Dedicated to Dedicating

National Jewish is dedicated. Both in the sense that its healthcare personnel are dedicated to patient care and in the more literal sense, that everything is dedicated by someone to something. Everything.

Got too many awards? Put 'em on a plaque. Got too many award plaques? Put them in a stack on the wall. 



The last plaque is the award for the faculty member with the most awards.

Stack of plaques still insufficient? Use them as wallpaper.

If you rearrange the plaques into the correct order a secret passage opens up. Leading to a room with more plaques.

 

Of course it's not all just about the plaques at NJH. They've also got dedicated bricks.

Dedicated bricks are just like dedicated plaques, but with more Old World charm.

 

And dedicated bricks with plaques.

The greatest honor is getting a brick made out of plaques.

 

Since apparently one can run out of bricks to dedicate there's always plant life and local fauna.

The best woody shrubs are always dedicated first.

Dig donors don't trifle with pea gravel and compost, though. They go straight to dedicating buildings. Unfortunately buildings tend to run out pretty fast. So why not dedicate... parts of buildings?

Best damn vital signs room in the country.

 

 

I guess one should look at all the dedications and memorials as a sign of people's trust in the institution to use their resources wisely and for the benefit of future generations, and less as some over the top onstentatious display or kickback to the plaque-making industry. NJH certainly does good work. It is a little distracting, though. And just a little ridiculous.

 

 

"I dedicate this picture in the name of Mars. Ooh isn't that lovely?"

Fighting the MAC Attack

Denver is home to many of the nation’s great medical institutions including National Jewish, its preeminent boutique hospital. Once a center for TB excellence, with the near eradication of TB in the US it has had to move on to other mycobacterium and other lung diseases to remain relevant. It is therefore now also the nation’s best MAC (Mycobacterium avium-complex) hospital, and provides both an award winning breadth of care and an award winning mani-pedi. 

I spent four weeks there to learn all about Mycobacterium: its likes, its dislikes; hopes, dreams; everything. Having a particular interest in tuberculosis I figured I’d get an excellent education on the whole family of bugs in general, with a little bit of TB on the side to keep me interested. Instead, it was pretty much all MAC. There certainly was some M. abscessus masquerading as MAC and an interesting other NTM here or there, but there was essentially no TB and essentially nothing but MAC. MAC, MAC, MAC. Soooo much MAC.

MAC for those unaware, is America’s great undocumented plague. It’s in your jacuzzi, it’s in your shower, it’s in your pool. It’s probably sleeping with your wife. It’s also in the environment as well, and we all likely eat and breath it every day, but for some reason a very small – exceedingly small – portion of the population gets permanently infected with it and develops disease. They are, largely, the Lady Windermere population. There’s also a classic subset of tobacco-smoking, beer-drinking, middle-aged males who get it, but they’re a minority at National Jewish. Instead the Lady Windermeres are thin, tall, middle-aged Caucasian females historically with a tendency towards fastidiousness, but now, all too frequently, a tendency for breast augmentation surgery.* They are what keep NJH’s engines moving.

At Denver’s national Lady Windermere health center and spa, men and women are scheduled for two week stay where they get their MAC treated, their comorbidities managed, and explore all that cosmopolitan Denver has to offer. While there they get the attention of a personal physician dedicated daily to their care for (just about) as long as they want. Consultants, dietitians, and masseuse are readily on hand. The laboratory is ready to run a generous and likely excess number of tests. And top Michelin rated chefs prepare the day’s specials in the facility cafeteria. Although at a hospital patients are not actually hospitalized, but instead spend their nights at any one of many luxurious local accommodations. Throw in a novelty T-shirt and a romantic dinner for two the final night of their stay, and the boutique experience is complete.

Because the NJH MAC ExperienceTM is so long and intensive it is typically the realm of those who can afford to stay in a hotel for two weeks and receive countless tests and procedures. In other words, it is the affluent portion of the Lady Windermeres who make it to Denver for care. Thankfully both cash and credit are accepted. 

