Nothing makes an Army drill sargent (prounounced something like ‘Sar-Ughnt’) more testy than when a good number of his/her unit skips morning physical training.

I take that back…there’s a veritable Olympics of things competing to be the thing a drill sargent hates the most.  But showing up late for PT is definitely on the list.

One of my jobs is to set up patients with this Army thing called a Profile.  THE profile.  After a few months here, I can say in all certainty that the profile is my own personal battlefield.  Everything I do seems to revolve around this paean to administrative oversight.

Simply put, the profile defines what an injured soldier can and can’t do.  They get very specific: Soldier may mix cocktails, but d/t a herniated C-4 disk, he may not tip his head back to drink them.

Oh MAN...we can't come in 'till 9. Super tired...

One of the big reasons I see patients is to “review the profile.”  Read between the lines, and typically, the visit is really about the patient trying to get some other restriction put on their profile.  Restrictions that will make most soldiers ecstatic and drive a drill sargent nuts.

The most ubiquitous profile restriction is the “0900 work call”.  Prounounced “Oh-9 call”.

Droopy-eyed private: “Uh, man, sir, uh.  Need an Oh-9 profile.  TONS of sleep meds. Can’t get up for 0630 PT.  Help.  Desperate and all that.”

Me, Dr. Naive:  “Ok.”  Fill out form.

Private: “THANKS, man.  Can I get Oh-9 profiles for the rest of my X-Box buddies.  Now that I can stay up all night playing Soldier of Fortune, I need my buddies cuz we compete against each other.”

“Soldier of Fortune…isn’t that pretty bloody.”

Evil smile, “YEAH, totally.  We just run around shooting everybody.”

“K.  Why are you on meds again?”

“Can’t sleep.  PTSD.  Keep seeing people get shot when I close my eyes.”

Embellished only slightly, I’m coming to the point where I can’t see a SINGLE medical reason to approve someone for 0900 work call.  Sleep meds don’t last forever.  If you take them at 7pm and are in bed by 0800, you should be able to get up in time for PT.

I’m asking around to doctors I know:  Any medical reason you can think of to allow someone to come in at 0900 rather than 0630?


Giant Party at the Brandenburg Gate

20 year ago tomorrow, the Berlin Wall was breached.  The first East Berliner to make it across – legally – was a woman named Angelika Wachs (news to me…old hat to everyone over here).

Algelika Wachs

My favorite band of all time – U2 – performed a live show in Berlin this past Thursday to start the festivities, which will continue through this week.  We live 3 hours from Berlin, and may as well still be in Olympia, unfortunately.  The celebration isn’t history…but it will get close and I’d love to be there.

The U2 show was free.  All you had to do was get a ticket via the internet.  And you had to do it within a 3 hour time-span because that’s how long the 10,000 available tickets were available.  Being a free concert, you might find the need for tickets a bit ironic.

Even more ironic:  if you didn’t have a ticket, you couldn’t see the show.  Why?  Because MTV (the show’s producers) had erected – you guessed it – a WALL to obscure the performance.



At Least Insurance Is Unhappy

[picapp src=”8/c/c/9/Activists_Protest_Health_2d6a.jpg?adImageId=5600841&imageId=6721596″ width=”380″ height=”570″ /]
The day that medical insurance execs and medical malpractice lawyers are screaming that their sky is falling, is the day that the U.S. has gotten serious about health care reform.

It sounds like half that equation is at least whining, so maybe some modicum of real reform is coming.

If You Want to Learn English…Move To Germany

The German village where we now live – Bruchmulbach – is surrounded on all sides by American military bases.  And we’re not talking quaint Alamo-throwback musket armories, either.  The bases around here are the real deal.

ramairRamstein – 10 minutes from us – is the largest Air Force base in Europe.  A totally self-sufficient fenced city, the installation comes complete with a 2-level mall, restaruants, sports bar with the requisite 38 flat panel high-def T.V.’s, 18-hole golf course, fast food, a police and fire force, grocery stores, gas stations, brand-new 10 million dollar pool facility (I’m lovin’that), preschool through high school and a wide array of corresponding sports teams, as well as a full-sized airfield with trans-continental military flights leaving and arriving daily.

