“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler






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The Poem. 

So at ten past five today I got a text from my office manager, which went something like this: 

"Hi! We're starting a newsletter and thought it would be great to include a poem and I thought of you! Maybe something funny and light? We need it by Tuesday [four days from now]."

Well. See what comes of having a reputation as a semi-wit (not to say halfwit)? 

I replied, "Is it OK if it's a limerick? I don't think I'm up to a sonnet. And do you have a theme you'd like me to use?"

"Well, the new doctors are joining the group, so maybe something welcoming them?"

I replied that I would do my best. My mind started percolating. New doctors, huh? I thought. Welcome to the jungle.

And there I had it. I quickly looked up Guns N' Roses lyrics and came up with the following. 

Welcome to the jungle, we got fun and games

Like “Who’s the Doctor of the Day?” and “How do I file these claims?”

The paperwork will haunt you, we’ve all been there before

Feel free to ask unless you see us pounding on the door

 

Welcome to the jungle, we take it day by day

If the quarterback is freaking out, it’s best to stay away  [quarterback is our term for head nurse]

The patients all have Covid, at least they think they do

If we’re lucky they will wear a mask so we won’t get it too

 

Welcome to the jungle, it’s really not that bad

The staffing here is all top notch and Urgent Care is rad

We’re here to help, from unknown rash to “Name that Specialist!”

We look out for each other and we’re happy to assist.

Considering I batted this out in 45 minutes, I don't think it's too bad. Now they want me to do another one for next month... 

Labels: Pop Culture, The Doctor's Life

posted by Dr. Alice at #

 

 You Can Sell Your Soul and Still Lose

One of my longtime goals has been to write mysteries (I do write fan fiction but would like to write something I can sell to the public). In pursuit of this goal, I have started to follow several blogs about writing including According to Hoyt, Mad Genius Club, Robert Kroese, Monster Hunter Nation and Celia Hayes. 

These blogs and their authors have some things in common. They tend to work in the scifi/fantasy genres, though not all of them do; they publish independently, usually via Amazon (some of them also have conventional publishers but do at least some independent publishing); and they trend to the conservative/libertarian side of the aisle, or at the very least they keep politics out of their writing. As a result they have met more setbacks in the course of their careers than one might expect (and Lord knows, most writers face enough of those). They don't whine about it but they do discuss it. Most publishers strongly prefer "diversity" in the works they publish these days, as defined by issues related to race, sexuality or gender. If the author's work checks more than one of those boxes it's even better. That is not to say that the writers I follow limit themselves to tales about strong, silent white men who conquer new worlds and exploit their resources when they are not killing dragons and marrying princesses. Their works are far more interesting than that, often irreverent and tweak quite a few sacred cows. This, of course, is why they keep running into roadblocks. Publishers expect novels to meet certain criteria (see my recent post on Charles Stross and his Laundry Files series, which has turned into a labored metaphor for global warming). The rule for books, I feel, is that the work should be fun and interesting rather than grim and judgemental.

But... denizens of the scifi universe now appear to be turning on even the most rigorously diverse writers. The most recent example is an author named Stephanie Burke. She was a guest presenter at the scifi convention Balticon last month and her bio reads, in part, as follows: 

Stephanie Burke is a USA Today best selling multi-published, multi-award-winning author, master costumer, handicapped, wife and mother of two. From sex-shifting, shape-shifting dragons to undersea worlds, up to sexually confused elemental fey and homoerotic mysteries, all the way to pastel challenged urban sprites, Stephanie has done it all and hopes to do more.

So far, so diverse. I wish to point out here that I have not read any of her works and do not intend to analyze or criticize her writing, as I am unable to do so. My point is that today I learned from Twitter that midway through Balticon she was accused of making "offensive statements" (details unspecified) and was asked to leave. Her presentations were canceled even though the accusation was apparently unsubstantiated. Link is here. Ms. Burke was extremely upset by this incident, and rightfully so.

Example Number Two: right around that same time, author Mercedes Lackey was speaking on a panel for the Science Fiction and Fantasy Writers of America (SFWA) and used the term "colored" when speaking about an author and critic named Samuel Delany. He is well known, well-respected and, yes, African-American. Mr. Delany specifically said that he was not offended by the term or by Ms. Lackey, who was praising his work at the time. Not only was she kicked out of the convention after this incident, but so was her husband. 

Per Wikipedia, [Ms. Lackey] has... published several novels re-working well-known fairy tales set in a mid-19th to early 20th century setting in which magic is real, although hidden from the mundane world. These novels explore issues of ecology, social class, and gender roles.

