I woke up in Washington D.C today. I'm going to meet my friend Johnson "Spud" Maxey tomorrow to go to the International Spy Museum and to eat some Ethiopian food at his request. Today I wanted to spend the day on the Mall. I ate breakfast near my place at the Club Quarters and it was here that I read that health care reform will be dropped in it's current form by Obama and the Democratic majority in Congress.
I am two blocks away from the White House so I stared at it. After breakfast I started walking and my path took me past a woman in a short black cocktail dress and strappy high heels absolutely yelling into her cell phone. She was pissed at somebody, perhaps her boyfriend, and every other word out of her mouth was f--k this and f--k that and "You better get your f--king ass out here!" etc. She and I were the only ones on the street since it was about 8A and D.C. was sleeping in, or trying to. I took this as a metaphor for...what? I don't know.
Anyway, I was to the White House in a snap. I almost got Lafayette Square to myself. It was only me and the guy with tattoos on his forehead who had been part of a group sitting in front of the White House continuously since 1981 demanding nuclear de-escalation. An issue that has fallen far on the "to do list" of the nation.
Health care is on top and this thing has upset me. While staring at the White House I couldn't help but feel that President Obama and the Congress have not done us a service at this time, that health care for more Americans was within our grasp. In fact, we had it in the boat but it wiggled out. I don't think they should have given up. Since the turn of the previous century there have been two Republicans and a hand-full of Democrats that have tried to get more broad coverage for Americans and all have failed. It appears now that Obama may fail as well and this is especially crushing since he was elected on a health care platform and he came so close. Health care is the holy grail and no President has found it yet.
As a physician I have worked in public hospitals: Hennepin County Medical Center in Minneapolis and Bellevue Hospital in New York City. I have felt, like others, that there is disparity in health care delivery and those without insurance are at a distinct disadvantage. Some could afford it and choose not to buy it, they deserve some knuckle rapping, but I also think that there are enough that are struggling, or are not sophisticated enough, to figure out a system that follows no reasonable rules of economics and they suffer disproportionately.
The preamble to the constitution addresses ensuring domestic tranquility and promoting the general welfare of Americans. Health care is right down its alley. Yet the Constitution does not state a right to health care, as it doesn't mention a right to a public education, yet we have chosen to offer that to the citizens of our country. Arthur Caplan, at the Penn Center for Bioethics, addressed this at a recent keynote speech at a Critical Care meeting. He invoked our desire as a nation to see equal opportunity for all, as one might evoke with creating public education, and he went on to suggest that more accessible health care may also afford more equality of opportunity. By not having reasonable access to health care there are those with asthma, diabetes, seizure disorders, etc. who may not be able to get reasonable health care and thus they experience disproportionate limitations financially and physically that limit their access to a more level playing field of opportunity through little fault of their own.
As cost has always been an issue let me throw this out. The governor of Colorado told me that his office estimated that each uninsured person in his state costs more than $20,000 a year in E.R. costs alone. The average cost per insured person in Colorado seems to be approximately $7,000 based on government statistics from all fifty states. One could estimate 500,000-1,000,000 uninsured in Colorado alone (40 million in U.S.). If one conservatively thinks that there would be $10,000 a year saved on 500,000 people if they were brought into some insurance pool this would add up to $5 billion dollars of savings in Colorado alone.
My personal feeling is that a lack of reasonable health care access for everyone in a country that claims to be the beacon of truth and justice in the world should leave us embarrassed. Lyndon Johnson tried to limit the Congress into drilling down on the cost of medicare because he thought health care coverage, in some form, for the elderly was a necessity in this country. He likened it to having milk and bread in your kitchen. No matter how much milk and bread cost you would just have to spend the money because you had to. Broad health care access is just such an issue. The cost matters, but it doesn't matter, so why not JUST DO IT. We can adjust the budget deficit, we can afford not to buy the next weapons system, or we can let the grass grow at the campsites of our National Parks, or we could all reap the financial benefit of a more healthy medical sector, but health care is bread and milk for the nation. We need it, be it in single party payer form, with a public option in a privately managed system, or some form of mandate without a public option and it seems extremely disappointing that we can't seem to do this.
