Unsuffer This

January 31, 2010

(click for song):          Trouble

“I’m sorry to wake you, doctor, but we can’t find the heartbeat.  Can you come?”

“What heartbeat?  Ms. Evans delivered at five o’clock.  I don’t have anyone else in labor.”

“She’s here for a scheduled section, doctor.  I know she’s not yours, but can you please come?”

“Yes.  Of course.”  I looked at the clock next to my bed in the call room.  It was 6:35AM.  I had dropped like a doll on top of the blankets an hour earlier without even changing out of my scrubs.  I was exhausted, and had hoped to sleep until my replacement arrived at eight o’clock.

I turned on the light, splashed some water on my face, noticed my red eyes and bed hair in the mirror, let a twitch of self-conscious worry about looking professional seize me, smoothed my hair once, and then shuffled quickly out to the labor and delivery unit.

Rachel, who had teased me earlier by threatening to page me five minutes after I fell asleep, intercepted me at the doorway looking miserable and slightly scared.  “Sorry, Nick.  This is a 39 week nullip here for a scheduled c-section for placenta previa.  Hasn’t felt the baby move for 2 days.  Didn’t realize she should call.   Linda’s been all over her belly with the Doppler.  I checked it while she was calling you.  Nothing.  We thought you could take a look with the ultrasound.  I hope you don’t mind.  She knows something’s up – I didn’t want her to wait.”

I nodded, grabbed the little cart with the ultrasound on it, and wheeled it into the recovery room.  This young woman was here to have her first baby, was scheduled to have a caesarian section one week before the due date.  The placenta, which is like a tangle of roots and soil from which sprouts the umbilical cord and which normally attaches to the side wall of the uterus, covered instead the opening of this woman’s uterus.  If she were to labor normally, her dilating cervix could make her hemorrhage.  Statistically, 39 weeks is the time when babies are least likely to suffer complications, so here she was waiting today for my incoming colleague to give her a c-section.  Formal ultrasounds are done in the radiology department, but we kept a little machine in labor and delivery to confirm things like fluid levels and the positions of babies’ heads.

I opened the curtain to find a young Latina woman in the bed, johnnie lifted to reveal the large bulb of her abdomen.  Her face was heart-shaped, with a jutting chin.  Her long black hair was mostly gathered inside of a blue lunch-lady surgical cap, with one wisp stuck to her damp cheek.  Her eyes were dry, now, but clearly puffy from crying.  She stared intently into the eyes of the young man who knelt on the floor with his elbows wedged under his chest on the bed next to her pillow.  His two hands cradled one of hers, his stubby fingers interlaced with hers, stroking her hand with one thumb rhythmically, as he would a rosary.

“Hola,” I said, in my best calm, avuncular tone, and plugged the machine into the wall behind them.  They looked at me expectantly.  Pleadingly, or perhaps I imagined this.  “Yo soy Doctor Mayper.  ¿Español es mejor?  ¿Engles?”  I’m Doctor Mayper.  Is Spanish better?  English?

“Español,” said the young man.  Spanish.

So, in clumsy Spanish, I told them what they already clearly knew.  That the nurses were having a hard time finding the baby’s heartbeat, and that I was there to take a look with the ultrasound.  I felt relieved when they both continued to look worried as I set up, because that meant they probably did not hold false optimism.  Sometimes a new nurse like Linda might misjudge something like a fetal heart beat, but Rachel was a skilled and experienced charge nurse whom I trusted.  If she hadn’t been able to find a heartbeat, then there was probably no heartbeat to find.

I sat on the edge of the bed and turned the machine on.  Linda, a young blonde-haired woman with freckles and an upturned nose, whom I had vaguely dismissed during the few months she had worked here, hovered at the side of the monitor, fidgeting.  Rachel, an African-American woman in her late 30s with hair so straight that I wondered if she ironed it, a nurse both competent and so funny that I wished I could arrange my schedule to take call only when she would be the night nurse in charge, hung back frowning, arms crossed, rocking back and forth unconsciously.

As the monitor warmed up, I asked the couple their names.  Luz Martinez.  Jose Salvador.  I squirted the cold blue gel onto the flat tip of the ultrasound probe.  Adjusted the monitor so that we could all see, and pressed the probe against her belly.

