Dr Karen Sibert was one of my teachers at Duke, where I did my anesthesiology residency. She’s an insightful writer on the cultural and scientific issues surrounding anesthesiology practice, and the practice of medicine more generally.
Dr Karen Sibert was one of my teachers at Duke, where I did my anesthesiology residency. She’s an insightful writer on the cultural and scientific issues surrounding anesthesiology practice, and the practice of medicine more generally.
I was off work last week, so of course my thoughts turned to a road trip. Especially since my wife was able to arrange her work affairs in order to join me, we were a “go”. But where to?
Since Dana joined me in Colorado last summer, after our nest became empty, we decided to take regular advantage of the attractions offered by the American West and Southwest. We skied last winter at several nearby resorts; we went together to Santa Fe for a long weekend in the spring; and I did a solo jaunt near the Four Corners of Colorado, Utah, Arizona, and New Mexico in late June. Yellowstone National Park is on our list, as is Glacier National Park. Both, however, are a bit too far away for a 3- or 4-day trip, which is all we could spare this time. As well, accomodation convenient to either of those was not available this week, at the tail end of the tourist season. Yellowstone, it seems, books up many months in advance.
We have also had the Badlands/Black Hills of South Dakota on our Western Bucket List. A quick online check showed available hotel rooms in Rapid City, South Dakota, the “Gateway” to the Black Hills. A few clicks, and off we went, trusting the rest to serendipity. We were not disappointed.
I confess to having known next to nothing about South Dakota before this trip. In my mind, South Dakota was a slightly-warmer North Dakota, a land of flat, featureless terrain farmed by people speaking in jarring “Fargo” accents. I was soon disabused of my ignorance – accents notwithstanding – by our trip through some of the loveliest terrain I’ve seen in the United States.
To get to South Dakota from Denver, one travels north through through Wyoming, via Cheyenne, then east to South Dakota. Six hours and you’re there. Wyoming itself is gorgeous; it’s the least-densely-populated US state, and we loved its stately solitude. We drove through farming and ranching country, and at times had no one else in view on the highway. The land is a gently-rolling grassland, the western end of the prairie that comprises the Great Plains, as it segues into the Rocky Mountains.
Traveler tip: we stopped in Lusk, Wyoming, county seat for 2,500 souls, at one person per square mile, who are likely well-outnumbered by coyotes. If you find yourself nearby, be sure to stop for lunch at Rough ‘N Refined. Order any sandwich on their sprouted-wheat bread, and you won’t be sorry. We stopped on both our outbound and our homebound drives!
Wanting to see as much as we could during our short trip, we had managed an uncharacteristically-early start out of Denver. We chose our route to take us through Custer State Park near Custer, SD, en route to our hotel in Rapid City. By this time we’d turned eastward out of Wyoming, and the terrain began to show some uplift, leading into the Black Hills of South Dakota. They are so named because, at a distance, their extensive tree cover made them look black to the Native Americans and French trappers who named them, each in their own language. The Black Hills contain the highest peak east of the Rockies, so they are true mountains. They looked to me like a cross between Rockies and Alleghenies – the extensive vegetation and overall rounded lushness of the latter, but the cragginess and exposed rock of the former.
Custer State Park has the largest bison herd in North America, enough that an annual cull is required to balance herd numbers and grazing resources. Signs dotted the roadway warning that Bison Are Dangerous. If you’ve seen one up close, the warnings are superfluous. Mature bulls can weigh a ton and a half, cows considerably less. I’d think a lashing hoof could easily cave in a skull; a toss of the head, disembowel an antagonist with a curved horn. We gave them their space, and admired them from a respectful distance. Antelope and mostly-tamed burros rounded out the wildlife contingent. The burros are the descendants of animals that were used to convey tourists into the park’s mountains; they were released into the park when the internal combustion engine supplanted them. Tourists stopped to feed them carrots, and they showed no fear of people.
Further along our route toward Rapid City was Mount Rushmore National Monument. By this point the terrain was quite mountainous, of course. The crowds were moderate and the weather continued to cooperate; we arrived in late day when the light was in a pretty decent position for picture-taking. The park is clean and well-maintained, and is quieter and more understated than some others I’ve visited. I wonder how many visitors it receives annually? I suspect that it is not top-of-mind for tourists as a sole destination, the way Yellowstone or Glacier is; but for anyone visiting this part of the country, it’s an easy stop. An hour proved plenty of time; onward to Rapid City.
We stayed at the Alex Johnson Hotel, a renovated historical inn in this charming town of 75,000 in southwest South Dakota. It’s named for Rapid Creek, which bisects the city. The weather was spectacular, with warm days and cool nights, and the people were as hospitable as one expects from Midwesterners. We managed to find several nice places to eat, among them Boticelli’s, the Vertex (atop the hotel), and Delmonica’s – all within a block of the hotel. Tally’s Silver Spoon, directly across the street, became our breakfast spot of choice. Rapid City is the Gateway to the Black Hills, perfect for staging day trips to nearby attractions, none of which was more than an hour and a half’s drive away.
Next day we visited nearby Deadwood, South Dakota. This was a lot of fun for us, because we are both fans of the eponymous HBO TV series that aired in the early aughts. Deadwood nowadays is dedicated to tourist-cash extraction, via music venues, casinos, and bars. The town was downshifting from the previous couple of weeks’ madness around the Sturgis motorcycle rally – Sturgis is maybe ten miles away, and the entire state feels the $800 million impact of a million bikers descending upon it. This weekend there was a classic-car rally and an oldies-music tour getting underway. We had a quick lunch and checked out both bars that claimed to be the site of Wild Bill Hickock’s murder at the hands of “the coward, Jack McCall”.
Feeling oppressed by the Vegas-hangover gestalt of the place, we headed up into the overlooking hills to visit Mt. Moriah cemetery, where townsfolk both prominent and obscure have found their final rest since Deadwood’s incorporation in the 1870’s. Wild Bill Hickock and Martha “Calamity Jane” Canary are buried there, side-by-side. Seth Bullock and his wife are interred a few hundred yards farther uphill, away from the main cemetery. Bullock was the town’s first marshall, a businessman, investor, and hotelier, and one of its leading citizens and greatest booster throughout his life. He was a lifelong friend of Teddy Roosevelt after meeting him in the 1880’s, and he wanted his gravesite to have a sight-line to the TR Memorial on a nearby peak.
Our next day was dedicated to Badlands National Park. Again an hour’s drive from Rapid City, the Badlands is the largest “mixed-grass prairie” in North America. Again, both Native Americans and French trappers thus named it in their own languages, the French because it was considered “bad land” to travel through. The terrain seemed to me, as did the Black Hills, an amalgamation of other places I’ve visited – possibly Bryce Canyon, Utah, with its erosion-formed rocky hoodoos, crossed with the rolling grasslands of Wyoming and South Dakota. It was odd to see the lush and the barren so closely interposed with each other. We did a five-mile hike, and headed into nearby Wall, SD for lunch.