Just up the road from us is Landstuhl Regional Medical Center, which is one of the largest military hospitals in the world and one of the largest hospitals in Europe, military or civilian.  As mentioned recently, I got lost in there and wondered if I would ever escape without the assistance of a space-time wormhole (I did, but it was close).

Oh, another thing your tax dollars fund is a complete bussing system to get all the civilian kids from their outlying German villages to the schools on the bases.  This made our initial choice to put all the kids in base schools a pretty easy one.  Teachers are shipped from the States all credentialed and up to the exacting standards of the U.S. Dept. of Education.  Schools have playgrounds and dry-erase boards and gyms and cafeterias.  The whole thing.

landstuhlLittle America.  Right here in the south of Germany.

But just the other day, I saw a patient who has lived in Germany for 40 years…and doesn’t speak anything but rudimentary German.  Clearly, you can live an entire life here and never really learn the local language, the customs or the culture.

The military, actually, is trying for this.  Most of their people have been moved here, will move again in 3 years, and so the more like America their lives are, the better it is for these families.  You even spend U.S. dollars on the bases, even though everyone for hundreds of miles in every direction uses Euros.

But for people like me, who came here volitionally and want to intersect with this new world, this re-creation of where I just came from, isn’t such a welcome thing.  Cindy Lauper had some chops 20 years ago, but do I really need to hear “Time After Time” as I drive across the pastoral German countryside on my way to work?

Since the bases here are such a huge part of the local economy-  wait, amend that: They ARE the economy here.  They’re it.  We’re talking millions of dollars every year from these military operations.  As a result, along with all the completely Americo-centric base workings, the local area totally caters to Americans too.  As soon as you say you want to speak English around here…they just switch over from their German to usually a very well-learned English.  Walking down the street in Portland, if some guy came up to ask you a question and said he only speaks German, could you switch over and cordially address his needs in his own language?

I couldn’t.  Not in ANY other language on planet earth.  MY ways are the ways of the world, right?  I should mention, in my defense, that for a few ultra-geeky years in Jr. High I might have had some hope using Klingon, but again, we’re talking about this planet.  And if I did meet a monolingual Klingon speaker in downtown Portland, we’d have much bigger problems than mere cultural ignorance.

stoneAnyway, our big decision (among what seems like a gagillion of them lately) was to pull the kids out of their American schools…and HOMESCHOOL them.  That’s right.  We’re pullin’ em out.  They can learn the 3 R’s in the AM, and work on German during the afternoons.  I’m hoping to find some nice German grandma who misses her kids to come over 2-3 times a week for cheap to tutor them as well, and we just bought Rosetta Stone, homeschool edition (created for monolingual parents with visions of grandeur).

If I leave here bankrupt and sick with some strange German microbe that ate the flesh off my face and all tips of my body…but my kids learned fluent German, I’ll be perfectly happy with our time here.  I promise.  No complaining.

Don't worry about German, kids, just keep up with your AMERICAN
Don't worry about German, kids, just keep up with your AMERICAN

The military base schools have a German “appreciation” class, but they should be ashamed of it.  It makes no attempt to actually teach the German language.  It’s just meant to let kids know about life in Germany (makes sense, if you live in Thailand).  The first class consisted of some guy opening up his laptop and reading off Bill Gates quotes – in English – about following your dreams and not letting anyone tell you you’re a loser.  Frankly, if enough people tell you you’re a loser – in, say,  French, German, Farsi, Hindu, Arabic, Japanese, Chinese and Russian – at some point, we Americans might want to listen.

And, when approached critically, I have to say that much of American school is laughable.  So much time is spent lining up, obeying, filling out forms and being entertained…I’m not sure that kids learn much at all.  We’re certainly not keeping up internationally (AGAIN!  Health care, education…what ELSE can the rest of the developed world do better than us?).

