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The Board of Directors Here at Spo-Reflections is a lot like Youtube: both become officially outraged at offenses at content but they don’t put a stop to things when they see the comments are coming in. TBDHSR fustigated me that Harper is ‘not that old” and knock off the equivocations. However they were pleased as punch to see the numbers of thoughtful comments from yesterday’s entry. Nevertheless they advised me I write about something insipid to calm things down a bit. So here’s a boring one.

Every med school as an unofficial panacea; mine was ‘Push fluids’. They needn’t have worried as I am continually watching my intake. After all I am a ‘water sign’ who lives in a roasting desert.  I am grateful to have a menu of moistures from which to choose.

Tap water –

What comes out of the pipes here isn’t too bad. Our water comes from the Colorado River basin. Goodness knows how many kidneys it passes through before it goes through mine but it seems OK. It tastes only a bit ‘off’ and this is only noted when compared to bottled or treated water. It has a slightly chalk taste to it. I have no overt qualms to drink it on the grounds some water is better than none. However, it makes awful tea for on the surface of the cooled cuppa there is a most unappetizing slight chemical oil slick.

I give Arizona tap water 3 stars.

Filtered water –

Under the sink is contraption resembling pan pines that filters the tap water before it goes the fridge to make the ice cubes. There is also a dispenser off the sink. I’ve forgotten what it horrible feints it filters. Whatever it allegedly removes the results are the water tastes better. This is the ‘house water’, the WOC (Water of choice). It has a less of flat taste. Once a year some nice man comes to change the filters. Like the manufacturing of sausages I don’t ask.

I give AZ filtered water 4 stars.

Bottled water –

Nowadays it is not PC to drink bottled water as it makes a for a lot of plastic waste. I drink some only when I am on the run and can’t find a drinking fountain. I suspect most bottled water is just sales huckom so I always buy what’s cheapest.

I give bottled water 2 stars.

Evian water –

OK I lied, this one is different. Evian water has a soft alkaline taste as if it has been through a rock pile. It is frightfully expensive and I always feel guilty for drinking some.  It seems to have disappeared from all the AZ gas stations so that’s a mercy. I sometimes keep a six pack in my office fridge mostly to impress the new patients who ask for a drink. Lugging Evian water to and from work is a bit of a task, which worsens its already bad carbon footprint.

I give Evian 4 stars.

Carbonated water –

Sometimes it is fun to have a some fizzywater. They don’t lack for variety; the number of flavors seem to have accelerated in the past year. In a double blind taste test I discovered the generic store stuff tastes nearly as good as La Croix so I buy Albertsons. Curiously I am still thirsty after I drink them.

I give fizzy-water 3 stars

My favorite water –

This would be the tap water that originates from The Great Lakes whether in Chicago or Grosse Pointe. No doubt this is cognitive bias on my part as it is the water I grew up drinking. I should do another double-blind taste test but there is a part of me that likes to believe it is the best water and don’t question me.

I give Lake Michigan water 5 stars.

Keep hydrated this summer!

Harper is showing signs of aging: her golden-brown hair is turning white, especially around the snout and eyes. She seems to have a lower energy level and she seems to sleep a more. She doesn’t leap up as quick or as high as before but she still shows enthusiasm at the canine sensation I am contemplating a walk.  At this time of year after dinner we wait for the pavement to cool I don’t go directly to the drawer with the leashes and doggie bags but to the computer to do some paperwork until the sun sets. You try telling a dog we have to wait for sunset to go out. Harper comes a-running when she hears or senses I am done – ready for her walk.

Summer in Arizona is a tough time for dog walks. It gets quickly gets hot – too hot for dog paws While the evening strolls are problematic the morning walks are delightful. At 5AM the sun is up and the sidewalk not yet dangerous to go for our morning strolls. YShe quickly starts to pant into these hot summer strolls but she shows no signs of wanting to turn around. She perseveres. I make certain there is always fresh cold water in the clack dish for her return home.

By now everything  outside has dried up. The plants are kexy things of a uniform brown ugliness although no two are alike.  I can’t imagine these have any scent to them but Harper sticks her nose deep into these things trying to discover what’s happening.

I need to be mindful she has enough time on these walks as otherwise she gets no exercise. It’s the dog days of summer and we are all more likely to just stay indoors and not move. I used to invite Someone to accompany us but I’ve stopped doing this, somewhat because he doesn’t ever want to go but mostly because I want time alone with her. The dog walks are our time. Others aren’t invited.

