After the laundry is done I hang up the clean things on one end of the clothes rack while I take down the new things from the other end. As a consequence of system Spo-garments get used at the same frequency and things wear out all at once. When this happens everything needs to be replaced at the same time.  This weekend it was time for trousers. I think the trousers collections lasts for 5-7 years but it could be longer. The majority of the time I wear khakis and they are now dog-eared and cuff-torn to to the point they all want replacing. So it is hippity-hop to the trousers shop I go. 

I dislike shopping – to be more accurate I don’t like going to shopping places. When obliged to purchase clothes I try to do this on-line but trousers remain an on-site process. I want to feel the quality of the material (no rubbish) and ascertain sizes and cuts. Someone advised I go to the local mall to give me options of several stores. As a shopper he’s the type that wanders store to store comparing prices and such. I take a different approach: time is more important to me than money. I want to get in and out as quickly as possible and if this means parking at the closest store (preferably at opening time) so be it. I made my list:  two regular khaki; one blue; one black – and another black for Someone who is taking my same size these days.

The mall was unsettling. There were few people. I’ve heard malls are in decline and by the looks of things this is indeed so. I got there at opening 10AM. There is a sense of decay to the place.  Many stores look closed and what was open looked none too appealing. I hit Macy’s. No such luck. I take a 34 W and 32 L. These measurements are either so rare or so common they sell out as there was nothing in that size.  I’d hoped to have some nice salesman swoop down on my going through the bins to ask me if I was being served. They would listen to my woes and somehow solve my problem – but there was no one.  I am not a crook but I thought how easily it would be to stuff my pockets and run in this ghost town.*

At the other end of the mall is JCPenny. I remember this store from my youth. I was surprised to see it still around, thought it had died decades ago.  The men’s shop is on the second floor is right next to the appliances which is unsettling in itself.  JCPenny was also bereft of salespeople. **  Happily I found my five trousers and got in and out relatively quick.

When I got home I found to my horror the trousers were now too long. Dammit they were OK in the store, so what the hell? It is hoped by washing and drying them well they will shrink. I can always do up the cuffs myself.  In the end if it’s a bust I can be comforted in another 5-7 years I can do better.


*I suspect they have cameras for this sort of shenaniganery. Would Mr. Macy had staff to watch me as well. 

**I have a vague memory of going into Mens departments in which were suited gents and tailors who served obsequiously and with the knowledge of how to dress a man.  Those days went out with full service gas more’s the pity. 

Note: The Board of Directors Here at Spo-Reflections thought this entry rawther altiloquent. The told me to expunge the similes and smarty-pants words. Nerts to them. I left’em as they are.   After all this article is about control.   – Spo

In my line of work I see a lot of stress. One of the most frequent and most upsetting emotions people have is the feeling of not being in control. “I have control issues” they tell me. They quickly go into a horrible fantod when they feel not in control. They spend a lot of time and energy etc. trying to be in control.  For folks with ‘control issues” the poor dears never seem to have any control. It’s like being a perfectionist who can never get anything right.  The gods seem to find the vow for control comical; they like to surround thems with control issues lots of thing uncontrollable.

After thirty years of encountering this issue I’ve come to these conclusions:

There isn’t much you can control.

Control is overrated.

Letting go of needing control paradoxically helps you feel more in control.

Alas, these truisms are seldom comforting to these poor unfortunate souls. Rather than feeling relief to hear their ponderous yokes can be thrown off patients with control issues double down and up the ante in their agitation to become more in control. Oh the pain.

One of the reasons they fare so badly is they continuously confuse things they can control with what they can’t control.*  In ‘The Serenity Prayer’ people ask for the knowledge to know the difference. Not so my patients.

Alas, Babylon! One can’t control Life – or most of it. In the proverbial Pandora’s box of Life’s uncontrollable elements there is hope. There are few things we can control, and happily they do a lot of good. In Life’s game you don’t have many cards but you hold a few trumps.

– Things you CAN’T control –

Other people  (what they do and what they think of you)

The weather

The past

Random bad events  – which are not due to God’s will/Fate/destiny etc.


