A horse is a horse of course, of course...

Don't you love it when the experts are wrong? All those authorities--owners, trainers, jockeys, analysts, gamblers, etc., etc., etc. They all knew that stupid plug was going to win..without a doubt! They forgot one thing. They were dealing with a damn horse and nobody explained to him that he was supposed to win. My vote? Send him to the glue factory now and spare us all the learned explanations of why the horse that couldn't lose turned out to finish LAST! WILBUR???!!!

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Grandparents' Day

My first Grandparents' Day at pre-school. A communal breakfast in the small social hall followed by high-schoolers leading us to the proper classes. I must say it's a little scary seeing all those people my age and realizing I've reached that stage in life. Tempus Fugit, as they say. We sat in the back of the class and watched the 3 and 4 year olds listen to a story and answer questions about Shabbat (it being Friday and all), then sing songs about Shabbat, then do an art project about Shabbat, then we took pictures as they all participated in...Shabbat rituals. Notice a theme?

My mind wandered back to a different era. I was a 3rd grader (~1959) at Fallstaff (public) school and it was Parents' Day. My father was working and couldn't attend. My mother taught on the other side of the city and didn't drive. Dad's drug store was close to the school where Mom taught, so he dropped her off in the mornings and picked her up later in the day. It was, therefore, up to my grandmother who lived with us to come to class that day to report on how Mrs. Dix was treating her grandson. I don't remember much about it. Just another day in the life of an 8 year old. Of course, there was a big row in our house that night-my mother very angry at her mother. Why? Following dismissal, after careful observation of my class, my bubbie approached poor Mrs. Dix (clearly not an MOT) and accused her of being an anti-Semite. The reason: She hadn't called on me enough during the day, thereby not adequately showcasing my superior intellect to the assembled parents. My mother pointed out to her that (Baltimore then being the ghettoized town that it was), EVERY other child in my class was also Jewish. That took some of the wind out of Bubbie's sails, but I think she remained unconvinced.

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Paper Chase

I'm writing this quickly. I'm afraid I don't have much time. Any minute I expect to hear that Anne Frank police siren dopplering closer, the warbling crescendo suddenly cutting off, followed by the sound of massive black Mercedes doors being pushed open and quickly slamming shut. Then, the inevitable heavy boot falls on the stairs, the pounding on the front door. Should I bother double locking? It makes no sense. They'll just come crashing through anyway, confronting me as I cower at my computer, clad in my pajamas.

I knew it was wrong as I was doing it. I had read the warning on the screen at work-the admonition not to waste paper. My God, there was even a paper conservation act that had been passed by congress to keep people like me from squandering our nation's precious natural resources. Its bold text flashes in front of you under the sign of the big eagle every time you log-on to the federal computer system. But squander I did. I couldn't help myself. I tried. Really! I tried printing out the one sheet that needed correcting instead of the whole disability report. But no, it didn't work.

I'd been warned during training that the program we use is not really a word processor and has many bugs. Printing bugs included. "Why use it then," I asked? The sudden sound of silence in the classroom and the icy, condescending stare I received from the instructor was an eloquent non-verbal reminder that I needn't ask "why" questions when it comes to the government.

As I made my way through the cubicular maze to the OMVE office laser printer, I saw that there was a stack of paper in the hopper. That couldn't be all mine, could it? I stared at the pile. Just how many laws had I broken? I quickened my pace to get to the Lexmark as fast as I could. I glanced right and left, wondering if I'd been detected. So far, so good! I picked up the stack and was suddenly transfixed by its weight. It was worse than I had imagined. At least 20 superfluous sheets. I began perspiring heavily. I stood there planning my next move, trying not to be too obvious in my discomfort when I suddenly felt a tap on the shoulder and whirled around to see a white haired gent smiling, half bent with stooped shoulders-the posture my bride always warns me that I will end up with if I don't stand up straight-sporting plaid pants pulled up to mid-chest level, white shoes-the kind they aren't allowed to issue unless you are at least 75, banlon shirt and super wide-lapelled polyester Madras suit coat. I knew this guy-an older doc from my neck of the woods, a holdover from the era when nobody questioned what doctors did or why they did it- a survivor from the time that when you called a restaurant for a reservation and said Doctor so and so, they actually saved you a nice table, and when you finally showed up, they let you cut ahead of all the non-Doctors waiting in line. Very likely a former officer at the Silver Birch -a 1950's and 60's upper-middle class Jewish alternative (Uncle George took me there a few times) to the gentile swim clubs that wouldn't let my people in. He looked at me, glanced at my papers and croaked, " Ditch 'em quick!" I breathed a sigh of relief. He won't rat me out. I found my way back to my alcove and quickly plunged my shame deep into the govt. issued pre-shred box we each have on our desks. I dove back into the case I was working on.

It couldn't have been more than 5 or so minutes when I heard it-the rhythmic creaking sound of the bent wheel on a supermarket cart being pushed by a heavy set, cocoa colored woman wearing too much makeup, a grey office smock, and latex gloves softly alto-humming a spiritual. It was her job to collect the contents of all of the boxes and deliver them to the OSD (Office of Shredding and Destruction). I nonchalantly handed her my box. She hefted it, winked at me and dumped its contents into her cart. "Thanks, Shugah.." was all she said. I turned my attention back to the computer, subliminally noting that she pressed something on the side of her cart.

I finished my report and saw that it was about 45 minutes before I usually knock off for the day. I ambled over to the administrator's desk for another record to start checking. Rather than handing me one, without looking up from her terminal she said to me, "Oh, don't start one now. You'll do it tomorrow." OK, I figured. Tomorrow. I gathered up my briefcase, said goodbye to my colleagues and walked out. As I pushed the button at the elevator bank, my mind wandered back to the supermarket cart and it started to all make sense. I felt a tingling slowly work its way from sacrum to atlas. It was then I knew. It wouldn't be too long until I was visited by the dreaded FPP (Federal Paper Police). I made it home, to my room and here I sit waiting, just waiting. But you know...Despite everything, I feel people are really good at heart...