As much as I give it a hard time, National Jewish is an amazing place. The thoroughness of care and the research being done there are remarkable. Although it does attract the rich for financial reasons, the poor and underserved are present as well. Moreover the physicians and nurses who work there are dedicated, hardworking, and give much of their lives to their patients. It’s likely entirely unreproducible due to the realities of medical finance in the rest of the world -- and perhaps with some of its excesses this is for the best -- but truly there is no institution that can compare. NJH is a place like no other. At least that's what all the travel agents say.


*It is apparently a well known, but unscientifically established, fact among radiologists that the positive predictive value (PPV) of breast implants for MAC in a woman with right middle lobe and lingular bronchiectasis is high. Similarly, male nipple rings in a chest CT? Diagnostic of HIV.**

**This is not meant to slander HIV+ individuals or men who like nipple rings. Just radiologists. What louts.

Surviving the Colorado Curse

Steep atop Denver International’s darkest crag lies perched, peering, seeing, watching: the cursed stallion.

 

With beady red eyes, bulging blue veins, and a nasty bite he haunts the mile high city. All who fly into Colorado’s newest, great airport are cursed. Cursed with a terrible curse.

I myself was afflicted by the apocalyptic hell beast, and it began the day prior to my arrival – a tribute to its cursiness. An innocents night sledding was ended tragically by my left knee bending in half the way nature never intended. Contributing factors may have included sledding from the top of a three hundred plus yard sledding hill, a small craft advisory, and a near complete lack of prior sledding experience; nevertheless, I was without warning catapulted from my sled and onto my left leg which promptly collapsed like papermache. I additionally somehow got a road rash on my right forearm from the experience, the stallion!

A few days later transgressions continued when I learned my four-week clinical “elective” would actually be four weeks of 12 hour days, tedious dictations, and regular floggings. I had hoped to commute to the hospital via bus or carpool with a friend, but the partial ACL tear, mild MCL sprain, mild LCL sprain, patellar-tibial contusion, and gastrocnemius strain all limited the feasibility of the former while working till the darkest dark of night limited the feasibility of the latter. Eventually I was forced to rent a car for the mere sum of a whole hell of a lot more than advertised.

Paying about 3 times more than listed for taxes, fees, and any lick of insurance coverage was actually one of the few fortuitous decisions I made, however, as within 2 days of acquiring the new car – and 5 days from my original sledding accident – a young woman decided to drive into the side of it. Her initial reaction to pulling out into traffic and hitting my front bumper consisted of “why didn’t you stop?!” as if in the US -- or anywhere on any planet for that matter -- it’s perfectly acceptable to make left hand turns in front of rapidly oncoming automobiles whenever you want. Once her boyfriend pointed out this was insanity she then fell back to exclaiming, “it’s not my fault!” endlessly until the police finally came. My reward for this? A new car and a significantly more expensive new rental car contract. Curse you cursed stallion!

I had to lay low for the next few weeks while the jinx passed, and was thankfully sheltered by my friend Adam and Kate in their basement under an alias. They thankfully are exceedingly generous hosts, Kate’s cooking exceedingly delicious, and their children exceedingly prone to hop merrily in place at the slightest provocation. Aside from some additional difficulty finding dry cleaning – I eventually had to go to Denver’s Korea Town – and a general lack of improvement in range in motion of my knee, things began to blow over. Unfortunately a final blow came the final week when an unknown assailant struck down Dara their slouchier, whiter dog. Some say it was a veterinarian putting an old, good dog down to her final resting place. Others say it was that stallion. And still others say it was the stallion posing as a veterinarian. All that’s clear is that through Dar-Dar’s sacrifice the curse was lifted. Or it just went away on its own. Curses are weird like that. The boys were saddened by the loss of their beloved pet, but after determining she had gone down into the pits of the Earth to doggy heaven and that they’d likely be getting another, younger dog in the future they decided they were ok with their other remaining pets. They eventually returned to hopping, and after working far more than I ever cared to on an elective, I flew home away from the demon's stare.

This post is dedicated to Dar-Dar. The best old, white dog I have ever known. We'll miss you girl.

 En memorum.

This photo is an approximation. I do not actually have a photo of Dara, but she looked kind of like this. But older.