American readers are likely aware that the Great Plains was, quite literally, ground zero during the Cold War from the 1950’s through the 1990’s. The better to lay waste to the Soviet Union by launching missiles over the North Pole, the upper Midwest housed the land-based component of the nuclear-deterrence “triad”, comprising also submarine-launched and bomber-delivered nukes. Spread across Montana, the Dakotas, Missouri, and Nebraska were some 1,000 intercontinental ballistic missiles (ICBM’s) grouped in clusters of perhaps ten underground silos spaced a few miles apart. Each silo was connected, like spokes around a hub, to a control center from which the launch command would come. All but around a hundred missiles have been decommissioned, as we and the Soviets reduced our strategic arsenals starting in the 1970’s.
Control Center Delta-1, and Silo Delta-9, 11 miles apart near Wall, SD, have been converted to displays. We arrived too late in the day to clamber around inside them. It was eerie nonetheless to drive up to a nondescript, fenced rectangle of concrete in a pasture – a proximity which would have gotten us shot during the Cold War – to look upon the instrument of Armageddon for Vladivostok, Moscow, or perhaps St Petersburg.
By this time we were thoroughly spent, so it was back to Rapid City for another nice dinner, and drinks for me on the rooftop bar while my wife did some work in the room.
Saturday we drove home, via the spectacular Needles Highway through Custer State Park. We stopped at the Crazy Horse Memorial near Custer, which has been in progress for sixty years, in fits and starts as politics and finances have allowed. The massive mountain sculpture, similar in concept to Mt Rushmore, is being hewn from granite on a thousand acres of private land, relying on donations to foot the cost. We stopped for a gander and bought a few raffle tickets – the prize being, fittingly, a brand-new Indian motorcycle – before hitting the road for home, back the way we came, through eastern Wyoming.
The American West continues to fascinate and amaze us. We can’t wait for our next journey somewhere out here. Montana, perhaps? Western Wyoming, in the mountains? We shall see.
You’re thirty-something years old, and as far as I know, don’t live in Mom’s basement. (I didn’t independently verify this.) You’re coming to an outpatient-surgery facility to have a minor adjustment made to your penis. Your trouble: the thing hurts when erect. It’s understandable that you might not want to share the details of this problem with your mother.
SO WHY THE F&%K WOULD YOU BRING HER TO THE HOSPITAL WITH YOU??? Do you not have a Significant Other — who is already presumably familiar with the nuances of your schlong — or a friend, who won’t want to hear about it, but will drive you to and fro anyway, and probably give you some grief about it — to handle transportation and immediate post-procedure supervision? For god’s sake, man, use your head (the one attached to your neck, presumably containing whatever brains you were allotted)!
These days in medicine, we are rated by our “consumers” (that’s you) on various components of “patient satisfaction”. One of those components is “respect for privacy”. I was recently severely down-rated on this point by the above-described patient. He was taken aback that I — so he thought — discussed his penis problem in extensive detail in front of his mother, and that I should have asked Mom to go to the waiting room first.
A couple of problems with this. First of all, I became an anesthesiologist precisely so I would never have to discuss a man’s dick issues with him. As an anesthesiologist, I am primarily concerned with the command-and-control aspects of pecker management: the heart that pumps blood to it; the lungs that provide it with oxygen; and the brain that manages its hydraulics. In most cases, I don’t even have to look at it. That’s fine with me; seen one, you’ve seen ‘em all. So I am certain I never discussed the man’s unit, with or without his Moms in the cubicle.
His urological surgeon, however, did just that, in great detail, in said cubicle, with Moms sitting right there. That’s entirely proper and correct. But what about HIPAA, you ask? Privacy, blah, blah, blah? HIPAA expressly allows us to discuss intimate medical matters in front of anyone the patient allows to be present. In other words, it’s not OUR job to kick Moms to the waiting room — it’s YOURS. So if you don’t want her to hear about the pustulent chancre that is consuming your manhood, ASK HER TO WAIT IN THE WAITING ROOM. And honestly, what kind of Mother wouldn’t have figured this out herself, and decamped to the holding area, where the burnt-petroleum coffee and outdated magazines live?
So I got dinged because this patient couldn’t figure out that I was his anesthesiologist, not his surgeon. And the dinging was done because he lacked the stones to tell Moms to beat it (uh, sorry, bad euphemism) while he and the Doc discussed private matters.
Good Lord, people, does common sense enter into this at any point?
Finally got around to selecting some photographs from my recent Southwestern jaunt, and getting them (mostly) geotagged. I’ll have more to say about that onerous process later. I have figured out what I hope will prove a workable technological solution.
I’m neither fan nor intentional practitioner of the classic “beautiful landscape” photograph, because they are so ubiquitous and over-done that it’s impossible to add anything to the genre — the domain of pictorialists and f/64 adherents like William Henry Jackson or Ansel Adams. But I do succumb occasionally, especially when overwhelmed by the otherworldly majesty of the American Southwest. Making a picture that I know will be little more than a documentary tourist-snapshot becomes a necessary evil, somehow — such as with this panorama of Inspiration Point, at Bryce Canyon National Park, in Utah:
This was my first trip to Bryce; the place is beyond description, whether in words or photographs, so cliché is always looming at the periphery of one’s eye. Here’s Bryce Point in the Park, via the Superwide:
From the National Park Service educational placards available in the Park — here as elsewhere, excellent — I learned that those stone spires are called hoodoos. They were formed, of course, by countless millennia of water erosion of the soft stone. If you can visit such a place without contemplating your own unimportance in the Grand Scheme of Things, you have a well-developed ego indeed.
The Superwide would seem to be a camera made for this kind of landscape imagery. But its field of view is so wide that, again, you really want to be closer to the subject to use it to its full advantage. This photo was made in Marble Canyon, Arizona, near the Utah border:
The problem with an ultra-wide-angle camera specifically, and with Big Landscape images, is one of scale. It’s hard to immediately understand just how big is the thing you’re looking at:
I added a foreground element to help the eye figure things out, as with this image, made in North Rim, Arizona, which is not far from the Grand Canyon:
Spectators also have their uses, as here at Inspiration Point in Bryce:
That gentleman was one of a group of four exuberant foreign visitors to the park. They seemed to be thoroughly enjoying themselves, as were these guys at Farview Point — though Mom was having some trouble corralling the kids:
Which brings me back to kitsch, in this shot of the Painted Desert Indian Center, in Holbrook, Arizona:
I wouldn’t have thought of dinosaurs and Native Americans as a natural souvenir-shop match, given that the latter didn’t arrive on this continent until around 15,000 years ago. But clearly I underestimated the commercial zeal of the proprietor. Connected by a 500-yard drive through this I-40 viaduct, from the other direction…
…is this tourist establishment, evidently under the same management as Painted Desert:
The Southwest seems full of such places — the desert equivalent of the Alligator Farms along the Gulf Coast of my youth, garish signs promising wonders within to behold.