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Movie night

When my daughter calls, she greets me one of two ways. Hi! means it's a purely social call. Hi, how are you? means she is going to ask me to do something for her. It never fails. I got a Hi, how are you? a couple of days ago, so I'm babysitting tonight. I really don't mind since they have cable and I get to watch movies. She also has great snack food at her house. The kids will be asleep so it should be no problem. Big Mother's Day celebration tomorrow. I'll take notes and report back.

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Charting the course

It's actually an interesting job. I know a number of the other physicians there. A few are my age, but most are elderly. It is a very relaxed atmosphere. Sort of like the elephant's graveyard. I was walking back to my alcove carrying a chart the other day when I ran into a fellow who had been a much feared "attending" when I was a resident in the late 1970's. He stopped me and pointed out that I was walking "way too fast." Basically, my job is to plow through all of the medical evidence that has been collected and scanned onto the internet by the disability examiners across the country and then to decide whether the claimant has a serious heart issue (since I'm a cardiologist) according to Social Security's definitions for what constitutes severe impairment. It's like trying to put all of the pieces of a puzzle together. My mentor is a very sweet doc of 79 who has been there forever. He is a terrific resource for my questions, but he's been around so long and has such extensive experience that I have to leave 20 minutes open for each of his answers. The time goes quickly, though.
Almost had some surgery today. I had been having some discomfort in my left knee and had an MRI performed. I have a torn medial meniscus. My insurance status was unclear since I just switched from my previous group to my wife's policy from work so I have opted to wait a few weeks until I get the official word that I am covered. In the meantime I really can't ride my bike or walk any distance. Very limiting and no fun.

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(Dis)able was I ere I saw Elba,Sid

Well, I had quite a week. I spent about 4 hours per day in a classroom at Woodlawn studying the intricacies of how to gather and present the medical evidence needed to make the case or reject requests for disability. It is a very involved process and it requires scouring all of the information that is sent to the chart and then deciding if the documented information is consistent with the government's definition for the presence of a medical problem severe enough to preclude the client from engaging in gainful employment. If it does not, then I have to make a determination of the type of activities (with respect to cardiac problems since that is my specialty) the client is able to handle. They apparently employ several battalions (perhaps even regiments) of quality assurance testers who comb through the final reports to see if all the questions have been answered properly and if the conclusions are supported by the evidence. Then there are cadres of administrative law judges employed by SSA to hear appeals and reverse medical decisions. I can't wait to start.

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If I ruled the world...

Finally, the definitive answer to those who think Jews control the world and who lose sleep (May they lose a lot of sleep-Amen!) about a universal Jewish conspiracy. This week is Passover. There's a lot of cooking and baking that needs to be done in preparation. Unbeknownst to virtually everyone, the manufacturers of stick margarine which was Kosher for Passover (when there are special restrictions on food more stringent than the usual laws of Kashrut (pronounced kosh-as in gosh-root) decided not to produce any this year. This became evident just a few days before the holiday started and caused otherwise (sort of) rational women to panic and begin pulling out their hair (or pulling fibers from their Shaitlach-whichever the case). There was, in fact, an article in the Wall Street Journal about it. Only tub based margarine was available and who knows how to cook with that? All those recipes and no way to make them work! So, How is it (if we are all-powerful and "rule the world"), that we couldn't even get the margarine we needed? And how is it (if all the Jews in the world are connected and in cahoots), that virtually NO ONE knew about this nefarious plot that (trust me) had a great deal of impact on the lives of many of us, until it was too late to do anything about it? Res Ipsa Loquitor I rest my case.

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Meet and Greet

I finally got there! I received the call that my security clearance had gone through. I was to meet one of the supervisors at 7:30 on Monday morning for an orientation session. The facility at Woodlawn is 10 miles from my home, but I had no idea how long it would take to get there. For 25 years I had passed under the Baltimore Beltway on my way to the office and hospital. That underpass is about 4 miles from Social Security and there were very few days I recall over those years that the traffic overhead was not backed up. I left 45 minutes for the drive but got there in 15, despite the rolling backup for the final 5 miles. I had a book to read so I had something to do with the half hour I found myself with. Of course, once 7:30 rolled around my contact person was nowhere to be seen. (Note to self: Never have a third party arrange where you will meet a second party). I finally started wandering around the outside of the building and found my contract officer waiting for me at another entrance. I received a quick tour of the first floor and was taken to the security office where I had my id badge picture taken. Of course, she spelled my name wrong on the first attempt and that card had to be destroyed. I also found out later in the day that she had kept my driver's license, so I had to drive the 10 miles again on Tuesday to pick it up. We took the elevator up to my new department, and I began meeting people. It was actually a bit amusing, each one of them greeting me with: "It's so good to finally meet you!" I guess so. My name had been kicking around that office for 8 months.
I remained attentive and tried to listen carefully for the things they were saying and what they weren't saying overtly. I was cautioned that I would be controlling millions of dollars in funding on a regular basis. What flashed through my mind? Well, for 25 years my career involved taking care of people and making small and large decisions that had major impact on their lives and health. Many of those decisions resulted in worry and lost sleep for me. I'm predicting from the outset that, though I intend on being fair and thorough in the evaluative process, I will not lose any sleep over this job, nor will I worry about my decisions. Let's see how that works out. Anyway, I ran into a number of docs of other specialties who work there. There were a few of my old professors, now VERY gray, and there was a friend just a few years older than me. We actually went to camp together back in the 1960's. He had the distinction back then of being able to swim three complete pool lengths underwater. I'm bettin' he can't do that now. I'll be starting formal orientation on the 22nd.

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You are what you....

