’t wipe down the gym equipment with hand sanitizer, even though the rule says to do so, on the scientific rationale this does no good. At the grocery store I don’t point out to the check-out lady my vegetables are the more expensive organic ones, but hope she won’t notice. There goes my good Henley St. name. Perhaps I qualify after all for a federal government job.


The Other Doctor called in sick today and The Wonder Receptionist is taking time off for a family matter, so things are a bit quiet here at the office. I sense the former’s absence will create ‘cover’ work, while the absence of the latter will mean the phone calls won’t get through. Today’s pharmaceutical lunch may be canceled due to lack of attendance. I will have to run out in mid-day traffic to find something to eat as quickly as possible between noon and 1230 in time to get back to the helm. For all my wool-gathering, I am never asleep at the switch.

The clinic has lost another potential new prescriber. For some time the bosses have been trying to get a 3rd doctor but no such luck. A physician or RN gets oh-so-close and then they bail. I am told this last one went a little off the deep end just before starting. Apparently she was appalled to learn part of the job of working with anxious or ADHD patients means sometimes prescribing controlled substance Rx. Worse, she has to cover her patient’s phone calls. It was probably good to find this out prior to her being on board.

I am clearing out my files of ‘clippings of interest’ and ‘patient resources’. In my field things come and go so quickly; last year’s research and recommendations may already be outdated. While it is exciting to be an ever-growing branch of Medicine, it is rawther difficult to keep up. Sometimes it is easier just to go to Youtube than read JAMA, which I read mainly for the lovely art history articles that illustrates the front covers.

I am practicing my Spanish lessons on the clerical staff. They are too polite to tell me my Spanish is god-awful, so getting feedback is faulty. My formal grammar is politely corrected to everyday vernacular, which I appreciate. I can’t seem to remember the who/what/where/why words but the swear words have landed safely into my lexicon. Cabron is my new favorite, probably because it isn’t clear to me what it means exactly.  For all I know I am getting the Spanish version of “The dirty Hungarian translation book”.


I just finished a three part lecture on opera production. The lecturer (who was well over four feet) said opera audiences fall into two categories: thems who want their tastes reinforced and thems who want something new to discover. I thought this a nice summary of human nature. We want familiar, comfortable things but we also crave novelty.

The dilemma of familiar vs. novelty is played out each January when I nudge Someone to work upon the new year’s holidays. Do we go back to the annual familiar haunts or do we try something new and adventuresome? We have only so much time-off (and money) so it is one or the other.

Most of the time we do the familiar rounds: Palm Springs in February; Flagstaff in June; Utah in July; Canada in August. We do them as we like them. The same B&Bs, restaurants, and theatres give me comfort and are thus meritorious. However, these trips have in them a slight cacophonous undertone, emanating from my bucket list, of roads not taken and places not seen.

For thems interested, here is a my (travel) bucket list:

See Ireland

See Iceland

See the Northern lights

Attend an opera at Sydney

Go boating into a Norwegian fjord and meet some trolls.

Visit a tea plantation (proper one, no rubbish)

Rolling down grass hills in all 50 states*

Alas, most of these dreams require significant time off to do them properly, which means getting a colleague to cover. This is no small feat. Someone is Sancho Panza to my Don Quixote; he points out the longer we are away the more expensive it gets to house Harper and hotel bills etc. (and he too has issues of getting off time). It looks like we must be content with the usual familiar places nearby and not time-consuming.  While it is lovely to be back with ‘old friends’ it would be more so to meet ‘new ones’. This may be especially so if they involved Irish, Icelanders, Aussie Opera queens, or Southern gentleman one accidently knocks over while rolling down grass hills in Savannah – which happens to have nearby the only USA tea plantation.

Rolling down grass hills.


*I think I have five more states to go. These are nearly all in the South – and Vermont. I just hope there aren’t too many ticks and snakes.

Now that I am the nabob of five hundred navvies I better ‘put out’ as it were with something worth reading. Alas, all I got today is “random thoughts”.

insanityIt’s the Phoenix ‘cold season’ which consists of clouds, rain, and lows dipping into the 30s. It feels like the Pacific Northwest. One is obliged to finally get out a jacket and turn on the heat. Inclement weather makes many of my fellow Phoenicians morose;  this is the sort of weather they wished to avoid when they moved away from the Northeast, the Northwest, the Midwest, the Canada, etc.  I like it rather; rainy cloudy days invariably cheer me up. It reinforces the belief once upon a time in a previous life I was a Tlingit.

People are waxing wroth last weekend over ‘alternative facts”, which seems to be just a quaint euphemism for lies and falsehoods. Science uses the less pejorative expression ‘cognitive bias’: we believe what we wish is true.  It is hoped we are open to objective collaboration and facts but this doesn’t seem to be in vogue at the moment.  My patients have all sorts of zany ideas about mental illness and treatment. One of my tasks is to provide accurate and evidence-based medicine to them, whether they like it or not. More and more patients take offense when I challenge their beliefs. I try to persuade them my medical degree and 25 years of experience beats their google-search.

