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I recently reheard the story of Pandora. For thems unfamiliar with this Greek myth it is a tale ultimately about keeping hope despite sorrow.  Zeus is honked off at the mortals for having power and fire and basically just for being generally happy so he designs a guaranteed disaster to wreck havoc. He creates the woman Pandora and gives her for a wedding present a jar *  – and tells her under no circumstances never to open it. She’s curious, she opens it, and all the woes of the world fly out. Mankind is forever plagued with war, death and disease, turmoil, and strip malls. However, at the bottom of the jar is one other thing: Hope. Some god (curiously, never named) but Hope in the jar out of pity for mankind so they wouldn’t despair. Despite the woes of the world there is always hope goes the tale.

One of my professors in my residency programme taught us never remove a patient’s hope. Even with the dying provide hope to help make their departure better, less uncomfortable and more meaningful.

I have lots of patients who feel hopeless. Sometimes they present their hopelessness as a sort of challenge like a gauntlet thrown down: “Find some way why I should hope my lot will ne any better”. Sometimes all the hope I can have for them is to somehow alleviate chronic suffering to feel and function a bit better.  I am daily tried by this axiom.  Presently I have a handful of patients for whom I have nothing more to offer or to give them. They still keep coming to see me despite ,my recommendations to go elsewhere (hoping they will find someone who can think of something). You would think they would take this commonsense and logical advice: why stay when someone one can’t help you. There are many reasons why they stay with me, but one of these is hope: they still hope I can do something. To ‘give up’ and go away succumbs to the awful realization I have no hope for them.

The opposite of feeling happy is not feeling sad nor is it feeling angry. When you feel sad or angry you still give a damn about something. The actual opposite of happiness is hopelessness: the emotional conclusion things will never be better or different.

There has been a rise in the rates of depression and suicides and drug abuse in the world (particularly in the USA) correlated to the sense of hopelessness. The still voice of Hope is more readily shouted down these days by the legion of woes emanating from the jar of Pandora. The challenge is to discriminate what looks hopeless but isn’t so from the things that are unfixable. Finding Hope in every situation is becoming harder to do for me.


*If you are like me you grew up hearing this tale as Pandora’s box, not a jar.  It turns out the Greek word for jar got misinterpreted as box.  The up to date versions of this myth are reusing the word jar. Also in the original myth Pandora is not an innocent done in by her human curiosity. She was purposely designed by the gods as something malevolent to do Zeus’ biding.



In order to get through life without going mad or losing our marbles we have to delude ourselves from some harsh realities. One of the hardest truths to accept is the realization the majority of us are unimportant and nothing special.* I am one of those people.

I like to believe I am overall a good person who continually works on getting through life with probity and good will without too much ‘Shadow’ mucking up my intents. I am good at what I do and what I do benefits others. My work has meaning. I have a loving family and relationships. Other than my copious carbon footprint I will leave this earth with the quiet satisfaction I beheld a marvelous story and the world was not worse for my being here.

But that’s it. I haven’t done anything noteworthy to get me  into the annals of history. When I go I will be remembered for a little while by thems who knew me until they too die off and I am forgotten. If some of my siblings’ decedents happen to be into genealogy I may be remembered as a dead-end side branch in the family tree.  I will join the billions of people who have gone to their graves unknown and forgotten.

Most folks don’t think this way; they go through life without conscious cosmic thoughts of whether or not they will endure somehow. A tiny minority of us want to ‘live on’; they try hard to become memorable in any way then can.  Often they are depressed knowing their chances of success is very low. A few – very few – get into the history books to be one of those remembered.

This realization doesn’t evoke depression or grief in me but a sort of relief I will not be going down the path towards greatness. I am OK with my lot. At 56 years old I am not looking towards the future in desperation to ‘do something’ like writing a great novel or rising through politics or becoming a legend in my field.