– Things you CAN control –


The company you keep

How you treat others

Asking for help

Your choice in beliefs and attitude

Saying ‘no”

The philosophy of Stoicism rests upon the axiom Life is not a field knee-deep in buttercups and daisies but full-up with sorrow and disappointments. One can not control things yet we take comfort knowing we will be OK enough.

Spo fans are welcome to put into the comments additions (and disagreements) what you think we can/can not control.

*This in itself is a problem viz. control-types don’t want to sort out what they can’t control; they want to control everything.

I’ve been lately thinking a lot about failure, particularly those of my own. I recognize I’ve gone through life having a handful of shortcomings. All people have some of course, and it is easy to dwell on them. There are only two good reasons to reflect ones failures: to learn their lessons and to remedy what can be done about them. It is hoped most failures fall into either category (preferably the latter one).  The trick is to not succumb to emotional humbuggery ‘It is a failure that can’t now be fixed”.

One of the largest failures of my life is establishing networks. This is particularly true in my career. I don’t have a professional network. I have worked alone for 15 years in setting in which I don’t interact with other doctors. If I were to suddenly need a new job I could not pick up the phone or text colleagues to inquire after a new post. If I were in need of a consultation or a collegial shoulder to cry upon I am out of luck. I know no one. When I go to local conferences I am amazed and envious folks know each other/work together.

Then there is a failure too in my home life. I am blessed with friends and family who are far-flung. What I have failed to do is nourish a local network here in Arizona.  I could not call someone to come over right away to help with a home matter or to drive me somewhere or tend Harper during a time of crisis.

People are social critters; we need networks for our well-being as well as security. ” I ask all new patients ‘what is your network”.  “Nobody” is a common answer.  I often hear of  ‘X’ needing surgery and weeks at home for convalescence – but they have no one really to help them getting to/from appointments let alone to take care of them. This may be more a risk factor than smoking.
“The best time to dig a well is before you are thirsty”.  This expression reminds me to get cracking on these deficits before it becomes necessary. Building a network when you need one doesn’t work; it has to be done before.

Is it too late to develop networks? Is this a failure I have to be at peace with? Probably not. However this is no easy quick task to remedy.  It will require time and effort to do; it won’t happen passively.  I feel I must do something before I become thirsty at work and at home.

Brother #4 et. al. left today after their long weekend. They had a delightful time. The weather was good and they got to see the sights. We had some laughs and a couple of good suppers Now the house is quiet again. I enjoyed their visit but it is nice to have the place to myself again. Even the best of visits are a tad exhausting.  I am looking forward to things going back to normal. I will spend the next few days doing linen laundry and putting back a few things moved or put away for the visit. It feels good to once again walk around in my underwear and play music out loud.

In the festive spirit of their visit I  ate food I normally don’t consume: grilled steak, cake, ice cream (chocolate and vanilla), and lots of (nasty) chips. These were delicious. On the negative after ingesting these delicacies I would immediately want to go to sleep. In the evening we played some board games I don’t quite remember being in. I didn’t win any of them no surprise. It doesn’t help the annual allergies started so I am back on the antihistamines.  I could sleep for days if left alone.  Despite the lethargy I am determined to go to the gym after work today; it will be my first time in a week.

It is only Tuesday but I am already wishing for Friday. I am in much of a rest – and a haircut. I look like a Wild Man from Borneo as we used to say while we were growing up. I have never met any men from Borneo, wild or not, so I don’t know if I truly resemble one. If they look like how I look I am sorry for them.



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. 

I have canceled my usual Friday night happy hour with chums to go directly home after work to attend a sort of birthday party. My niece A.K.A. Warrior Queen has arranged a soirée for her stuffed animal. She got it here last time she visited Arizona. I forget what sort of animal it is or its age. We are to have a cake and there may be prizes.  Her father, Brother #4, will be grilling something for the supper.