According to my language app, I’ve done a daily lesson for two weeks in a row and to keep going. The fit-bit and the Runkeeper apps remind me to do a daily exercise, while my phone tells me it’s time to go to sleep. As I write this I realize I have the technological equivalent of a nagging spouse or parent.  On the other hand I can’t be trusted to remember these things on my own, so I shan’t complain.

Last night The Lovely Neighbor had me over for ‘southern food’ consisting of fried catfish, homemade slaw, potatoes, and black-eyed peas. We also had hushpuppies, which she lamented were not very good as she forgot baking soda or something. I had never had one before, so I had no reference. I gave one to Harper who did not eat it – perhaps as she was hushed already.


The Good Folks at WordPress inform me a person named Pearl Necklace is now following my blog, which totals 500. This is an honor. I thank Ms. Necklace and all who read my scribbles. I am pleased as punch. My inner literary parents, Charles Dickens and Alice Thomas Ellis, are proud of their boy other than when he dangles modifiers and forgets what he writes is something Mother had written already.

The Board of Directors Here at Spo-reflections, never one to miss the black lining of any silver cloud, is fretful  now that I have enough followers to open a small country I need to ‘put out quality’ as it were. Measuring “quality” is a bit vague. I vituperated I must be something of ‘quality’ as I’ve managed to lure in 500 followers.  They admitted I had a point. All the same, please post something without too much palaver or too many pleonasms.

Alas, as I sit this Sunday morning and look around for tidbits upon which to create a composition, all I have is the vacuum cleaner, which is inutile at the moment. That sucks. I was hoping to tidy up today. These days the Spo-house appliances are in various attitudes of cooperation. The rice cooker is hit-and-miss while the crockpot remains intrepid and reliable. I am ready to throw the beard trimmer into the rubbish, for it doesn’t hold power anymore. Shouting imprecations at the devices does no good, and I daresay they are in cahoots, plotting outrages. I worry being monstrous to the mix-master will result in the office printer becoming indurate. Happily the Kindle isn’t being nasty although it needs charging if I can only find the proper cord to do so.

My 500 followers and their relations are free to leave in the comment section proposals for future entries, as well as questions for Urs Truly or just hellos nice to read this.  For every comment placed, a rat in Tewkesbury gets off from being eaten.



For the past two months and more I’ve been peeling patients off the ceiling in their anger, shock, grief, and anxiety about the incoming/now president Kim Jong-Trump. They turn to me for advice and answers –  and Valium – for help in this deemed dark drama.  My first proclivity is to answer ‘How the ** should I know. I feel the same way!”.  However, it is not impossible to give counsel and support when one feels similar.

I thought I would pass on a few things my patients find helpful – and a few I have found helpful from my patients.


It was Martin Luther or Thomas Moore (or both) who said the devil cannot abide being mocked. Arguments, anger, logic and reason are all no good with Hair Furor. The chink in his armor is laughter. He cannot abide feeling he is being laughed at.  Just witness his tirades after Saturday Night Live airs their weekly spoof.  Keep up with the laughter and satire.  If someone complains you are not giving Orange Julius/the office the respect he/it deserves, point out it is my first amendment right to do so and in the vein of how President Obama was treated.

Don’t become isolated

Wanting to crawl into a hole, hedgehog-like, appeals to the part in us that wants to avoid pain. There is support and power in comradely. In the “Harry Potter” books Luna gives Harry the sensible advice Voldemort probably wants him to feel cut off and isolated from others, as that way he won’t be much of a threat.

Remember History

What happens today is not likely to last; the pendulum of history swings from one side of politics to another. Bad leaders and nations come and go.

Keep in mind: Rome survived Nero.

Be active

Take political action; you can make a difference. Write, protest, hold your representatives accountable. Don’t just vent or whine on social media. Be active and be strong.

Get the facts

Speaking specifically about the Orangutan in the Office and his minions, focus on facts not emotions. When someone froths about something challenge them to prove it, quote their sources, etc. Truth wins in the end despite the past year’s events to make it seem otherwise.

And if all else fails:

Take the valium.   🙂


Behold! Shirt #101 is concluded! 

I bought this fabric some years ago when I was visiting Honolulu. The pattern looked fabulous and it captured the ur-text of the place. The fabric sat on the shelf for years until I finally got around to tackling the ticklish task of how to properly line up the front.

It turned out well; the front lines up well enough. I fear the shirt is a bit small. On the positive, I have a new frock for February’s winter holiday. On the negative I need to lose some weight pronto to fit into it. Imagine showing up in Palm Springs looking pudgy! Oh, the horror! Oh, the talk!

The red matches my eyes.


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January 2017

Spo-Reflections 2006-2018