I have a sense she is in decline. Every time we go for a walk I wonder how many more do we have. Who can say when she will become too decrepit to go out. Lately I am less wanting to go out and do things in order to stay home with her.

Until that inevitable time we  go twice a day (if we are good) back out onto the same trails which never seem to disappoint. Lucky dog to encounter the world so!  I am glad to be part of this, and provide such.



I am not a fan of Robert Heinlein. There are many reasons for this but one of them is about the traits of his novels’ heroes. They are often ‘The self-sufficient man’. The fellows could do everything themselves thus never needing help from others. Mr. Heinlein extols his readers (mostly boys) to be likewise and he castigates thems who do not. Asking for help is a sign of failure. The truth is the opposite: we continually need help. We are a species that evolved to live in groups and cooperate to achieve our survival. All day long we seek assistance from others.

Throughout my workday I listen to patients’ fears. There are usual ones like public speaking, flying, and animals with nasty pointed teeth. “Asking for help” is a subtle but ubiquitous anxiety for most, which is odd as we all do it and need to. Many people avoid asking for help as they fear rejection or the judgment of others for doing so. I think men suffer most from the Shadow side of the Self-sufficient Man archetype.*

I try to teach patients it is OK to ask for help. To better their chances of getting results and feeling good about the process I give’m a few tips. We tend to ask for help badly, You would think by now we would be good at it. Many ask do so in an apologetic manner (I’m sooo sorry to bother you) and don’t communicate the specifics.  We often ask for help via text or email thinking this is the best way. Studies support the opposite: we are much more likely to get a ‘yes’ reply if we ask for help face to face or a phone call. Another matter to consider: we are awful at registering a person wants or needs help, yet people often assume our loved ones can sense we need help so they don’t directly ask and become upset when the others don’t pick up on our allegedly obvious vibes. I can’t remember the exact term for thi, but it is based on the illusion of transparency. Bottom line: you have to ask, even those you think should be able to read your mind.

When I need help I first tell my Self-Sufficient Man Complex shaming me yeah, I hear you but buzz off. Then find the person I want to ask and do so face to face. “I need your help” I say. Then I state in simple, realistic, and clear words what I want. “I need you to call this patient back for me to say she needs to come in” or “I want you please to call Hector (the groundskeeper) to come tidy up the yard” or “Thank you! I can’t get into my account I want you to help me figure out why not”.   Another tip: if there help was helpful, tell them about it later. “I wanted to let you know your help was really helpful, thank you”.

Let’s stop giving The Self-Sufficient Man more libido (psychic energy) than he needs or deserves.



*The cliché of men not asking for directions touches spot-on this archetype.


So-called truths are often not so. I recently heard a podcast debunking the concept of ‘alpha-males’ in wolf packs.* The Firesign Theatre strikes again: “Everything you know is wrong!” When I pull back the curtain on something to reveal the great and powerful Oz is a humbug I often feel a sense of being had. The alpha-male wolf nonsense evoked relief. The clap-trap behind this concept has done a lot of damage and it can be thrown out for the rubbish it is.

I grew up always at the other end of the hierarchy of alpha-males. Only at home did I have some clout. As the oldest of a bunch of brothers (fine fellows all, well over four feet) I am still  called upon to take the role of time-keeper whistle-blower referee. On the other hand they are all taller than I which sort of lowers (pun intended) my role as ‘big brother alpha-male’.

My nerdy wimpy self now has a board-certified double specialty connected to it. I forget I am the ersatz alpha-male. Being the ‘M.D.” at work puts me in the alpha-role more than I realize. I am not one of those bossy a-hole doctors barking orders at the minions. Despite my jovial nature and polite manners (think Lily Tomlin in “Big Business”) everyone at work addresses me as ‘doctor’ even though I’ve tried to make it OK to call me by my first name. The thralls all seem to do my bidding without question. I’ve noticed when I cut people off they shut up and let me go on not call me on it. It’s good to be King but it needs careful consideration when to pull out such archetypal energy.

In the bad old days when doctors = god patients did things without question. Nowadays the doctor/patient relationship is dialogue and consensual process (good!). All the same there is a part of patients that wants/needs me to be the alpha;  too much laid-back interactions makes them uncomfortable.  It is hard for me to conjure me-big-doctor alpha-male dressed in loud brightly colored aloha-style shirts. It’s like seeing your pilot wearing T-shirts and cut offs in the cockpit. You know he/she can fly the plane but you want to see a uniform.