A somewhat scary trip today. I've spoken of my mother-in-law on these pages before. It's become my responsibility to keep an eye on her during the week. Well, today I needed to clean her refrigerator and ended up taking a journey deep into the valley of forgotten food. It was nasty. I'm very familiar with that refrigerator, having snacked and grazed from its cheery interior since I first met my bride back in 1971. It's been like a second home to me, albeit a cold one. But, in any case, I've always looked forward to tugging on the magnetically fastened door, feeling that reassuring pop as it opened with a flash of light and a rush of chilled air-a cool yet warm place-eagerly anticipating my next nosh.

Today I approached it from a different perspective. "Bubbie" is just not herself anymore and needs help. The once gleaming grotto of gustatory delight still cycles on and off as before, but now as merely a pathetic caricature of its former self. No longer a place of delicacies and caloric wonderment, it's just cold storage; a cruel reminder of the glorious galley that Bubbie commanded in her salad days (sorry).

The task was before me. It was full. Well, perhaps packed is a better description. At the base, on each of the spill encrusted shelves, lived a layer of containers and bottles of various shapes and heights forming a sort of skyline, if you will. Balanced between the towering spires of poly and glass, plates were suspended-defying gravity's pull with cirque-like precision- each plate sporting a crumpled sheet of contents-concealing aluminum foil, camouflaging the inevitable decomposition within. I opened a few. It's a shame we don't have any kids around who need a science project. Mold is always a good back up when the Lego cyclotron doesn't pan out. As I unfurled (aluminum furl, you see) the little packages, I was flooded with memories of all the recent dinners we've eaten with Bubbie. Ah--Last week's brisket...The kishke from the end of February... I thought of giving a call to the crew down at the Smithsonian who, I believe, are still trying to work out how the ancient Egyptians preserved corpses. Problem solved. All they need do is drive up here and I can show them Bubbie's mummified chicken from sometime last winter. Sad. Then came the parade of pickles. Little Sweeties, Half Done Dills, Gherkins (what are gherkins, anyway?) They were pathetic. Not crisp and crunchy..mushy and (like many of us) past their prime.

Way in the back was a big plastic tub. I saw a few dozen pale lumps inside, some of which appeared to be fermenting. I think they were left over cookie dough balls. Bubbie last made cookies about the time I first applied for that SSA job back in September. The tub was snuggled close to a plastic bag of ready to bake Nestle's cookie dough bits. It was stamped: "Best used before February 2001". Hmmm..6 tubs of cream cheese, some borsht and a box of dried up dried prunes from God knows when. There was a box of Weight Watcher's chocolate power bars. I ate one of those. There were also little containers of rice pudding. I had one. Then I saw that all of the other pudding containers were bloated and started wondering just how long I had before the Botulinum toxin started shutting down my diaphragm and intercostal muscles. It's been a long time since Med School, but I did remember just how little of the toxin can kill you. Then there was the tub of olives that I think someone sent over when we were sitting shiva for my father-in-law in 1995 and a few bottles of relish that he had bought and opened a few years before that. Sounds crazy, right? I guess it's no different than cleaning out a closet where you wouldn't think twice about coming across something from 15 years ago. Well, maybe a refrigerator is different.

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Just say Uncle...

Life is funny, is it not? I finally heard from Social Security. My clearance came through. I guess nothing from my "permanent record" at school had any influence on the outcome. I'm also relieved that my little jaunt through the abandoned missile base and subsequent apprehension when I was in college has not fouled up my chances for this retirement position. I suspect that all of that was cancelled out by the fact that my hotel room was "tossed" by the KGB when my bride and I visited the Soviet Union in 1984. I probably got points for that. We were visiting refuseniks at the time- but that's another story altogether. Of course when I was called today (after approximately 8 months of jumping through hoops to get the job) and was told that I would be starting on the 21st of April, I had to tell them "Sorry-it's the second day of Passover and I will not be able to work." I felt a little silly, but ya' gotta' do what ya' gotta' do. The administrator said she understood and that it was not a problem. So now I'll be working for Uncle. I make a promise to all of my U.S. readers that I will not abuse the privilege of working for the government. I will not abuse the credit card, nor will I travel first class nor charge expensive meals. I will not be bribed by any lobbyists. You have my word.

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Anticipation...

We're workin' on 4 weeks now. I'm still waiting for my security clearance to go through so I can begin the job at SSA. You need to realize I started this process last September. Really, that's when I contacted them and the application process began. It's nearly 8 months. Does the rest of the government work like this?

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Close one!

It was only by chance that I stopped at my mother-in-law's today. She's been slowly failing-generally showing poor judgement and not keeping things together very well. She's always forgetting to add some key ingredient to her recipes, and she loses track of time. My job is to make sure she gets her medicines every day and to try and stop over to make sure she gets out of bed, gets dressed, cleans the kitchen, etc., etc.
I arrived for my random house check and saw that her car was there. I walked up the porch steps, noticing the screen door was unlocked. The front door was ajar. As I walked in, I called out to her but stopped when I noticed she was sitting at the dining room table with a man I did not recognize. There were papers spread about. "Oh good! You're here," she said. "Sit down." In a flash I ascertained that she was in earnest discussion with a dreaded INSURANCE MAN! It was clear she didn't know him. He was trying to sell her a policy that would pay for interim home care "mainly to preserve your dignity". I was not actually listening to his pitch, but was more interested in figuring out how he got to her. At the same time, I was trying to fathom the disappointment he felt now that someone under 80 was present. In general this must be like shooting fish in a barrel for these guys. Frankly, I don't know whether this guy was legit or not, but it's clear how the elderly are at risk for getting scammed. Speak with an air of authority, be compassionate, and play to their fears. He knew there would be no commission today. He did share that he was having a heart catheterization tomorrow. I didn't out myself as a Cardiologist. Mercifully, he left after about 15 minutes of double talk. Finally I got to ask her: "Where did he come from?" "Oh, I sent in a card from a magazine," she confessed. I informed her that that was the last time she would be doing something like that.

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Blood is thicker than...