The rest of what I shot seemed to have no purpose. I tried to yield to whatever caught my eye, without overthinking why. Inexplicability and incongruity — being mismatched to the surroundings or the situation — have always been a visual draw.
Tourists are also a rich vein to mine; each one seems to be in a world of his or her making, sometimes only peripherally related to the nominal purpose of the visit:
Others defy categorization; they are simply interesting, or plain ol’ beautiful, which is often its own best excuse:
I don’t recall ever returning from a photographic-purposed trip feeling satisfied with what I got on film or memory card. No exception this time. Dissatisfaction is much of what keeps me coming back to photography; the sense that, with just a bit more something on my part, what I saw in my head would make it to the photograph and tell the story I’d hoped it might when I pressed the shutter. The agony and the ecstasy….
Geotagging. Sigh. That tedious ritual of metadata-post-production was my biggest challenge this trip. But if one has the location of the shot, the rest of the story is there for the taking, prompted by latitudes and longitudes, and the time of day.
I have one camera — a medium-format digital — with an accessory module that GPS- and time-stamps each image as it’s shot. Of course, if the module has shut itself off to save its battery (it eats them like a Komodo Dragon devours rancid goat carcasses), then it has to be awakened with a slight shutter-press, so it can re-acquire the satellites and spit out a location fix. Meanwhile, one’s moment may have fled. Not ideal. And I didn’t bring that camera on this trip, because I wanted to travel lightly. None of my other cameras — film nor digital — has GPS capability.
My field-kludgy, and ultimately unworkable, approach was to take an iPhone snap of each scene where I also made either a digital or film image — when I could remember to do so. I also kept a “shoot log” of film images on my phone, containing notes I can refer back to. The idea is that, when I import the images into my cataloging / editing software (Adobe Lightroom), I can arrange them by capture time and thus have the geotagged iPhone shots appear next to the digital shots made simultaneously. For the film images, I can simply match them up visually. In either case, I then can copy the GPS coordinates from iPhone to digital or film image, and Lightroom takes care of the rest.
Sounds great, but harder to achieve in practice than you might imagine. First, the digital cameras and the iPhone have to be set to the same time zone, and to as close to the same time as possible, if you want them to pop up next to each other in chronological order. If you happen to cross into another time zone, the iPhone will reset itself while the cameras won’t, and now you’re out of sync. And then there’s Daylight Saving Time to contend with; they don’t do it in Arizona, which I traversed for this voyage. The ideal is to keep everything set to UTC (Zulu time or GMT), but that isn’t workable on your personal phone. I mean, I guess it probably is, if you commit, with all your interconnected tech, to operate only in UTC. I tried it once; it was a hell of a lot of trouble, and all of my files got jacked up.
But then I vaguely remembered that Lightroom can import a GPX “track log” file, which it can use to geotag photos based on their “capture” time. Using any GPS device that can save and output a GPX file, I can turn on the GPS and let it track my movements. Every few seconds, the unit records the time and the lat/lon coordinates into the GPX file. That file gets imported into Lightroom, which matches coordinates to images based on capture time, and tags the images accordingly. For film images, I will have to record the time each one is shot from the clock on the GPS unit, make that the film photo’s “capture” time in Lightroom, and then let LR treat those images just like the digitals. Voila.
This newly-discovered “need” gave me an excuse to purchase a handheld GPS unit. We’d been thinking about one of those for skiing, hiking, and traveling purposes — it’s handy to have a sat-nav capability that doesn’t require a cell phone connection, like the iPhone does. I went with the Garmin GPSMap 64sc, despite its smallish, low-res screen, because it operates using buttons — much easier to manage in ski gloves than the touch screens on newer models. It’s also water-resistant and somewhat rugged. And of course, this unit can record and export the aforementioned GPX track log file.
But the killer feature is its 8MP camera. At first this seemed like the worst kind of feature bloat; why would you need a camera in your GPS unit? Well, I can snap a geotagged photo every time I shoot a film photo, and match them up visually with the film images, doing away with the need either to record image times in my shoot log, or to modify image capture times in Lightroom so that the track log can tag them properly. Two fewer steps to worry about. So now I have all bases — film and digital — covered. And I got to purchase a cool new toy without producing a wifely glare of disapproval; what’s not to like?
I’ll report back after I’ve field-tested this methodology.
Eighteen hundred miles and four days later, I made it back to Denver. I hope I cleared the cobwebs a bit. I needed to skip town for a few days and press a shutter button, regardless of the result. My digital images await my editor’s eye, and I just got back the proof scans of my film images. I shot all of those with the Hasselblad Superwide. I’ll post a selection of images later in the week after I’ve had time to do some culling and captioning.
I’m still learning how to get the best from the Superwide. I have to keep reminding myself that its best use is to get close to whatever I’m shooting, and put its wide, distortion-free field and immense depth of focus to work to tell the photograph’s story. The temptation with such a specialist camera is to make the camera itself the story – here’s a cool “wide angle” shot taken from half a mile away wow that’s really sharp isn’t that interesting….not.
To recap my itinerary, I started on Wednesday afternoon in Denver, and drove west to Grand Junction, Colorado, on the other side of the Front Range. GJ is not far from Utah; it’s a favorite starting point for staging into southeastern Utah’s system of parks and public-access spaces. It’s a 250-mile drive, but with frequent stops it took me 6 hours to get there. No matter; the point was to get out and look at stuff, and maybe make a picture or two.
Thursday morning I drove to St George, Utah, through some of the most beautiful country in North America. I stopped, among other places, at Bryce Canyon, which I mentioned in my last post. The images I made – stay tuned – don’t really do it justice. That, in fact, is why I don’t consider myself a “landscape” photographer, in the tradition of Ansel Adams and others; anything I might shoot in that genre has already been done, and better, than I could do it. Simple documentation of locales doesn’t interest me much. But that said, there was a lot of cool “landscape-y” stuff along the route to St. George, so I gave in to temptation. I’ll post a selection of Bryce images soon.
Friday morning I left for the final outbound leg, to Gallup, NM. This southeasterly route shallowly cuts off the northeast corner of Arizona. The best part came along US Highway 89/89A, which I picked up at Fredonia, AZ, and followed in a meandering southeasterly direction, skirting Grand Canyon National Park to the north and east. I was tempted, but I’ve already been to the south rim of the Grand Canyon, and didn’t feel much like arriving at mid-day or early afternoon, to deal with harsh light and hordes of tourists. Besides, I was still reeling from Bryce, and not sure I wanted to look at some old ditch in the desert after beholding the wonders in Utah.
