Gardening is sexy

Maybe it's me, but let me explain. Perhaps it has something to do with my mindest, and the dearth of acceptable receptacles here, but the weather today reminded me of Spring, and everyone knows that's what makes a man's mind fancy. Nevertheless, today started with optimism. I planned to plant tulip bulbs. (I'll digress here and say that bulbs reminds me of bulbous, which reminds me of boobs..but like I said, I digress). Anyway, I researched the topic vigorously, and determined that November 8 was the ideal day to proceed. Not to mention that the forecast was for 70 degree weather.

I was quickly disappointed. Blackburn's Nursery, that little oasis of wonderful flora amidst the grotesque yard sales and billboards which line Hwy 23 in Appalachia, was closed. Perhaps because my enthusiasm got me there before noon and I was too early. Blackburn's is where I go to stock up on various plantings, mulches, and other things I don't really need. It's also where I got the bulb for the beautiful plant shown in this picture. This past spring I picked out the bulb with the help of an enthusiastic and wonderful helper. I don't think she's there anymore. I wish she could see what grew out of our too brief connection; I think she'd be pleased.

Not to be dissuaded however, I made the 40 minute drive back home, re-did my fantasy line-ups, and went straight to Lowe's. Unfortunately, no tulips there either. However, I did run across this interesting make-believe green house (2nd picture) and calls attention once again to things earthy and sensual. As I placed gently the prescribed 2 or 3 seeds (or maybe 8-10) into each little receptacle, my mind pondered how this seed planting is not nearly as fun as how humans do it. I trust that next spring the fruits of my labors will bring forth chives, basil, brussell sprouts, and some other fun stuff. (hopefully not of the 2-legged variety..just sayin).

To sleep, perchance to dream....

Chicago in the Fall is the perfect place to be. Unless you're stuck at the Westin O'Hare. I can look out my window and see planes landing, but can't see the skyline. That's OK though, because I'm here to learn about sleep medicine. If I stay awake during class I learn some fun things, ie about parasomnias and night terrors. ("From ghoulies and ghosties, and long-leggedy beasties, and things that go bump in the night....").

I thought this picture of shorty and my granddog was perfect timing. Alycia calls her the Tattoo-Princess.

I miss them both.   

26 Things...Stepping up to the varsity team.

It's been awhile and I've been waiting to purchase a photo box to have some fun with lighting. However my friend Jeff brought me a gift to the office today. As  he can do, he's sucking up for my business. He brought an invitation for a trip to Portland, candies for the girls, and this little gem in a halloween bag. The labelled proof is 140, double-distilled in 1992. Released this month. Tastes of toffee, molasses, vanilla, & coffee. Although my house bourbon is Maker's, and when I go out I get stuffy and order Woodford, and when I really want to show off I ask for Old Pogue, this elixir is uber-special. Even you know who might like it (you maybe?). Poured over ice, with hardly a splash, it makes for a very sublime evening.

Hence, I made my own light-box: 2 white garbage bags sitting on the stove-top. If you ever get the chance ask for a couple fingers of Stagg. If you can't find it, my door's always open, and if the stars align just right, you might be able to enjoy a sublime evening with me.

Apple Festival

The temptation was great to portray the annual event in Appalachia through my eyes. Almost everything that I deem despicable  is on view there: grotesque obesity, tobacco smoking in my face, accents that sound like dirty fingernails on chalkboard, hideous dress, foul body odors, bad tattoos and hair, laughable "crafts", and on and on. It's a bad county fair on steroids; it's uber-Walmarting.

But, my shorty's didn't see any of that. They could care less that bad teeth and low IQ's are a direct descendent of a shallow gene pool. They don't know that my (and their future) tax dollars support the "disabled" walking down Main Street  eating corn dogs while high on Lortabs. They could care less.

They do know that they rode the tilt-a-whirl, that I bought them $2 pocket knives, that  a half Mountain Dew on a hot day is dreamy, and they got face paint. Those memories will stay with them a long time. There will be enough time in their lives to form their own prejudices and opinions.