I took an impromptu drive to New York Monday night. It's about 180 miles and it usually takes about 3 1/2 hours depending on traffic. When my bride and I make the trip, I usually drive the first two hours and after we stop for a short break at one of those mega-pissoirs on the New Jersey Turnpike, she does the rest. I love those places named for various storied figures of American history, and on occasion, we've driven from Clara Barton straight through to Vince Lombardi. They draw you in with a promise of free, unlimited urination in a setting of relative cleanliness, ease and comfort (although they do insist architecturally that you line up for public short arm inspection), and once you have been drawn into their web, they are licensed by the state to engage in highway robbery (couldn't be a better place for that, I suppose) by charging outrageous prices for all manner of brightly packaged junk food.

But I digress. Here's the back story: When my son was in college at Columbia, he registered for bone marrow donation. A number of months ago he received word from the registry that his tissue type matched someone who might need a transplant. He subsequently underwent more extensive examination and was recently notified that his stem cells could be used. In preparation for the harvest, he had to receive 5 days of injections of an agent to boost his marrow production of those hematopoietic stem cells that could then repopulate the marrow of the recipient who, several days before the transplant, would have his own malignant marrow wiped out by radiation and chemotherapy. The harvest of my son's healthy stem cells would occur on Tuesday in a hospital in Manhattan. He would undergo a procedure called apheresis where he is hooked up to a machine by several IV's and, as his blood flows through the apparatus, it is filtered and the "buffy coat" of white blood cells containing those stem cells is removed and subsequently transported and administered to the transplant recipient.

First off, I wasn't thrilled about his receiving injections of this stuff to boost his white cell count. Though I am a physician, I have always felt that unless you ABSOLUTELY need to take a medicine, you shouldn't. And then knowing he was going to have to be hooked up to a blood filtering machine also gave me pause to worry. I feel the same about "procedures" as I do about medicines. Since there is always a finite possibility that something can go wrong, best to not have things done that you don't really need to do. I also had some worries about tainted heparin which has been in the medical news lately, but was assured that he did not risk any heparin exposure with the apheresis. Also, generally speaking, being or being closely related to a physician or an attorney often guarantees a disaster of some sort. My son who is an attorney, therefore, had two strikes against him but was determined to go through with it.

While eating dinner at home Monday night, we realized he would be alone on Tuesday. His wife was in Israel for a family function. My bride had a big day in the office coming up, but I was free-so I decided to drive up to be with him. I didn't call him until I was passing Newark airport-about 1/2 hour from his place on the Upper West Side- since I knew he would not be thrilled (a euphemistic understatement, I know) that Dad had come to keep an eye on him. But too bad, ya' know? That's what parents do.

It turned out to be quite an experience. On Tuesday morning we took a cab to the hospital and were met by a young woman from the registry who treated us to breakfast in the cafeteria to help pass the time waiting the final hour after my son had received his last injection of the medication. We then entered the apheresis unit which was a large room with 4 or 5 of the machines along its walls and comfortable recliner chairs in between each unit-sort of like a dialysis unit for those familiar with that. There were patients already there undergoing the procedure, though all the others were cancer victims saving their own cells, my son being the only one there donating to another. After having IV's started in both arms, the device began doing its thing and we started the long wait.

It took about 5 1/2 hours. We played scrabble, watched TV, read books and chatted. I had to feed him, cover and uncover him with blankets and even help him with his runny nose. I had flashbacks to when he was a little boy. I don't think the irony of his temporary helplessness and the need to depend on me (he's a very independent guy) was lost on him.

We got a chance to meet some of the other patients and their families. Though my career was not spent dealing with cancer victims, virtually all of my patients had significant heart disease of one type or another and had to learn (as these folks have) how to deal with a long term problem that was likely to ultimately kill them. So, I have had a great deal of experience talking to patients with serious health issues, and once it was ascertained that I was a physician, several of them opened up to me sharing their hopes, frustrations, and fears. It's one of the two-edged swords of being a doctor. More than once I have had to listen to someone whom I've just casually met in a social setting describe in graphic detail their recent hemorrhoid operation and subsequent difficulties of a defecatory nature. On the other hand, as happened in the apheresis unit, when people sense a sympathetic ear, they do share many of their feelings and thoughts, and it often is (and was in this instance) an uplifting experience.

It was finally over and we took a cab back to his apartment, hugged and I began the journey through NYC rush hour traffic back to Baltimore. It wasn't too bad, actually. The next morning I tried calling him to find out how he was doing. I knew he had had some symptoms of hypocalcemia (not unexpected) during the procedure and they had given him some IV calcium. No answer. OK, I thought. I'll call back in 1/2 an hour. I called again in 15 minutes. Then I started calling every 10 minutes. I was sure his heart had stopped (God forbid!) sometime in the middle of the night due to the calcium imbalance. I knew I should have stayed over. I called his office and got voice mail. I sent him an email. I was ready to try and call his wife in Israel when, in desperation, I called him back one more time. "Hi, Dad. I was about to call you." "Nice to hear from you," I said. "I was sure you were dead in your sleep from hypocalcemia." "Well, he said, "It would have been peaceful." "Not for me," said I. Ah...The joys of parenthood.

But having said all that, I'm very proud of my son for unselfishly demonstrating the concept of Tikkun Olam (making the world a better place) and for being a mensch which is the most any parent could hope for.

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Best Martyrdom Ever

Sitting at a small birthday celebration with my mother-in-law, my bride, my daughter and son-in-law. We're all eating snacks and have drinks--except for my 84 year old mother-in-law. "Would you like me to get you a drink, Bubbie?" my daughter asks. "No" she says, pointing to the ice bucket "I'll just wait until some of that melts."
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Travelin' Man

We're back. It was quite a bori relaxing vacation. I'm not complaining. My bride works very hard, long hours (she's the executive director of the largest Orthodox synagogue in the US), and the slow pace was good for her. Since my job for the last 6 months has not been particularly demanding, I was already in relaxation mode. I did a lot of reading and turned on the in-cabin TV a few times. I don't watch much at home, but I think I'm going to send Royal Caribbean a note concerning their choice of programming. I mean really- the Hand Washing channel? the Ozzie and Harriet channel? Please! Can you imagine a TV channel that shows nothing but O&H reruns? I hadn't thought about the Nelsons (accompanied by that incessant, annoying 1950's laugh track) in decades. Of course between episodes we did get to spend quality time with hosts Gunnar and Matthew. What was it with Rick? Was he actually drugged out as a teenager or was it early Parkinson's disease? He sported masklike facies (hypomimia) with eyes half shut (dreamboat style, I guess) in those music videos we're treated to at the end of each show.