I'm beginning to discern a pattern here. Are you? It doesn't matter how much diversity street cred you have, if you don't toe the political line your readers and publishers can turn on you in a heartbeat. If you need another example, look at the one everybody knows: J.K. Rowling. Her adoration ratings, already quite high, jumped after she stated that Dumbledore was gay and had been in love with his nemesis Grindelwald - until she stepped up to the plate to support the rights of cis women. Since that time she has been pilloried on social media. (Incidentally, I think this explanation of Dumbledore's motivations is consistent with everything we learn about him in the series. But it was not touched upon because it was a children's book series, and because as a product of the nineteenth century, Dumbledore would have had very good reasons to conceal his sexuality for his entire life.)

So my takeaway from these developments is as follows. Write what you want to write, but don't join the diversity conga line in a misguided hope for success. All it takes is one wrong turn of phrase, or even (as we have seen above) one wrong word. Your career will be instantly trashed. 

Labels: Politics, Pop Culture, Writing

posted by Dr. Alice at #

 

Book Review: Quantum of Nightmares

Today I took some time off packing for my upcoming move to finish a book. (Should not have, but did.) The book in question was "Quantum of Nightmares," by Charles Stross. It's the most recent installment in his "Tales of the New Management" series; briefly, back in 2000 Mr. Stross began writing a book called "The Atrocity Archive," set in the UK in a universe where magic exists. Not Harry Potter type magic, but mathematical magic. This book was well received and led to a series known as "The Laundry Files." 

The setting is modern-day UK and, at least at the start of the series, the public at large is unaware of magic; the Laundry is a government organization tasked with protecting the world against Cthulhu-type monsters from beyond the stars. As a government organization, it is also subject to workplace mandates and paperwork that would drive anyone mad. Stross loves to satirize management and the series as a whole is quite fun. It's a mix of horror and satire. 

Early in the series, the reader was introduced to the looming problem of CASE NIGHTMARE GREEN (it's always capitalized in the books), when the Stars Come Right, everyone will be able to practice magic in some form and the world will come apart at the seams. As time went on it became more and more obvious that NIGHTMARE GREEN was a metaphor for global warming, the author's bully pulpit became more obvious, and the series as a whole became less fun. I stuck with it until "Tales of the New Management," an extension of the original series, became the, ah, new normal. This series is set after the Laundry is dissolved, and Nyarlahotep has become the Prime Minister of the UK (trust me, things could be worse than having him in charge). 

Suffice to say that after purchasing Q of N on Kindle, I sent it back within 24 hours and wrote a blistering review on Amazon. Finally, I tracked it down at the library and checked it out in the interest of giving it one more try.

And my review is: nope. Reluctantly.

Mr. Stross has a real talent for juggling multiple plotlines, and this is my weakness. Be it Charles Dickens or Tom Clancy, give me multiple plotlines and I am a happy camper. Q of N has lots o' plot, but... it's hard to explain... the transition from plot thread to plot thread is just too obvious. Sort of along the lines of "OK, here's Character A's viewpoint." Then "Character B, C... etc." with no lead-in. Each section of the book is just plunked down with no attempt at connection. 

But far more important is the fact that not one of the characters in this book is likeable. None of them are nice people. To a certain extent you can empathize with them, but not nearly as much as one would think. This, also, is a habit of Stross. Even in the early days of the Laundry series, he took pleasure in pointing out that the (somewhat more likeable) characters were, in his words, "serial killers" and "unreliable narrators." The characters do kill bad guys in the course of the series, but their reasons are well explained. You can't have it both ways, Stross. Stick a sock in it.  

The book has a great slam-bang finish in which all of the plot threads are brought together successfully, but the overlying anti-capitalist approach, about as subtle as a sledgehammer, takes all the fun out of it. Suffice to say that the meat department of a supermarket chain is the center of the action and the plot recalls Upton Sinclair and Jonathan Swift. They both wrote it better. 

I do recommend the Laundry Files, at least the first five or six books. But as I said in my review, I think Mr. Stross needs a nice benzodiazepine cocktail before going back to his word processor. And the "Tales of the New Management" has had all the fun sucked out of it. 

Labels: Books, Pop Culture

posted by Dr. Alice at #

 

 Daytime Television

Spending more time with my parents as I have done recently, I have become familiar with the drone of television in the background. It haunts me on an almost daily basis, to the point that it has become "white noise." I have the weekday schedule of my father's favorite channel nearly memorized: Perry Mason, then Matlock, then In the Heat of the Night, then The Waltons... you get the idea. The afternoon is a parade of Westerns, one after the other: Bonanza, Gunsmoke, The Rifleman. 