The White House just sat there, in its beauty and splendor. I walked around and took pictures of the Washington Monument, saw Whistlers Peacock room, and went to the Air and Space Museum after having a hot dog near a childrens group so large that they reminded me of a school of sardines. Then I went to the National Art Museum and saw a Chekov film in Russian with subtitles.
When all is summed up I feel lucky to have economic stability, wonderful friends and family, and I'm lucky to be in D.C.
Saturday, January 23, 2010
Wednesday, January 20, 2010
TB-like bacteria that cause leprosy, AND read the Bible with some skepticism.
Here's the skinny on nontuberculous mycobacterium. Mycobacterium is a genus of bacteria. Remember, in a family of bacteria there is the genus, Mycobacterium and the species, like tuberculosis, leprosy, and about 130 other species of bacteria that cause lung disease, skin disease and a bunch of other problems. These other species don't get the press that tuberculosis gets.
Nontuberculous mycobacterium share some of the structure of tuberculosis but they have never been known to be transmitted from person to person like TB. I think that is why they fly under the radar.
The classic findings of these bacteria are mycolic acid in their cell wall and a similar structure in something called 16s rRNA. Within this 16s rRNA there are subtle differences which seem to give the different genus' of mycobacterium their unique fingerprint, but this might be getting a little technical.
The most common lung disease from nontuberculous mycobacterium is caused by MAC, or mycobacterium avium intracellulare. It is commonly found in those that work with soil like construction workers and farmers since it is most prevalent in the soil. It is also common, for some unknown reason, in older women who are skinny. We are finding out that cholesterol and and the "fat" hormone leptin may play a role in fighting mycobacterium infection. These are the only diseases that may let you feel good about being obese with a high cholesterol because the immune system may work better against mycobacterium if you have extra weight and higher cholesterol. There are many other reasons to not be fat with a high cholesterol though so I wouldn't go pigging out on McDonalds' just yet.
Recently the New York Times and other papers reported the work of a Colorado State scientist, Norman Pace, who swabs things like subways, clothes and shower heads and found evidence of this bacteria to be ubiquitous. In fact he found that these bacteria form a film that allow them to survive in great numbers in shower heads. There have also been case reports of women having lung infection from isolates found to be from their showers. Hot tubs seem to be a source as well since the chlorine kills other bacteria but not mycobacterium. Infection is rare though so don't go selling your hot tub in a garage sale and if showers are your bag, and you're otherwise healthy, don't stop washing since your social well-being may be at risk more than your health.
Leprosy is caused by a mycobacterium that grows best in the 9 band armadillo, perhaps this accounts for reports of leprosy in Louisiana. But it is most common in India, the continent of Africa, and Brazil. It is a neuropathic bacteria that also causes depigmentation of the skin. Usually patients present with anesthetic patches on their skin and sometimes lumps. The immune system seems to have a difficult time with leprosy so antibiotic therapy is sometimes required for up to ten years. Antibiotic therapy for TB is usually 9 months, for bronchitis, 10 days.
The Bible references leprosy a lot. But recently scientists and Bible scholars have been noting these references with some skepticism since diagnostic skills were not as astute in Christ's time. After the Bible scholars such as Hippocrates, Herodotus and Galen have referenced leprosy. A common theme seems to suggest that these patients were "white as snow" and they comment on plaques of the skin and sometimes growths on the limbs. Many other disease have been suggested by modern science that would account for these reports from the Bible and Greeks such as: vitiligo(immune mediated depigmentation of the skin not caused by infection), psoriasis, elephantiasis(caused by a parasite), ringworm(fungus), elephant man's disease(neurofibromatosis) and other skin infections like those caused by Staph or Strep. It is commonly noted that the clothes and homes of lepers were "moldy" or the equivalent in our modern speak. Often the clothes and homes of these people were burned needlessly as a consequence.
So if you have boil on your skin don't let anyone burn your house down.
That's it for now.
Nontuberculous mycobacterium share some of the structure of tuberculosis but they have never been known to be transmitted from person to person like TB. I think that is why they fly under the radar.