Hey Man, I'm an ARTIST, man!
Hey man, I'm an ARTIST, man!

In France, for example, every village kid is entitled to real, genuine, music training in their local villages.  As part of their taxes, every kid gets a solid hour a week of actual music theory.  I’m talking just the bookish part of music for an hour every week, no instruments.  The boring stuff.  The hard stuff.  The stuff nobody has to learn in the States unless they REALLY want to do it, go to college to learn it, and spend 2 years on lower-level classes before they’re allowed to jump into the real thing.  This is America!  Learning is FUN!

Back to France:  THEN, kids get an hour a week of training on an actual instrument.  This would be the fun part.  The payoff for muddling through a weekly hour of theory.  They learn with a private instructor, in small groups of 4 or 5.  THIS is the way to actually learn music.  For American taxes, kids get some goofy music appreciation class where 55 kids sit around listening to “Bridge Over Troubled Water” while making sure to keep their legs crossed.  In my 6th grade music class, I got to listen to a recording of Janis Joplin mumble in a drugged stupor on stage until she collapsed.

germangIt’s true that our 4 kids could end up total imbeciles.  I don’t think the U.S. Education system is totally worthless, and there are some good things about the schools that we will lose.  We worry about that.  But I think, given the options, that our Rosetta Stone + Grandma approach holds out at least as much hope of truly teaching our kids another language and culture than what is offered on the military bases.  With good curriculum and focus, we should be able to get them up to speed on the academic topics too.  We aren’t the first one to plow this field.

Then again, we’ve been at it a week.  I’m still all filled with principle and certainty.  We’ll see where we are in a month.

Ode To Mr. Fingerprint

We can’t figure it out, exactly.  There isn’t one thing that we can point to and say, “Yeah!  That’s were everything became too much.”

But somewhere along the way, this little adventure piled up and reduced both of us to tears.  How the Army manages to organize itself enough to go around the world killing people – unless through excessive paperwork – still mystifies me.  But I can say that if they just stuck to the paperwork – threatened to attack the terrorists with administrative paperwork – world peace would be ho-hum news. 

“We give up!  We recant!  Never mind all that Allah stuff!  We’re Americans now.  Look, look, we’re buying Hummers and we all have flat-screen T.V. in our camel-skin tents with only CNN and Disney channels on them.”

I will say this:  With exception of the laudable fingerprint dude, I have never been to an Army office and gotten done what I came there to do on my first attempt.  Never.  And, for the guy to do my fingerprints that day, he had to overlook 2 reasons to send me away. 

If I’d had a trophy, I would have given it to him.  I DID sing his praises; describing his feat in a halting, emotional, too-grateful voice.

“I….I….I just want to let you know that.  *AHEM!*  Sorry, something in my throat.  Some sort of lump.  Anyway….”

Corpulent man in too-short square tie knit by kids in Taiwan R.O.C. funded by Wal-Mart stares dully, shifting slightly in his creaking office chair.

“You’re the first, EVER, to give me what I came to get on my very first attempt!  It’s a record.  Over the past 6 months, in dozens – maybe hundreds – of office visits my wife and I have needed to make just so I can do a job, you’re the first to not send me away on my first request.”

“Huh.  That’s good.  Fill out an I.C.E. card, alright?”

“What’s that?”

“A card.  You know, a card.  Tell ’em how I’m doin’.  Let ’em know I set you up.”

Right.  I.C.E. card.  I took that thing home, spent 45 minutes filling it up with love and gratitude toward the first man EVER to spare me making 2+ trips just to get a simple administrative task done.

Then I realized it would take another trip to that office to put the card in the guy’s box.

And I shredded the thing.

Never Offer To Cut Off Your Own Leg

At least, not in the Army.  They might just take you up on your offer.