Apple Day was not that time though.T

Boxer, boxers, and all is right in the universe.

My father was a prizefighter. Growing up in the 'hood in west Louisville I was always reminded of that. Before Cassius Clay (aka Muhammad Ali) he was the most popular fighter who had Louisville roots. Cecil Payne fought for the featherweight championship of the world. He was good and made a lot of money and like most other 20 year-olds, he blew it on parties, women, and alcohol. But he lived. He lived large.  He lived until I was 8 years old; and then he died. He died at age 51, 6 years younger than I am now. He died of leukemia, a relentless, unforgivable, untreatable cancer of the bone marrow. White blood cells grow inexorably, replacing platelets and red blood cells like republicans infiltrate tax cut rallies in DC. That sucked. But we persevered.

In my neighborhood, fisticuffs was respected. No knives, no guns, just good threads and a good left hook. Watch the movie "A Bronx Tale" and you will see me and my neighborhood there.  A boy's (man's) respect was measured by not backing down from a diss (although that was not a term invented yet). I had the (mis)fortune of hanging with guys 4 years older than me. That was the demographics of 32nd Street. Any strange 9 year old who happened by was challenged by my friends to a fight, and I was the dedicated terminator. I took on kids literally twice my size, and they often left crying. I was a bad ass. That has followed me all these years, and it's been a part of my make up. That's why curse words are used as exclamation points. In the early 60's,  Adler socks, Flag Brothers shoes, and pegged pants were au couture.  Life was good then. (Although I do have to digress and remind myself that Billy Donohue kicked my ass on the front porch of those apartments long gone..I deserved it).

My fathers legend still permeates the Payne family tree and everyone associated with us. My father-in-law Joe remembers my father well, and I think is still in awe that his daughter married me. More about Joe in a future blog. He deserves a separate, special recognition. That said, legends die gracefully, but they tend to fade away. Erica decided that there was a need to extend the story at least a dog's life. So she purchased Cecil, the boxer. The kids, like all kids needed a dog. So it was fate. Cecil is 9 months old, now a tripod (thanks to a congenital absence of a hind femur) but he's perfect. He pees when he sees me. I like him. A lot.

*In the pictures above you see Debbie massaging Cecil's good leg. He loves that. When he sees her, he flops down in front of her. It seems that the good leg enjoys special attention from a hot nana.
In the other picture my dad is beside the poster of one of the best heavyweights of all time. In fact after my dad retired, he referreed a Dempsey fight. Those were the golden days of boxing.

**My boxing career ended in a record of 2-1. I was trained by Joe Martin, the retired cop who discovered Ali. It's probably better that I went to school. I probably couldn't carry my dad's jock.

***Im told that chicks like bad boys, so there you have it.

Pornography & Health Care Reform

The public’s discussion of health care reform (really more accurately insurance reform) has not been particularly sexy, but it sure has been pornographic. Not in the legs wide open, insert tumescent phallus sort of way, but in a disgusting, dirty, “I can’t believe they did that” sort of way.  There’s a difference. Blue movies and Penthouse Forum serve a purpose. Town hall meetings about reform, where guns are checked at the door, are as disgusting a display of Americana as one can ever imagine. I am certain we have lost any sensibility we may have ever had. The recent presidential address to congress is a perfect example of the crassness we witness. Rep Joe Wilson’s “you lie” outburst is evidence that the GOP is a manifesto of fat, dirty, old men. They have lost relevance and are respected only by the Limbaughs and Hannitys of the world.

I have been in clinical medicine, counting my drug days, more than 40 years. I have an opinion of health care and how it should be managed. Many won’t agree with me, but they are ill-advised, wrong, or probably stupid. I’ll try to straighten everyone out here.