The classic findings of these bacteria are mycolic acid in their cell wall and a similar structure in something called 16s rRNA. Within this 16s rRNA there are subtle differences which seem to give the different genus' of mycobacterium their unique fingerprint, but this might be getting a little technical.
The most common lung disease from nontuberculous mycobacterium is caused by MAC, or mycobacterium avium intracellulare. It is commonly found in those that work with soil like construction workers and farmers since it is most prevalent in the soil. It is also common, for some unknown reason, in older women who are skinny. We are finding out that cholesterol and and the "fat" hormone leptin may play a role in fighting mycobacterium infection. These are the only diseases that may let you feel good about being obese with a high cholesterol because the immune system may work better against mycobacterium if you have extra weight and higher cholesterol. There are many other reasons to not be fat with a high cholesterol though so I wouldn't go pigging out on McDonalds' just yet.
Recently the New York Times and other papers reported the work of a Colorado State scientist, Norman Pace, who swabs things like subways, clothes and shower heads and found evidence of this bacteria to be ubiquitous. In fact he found that these bacteria form a film that allow them to survive in great numbers in shower heads. There have also been case reports of women having lung infection from isolates found to be from their showers. Hot tubs seem to be a source as well since the chlorine kills other bacteria but not mycobacterium. Infection is rare though so don't go selling your hot tub in a garage sale and if showers are your bag, and you're otherwise healthy, don't stop washing since your social well-being may be at risk more than your health.
Leprosy is caused by a mycobacterium that grows best in the 9 band armadillo, perhaps this accounts for reports of leprosy in Louisiana. But it is most common in India, the continent of Africa, and Brazil. It is a neuropathic bacteria that also causes depigmentation of the skin. Usually patients present with anesthetic patches on their skin and sometimes lumps. The immune system seems to have a difficult time with leprosy so antibiotic therapy is sometimes required for up to ten years. Antibiotic therapy for TB is usually 9 months, for bronchitis, 10 days.
The Bible references leprosy a lot. But recently scientists and Bible scholars have been noting these references with some skepticism since diagnostic skills were not as astute in Christ's time. After the Bible scholars such as Hippocrates, Herodotus and Galen have referenced leprosy. A common theme seems to suggest that these patients were "white as snow" and they comment on plaques of the skin and sometimes growths on the limbs. Many other disease have been suggested by modern science that would account for these reports from the Bible and Greeks such as: vitiligo(immune mediated depigmentation of the skin not caused by infection), psoriasis, elephantiasis(caused by a parasite), ringworm(fungus), elephant man's disease(neurofibromatosis) and other skin infections like those caused by Staph or Strep. It is commonly noted that the clothes and homes of lepers were "moldy" or the equivalent in our modern speak. Often the clothes and homes of these people were burned needlessly as a consequence.
So if you have boil on your skin don't let anyone burn your house down.
That's it for now.
Saturday, January 16, 2010
People of Philadelphia
I have been refreshed by the human spirit. The city of Philadelphia is dirty and beaten down, perhaps not as much as other cities in the Northeast, and less than others, but the people have generally been quite open and friendly. First, I have had a wonderful reception at U. Penn since my emails have led to email introductions and more emails and meetings than I imagined. I have been over to the Hospital at the University of Penn. a few times already and interestingly sat in on a session where the institution is trying out "narrative medicine" with staff doctors. This is based on a principle that patients who are able to tell a narrative of their ills feel more comfort in the care they are given, they have better outcomes and are more compliant with therapy. Doctors themselves are found to feel better about their patients as well if they can periodically give narrative amongst professionals about emotional issues they have with patients, nurses and other doctors. Kind of group therapy with the purpose of allowing "us" to keep from strangling our patients or ourselves. For deeper personal issues one has to maintain their therapist visits though. Black humor was endorsed by the moderator of the session, he is an english professor from Scotland.
As for the people of Philadelphia, I'll relate a few encounters I have had. Today on the subway I asked the person next to me how to get to the art museum. He was very helpful as were many others in the car. His recommendations were either confirmed or countermanded by at least 3 or 4 others in our vicinity. I heard recommendations to turn around, take a cab, and to get the 121, 34 and the 440 bus. I decided to get off the subway to take a cab. The bus system is difficult like it is in most cities until one gets the hang of it. But the enthusiasm of the people on the subway was way cool.
