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Note: this one started as a Spo-explanation on board certification and ended up in a rant. I decided to keep it as it is. Spo

Urs Truly is ‘board certified’ in Psychiatry, and in Neurology thank you very much. I passed a written and an oral examination to become so. [1] Being “BC” sounds good, does it not? Hospitals and clinics, in their advertising, boast their doctors are all board certified. Indeed, to be a member of certain institutions it is required one be board-certified. Once upon a time being BC was a lifelong certification. After 1992, this changed. Doctors who became board-certified after 1992 have to redo their certification every few years to retain that title. [2]

Becoming and staying board certified is a grueling, anxiety-provoking, time-sucking, very expensive process – and there is not a shred of evidence to support a doctor who is board-certified is a better physician for it. Doctors know this, but the public does not. They guess being board-certified means you are a better doctor- and the system profits from this by obliging doctors to re-certify themselves at enormous expense, let alone the time they have to take to study for it. Some years ago the certification boards created something called The Merit of continuation, or MOC. This is another ‘do this or lose your status’ exam. To say physicians have been up in arms about the the MOC is to put it mildly. This extra time/energy/money suck is total B.S. on the grounds there is no data showing this makes one a better doctor. Many accuse the MOC of being a money maker, based on the fears of ‘losing your certification”. [3]

Happily my BC-status is ‘grandfathered’ so the BSitude that is the MOC doesn’t apply to me. Think about this though. You would think the doctors certified before1992 would be the ones most in need of retesting and recertification. If the Boards ever dared to revoke their decision on this ‘grandfather exception’ rule, these doctors like myself (most over 60 years old) would probably retire than recertify. This is the last thing the Boards want to see happen. If I my BC title were to be revoked, sooner I’d eat rats at Tewkesbury than spend countless hours and thousands of dollars to retain it. I would wake up the next day with the mark of “not BC” on my forehead but no different in who I am, what I do, and what I know. There’s a shrink shortage anyway. I won’t be fired.

If re-certification doesn’t make one a better physician, what does? No one really knows. Lots of ink has been spilled on this topic. All doctors (board eligible and certified) have to do ongoing learning called ‘continuing medical education” viz. CME to renew their state licenses. No one asks me what I did, just did I meet the number. Arizona requires 20 credits per year. I love learning, so this is not a problem. Again there is no good evidence CME makes one a better doctor. I can pick 20 CME credits on any topic I want and it would count. Mind! I pick the ones I feel would be useful or I need updates in.

Patients tend to base “what makes a good doctor” mostly on courtesies, like is the doctor on time, does he listen to me, and does he explain things. [4] Insurance companies see a good doctor in matters of profit, how a physician affects their bottom line. I know a nephrologist absolutely brilliant in his work but because he is lousy as getting paperwork done, his job is in jeopardy. I know another physician whom many in my field for have no respect, but his patients love him, mostly because he works like Santa Claus. You ask for things and he provides them. He has a 5-star rating but a lousy reputation, and I would not send my nearest and dearest to him.

No doctor feels they don’t do a good job/don’t know what they are doing, which I’m afraid is a Dunning-Kruger matter. That ain’t good. So what to do?

Outside forces (social media)are influencing the metrics and not necessarily in a good way. Yelp ratings: do they count as a valid rating scale for a good doctor? Patients who bother to write reviews on line are the ones more likely to complain, and they often do so online about something the doctor feels they cannot defend or clarify. It is a common joke among physicians the negative review “the doctor didn’t listen to me” is code for “I asked for hydrocodone for my hangnail and the doctor didn’t waiter-like provide me with what I wanted”. Doctors won’t admit what is written on social media sites influences how the practice, but most are keenly aware of their online reputation and respond in ways to uphold online ratings, even if it doesn’t correlate with their understanding of being a good doctor. [5]

In summary, we do not have an evidence-supported means to ascertain what makes a good doctor. The many metrics being tried all fail as the definition isn’t clear.