Joe (do I really have to tell you that this isn’t even close to the guy’s real name?) had problems with his left leg after 2 deployments to Iraq and multiple exposures to high-velocity trauma.  Lots of problems, shall we say.  The leg often doesn’t work much at all.  Sometimes, this overwhelming feeling of burning pain spreads from his mid shin up to his knee and then pulses up into his thigh for hours.

But what’s debilitating leg pain got to do with being in the Army?  At least, that’s how Joe sees it.  Unlike most soldiers in the WTU, Joe is determined to stay in the military.  He wants to be sent “down range” (deployed) again.  Tomorrow, if possible.  He loves his unit and enjoys the excitement of his job. 

Joe does not understand that a soldier who can’t walk probably isn’t going to do well in a war zone.

Actually, Joe is quite smart.  He understands perfectly well that a debilitated soldier can’t perform a required in a combat situation.  But he doesn’t care.  He loves the Army.  Lives for the Army.  So he has worked with a lawyer for over a year now to keep himself in the Army.  The WTU doc before me has worked to this end – admittedly with some bemusement – for the past few months as well.

Recently, Joe met with a special review board comprised of high-ranking commanders.  They evaluated his chart, looked over the reports of his injuries, and then interviewed him personally.  I think this occurred at Walter Reed Hospital, in Washington D.C. in – the Mecca of Army Medicine.  As you might imagine, this was a big deal.

I don’t know the exact specifics of that interview, but here’s my reenactment:

“Soldier, you’ve served your country well.  We thank you for your sacrifice and heroism.  After thorough review of your file, we have determined that you are no longer qualified for active duty and will therefore be separated from the military with full medical coverage and benefits.  You will be given an honorable discharge and should have no problems entering civilian life.”

“Sir, it’s the leg, right?  That’s the problem?” Says Joe.

“Correct, Sargent.”

“What if the leg wasn’t a problem?  What then, sir?”

“Why, you’d stay in the military, Son!  Send you down range week after next.  Get you back in the fiiigght, boy!”

“Then cut it off!  Just cut the damn thing off!  I can run on a prosthetic.  There’s less to clean up if I get crosswise of an IED (roadside bomb) again, right?  Just send me down there with a couple of extra legs in my pack and I’m all good.”

This – honest to God – is a relatively faithful reenactment of this soldier’s conversation with his Army superiors.  Admiring his courage and commitment, I was more surprised to find that, following this meeting, our doctors in the WTU received this order from on high:

****de, de, d, d, deeeee —Official communication from High Command:  SGT Joe to be referred to surgery for evaluation of chronic leg dysfunction and pain.  Consider surgical correction.  Amputation a viable option.——-de, d, d, deeee,

***** Stop.

Good Samaritan…Law?

I recently fell victim to a rule here in Germany entitled ‘The Good Samaritan Law.’

The statute irked me even before I suffered under it, because it evokes a sacred parable, but totally misses the enduring message of the story.  Worse, for those not familiar with one of the most important stories in all of Christianity, familiarity with this law will likely make you presume the exact opposite storyline of The Good Samaritan.

You can read the story yourself in any self-respecting Bible containing the book of Luke.  Specifically, Luke chapter 10, verses 25-37.

Incidentally, Luke is my favorite of the Gospels not only because he was a doctor, but also because without him, we wouldn’t really know much about the early church after Jesus died.  Luke wrote Acts along with his Gospel.

Doctors.  Always so thorough.

473px-Rembrandt_Harmensz._van_Rijn_033Anyway, for a brief run-down of the story, a guy gets the smack-down by bandits while traveling by himself on a lonely road.

While laying there – naked, hacking, bleeding and wheezing – 3 different people walk by.  The first two people are the most likely to stop and help him because they’re either from his tribe, or religious-types who might just kinda want to reflect the love of God to the lost and suffering (and involuntarily naked).

However, those guys pass right on by as the man lays suffering in the gutter.  The person who does stop is the sworn enemy of the  beat-up guy:  the Samaritan.  Jews and Samaritans hated each other back then.  So much that cultured Jews wouldn’t even speak the name ‘Samaritan’.  Both groups had all these issues with each other and the way they regarded themselves as El Guapo of God, etc.