Hullabaloo Quebec, Quebec

Quebec, Quebec. Where Canada's at its coldest, snowiest, and Frenchiest. None of that may be individually or collectively true, but what is true is Quebec, Quebec is the home of the BeaverTail: Canada's contribution to the global obesity arm's race. Watch out America, they got Nutella on their funnel cake. Which they then smashed out and flattened with an iron... 

 If it's two-dimmensional there're less calories right?

Perhaps just as imporant as beaver tails in ensuring Quebec's eternal awesomeness, though, is the Carnaval de Quebec. In part because they have an ice castle, in part because they have Caribou liquor in hollowed out plastic canes, and in part, a very large part, because they have human fooseball.

She kicks like a French-Canadian girl

No, excuse me. Human fooseball on ice. Just in case strapping children to metal poles in freezing wheather wasn't already a good enough idea, they then make them dance. And if they don't want to dance, that's fine. They can feel free to dangle limpy from their chains. Unfortunately we only got to play human ice fooseball twice -- and the second round was prematurely ended by a family from Bufallo who play ice fooseball as if the life of their family pet depended on it -- but it was quite possibly the highlight of my year. Regular fooseball will never again provide the same joy.

A few brief moments struggling to stay upright while people kick balls at my head is not where the Carnival de Quebec ends, however. No, no my ignorant angloophone friends. There're also ice sculptures, toboggan rides, innertube slides, late night dance parties, maple syrup on ice, hottubs on ice -- which I guess are just regular hottubs -- broom hockey, regular hockey on TV probably somewhere, fancy crepes, psychadelic light parades, and snowball castle attack -- where you throw plastic snowballs through each other's ramparts or just at each other. It was awesome because instead of saying, "brrr it's snowing outside, lets stay inside and watch some curling," they said,"brr it's snowing outside, lets strip down and roll in it!"

Lest things get too sexy...

This isn't to say the Carnival de Quebec was all fun and whiskey, though. It also involved showers without shower doors -- why do Europeans insist on this insanity? -- long lines at the border, a few surely Quebecois restaurant owners, escargot, sleeping on the ground using hotel window curtains as blankets, and an indomitable, French-Canadian snow-king-man.

Juiced by a Caribou-fueled rage.

Photographie!

In Lieu of Cash, Please Send Granola

I have lived in the Upper Valley for over a year now. I am now qualified to pass judgement.

And my first judgement? Granola. I don't want your stinkin' granola. Who wants your granola? I don't know anyone who wants your granola. And, yet, everyone here makes it. Do they eat it? Feed it to their birds? Wash their childrens mouths out with it if they say naughty things? For something that generally costs a few bucks from the grocery store and tastes like different flavors of "myeh" I never could fathom why people bought it, and now I live in a land where people make it.

Making things is a way of life in Vermont and New Hampshire. In that sense it is this certain sense of true self-reliance and "Yankee ingenuity" which makes folks up here remarkable and unique. Unfortunately where as back in the day people made wooden trunks and wagon trains, now they make bad art and apple sauce.

Which brings me to my second judgement: apple sauce. The second largest state export behind granola? Apple sauce. I am fairly certain in the rest of the United States apple sauce does not remains a food product passed the age of three, but here everyone takes pride in their sauce. I'm sure there's even an apple saucing subculture if I were to look hard enough. Complete with their own lingo and apple sauced-based inside jokes. Initially I was inclined to believe the popularity of apple sauce stemmed in as much part from Vermonter's refusal to admit they just grow too darn many apples, but the longer I stay here the more I am convinced they may just realy love apples.

And lastly, syrup. I know grocery store syrup is essentially a flavored corn product, but it sure takes like syrup to me (in the sense that syrup to me tastes like a flavored corn product.) It's thick, it's amber, it's smell syrupy, it's essentially syrup in ever way aside from the fact that it's not. Most importantly, though, corn syrup syrup costs half the price of real deal, genuine maple syrup. Nevertheless, despite this, genuine maple syrup is the way people prove their Yankee roots in New Hampshire. Nothing will go further for your Upper Valley street cred than showing off a pantry full of maple syrup in every grade. Yes, there are apparently multiple grades of syrup? Why? Because the last thing you want to be seen doing is eating riff raff syrup.

