Nickolepsy

Nichols and May Examine Doctors

October 31, 2010
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When I graduated from medical school, my parents surprised me with a record album they had been keeping hidden for years: “Nichols and May Examine Doctors”.  It was recorded in 1960, so I expected the humor to be moldy with archaic assumptions about doctors and nurses and psychoanalysts and gender roles.  Though the jokes do depend on these assumptions, this is still, in 2010, the funniest bunch of sketches I can think of.  Mike Nichols (maybe best known for directing The Graduate) and Elaine May (best known, unfortunately, as writer and director of Ishtar) give us the audio equivalents of great New Yorker cartoons.  Their humor is so dry that it can take a moment to get the joke.  Once you’re clued in, you hang on every pause and every mumbled word, you suppress your laughter to avoid missing anything, and bounce in anticipation of inflicting this on your friends.  As I am bouncing now.

Empty your bladder first.  Here’s a taste.  This one starts slowly — stick with it.

A Little More Gauze

Here’s a psychoanalysis sketch.    It might be wasted on anyone under 40, but I love it and I don’t care.

Merry Christmas, Doctor

Here’s a psychoanalysis/hiccup sketch that only they could make work, and which makes me so very happy.

Interrupted Hour

I wish this were outdated.  I’m afraid it’s only exaggerated:

Calling Dr. Marx

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More Band Names (see June 5 for the first list)

October 30, 2010
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We saw Walter Sickert and The Army of Broken Toys last night in downtown Salem, MA.  They were great fun — a perfect fit with the general Rocky Horror/Jesus Saves ambience of Salem in October.  They were a motley group that wandered on and off of the stage, including a nun who handed out condoms (and carried a hole puncher in case anyone wanted their condom to be “Catholic Church approved”), a bow-tied, mustachioed string section that played GREAT pizzicato, and the massive, dreadlocked Walter Sickert, who seemed like the reincarnation of Jim Morrison, only sharp witted and rooted to his seat.

The band name works, but we thought we could do better.  Thank god for the good Czech beer they serve at Gulu Gulu.  Here is the best of what we came up with:

 

I Don’t Know Anyone Here — Can We Leave?

Your Father Was Right

B-Plus?  B-Fucking-Plus?

No, Really, It Doesn’t Make You Look Fat

It’s Not You.  It’s Me.

The…  Um…

I’ll Have $12 Worth Of Regular, Please

leave it.  LEAVE it.

Oh, God.  I’m Going To Vomit

I Forgot To Wipe

Full Frontal New Ditties (this, after one of the band members danced her way out of her dress.)

Size Doesn’t Matter

The Catholic Church Approved Condoms

I Just Need Some Percocet.

No More Injections

The Burnt-Out Night Nurses

Midwest Regional Association

Your Turn To Change The Diaper.

My Urine Bag Is Almost Full.

 


Posted in Funny/Odd

Song of the Day — Peter Gabriel

October 28, 2010
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We all open our hearts from time to time.  We fall in love.  We try horseback riding.  We reconnect with old friends.  We rediscover an old favorite song.

Keeping our hearts open is much more problematic.  We get hurt, we get bored, the intensity is too much, we’re attacked by shame… whatever.  Inevitably we find some reason to close the door.  As if this self-generated anesthesia were part of the rhythm that keeps us alive.  As if the wounds that we use to justify our withdrawal really were life-threatening.

Irene thinks that keeping my heart open is possible.  I begin to agree.  We talk about this on an emotional level, and sometimes on a spiritual level.  But it’s also true on a physical level — in my animal heart, as one set of valves closes, the other always opens.  Blood leaves through one set of doors, and returns through the other.

Irene also helps me remember another first-year medical student lesson:  the heart is not in the brain.  It’s in the body.  I should know that.  Often, it’s not until after I have laid hands on my patients that they tell me what they really came to see me for.  With that physical connection — with that safe and reassuring pressure of my stethoscope on my patient’s chest as I listen to the heart beating — the door opens and the important work begins.

This song is for Irene.

I Have The Touch


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Songs of the Day — The Flamingos and Neko Case

October 17, 2010
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These songs call to each other:

 

I Only Have Eyes For You

No Need To Cry

 

Jeez, get a room wouldja?


Song of the Day — Ray

October 17, 2010
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I keep humming this.  It’s from a TED lecture by Ze Frank.  I will hum this SO MANY TIMES this week.  Thanks to my oldest friend in the world for sending it to me.