So, the story in today’s parlayance would be something along the lines of: a hyper-conservative-to-the-distant-right-of-Pat-Robertson guy stops in a discordant wave of compassion to help a bleeding man with a pink neon sign strapped to his body cyclically buzzing “I’m a proud man-flamer and really, really damn proud of it.  Christians SUUUUCK!”  This would be after Richard Simmons, Barry Manilow, Franc from Father of the Bride, Surge from Beverly Hills Cop and Bruno all sauntered past without so much as a 2nd sideways glance.

THAT’S the story.  The point gets at perhaps Jesus’ most profound and challenging admonition: love your enemy.  Volitionally.  On purpose.  ‘Cause you want to, you chose to, nobody made you.

In the Sermon on the Mount – by my estimation, the greatest oratory in all of human history – Jesus says,

You have heard that it was said, “You shall love your neighbor and hate your enemy.”
But I say to you, love your enemies and pray for those who persecute you, so that you may be sons of your Father who is in heaven; for He causes His sun to rise on the evil and the good, and sends rain on the righteous and the unrighteous.
For if you love those who love you, what reward do you have? Do not even the tax collectors do the same? If you greet only your brothers, what more are you doing than others?

Arguably, this idea of extending love beyond your own brethren to everyone – even punks you hate – distinguishes Christianity from all other religions. In my mind, this teaching constitutes both the core of Christianity, and elevates it above the world’s other great religions.

300px-Bloch-SermonOnTheMountLove your neighbor as yourself was espoused by the common religious teaching at the time, thought to be imported from Asia.  Love your brother as yourself is the prominent admonition in Islam.  But love your enemy?  That’s out there.  Was then.  Is today.  Pretty much never successfully followed by Christians, but profound teaching nonetheless.

So, you can see that when I encounter The Good Samaritan used in less-than-exact terms, I get edgy.  That story rests squarely in the central belief system of my life.

And what is the German Good Sam Law?  Simply, that if you see someone in need of aid, you are required to offer any assistance you reasonably can (no road-shoulder femur reductions required if you’re a manager at Staples, for example).

The name of this law probably came from an identically-named law in the States.  However, in the States, the Good Sam law simply protects anyone from getting sued for attempting to be a “Good Samaritan” by helping someone in dire need…and the would-be Sam actually screws it up, or just doesn’t actually help, or only sorta helped but could have done better…or anything else the average creative American might come up with to get themselves a lawsuit against your average kindhearted bonehead.

I don’t mind the name applied to the American law because it’s simply a protection against lawsuits.  It doesn’t reference the parable incorrectly.

The German law is incorrectly named because the whole notion of a Good Samaritan is that their actions are by choice and unexpected.  Furthermore, the Good Sam is helping someone he is supposed to hate.

The German law simply forces you to help anyone, love ’em or hate ’em.  So, the name has been applied lazily, which undermines a story with sacred meaning that shouldn’t be distorted.

Hmph.  Did I get old suddenly?

And how did this law affect me?  Today, while on an exit ramp on the autobahn, we were flagged down by a couple next to their car.  The man waved frantically, wide-eyed, looking like something must have gone terribly wrong.  I would not have pulled over at that point in the U.S.  I would have assumed it was some sort of scam and known that Emergency people could probably handle it.  But this is Germany.  I’m obligated to be a “Good Samaritan” (contradiction in terms…see above).  So I pull over.  The man urgently asks for gas money.

His car is out of gas.

Am I supposed to “help” with this?  Would I be a “Bad Samaritan” in Germany if I didn’t help this guy out?  Worriedly, I pull out 20 Euro and give it to him, furtively casting glances over my shoulder for the “Polezi” and seeing a disembodied officer’s head nod in approval as I hand over the legal tender.

