Thursday, February 23, 2012

The Retrospectroscope

A useful tool for the elderly,the retrospectroscope for self-examination, when advanced along a lumen, viewing it through the lens of the scope, will display the interior of the channel the elderly created. The channel isn't called a "lumen" for nothing! The tool isn't called "scope" for nothing! Call it "breadth of illumination"! What was, isn't, but the pathology is usually so inexorably slow and often nuanced that it is often not displayed when the lens is fogged up and only seen when the flexible scope is advanced carefully and slowly. What you see is not always what you want to see. When you look up your own Ying-Yang, one's posture is difficult to maintain and sometimes painful, but self -examination is usually worth it. You are no longer armed with biopsy forceps so one cannot extirpate the lesions one discovers; you must merely observe as the diagnostician would do! Like all endoscopic procedures, regular assessments are of value in so far as providing knowledge, even if cure is not available. You can not change the past, but you may redress the past! You can record your findings and describe the intricacies of the pathology for others. You can reacquaint yourself with causality and preventative actions and be wise for others who are without the years necessary for acquiring such a tool. The good physician may give advice, but it may fall on deaf ears. So too, it was with me! The lesions we produce in life and the stumbles we create are the whetstones for what we become. I always learned more from my stumbles than my successes. To know it, we have to scope it with good illumination.

Tuesday, February 21, 2012

Boogeyman

Tomorrow is Ash Wednesday and I will meet my Boogeyman. Last night I dreamt of him. He appeared on a flat sea in the horizon; at a distance, a tall hairy Ellipsoid walking on water toward me, with seagulls flying in the background. It looked initially like a tall hairy dog, and then a burro, and then a young Wilding! The eyes were glistening! He asked me if I was alone! My Boogeyman is the interior evil that manifests from time to time when I don't nourish the goodness and feel alone. Not only does the Boogeyman speak for me, but he closes my ears and appears in the eyes and the mouth and posture, much like the Boogeyman of Dr. Jekyll. Jesus dealt with his Boogeyman three times in the wilderness by obedience to Goodness. It does no good to believe that the interior Boogeyman is not there with me. He is always there. When I went to a silent retreat on Ash Wednesday one time, I was assailed with a dream of my collection of sins. They came falling down from the sky like large raindrops with labels. The recognition of them is liberating in a setting that promotes goodness and forgiveness. When I was a little boy I always looked under my bed to make sure the Boogeyman was not there. He was never there or anywhere else outside of me. Having now found him, it is possible to keep him more or less in check by suffering through the knowledge of the sins of omission and commission and striving to nourish the goodness in preparation of Easter Day, when my load and my cross was shouldered anew!

Wednesday, February 15, 2012

Orca Incident

I often fished in Pedder Bay, near Lotus City, and particularly the mouth of the bay around the Race Rocks where sea life was abundant and with the feed chain in full swing, the top of the chain, killer whales, were also abundant! A local entrepreneur in the 70's developed a market for killer whales and Pedder Bay was used to create a holding pen for herded killer whales, to be sold to provide stock for Marine Shows throughout North America! Having our boat moored in Pedder bay for the summer that year, the whale pen was always a point of interest. Several adult whales were confined to a good portion of the bay by submersed netting with surface floats that were well demarcated and the whales could be seen swimming at the surface. My friend Bill, son Robert and I were fishing one beautiful summer day, and I said to Bill, who I thought had not been to Pedder Bay before, "Have you ever seen the Whale Corral here in the bay?" "No", he said. I told him we would come close to it so he could take good look. On the way back from our trip I cut the engine when we were near the pen so we could sit and watch. I had not noted how fast the tide was running and since we were without power, the boat slid gracefully over the netting into the centre of the pen. The whales had company. My boat was a displacement hull and the propeller was three feet below the water line. I could envision in an instant ripping out the net with my propeller; creating a big enough rent in the pen to allow several million dollars worth of whale make their escape. Bill, whose seamanship was of low quality, made his way to the cabin to make a cup of coffee. I don't think the truth had yet dawned on him or else he was disavowing us! My 12 year old son was just excited to be in whale company. The whales were, on the other hand, totally indifferent to us. They seemed happy enough. I couldn't chance powering over the net with a running propeller, so I started the boat at one end of the pen and raced to the other side, cutting the power at the last moment and allowing the way to carry me over. Luckily for us, there was no damage and were no observers. Capturing killer whales is now the crime, and had we damaged the net it was no solace that we might have been celebrated by a subset of people in today's contemporary mind-set. I'm just as glad for the anonymity. It was a stupid thing to do!

