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I have had some awfully difficult patients lately.  Males, in their early twenties, who misbehave and ignore all known authorities including me, and often tell me they will not take any “stinking” pills no matter what, and tell me to go do obscene things to myself. (I am old enough to know how and when to do the latter without their instruction.)

I felt silly that they bothered me, since I have actually had some success working with some very hardened criminals who have murdered folks and done some pretty heinous things.  As a matter of fact, such folks usually like me.  I actually remember from my prison work one cell block I often visited in person, where I earned the nickname “Mary Poppins” — for it was hot and I wore a hat tied with a scarf to fight the sun and the desert wind.

Even after the hat and scarf were determined to be a breach of prison security (since they covered my face and represented a potential method of disguise and flight for the inmates) they still called me “Mary Poppins” and broke into “A Spoonful of Sugar” whenever I entered the cell block.

Granted the inmates had few amusements, but I still think they liked me.

Sometimes, even with all my Herculean mental efforts, my best insights come from my husband.  Brilliant in aspects of his mind other than his excellent taste in women, he explained to me that the young toughs who came to my clinic and treated me so poorly were simply “pre-prison,” and had not yet dealt with the consequences of their actions.  Brilliant, and I believe, correct.

As a former prison doctor, I was more inclined to read a recent story about the effort to reduce state prison populations by turning low-level offenders back to county facilities. But this is the kind of headline that suggests there is something going on that is not at all what the story is about.

Counties and state government in California are not really in an adversarial relationship.  It is just that nothing works terribly well, which is no shock to anyone who has lived in California for a bit.

Border Patrol State of Jefferson (1941)

Rugged individualists in Northern California and Southern Oregon have wanted to form their own state of Jefferson for the past 70 years.

As far back as 1945 the folks in Northern California (along with Southern Oregon) wanted to secede because their agricultural interests made them feel

Read more on What Happens In Prison Anyway?…

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I have been “taking” tap in the not too distant past.  That means, I have been studying tap dancing, in a city just far enough from Los Angeles that we were pretty sure nobody in the class would go pro.  I had a real problem trying to get enough “sound” out of my taps.  I believe, without too much in the way of pretention, that I was able to get my feet in the right place at the right time.  Other students, obviously younger, just seemed to have more slap in their tap.

The sound is part of the great fun in tap dancing; I mean, come on, Fred Astaire danced on the radio.  My dance-teacher (I still have a tendency to call her “dance-Mistress,” in the European way told me that if I imagined my feet hitting one inch below the floor, instead of on the floor, that would treat the problem.  It did not.  After a day of psychiatrizing it seemed to be hard for me to find the force to stomp loudly. Read more on Dancing Outside The Box…

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In my previous entry to this blog, I talked about heroin overdoses and how people might be rescued – even if no doctors or EMTs are around.

Due to the timeliness, I mentioned the latest celebrity fatality, Philip Seymour Hoffman.  I am usually asked for my take on these things when a high-profile person dies because of drugs – whether legal prescription or illegal street drugs.

I hate doing this – mainly because it is a sad and depressing topic.  And yet, I do this not to capitalize on the notoriety of the victim, but with the intent of teaching the public about the dangers, possible solutions and new developments in treatment and education. Read more on Death From Drugs, Philip Seymour Hoffman and Staying Alive…

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You know me – Little Miss Skeptical.

I would never give a baby a loaded gun to play with, and I would never give non-medically trained civilians syringes full of drugs with the intent of having them stab somebody directly in the heart and push the plunger.

You probably know what I’m talking about if you saw the movie “Pulp Fiction” – apparently about four people in the world have not. Read more on Too Many Die From Heroin…

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Okay, let me get this straight –

Medical care costs are over $7,000 a year for seniors who keep on living, and over $37,000 a year for seniors in their last year of life.

That study was done nearly 20 years ago – so adjusted for inflation, that comes to: Read more on To Die Or Not To Die…

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Okay, let me get this straight.

A study, done by people who at least in part are employees of the CVS pharmacy chain, has established to a wildly impressive level of significance that prescriptions for (cheaper) generic drugs are more likely to get filled than prescriptions labeled “brand name only.”

Brand-name only prescriptions are 50 to 60% less likely to get filled.  This is the summary of the article on CVS website.

Of course there is a little more info in the first article linked above — like specialists being more likely to write “dispense as written,” and such. Read more on Brand Name vs. Generics — Again and Again…

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I did not really “get” what and who Edith Piaf was until I got to France and first slipped a cassette of her “greatest hits” into what now seems to have been an over sized cassette player. I had heard of her by reputation in eighth grade French class, but had not yet heard a recording of her work. But my discovery of my love for her in France was when I was a first year medical student in the fall of 1973, freezing in an apartment over a cafe and a dress shop, looking for a few minutes of respite from studying in a way that was more compulsive and obsessional than efficient. My Mother-Of-Blessed-Memory had been full of ideas about things that I could do if and when my wild adventure in Europe did not work, and I would come back to Boston and become either an excessively-qualified nurse or an excessively-qualified French teacher who had “tried” medicine in France. Me — I just told her what I had learned ancient Greek soldiers told people when they went off to war: That I would “come back with my shield or upon it.”  It meant that I would not be the coward who drops their shield and runs, but if I died they would send back my dead body. She was horrified and yelled at me, right there in the airport, but that was how I felt about being a doctor and how I basically feel about my life now — I have to do what I can do and I am meant to do and is important.  I really do not have much better than medicine for that. Read more on The Phenomenal Edith Piaf…

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The story of CVS (Caremark) pharmacies no longer selling tobacco products seems to be dominating today’s headlines across the board.

It is true that numerous studies have identified smoking as the single major cause of preventable death in these United States.  It is also true that smoking has diminished in recent years.  Most of the studies I see show that the numbers have gone down from maybe 25% of the population to maybe 15% of the population, which will surely prolong and increase the quality of the lives of the individuals who have kicked the habit.

Legislation may have helped some.  I have heard time and time again that nicotine is one of the most addictive, perhaps THE most addictive substance known to man.  I have heard from plenty of patients how an unexpected stimulus or even memory has caused relapse. Read more on CVS Chain Kicks Tobacco’s Butt (Out Of Their Stores)…

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Okay, an environmental group based in San Francisco says that 17% of our species are threatened by rising sea levels.

Yeah, I saw “An Inconvenient Truth” when it came out.  Al Gore did the best he could but he is not my choice for a scientific spokesman on global warming.

This being said, he had plenty of enthusiasm and seemed to be real.  My immediate reaction when I saw the film was “Yeah.  This looks like real science.”  I mean, when I was in prep school I actually thought Scientific American was more “fun” than “Seventeen”–  which my mother of blessed memory actually encouraged me to read, thinking it would somehow make me more socially acceptable or maybe even more “normal.” Read more on Global Warming Is Science Not Politics And It Is Affecting Humans…

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Every year, back comes the Super Bowl. It is the closest Americans get to throwing Christians to the lions in a Coliseum.

Of course, since Christians are a majority in our delightful money-worshipping theocracy, we can expurgate the violent tendencies of a beer soaked, unhealthy snack-stuffed populace by throwing two teams of highly paid professional athletes at each other.

The only alternative programming known to me in the media is the Puppy Bowl of the Animal Planet Channel.  This is sufficiently important to be covered by Variety, the bible of the entertainment industry. I have an unusually high “cutesy” tolerance, but this canine phenomenon, with its attendant spin-offs and franchises (and extended parodying of professional football) is enough to generate nausea even in me. Read more on Superbowl Every Year…

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