The guy acts instantly relieved and immensely grateful.  He tries to give me his worthless “gold” chain, which we refuse.  I then realize that those 20 Euro cost me about 30 U.S. dollars, plus whatever cost I incurred to get them from the cash machine the day before.  Driving away, I realize that 30 bucks is more than enough to get some gas.  5 would have been fine.  I also wonder why the guy is trying to get money RIGHT THERE, why not wait ’till they got to the gas station, then peddle money?  My cash isn’t going to get him off the should of the road.

I gave more than I could afford, trying to avoid becoming a “Bad Samaritan”, and in truth, I was probably scammed.  In normal life, I virtually never give money to individual people I don’t know because I can’t be sure that what they do with the money will be beneficial.  I’ve long come to accept that giving money to beggars is really about my guilt issues, rather than my genuine desire to help them.

This time, giving that money derived from being afraid that I would go to German jail, forever labeled as a Bad Samaritan.

So, I’m critical of the title of the law.  I also think the whole idea of a law that forces you to help people has lots of ethical and liberty issues with it.

Germany’s great…but they ought to take another look at their law, starting with the name of it.

Vanished and Forgotten

I spent the past two weeks working as a stand-in for a private practice family doctor in the tiny town of McCleary, Washington.

The stirringly beautiful enclave is better described as a village.  Calling it a ‘town’ implies a bit more hustle and bustle than actually goes on here.

Evergreen trees pepper the landscape, outnumbering cars ten to one.  Wooden cabins and simple churches with peeling paint line the single main road.  A generous census – throwing in some dogs and cats to pad the number – wouldn’t put the population over 2000.

But even here, in one of the most idyllic settings in all of rural America, something wicked this way…came.

lindseyOn a soft warm night typical for Western Washington this time of year, 10-year old Lindsey J. Baum disappeared while on a short walk home from her friend’s house.

She was last seen on June 26th around 9pm wearing a gray hoodie.  Lindsey should have made it home well before dark at this latitude in early summer.  But after weeks with no leads, authorities now assume the girl was abducted.

Each day as I worked in the small medical clinic, I overheard discussions about Lindsey.  Frequently, people decried the lack of “truly effective” sex offender laws.

The one running blog I found about the situation abounds with merciless criticism of those who allowed her to walk home alone.  The posts have an annoying, self-anointed authority and certitude about them, coupled with virtually zero compassion.

townMy criticism, however, focuses on the response of the outlying communities during this tragedy.

7 years ago, about this same time of year, a similar event occurred to a young girl not much older than Lindsey in Salt Lake City.  In that case, word of the abduction spread to every news outlet in the English-speaking world in a matter of hours.  Pictures of her were posted on websites and in newspapers in ever-widening circles, to include towns and cities hundreds of miles away.

Every day, this girl’s story stayed in public view.  News of her disappearance became a dull, throbbing headache to virtually the entire Western United States.

That girl, Elizabeth Smart, survived her ordeal and was returned to her parents fully 8 months after being led at knife-point from her own bedroom.  Her abductor was recognized by someone who had seen a picture of him on “America’s Most Wanted”.  Nearly a year after the incident, this girl’s abduction was still making top news stories.  Why?

The Smart family drove this process, true.  The parents had money, were excellent communicators and kept their wits about them in a horrific situation.

But they also commanded a small army of help. Literally thousands of people lined up to join the effort.  The Laura Recovery Center and other organizations dedicated to this type of tragedy joined the effort as well.

People worked continually to get the Smart family onto national news and talk shows.  Pictures of the victim and her suspected abductor appeared on Larry King Live and Oprah.  And, of course, the show that ultimately led to the break in the case managed to make the story seem relevant months after the incident occurred.

By contrast, Lindsey is yesterday’s news.  You can’t find a current story on her anywhere.  For all I know, she’s home watching Hannah Montana and pondering boyfriend proposals.

mapMcCleary is so tiny, its presence is rewarded with a dot only on maps with an unusual commitment to cartographic accuracy.  The community there can’t make much noise by themselves; certainly nothing to approach the caucophony of a galvanized rescue movement in the heart of upscale Salt Lake City.