Meanwhile I do my best to keep up on the latest means of shrinking heads. I try to be on time and I try to listen, and I change into a clean shirt from time to time. This stuff works better for my reputation than a board-certified title. And the MOC and the Boards can put it where the monkey keeps his nuts.

[1] Thems that haven’t done or haven’t passed the board exams are given the euphemistic title of being ‘board eligible’.

[2] My class of ’92 was the last to become BC for life. I thank The Fates and anyone else I do not have to go through that awful ordeal ever again.

[3] The physician rebellion appears to be working somewhat as the MOC is being modified and in time maybe eliminated. Good.

[4] I wasn’t the brightest one in medical school but I learned quickly being on time, listening, and explaining things goes a hell of a long way. Why others more brilliant than I don’t think of doing these things is a mystery to me.

[5] Urs Truly doesn’t give tuppence about what’s written about him on line. There is a 3-4 month waiting period for new patients to see me. When I ask them how they fond me they often say they read something good about me on line. One patient told me he read on line someone thought me “pompous and god-like” which is exactly why he did make the appointment “I’m like that, so I thought you would know how to help me”. I was touched by this complimentary thunderbolt, but afterwards I did stop wearing the eyepatch to work and I left the two ravens at home.

Years ago (or should that be: ‘once upon a time’ ?) there lived in a faraway land a critical Spo-fan I shall call Thomas Gradgrind. He commented why fill my blog with ‘fairy-tale rubbish’. Mr. Gradgrind criticized that my blog was very good, but the ‘dungeons and dragons stuff cheapened it’; this made the blog difficult for the readers (meaning him) to take it less seriously. Stories of imagination do tend to upset those without one. Thomas G. didn’t stick around* so I never got to write him a brilliant riposte as to why Spo-reflections if up to its oxters with such. Here it is. Spo

I am not going to do a detailed job of discriminating the differences between a fairy tale, a myth, and science-fiction. They all fall under the common category ‘stories’. Fairy tales tend to have ordinary folk in them, while myths have gods/immortals in them and sci-fi has aliens and the like . I am writing about fairy tales, the sort of stories grandmother types have told their grandchildren throughout time.

The need to tell such stories is universal; all cultures do it. Indeed, there are countless variations of the same ones. For example, there are many versions of the classic Cinderella story. Almost all cultures have one, for it touches on the universal story of “rags to riches”. Sometimes a familiar story is retold with a difficult ‘spin’ to serve the needs of the times. Think of “Wicked” or “The Canterville Ghost” or “Into the Woods”**

Since The Dawn of Man we have enjoyed being entertained, and stories filled this purpose before radio and television took the place of the inglenook and the bedside. Stories allow us to enter into a hypothetical world in order to examine our own and to make sense of something. It is no trifle that many stories start with the teller and listener removing themselves from the reality of here and now. George Lucas’s original ‘Star Wars’ is not science fiction but a fairy-tale, which he framed with those now iconic words: ‘once upon a time long ago in a galaxy far far away’.*** Fairy tales address our childlike need for justice and closure. They make us imagine (pun intended) a hypothetical setting in which magic mends what we don’t have in reality. Bad people are punished and good people are rewarded. Fairy-tales tell children to behave and things work out, despite the seemingly futility to do so.

There is a concept in psychology called ‘a transitional object’. This is an item, like a stuffed animal, that children use to go between their inner reality and the outside world. It helps them make as safe transition from the former towards the latter. Fairy tales do the same. Small wonder then when we reread a fairytale book from our childhood or see a Disney movie we feels childlike again.

An objection to fairy tales is ‘they are not reality’. In reality bad people are not always punished and order and righteousness don’t always occur. Fairy tales aren’t meant for escapism but to give the listener hope that despite everything good can happen.

Terry Prachett wrote humans don’t need stories to make life bearable; humans need stories to be human.

“You need to believe in things that aren’t true, how else can they become?”

Once upon a time, in a far-off kingdom, there lived a young maiden, a sad young man, and a childless baker with his wife.