Shadows and fuzzy gray lines played on the monitor, splitting and coalescing like a grainy black and white kaleidoscope until I got my bearings.  There the spine, looking like the crossties of a train track.  There the balloon of the skull.  Slide the tip of the probe over, as if massaging her belly.  The face with its dark eye sockets.  Slide the probe up.  That’s the abdomen.  Back toward the skull.  Back down.  Back and forth.  Narrow in on the chest, a sinking sensation in my own at the lack of a butterfly heartbeat.

My eyes, which had darted back and forth between Luz’s belly and the monitor screen as I got my bearings, now stayed fixed on the screen.  The back and forth sweeps of the probe shrank to tiny scooping arcs, as if it were a spoon and I were using it to scoop a beating heart from the bottom of a bowl of soup.

With each adjustment it became more obvious that this baby’s heart had stopped fluttering.  The monitor blurred and swam briefly as I blinked away tears.  There.  That’s two, four chambers.  Try another angle.  Yes.  Another angle.  My world had shrunk to this staticky image on a screen, of a heart that would not beat, in a shadowy body that floated passively as its mothers breathing turned to sobs, bobbing up and down like a corpse floating next to a wharf at high tide.

Not “like” a corpse.  A corpse.

My vision grew watery again.  As I stared at this calm, still heart, my head swam and my heart raced.  I looked at Luz, then Jose, as if seeing them for the first time.  Luz had covered her face with her free hand.  Tears crawled down Jose’s cheeks.  He clutched her hand to his mouth, squeezing it, his hands pressed close as if in prayer, staring at the screen.

I lifted the probe from her skin in defeat.  “Lo siento,” I said.  I’m sorry.  Gel lay smeared on her belly, heaped at the sides like plowed snow.  She peeked over her hand at the monitor, which of course now showed only static.  Her face folded at the sight as if in anger, then she clawed at her forehead with her fingers, pounded her eyes with her hand, and sobbed deep, gasping, gulping sobs.

Still holding the probe uselessly in my hand, tears now pouring out of me, I looked to Jose.  He still clutched her hand, but had moved it with his, pressed his thumbs against his forehead and rocked back and forth tapping against them as if in gentle mimicry of Luz’ pounding.


After the c-section I hung around to interpret.  The hospital has professional Spanish language interpreters, but the visitations of medical professionals kept leaving Luz and Jose with unanswered questions.  So I appointed myself general liaison from the arcane country of medicine.  I had no other responsibilities, and could afford to sit the whole morning with them after the c-section.  To be honest, I was there also because I couldn’t figure out how to cope with this horror.  It was a relief to find something useful to do.

I had scrubbed in for the c-section, as first assistant to my colleague Jean Baptiste.  Dr. Jean, as most people called him.  The boom box that usually sprinkles the room with quiet music during operations lay silent.   Words were scarce – just the bare minimum needed to keep the correct instruments flowing into and out of the operating field.  Luz’s body was covered with a sterile blue drape, With a circular window open in the middle to reveal her lower abdomen.   It inflected at her chest, and soared up like curtains to clamps a couple of feet above her body, hiding her face and head from our view.  Jose sat, wearing a yellow hospital gown and his own lunch lady hat, behind the curtain to be with Luz.  She was awake the whole time, of course, spinal block numbing her body from ribs to toes.

The baby was a little bit stiff as he came out.  Dr. Jean nodded to me as he cut the cord, and I lay the baby in the blanket held by the pediatric nurse behind me.  It felt surreal, this ritual performed every day with babies floppy or crying, now steeped in silence.  As the nurse swaddled him, I turned to Luz and Jose.  “Baron,” I said.  Boy.  Instantly I regretted the word, spoken out of habit.  How could this matter to them?  But, oddly, a small smile flickered on each of their faces before the deluge of grief returned.

The pediatric nurse brought their son to Luz, and held him close to her face.  Luz kissed his thick black hair, her eyes tightly closed with tears somehow escaping anyway.  The nurse gestured to Jose.  Did he want to hold the baby?  He opened his arms uncertainly, took the swaddled, lifeless body, then clutched his son to his chest and closed his eyes.  Rocked back and forth a little.  Softly murmured, “mi hijo, mi hijo.”  My son, my son.

The baby’s face was tinged, mottled with purple and red, and a little bit puffy.  As Luz had kissed him I had felt thankful that his skull hadn’t started to soften yet.  Sometimes, when the baby has died a long time before delivery, we need to wrap him or her carefully in a damp blanket, only the face exposed, the gelatinous head buried in folds of cloth.