The only paper that has carried regular updates about Lindsey is The Daily World, which covers sparsely-populated Grays Harbor County.  A little village like McCleary needs help.  It needs the media power of cities like Tacoma and Seattle, and even here in Olympia.

Yet daily checks of the Seattle Times reveal constant updates about Amanda Knox – a case involving a beautiful college student, sex, drugs and murder – deliciously entering year 3 of drama, but nothing about little Lindsey.  Here in the capital of Washington, The Olympian seems to have the memory of a golden retriever regarding this case, and we’re only 20 minutes down the road.

The Puget Sound region should be plastered with information about Lindsey Baum.  Every 3rd street light and telephone pole should have a Lindsey Baum flyer attached to it.  Every newspaper in the region should have a running narrative of the latest updates on her case next to their logos.  Every citizen from Port Angeles to Portland, from Westport to Boise should know the name, and the story, of Lindsey Baum.

This isn’t idealistic, hyper-passionate pontificating, either.  I distinctly remember stopping for a lay-over flight in Salt Lake City during the summer of 2002.  As we made our way from one flight to another, we could rightly have called the place “Elizabeth Smart International Airport.”  Thousands of fliers and posters papered halls, pillars, windows and doors everywhere we went.

I don’t think anything will change with tougher pedophilia and kidnapping laws.  I also do not think parents need to be more vigilant about this kind of thing.  Increasing either has too many unwanted side-effects.

CandleWhat needs to change is how our communities respond to such a horror.

The abduction of any of my 4 children is the singular fear of my life.  If it did happen to our family, I can only hope that hundreds, even thousands of concerned citizens would take up the burden to rescue that child.  Even if I lived in a forgotten small town off in the hills and away from the city lights.  Even if I was poor.  Even if divorced, uneducated, bad on camera, or just plain ugly.

The way to stop child abduction is to make it really, really hard to steal a child.  An army of awareness might save Lindsey Baum from this evil she faces.  Ignorance lets it flourish.

Graduated – No Crying

The last days of residency passed – perhaps with a bang, and certainly no whimpers – and I am now full into my first week as a real, live doctor.

Everything feels the same, but with more sleep.

My graduation ceremony occurred 4 days ago, on Saturday.  For as emotional as I felt that night, I managed to survive the entire ordeal without much blubbering.  This had largely to do with my particular approach to the ceremony itself, which involved a skateboard, a wacky helmet and some iffy poetry.

Since there are only 6 graduating residents from our program, each of us enjoys (or endures) a sizeable amount of limelight as we graduate.  It starts with a picture slide show of us from our earliest days up to the present.  Some of my shots were strange, if not embarrassing, as you might imagine.

We are then introduced – for an agonizingly long time – by a faculty member.  Here our history, foibles and dreams are put on display for all in attendance to see.  This part can also be rather painful too.

It was then my turn to speak.  We aren’t given time-limits on our speeches.  As mentioned, there’s only 6 of us, so I guess we have the berth and he right to ramble a bit if we want to.

I survived the process with almost zero public display of emotion.

I’m not sure why this was some sort of goal for me.  I’ve always been a lousy crier.  I’m good at complaining, whining, moaning and bellyaching, mind you.  Rather too good.  But my crying skills must have atrophied somewhere in my childhood.

If I were to guess, I suppose it happened when I was about 5 years old and my biological father had just punched his girlfriend in the face.  He then leered at me and asked, “You gonna cry about that like a little girl?” in a drunken haze.

“Nope.”  I said.  And I never have.  These days, I can only cry when Ariel gets her statue of Eric blown up by King Triton, or the Broncos trade their franchise quarterback to the Bears.

So, I have some issues.  Fine.  I’ll bet you do too.  Intellectually, I admire the Roger Federers of rhe world who can stand on the international stage with unabashed tears streaming down their cheeks when they lose (or even win, sometimes) their latest tennis match.  Emotionally, I want to smack them with their own tear-stained pink hankies, tell them to find their purse and go back to the parlour where life doesn’t hurt so much.