*I don’t know what happened to him; he sort of disappeared. I suspect foul play. The Board of Directors Here at Spo-reflections doesn’t take kindly to being called imaginary. I fear they sent The Furies (or someone like them) and drove poor Mr. Gradgrind to distraction.

** The musical ‘Into the Woods’ is my favorite musical for just this reason. If you don’t know this splendid show, I very much recommend it. Act I has several familiar fairy tales in it; it ends with ‘happy ever after’. Then Act II opens and tells us what happens after ‘happy ever after”. Marvelous.

***Thems into Star Wars sometimes insist Stars Wars is proper sci-fi NOT a fairy tale. Their umbrage rests upon the erroneous assumption fairy-tale is the prerogative equivalent of childish and not serious. Jungians take fairy tales very seriously. They are truths disguised in things not true.

Thank you everybody, for the love and salutations about yesterday’s post. You are dears, all of you, and I promise not to feed you buns and things.

Last night I made a new pasta dish and had a Highland Mark single malt scotch (no rubbish) for a celebratory snort. Someone and I hoped to watch the first episode of a lecture series on “The Medici” * but COX was down. Someone was quite cross trying to get hold of somebody about the matter. Their motto ought to be: “We don’t care, we don’t have to, we’re the cable company.” Dealing with COX is Someone’s job, while mine is picking up after Harper. I feel I have the better deal.

I got into my head this was Labor Day weekend. The Cosmic Calendar corrected me today there is more August to slog through. While we waited for The Medici or somebody like them, I cut out fabric for the new fall collection of masks. Who knew I would need to keep doing these? I am getting better with practice, but I would rather not viz. no need to make more. It’s another example one could stew on the ‘it’s not fair’ situation or go ahead and do the right thing – which in this case means making masks. I don’t want to go to Uncle Albertsons in last year’s ensemble.

It’s an ill wind that blows nobody good however. By having a few extra days of August I can still make my ‘soup of the month’ resolution. I think I will make corn chowder. Someone does not care for soup, but he likes corn, so I hope he will eat some. I seem incapable of making only a small amounts of soup; I end up freezing a lot and what is not ate goes down the waste-pipe, an awful waste indeed. To make the soup more enticing, I am making mine with bacon. Bacon is nasty, greasy, and bad-for-you, and I like it a lot. A wee bit in the soup – or anything else – makes things better.

I keep writing Spo-bits only to erase them on the grounds they would make entries of their own. Stay tuned when Urs Truly tackles such lofty topics of The Old Testament, why we need fairy tales, what makes a good doctor, and other entries guaranteed to knock your socks off.

Everyone have a good Sunday

Remember, there is a past version of you that is so proud of how far you have come.

*I sense ends badly. No spoilers now.

I’ve debating whether or not to write this entry. I decided to do so. I won’t dwell upon the specifics, but on the concept, for the latter is the more important matter. Spo

Every year on 28 August I remember back to the early 90s, when on this day I received very bad news from my doctor. It was a diagnosis unexpected and a deadly one. At the time there were treatments, but none of them were stellar. These were mostly for stalling death. I was thirty years old at the time, and I had just finished residency. Finally! Out of school and I was a doctor! The future was golden. And then came the news. As Harper in “Angels of America’ said: “I have to go now, something just fell apart”. *

With only a few years left to live probably, I had to compact a lifetime of growing and coming to terms with dying into what time I had left. It wasn’t so much ‘see Paris” but make meaning with what I had and while I can. A dream of mine was to own a house with plenty of gardens, which I did. I entered into Jungian psychoanalysis to explore who I was and closure. I accomplished what I could, and then I waited.

As you can see I didn’t die.

The treatments worked much to everyone’s surprise. Things looked good but I was cautioned not get my hopes up. With each year of doing OK my demise was postponed a bit. My modest goal ‘live to see 1995’ was changed to ‘see the year 2000’. Then it was ‘make it to forty”. Then it became fifty. Along the way I added new goals, like having a long time relationship and some travel. I learned new skills and hobbies. I wasn’t going to die; I needed to get a retirement plan. Can you imagine?