Besides watching TV, we did get to rub elbows with some 3000 shipmates and 1600 crew members. Too many people in close proximity for my taste. I don't think I need to describe what happens at the buffet table when they all decide to eat lunch, do I? I didn't think so. It's not a pretty sight.

Then came the excursions. We generally don't go on them unless there's something really special that we can't do by ourselves. Basically the islands are all the same. The only difference in the junk in the stores is which island's name has been stenciled on during its manufacture in China or Korea.

On Labadee we spoke to a fellow who took the "zip line" ride down a mountain. Way too expensive and revealing when he shared with us his discomfort on the way to the jumping off point where he saw teams of shotgun toting security men patrolling the borders around the stretch of beach where they allowed us to stay during the day. It's sort of like living in Chevron (Hebron) in the disputed territories in Israel. If it weren't for the army, there would be no settlers. Likewise, if not for the shotguns, I suspect there would be no tours of this little corner of paradise.

So now it's back to life. I'll tell you about my fingerprinting adventure the next time.

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Don't Rock the Boat

For the next 9 days my bride and I will be cruising in the Caribbean. I will do my best not to gain weight. I don't know if I will be able to contribute anything to this blog while I'm on the high seas, but I'll take notes to let you all know if anything interesting (or thought provoking) happens while I'm away. I never received the fingerprint kit in the mail so I was unable to complete the security clearance procedure for SSA. I suspect it will come while we are away-then another few weeks wait while they check me out. Today is my last day at the cardiac rehab program. They are moving to a hospital next week and will no longer need me there to "put out fires". Note to the schmendrick who contacted me about my commentary on Dr. Jarvik: Put it in the Comments section rather than emailing me. That's why it's there. Thank you.

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That's the signpost up ahead - your next stop.....

It finally happened! I got the contract from SSA. I received the document via email and sent back a signed copy. Called my friend in the disability office to find out when I could actually start and was told I needed to pass the security check before I could begin. They were supposed to send me some forms to fill out but forgot to include them. Also need to get fingerprinted and it says the contractor (that's me--an offerer no longer) will bear the cost of the procedure. It would be nice if I could get all of that done before my bride and I go away at the end of this week. Speaking of my bride, it was her birthday this past Monday so I went to a mall I never go to to look for her present. (BTW-I already returned it today-she's very easy to buy for; returns virtually everything.) Anyway, that little excursion was a foreshadowing of things to come in my life, I'm afraid. It took me at least 15 minutes to find (what I thought) was the correct exit to a parking lot that I'm very unfamiliar with. Once in the lot I couldn't find my car. I pressed the key fob and faintly heard a honk above all the din. Over the next 20 minutes I tried walking in every possible direction while listening to distant honks become more distant. It was a mash-up of a Seinfeld and a Twilight Zone. I finally realized I was on the wrong level. I'd probably still be there if not for that minor epiphany.

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From Woodlawn with Love

So it's been over a week since I completed all of the required paperwork for the SSA position. I called my contact there last week and was assured that the grants office would move on my case since the disability determination office would really like me to start. I called today to check on progress and was told that once the grants and acquisitions office approves me, then I need to pass a security check. I knew it! That jaunt through the "abandoned" missile base back in 1970 is going to come back and bite me! I hope they don't flutter (spy jargon-subject to a lie detector) me. I wonder how much waterboarding I could endure? Everyone breaks under questioning-it's just a question of how long one can hold out. It's important to stick to your legend no matter what. I never told you all, but I did apply to the CIA two years ago for a medical officer position. Haven't heard a thing yet. My sense is that they're doing a very thorough background search before I'm formally approached. Perhaps I am a little old to participate in mokroye delo , but I do possess certain talents (which I am not at liberty to discuss here) that would be invaluable to The Company.

Well, I sent an email off to SSA and hope to motivate them a bit. Ha!

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How the Mighty Have Fallen

Pfizer pulls controversial Lipitor TV ads.
The CBS Evening News (2/25, story 6, 0:30, Couric) reported, "You won't be seeing any more of those Lipitor (atorvastatin calcium) ads featuring Dr. Robert Jarvik who invented the artificial heart." Drugmaker "Pfizer said it's pulling the ads for the cholesterol-lowering drug because they led to 'misimpressions.'"

According to NBC Nightly News (2/25, story 9, 0:35, Williams), "Questions about Dr. Jarvik's credibility as a spokesman" have been raised by a congressional committee, among others.

On the front page of its Business Day section, the New York Times (2/26, C1, Saul) notes that Pfizer "spent more than $258 million advertising Lipitor since January 2006, most of it on the Jarvik campaign, as the company sought to protect Lipitor, the world's best-selling drug, from competition by cheaper generics."

According to the Wall Street Journal (2/26, B5, Johnson), "Dr. Jarvik has starred in six campaigns for Pfizer." As an example, "[o]ne ad depicts him at a lake discussing why he takes Lipitor." The ad "plays up the fact that he is a physician, saying, 'Just because I'm a doctor doesn't mean I don't worry about my cholesterol,'" and adding, "Lipitor is one of the most researched medicines. You don't have to be a doctor to appreciate that."

I'd like to take this opportunity to thank all of the readers of
Shy and Retiring for the grassroots letter writing campaign that was finally able to convince Pfizer to dislodge and jettison that mountebank Jarvik from his position as spokesdoctor for Lipitor. This was a very effective use of our collective voice here at S&R, but realize that we have only won half of the battle. The next (and most critical) phase is to convince the suits at Pfizer that yours truly should be offered the exalted position of touter-in-chief for Atorvastatin. I refer you to an earlier post where my unique qualifications for this job were clearly outlined .