Anyway, I wasn’t going to cry.  Smash my thumb with a hammer…we’ll talk.  But for this?  No way.

So, my approach was to first ride my Sector 9 longboard skateboard up to the podium wearing a tin foil-wrapped, overly-festooned bike helmet.  Why such a rather dumb graduation display?  Why, especially, at a solemn ceremony for a new practitioner of the healing arts?

sector9Aside from the fact that medicine is frequently too pompous and full of itself, I figured that if I could keep it fun and light, I could keep my eyes dry.  Plus, I ride my longboard to work most days, and I religiously never wear a helmet of any kind, much to the dismay and consternation of virtually every person I meet on the hospital campus.  For 3 years I’ve put up with near-constant haranguing to wear a helmet.

Why don’t I wear a helmet?  Well, I just figure that anyone traveling less than a mile, at about a mile an hour, while less than 3 inches off the ground…should garner me the right to feel the wind in their hair.  Granted, there isn’t much wind at that speed…and I don’t have much hair.  But that’s my metaphorical argument, people, and I’m sticking to it.

I also think that Americans are too stupidly safe these days.  We think we have allergies to things that 6000 years of humanity had no problem with.  We pad every corner in our houses and put seatbelts on our T.V.’s just in case the wall trembles and pushes that deadly thing over on a kid.  We have warnings on things like plastic 5-gallon buckets and nylon shower curtains.  Frankly, the fact that my children will never ride barefoot in the back of a bouncing pick up truck, screaming like golden-haired eagles as the wind whips wildly into their eyes, brings me no end of sorrow.

I grew up burning leaves, shooting bottle-rockets out of my hand and hunting fish with a whittled stick.  I think life is risky, and living life is an exercise in managing that risk.  Knee-jerk safety measures without true analysis of risk leads to heard-mentality that rarely leads to anything but really really bad groupthink: racism, genocide, militant nationalism, day-glo, Milli Vanilli, toilet-seat-shaped pillows for airplane flights that everyone carries around airports but never actually use for more than 10 minutes, to name a few.

So, in truth, I don’t wear my helmet when longboarding because I’m determined to not become a Nazi.  Gotta admire a guy like that, right?

Anyway, I understand that most of you dear readers will find fault in my little tirade, and will probably want to admonish my opinion about helmets just like all of the faculty, nurses, staff and freaking maintenance workers I see.

But take heart!  You don’t need to worry!  I rode to the podium in a helmet for the first time.  Just to make everyone happy.  Just to acknowledge that I’ve finally heard the message.  I give up.  It’s time to be responsible and extra-duty safe.  I’m a doctor now.

‘Course, my helmet was covered in tin foil and had sticks extending from it in every direction with tinfoil balls on the end of the sticks…but it was a helmet.

Then I delivered a poem.  It was supposed to be a rap – with a thumping beat and maybe a couple of dancers and lights flashing/spinning with everyone on their feet, their hands in the air all hip-hoppin’ on the floor.

But I’m white.  I’m a doc.  I’m in a tie.

Forget it.  It’s a poem.  A really bad 1-2-3-2 rhyme sequence that rhythmically scans like ice cream might feel if you were dumb enough pick a pile of it out of a sandbox and eat it.  But, in honour of my creation and the initial inspiration for it, I allowed that I would not in fact be delivering a rap, OR a poem that night.  It would be an amalgam, a mixture…a PAP.

This is fitting, of course, since we were all gathered to celebrate my new status as a fully-trained family medicine doctor.

My Pap made my mom cry.  I think my Dad too.  Kinda my wife.  And most of the people I talked to afterward said it made them a bit misty.  My goofy, two-bit hyper-syllabic tossed salad?

Cool.  People cried.  I didn’t.  I was too busy looking goofy, or saying goofy things.

Dear old Dad would be proud.