His puffy face pinched his eyelids closed, as if he were trying to ignore us, as if in imitation of his parents’ expressions.  He had felt warm – a last gift from his mother – but stiffer than a living baby.  I couldn’t decide which was more disturbing – the warmth or the stiffness.  I had quickly checked his neck, his cord, scanned his body, but saw no sign of why he had died.  The placenta was normal, the amniotic fluid clear.  I wished he would look peaceful, but instead his puffy eyelids made him look vaguely annoyed.


As Luz was being cleaned and brought to the recovery room, I sat with Jose in a small side room and asked if he had any questions.

He asked, “¿Mi hijo… sufrió?” Did my son suffer?

I froze a split second longer than I would have wanted to.  Of course there is only one correct answer to that question.  “No,” I said.  I could imagine agonizing suffocation, pain incomprehensible to such a young, tiny person.  Such thoughts torture me sometimes.  But I could know nothing for certain, and my responsibility was to the living.

He looked at me.  “¿No cree que sufrió?”  You don’t think he suffered?

I pursed my lips, raised my eyebrows.  Closed my eyes to try to banish my own demon thoughts.  Shook my head gently.  Looked back at him.  “Se fue a dormir.”  He went to sleep.

Jose clutched his face, bowed his head and sobbed audibly.  I had not seen him allow such expression in front of Luz.  I reached out and patted his shoulder, crying again myself, thinking guiltily of my own three living sons.  He shuddered a little and shook his head.  I withdrew my hand.  Then, twisting in his chair away from me towards the wall, he let escape the same deep, gasping, gulping wail that had erupted from Luz earlier when she saw the blank ultrasound screen.

I sat with them, first in the recovery room where nurses came and went carrying sad faces, then in the postpartum bedroom where the nurse visits were interspersed with concerned specialists wanting to impart information, ask preferences, get signatures on permission forms.  The three of us had never met before that morning, but every time I asked if they wanted privacy they seemed sincere in their reassurances that they were happy I could stay.  When we were alone, I mostly sat in the corner chair, gazing out the window and looking back at them occasionally, wondering if I had betrayed Jose by covering up my nightmare fantasies about how their son had died.

They had to make decisions, the biggest of which was whether they wanted an autopsy.  The neonatologist, the head of the special care nursery, the chief pathologist, even the geneticist (who happened to be in the hospital for a meeting with the pathologist that day) all came to speak in somber but urgent tones about the benefits for future pregnancies, future babies, if Luz and Jose were to be able to understand what had happened this time.  No need to decide now, they were told, but the clock is ticking so please tell us as soon as you make your decision.  We’re so sorry.  We know this is a difficult time.

Then the specialists would leave, nodding at me, thanking me for interpreting, and Luz – usually Luz, except when she would nod at Jose as if to tell him it was his turn to ask something – would ask what felt like the important questions.

“¿Tienen que cortar a abrir su cuerpo?”  Do they have to cut him to open his body?

“Si.” Yes.

“¿Se lo puso de nuevo juntos después?”  Do they put him back together afterwards?


“¿Está seguro de que no se sentirá ningún dolor?”  Are you sure he won’t feel any pain?

“Si, lo prometo.”  Yes, I promise.  “Nunca se sentirá dolor.  Nunca.  Sé que estos médicos y que se amable y respetuoso.  Quiero confiar en ellos con mi bebé.”  He will never feel pain.   Never.  I know these doctors, and they will be gentle and respectful.  I would trust them with my baby.

This was all true.  I felt relieved to be able to say such honest reassuring things.

“Doctor,” Jose said after a long silence.  “Diganos lo que haría.”  Doctor, tell us what you would do.

“Esta decision tiene que venir del corazón.  Yo vivo en este mundo de la medicina, y no se puede imaginar a lo que la vida fuera de la que es.  Sin embargo, una autopsia puede ser la única forma de descubrir algo que podemos hacer para proteger a sus futuros bebés.”  This decision must come from your hearts.  I live in this world of medicine, and can’t imagine anymore what life outside of it is like.  But an autopsy may be the only way to discover something that we could do to protect your future babies.

“Gracias, doctor.  Mi esposa y yo quiero estar sola ahora.”  Thank you, doctor.  My wife and I would like to be alone now.


I visited them twice more during her stay, but the next time I visited the hospital they had already gone home.  I called Rachel – the first time she and I had spoken outside of work – and she told me they were planning to move back to Colombia as soon as Luz could safely travel.  They had asked to have the autopsy, and had arranged then for the body to be flown to their home in Colombia for the funeral.

I asked if she knew what they had named him?

Jesús, she said.  Jesús Salvador Martinez.