There Are No Puffin in Maine

Puffin are little tiny birds that live in the North Pole and can only be seen by Eskimos. They are also a delicious cereal. They do not, however, despite claims to the contrary, seem to exist in Maine. I had never before considered what it would be to see a puffin in person, and would never before have claimed to have wanted to do so, but then I moved to New Hampshire which apparently is next door to Maine, and that's where I was told puffin hang out, like, all the time. Now I had to see one. Capture and befriend one if possible. Forget moose, there're itty bitty flightless birds up here! They are flightless right? And grant wishes?

That was the plan at least. Kristen and I ventured up to Boothbay Harbor, Maine, this last weekend nominally in search of a charming bed and breakfast, but secretly to abscond with a magical sea parrot. Unfortunately it turns out they only seem to manifest in late spring and early summer in these parts of the planet so we failed. That should come as no great surprise considering puffin are probably as real as the chupacabra -- made up beasts to keep children in line. "Eat your soup or the puffin will get you!" What was perhaps more of a surprise, though, was that there are apparently no people in Maine either. March is still the off season for tourism in the area as it is typically still encased in snow and prowling with blood thirsty snow men, and so the town of Boothbay Harbor is still in the hands of a caretaker government consisting of a pair of snowbirds too old to migrate and a swarthy sea captain who just can't quit the sea. The town was sparsely populated during the day and all but abandoned at night. We could have looted the place at will had we only thought to bring a larger car. Seeing as off season also means cheap season though we went anyway, and it was great.

We stayed at the Welch House Inn, affectionately known, we imagined, as the Wench House Inn by the locals, and it was amazing. For $90 a night we had a beautiful room, a gorgeous view of the harbor, a tasty breakfast, a cozy gas fireplace, and a whirlpool bath. The owner was exceedingly friendly and helpful and made a delicious Gypsy Eggs Benedict which was both the first time I'd eaten Eggs Benedict and the first time I'd eaten gypsy. The whole experience was as I would expect a bed and breakfast experience to be were I to have ever before considered a bed and breakfast. I am not sure any other B&B will be able to compete now; we will forever be bed and breakfast snobs.

Tour guides say Maine is the land of lighthouses and that is true. Just look at our pictures -- they're stacked like dominoes. But Maine is also just as much the land of toll booths and toll ways as it seems you cannot drive on any highway without being asked for a dollar. As a man that prides himself on his supply of quarters he carries (I sometimes have to drive a toll road for work), I was quickly quarterless. Thankfully Kristen had an assortment of loose change scattered throughout her purse and we did not have to resort to offering the contents of my glove compartment in barter. I suspect the majority of the nation’s quarters are currently residing in Maine thanks to their toll booths, and I have a suspicion it is secretly feeding an underground pinball economy. 

Anyways, for those who have not been to Maine here is a summary. It is rocky. There are a lot of lighthouses because of said rocks. People say "wicked" a lot. Oh, and lobster.

Pink Slime is Ruining America and Poisoning Your Kids

Pink slime. Hide your children. Hide your wives. It's in your beef, and it's in your family. If the volume of attention a subject gets is any indication of its importance in life -- and it is -- pinky slimy slime is single-handedly destroying, corrupting and befouling everything, everywhere, all the time. Beware the slime Yahoo News tells me.

Thankfully we still have heroes. Thankfully we still have TV chefs, a feckless press, and a shallow social media which can all mobilize to save our great nation. Thanks to their tireless yet trendy efforts pink slime, or ammonia-treated ground beef filler as it is perhaps less pejoratively known, has been removed from a number of fast food chains and now, glory be, will be removed -- at least in part -- from our children's schools. With this great victory in mind let us revel.

Never will we have to be like the Native Americans who consumed all parts of the animal. Huzzah! That's what pets and Fancy Feast are for.

Never will we have to worry about infections from a food product never associated with infection. Hurray! But lets fret anyway. 

Never will we have to pay for ugly food. Hot dang! Instead we can pay more for normal, regular food.

Never will we have to worry about ammonia in our beef. Shazam! Just the ammonia in the hundreds of other food products.

Never will we have to think critically about a subject. Good gravy, holy moly! Blog posts and Internet petitions are sufficient substitutes for due discourse and democratic action.



Alright. This is getting boring already. Time to tweet about Kony. I hear he's dating one of the Kardashians.