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Fedbizopps II

Arrgh! Finally finished all of the forms and registrations needed for the SSA job. I have my own DUNS number, MPIN, TPIN, TIN, CCR entry and ORCA entry. I have successfully navigated my way through the original proposal's 63 page form. I submitted three paper and two online copies of that mini-tome. I have spoken with folks on multiple help desks (who were surprisingly cordial, I might add), and I have met face to face with one of my erstwhile online SSA friends. I took one trip out to deliver the stuff and realized that I had driven to the wrong location. Fortunately, my original contact person called me to find out my application status while I was driving around searching for the correct address and she was able to guide me correctly. Now to sit back and see just how long the remainder of the process takes.

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License to Shill II

Well, now it appears that Dr. Jarvik may have been using a stunt double in his celebrated pro-Lipitor commercials. It wasn't really him rowing. Loyal readers of this Blog (I'm not sure if there are any readers-loyal or not.) will recall that I offered my services to Pfizer (in light of my unique qualifications) in my entry of 1/8/08. The fact of the matter is that I MYSELF bike 4-5 miles on most days. I have never used a double. Of course, the price for my endorsement has gone up but is still negotiable. I'm waiting.

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Pudding my best foot forward

I'm on a streak. Got into trouble again yesterday. Some of my online friends had been talking about banana pudding for weeks so I finally asked for the recipe. I gathered all of the ingredients and went to work. Here's the recipe:

2 packages of vanilla (I used banana) pudding
1 quart of milk
1 can of sweetened condensed milk
1 tub of Coolwhip
1 brick of creamcheese
3 bananas
Vanilla wafers

Dir: Combine ingredients (except for wafers and bananas) in blender at low speed until creamy.
Pour in bowl.
Slice in bananas, cover, and chill in refrigerator.
Spoon over crisp vanilla wafers.
Enjoy.
Watch thighs, mid section, and buttocks expand.
Get hollered at by all females in life who try it.

I slowly put all of the ingredients into the mixer except for one. I sort of dropped that brick of creamcheese right in, wondering how the appliance would deal with it. Big mistake. The bowl started violently shaking from the unbalanced addition, much like an asymmetric load in a washing machine. Everything started sloshing around and splattering. I grabbed for the control bar but slid it to "high" (I don't think I've ever used the mixer before) instead of "off". That's when the pudding hit the fan, the eruption occured, and the entire corner of the kitchen where I was working-myself included- was covered in a sticky, milky mess. Needless to say, it took a while to clean up. I ultimately got most of it into a huge bowl, cut up the bananas, covered it, and coaxed it into the refrigerator.
I also made "from scratch" pizza with whole wheat flour. The last time I had used yeast was when I grew it in microbiology class in college. It's amazing how quickly they start generating gas once you add them to water. The pizza was good. Great crust! Then came dessert. My bride said it was delicious but accused me of sabotaging her "diet" (She only weighs 110 lbs). I took the bowl to my daughter's house and gave her two thirds of it, but she joined forces with her mother.."You're a cardiologist..What were you thinking?" The only one who didn't give me grief was my grandson. He liked it. That was good enough for me.

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Go with the Flow

Alright, I screwed up at the bank. My bride gave me an envelope with a few checks and a deposit slip. Somehow the checks got into the wrong account. Actually it was the wrong bank. I knew I was in trouble the moment I left and realized what I had done. To keep this from ever happening again, I quickly made my way home and composed The Husbands' Flow Sheet which I will carry with me from now on.

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A look under the hood

In my heart, I knew an excursion to the dealership for my Altima's 7500 mile check would yield something memorable to write about. I'd been putting it off for months. I had received the "friendly" reminder back in September, though with the reduced amount I've been driving (now that I don't run to the office most days), I hadn't even reached 7000 miles. Today's trip was also prompted by the fact that a few days ago I had collapsed the right front portion of the bumper by trying to occupy a space already spoken for by a big block of ice-'nuff said.. I needed an estimate for body work. When I checked in, I was told that my model had been recalled for reprogramming of the computer-Sounds serious! I was informed by the smarm friendly service manager that it would take "several hours extra". Hmmm...Reprogramming. Somehow I suspected that they hadn't tasked that gig out to a battalion of nerds. The same genius who changes your oil attaches an electrode or two somewhere or other and pushes a button on a black box which updates the software. Several hours extra. For God's sake- when we reprogram a pacemaker in the office, it only takes about 5 minutes.

Anyway, I was called back in the afternoon to come and get my vehicle, though they still hadn't performed the estimation for the body work. I did manage to convince them to take the car to their body shop (about 100 yards from the service area) before I got there so some of my time could be saved. I arrived about a half hour later and did the full 100 yards from service to collision without the "guide" they suggested accompany me. They still hadn't done the estimate. I was having a coffee at the courtesy bar and had shaved off another 15 minutes of my lifetime when a guy who looked suspiciously like Delbert McClintock (John Goodman in Arachnophobia) sauntered out. We walked over to the car and he gave it the old professional once over (with clipboard in hand and pencil behind the ear, naturally). I fully expected to hear:

Molly Jennings: Why is all the wood rotting?
Delbert McClintock: I'll tell you why. Bad wood.
Molly Jennings: So... what do we do?
Delbert McClintock: Tear out bad wood. Put in good wood.

Gentle reader, I kid you not. Here is what he actually said to me as he regarded my poor little disfigured Nissan:

Ouch..That musta hurt!