I am not good at grilling. Were I was better at it! This may be from lack of practice although I don’t remember being too good at it even when I tried. Once upon a time when the outside gas grill was functioning we did a lot of grilling. I was just getting the hang of it when the grill went kaput. That was years ago. We have two Webbers, a tall and a small, standing next to the defunct gas grill. Neither of the black beasts have been used in ages. Setting up the coals and waiting for them to glow and running in and out of the house with platters of food (in the ardent heat of summer) is rather time consuming.

I have a bit of guilt whenever I am grilling. As a cooking technique grilling isn’t very PC what with its consumption of coal and lighter fluid generating nasty fumes into Phoenix’ already quite polluted air. Then there is the high fat-high cholesterol meats with their charred bits full of carcinogens and nitrates (not good for health and heart). Nevertheless the cooking method is still part of a man’s measure, like changing a tire. A real man knows how to grill.

I confess grilled food is my guilty pleasure. These days I don’t each much meat and less beef but Oh! The joy of on-the-grill cheeseburger or baby-back ribs! There is nothing quite like BBQ!

I am much looking forward to tonight’s dinner. Perhaps Brother #4 can teach me some tips and I got dips on all the ribs.




NOTE: this one was written without too much careful thought or editing. It is more catharsis than careful prose. I thought to store it away until I could carefully comb it for errors and such. I decided to post it as it is.   

When I was a newbie shrink I was filled with enthusiasm and psychoanalytical theories; I was ready to shrink heads and assist others in their exploration towards awareness and better being.  Thirty years later I am not so excited in that way. I now know many (most?) people don’t want to ‘get better’ or they lack the courage and/or resources to do so even when they want to.  A lot of my nowadays work it trying to do what I can; I try to alleviate some pain and keep major bouts from blossoming.  The vast majority of my patients aren’t looking for self-achievement; they are looking for a means to keep their symptoms from dominating their lives so they can function. Medications often work better than insight-oriented analysis when it comes to helping agoraphobia or manic reckless behavior.  For folks with intrusive ruminating thoughts it’s better to give them Prozac than to explore their alleged unconscious violent ideation towards others, which was the standard approach in psychoanalysis for the treatment of OCD.  What I professionally do, and the tools and paradigms I use have little resemblance to what I had in the early 90s. It’s like looking back in your photos to how your dressed in the 70s. Oh the embarrassment.

Sometimes I think this is a bad thing viz. being mostly someone who writes prescriptions to treat a conglomerate of symptoms. I no longer deal with patients more personal problems. It feels a bit soulless. After all Psyche is the Greek word for soul. I hear tell psychiatry residencies no longer teach psychotherapy other than the basics of how cognitive behavioral therapy works (the one therapy with data to back up its efficacy).  Having psychiatrists learn psychoanalysis has been compared to astronomy students being obliged to learn astrology.

One the positive what I do is more and more ‘evidence-based’ and not based on theories without good data to back it up.  I feel more like a proper physician. Funny how my field was once criticized for being mumbo-jumbo and now it is accused of pushing pills.

All the same it is a field constantly growing as we learn more about the puzzle that is the human brain. It’s exciting to be continually learning   albeit a bit discombobulating to have all my beliefs redone every decade or so.

It’s late and I am tired. I’ve been dealing with patients and their matters all day and into the night. It’s been a rather tough week with each day ending with a sense I don’t think I can or want to keep going.   Perhaps I will feel better about it all tomorrow after a rest. It will be another full day as I try to juggle objective scientific data with human empathy and compassion.  May my efforts do someone some good.


Ever since The Board of Directors Here at Spo-Reflections burned down the board room I’ve had no place to write. I start entries at various home and work computers, but these prodromal compositions get left behind like the half-consumed cups at home. I think this is my fifth attempt at writing something anything; I am darned determined to publish this one. 

After my ‘scope on Monday I’m still not feeling myself. If I were a Crayola crayon I would be in need of sharpening; if I were a podcast episode I’d be running at 1/2 to 3/4 speed.  Mercifully I can still remember my zip code and my way home from work. Someone says I am ‘somaticizing’ which smacks of temerity as I am the shrink at Casa de Spo not he. 