Yesterday, I was walking to work behind a woman in a burka. She tossed a gum wrapper on the street.
On the steps of the Philadelphia Art Museum, where Rocky made his triumphant run, there was a muslim kid in bare feet, on a cold day, and white religious outfit preaching about Ala. He was saying how "We should all lie prostate at the feet of God", as I was passing. I suggested he wanted to use the word prostrate. He nodded his head in agreement and without missing a beat repeated his instructions, "We should all lie prostrate at the feet of God..." I apologized for being so bold but he didn't seem to mind.
The security officer at the entrance to the Science Center at U Penn, where the Center for Bioethics has offices, told me about her sinuses when I asked her how she was doing, although I wasn't really expecting a medical report. She didn't know that I was a sinus expert from my practice so I gave her a few pointers, yet I still don't think she knows I'm a doctor. She was grateful and not pissy or resistant. Yet I seem to be maintaining my reputation as being a "know-it-all". But perhaps this is the refreshing part of living in a place that respects accuracy. There is often little difficulty here, and from my memory of New York, if one person helps by correcting or helping another with an accurate correction or a pointer. There is not that visceral uncomfortable feeling that one gets when being corrected or doing the correcting as one gets in other places. There's not so much of the "you're not smarter than me" crap. I like that. I certainly have received enough correction already at U Penn when it comes to ethics and that's OK with me. The U Penn crowd may or may not be smarter than me but what I do know is that they know more about ethics than me. I continue to pursue a path of less vanity and the people of Philadelphia have shown me the way so far.
As for the people of Philadelphia, I'll relate a few encounters I have had. Today on the subway I asked the person next to me how to get to the art museum. He was very helpful as were many others in the car. His recommendations were either confirmed or countermanded by at least 3 or 4 others in our vicinity. I heard recommendations to turn around, take a cab, and to get the 121, 34 and the 440 bus. I decided to get off the subway to take a cab. The bus system is difficult like it is in most cities until one gets the hang of it. But the enthusiasm of the people on the subway was way cool.
Yesterday, I was walking to work behind a woman in a burka. She tossed a gum wrapper on the street.
On the steps of the Philadelphia Art Museum, where Rocky made his triumphant run, there was a muslim kid in bare feet, on a cold day, and white religious outfit preaching about Ala. He was saying how "We should all lie prostate at the feet of God", as I was passing. I suggested he wanted to use the word prostrate. He nodded his head in agreement and without missing a beat repeated his instructions, "We should all lie prostrate at the feet of God..." I apologized for being so bold but he didn't seem to mind.
The security officer at the entrance to the Science Center at U Penn, where the Center for Bioethics has offices, told me about her sinuses when I asked her how she was doing, although I wasn't really expecting a medical report. She didn't know that I was a sinus expert from my practice so I gave her a few pointers, yet I still don't think she knows I'm a doctor. She was grateful and not pissy or resistant. Yet I seem to be maintaining my reputation as being a "know-it-all". But perhaps this is the refreshing part of living in a place that respects accuracy. There is often little difficulty here, and from my memory of New York, if one person helps by correcting or helping another with an accurate correction or a pointer. There is not that visceral uncomfortable feeling that one gets when being corrected or doing the correcting as one gets in other places. There's not so much of the "you're not smarter than me" crap. I like that. I certainly have received enough correction already at U Penn when it comes to ethics and that's OK with me. The U Penn crowd may or may not be smarter than me but what I do know is that they know more about ethics than me. I continue to pursue a path of less vanity and the people of Philadelphia have shown me the way so far.
Tuesday, January 12, 2010
Arrive, Philadelphia
I arrived in Philadelphia with the sun shining and a refreshing feeling of being on the Eastcoast again after last living in New York City more than thirteen years ago. The cab took me past refineries and industrial stuff that give it its industrial reputation. I'm staying at a place named Club Quarters, a corporate housing hotel that gives me about 300 sq. ft. of living. I can stand in my apartment and make my bed, answer the phone, cook, and iron my shirts from the same spot. As one goes further East the smaller the living space becomes.