The route goes through the Navajo and Paiute reservations, and is a stark and beautiful desert landscape. Then, as US 89 veers due south towards Flagstaff, AZ, one traverses the Cococino National Forest, again a place of surpassing beauty. Then it’s on to I-40E near Winona, AZ, and there’s not much to look at until you get to Gallup. I was sorely tempted by the Petrified Forest and the Meteor Crater, but I arrived too late in the day for those attractions. Something for next time.
Saturday was my day to drive home; I was road-sick by this point, and the novelty of driving had worn off pretty thoroughly. My plan was to head towards Durango, CO, a part of my newly-adopted home state I’d not yet seen. US 491 took me north through Navajo and Ute nations lands, and Shiprock, NM, where it crosses US 64 at right angles. Then it was on to Farmington, NM and north to Durango. I didn’t find this leg of the trip compelling; it felt like a segment to get through quickly. Only when I got into CO and the terrain began to climb again did I really enjoy the view. Note to self for future trips.
There are numerous wildfires burning throughout the West, and I frequently encountered haze and the piney smell of burning wood, like a distant campfire. The Durango-to-Denver final homeward hop took me through at least four national forests, and I wound up having to alter my route slightly because of a road closure on US 280, due to fire. I finally made my way via Leadville, CO, through Breckinridge, to I-70 westbound and home. Saturday’s drive was something like 10 hours, which I’d have broken up if I’d planned better, and surrendered less to whim.
A note about what worked, and what didn’t. The American Southwest worked, overtime. My love for the region has been firmly cemented; the mix of desert, mountain, and forest is just enchanting. If I can convince my wife, I’d like to retire there. If they still have any water left.
The Fuji X-Pro1 with the Leica 35/2 Summicron ASPH worked – even though a 35 on its APS sensor is more like a 50, a bit too wide for my taste. That’s what feet are for, to move oneself backward away from the subject. Not bad for a 6-year-old camera, which might as well be from the Pleistocene, given the half-life of digital cameras. I wouldn’t say that the Leica lenses are better than the native Fuji lenses; they are different, in a pleasing way. Less bitingly sharp, with maybe better micro-contrast.
The Superwide worked, and will work even better once i’ve figured out how to get the best from it. It’s lightweight, simple, and oh, my, that lens. Get closer…. I was asked several times about the “video” camera I was using; when I mentioned “film” you might have thought I was holding a moon rock or the tibia of St Paul or something. I make a habit of looking, and mine was the only film camera I saw in my four days of travel. I saw no evidence of the current film resurgence, beyond the trunk of my car.
Which performed admirably; but Subaru’s in-car navigation decidedly sucked. This is evidently true of every OEM nav/entertainment system; at my last service visit the manager admitted as much. She told me that all the carmakers want to “own the customer experience”, whatever the f*^k that means. What they “own” is a steaming pile of flyspecked dung. My 2016 Outback’s systems are NOT Android- or Apple CarKit-compatible, but new models will be after 2019. I’m hoping for a firmware upgrade that will allow me belated entry to the 21st century.
Software, whether nav, entertainment, weather, traffic, is clearly not their core competency. Hell, it’s not even a peripheral competency. About all the Subaru’s mapping is good for is following one’s route, assuming the display doesn’t freeze up, as happened a couple of times. The system was frequently confused about routes and road closures, or wouldn’t timely update. Trying to enter a simple address or find a destination via its sluggish interface invoked a hell-scape of touchscreen buttons and sub-menus – compared to the brainless simplicity of searching for a destination in Apple or Google Maps. Of course, I’d never try to work a complex menu while driving; but data entry is disabled even for one’s shotgun passenger as long as the transmission is not in “park” I’ll never buy another car that locks me into an OEM nav/entertainment system. (That this is a first-world problem of the highest order, I freely stipulate.)
Google and Apple Maps worked, mostly, but they rely on an internet connection (cell-phone service) to update properly. Thanks to Verizon, which also worked, coverage loss didn’t happen very often. We recently switched to Verizon after 15 years with AT&T, and the coverage has been overall much better than, though not always as fast as, AT&T’s. I’m old enough to remember when you’d call AAA for a paper-map “TripTik”, or use a printed Rand McNally Road Atlas, in order to get from A to B. I’d say that satellite-based navigation is the best thing to happen for the traveler since they figured out how to measure longitude.
Mike’s Camera in Denver also works. I dropped my film off yesterday morning, a Sunday. They uploaded proof scans this morning, just after opening. Flawless. I’ll look at the negatives themselves to check for issues. As for film, the jury is still out on Cinestill 50D; Ektar 100 is my preferred emulsion for this sort of photography. I’ll have more to say, maybe, after I’ve gone over the negatives and scans.
Pictures to follow.
So far my impromptu jaunt through the Southwest has presented me with one amazing scenic vista after another. It’s overwhelming and awe-inspiring. Knowing when to stop shooting is the problem out here; at some point one becomes beauty-soaked; you just have to put away the camera and say, “enough”, and look around and take in the splendor before you.
That said, fear of the photographic-cliché landscape has thus far not prevented my shooting seven rolls of 120 film with the Superwide (that’s 12 shots per roll); and a couple hundred digital images with my aging-but-competent Fuji X-Pro1. As an experiment, I’m using my Leica 35mm f/2.0 Summicron with the Fuji, via an adapter. We’ll see how that turns out. It’s equivalent to a 50mm “normal” lens on the cropped-sensor Fuji, so a bit less wide than I normally like to shoot. So I just stand back a little farther. It’ll be interesting to compare the look of Fuji’s own lenses with the Leica on this sensor. Fuji’s lenses are superb, so the Leica will have a job to match them.
Yesterday and today have been a treat. Almost on a whim, en route from Grand Junction, CO to St. George, UT I decided to stop at Bryce Canyon, in southern Utah. It was fairly late in the day, which turned out to be the ideal time to visit. I’ll post images after I’ve gotten home and sorted through them. Suffice to say, Bryce might be the most beautiful natural “attraction” I’ve seen, second only to the Grand Canyon. And I’m not certain about that. There was hardly anyone there, which added immensely to the experience. (I met a couple from Iowa who told me that Arches National Park was a madhouse.)
I crashed in St. George last night, and departed – after a leisurely breakfast buffet of cold, rubbery eggs and acceptably flaccid bacon (I like my bacon thus) – for Flagstaff, AZ. My intention was to stay there tonight, but it’s close to the Grand Canyon and it’s Friday night, so “cheap”-ish hotels are in short supply. Instead, I’ll go on to Gallup, NM, then back to Denver tomorrow via Durango, CO. Nearly that entire route is lined by national forests, so it should be beautiful.
