Category Archives: The Barbarous Craft
Something the Lord Made was one of those sneaker movies — if you weren’t paying attention to HBO last year, it snuck right by you. It’s the story of one of the pioneers of open heart surgery, Alfred Blalock (Alan Rickman), and his skilled assistant, Vivien Thomas (Mos Def). In the 1940s, the idea of open heart surgery violated deeply held prejudices in the medical community. “Don’t touch the heart” was right up there with “First, do no harm.” Blalock and Thomas bucked tradition to develop an operation to cure the congenital defect causing blue baby syndrome.
Thomas is portrayed as equal to Blalock in medical insight, superior to Blalock in technical skill. Since he’s poor, black, and not an MD, Thomas slips way behind Blalock when the accolades roll in.
This is not your typical Hollywood movie. First, they get the medicine right. (Trust me, this is rare.) Second, they resist the urge to promote Blalock to sainthood. Rickman’s Blalock is arrogant, a hot-head in the OR, but also kind and charitable. And yet . . . Push comes to shove, he slights Thomas when it comes time to give out credit. It’s not blatant racism; it’s the subtle variety that creeps into relationships, affecting peoples’ assumptions regarding one another.
The scene in which Thomas confronts Blalock is stirring. It’s hard not to feel a little sympathy for Blalock who, confronted with his prejudice, protests, I’ve always fought in your corner. It’s true, too. But Blalock failed Thomas when it mattered most, and Thomas has called him on it.
Thomas’s subsequent efforts to stay in medicine in some capacity, in any capacity, are heartbreaking. The scenes depicting his rapprochement with Blalock, and Blalock’s eventual roundabout apology, choke me up every time.
Something the Lord Made is a fine piece of medical history, but it’s an even finer portrait of a relationship between two great men — one of them, deeply flawed.
D.
During internship, I had a one month rotation on the neurosurgery service. Neurosurgery had a one night in four call schedule with no general surgery duties, so we all looked forward to this rotation. The ward was abysmal, but the neurosurgery ICU nurses had the best reputation in the county hospital.
These nurses knew more about neurosurgery than I would ever know, and they rarely let me forget it. If you think this engendered a constant struggle for dominance, think again. Only a fool of an intern would go up against one of them, and he wouldn’t survive. The neurosurgery residents had learned to trust them. They certainly didn’t trust us.
Neurosurgery is a different world than the rest of medicine. Your patient was discharged today? Huzzah! And you say he left on his own two feet? I’ll buy you a drink. (more…)
Remember how vibrator afficionado walking neocon talking point ripe dingleberry TV commentator Bill O’Reilly recently smeared the people of San Francisco for exercising their right of political dissent?
“If Al Qaeda comes in here and blows you up, we’re not going to do anything about it.”
Now, O’Reilly’s trying to wriggle out of his mean, nasty, beady-eyed comment by claiming the uproar was due to “far left internet smear sites.” He wants to honor the memory of his hero, Joseph McCarthy, by publishing a blacklist of these sites: “Now we can all know who was with the anti-military Internet crowd. We’ll post the names of all who support the smear merchants on billoreilly.com.”
Arianna Huffington wants to help. If you’d like to be added to Bill O’Reilly’s enemies list, click here. Sure, it’s symbolic, but if it helps Arianna goad Bill, I’m all for it.
***
Phone call from the Emergency Room at 1:30AM.
“Hello, Dr. Hoffman?”
“Yeah.”
“Sorry. We called you in error.”
“What?”
“We called you in error.” Click.
***
One last thought about dreams:
Over the years, I’ve had several dreams which provided worthwhile images for fiction. Not stories, mind you; those invariably suck. (Each time, I would wake up thinking, “Wow, what a story!” but within a half hour, the glee has faded, and I can’t imagine why I found the tale so captivating.) But the images: crisp and dripping with archetype, screaming to be incorporated into a short story or novel.
As I was driving in this morning, I thought about the stories I’ve written which used those images. None of them has been published. This failing, I think, has nothing to do with the images, but with the additional crap I’ve layered over them.
Here’s an example. Several years ago, I dreamed about a trio of white explorers who conspired to witness a native ritual forbidden to outsiders (a la Sir Richard Burton). In this ritual, the tribesmen wore huge, brightly painted papier mache heads meant to represent their old gods. Thus adorned, they would dance and parade for hours as they climbed to the mouth of an inactive volcano. There they would fling the heads down into the volcano and race back to the city, unencumbered by their old gods.
In the dream, the explorers are discovered, and they are thrown into the volcano, fake heads and all.
I love two things about that image: first, the notion of shedding one’s superstitions in such a graphic way, and second, the idea that the explorers (representing the more wicked aspects of the modern world) would be shed with equal joy.