In the musical “Pippen” the hero Pippin dreams of a great life.  “Don’t you see I want my life to be something more than long?” he sings in the opening song. He longs for greatness. He tries politics and war and hedonism – and fails in all.  By the end of the musical he has fallen for a widow with a child pointing him towards domestic living and daily drudgery.  The master of ceremonies suggests he commit suicide in a brilliant ending rather than succumb to the mundane.  Pippen chooses the latter. The master strips him, the woman and child, and finally the stage to nothing. He walks off and tells Pippen to live trapped in ‘that’.  The widow asks Pippen if he feels trapped. Pippen replies yes he does, but he feels good – and that’s not bad for an ending of a musical.  With smile and a bit of flair, the three of them bow, and the curtain drops and the play is done.

I feel likewise.  🙂



*I think the other hard truth is the world is not just. The beneficiaries of good fortune often do nothing to earn it while the bad people often get away with their actions without consequences. There is no gods or karma to remedy this.

Someone and I recently had experiences of mono no aware viz. the passing of Time and the ephemeral element of such. Last weekend he had dinner with a friend of ours whom we haven’t seen or heard from in many years perhaps decades. Someone reported it was a nice but sort of sad for our friend had clearly aged; he was not as ‘sharp’ as was.  They talked of times together (circa late 90s/early 00s) at places no longer open with friends no longer in touch.

While traveling to Michigan last weekend I wanted to eat at Olga’s, a Greek restaurant I regularly visited in my college days back in the early 80s. Olga was a vivacious young woman then who was just opening her first store. Last Saturdays’ food was the same but the place didn’t have the ambience of my college days. There was a sense of fading to the place; it lacked ‘vitality’. When I went to wash my hands I noticed on the cork bulletin board was a memorial: Olga had died only a few months ago. She was in her 90s.

We would all like to push the pause button in order to stop Time. People and places for which we have warm memories – we want them to stay just as they are. Of course this does not happen. In time people age and disappear and places change or close – they certainly don’t stay the same as when we were there.

One of my favorite poems “The Lost Hotels of Paris” by Jack Gilbert starts with the lines:

The Lord gives everything and charges
by taking it back. What a bargain.
Like being young for a while.

I wrote this entry while witnessing the terrible news of the burning of Notre Dame Cathedral. What a loss; what a sorrow. It raised in me the question not why it burned down but why this hasn’t happened sooner given centuries of candles and tribulations it has endured.

Later in the poem are these lines:

It is right to mourn the small hotels of Paris that used to be when we used to be. My mansard looking down on Notre Dame every morning is gone,
and me listening to the bell at night.  Venice is no more. The best Greek Islands
have drowned in acceleration.

The irony of these lines is Notre Dame has gone the way of the small hotels: another victim of Time.

It’s sad to see things go. This phenomenon will worsen as I age. A younger man does not think this way. He is making memories rather. He is visiting the small hotels of Paris or their equivalent.

But it’s the having not the keeping that is the treasure.

This is my favorite line of the poem. We may not be able to halt Time or keep things but we have the experiences.

My intuition tells me it is only a matter of time until Olga’s place closes and this too becomes a memory. I take solace these are good memories. I merely have to close my eyes and I am back in college with the future before me, eating gyros and laughing with Olga.

The Lord gives everything and charges by taking it back is indeed a bargain. I am glad to have had many equivalents of the small hotels of Paris.



Warrior-Queen is accompanying Harper and I on our walks. While we stroll she tells me about a local variety of unicorn indigenous to the desert. Who knew? She conveys having done a lot of careful research on this subject. Her fondness for unicorns extends to her clothing and her reading material which are all about unicorns.  Friday last we had a birthday party for one of her stuffed animals (a fox); the cake and cookies were unicorn-themed as shown above.

I find this fascinating. She is so serious on the subject. In general she’s rather reserved [1] but on the topic of unicorns she speaks with the enthusiasm of professor with great expertise. As I ask questions I hold back on the main one I want to ask: whether or not she believes any of this. Her sincerity and seriousness seem genuine. Discreetly I’ve asked questions not to challenge but to expand on my ignorance on the topic. She’s been consistent in her beliefs making sure I don’t mix up ‘facts’ which unicorn is which and what each does. 