Today’s trip has taken me along US Highway 89 and 89A, which traverses a stretch of desert containing Paiute and Navaho reservations, as well as some remarkable scenery. I probably stopped at every “scenic overlook” along the route. The desert Southwest defies description; it’s a lunar-scape painted in pastel, warm colors. Of course, I wasn’t going to get Bryce-lucky again with the timing. It’s usually true that, when one visits anywhere, it’s at the wrong time of day for photographs; today, I went through at mid-day, with a scalding sun nearly directly overhead, broiling a sky already hazy from wildfires in the region. Nevertheless, I managed to expend some film.
I am big on geotagging my photos. One of my digital cameras – not in use this trip – has a GPS receiver I can put in the flash shoe. It tags the image “metadata” with the location of the shot, which I can then map in my image-management software, Adobe Lightroom. There is no GPS capability for the X-Pro1, nor for any of the Fuji X-series cameras. As for film cameras, forget it. I’m still trying to figure out the best way to conveniently record locations for film images. For now I make an iPhone image, which is automatically geotagged, in each area I shoot film photos, and I match them up later in Lightroom. It’s cumbersome – just like film photography in general in the digital age.
I’m wondering if a better method would be to use a standalone GPS receiver that can record and export a GPX “track log” file containing waypoints marked at every place I’ve made an image. I could then make sure my non-GPS digital cameras are time-synced with the GPS receiver, and I could manually record in my shoot log the time I make a film image. Once I ingest the photographs, I can also import the GPX file, and Lightroom will automatically match them up by time, and tag the images accordingly. I’d still have to manually enter the time for each film image. Accurate, but still cumbersome. That’s analog for you.
Time to hit the road for Gallup, which is about three hours down the road. More to come.
Our group schedules vacation time in the fall for the following year. I had grabbed this week, with no firm intention of how to use it. My wife is tied down at work with her usual month-end madness; thus I found myself at loose ends.
Road trip! I have been feeling restless and antsy, wanting to get out and make some pictures. So I pointed the car west on I 70, destination Grand Junction, CO. Beyond that, I’m not sure.
Stopped for lunch at Idaho Springs, and saw the sign for this barbecue place. Sliced-brisket sandwich, with spicy coleslaw and mac & cheese sides. Shiner Bock on draft to go along with it. If you ever find yourself in a Idaho Springs, give Smokin’ Yards barbecue a shot.
I’m going mostly analog on this trip, so pictures will have to wait until I get back and get them processed and scanned. But I will be posting a few digital shots along the way. Hopefully I can find something worthwhile to photograph.
This is what happens to dessert.
This is the photo that should have accompanied the last text.
Sake. After lots of bourbon ,rye, and sushi at Izakaya Den in Denver.
Date night with the missus. That’s a Foxhattan on the left, a John Daly on the right.
It’s summertime, and thus time for my favorite microbe to make an appearance.
Luckily, you can’t get primary amoebic meningoencephalitis from drinking the water; you have to get it way up in your nose. Usually it lives in warm, stagnant, fresh-water ponds; you can’t throw a rock in south Louisiana without hitting one of those. I’m amazed there aren’t ten cases a week down there. But this is the first I’ve heard of it being found in a municipal water supply.
Get it into your nasal cavity, and it ascends the olfactory (smell) nerves that penetrate the bony plate at the base of your skull, leading directly to the front part of your brain. Once there, it proceeds to eat brain tissue, forming abscesses. The disease is fatal in a high proportion of cases. Like 95% fatal. There have only been something like 3 or 4 survivors of documented cases of PAM.
Best chance – not that it’s much of a chance – for successful treatment is for the ER doc to suspect the diagnosis promptly, and begin the appropriate antimicrobial treatment. We’re not talking about wheedling a Z-Pak from the urgent-care center; the drugs that kill this beast are some toxic s&^t. Unfortunately, by the time most victims get to the ER, and someone figures out what’s going on, it’s too late. (Honestly, it was probably too late the moment you snuffed in that big snort of pond-water.) Better break out those nose-clips.
It’s morbidly-cool stuff like this that almost had me becoming an infectious-diseases doctor. I’d have wanted to go somewhere to study and treat the really bad stuff. Like those larval worms that make your man-sack swell to gigantic proportions by clogging your lymphatics. Or the various and sundry, sometimes yards-long, worms that might take up residence in your intestines.
People don’t realize just how overmatched we are by the microbial hordes. We are so hugely out-numbered and out-gunned it’s almost comically futile.
Last night I packed up one of my old cameras, a Rolleiflex twin-lens reflex camera of 1950’s vintage, to send to a technician for servicing. The camera had been serviced, but not very expertly, about eight years ago, and could use a re-do. It needs a good CLA, or Clean, Lube, and Adjust; and the film-winding crank is stiff and squeaky, which should never be the case in a mechanical jewel like a Rolleiflex.
Cameras of this age are generally all-mechanical works of functional art, made by craftsmen. They are mostly metal, with a few plastic components. Those get brittle with age; lubricants – of which there can be ten different types in a single camera – dry out and gum things up, unless they are periodically removed with solvent and replaced judiciously. Mechanical, spring-actuated shutters get out of adjustment and result in over-or underexposure. Other parts just stop working with age. The Rolleiflex, for instance, has a selenium-cell light meter. Selenium cells by their nature cease function after a certain number of years, and haven’t been manufactured for some time. As far as I know, there is no modern replacement for that old tech that can be installed into the camera and calibrated to work. Luckily, the light meter is non-critical; the camera works fine without it, and I can use a handheld meter, or simply guess at the exposure. I’ve gotten reasonably good at that over the years.
I have probably half a dozen older cameras, none of which is in current production. In most cases, like the Rolleiflex, the companies that made them no longer exist. As you can imagine, this can make sourcing parts a dicey proposition. The better technicians keep a stock of parts salvaged from unrepairable cameras, or bought from the manufacturers while they were still available, and hoarded against future need. In some cases, simple parts can be fabricated new; this could be a great place to put a 3D printer to use.
But the larger problem is that nearly every technician I’ve interacted with is at least middle-aged, like me, if not older. They and I will likely be retiring at around the same age, and there can’t be many people clamoring to learn their craft and carry on the tradition. If vintage cameras are slowly – or rapidly – disappearing, who’d want to bother learning how to repair them?
For instance, a few years back I sent a Crown Graphic camera to a gentleman based in Nevada, who had been a service technician for the Graflex company. He’d bought out Graflex’s stock of parts when that company ceased to exist. He went into business for himself servicing the Speed Graphic and Crown Graphic cameras that company made. These are the old-fashioned, boxy “press” cameras of film-noir fame; you’d know one if you saw one. They were ubiquitous until the 60’s, when smaller, more convenient cameras displaced them. The fellow was advanced in years, and had been in poor health, when I sent my camera to him a decade ago. He died in 2014, and I know of no one else living with his fund of knowledge and skill in repairing Graflex cameras.