Sunday, February 12, 2012

Anatomy Exam

In 1960 my surgical colleague and I were seconded by the Department of Surgery, to the Department of Anatomy at the University of British Columbia for a year.My colleague liked it so much he stayed as an Assistant Professor in Anatomy, but I returned to my surgical training. We were designated Teaching Fellows in Anatomy and taught and assisted the 65, first year medical students, on Monday, Wednesday and Friday; all long days in the dissection room. Keeping to the manual; not letting them forge ahead; not macerating the tissue and getting lost; keeping the human road map clear and avoiding misidentifying the signposts and going down the wrong road. We shepherded them throughout the year. They learned that under the skin we are all of the same clay, except the odd anomalous region where we are not. The famous examination that ushered in a sense of dread in all of them, was the spot examination. It was a step off the cliff that produced anticipation anxiety. Sixty-five specimen stations were set up on a quadrangular group of tables in a large room; each 2 stations manned on the outside by an invigilator from the teaching staff; and a bell rang every 90 seconds to signal the students to move to the next numbered station. Aside from the bell, and the rustle of their pen on paper, and scraping of chairs, there was no sound as they moved around the inside of the tables. Penned in like sheep being led to the slaughter. The stations may have contained a bone part to identify, a slide of pancreas with an arrow at an islet of Langerhans,a foramen at the base of the skull, a nerve tagged in a shoulder specimen, and so on! It was not only a test of knowledge, but a test of performance under pressure. I was manning the 2 stations next to the Department Chair. A student examining a slide in front of the chairman was not wearing a white shirt and tie. I heard the chairman say to the student, "Mr Doe, students of a medical class that are careless about their dress are likely to be careless about their practice and often do not pass this course!" As this man moved to my station, his distress was so devastating that I realized, at that moment, that a life in the academic community may be too far removed for my core, and wasn't enough for my reality. Him, the casualty: me, the lesson! A surgical career may be rough work, but at least, pressure and compassion go hand in hand in that milieu!

Dorothy and Martha

Dorothy and Martha were two Labrador Retrievers I spent a year with. They were experimental subjects in my project, determining the effect of hypertensive agents on cellular exchange of potassium and sodium. A conflict I wrestled with was, I have always had a love of dogs, as does my pianist and my children. The dog lab was at the University of British Columbia and the year was 1960. At that time UBC had a large attached farm and I would pick up Martha from the kennels on Tuesday and Dorothy on Thursday. They were well looked after in the kennels because they needed to be healthy throughout the period of experimentation. When I picked them up, they seemed to know which was their day, and after a little quivering they would come with me down the trail, ambivalent, since they enjoyed the time out in the un-kenneled world, and with an interlude before the day's trial. My predecessor had spent a year teaching them to lie still and supine on a table for 4 to 5 hours while they were cannulated in the femoral artery and two veins, infused, injected, arterial pressures measured, and blood sampled over the period, all the while un-anaesthetized and unrestrained. I have often thought of Dorothy and Martha, and still do 52 years later. I think they were precious. I suppose that is sentimental! I don't care. That year was my only encounter with animal experimentation, thank goodness. In some curious fashion they were attached to me despite the pain and discomfort I must have inflicted on them, which they bore in silence. At the end of it all, we always had a little play and they gave me tail wagging. I suppose even painful attention is better than no attention in the permanently kenneled. Though animal experimentation, even then, went through rigorous ethics assessment and is the heart beat of scientific progress, the feelings I have today are mixed with the sense of man's inhumanity to dog, and what they will say to me in the hereafter, when I ask their forgiveness for fooling them.

Saturday, February 4, 2012

Dormant Spray

Luckily, we now have 6 sunny days in a row to come on the wet coast here on Lotus Island! There wasn't much sun today since we have had dense fog but it is warm and DRY and that's what counts for spraying. The sun burst through for a few hours. No wind has meant that the sulfur and oil has not blown back in my face as much as usual, but still, you can't spray with the hose sprayer without some drenching. The hose sprayer is strong enough that I can spray from the ground as the 12 trees, although about 100 years old, have been kept to twenty feet by my very good pruner. My glasses get repeatedly covered with oil and water so I feel a little like Mr. Magoo fumbling his way to the tree. I am commanded to wear a mask so the glasses also fog up from the inside and it's hard to clean your glasses with slippery, oily, yellow-orange hands. At least the oil doesn't line my aveoli! I didn't spray last year, to my dismay, when I saw the number of egg cases of tent caterpillars this year and recalled the scabby pears and apples and the powdery mildew in the summer. Sulfur for the fungus and oil for the worms. I'm intent on eradication this year and will spray again March 1st. In a sense it is not unlike the practice of medicine! There is a tide in the affairs of men, and making hay when the sun shines, is seizing the day! I see a lot of black and green algae on the wooden decks and particularly thick on the cement aggregate patio. The price of warm weather and el Nino. I will also spray this with the fungus and algae off compound and then power wash. There is fungus,moss and lichen on the roof shingles too, though they are not so bad, but spraying the shady side of the roof is also on the agenda before it rains again. What a battle with Mother Nature this week but I am girded for it and the only downside is a ring around the bathtub every night! The shingles are cedar but 17 years old so I dare not scrape or tread too roughly. Spray and leave has worked in the past. It's all still better than shoveling snow!