I forget when children cease seeing their stuffed animals and toys as real. I suspect exposure to things via the internet speeds up the end of childhood innocence. The sad realization Santa and his sorts ‘aren’t real’ must come earlier in life than when I was a boy. [2] I wonder if her friends ‘believe as well’ or do they tell her unicorns aren’t real. If the latter, does she utilize cognitive bias to dismiss arguments contrary to her beliefs as false news and facts to go on believing what she wants to believe? [3]

Her father Brother #4 is very much into Dungeons and Dragons which at some level he knows is all make-believe. All the same he is “into it” as he is into his fantasy football; both seem ‘quite real’ in a way for him.  Perhaps WQ is no different.

I think it’s sweet she believes in a fantasy world full of unicorns of various types and colours and abilities. Using ones imagination and is useful in the development good thinking and problem solving . This makes us better persons. 

In time as she grows she will give up on unicorns and perhaps be slightly embarrassed by once upon a time belief in them, dismissing it as ‘childish’. I hope the consequence of her careful research on the topic may someday apply to scientific research or creative writing.  

Thems who travel to Fantastica come back better for having gone.



[1] WQ is nine years old.  Last time she was here I think she was six. She was quite bubbly then and with major mood swings ranging from delightful squeals to lamentations of the worst sort. If she had been a patient I would have recommended a mood-stabilizer like lithium. I was assured she was merely being a normal six-year-old girl. Oh the pain. 

[2] I did not learn about ‘where babies come from’ until way late in grade school when a snarky boy told me at recess what had to be done. I was shocked. It sounded not at all fun and certainly nothing I wanted to do. Who says being gay ain’t inherent? 

[3] You will be shocked shocked shocked to learn this still happens even in grown ups. 


Most of human misery derives from our need to feel included in a group. One of mankind’s greatest gift – and curse – is our innate need to form into tribes. This would be OK by itself but history shows Tribes always have some element of ‘us vs. them’. Defining the group if often done by villainizing those not in the group. It is chilling how quickly and arbitrarily this happens. A difference as trivial as who has a green ID badge vs a red one is enough to quickly form people into opposing sides, that old us vs. them. We’ve been doing this since we came down from the trees and I daresay we won’t be rid of the habit.

It’s bad enough we do this over moot things but go look at history when the differences are more palpable: sex, race, religion, and nationality. Exclusion, pogroms, and wars are often rationalized over rights or resources but this is superficial stuff compared to the archaic simpler explanation of ‘us vs. them”.  Those who are “them” are a threat and if we don’t wipe ‘them’ out they will certainly wipe ‘us’ out.  When ‘us’ creates a ‘them’ their members cease being fellow humans but something less.  The more ‘them’ the ‘us’ group can make them the easier it is to justify their exploitation and annihilation.

Another sad element of ‘us’ vs. ‘them’ is how quickly and/or unconscious the ‘us’ members will go along with the ‘us’ rules and beliefs. This is to assure ‘us’ status; the loss of ‘us’ is to become a ‘them’ with all its consequences.

It would be nice if Sylvester McMonkey McBean or something like him came along to teach us a lesson so we will rise above our monkey brain parts but fat chance of that. History is full of Mr. McBeans and they are mostly assassinated. The best we can do it be forever diligent of going into the primordial  ‘us. vs. them’ mentality. If we are to survive as a species we must keep dialogue with ‘them’ to remember they are really only different versions of ‘us’.




Tony G. (the dear!) recently asked how I started making shirts. It is a good story, one I often tell my patients for it has a good lesson to it. I thought I would share it not only with Tony but with Spo-fans.

Sometimes when a patient admires the Spo-shirt I’m wearing to work I thank them for the compliment and then I tell them I made it. Often they are incredulous that I did so; they sometimes admire my ‘talent’ to sew.  I tell them this tale:

Many years ago chums and I would holiday every winter in the Florida Keys. A woman there had a shirt shop. She made loud colorful aloha-style shirts. I loved them and every year I would get a new one as a souvenir. This went on for four or five years. Then she announced she was retiring; there would be no more shirts. I became lugubrious. I wasn’t going to get anymore shirts. While I lamented this loss one friend said “Hey, I got an idea! Why don’t you make your own?” My immediate emotional response was “Oh, I can’t do that”. I then listed the many reasons why I can’t: I didn’t have a sewing machine; I didn’t know how to sew; I had no relations who could teach me.  Another friend said “Well, you could learn”.  My response to this was to point out I didn’t have time to do the things I needed and wanted to do let alone find time to learn how to sew – it was not possible.  A third friend, Jerrold, who sews for a living, hummphed and pointed out if junior-high school girls can do this so could I.  It dawned on me then what I just said: “I can’t do that” and “It’s not possible”.  These are big no-nos in Cognitive Behavioral Therapy in which one looks at negative reasoning, assumptions, and fears. I call out patients on these all the time. So I decided to try, somewhat to show Jerrold but mostly not to be a hypocrite. Doctor heal thyself.

I borrowed Someone’s sister’s sewing machine and I bought a ‘sewing for idiots’ pattern. I purposely didn’t take lessons but tried on my own. After a lot of trial and error and more than a few frustrated near-abortions I finally made me a shirt. The garment was crude but I had the satisfaction I had succeeded. Now, that was to be it; I wasn’t planning on continuing the challenge. To my surprise I discovered I actually liked sewing.  I figured if I made a second shirt it would be much better. So I did……

That was many years ago. Since then I’ve made over a hundred shirts. I got better at it. I didn’t have the ‘knack’ but practice made improvements. In time I also learned how to take in/out my trousers and do cuffs. I’ve made curtains and quilts. Seasoned Spo-fans know I once sent a shirt around the world for a fund raiser. What was supposed to be six months-long endeavor to six or eight people ended up lasting two years. International strangers saw it and they wanted to be participate. By the time the shirt returned it came attached to many new people I now count as friends. Mitchell at Mitchell is Moving! is an example.

So –  I have a hobby I enjoy and I developed autodidact skills.  I have a network of friends – and it’s all because one day I didn’t succumb to “I can’t do that/it’s impossible” but I said ‘Maybe I can do that; maybe it’s not impossible; I will try”.

It’s amazing what can happen when we challenge or negative assumptions.

At this point in my narrative to the patient I add: “I think if I went back in time to myself ten years ago and said “Hello! I’m from the future! Look at what you’re going to be doing”  I think my younger self would respond “Are you high? I have no desire, no talent, not time go back to The Twilight Zone as that isn’t happening”.

To this day whenever I am faced with something new and unfamiliar I still have an emotional response to become timorous and want to back away. I then remind myself ‘this is how you felt about making a shirt, so why don’t you try it’. Most of the time I do try and most of the time I find it a marvelous experience.

Go thou and do likewise. 🙂


The Board of Directors grudgingly gave me permission to write another entry about my pal Charles Dickens. Alas for most people Mr. D is trotted out only once a year at Christmas time. I concur his “A Christmas Carol” is a masterpiece but not for the manifest reason it is a thumping good story.  After a few flops Charlie Boy needed a bang-slap success sale and fast – which he did but his genius is he did it through a story meant to bitch-slap the 1% who could afford to buy it. 

Dickens was a lifelong advocate for The Poor. You will be shocked, shocked, shocked to know The Rich in his time believed poverty was the result of ones laziness and all your own fault; if you would only work harder you can pull yourself up by your bootstraps. Indeed, to assist the poor makes them worse off and upsets social and divine justice.*

Dickens felt otherwise: success on a personal level is meaningless without engaging with others in the world.  He wanted to get this point through the obstinate heads of thems in charge in a way they would actually listen. He did this through his works. Let’s go have a look see.

“A Christmas Carol” starts almost comic: “Marley was dead as a door nail”.  This is not chance. We need to know he is dead so the ghost is recognized as real and not coming from Scrooge’s own senses. Often in film Jacob Marley is the rushed introduction to get to the meaty middle. In the book Jacob Marley is a center character critical to story.