(He’s not THAT old.  Just older than I am.  When we first met, in 1965, though, he was almost twice my age.  I guess that’s pretty damned old.)

Whip

Hi, David.


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Song of the Day — Mark Sandman

October 13, 2010
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Last weekend was sunny.  Warm.  Perfect.

Except in my head.  In my head it snowed.   Like this:

Snow

The song is not depressing.  It’s calm.  Mark Sandman died of a heart attack when he was my age.  That’s depressing.  He left SO MUCH great music.  That’s… That’s a goal worth shooting for.  Not the music, necessarily, but something that a stranger might appreciate after I die.  That seems unlikely — but would be impossible if I stop writing and publishing.

It’s not that that sort of legacy is more important than personally influencing peoples’ lives.  It’s not.  That solo, personal interaction is the only way to leave a deep mark on someone.  If my life has meaning, it is meaning built around that sort of personal influence.  What, then, is so attractive about the idea of some stranger someday reading my words (or whatever the hell I’ve left that could be worth looking at)?

I don’t know.  However undeep, I’d love to reach from beyond that veil and calm someone the way Mark Sandman calmed me this weekend.  Take a simple image, a simple mood.  Play with it, lay it out, adorn it minimally, and maybe then someday a melancholy man will play it over and over in his head until his heartbeat matches mine and he can breathe again.


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The Assent Of Man

October 12, 2010
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This time I had my wallet open, five-dollar bill in my hand before Dana turned to help me.  It didn’t matter.  We danced our usual dance.

“That one’s on the house, honey,” she said, smiling and nodding toward the cup of coffee in front of me.

“No, no,” I said.  “I’m paying,” and put the five on the counter. She pursed her lips, traces of the smile still there, and shook her head.  A lock of thin, blonde hair escaped from her ponytail and slid down past her ear.  It covered part of the tattoo on the side of her neck.  I had forgotten about her tattoo.  Her eyes, blue and a little bit puffy, crinkled in mock anger.  I frowned a little at her for real, as if to say, “Just give me a break this time.”

Usually I dance along, matching her smile for smile and gracious for gracious.  Today I needed a win.  The weather was gray and drippy, I had stayed up too late the night before, and I wanted to get through morning rounds at the hospital quickly.  There was no one in labor — if I were lucky, I’d be able to shave a bit off of the pile of paper on my desk before being paged.  Just let me pay for my coffee, I thought.  I don’t want to talk, I don’t want to play games, I just want to get to work.

~

The day before in clinic had been busy and frustrating.  I had left notes undone, had put off the filling out of forms.  After clinic I had gone home, fussed at my wife, and nagged my boys until the living room and kitchen were tidy.  Then everyone had escaped to their rooms or their friends’ houses, leaving me alone as I drank wine and folded laundry.

Somehow that hour folding laundry felt like the only real one of the day.  I reveled in the quiet.  I poured the glass of wine, sipped it, plunged my hands into the warm, dry, inchoate mass of cloth, and then piled it on the table behind me.  Sip wine, match socks, sip, smooth and fold pants, snap and fold towel, sip again.  I brought order to chaos.  I felt like a god.

Folding laundry makes me feel like a god.

Being a doctor doesn’t.

Even the infrequent life-and-death moments that I face feel quite earthly.  My work mostly involves the give-and-take negotiations of office visits.  When I’m on call at the hospital, I occasionally face a tense situation (like a difficult birth) that requires calm and focus.  Those moments are less common than you might think.  Lapses and wrong decisions can have terrible consequences, of course, so, like my colleagues, I’ve developed rituals that I follow compulsively.  It’s not exactly a godlike existence.

The paperwork is my one work-related shot at godhood.  Shrinking that pile brings order to chaos.  It doesn’t feel warm and soft in my hands like clean laundry does, but that’s not the problem.  The problem is that the pile is a prank played on me by the real gods.  When the 7PM pile is bigger then the 7AM pile had been, I am Sisyphus.  When it’s smaller, I am Tantalus.

Last night I was Sisyphus.  I’d rather be Tantalus.

Today I could be Tantalus.

~

Dana didn’t let me off the hook.  She leaned towards me, over the counter, and said quietly, firmly, “This is on the house.  I wouldn’t have my son if it wasn’t for you.”

That was simply not true.  I’ll tell you what really happened.

I first met Dana a couple of years ago.  I happened to be on call the weekend she went into labor.  Her labor was pretty normal — we had a few worrisome moments when the baby’s heart rate dropped, but he turned out to be fine — and the delivery was straightforward.