It is hard to be The Great and Powerful Oz when you are more like Judy Garland.



*Turns out the actions of the ‘alpha-male’ wolf is more of less doing the ‘dad role’ to his family. That’s it. Even the author of the seminal treatise on the topic can’t seem to shut it down.


Last weekend while in Wisconsin I saw a painting of a historical nature that resembles one I saw in Ottawa. I was pleased as punch I was correct it was a painting by Benjamin West. The one in WI shows Charles II arriving at Dover; the other one (in Ottawa) is The death of General Wolfe.  Both paintings are examples of ‘photo shopping”: some if not most of the people in them were not present at the times of the events. Mostly likely Mr. West was paid by patrons to do so.

west death of general wolfe

I still don’t know whether to laugh or cry when I see history repeating itself. It supports the notion people don’t change which is both alarming and a comfort. People nowadays are all up in arms about fake photos and such but artwork has been putting up ‘fake news’ from the get-go. I don’t know if paintings like Mr. West’s were taken as literally truth. Did people believe the contents of paintings are how things actually happened? I remember as a boy going to art museums in which I saw Biblical characters dressed in 15th-18th century attire (usually Flemish) and smelling a rat. I guess even then I was looking for proper representation in the media!

Although I know Mr. West’s painting contents are BS I suppose historical representation is not the point. As I sit at my office desk I look across the desk to a print of Wolfe. It hangs there as I like it and it reminds me of the good times I had in Ottawa to finally see the real McCoy.

Art isn’t the news but something else. As I type this out I realize in my youth one of the reasons I liked ‘proper paintings’ was they are told a specific story. I don’t have to think much. In contrast I found modern art infuriating as “I don’t know what it is supposed to be about, will someone tell me what it means?”.  Nowadays I am leaning away from The Old Masters whom I suspect were as dastardly as present day pharmaceutical representatives towards the abstract. Abstract/modern art allows me my own thoughts and emotions. Who would have thunk it?

Ginseng root


I’m at that age when my back goes out more than I do. This morning it went into one of its spasms. It is not a sharp pain but it is nasty. It makes me quite hobbled and it ruined my work-to-be-done plans. Usually there is a peripeteia before it busts but not today. It just seemed to happen. Oh the pain. I look like Groucho Marx when I walk about when I am walking about at all. 

My inability to sit still trumped my decrepitude that I got a few things done. The freezer needed desperate defrosting which in this heat happened in no time. There was a Ziploc bag of Halloween candy hiding among the Tupperware boxes with their unknown contents. I ate Kerr’s molasses candy with relish with a Motrin 800mg chaser. Both helped the pain.

It is nice to be caught up with paperwork, Spanish lessons, laundry, and ironing, – temporality. Someone is ushering this evening so I am home alone reading and writing blogs. 

If my back lets up I plan to do those put-off chores tomorrow. There is no lack of tasks. It’s been ages since I worked on a shirt; I have a few bags of cut-out bits wanting sewing. The hallways are full up with Harper-hair dust bunnies.

If I am no better than I will let things go another day and watch read away the day. Perhaps I should read “The Scientific Statement of Being” and convince my lower back pain it is only error and go away.  Maybe I will think up a proper no-rubbish entry.  Tune in to find out. 

I regularly read Cooks Illustrated magazine. For thems unfamiliar with this food journal its goal is to explore the science of cooking in order to come up with new and improved ways to make established favorites. They take a dish, ‘take it apart’ and spend one to two pages explaining the trial and error they encountered on the road to the best recipe possible. The latest edition had a recipe for Sloppy Joes and how to do’em right. Spo-fans know I am always on the lookout for ‘proper’ recipes so I was intrigued to try out Cook Ilustrated’s ultimate recipe.

I am fond of Sloppy Joes; they are associated with family get-togethers and tailgate parties at football games. Recipes for Sloppy Joes are legion; I don’t think I’ve ever had or made the same version twice other than when I succumb to making the tinned Manwich variety (oh the embarrassment).

Someone is Sancho Panza to my Don Quixote on my quest to achieve culinary apotheosis. He’s grown dubious of these ‘new and improved versions” on the practical grounds they often take a lot of time to do and they often produce not much improvement over what we’ve always done. [1]  In my defense my attempts are admittedly different and not in a bad way. They never get a thumbs down. [2]

I got the ingredients and shooed Someone out of the kitchen for my quixotic attempt to create a Sloppy Joe culinary masterpiece.