Today marks 30 years since the shake up. I am 59 years old. Not only does 28 August mark another anniversary, but when you see the math, I have been more years post-diagnosis (30) than years prior (29).

This is beyond extraordinary. I am now old enough to deal with typical older-man problems like high blood pressure and achy knees. My health goal isn’t keeping alive but peeing better.

Dodging the death knell leaves one with a sense that each year – nay each day – is a minor miracle. The Stoics carry a coin with them, inscribed with the Latin expression “Momento Mori“, or “remember you will die”. This habit is not grim but to be keep gratitude and do the right thing and make everything count and not waste time. I don’t need a coin to remind me. My matter, dormant for thirty years, could resurface at any time and do me in. I am ready for it if it does.The mortality work most start in doing in their 70s I did in my 30s. Now I live until I really die, if by that or ironically by an old person’s malady like a heart attack or a stroke.

Today I plan to make a cake. It isn’t a birthday cake but something else, a celebration cake Iet’s call it. It has a mixture of death, life, and gratitude. I won’t bother with a candle and blow it out and make a wish. I already got my wish.

I hope to live to see the score go to 40 to 29.

“Come celebrate
with me that everyday
something has tried to kill me
and has failed.” – Lucille Clifton

*Someone is so found of the name Harper, so he asked our dog be named so.

**Denial; anger; depression; bargaining; acceptance.

Dog walks are changing. Harper used to shake me out of my sleep, excited about going for a morning stroll. Now the roles are reversing. More often than not I am the one who gets up first and I have to encourage her to wake and get moving. She isn’t as quick or enthused anymore. Indeed, some mornings it is a struggle to get her going. Someone thinks it is inclement weather has curbed her enthusiasm (she hates the rain). I think it is age. She sleeps much more now and when she does it is slumber so deep as to make me think she won’t wake up.

Another change: she often tugs at her leash as if to say she doesn’t want to walk anymore and let’s go home. Maybe this isn’t fatigue or depression but boredom. We’ve become too set in our ways taking the same routes. I am trying to go on roads less traveled, hoping the unfamiliar bushes and sniffs will rouse up some interest. I hope the cooler mornings allow us longer walks without her becoming overheated.

After our walks I take her leash off while standing in the driveway so she can wait while I go round to the back to the rubbish can to discard the doggie-bag. She doesn’t run off, but waits for me around the corner. She is still eager to get indoors, for all morning dog walks end with a treat or a stick. While she runs off to eat this, I replenish the clack dish with a cup of Kibbles and I mind the water bowl.

“How’s the dog walk?” Someone asks, often still in bed . I give my report, often using the words “your dog”, which is a mild poke I’ve done all the work while His Highness slept in. If this indirect speech act is to prompt him to join us next time, it never works. Someone is not a morning person.

Sometimes he will join us for the post-dinner dog walk. This still gets Harper quite excited and I see the ‘old self” in her enthusiasm. She loves to walk with her Someone. This sometimes makes me a bit jealous, like a stay at home parent doing all the drudgery while the away parent, coming home, gets the praise. I like walking with Someone too. He is better company than the cellphone.

Harper and I are on patrol for rocks. I carry an empty backpack in case we come across a lovely. Then, into The Ghost Bag it goes, and brought home for painting. Our walks are stop and go endeavors, more sniffs than exercise. The extra weight on my back from the stone(s) provides a bit more calorie consumption.

My walking app shows despite changes we are still averaging 12-14 walks per week, like always. The contents are changing but the frequency remains. We don’t move as fast but we keep moving. Good for us.

The other day I wrote in an entry almost as an afterthought “the acceptance of ambivalence is definition of mental health”. This made a few Spo-fans sit up and wonder about this; they asked me to expand. So here it goes. Spo

My psychiatric residency was in the early 90s at the University of Chicago. My class was the last to get a classical analytical training. I once asked Professor Fisher “what is the definition of mental health?”. After all, we were dealing with mental illness, but no one had yet defined what is mental health. Dr. Fisher was a Freudian analyst; she thought in Freudian terms and used lexicon to match. She paused for a moment, and replied;

“Mental health is the acceptance of ambivalence”.