Dr. Caplan, Director at Penn Center for Biomedical Ethics, is in Japan so I didn't get to meet with him today. Janice Pringle, his assistant, got me settled into my office without at window near some old chairs and a table. But I have a computer so I work on getting some emails out that let other ethicists at Penn know that I'm around. I am anonymous.
The questions I want to answer while I'm here for the next two months include a nursing issue and a case against "evidence-based" medicine. The trend in critical care medicine seems to be practice by "evidence-based" medicine, but Mark Tonelli, at the University of Washington, has written that a more case-based medicine may be more appropriate, much like lawyers use to try cases. I would like to test the waters at the Penn Center for Biomedical Ethics on this subject.
But I also want to discover a way to help prevent nursing burnout on ICUs. Many nurses that I have worked with seem to voice a conflict like this: they have patients that are frequently admitted to the ICU because the patient doesn't take care of himself, nurses are obligated, and in fact want to take care of, patients the best way they know how. But they are also very concerned about the economy and the cost of medicine, as we all are. They have to spend 8-12 hours a day with people that drink too much, do drugs too much or don't go to dialysis like they should if they have kidney failure. It is this kind of patient that stretchs the cost of health care; not the only group that does, but they are patients who slaps the nurses, and doctors like myself, in the face daily. What do we do? We are obligated to care for the senseless and emotionally challenged but should we have to? What is the nursing obligation, or the doctor obligation, to care for these patients in these troubled economic times. Many in America want to cut the cost of medical care but when it comes to the individual desires to get the most out of the system we all would like "as much as it takes to get us through".
There are some principles of ethics that we all follow in America. The first principle is that of autonomy, the idea that we should be able to make decisions for ourselves that allow us to receive the care that it takes to keep us alive and comfortable. But the fourth principle of ethics(be kind and do no harm are in the middle) includes one that is economically fair to the community. How do these reconcile, the first that allows for giving care to whomever wants it for whatever reason (I just missed my dialysis or I do street drugs...) and the fourth that suggests we should have some resposibility to the community for cost savings. The American College of Chest Physicians has said in the past that we are obligated to care for an individual on the ICU with no cost limitations, within reason, since the money saved by "rationing" care or withholding care would not necessarily end up in the pot for other health care issues like vaccinations for children, hospice care, etc. But is this fair? How can we protect nurses who have to care for those that abuse the system so nurses don't burnout or we don't break the community bank. Who could knowingly withhold care from one individual, knowing he or she would die, staring that patient or family in the face, to save money for the greater good? This is what I would like to discuss at Penn.
Another advantage of being on the East Coast is that the news is more in your face. I read the New York Daily News today that reported that Sara Palin took a job with Fox News for a purported three year contract. It also reported that she is more interested in getting wealth from her new found fame more than she is positioning herself for a run for the president in 2012. "She wants to continue making her views heard"...but, "It doesn't have anything to do with a political strategy in the future." She'll report on "Real American Stories", a series looking at inspirational tales set to launch this year." Whew...
The book Game Change seems to be reporting that Bill and Hillary Clinton didn't get along sometimes on the 2008 campaign tial...Really?! And that Bill suggested a few years ago Barack Obama would have been fetching coffee for Ted Kennedy and Bill Clinton and this didn't make him ready for being President. Ouch.
Dr. Caplan, Director at Penn Center for Biomedical Ethics, is in Japan so I didn't get to meet with him today. Janice Pringle, his assistant, got me settled into my office without at window near some old chairs and a table. But I have a computer so I work on getting some emails out that let other ethicists at Penn know that I'm around. I am anonymous.
The questions I want to answer while I'm here for the next two months include a nursing issue and a case against "evidence-based" medicine. The trend in critical care medicine seems to be practice by "evidence-based" medicine, but Mark Tonelli, at the University of Washington, has written that a more case-based medicine may be more appropriate, much like lawyers use to try cases. I would like to test the waters at the Penn Center for Biomedical Ethics on this subject.