There were only two reasons why her delivery sticks in my mind.  One was that she had come in determined to give her baby up for adoption, and had asked not to be shown the baby after he was born.  Then, just before she started the pushing phase, she announced that she was going to keep the baby, and would I please please hand him to her when he was out.

After I handed him to her, she clutched him as if he were her long-lost love, but she didn’t kiss him or nuzzle him.  She looked at him with astonishment, as if she weren’t sure he was real.  She barely seemed to notice when I delivered the placenta, or even when I stitched her laceration.  She held his slippery little body tightly to her chest with her eyes closed, then lifted him and stared at his face, then clutched him back again, over and over.  She breathed deep, shaky breaths, and silent tears trickled down the sides of her cheeks.

The second reason I remember her delivery is that she works down the street from the hospital, in the cafe where I often get my morning coffee.  On the day  I admitted her to the hospital, I had vaguely recognized her as the new person behind the counter at the cafe.  In the process of admitting her, I learned some of her most painful secrets.

She was a mess back then.  She had had problems with Oxycontin and alcohol in the past, although she had been clean and sober since before the pregnancy.   We talked about this on the day I admitted her, and I asked why all of her urine drug screens had been positive for marijuana.  She pooh-poohed this, saying “That’s an herb, not a drug.”

She had had Chlamydia twice (one of those times being at the beginning of the pregnancy).  She refused to name the father of her baby, saying only, “He’s an asshole.  I don’t know where he is.  He’d be the world’s shittiest father.”  She had moved back in with her mother — at the age of 31 — after she had found out she was pregnant.  She said that she and her mother got along well enough, and that she liked working at the cafe.  “I never thought I’d like such a boring life,” she said, and then laughed.

As we finished the process of admitting her that day, I said that she seemed to be finding herself.  She said, “Yeah, right,” then snorted.  “I’d still be a shitty mother.  Maybe someday.”

That night, her baby’s heart rate dipped a couple of times, briefly.  I told her that I was a little worried about the baby’s circulation.  She looked surprised and angry.  The heart rate recovered, and then stayed reassuring.  The next time I came in, she said, “My mom wants to know why you’re not doing a c-section.”  They had spoken on the phone.  I explained that the dip in heart rate was the equivalent of his holding his breath for 30 seconds.  Not a problem in itself, just a little red flag that told us that to keep an eye on the baby.  She was silent for a moment, and then said, “Oh.”  Then, “Ok.”  Then her eyebrows buckled and she frowned.  “You sure?  Just because I’m not keeping the baby doesn’t mean I don’t care.  I’d have the c-section, you know.  I know what’s important.”

I told her that I was as sure as I could be that the baby was fine at that moment, that it was perfectly clear that she cared, that I had assumed she wanted to do the right thing, and that we were going to do everything to make sure we ended up with healthy baby and healthy her.  The rest of her labor and delivery went uneventfully – except, of course, for her announcement that she would not be putting him up for adoption.

~

Ever since then we have struggled over who would pay for my coffee. At first she pushed me not to pay, saying each time, “I’ll cover it.”  I refused to let her pay.  Sometimes before she handed me the cup, she would announce that she was buying my coffee that day, and then ostentatiously put money in the register to cover it.  I would then put extra money in the tip jar, and she would glare at me.

We gradually accomodated each other.  She loved it once when I said that I didn’t feel human until I had my coffee.  She called me “Dr. Human” for a while.  I felt like more of a Dr. Monster, though, letting this person who earned so little money buy me anything.  After a couple of months we each relaxed, and now she often doles out compliments instead of money.  Sometimes she “by accident” gives me a large instead of a medium, and then says, laughing, “You don’t want me to waste the cup, do you?  You’ll be EXTRA human today.”

Usually when I see her I ask about her baby — now toddler.  She always has photos, and always seems excited to show them.  “He’s my love, you know,” she says.  “God really blessed me with this one.”  I murmur appreciation.  It’s a pleasure to see how happy she has become.

~

Today, I was in no mood for pleasure.  I was surprised that she so brazenly refused to let me pay.  Then, when she said that she wouldn’t have her son if it hadn’t been for me, I realized that she thought I had saved his life.

“No, no,” I said.  I took a deep breath and put my hands on the counter.  She started to say something, but I needed to make her understand what had really happened.  “He would have been FINE.  Have you thought this whole time that I saved his life?  I didn’t need to do ANYTHING for him.  I don’t remember what I said to you, but, REALLY, I was just a bystander, keeping an eye on him.  YOU did all the work.”