What does this mean?

In all human feelings and interactions we do not feel ‘just one way or thing”. We feel and think a mixture of thoughts and feelings. Sometimes we are not aware of all the elements; some are unconscious. We like things clean, black or white, and with simple explanations. But it is not so. Even in the strongest of feelings and most clearly defined social norms there are those ‘other elements’. I often see this in patients who feel guilty or ashamed for harboring ‘other feelings than I should” Here are some typical examples:

A mother voicing she is glad for her surprise pregnancy, but also feels ‘F-ck! I don’t want this child! I wish it hadn’t happened! ” Try saying that at the baby shower.

People on their wedding day, excited to marry, yet also feeling scared and doubtful if this is the right to do.

When our elderly loved ones die, we feel mostly relief, not grief, but we don’t say this at the funeral, “what a relief to all she’s gone” but hold it in and pretend we are all sorrow.

The acceptance of ambivalence is based on the axiom we have mixed feelings and we should acknowledge and allow this. It is OK, and even a bit funny to have paradoxical feelings in the same person/situation.

When I teach this to someone feeling ashamed or trying to deny those other parts, I assure them how often I hear this and it is normal I point out the easy example of being angry and upset with your child for being a little bastard you would love to slap, but you still love them don’t you?

“You know (you think or even say to your loved one) sometimes you drive me mad, and I could just strangle you. You can really be a shit. However even when I feel this I know I love you too”.*

A less Freudian definition to ‘mental health” is the sense of contentment. What I have is good enough. The people in my life, my things, more job, my health etc. are OK and not deficit. I am content.

Another element to mental health is resiliency. Despite what happens you are able to bend and maneuver. You know bad things happen, as Life is that way. You are bummed but you aren’t shocked but you do what has to be done and do the right things.

Maybe the main element of mental health is having meaning in your life. In all things, find meaning or something to allow you to learn and grow. Pain, loss, tragedy etc. are merely awful if one cannot get something out of it.

So there you have it.

Accept having mixed feelings

Find contentment.

Make meaning.

A collection of fine whiskies and bourbons – that’s a bonus. 🙂

*In the disorder ‘Borderline Personality Disorder” folks with this condition fail to allow mixed feelings but go between intense emotions often 180 to each other. One moment they want to destroy their others; then they fear the others will leave them. “I hate you! Don’t leave me!” A sort of Dr. Jekyll/Mr. Hyde – is a book about trying to cut off good/bad states into separate entities. (spoilers: this doesn’t work).

What’s top of my mind: An old photograph. There is a photo taken of my brothers and I, taken when I was nine or ten years old. In the picture it is autumn; the leaves are golden, and we are squatting down holding pumpkins. Brother #4 was small enough to be standing next to his pumpkin. In late October, when I next visit Father, the four of us will all be there. We plan to visit a cider mill , which was a long time Spo tradition to do. I think it a good idea to get a new photo of us four men in the same position holding pumpkins. First we need to find that photo. Who has a copy? We all can visualize it but who has the actual photo? Wouldn’t that make a fun blog entry! Seeing the two photos side by side separated by fifty years?

Where I’ve been: The dentist. The Good Dentist confirmed my fear: the cap he placed on the starboard side lower berth molar has come off. He explained he could redo it but chances are my alligator-like bite will only chip it off again in time. Stinko. A crown would work better, but that’s expensive, so I declined both. The ragged edge of the mentioned molar will probably wear down in time anyway, as all my choppers have done.

Where I’m going: The theatre? We recently bought our tickets for the upcoming season for the “Live from the Met” opera and the local ballet company. There is no word yet from the Phoenix Symphony if they plan on going back to work. We are either very hopeful or perhaps living in a fool’s paradise a) these are going to happen and b) I will feel comfortable to go when the do. Presently I don’t feel comfortable in a crowd if I don’t see everyone in masks. I can’t imagine sitting in a dark theatre believing everyone will leave their masks on. Are your local arts back in business?