It was the following Sunday when I paid a visit to an ordinary-looking, white split-level ranch house next to the bay.  The house, which belonged to Jose’s uncle and aunt, was immaculately painted, the grass trimmed, small green shoots emerging from a garden plot in the side yard.  A pale blue boat resting on its trailer in the driveway.   A metal Christian fish ornament sticking to the rear of the pickup truck parked on the street.

Jose came out as I parked my car behind the pickup truck.  He waited at the bottom of the driveway as I walked down, then gave me a beatific smile as he took my hand in both of his and held it.  The bizarre thought that he was about to kiss me flashed through my mind, but he just nodded his head as he stared at my face.  My heart sank as I looked into the eyes of this handsome, poised young man who deserve so much to be gripping a baby boy in these hands, lifting him up against the clear sky in this warm spring air and listening to his squeals of joy.  But still Jose smiled.

He brought me past the garden plot to the back patio that overlooked the bay.  There Luz sat, like a queen in a white wicker chair, facing away from the late morning sun, strands of hair floating here and there in the breeze, wearing a pale nightgown and a peaceful smile.

“Muchas gracias por venir, doctor.  Significa mucho para nosotros.”  Thank you so much for coming, doctor.  It means so much to us.

I smiled for the first time, very slightly.  “De nada.  Tuve el honor que me invitara.  ¿Cómo se siente?”  It’s nothing.  I was honored that you would invite me.  How are you feeling?

I paused, horror stricken again at my mental image of her baby strangling inside of her, wondering how I would have felt about seeing the personification of my son’s death walk towards me on that patio.  I shook my head to clear it, smiled again, and said, “No solo su alma, quiero decir.  Espero que su cuerpo se está recuperando, también.”  Not just your soul, I mean.  I hope your body is recovering, too.

She nodded, her face returning to neutral.  Jose anxiously showed me to the chair he hoped I would sit in, so I gave her my painstakingly written condolence card and the white rose I carried for her, and sat.  We spoke of life in Colombia, of our frustration that the autopsy would likely reveal nothing, of my heartfelt respect for them as people.  They had been gracious to everyone, had let themselves feel the pain, yet had not seemed to let it ferment into poison.  They seemed to have no need to find a scapegoat.  I half wished they would have chosen me as a scapegoat, because then I could focus on that rather than the incomprehensible truth that had brought us together.

The visit ended pleasantly, and a little distantly.  Conversation lagged, I told her I hoped she could rest, and said I should go, implying prior engagement.  Jose quickly asked if he could show me something first.  Of course.  I held Luz’s hand in both of mine, wished her strength and peace and a happy life, then let Jose lead me along the rocky edge of the bay to a nearby pier.  Next to the pier a boulder jutted from the ground, newly chiseled rectangle holding a metal plaque.

The plaque read, in English:

Jesús Salvador Martinez

Born April 16, 2006

Died April 14, 2006

These were the dates written on the birth certificate and the death certificate that I had had to sign, one after the other, the previous week.

“Mi tía y el tío quería ser capaz de visitario.  Pensamos que tal vez usted querría eso.  Usted es bienvenido aquí en cualquier momento.  En cualquier momento.”  My aunt and uncle wanted to be able to visit him.  We thought maybe you would want that, too.  You are welcome here anytime.  Anytime.

He reached out with his hand to hold my shoulder the way I had tried to hold his back in the small conference room on that terrible morning.  He kept it there on our walk back to the house.


This Poem Is Much Funnier To Listen To Than To Read

January 30, 2010
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Billy Collins, off of Garrison Keillor’s compilation English Majors

The Lanyard

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Song of the Day — The Puppini Sisters

January 30, 2010
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Let’s keep going with the cover songs.  Let’s see… We’ve done Appalachian hip hop.  Early Joni Mitchell rap.  How about Andrews Sisters impersonators go disco?

I Will Survive

I’ll throw in the impersonators (named The Puppini Sisters) version of the Andrews Sisters biggest hit:

Boogie Woogie Bugle Boy (of Company B)

These are off of the album Betcha Bottom Dollar

Soft, Gentle Song of the Day — Nina Gordon

January 29, 2010
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Not everything I listen to these days has a beat to it.  Here is a lovely cover of a sweet, touchy-feely ditty originally recorded by Ice Cube with N.W.A.