I think I’ll be able to source film for as long as I want to shoot it; film has made a comeback over the last few years, and the big film companies have figured out how to make it profitably at much lower production volumes than during their heyday. Heck, Kodak alone has recently resurrected two films, one a beloved high-speed B&W emulsion, the other a color-transparency film. Processing is a concern for color film. But as long as someone is shooting it, I should be able to get it developed, albeit at an ever-increasing price. Black-and-white processing doesn’t worry me at all; it’s brain-dead simple, and the chemicals required are abundant and easy to acquire. You can develop B&W film in coffee, believe it or not.
I think what will finally drive me to all-digital photography will be when I can no longer get a broken camera repaired because there’s no one trained to do the work. I suspect this will happen even before I make it to that Darkroom In The Sky, and my camera closet will then become a museum. Carpe diem et imagonem photographicam, I might say.
Drug prohibition, like alcohol Prohibition before it, has been a spectacular and catastrophic failure.
My turn in the on-call barrel again today. I’m on the 7 am-7 pm day shift, first call. It’s now nearly 8 pm and I’m still working, which is often the case. Our practice’s custom is to finish the cases we start, except in exceptional circumstances.
There’s no general agreement or “rule” on how we handle these cases that crop up near shift-change time. This case was posted for 6 pm, which everyone knows is tongue-in-cheek. A Saturday evening case near OR-staff shift change simply is not going to start on time. If I have reasonable confidence that a case will end by 7pm, or shortly after, I’ll do it. This one was less certain, so I decided just to suck it up. At this point, my evening is spoken for, so another hour or so in the OR won’t make or break it.
Anything later than that, or certain to last for hours on end, and I’d have asked the incoming person if s/he wouldn’t mind coming in a bit early. I did that very thing for a partner a few weeks ago, and was glad to do it. Common sense – and common courtesy – should prevail whenever possible.
Plus, there are some cases you don’t want to turn over to someone else after you’ve started them, because it can be hard to get into the “flow” of a case if you haven’t handled it from the start. That’s not a big deal for the “simple” stuff; a good bit of what we do could be handled by a docile chimpanzee.
This case is kinda in-between simple and not simple. The patient is a middle-aged woman with an intestinal obstruction due to a section of large bowel twisting upon itself, thereby interrupting its own blood supply. When bowel becomes ischemic from lack of blood flow, its walls can begin to break down and leak bacterial toxins into the bloodstream, causing sepsis. This syndrome of overwhelming infection, and end-organ complications, can rapidly kill. Things have not yet gotten to that point, thankfully. She’s been stable for me, but I think she might be in for a rough few days.
I started the day with an early back operation, lasting until around noon. Uneventful. Had a few loose ends to tidy up on our Acute Pain service, which I’m also covering this weekend, so I didn’t get to spend much of the afternoon at home before this case was booked. That’s how it goes. You never know what’s gonna come in across the transom. Therein lies both the challenge and the terror.
I do it all over again tomorrow morning. I’m third-call, day shift. Hoping to sleep in a bit, maybe have my coffee in my pajamas, on the porch. There, I’ve jinxed myself.
Well, after yesterday’s whinge-fest of a blog post, I’m happy to report I encountered no road-ragers during my commutes today. And I worked with a couple of exceptionally pleasant surgeons, and the OR staff were as nice as always. The patients, however, tested my patience.
“Don’t eat or drink for x hours before surgery” includes fruit smoothies and popcorn, which were the forbidden pre-operative foods of choice, respectively, for two of my patients today. Some days I just want to pull out my hair. Yes, we told you not to eat or drink (miscreants frequently claim they weren’t told this. Bulls**t. It’s like saying you went to Mass but no one told you to kneel.) No, we weren’t kidding. (We don’t tell jokes.) The average American can go without food for a few hours without shriveling to dust. Your belly won’t bloat, nor will flies crawl over your dessicated lips, if you forego the chicken and waffles before your bunionectomy.
It seems that when we want some patients to think (common sense), they are often not up to the task. But if we simply want them to do, rather than think, suddenly everyone’s a Rhodes Scholar, heading to the Internet to consult with some shaman somewhere. Still others seem to believe it’s their duty to disobey anything they are told by an “authority” figure, even if it’s for their own good. People, pre-op instructions are decidedly not the place to work out your issues with authority.
If you’re having surgery, and your surgeon or another person in the know instructs you not to eat or drink for x hours prior — DON’T EAT OR DRINK!! We aren’t kidding. Don’t eat a fruit smoothie because “my blood sugar was low!”. That’s why God made apple juice, which most people can drink safely up to 4 hours before most surgeries. I don’t care about your low blood sugar; that might be uncomfortable (suck it up, you’ll live), but it won’t kill you like lungs full of smoothie just might. And I can only imagine what tiny popcorn particles marinated in stomach acid could do to lung tissue. Stomach acid is made to digest meat; lungs are meat; and small particles are just about the ideal way to ensure that acid gets to every part of the lungs.
The ironic thing is that more-recent evidence has demonstrated the benefits of drinking carbohydrate-containing liquids, like sports drinks, up to shortly before surgery. We are starting to advocate this step for more types of surgeries. But I’d say the single greatest obstacle to doing so more widely is our well-founded fear that we can’t trust patients not to abuse the license, because so many people can’t or won’t follow simple instructions.
End of rant. Thank you for your attention.
I might just need an attitude adjustment. I have been a grumpy SOB lately. Herewith, an exploration of my current neurotransmitter imbalance.
I brought two patients to PACU (Post Anesthesia Care Unit, or “recovery room”) yesterday, each of whom was having a transient issue that might require swift intervention upon PACU arrival. The necessary equipment is always available at all PACU patient bays. In times past, this equipment was kept deployed, connected, and ready for use within seconds. That’s as it should be; PACU’s are critical-care units, and bad things can happen in a hurry.
However, in each case I had to wait, temporizing as best I could, while the PACU nurse fiddled with peel-apart packaging to free the equipment; or tried vainly to dislodge the gear from plastic storage bags that wanted to grip it, while other loose components fell from bag to floor, and rolled under the stretcher, out of reach; or struggled to get suction or oxygen tubing freed from its bound coil, and connected to its wall outlet. Time wasted for no reason, because some higher authority decided, on poor or no evidence, that having this essential non-sterile gear opened and ready to go poses some putative infection risk. The PACU nurses’ management has forbidden them to open these items until they are needed. Happily, things turned out well for my two patients yesterday, despite the institutional and regulatory hurdles we had to clear. But why should needless struggle have added to the stress of the situation?
Physicians are trained in a scientific tradition that nevertheless takes into account the innate variability of the “biological units” we call patients, and the unknowability of many things we have to leave instead to art, or judgment. Within these limitations, we do our best to follow the evidence. But we all feel at times that “evidence”, especially the incomplete or inaccurate variety, is used as a cudgel to put us in our places, or to advance the ambitions of certain groups of allied professionals, rather than to advance the cause of patient care – or at least to prompt further search for the right answers. Gulliver bound by Lilliputians, if you must have a literary metaphor; or insects biting at one’s ankles.