What I’m watching: Ancient Mesopotamia (provisional). I am a big fan of “The Great Courses” which provides college-level lecture series on just about everything. I prefer their audio-lectures as they can be heard in the car. The video lectures admittedly are better, but I don’t make time to watch them. I have several bought and waiting to be seen: Meteorology; Geology; The history of the Persian Empire *; Ancient Mesopotamia. Time to get cracking! Since my pen name has the pretext ‘Ur”, I should learn more about the city of Ur, from which it derives.

What I’m reading: Mystery of the Moaning Cave. This is another book from the “Alfred Hitchcock and the three investigators” mystery series. These dated books have the three protagonists (three white Americans) team up with a boy of some other type, who helps them in their case, but always marvels and bows to their superiority. Oh the embarrassment. The last read (The Secret of Skeleton Island) had a Greek lad; The Moaning Cave takes place in Southern California, and has an obsequious Mexican lad. In their defense, in these books the ethnic boy is often perceived as the problem person, when in the end the actual villains turn out to be a group of adult white men. Unlike in real life, the bad white guys get their comeuppance.

What I’m listening to: Mrs. Oliver. Spo-fans may recall there is a great horned owl in my neighborhood. I named her Mrs. Oliver. Her presence is somewhat seasonal as she is heard only in the cooler months, before the sun rises. I hear her when we go on our morning walks. Now that the 5AM strolls are again being done in the dark, I listen for her. It makes glad to hear her return year after year. Sometimes there are two of them. I suppose it may not be the same Mrs. Oliver, but her descendants. I miss them when I don’t hear them.

What I’m eating: Heirloom tomatoes. Uncle Albertsons has some for sale now among the rubbish-types. Next to the homogenous thick-skinned (and tasteless) toms are the red. yellow, and sometimes purple types, irregular in shape and looking somewhat delicate compared to their neighbors. They have blemishes and ‘don’t look so good’, but I know better. . I don’t bother to look at the price as it’s worth it. Every few days I buy a few and bring them home for slicing and served with olive oil and balsamic vinegar with Italian seasoning. My soul swoons

Who I’m paying attention to: The Medical Assistant. The latest incarnation of The Medical Assistant seems to be all right ‘so far so good”. She is courteous to me and to others. She doesn’t become fretful or vexed with problems – always a good sign. As a bonus, she seems to know all the good restaurants, so when the pharmaceutical representatives provide luncheon we eat quite well, thanks to her doing the ordering.

What I’m planning: House repairs. La Casa de Spo is in disrepair. My eyes cross at the amount of tasks wanting attention. As is my wont, I will make a little list of things that won’t be missed, so when Someone is a good mood I will present it and let us get cracking on the more pressing projects.

What’s making me smile: Something not nice to admit. There have been headlines in the news of late of folks obstinate in their beliefs about covid and the vaccine who have died from covid19. This generates in me sadness at the consequences of Ignorance and bad choices. It is like watching a Greek tragedy where you know the protagonist is going to hell in a handbasket but is unable to connect the dose and see his folly. The headlines have a dark comic element to them, along the line:

Radio host, firm denier of vaccines, dies from covid19

This make me smile before the better angels of my nature slap me on the hand that isn’t nice. And it isn’t nice, but it is there.

The acceptance of ambivalence is the definition of mental health.

*It ends badly.

Looking for something to write upon, the subject of knitting comes up. It’s been in the back of my mind for awhile. The Muses (or somebody like them) has nudged me to write upon it. So here it is. Spo

I have never knitted or done crochet.* The only relation I had who did so was my paternal grandmother. She knitted sweaters and blankets, and she did a good job, but I never saw her actually knitting anything. So she never modelled knitting as something fun to do. Like most (all?) boys I grew up believing knitting was something for girls, particularly married and ‘expecting’ ones, and grandmothers who had nothing else to do when they were not baking cookies. Certainly I wasn’t going to do anything else what would make others question my masculinity or my sanity. As a lad, I had enough challenges already.