She glanced around, making sure no one was in line, and that her coworkers couldn’t hear us.  She leaned over the counter, put her hand on mine to keep me there, and said in a quiet, strong voice, “Oh, I remember what you said.  I remember EXACTLY what you said.  You said he held his breath.  That’s when I knew how scared I was for my little boy.  That’s when my heart started to open.  You told me that you would keep him safe, and that’s when it opened all the way.  I kept my heart closed the whole time I was pregnant, because I shouldn’t have got knocked up, and I knew I had problems, and I was scared of what my mom would think of me ‘cause I knew I couldn’t be as good a mom as her.”  Her voice cracked.  “But you saw through me, you saw that God loves me, and you told me that of course I cared about my little boy.”

She paused for a moment, and a tear dropped from one eye.  I started to respond, but she pressed my hand harder against the counter to hush me.  “God blessed me that night.  I know it was really Him that opened my heart, and that He worked through you.  I thank Him every day.  But He’s way up there, and you’re right here.”  She wiped her eyes with her sleeve and looked straight at me.  “ You are right… ” She gently knocked my hand against the counter as she said it.  “…here.”  She knocked my hand against the counter again, then clasped it.   “I’ve worked really hard to be good.  I don’t swear no more.  I don’t smoke weed.  I can be that good person you saw that night.  You look stressed out.  Let me pay for your cup of human this time.  OK?  Because God loves you, too.”

My heart opened.

I let her give me the coffee, watched as she fished a couple of crumpled dollar bills from her pocket and put them in the register.  I put my five away, and stood there.  She looked up.  Returning to her usual perky tone, she said, “I get you something else?”

“Yeah,” I said.

I asked her to give me a photo of Robbie, her little boy.  She sniffed once, wiped her nose on her sleeve, grinned, then pulled off the little photo taped to the side of the register and handed it to me.  He has her thin blond hair, her wide set eyes and her broad face.  I put his photo in my jacket pocket, and picked up my cup of human.


Posted in Birth Stories
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Addended Song of the Day — George Gershwin

October 10, 2010
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This is my other favorite from the soundtrack of “Manhattan”.  I used to hate the violin.  Then I heard this song.  Now I’m a sucker for good solo fiddle music.

I cannot play this song just once.  It’s the potato chips of music.  I keep diving into the bag for more.  Like this:

Love Is Here To Stay

Love Is Here To Stay

Love Is Here To Stay

Love Is Here To Stay

Love Is Here To Stay


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Song of the Day — George Gershwin

October 10, 2010
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My left brain is a clingy bastard who can’t stand to be left out of anything I do.  He insists on tagging along even when I listen to music.

I mollify him with lyrics,

with who plays each instrument,

with what was going on in the world when the song was recorded,

with where I first heard it,

with how the song reflects a stage of a band’s career,

with why it makes me feel the way it makes me feel.

Right brain loves the music for itself.  Usually right brain hums quietly in the background, appreciating the brief moments when left brain stops chattering.  It’s as if the three of us — left brain, right brain and I — are watching a movie with great dialogue and a great soundtrack.  Lefty and I focus on the words.  Righty exults in those moments when the dialogue stops and the background music swells.  Those moments remind me that he exists.

~

Every once in a while, Righty takes over.  He shushes Lefty, and makes me listen.  No context.  No words.  No meaning.  Just the thing in itself.

Righty loves Rhapsody In Blue.  Loves it.  Lefty must, too, because he hushes with the first flutter of the clarinet and lets us climb on as it twists and carries us UP.  There are no lyrics.  I don’t know who plays what.  I know this was written within five years of 1930, but don’t care.  I don’t remember the first time I heard it, don’t know how it fits into Gershwin’s career, and don’t know much about his career anyway.  I don’t want to analyze why it makes me feel the way I feel.  It carries me off.  It makes me feel like I’m flying and doing somersaults in the air, darting about, adventuring with no goal and no destination.

This version is my favorite.  Listen.  Let the first ten seconds of clarinet grab you and pull you out of yourself.  I’ll hush now…

Rhapsody In Blue


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Song of the Day — Steve Martin

October 10, 2010
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He’s right.  It’s really hard to stay depressed while listening to banjo.  Even a lonesome rambler must get happy feet when Steve starts pickin’.

Ramblin’ Man

Hey!  A ramblin’ guy!

R-A, M-B, L-I-N…

Apostrophe!


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