Speaking of Someone he did a fine job getting the house ready for Brother #4 and family (who arrive soon). He washed all the windows and he cleaned up behind things that haven’t seen daylight in ages. It all looks clean and tidy. I am glad to have my evening/weekends freed up again. 

Between work and housekeeping there’s been precious little time for anything else, including reading blogs. I feel bad when I am not regularly reading my favorites. After all if people are going to read mine I should keep up reading theirs.  I don’t recall any blogger buddy has ever objurgated me for ‘lack of attendance’ but there it is.  While my Michigan relations are in the pool this weekend I can sit on the back porch and get caught up.  It’s an ill wind that blows nobody good; my lack of time precludes me from Facebook and Twitter etc. so I feel quite relaxed not knowing what That Dangerous Clown is up to these days.* 

So that’s the quick all the news that’s fit to print and otherwise. The niece A.K.A. Warrior Queen will be sleeping in The Blue Room, where Henrik the Ghost usually hangs out when he is in town. I hope she doesn’t upset him too much. I better sign off and make one final round about the place for any missed dust bunnies or half consumed cups. I turn my back only for a moment and the Cup Fairies hit quick.



*No good that’s certain. 


Once in a while all I want to do is close the door and withdraw from the world. Today is one of those days. I wish I had something important or amusing to write but I do not. I had a few ‘back up’ posts but I discovered in my rounds today many of my blogger buddies had ‘written it first’ so to publish my own would look like copy-catting. I am vain that way. 

Earlier today I wrote a piece about my colonoscopy this morning. Then I rewrote it only to erase it entirely. * I’ve felt slow and dimwitted all day, the result of having had no sleep and anesthesia. I am also feeling melancholic for a handful of reasons: I’ve learned of a trouble at work; the politics of the land are appalling; I missed a friend’s birthday. The list is longer than this but you get the gist. 

There is some loneliness happening as well. There are a handful of folks I would love to reach out to me but they are away busy I guess.  My telepathic powers emanating ‘please call or text me for I want to hear from you” must have been damaged while under the influence of the ketamine. 

I hope to feel better after I’ve slept and had a few real meals. I have two days to cheer up before Brother #4 arrives. Hector the yard man comes on Wednesday to tidy up the weeds that have grown quick as triffids in the recent rains. The house is as clean as it has been in a long while; I’m half-tempted to cancel on them jus to keep things tidy for as long as possible.

I was glad to get caught up with blog reads and see nearly  everyone is doing well enough.  

Hopefully tomorrow will be better.


*For thems interested: it went OK. 


The colonoscopy preparation instructions say I am not to eat anything for these next 24 hours, nor am I to drink fluids that are red or purple. I am presently consuming tea (hot and cold) and bright blue and yellow sports drinks. I am working in the yard; I’ve taken some allergy medication. Zylert on an empty stomach has left me tired and buzzed – almost intoxicated.  Curiously I don’t feel too hungry. During the breaks from the chores I thought to go online but food is everywhere: Facebook, blogs, pop up ads you name it, it has food mentioned. This may be a case of ‘Baader-Meinhof’; I want something to eat so I am noticing things I don’t normally see when surf the web. 

Someone is washing the windows while I tend the back yard. I am throwing out the dead plants and replenishing them with herbs and succulents recently bought at HomeDepot.  We are getting the place decent for Brother #3 and family who arrive this Wednesday.  The hot tub – unused for months – has a green tint to it making it unwholesome so it’s being drained at the moment. Last week I gave instructions to the pool man to pay extra attention to the pool. We usually don’t set foot in the cement pond until Memorial Day but Brother #3 is bound to want to go in it. He lives in Michigan and has antifreeze for plasma.

I hope we have things decent in time for their arrival. I have my ‘scope tomorrow morning at 7AM then I have the rest of the day off. I am hoping to spend the day  continuing the tidy up but I suspect I will sleep the entire day away. I’m supposed to raise at 245AM to drink large amounts of nasty concoctions so I’m not going to get any sleep. I will look a fright when I see the GI doctor but then again he will be more concerned with the other end of me. 

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