Knitting was never a secret longing, thwarted only by my vanity. It was only in the last few years I’ve developed some interest in trying it out. The late Ann-Marie loved knitting, and Sean of Idle Eyes likes it a lot. A couple of chums (male) on Facebook laud it as jolly good fun. So, it has raised my fancy to try.

I haven’t a clue how to start.

Last night I put out a message on Facebook, and got advice. A cousin of my father is apparently quite good and loves it so; she offered me to send some knitting needles and something called ‘starter yarn.’ I like this. While I knit I will think of her. SIL #3 volunteered to get me started next time I visit Michigan. Then there is the Spirit of Ann-Marie, who will be by my side, cheering me, on using F-bombs and such. The dears!

I don’t quite know yet why I am trying this. It probably falls into the common category of ‘things to try’ out of curiosity, to see if it goes anywhere.** My life is full of hobbies and interests that start with zeal only to fizzle. This is a pity at some level, but I like the notion I gave it a try and found out it does not float my goat.

Admittedly there isn’t much call for knitted items here in Arizona. I still have my sweater Grandmother knitted for me. It gets worn maybe 1-3x a year in January, when the temperature drops to a gelid 40F.

Well, I will worry about what to make later. I have to first see if I can hold the needles without putting out an eye or stabbing myself like a tomato pincushion. My first job I suppose is to get the hang of it, and move up as the spirits (AM et. al.) move me.

If there are Spo-fans who knit, I am curious to hear your thoughts on subject. Do you have any advice for an opsimath? Any is appreciated!

*I could never remember which is which until recently.

**I did this approach for blogging and for shirt-making, and look how that turns out!

Yesterday Saturday I bought eight sets of athletic socks, bright, soft, and fuzzy, like my men. My current ones are getting quite threadbare from years of use; all their heels are going out. We went to Costco to get them. For thems unfamiliar with Costco on a Saturday afternoon, it is like ‘People of Walmart’ without its charms. We got in and out without too much dodge-em car(t) shenanigans; mercifully there was no shooting. Happiness ( I once read) is a drawer of freshly folded socks. I felt good about mine.

Today I visit Joanne’s. I will go at 10AM just when it opens as it is not so hectic as Costco at that hour. I want to get some elastic bands to make more masks. Who knew I would need to make another ‘fall season’ of masks? While there I will get some white paint so I can paint additional stones. I am developing quite the crayola crayon collection of colourful rocks. I am also testing the limits of the HOA. There is a part of me that wants them to send me a beadledom note telling me to knock it off, so I can write back to say they are my emotional support rocks. This should cause some headache among the martinets.

My new pasta, the cascetelli, lived up to its promise to ‘hold the sauce’ and stay on the fork and feel good to the tooth. I have heaps, so today I will make dish involving scallops if Uncle Albertsons has any. Seafood is scarce here in the desert, so what is available is suspect. I could ask the fishmonger some questions but any response will probably dissuade me from purchasing anything. While there, I will stop by the pharmacy to see if they have booster covid19 vaccines. I will take one, if available.

Speaking of cooking I am going to pickle some turnips. I like turnips. I also like beets, parsnips, and particularly rutabagas. Someone does not like root vegetables, so making some pickled sticks of the stuff is a nice way to have something to crunch other than nasty chips.

I was quite sad to hear of the death of Nanci Griffith. She was one of my favorite singers. I am not much for country or folk music, but she had a way. For thems who don’t know of her, find a her rendition of “From a distance”; I think it is better than Bette’s.