But I also want to discover a way to help prevent nursing burnout on ICUs. Many nurses that I have worked with seem to voice a conflict like this: they have patients that are frequently admitted to the ICU because the patient doesn't take care of himself, nurses are obligated, and in fact want to take care of, patients the best way they know how. But they are also very concerned about the economy and the cost of medicine, as we all are. They have to spend 8-12 hours a day with people that drink too much, do drugs too much or don't go to dialysis like they should if they have kidney failure. It is this kind of patient that stretchs the cost of health care; not the only group that does, but they are patients who slaps the nurses, and doctors like myself, in the face daily. What do we do? We are obligated to care for the senseless and emotionally challenged but should we have to? What is the nursing obligation, or the doctor obligation, to care for these patients in these troubled economic times. Many in America want to cut the cost of medical care but when it comes to the individual desires to get the most out of the system we all would like "as much as it takes to get us through".
There are some principles of ethics that we all follow in America. The first principle is that of autonomy, the idea that we should be able to make decisions for ourselves that allow us to receive the care that it takes to keep us alive and comfortable. But the fourth principle of ethics(be kind and do no harm are in the middle) includes one that is economically fair to the community. How do these reconcile, the first that allows for giving care to whomever wants it for whatever reason (I just missed my dialysis or I do street drugs...) and the fourth that suggests we should have some resposibility to the community for cost savings. The American College of Chest Physicians has said in the past that we are obligated to care for an individual on the ICU with no cost limitations, within reason, since the money saved by "rationing" care or withholding care would not necessarily end up in the pot for other health care issues like vaccinations for children, hospice care, etc. But is this fair? How can we protect nurses who have to care for those that abuse the system so nurses don't burnout or we don't break the community bank. Who could knowingly withhold care from one individual, knowing he or she would die, staring that patient or family in the face, to save money for the greater good? This is what I would like to discuss at Penn.
Another advantage of being on the East Coast is that the news is more in your face. I read the New York Daily News today that reported that Sara Palin took a job with Fox News for a purported three year contract. It also reported that she is more interested in getting wealth from her new found fame more than she is positioning herself for a run for the president in 2012. "She wants to continue making her views heard"...but, "It doesn't have anything to do with a political strategy in the future." She'll report on "Real American Stories", a series looking at inspirational tales set to launch this year." Whew...
The book Game Change seems to be reporting that Bill and Hillary Clinton didn't get along sometimes on the 2008 campaign tial...Really?! And that Bill suggested a few years ago Barack Obama would have been fetching coffee for Ted Kennedy and Bill Clinton and this didn't make him ready for being President. Ouch.
Sunday, January 3, 2010
How I spent my Christmas vacation,2009(Travel)
I did not get the following things for Christmas: the chicken pox, a new or used jet airliner, or greater insight into my propensity to stress what I didn't get in life.
I did get some great time in the Twin Cities though. There was snow this year that made Christmas Eve and Day like a Charlie Brown Xmas with my family. Landing at Mpls/St.Paul Airport was like landing into a blizzard, since there was a blizzard. Each plane on the tarmac had it's very own de-icer assigned to it making the planes look like sharks with pilot fish hovering around them. This was all seen through the haziness of the snow. Plows were busy everywhere and the place seemed alive!
At the house I grew up in we had a great time, my sisters, brother-in-law David, Mom and I, minus Peg, my youngest sister who spent Xmas with her family in Atlanta. My Uncle Dick visited for Christmas Day from Stillwater MN. Great conversation and it was great to be around family and friends.
Some topics of conversation that came up included how the federal income tax developed and how the Athenians wanted to get rid of Socrates because he was a crashing know-it-all bore who couldn't keep his thoughts to himself. Not that I know as much as Socrates, or as much as Kimble-the-Street-Person for that matter, but I do like to weigh in on social and political topics myself. But Oscar Wilde once said, "If you want to tell the truth you better make people laugh otherwise they'll kill you." I agree with his sage advice and for my part tried to leave the heavy stuff alone. The thing about being in Minnesota is that there are some that talk more than I do so I join the scream fest to feel at home. There is no shortage of opinion in my family and friends there.
I also played some hockey. I don't skate very well since I grew up playing basketball but I like to get out with my friend Pete. Mostly I occupy the goal since if I try to skate with the hockey people I find myself falling a lot. Pete says I look like a starburst when I fall; first I lose balance, usually skating backwards, then slip up parallel to the ice sending my arms and legs out like a starburst then I hit my butt and head and feel that somethings never change. It used to be that others would ignore me when I fell but I have now reached the age where the kids skate around me perplexed asking, "Are you all right, Mister?". I'm usually cordial and don't ask them to buzz off or to mind their own business.