Physicians have historically sat atop the money and prestige heap within the healthcare industry – a collective status I freely admit has not been merited in all cases by the individual ability or character of my predecessors and colleagues. Medical-school admissions and subsequent training tend to select for driven individualists with strong egos who don’t always play well with others – an obvious downside to the upside of a world-leading level of training and capability among the US physician workforce. Though the culture is changing, you can’t have the one entirely without the other. Most physicians cherish the story, often true, that they succeeded by dint of demonstrated competence and grueling labor, and apportion respect only to those who have earned similar stripes.
Unfortunately some of my colleagues have approached their careers with a sense of entitlement, rather than the required servant heart. Resentment and jealousy have followed – understandable reactions when others see people they judge as no more virtuous or harder-working than themselves getting paid much better, and enjoying much more deference. To that I can only respond that I can’t help what life choices others have made (the opportunity cost of a decade forgone during training come to mind here), or the behavior of those who came before me. I have to do the best I can each day.
The ability and willingness to shoulder responsibility is the final differentiator. Someone has to make the hard decisions, and live or die by them. When you look around during a medical shit-storm and find that everyone else is looking at you, then it’s likely you’re the doctor in the room. If you want to trade places with me, you can have my paycheck and perks, such as they are. But the marketplace has rewarded my willingness and ability to make such decisions at a value determined by their relative scarcity. I make no apology for that. But I’ve never claimed to be a more-worthy human being based solely on my degree; I leave that judgment to my family, friends, and posterity.
Today I did a couple of cases at another of our facilities, a place I enjoy going because the staff there are friendly and helpful, and the surgeons pleasant and capable. I’d like to think they reciprocate the courtesy and respect I accord them. However, there’s someone there – let’s call him/her Clipboard – who I absolutely know will be on my ass if I wear my LSU or Alabama cloth scrub cap. I’m not special; Clipboard is on everyone’s ass about something, all the time. (Just ask them, as I did today.) Someone up the Lilliputian food chain decided that disposable paper bonnets pose less infection risk for patients; cloth caps are verboten. Like your parents used to say, “because I said so.”
The evidence for this claim is sketchy at best, and recently refuted by the only controlled, peer-reviewed study that’s looked at the matter. They are certainly hotter and more uncomfortable to wear, because they are hermetically sealed against sweat evaporation. But hospitals, with the government and payers (increasingly one and the same) bearing down on them over infection rates, often seem more concerned about doing something than about doing something effective. And, if I’m being candid, biting the ankles of people you’ve long felt have disdained you (real or imagined) can be soul-satisfying to a certain sort of person.
Today I wasn’t in the mood to be hassled, so I sweated quietly under my blue paper bonnet, and Clipboard didn’t trouble me. Except to drop off my mandatory safety-instruction packet while I was in the OR holding open someone’s airway during surgery. I kid you not. I had to sign for it with my right hand while lifting a chin with my left. Had I politely asked, or pointedly told, Clipboard to get the f&^% outta my face, I’d have been labeled a Disruptive Physician, with potentially severe career implications. The packet is the same as last year’s, and the one before that; its delivery no doubt gave someone in Legal the frisson of satisfaction that only comes from having Covered One’s Ass. I’d say that this vignette neatly encapsulates the state of modern medical practice.
And still the Lilliputians weren’t done with me. I got a mass email from my own group’s administration asking us to moderate our use of an expensive anesthetic drug at one of our facilities. It seems our use of the drug is the highest among all of this hospital chain’s facilities in our region. Big budget line items attract attention, but ideally they should also provoke inquiry and analysis. The question should become, is our use of the drug appropriate? Or, what is the cost of the problems we’ve avoided by using a more-expensive, but much more effective, drug? No one can, or is, tracking that.
This hospital’s pharmacy can produce in minutes a report detailing exactly what drugs I’ve used, on which patients, since I started working there. How about identify the individual anesthesiologists who are “excessive” utilizers, and email them directly for corrective education – or maybe even plumb their reasoning for using the drug? Instead, I get an anodyne form email, no doubt at the hospital’s behest, that educates no one, informs no one, leads to no conversation or process improvement. It’s an item that Clipboard would have checked off his/her list of to-do’s, while sucking a drop of blood from an ankle vein.
And the day started with not one but two incidents of road rage directed at me en route to work. I’ll spare you the details; but you’d think in a state where people are consuming a lot of legal weed, people would be more chill. But Denver drivers are the most aggressive and rude I’ve encountered anyplace I’ve lived.
So yeah, I’m grumpy.
Crawfish, Colorado style. A slightly different slant on a south Louisiana staple, but delicious. Amazing to see how crawfish and beer get people talking to each other, no matter what the time zone or altitude.
The occasion is the college graduation of Chandler Young, the daughter of David and Sylvia, who I’ve known since I was slender; and who are the proximate cause of our move to Colorado.
Chandler, like her older sister Taylor, is a young woman who exemplifies what I’ve loved about having a daughter of my own: confidence, smarts, and a common decency that reflects the influence of the many people who have loved her.
Congratulations, Chandler. The world is yours to conquer.
I put my last labor epidural in place just after midnight, and made a comfort adjustment to another put in by a colleague earlier in the day. I retired to the call room for my usual fitful, restless sleep. I tossed this way and that until 0640, having been left undisturbed by the nursing staff, God bless ‘em. The overheated room and unfamiliar bed were disturbance enough!
Aaron relieved me for the day at 0650. Those ten minutes are a kindness. Thanks Aaron!
One of my patients delivered just before I got up. Mother and baby are both well. We don’t usually get called when a delivery happens, unless there are problems we can fix. At that point, it’s a three-way effort between mother, obstetrical nurse, and obstetrician. The soon-to-be-new citizen has a say also, of course. The OB nurse turns off the epidural pump a few minutes after the baby is born, and removes the epidural catheter shortly thereafter. Worst part about that is removing the tape from Mom’s back that secures the catheter in place. I warn all of my laboring patients that they will curse my name during tape removal. If a little tape is good, more is better; I’d use duct tape if they’d let me, rather than have to replace an epidural at oh-dark-thirty because it wasn’t properly taped in place.
Always feels good to get in the car for home after a call shift. The drives gives time to decompress and reflect — an internal after-action report. There were no disasters to ponder on this ride, just the donut shop to find. It’s right on the way home, and not to be resisted on a beautiful Saturday morning.
As I feared it might, my 8-to-12-hour shift on the OB deck has turned into a 24. Making the best of it, though my current state of boredom beggars description.
I even went to the car, retrieved the Superwide, and shot some mostly execrable photographs around the hospital. After checking with the OB nurses to make sure nothing evil was stirring, of course. There are some columns along the patient pick-up/drop-off driveway with interesting late-day light playing on them. And from my call room, albeit through filthy, sealed windows (call rooms always bring to mind a third-world prison cell), there is some lovely, gleaming HVAC stuff out on the gravel roof: pipes, ductwork, rust stains, and the like. Eye candy for the bored photographer otherwise bereft of time, or inspiration.