Straight Out of Compton

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Song of the Day — Alabama 3

January 29, 2010
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This is my very favorite blend of country, acid house, blues and a little bit of gospel.  Alabama 3, which of course is 9 British guys wearing aliases, also goes by the name A3 here in the U.S.  They started out as The First Presleyterian Church of Elvis the Divine (UK).

Anyone who does not own their entire debut album, Exile On Coldharbor Lane, has about an hour of music in your future that you might just decide deserves some infinite repeating.

U Don’t Dance 2 Tekno Anymore

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Meager Postings

January 29, 2010

Real life sometimes interferes with important things like daily blog entries. It’s hard to reconcile the goal of posting daily with the goal of posting things with at least the quality of a second draft.

I have a few ideas competing for attention now. Ultimately, what interests me is most likely to be what works for you, too. I’m curious, though, if anyone has preferences:

*Plenty of birth stories wouldn’t mind being pushed out. Unfortunately, the ones most on my mind are the ones that haunt me. Babies die sometimes, and when they do it is every more overwhelmingly sad that I could have imagined.  Thing is, when I start talking about this people get uncomfortable.  So I keep it to myself.  But it never goes away.

*Grownups die too. Some of them are cool people who deserve a little cyberimmortality.

*Funny only happens in the moment. I’ll keep a lookout for those moments, and grab them when they float by.

*I like posting music. Has anyone tried to listen? I don’t care if you like it — I just want to know if you can hear it.

Well, I guess I hope you like it, too.

Check in this weekend. Something will be here.

Posted in General

This blog still runs on gasoline

January 28, 2010

I got an email this morning ordering me to cease and desist with all the explanations and requests for feedback. Sigh. I agree that they gum up the engine, and I’ll try to hold back.

A startlingly large number of you HAVE sent messages. Some via email, a lot on Facebook, a few here. Even a graffito burned into the side of the Millenium Falcon with a light saber. (I won’t name names, except to say that that one was written by Taejoon Ahn, UCSF Medical School class of 1997).

But the engine that runs this blog is hybrid, not electric. Someday I’ll be able to trade it in for one that can plug into my own domestic power supply for all of its energy needs. But feedback from friends, strangers, and even former friends whom I haven’t told yet to go away I have new friends now — this is the gasoline that makes writing fun.

Posted in Administrative

Kitty Cats and Hot Dogs

January 27, 2010

The vast majority of Americans spend a lifetime attached to their genitalia.  We think of these organs as urban dwellers who live in crowded neighborhoods.  The Boxer Tenements.  The Panty Projects.  The G-string Ghetto.  But really, our genitals spend a lot of time traveling.  We stuff them into our emotional baggage.  They lead us on crazy treasure hunts.  They fly with us on our guilt trips.

For those not fortunate enough to have lived with adolescent children, I have this message: Don’t Worry.  Your genitals may already be giving you the impatience, excitement, panic, pouting and raw confusion that you would hope for from your very own real teenager!  What’s more, a real teenager occasionally evolves into an adult and leaves home, but your genitals are attached to you at the hip!  Or, rather, between the hips.  I’m a doctor.  I should remember such details.

As a family doctor, in fact, I spend a surprising amount of time on the care and maintenance of genitalia.

These volatile teenagers between our legs don’t just keep us awake at night,

they don’t just want to make friends with all the wrong people,

they don’t just spend all morning sleeping when we would like for them to wake up and help,

they don’t just make messes then go to sleep, leaving us to clean up,

they don’t just embarrass us in public, with their jumping up and down and their sometimes wacky hairstyles.

They also get sick sometimes.  That’s where I get involved.

Well, to be honest, usually my involvement is more the equivalent of a well teen visit or a physical exam for school.  Lots of screening for cancer — of the cervix, the testicles, the prostate, the uterus.  Lots of talking to you about how to keep your permanent adolescent partner healthy.  Lots of mundane tests and treatments for the genital equivalent of colds and flus.  Most of the rest involves either supporting you in the process of delivering a real, detachable future adolescent, or helping to revive old Jumpin’ Jack.

Sometimes people come to me with wild problems or worries.  I’m not going to write about truly terrible or disturbing things here.  Those I usually need to refer anyway, to a blessed gynecologist or urologist who has the skills my patient needs.  But people find themselves in predicaments, or else wind up revealing more about themselves than they had intended.


Before this story, I have one anecdote more about a colleague than about his patient.  This colleague is a gynecologist who once told us of a patient of his who had shaved her pubic hair into the shape of a Christmas tree.

His main concern, when he told us about it?  “That young woman has WAY too much time on her hands.  I told her she should find a hobby, like macramé.”