When I wrote the story, however, I added a bunch of crap about missionaries with a phony religion based on corporate-American ethics and baseball (their martyr was pelted to death with hardballs after delivering his famous Sermon on the Mound). Killer of killers, I fell back on one of Strange Horizons’ notorious “plots we see too often”: my villain was crazy, and much of what he imagined in the course of the story turned out to be either delusion or dream.
Feh. I should start over from scratch and pare it back to the core image . . . once NaNoWriMo is over and done with.
***
One of these days, we should all take a look at that Strange Horizons page and come up with a list of counterexamples: stories that incorporated these trite plots and did so with spectacular results.
Someone once said to me, “Things are trite because they work.” Trick is to make the trite feel fresh . . .
D.
And now, a public service announcement.
Yesterday, I received a most unusual email: the usual litany of symptoms, followed by an ecstatic elegy to female breasts. The letter-writer found this blog through my other website, The Medical Consumer’s Advocate, my professional home on the web. This blog receives a few dozen hits a day from the Advocate, but most of those visitors run away screaming. At any rate, they usually don’t gush over the glories of mammae. Doubtless this fellow had read my Sociobiology of Boobage post and felt he’d identified a kindred spirit.
Let me be clear about this: this blog isn’t about me. Think of these posts as performance pieces, and the writer, a stand-up comic. These are characters I play, nothing more. I’m not obsessed with boobs no matter what that emailer might think.
I’m an ass man all the way. (more…)
A woman complained to her doctor that she suffered from voluminous farts which, paradoxically, (she really said “paradoxically”) had no odor whatsoever. In the exam room, she demonstrated one for him. Tore the table’s white sanitary paper right down the middle.
“Ma’am, I’d like you to see Dr. Hoffman.”
“Is he a stomach specialist?”
“Oh, he’s a specialist, all right.”
After giving me her history, she said, “Here, let me show you.”
“I think I get the –”
But I was too late. Nevertheless, her exemplary fart confirmed the diagnosis. I brought her back for a hearing test and eventually convinced her to buy a pair of hearing aids.
At followup, she said, “Dr. Hoffman, you haven’t helped me one bit. I’m still farting. They still don’t smell, but now they’re so loud they shake the windows.”
“That reminds me.”
“Hmm?”
“We need to schedule surgery for your nasal polyps.”
***
Honestly, did you ever expect to hear a joke with nasal polyps in the punch line? Hemorrhoids, yes. Anyone can tell a joke about hemorrhoids, but only an ENT can make nasal polyps funny.
***
I’m in a giddy mood because it’s before 10 PM, I’ve surpassed my NaNoWriMo quota for the day, and I played Stratego with my son. I even watched Evil Dead with him. How’s that for quality father-son time?
Who knows. If I can think up something fun, I might even write another blog entry.
D.
Last week, I wrote about the anguish of making life-or-death health care decisions for a child (Sorrow in the trenches). As part of that discussion, I used hemicorpectomy as an example of an operation so heinous no one in their right mind would say yes, sign me up — unless the only other option were the death of one’s child.
I encourage you not to google ‘hemicorpectomy’. Hell, you’re all writers (or, at the very least, intelligent readers). You can figure it out. Trust me, you don’t want the details.
(more…)
You are a Cartoon Muffin! You have a great sense
of humour and a quirky way of looking at
things. We always think you are joking, but
we’re never quite sure.
What kind of muffin are you?
brought to you by Quizilla
Be forewarned: if you read all possible responses to the questions, I can’t vouch for the safety of your keyboard. Vomit, you know. Bad for delicate electronics.
One of these days when I have nothing but oodles of time on my hands, I’m going to author my own Quizilla quiz. The possibilities are endless. What kind of heathen are you? Or: What deadly sin are you? Or, my favorite: What kind of sexually transmitted disease are you? What do you think?
In preparation for Discovery Health Channel’s airing of that H.P. Lovecraft classic, The Duggar Horror — ah, excuse me, I mean 14 Children and Pregnant Again, I have put up a link to my Muffin Saga under This Week’s Favorites. We’re watching it Right The Fuck Now. And oh. My. God. Is it ever cutesy-pie.
***
I learned something fascinating from our town’s Red Cross director (at least, I think he’s our director; we weren’t introduced). He was deployed to Louisiana for the Katrina disaster. He told us lots of fun stories (like the one about the sheriff who hijacked a Red Cross food shipment at gunpoint, only to be arrested for theft hours later), but here’s the interesting bit:
Louisiana didn’t give out any temporary licensures to out-of-state volunteer physicans, nor did FEMA. WTF??? Over thirty thousand docs signed up to volunteer. Did the State or Federal governments make use of any of these volunteers?