The recipes are quite simple; it is the careful ingredients and technique that makes the dishes what they are. Cooks Illustrated always explains ‘why’ decisions are made but one can skip to the end and just make the recipe.

The hamburger meat was to be a certain fat percentage and seasoned and cooked with precise instructions.  Tomato paste was used instead of ketchup to increase umami; cornstarch was used to help bind the meat to make it less sloppy. [3]  I remember it did not have nasty celery and green bell pepper bits as they were deemed to interfere with the meat and onion flavors.

The end product was flavorful and there were no nasty drops down the shirt front.  It didn’t take too much time to do.  Someone said it was good and ‘worth making again’ so it was deemed a success.

There was a sense of it being different/not what I am used to so I guess I am not that different from the other Spos who prefer familiarity to flavor.  You can take the boy out of the Midwest but perhaps you can’t take the Midwest out of the boy after all.



[1] The awful fact that he is usual right doesn’t deter me from continually trying.

[2]  Once upon a time I spent a lot of time and effort making pumpkin pie from real pumpkins. It was full of organic pumpkin and fresh spices.  My family didn’t care for it. They were so used to ‘that made from the Libby’s can” this ‘new’ one didn’t feel ‘right’ for them in looks, taste, and feel.  Needless to say I don’t bother to make it any more. Pearls for swine I say.

[3] My family would find this another disappointment. Nothing dripping out the sides while eating would be seen as an object of suspicion. After all Sloppy Joes are supposed to be sloppy.  Mother served hers with a spoon for the droppings and with plenty of napkins.  It seemed most contents fell out but this was deemed a sign of ‘good’ Joes.

Every morning when I get into the car I plug in the phone and scan the screen to decide what to hear on the drive to my work. I can almost hear a little gasp rising from the many apps. “Choose me!” they all seem to whisper. It must be just the way a director feels when he walks into an audition room full up with actors all wanting to be picked over the others. There is no lack of options to choose from. On any given day I have a lyceum of listing material:


CME (continuing medical education) lectures

Great courses series


A nonstop steady supply of podcasts

The duration of the drive varies between twenty minutes and an hour depending on traffic conditions and which star is my destination. Listening options too lengthy or in need of careful attention are glossed over in favor of shorter compositions. For this reason most of my podcast subscriptions are the types that have episodes no longer than twenty minutes. I’ve learned if I start something and traffic is bad or the trip ends sooner than the episode I don’t retain what I just heard. That’s bad if I am trying to listen to a CME lecture as there is a quiz to do afterwards. The Great Courses series are an omnibus of 12-24 lectures making it difficult for me remember what happened in the last one if there is too long an interim between listening times.

I need to get over my gluttony (or neurosis) of wanting to hear as much as a I can as it is humanely not possible to cram all these lovelies into ten commutes per week. I  am often tempted to take The Mae West advice* over revive The Thirty Years War practice of defenestration.**

In my ‘I Love Lucy’ effort to keep up with the chocolate-covered options coming my way each day I sometimes put something on for ‘background’.  But this trick never works said some sage squirrel. The only time I pull it off  is with podcasts  in which two or three people are gabbing rather than one person lecturing. Books and lectures demand I do nothing but focus. “Pay attention!” they seem to say. “I’m very important!”.***

I suppose I should send all of them packing to re-experience silence now there’s a thought!  I don’t think my brain will suffer too much for the attempt. In fact it may find peace and quiet rather nice. With delicious irony last week I heard a podcast suggesting doing just this.



*Once upon a time Miss Mae had a radio show which was (no surprise) quite salacious. When confronted by reporters some people were outraged at the show’s contents she responded with the sensible advice “They could have turned it off”.

**Go look it up. No, I’ll wait.

***As I write this I am half-hearing an episode from “Our Fake History”. It is about Blackbeard and it sounds jolly good fun. I am going to have to turn it off and restart it as it is going in one ear and out the other.