For instance, many years ago, when I was a medical student, I “shadowed” a gynecologist, Dr. Huang, in his private practice in the tony neighborhood of Pacific Heights, in San Francisco.  “Shadowing” means that I tagged along while he saw patients, which can be a frustrating experience for male medical students because many women understandably would rather not have some guy in there gawking at them.  The first patient scheduled one morning was a middle-aged Japanese-American woman, Ms. Okada, who was there for a routine Pap smear.

As I walked in, I felt inordinately grateful to her for allowing me to watch such an intimate exam.  Then, when Dr. Huang lifted the sheet to begin, I couldn’t help staring.  Not at her genitals, though.  At her tattoo.

There, hovering just above her pubic hair, with slightly blurred borders on one side as if it had been skywritten above a forested hill, was written these words:  “Carl’s pussy”.

Carl’s pussy.  Dr. Huang, usually the most stoic of guys, paused.  He asked, “Who’s Carl?”

“Old boyfriend,” she answered in a flat voice.  She didn’t lift her head to look at us.  Silence returned.

Dr. Huang picked up the speculum from the warmer, then paused again.  “Had trouble remembering where it was, did he?”

There was the briefest of pauses, but just as my stomach began to drop with embarrassment for him, Ms. Okada grabbed her knees and sat up, her chest and face silently shaking.  She was laughing.  She tried to speak, but just then a tiny spurt of urine shot out and hit the speculum.  Her face, already deep red, started to shift to an expression of mortification, then almost immediately collapsed back into even stronger laughter.

Dr. Huang allowed himself a tight smile and small chuckle, then dropped the speculum into the trash can and reached for another.  Finally Ms. Okada regained her voice.

“I’m sorry,” she said.

“Not at all,” he responded.  “Do you often lose urine like that?  Maybe I can help.”

She ignored his question.  “Do you know, doctor, how many times I’ve been asked about that stupid tattoo?”  She pronounced it stee-YEW-pid.

“I can refer you to a dermatologist for laser treatment if you want me to,” he said.

Again, she ignored him.  “But I have never…”  She briefly shook again with laughter, and I noticed another brief smile flash from Dr. Huang.  “I have never… It’s just…”  She looked vaguely puzzled.  “He was adorable, actually.  It’s just that he was…  He was…”  She laughed again, but managed to finish with sort of a high pitched squeal.  “He… was… so… STUPID!”

When she stopped laughing again, she opened the top of the sheet and looked down at her tattoo.  “I thought I loved him.  He was not an intelligent man.  But I was young.”  She lifted her head and looked straight at me.  “Young is as bad as stupid.  Remember that.”

Posted in Funny/Odd, Medical
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Hold, please

January 27, 2010
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This is a brief pause to recover from my call night last night, and to do administrative work on the site.

I’ll try to finish a VERY inappropriate post later this afternoon that I hope is funny.

In the meantime, because it is Inappropriate Day, listen to Queen (this is a single-entendre gift for Chip Hourihan):

Body Language

and my favorite Snoop Dogg cover:

Gin and Juice

OK, fine, it’s the only Snoop Dogg cover I know.

Will someone please let me know whether these song transfers work? The point is for you to listen, not to click on a dead link.

(Here’s the original version, for those who want to learn how great the Gourds’ cover is:

Gin and Juice — original)

Enough about contractions. Time for a retraction.

January 26, 2010
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The little embellishments in these mostly true stories don’t bother me.  Ted did not arrive to greet Henry with a shaved head and rat skull earring.  Noel did not meet Una until 1950.  Veronica had no rhinestone-crusted cellphone.

My mom, however, helped me see that a line about her father in Lost and Found was both sloppy writing and, more importantly, “a little brutal.”

Spot on, mama.   A troubled man who tried his best deserves more respect from the grandson who never knew him.  The line is now changed.  Your other stylistic suggestions I will use for a later edit.

With or without your permission I’d like to copy the haunting Robert Hayden poem you included in your email:

Sundays too my father got up early
and put his clothes on in the blueblack cold,
then with cracked hands that ached
from labor in the weekday weather made
banked fires blaze. No one ever thanked him.

I’d wake and hear the cold splintering, breaking.
When the rooms were warm, he’d call,
and slowly I would rise and dress,
fearing the chronic angers of that house,

speaking indifferently to him,
who had driven out the cold
and polished my good shoes as well.
What did I know, what did I know
of love’s austere and lonely offices?

I love you, mama.

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