Halt! We really have to put everything aside for a moment and think. This fellow looked like he was in his fifties, though morbidly obese people tend to look older than their chronological age. Let's assume he's 45, so we can figure that he's been doing this for some 20 years. How many times do you think he's repeated that line and thought he was being:
1)empathetic
2)cute
3)fatherly
..and felt good about it?
Hey, I worked with the public for many years and frequently cringed when I found myself contemplating using a hackneyed phrase or invoking what I hoped was a spontaneous witticism, knowing full well (at some level) that little I had to say was either original or witty. I can tell you that I approached these moments with trepidation and humility. So was I then supposed to respond? It was suddenly very clear. Not only was he taking an estimate of the damage to the car, he was going to estimate my parry to his verbal thrust. Somehow this would give him enough info to make a true estimation of the entire situation and charge me accordingly. But he had caught me off guard. I was only able to muster a meager "Yeah, it sure did." Embarrassing. I will never let that happen again!

He scribbled a few things onto the clipboard and we walked back to the office. He then spent some time crunching numbers in an ancient adding machine complete with a handle on its side. It was so old that at first I thought it was one of those ENIGMA devices and he was doing some code breaking for the allies. It finally spit out a length of tape showing all of the calculations and the grand total. He handed it to me, gave me a moment to digest it, then whipsawed me with the disclaimer that the kids in legal had scripted for him:

Ya know, this only applies to what I can see.

The estimate for the bumper was about two hundred dollars higher than others I had received. I certainly wasn't going to let these guys do the work. As I drove home, I noticed that the windshield washer fluid light was on. I had seen this appear earlier in the week. It was a little annoying that they hadn't topped that off while I was being serviced. Once I got home I decided to fill it myself. I was amazed at the volume of fluid required. As I continued pouring, I noticed that my foot felt wet. Glancing down, I saw a stream of blue fluid nourishing the asphalt of Bonnie Road. Utilizing my powers of reasoning, it dawned on me that my interaction with the parked ice block earlier this week had resulted in a crumpled bumper and a ruptured washer fluid reservoir. One would think that might have been picked up by the "computer programmers", the damage estimator or others on the crack team at the dealership service department. I guess not.

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It's not over 'till the paperwork's done.

So I decided to go through the document. 63 pages. I wondered how large a team it was that hunkered down at the big conference table over at Headquarters one morning over coffee, bagels and doughnuts to forge this tour de force on the anvil of creativity. (Honk if you liked that image.) Do you think there's one guy (or gal) whose job it is to take what everyone writes and then translate it into something unintelligible?.. Hold on, folks- we can't start this until the specialist from 3-O (Office of Obfuscation) gets here. They certainly earned their money on this one. I learned a new word: Offerer. When I first saw this neologism I thought..this is how a drunk addresses a policeman: "Excuse me, Offerer..." In any case, there were many sub-paragraphs defined by number/letter combinations sprinkled liberally with decimal points. There were hyperlinks to documents that I'll need to fill out. The rules and regulations for confidentiality were outlined with great precision. I believe I'll need to be fingerprinted. I'll need to decide if I'm a minority applicant or not. I wonder if they do a background check? About 37 years ago, my friend Lee and I were exploring an abandoned underground missile base when the police suddenly appeared- making me wonder (in retrospect) if it was a truly deserted facility. Think there's an FBI file on that? You know, even if there is, I bet FBI and SSA computers can't talk to one another, so I suppose I'm safe. There were instructions on how many copies (both paper and electronic) need to be included. And there was a deadline-something a procrastinator desperately needs. Fortunately my bride is heavily invested in my getting this retirement job and will make sure I finish all the paperwork in a timely manner. Also one of the docs I know who works there called and offered to give me a hand with the application. Here we go..First I'll need my resume-Haven't had to look at that for 25 years...more to follow, I'm sure.

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Fedbizopps

The amazing part wasn't that I heard from my lady friend at Social Security (I knew she would eventually get to me with the proposal for the position). It was that she called me at 4:45 on Friday afternoon. I've often had the misfortune of driving on I-695 which passes by the on ramp from Social Security Headquarters on Fridays at 3:00 pm. The exodus of vehicles leaving is impressive. I asked her what in the world she was doing there at that hour. It turns out she's on flextime and comes in late in the mornings. I was impressed. The oxymoronic concept of an honest government worker (?cheerfully) serving her time and not gaming the system gave me pause for thought. Anyway, she told me it (whatever it is) was "finally out." and she gave me some code number with which I would be able to go to fedbiz.opps "on the web" and find some questions I needed to answer "..but they made a mistake and it's listed under mental health rather than cardiology." Perfect. I suspected that the mental health listing was a bad omen though I quickly suppressed that thought. Of course when I got home and tried putting fedbiz.opps in my browser, I was taken to a Google search page that listed sites offering contracts for producing boots for the Navy or for fabricating modular homes in St. Louis. Plugging in the number she gave me did not reveal any listing for my position. SSA is closed on Monday for MLK Day so I won't be able to even try to call her 'till Tuesday. I'll keep looking.

Well, I still couldn't find it, but my bride did-sort of like 9 years ago when I'd written a speech to give at my daughter's wedding reception. I passworded the document and promptly forgot the secret word. I tried everything I could think of and even had my Aussie cyberpal Baudwalker send me a cracker program that worked on it by brute force for about 8 days. While it was still chugging along, I confessed to my wife that I couldn't get to my speech. She sat down at the keyboard and within 5 minutes came up with the password, proving once again that she knows more about what goes on in my mind than I do.

So, we found the paperwork online and it's a 63 page document written in governmentese with all kinds of clauses and subclauses, regulations, rules, policies, etc. that I'll get my attorney to go through. Maybe I should just take that Walmart greeter job.