I also got invited to watch Pete, his sons Mike and Joey, and our friend Bruce take the engine out of a small Chevy truck. What a cool experience; I never got to do this as a kid and it was hellishly interesting. Disconnect all the tubes and pipes, take the stick to the transmission out, unbolt some stuff, get an engine winch, and presto! it's out. I helped Mike with the transmission and took the water pump off...and ate donuts while Pete, Bruce and the kids did most of the work. I mainly asked questions. John Robinson was there for legal advice. He's a paralegal and consumate friend. John and I agreed by noon that neither of us could feel our toes since we did this in a garage with the temperature being about 15 degrees F. We all went to Matt's, home of the Juicy Lucy(two patties of burger with melted yellow cheese boiling hot between) for lunch. Nobody leaves without a scalded mouth.
The day before I left I accompanied my Mom on a search for a bookshelf since this was my present to her for Christmas. We had a nice mother-son time and she didn't complain about my driving once, except to comment on how close I come to cars when I turn.
All-in-all a great time.
I did get some great time in the Twin Cities though. There was snow this year that made Christmas Eve and Day like a Charlie Brown Xmas with my family. Landing at Mpls/St.Paul Airport was like landing into a blizzard, since there was a blizzard. Each plane on the tarmac had it's very own de-icer assigned to it making the planes look like sharks with pilot fish hovering around them. This was all seen through the haziness of the snow. Plows were busy everywhere and the place seemed alive!
At the house I grew up in we had a great time, my sisters, brother-in-law David, Mom and I, minus Peg, my youngest sister who spent Xmas with her family in Atlanta. My Uncle Dick visited for Christmas Day from Stillwater MN. Great conversation and it was great to be around family and friends.
Some topics of conversation that came up included how the federal income tax developed and how the Athenians wanted to get rid of Socrates because he was a crashing know-it-all bore who couldn't keep his thoughts to himself. Not that I know as much as Socrates, or as much as Kimble-the-Street-Person for that matter, but I do like to weigh in on social and political topics myself. But Oscar Wilde once said, "If you want to tell the truth you better make people laugh otherwise they'll kill you." I agree with his sage advice and for my part tried to leave the heavy stuff alone. The thing about being in Minnesota is that there are some that talk more than I do so I join the scream fest to feel at home. There is no shortage of opinion in my family and friends there.
I also played some hockey. I don't skate very well since I grew up playing basketball but I like to get out with my friend Pete. Mostly I occupy the goal since if I try to skate with the hockey people I find myself falling a lot. Pete says I look like a starburst when I fall; first I lose balance, usually skating backwards, then slip up parallel to the ice sending my arms and legs out like a starburst then I hit my butt and head and feel that somethings never change. It used to be that others would ignore me when I fell but I have now reached the age where the kids skate around me perplexed asking, "Are you all right, Mister?". I'm usually cordial and don't ask them to buzz off or to mind their own business.
I also got invited to watch Pete, his sons Mike and Joey, and our friend Bruce take the engine out of a small Chevy truck. What a cool experience; I never got to do this as a kid and it was hellishly interesting. Disconnect all the tubes and pipes, take the stick to the transmission out, unbolt some stuff, get an engine winch, and presto! it's out. I helped Mike with the transmission and took the water pump off...and ate donuts while Pete, Bruce and the kids did most of the work. I mainly asked questions. John Robinson was there for legal advice. He's a paralegal and consumate friend. John and I agreed by noon that neither of us could feel our toes since we did this in a garage with the temperature being about 15 degrees F. We all went to Matt's, home of the Juicy Lucy(two patties of burger with melted yellow cheese boiling hot between) for lunch. Nobody leaves without a scalded mouth.
The day before I left I accompanied my Mom on a search for a bookshelf since this was my present to her for Christmas. We had a nice mother-son time and she didn't complain about my driving once, except to comment on how close I come to cars when I turn.
All-in-all a great time.
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