Scrooge in an amalgam of the 19th century elite. When the specter appears Scrooge can’t understand why Marley is chained: he was a good businessman who succeeded through persistent and self-made industry – good Protestant English virtues. Jacob explains plainly he is cursed because he did not do the actual task of Life: look outward and help others. Another small but crucial detail to Marley is showing Scrooge an escape from damnation will do him no good. This ain’t no “It’s a wonderful life” where Clarence earns his wings through a goodly deed. Marley does NOT get redemption for he is one of the damned. This is bone chilling!  In the better renditions of “A Christmas Carol” the directors keep the novel’s next scene where Marley shows Scrooge the legions of the damned roaming the earth impotent to help themselves and others. 

Sometimes modern readers criticize Dickens for creating a character who too quickly changes his approach. Scrooge’s transformation is too pat. It is hard to believe believe; we believe true transition takes time as anyone in counseling can attest. This is based on our failure to recognize Ebenezer is visited by a genuine ghost from hell ascertaining there is divine justice and the reality of eternal punishment. 

Thanks to this book Dickens transformed Christmas into the holiday we all now know, which includes ‘giving to the poor’. May The Ghost of Jacob Marley continue to haunt and remind us charity, mercy, forbearance, and benevolence remain our true business. 




*Aren’t you glad you live in the 21st century where such a thing never happens?

Last week an agent from a laboratory company came to the clinic and gave us lunch. In return we listened to her presentation on genetic testing. I had to refrain myself from calling out the razzle-dazzle hype and downright rubbish.  I wanted to say there is no good evidence (yet) genetic testing ‘improves patient care” (whatever that loose term means) and since insurance doesn’t cover genetic testing ordering it as ‘pay out of pocket’ borders on patient cruelty.

Nothing quite gets me into a swivet as pseudoscience. It is like fool’s gold: it looks genuine and so much cheaper and available yet it’s trash.

There’s been a lot of hype on the internet lately about Herr Furor and his myrmidons banning seven words.* One of the words is ‘evidence-based”. Medicine is slowly going from ‘time-honored’ treatments to ‘evidence-based” and a good thing too. Imagine your physician telling you to take some sort of treatment without any proper data backing up its efficacy.

I spend a lot of my professional life telling patients the ‘facts as I know them’ rather than what they want to hear (usually along the line what they are doing is OK).  I find it appalling anyone would reject something ‘evidence-based’ in lieu of dogma or delusion or desire, but it is human nature to do just that.

Ironically I am always on the look-out for evidence-based information to change as more evidence comes along to alter it. This is science; this is how to test a hypothesis. The solution to ‘bad science’ is not ‘no science’ but ‘more science’. Alas, I sometimes forget not everyone wants to learn and grow and not everyone prefers Truth to Belief.

Meanwhile, I keep asking questions and calling out the B.S. It isn’t very satisfactory but it is better than going along with rubbish.



*The truth of the story is these seven words are not ‘banned’ nor is this the dirty work of Hair Furor. It is a list of recommended words not to put into a governmental grant proposals lest the GOPers read them, wig out, and reject the grant out of reflex paranoia.  It was suggested to use alternative words to better the chances of getting your grant. After you get the money, then proceed as usual.  It is still an awful thing to have to do viz. pussyfoot around word-choice , but in all fairness we all do this to some degree with our bosses, relatives, sales people etc. to get what we want out of them.

A few Spo-fans have asked for stories and details about the wedding. There were the usual things: we held hands and made promises. Pictures were taken. Afterwards well-wishers came up with outstretched hands and congratulations were given.

What I thought I would write about was something that happened that was unexpected and wonderful.

We got married by a California County justice of the peace. This required having an appointment and ‘standing in line’ as it were. Before our appointment was a young couple, eloquently dressed in nice white and black satin suits. They had a wedding party of four or five people, probably friends and family. Our coterie consisted of Someone and Urs Truly – dressed in smart jackets with flower corsages – and our acolytes who were mostly in Spo-shirts.