It seems Titivillus and his minions are working overtime at keeping me away from my blogging. I have three or four prodromal proses in various computers. Alas Babylon! These half-baked compositions always seem to be not where I am at the moment.* TBDHSR is understandably concerned about my failure to ‘keep things up’ but the funeral pyre (ready for lighting) on my front lawn is a bit much. Worse luck! I have a bit of time before the workday starts to scribble out some thoughts but my mind’s a blank. I guess it will have to be one of those ‘what’s happening” entries. This usually pleases no one but beggars can’t be choosers.**

Today after work I am finally – finally! – getting my teeth cleaned. It’s been ages since they were properly attended to. About two years ago I decided to try out the local dental school for my needs. it was nearby and practically free. I thought this would save me money and I would get good-enough care. In hindsight this is one of those ‘what on earth was I thinking?” decisions. Because of the slow pace there I would have to take the whole afternoon off to accommodate their careful care. I lost a lot of income for not seeing patients of my own. Penny-wise; pound-foolish. More often than not they would not complete something and tell me to make another appointment soon to finish things. This usually happened many months later, which by then meant having to ‘start all over again’. By the time they finally got around to getting my teeth cleaned the student’s supervisor decided she had not done a good enough job and I would I please come back soon to redo it. Bless their hearts that was enough. I am now more interested in time than saving money.

Last week I met the new dentist whom I found in one of the rag-mags at my favorite bar. He and his (dental) partner have been advertising in the community for years. Going there was a night and day experience. The office was spectacular and the staff more like concierges than hygienists. This afternoon after work (they have EVENING HOURS!!) my puffy gums are being blown to hell with some sort of laser technology. Best yet this will take just an hour to do – not 4-5 hour spurts done over a series of years. I will lose a lot of blood but it’s worth it to have teeth that don’t look like old piano keys.

A part of me feels guilty for all of this lovely service. Unlike my fellow white male counterparts I don’t feel comfortable with elitist care. There is a sense of being in the 1% with all its perks while the hoi polloi remain ill-served back at the subsidized dental school. Someone says I should knock off the liberal guilt and be grateful I can afford it. After tonight I soon I won’t be spitting blood every time I brush my buckies.

Besides, everyone at the new dentist office is drop-dead gorgeous including the dentists. That alone is worth the price of admission. 🙂

Clipart picture of a tooth cartoon character with braces on teeth


*This one is ‘at the Phoenix office”. Although there is work to be done I’ve postponed all activities to write this. I am hell-bent (keeping with the theme of damnation) to put out.

** I once tried to give a street person an orange. He declined the offered fruit and said he only took cash. I was bewildered as he has just asked me for help to ‘get something to eat’. He seemed a bit peeved at my careful inquiry into this seeming inconsistency and I was asked to move along.

Last night on the flight home from Wisconsin I wrote an entry about some melancholic feelings I was having after my holiday. I went to post it this morning but I can’t find it. I frequently misplace things and I am forever taunted by the Car Key Gnomes and Cup Sprites moving my things around but this one has me nonplussed. Where is it? Did I write it only to erase it?  Who can say.

The Board of Directors Here at Spo-reflections in their latest board meeting suggested I ‘shake things up” but they didn’t give me guidance what this means. Once again I am to deduce what on earth I am supposed to do. It reminds me of  when Mother would tell me to ‘stop doing that’ without clarifying what I was doing wrong. TBDHSR are going to be mad as wet hens when they discover I’ve decided to revive my “Poetry” entries.

Oh the horror.

I like a good poem and I like to pass on the ones I find amusing, moving, and powerful. They are poison at the box office (hence the ire of the who-know-who) but there it is. I will try this on a regular basis for a while until they catch on what I am doing and threaten to use my nadgers for earrings.

In honor of the misplaced entry that ought to be here this morning:

Forgetfulness – Billy Collins

The name of the author is the first to go
followed obediently by the title, the plot,
the heartbreaking conclusion, the entire novel
which suddenly becomes one you have never read,
never even heard of,

as if, one by one, the memories you used to harbor
decided to retire to the southern hemisphere of the brain,
to a little fishing village where there are no phones.

Long ago you kissed the names of the nine Muses goodbye
and watched the quadratic equation pack its bag,
and even now as you memorize the order of the planets,

something else is slipping away, a state flower perhaps,
the address of an uncle, the capital of Paraguay.

Whatever it is you are struggling to remember,
it is not poised on the tip of your tongue,
not even lurking in some obscure corner of your spleen.

It has floated away down a dark mythological river
whose name begins with an L as far as you can recall,
well on your own way to oblivion where you will join those
who have even forgotten how to swim and how to ride a bicycle.

No wonder you rise in the middle of the night
to look up the date of a famous battle in a book on war.
No wonder the moon in the window seems to have drifted
out of a love poem that you used to know by heart.


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June 2019

Spo-Reflections 2006-2018