I asked him if there were enough local physicians to cover the need. His response: “What local physicians?”
Go figure.
We need national licensure for physicians. If that’s too radical, we need some way to cut the bullshit red tape that keeps volunteers from volunteering. This is ridiculous.
D.
Luis Vierra (not his real name) came to our clinic thinking he had sinusitis. Sixteen, handsome enough to draw crowds away from a boy band convention, and with a haawt & steady girlfriend back home, Luis had much better things to do than sit around all day in the County Hospital clinic.
He couldn’t breathe through his right nostril. As for the swelling alongside his nose, he figured that “just happened” with sinusitis — that and the pain, a dull, penetrating pain, like brain freeze from hell. The numbness of his cheek skin puzzled him.
It didn’t puzzle us.
(more…)
Excerpt from an email I received on 9/20:
The Department of Health and Human Services deployed over 1,200 members of the U.S. Public Health Service Commissioned Corps, our largest single deployment since the Korean War. We also issued a call for non-uniformed services individuals like you to help with the massive health and medical services relief effort. More than 34,000 Americans responded to assist in this disaster relief effort.
Our response to the storm has changed as the needs of those effected have
changed. Local communities throughout the United States are supporting
evacuees. Those communities, their state governments, and the private sector are now better able to address their [sic]. The requests for assistance are declining in number and urgency, though we expect a continuing need in some communities for relief and respite of those currently providing services and the high number of persons being cared for.
We have deployed more than 150 “unpaid, temporary federal employees” at the request of state and local health departments; and, we will send more. But, at this stage of the response, we believe that the extremely high demand for additional personnel that we originally anticipated will not occur. While we will certainly call on a number of you to help in the response, we believe those numbers will now be in the hundreds rather than the thousands. (emphasis mine)
Summary: Don’t call us, we’ll call you.
***
Three thoughts.
(1) “Those communities, their state governments, and the private sector are now better able to address their [sic].” Is this truth or politics?
(2) With Rita on its way and another two months of hurricane season still to go, I’m thinking the surge genrul’s email might be a bit premature.
(3) Kinda cool that 34,000 folks from the health care community offered to volunteer. I’m not sure how this totes up on a percentage basis, but I’m glad to see the number is in the tens of thousands rather than the thousands or hundreds.
On the other hand, when I submitted my info at the Feds’ HHS website, I was the first otolaryngologist to sign up. That makes me wonder what fraction of those 34,000 were MDs or DOs.
***
Back to my hurricane fears. Especially scary: the high temperature waters of the Caribbean. (This links to a cute jpeg from NOAA.) Hurricanes draw their power from an ocean or gulf’s warm surface temperatures. In the Caribbean, current temperatures are toasty — if not at a record high, then close to it. If a hurricane arises in the southern Gulf of Mexico/Caribbean, it’ll be a whopper. Maybe it’ll smack into Mexico; maybe not.
D.
I’ve written before about the student’s dream and my bizarre versions of same. Here’s last night’s version, which my subconscious felt compelled to return to, over and over again:
I’m back in residency training and it’s July 1st*. Even though I am a higher level resident, the medical students, interns, and junior residents are off doing orientation bullcrap, which leaves me to round on a new service. Knowing I have four patients on the ward, I allot myself 30 minutes to familiarize myself with their charts and bring myself up to date on how they’ve been doing over the past twelve hours.
That 30 minutes evaporates, and suddenly my attending physician (the boss) is right there at my side, wanting to round. Fortunately, the dream takes a fantastic turn. As we come to each patient’s bedside, I vaporize said patient with my fire breath spell.
“My God,” sez the boss. “Is that how you treat your patients in real life?”
D.
*Why is this important, you ask? You would do better to ask, why should I never never never show up in the emergency room of a teaching hospital on July 1st? Because that’s when all the newbies come on board. Shiver.
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Something the Lord Made was one of those sneaker movies — if you weren’t paying attention to HBO last year, it snuck right by you. It’s the story of one of the pioneers of open heart surgery, Alfred Blalock (Alan Rickman), and his skilled assistant, Vivien Thomas (Mos Def). In the 1940s, the idea of open heart surgery violated deeply held prejudices in the medical community. “Don’t touch the heart” was right up there with “First, do no harm.” Blalock and Thomas bucked tradition to develop an operation to cure the congenital defect causing blue baby syndrome.
During internship, I had a one month rotation on the neurosurgery service. Neurosurgery had a one night in four call schedule with no general surgery duties, so we all looked forward to this rotation. The ward was abysmal, but the neurosurgery ICU nurses had the best reputation in the county hospital.