Here are some truisms:

1. Nothing is free. As Debbie & I discussed this recently she pointed that out. She’s spot on. We all are responsible in some monetary fashion for our health care. For those unemployed, 30 year old men who can’t work because they have back pain, too fucking bad. If you’re going to sell oxycontins to your cousin/girlfriend, put a little aside to pay a monthly insurance premium. Otherwise, I could care less if you have a tummy ache.
2. On the other hand, there is a segment of the population who are truly unfortunate and have health issues. Those with devastating neurological illnesses, have suffered major trauma, or the children. None of it is your fault, and there needs to be a safety net. No one should go bankrupt taking care of themselves or their loved ones.
3. Insurance companies by default are bad. Speaking of pornographic, add another X to XXX-rated.
4. Medical device companies and the pharmaceutical industry are not nearly as demonic as many wish to think. Lots of people want to pick these companies out as responsible for the ills of medical care. This is misdirected vehemence. But for the good of these companies (mostly American), we would not have many of the medical advances we enjoy. Give them a break.
5. People need to be responsible for their own health. It’s not up to me, Anthem, your church, your mother, the school, or the police to make you make right decisions about diet, exercise, abstinence from goofy sex, alcohol, tobacco, or riding a red-neck 4-wheeler without a helmet. Get a grip, take some personal responsibility, quit watching Judge Judy, and be productive. Otherwise, fuck you.
6. Making doctors be responsible for health care reform is a Sisyphean challenge. To wit, a patient I see in the office every day: A 40 year old anxious female with unusual chest pain concerned she has a heart problem, referred by her frustrated primary care doctor. In any other parallel universe I’d pat her on the shoulder, tell her to take a Tylenol, and get control of her anxiety disorder. But, I’m torn. If I don’t DO something: the primary MD won’t refer me any more patients, the patient will go to another quack doctor, and I will be perceived as a bad cardiologist. So, it’s very easy for me to order a $2000 stress test to prove to her, and everyone within a 3-county radius that her heart pain is in fact due to her Lortab inhaling husband.  In this scenario, I pocket the money, and don’t look back. That’s real waste, fraud, and abuse. I’m party to it, but if I don’t play, I’m shit. Stupid system, stupid expectations by patients, referring doctors, and society. Fuck it. I’ll retire a rich man partly because of her. I'm glad I'll be in another line of business when the rest of society catches on to this ridiculous economy.
7. Fat people, people who smoke, drink too much, people who don’t exercise, miss their office appointments, who don’t take their prescribed medications, and stupid people who can’t read beyond a 4^th grade level are Darwin’s children. It’s not my fault. It isn’t yours either.
8. There has to be insurance coverage for the 47 million uninsured. There just has to be. If that means the government expands Medicare, Medicaid, or provides for  insurance cooperatives, so be it. Fuck Aetna, Anthem, and any other insurance company. They need to be competitive.
9. I don’t know much about the Canadian health care system, or any other country’s health care, but I understand one concern is that there is a long “waiting period” for some procedures and operations. Americans are a fast-food society and want EVERYTHING right now, either their greasy Big Mac, or their bypass surgery. Americans expect drive-thru health care. Fuck ‘em. It’s probably not good medicine anyway. Taking a wait & see attitude on many illnsses is often a good thing. Just because you have a 90% blockage in a heart artery doesn’t mean you need a stent yesterday. Take your medicines, lose weight, quit smoking, then come back to me if you still have chest pain. Otherwise, fuck you. On the other hand, if I have a big old mass growing on my right nut, I want it ripped out right now. Some things can’t wait. We need a system that knows the difference when somnabulence is correct and alacrity is in order.
10. We’ve all read where we need not health care, but health maintenance. And for the most part this is true. Healthy people are cheaper. Insurance companies learned long ago that the cheapest patients are dead patients however. In effect, we are all going to die of something. The cheapest care is keeping one healthy for as long as possible, but when your time is up…it’s done. We spend 50% of our health care dollar on the last 6 months of life. That is pornographic. We need required living wills,  and doctors, nurse, attorneys, and family members need to respect this. Grandad (like me) is going to die. Don’t prolong it. Don’t spend $100,000 on ICU care on a demented 90 year-old. He doesn’t want it. (despite my earlier post).

I could say more. But if just a little of the above is taken to heart, we will have plenty of dollars to revamp the system, and have money leftover for making finally a good mass-transit system in this country.