Finally, I was delighted by all the comments on last week’s entry about things I have never done. The Board of Directors Here at Spo-reflections was delighted by the traffic, and they hope to repeat it someday. As a reward for a job well done, they promise to find me a moose and grill it on that gawd-awful fire pit in the middle of Heorot Johnsons II. The pit, which is directly connected to Muspelhelm, makes a lot of smoke, and when lit, it threatens to burn down the place every time. I have pointed out they cannot afford a Heorot Johnsons III.

As for coq au vin, they have never heard of it, but they said they would look for some next time they go a-viking to Gaul, going door to door, disguised as Mormons on their mission. The dears. One could do worse with bosses like them.

Once again someone left the pilot light on.

I haven’t written an ‘notes from the office’ entry in a while. This one was inspired by a handful of wights that wandered in this week, for which I didn’t do well with my saving throw.*

Humans have a tendency to look to the negative rather than the positive. This is called ‘the negative bias”. This anxious paranoid approach is stamped into our genetics from the get go. Back when we were learning to walk erect and make macramé any strange thing was considered ‘bad until proven otherwise’. Missing ‘good’ opportunities is a shame, but possibly replicated, but death happens only once. We are descendants of thems who startled and ran away and not from thems who thought ‘Wonder what that is, gee! Let’s run that way and find out”. Survival behavior comes with the propensity to immediately go to the worse-case scenario emotions. The rationale ‘let’s think this out’ part- that came later. Alas, it didn’t eject those ancient survival reactions. It merely got aboard the rodeo horse and hopes to hold on.

Most all counseling is geared towards getting folks to not to act on their reactions but think things out prior to doing so. Cognitive Behavioral Therapy works does not try to stop negative emotions (nearly impossible) but works around/over them. Here are some common examples: when someone slights us, we tend to go to ‘they must hate us’ and/or ‘we must be a bad person’. Another example is to turn down an invitation on the grounds it sounds scary, I will make a fool of myself, no one will like me” that sort of stuff.

The natural tendency to gravitate to bad things is cynically exploited by the media. Bad news sells better than good. “if it bleeds, it leads”. Happy positive news is ho-hum while shocking horrible headlines grab our attention and lures us to look even, when we don’t want to.** This is universal; all sides do it. Fox News keeps people glued with their incendiary headlines and Huffington Post (who should have known better) spent four years with lurid headlines along the line of ‘look what that horrible Trump is doing !” It works and we watch.

The occasional stress from hearing a roar in the forest or coming across a strange thing on the veldt is one thing, but continuous coverage of bad news is another. The human brain wasn’t designed for that sort of shit overload. We shudder hearing tales of children trapped in a violent unpredictable household, yet we create something similar with TVs everywhere. Some of us have connected the dots we need to unplug from the news, as it is ‘simply too much’.

So what’s to be done if social media is in cahoots with our reflexes for worse-case scenarios? How do we thwart doom-scrolling from making us all paranoia with premature deaths?

First step is ‘recognize to catastrophize’ viz. it is happening. Second step is to give yourself a break; this is not failure; this is human nature. Anxiety makes a good servant but a lousy boss. After it happens, take a few deep slow breaths (for when vexed, we breathe fast and shallow). Best case next is to turn it off; it is hurting. Get the gist and be done with it.

I often instruct patients to go on a ‘strict media-diet’, getting folks to think the news as no different than junk food. It needs limits. Reading the news maybe better than watching it, for it allows us to pause, think, and control how much. Have ‘media-free’ days. Don’t worry you won’t miss anything. Important stuff will be repeated ad nauseam.

We may not be able to turn off our amygdalas, but we can veto it, and limit exposure to triggers.

*This is a reference to ‘Dungeons and Dragons’, in which a player rolls a dice, a ‘saving throw’, to see if by some luck you dodge the monster’s attack. If you make your saving throw, the poison/arrow/claw/fireball/sarcasm thrown your way didn’t hit. If you don’t make the number, your are Stirge-fodder.

**Anyone who has driven in slowed-down traffic due to an accident knows this. The police and the wrecked car are off the road and not obstructing traffic, but everyone slows down to look rather than looking forward and keep going.

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August 2021

Spo-Reflections 2006-2018