Just before our turn to say I do, while I was at the glass window registering my information, I felt a finger tap on my shoulder. I turned around to see a young man of about twenty. He introduced himself as Oscar; his bride was Adrianna. Oscar was dressed in a red T-shirt and khaki pants. In broken English he asked would I witness his wedding registration. They could not get married without a witness; they had no one to do so. A lot rushed through my mind in the five second pause before I said yes. Where were their friends and family? Why were they alone? What was their story? Adrianna explained they had a 3yo was ‘she was at home’.  Apparently they were on break from their restaurant jobs to come to city hall to get hitched. Oscar tried to give me twenty dollars but Adrianna told him that would be insulting to me. What I didn’t say at the time was they had just made my wedding day into something marvelous beyond measure.

After Someone and I got hitched it was their turn. There they stood, alone, facing each other, both wearing nice but inexpensive clothing so unlike the first couple mentioned. I was glad our wedding separated the two couples, lest O and A felt bad by the finery of the first couple (or worse, made fun of). In the brief ceremony, Mr. Oscar struggled a bit with the English; Ms. Adriana struggled a bit to hold back tears. Where was Urs Truly? He was running around with her camera, taking as many photos as he could muster. I wondered: if I hadn’t said yes, would they had been with no one to take any photos?

Someone et. al. waited for me out in the hall. Afterwards, we came out and the two wedding parties combined for a permutation of photos and all shook hands and kissed the bride (although some of us I suspect wanted to kiss the groom rather). They assured me I would be always welcome at the restaurant where they worked; they would make sure I was treated well.

I never got their names. I probably won’t ever see them again.

That night Someone and I took our friends to eat at a very fancy Palm Springs restaurant. The wine flowed as they say. While we dined I saw young Hispanic types running around busing tables and pouring water and waiting on rich white folks. Throughout dinner I thought of Oscar and Adrianna, also now married and probably eating on break at the restaurant. I compared the couples in my mind. Someone and I are well off and we solidified twenty years together – about the same time as the ages of Adrianna and Oscar. They were just starting off; they have their lives ahead of them. I sense they will struggle with funds, free time, and a raising a child (born out of wedlock).  I also thought of that awful man in the White House, who wants to vilify people like this hardworking couple.

I thank The Fates for arranging these crossed threads for the lessons they provided me.

It’s Saturday morning and I am up to my ears in There’s-work-to-be-done Spo-chores. But I pause in my industry to scribble out an entry.  

This one is for the Spo-fans who are bibliophiles and members of the clerisy.

I surmise when I am old and haggard* the one pleasure left will be the memory of books. When I need cheering up I can think back on the TGR (thumping good reads) I have experienced. If my eyesight is fortunate I can reopen a few of these blessed tomes and visit old friends. Milo, Alice, Bilbo Baggins, and the Pevensies are not gone but only waiting.

I don’t recall how I found it, but had for sale a book from my childhood: “Ghosts and Goblins”. It’s been 45 years since I have read it. I was a rapacious reader in elementary school. G&G was one of those books I never tired to reread. Back then, library books had little pouches inside them with index cards upon which you signed your name at check-out. You could see the book’s check-out history, who all had read it prior. The library had to keep replacing the card, for I would fill them up.

Synchronicity and the pending holiday demanded I purchase the book. It arrived yesterday.

Is there anything as rapturous as holding a book you once upon a time cherished so? Kindle will never capture the feel and redolence of an old book. They smell of ink, old paper, binding gum, and childhood. They are an olfactory delight as well as a TGR. Even the feel of the pages turning is a pleasure.

As mentioned I haven’t read the stories in 45 years, but they all came back quickly. The illustrations elicited delights of recognition “Oh! I remember you!” I refused to go to bed but stayed up lost in a world of ghouls, goblins, and grindylows.

As a boy I remember the book as large and lofty and the stories as complicated.  The book is much smaller than I recall. The stories were charming, but hardly the erudite compositions I thought they were. Most of them were simple folk-tales written for a ten-year-old to enjoy.  So in some way the book was a disappointment, a let down –  ‘it wasn’t what I remembered”.

On the other hand my inner-ten-year-old was thrilled as if he had won the lottery. The memories of the stories and the countless trips to the library came out of the pages.

All month long I’ve tried to capture the puerile emotions of Halloween with little success. This book did so. Better yet it revived the love of reading.  I could not ask for anything better.


*2018 is a good guess.

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