It’s a breezy, warm, dry day in Denver, with a beautiful blue sky. A good night to be drinking wine on my balcony while we watch the joggers, cyclists, and dog-walkers go by on their way to the park.
I was a last-minute substitute on the OB deck today. The regularly-scheduled anesthesiologist was pulled away with several others for a liver transplant, so I got the nod. Not a huge deal, but I was sorta mentally ready for that balcony, and that wine.
I was originally scheduled today to do a couple of spine cases at one of our hospitals where I normally spend very little time, though it’s technically within my call “pod” region here. I got a text at 11 pm last night that re-shuffled today’s OR personnel in order to cover a specialized case that was added. So I was pulled back to the OB suite I usually cover, at a different hospital, to free up someone for the add-on. This was a relief for several reasons.
First, the substitute place is much closer to home. The nursing staff and obstetricians I work with are really chill and pleasant people, and I like the work itself. I know where everything is, so every case doesn’t seem like a burglary, with me rifling through drawers to find drugs and supplies.
But mainly it’s because, at the other place, I’m pretty sure I’d have been getting my balls broken by the nursing staff over something or other from the moment I set foot on the OR floor. It’s just how they seem to roll there.
Under pressure from government and 3rd-party payers, hospitals are focusing intensely on trying to further reduce the incidence of perioperative infections, which stubbornly persist in the single digits despite everything we’ve tried. Infections are costly, both in dollars and in lives, and reducing them is a worthy goal. But it’s become a point of contention between nursing, administration, and medical staff. A cynic or paranoid would suspect there are elements of a power struggle involved. But I’m Polly-Effing-Anna, so I’d never think such a thing.
Here’s a for-instance. They don’t like cloth scrub caps, because they’ve convinced themselves (based upon no evidence, and contrary to the little good evidence that does exist) that cloth surgical caps are more likely to be associated with infections. Never mind that a recent, well-conducted study debunked this notion pretty thoroughly. I can be assured that if I wear my favorite LSU cloth scrub cap, I’m going to get grief for grief’s sake from some functionary.
They also insist that we wear long-sleeved scrub “jackets” over our scrubs to cover our arms while in the OR, because they’re convinced themselves and the administration that all of the skin flakes cascading off of everyone’s bare arms are the cause of infections – again, an evidence-light assertion, but a convenient cudgel to wield against the medical staff. Nonetheless, because I’m perhaps the consummate Team Player, I told them I’d be happy to wear a jacket, but not to bring me one that’s two sizes too small. I also suggested, perhaps bitingly, that before implementing such a policy, they might have made sure to provide the means for compliance – like, say, stocking an adequate supply of jackets sized for those of us who aren’t wraiths.
Sadly, there’s a lot of this kind of low-grade aggravation besetting the practice of medicine, like a cloud of mosquitoes constantly biting the tender flesh around one’s ankles. It strikes many of us docs as pointless gamesmanship and dominance-seeking behavior, especially galling because there’s generally no scientific basis for any of it. I suppose every job has similar annoyances. Sucking it up and trying to keep my tongue in check is all I guess I can do.
I’ve not been a recent country-music fan, with the watery, overproduced Nash Vegas quasi-pop that now befouls the genre. But I grew up listening to old-skool C&W in the car with Dad: the likes of Lefty Frizzel, Faron Young, Jim Reeves, Charley Pride, and – of course – Merle Haggard. So when I heard Merle’s plaintive baritone atop the twang of a Telecaster, memories flooded back. Mama Tried became the song I can’t get out of my head.
Now I’m hooked. Merle led me to the Bakersfield Sound. I’d heard the term before, but didn’t know what it meant. It was developed in the 1950’s, by Buck Owens and a few others, from the music the Okies brought with them to California during the Depression, as they fled the Dust Bowl for work out West. Haggard and a handful of colleagues chipped in to help put it on the map. It’s a stripped-down, clean sound that was expressly a reaction to the over-orchestrated stuff that Nashville was putting out. Just a clear voice like Merle’s or Buck’s, with a soft drum keeping time, a Telecaster for punctuation, and maybe an acoustic guitar providing a rhythm line. Quintessentially American.
I’ve also revisited a few of Dad’s favorites, among those I mentioned above. And I found one or two I’d never heard of before – like Gary Stewart, with his high, almost falsetto, vibrato, King of the Honkeytonks. My wife, who as far as I know does not read this blog, would be happy to know he was born in Letcher County, Kentucky.
I have something like 40 songs on a Spotify playlist, which have been in continuous rotation in the car for a week or so. I give it another few weeks, then I’ll be on to the next thing. But those sweet Telecaster licks from Mama Tried will be harder to expunge.
It’s been one of those days where I take 2 steps forward, then 3 back. Lots of waiting around for a relatively small amount of doing stuff. Finally slouching towards the end of it, with no casualties.
My first case, scheduled for 8:15 a.m., cancelled before I’d even gotten out of bed. That text message arrived simultaneous with my alarm; a return to sleep was not going to happen. I made my own coffee and breakfast at home – an unusual occurrence on a workday – and plunged into I-25 commuter traffic. Not a cloud in the sky; I let a woman merge ahead of me and she even waved thanks at me! There’s a portent for the day! Not once did anyone flip me off during my 30-minute commute.
Three cases for sedation for chronic-pain procedures followed at one of our surgery centers. Then a hurried flight to the next hospital to be on time for a 1:45 pm case. That the surgeon cancelled, reason unstated, after I’d waited nearly an hour to start it. The patient had been waiting, alone, in a cold pre-op room, even longer than that. Grrrr. Not cool. One can’t take basic human courtesy for granted, even (especially?) among the highly educated.
Next, a GYN add-on had my name on it. Ruptured ovarian cyst in a young woman, presenting with severe abdominal pain. It took two hours for her to get from the gynecologist’s office to the hospital, and negotiate the admitting bureaucracy to arrive on our pre-op unit. We had her ready for the OR in something like 20 minutes. People respond to incentives; admitting’s was to get to the end of their shift without overwork, while mine was to finish this case and go home.
The plan was to examine the cyst through the laparoscope, and hopefully remove it while preserving the ovary containing it. She had a pelvis full of clotted blood – blood is highly irritating, and that explained her pain. She’s about my daughter’s age, so I took a paternal interest in her welfare. Her parents are en route from out of state, and I know how I’d feel in their shoes. We were able to do as planned for her, and I dropped her off in the recovery room in better shape than when I met her.
This day was like most of my days: a lot of waiting around, with a lot of ordinary, non-dramatic workaday stuff in between. Not super exciting; but when my day is exciting, it’s usually for the wrong reasons. I can deal with going home bored.