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Clean up day

A little bit of nostalgia today. Went to the office with some large cardboard boxes, emptied my desk and cleared my room. I lugged it all home and spent several hours sifting through it. I certainly had accumulated a lot of garbage over 24 years of practice, but there were a few gems. There were prescription pads displaying the many iterations of our group over the years. There were applications for privileges at various hospitals along with letters of support from colleagues. There was abundant drug company swag and there was a copy of one great letter of rebuke I had composed and forwarded back in 1993 to one of the major drug companies who had sent a flier inviting our group for a night of "male bonding" at the ball park. We were supposed to bring our "Skoal or Redman" and bring an "appetite for ball park junk food." Somehow I felt that excluding women, chewing tobacco and eating junk was not the right message to send to a group of cardiologists. Particularly stupid for a drug company, no? I expect some of you (that is if anyone actually reads my rant) are saying, "Get a life-Don't be such a tight-ass." Well, I can't help it. That's me. What else was in the desk? There were lots of notes about things I intended to do but never got around to, tons of slides sent by drug companies (anyone seen a slide projector lately?), VCR tapes of echocardiograms, old interesting EKG's, letters (mostly nice ones) from patients, etc, etc. Throwing 95% of it away didn't hurt one bit. I left most of my books. Old textbooks are basically worthless. We already laugh at some of the things we were doing just a few years ago. I took down my diplomas and certificates. I removed the bronze cast of Gandhi that one of my patients (a 90 something Optometrist who had worn stereo earplugs piping in classical music almost constantly for the last 4 years of his life so that he wouldn't have to listen to his wife nag him) had crafted. From the wall opposite my desk I removed the physician's Oath of Maimonides-a simple prayer which I read most every day I saw patients. BTW, it was probably not written by Maimonides but it's inspiring, nonetheless. I took them all down and packed them away. My secretary (excuse me---Administrative Assistant!) looked sad as I left. But I wasn't.

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Rejection

Well, their people wouldn't talk to my people so I'm back to square one and still waiting to hear from Social Security.

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License to Shill

So, I did speak with the lady from Social Security last week. She assured me that they were still working on my contract and "It should be finished soon...I know I told you that two weeks ago..but this time I mean it." I feel much better now, knowing that the vast, efficient machinery of the SSA is firmly behind my application to review cardiac disability charts.

Also found out last week that the cardiac rehab program will be moving to the hospital in mid-March instead of February. So they'll need me for another month. Thus, I'm obligated (more or less) to additional time drinking coffee, reading, Internet surfing, and watching members of various shapes, sizes and ages (some more pleasing to observe than others) exercise.

Actually, I was useful several times over the last week. A few of the rehab clients had bona fide heart rhythm disturbances (Atrial Fibrillation, Atrial Flutter with block , and PSVT) which needed quick evaluation and disposition (as opposed to datposition). Sent one to the office of what my group lovingly refers to as "the others" or "the dark side" (a rival cardiology group in the next building). Sent one to the hospital via ambulance without doing much to him since he was quite stable. The third one was in a rhythm with a rapid rate and I ended up gently touching his Carotid artery to "break" the arrhythmia (Don't try this at home unless your doctor says it's OK). So much for trying to reduce the drama in my life.

I see in one of the medical news publications emailed to me several times per week that Pfizer is being questioned by the FDA as to why they used Dr. Robert Jarvik as a spokesperson for the anti-cholesterol drug Lipitor since, though he is a physician, he is not licensed to practice. He appears to be giving "medical advice" in the commercials. Pfizer has no need to worry. If they can't use Jarvik but they feel they need a doctor/inventor, I'm their man. I take Lipitor, I have a license, and I have plans for several devices designed to improve life and ease human suffering: NagAtroN- Fully Programmable GPS /Auto Navigation system incorporating the voice of the driver’s (D) significant other (SO) and utilizing SO’s pet phrases for pointing out the inability of D to follow directions properly, keep to the speed limit, signal turns, etc, etc. Default VOX files are female, directed at male D but may be modified for alternate lifestyles. This device saves wear and tear on SO's voice and allows SO to relax while feeling confident that all mistakes made by D will be promptly pointed out and properly logged for printout and future reference; Sticky Bunz-industrial strength velcro panties one wears during a bath, adherent to its velcromate (I just made up that word)- a matching pad placed in the tub below one's buttocks, allowing care-free relaxation while soaking/reading and thus eliminating the constant fear of sliding into the water; and Reflect a Bowl- an oval shaped mirror one may affix to the underside of a toilet seat cover, allowing beard and moustache trimming by kneeling in front of the commode, eliminating the necessity for husband-based sink clean up (a universally unsuccessful enterprise), and therefore a boon to marital harmony. I'm having my people call their people today.

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Your Government (In)Action

Well, It's been since September and I'm still trying to arrange that part time job at Social Security. I had originally contacted them last spring and was told that they didn't need cardiologists. In the late summer, one of my former partners (who had left the practice years ago) told me that he had a friend who worked there, they probably did need a cardiologist, and that his friend would speak to them on my behalf. He did. So I called a woman at the Woodlawn office (the main Social Security complex) about the position, and she began to gear up to send my information through the system. I tried not to annoy her (I'm Shy, remember) but, like many things in life, you have to make some of your own luck. I spoke with her in September and was told they had to finish up their "year" and couldn't start the process until October. Spoke with her again in October, then in November. At some point she had me speak with another person who arranged for me to get a special number that allows me to contract with the government. Did that and now have my unique "D-U-N-S" number. She then sent all my info to someone else who was supposed to do God knows what to it and then get back to her. I called the original woman two weeks ago and was told I would be hearing something soon. Soon is a word that has no precise meaning. It's more of a concept than it is a measure of time. I'm thinking it's like the word day as used in the biblical creation story-where one day may have represented millions of years of evolution (we're not gettin' into that debate here). Well in my universe, soon is less than 2 weeks. So I tried calling back yesterday but got no answer. I'll try again today. I'm hoping to hear from them before one of those giant asteroids hits us and wipes out all life again.

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Start Saving for the Wedding

So my daughter and son-in-law had a little girl who appears healthy(Thank God) and (so far) pretty placid. That's her big brother holding her in the first pic.The baby will be named this Thursday in Synagogue and there will be an Oneg Shabbat/Simchat Bat at their place after Shabbat dinner this week. We'll have the entire family there and my son and daughter-in-law will come down from Manhattan. Our daughter is doing fine and will be in the hospital only one more day. Of course all of this excitement gave me more reason not to do all of the things I've been meaning to do. Back to the gym tomorrow.

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