In a desperate grab to maintain my sanity I have started deconstructing these shows - at least, some of them. "Perry Mason" is still the king as far as I'm concerned. Yes, the general plot is the same episode after episode, but it has a great noir feel and the cast is just excellent. I can't get enough of Hamilton Burger and Paul Drake, not to mention Della Street - the perfect secretary and co-sleuth. But "Matlock"... ugh. The show was Andy Griffith's late-in-life meal ticket, and I can empathize with that, but it just isn't that good; from the Eighties hairstyles and power suits to the awful overacting, it is nothing short of cringeworthy.

"In the Heat of the Night" was a favorite of mine back when I was a medical resident. Set in a small Southern town, the show featured location shooting which added lots of atmosphere and overall did a good job portraying the daily life of law enforcement. Plus, Carroll O'Connor anchored the whole production as the police chief struggling with the effects of racism on the town and trying to shake his personal racist past. Sadly, on re-viewing the show it is marred by overacting among the weekly characters/suspects and more bad Southern accents than you could shake a stick at. 

"The Waltons" was a favorite of mine back in elementary school and junior high. A low-key drama, it showcased the trials and tribulations of a rural family growing up during the Depression and WWII. It was narrated at the beginning and end of each episode by the oldest son, the first in his family to go to college and who would go on to become a writer; it gave the show a retrospective and nostalgic feeling, sort of the "I remember the time Mama had to go off to the tuberculosis sanitarium" sort of thing. (Yes, that was an actual plot.) It's a comforting sort of show, but after a while it just became tiresome plus the child actors started aging out of the cast after a few years. Sometimes I like to imagine it's set in a postapocalyptic future, where Walton's Mountain is salted with booby traps and the family is living on squirrels and coffee... but it's hard to see that there would be much difference.

On to the Westerns. Not much to say here, they're all alike really. I have realized over time that Westerns are just soap operas with the addition of gunfire. "Bonanza" seems to have more variety than the others, but it all comes down to Hoss being clueless, Little Joe getting framed for murder or Adam lecturing the townsfolk about the importance of being more openminded. "Big Valley" has it all over Bonanza as far as I'm concerned. 

And then there's Adam-12. This was a Jack Webb production, similar to "Dragnet" in that it was a salute to police and their service to the public. The difference here was that the cast was younger and better looking, two earnest whiter-than-white guys in a patrol car driving around Los Angeles all day dealing with all sorts of stuff during their shift. The show is so dated that trying to imagine the patrolmen thrust into the reality of present day Los Angeles is impossible; the poor guys would get cut down by gunfire five minutes into their shift.

After "Adam-12" it's time for the evening news, returning to the 21st century once again. Not much to be said here, except that when compared to today's news these dated old shows are much more tempting. 

Labels: Pop Culture

posted by Dr. Alice at #

 
"But I'm Feeling MUCH Better Now!"

Labels: Family, Pop Culture

posted by Dr. Alice at #

 
Thoughts on Fan Fiction

Fan fiction, for those who don't know, is a term for writings or artwork based on a preexisting work, written by fans of said work. The work in question could be a film, a television show, literature, radio program, comic strip or even other works such as video games.  Fanfic has been around for decades and first really made it into the public eye with Star Trek, I believe. Fans of the show wrote stories about the characters which were collected, mimeographed and stapled into fanzines and then mailed to subscribers. Nowadays fan fiction is published on websites (the two best known are Archive of Our Own and FanFiction).

Traditionally fanfic has not been highly regarded; if you say the phrase "fan fiction" most people will either be unaware of what you are talking about or will cringe in revulsion. There are reasons for its poor reputation. Unfortunately, although some fan fiction is well written the genre as a whole has a reputation for bad writing. Consider the term "Mary Sue." The original Mary Sue was the main character of a Star Trek fic, a Starfleet cadet who wound up on the Enterprise somehow. She was depicted as impossibly gifted and accomplished, although the story contained no scenes showing her doing anything which would justify this portrayal. Readers expecting Kirk and Spock got Mary Sue, plus main characters basically drooling over her and how amazing she was. The author of the story was named Mary Sue Something-or-Other, and the story was immediately recognized as nothing more than wish fulfillment. It was reviled by other fans and "Mary Sue" is now used as shorthand for this type of character. But there are other reasons for the critical view of fan fiction: often it is simply viewed as derivative and lacking in imagination since it is based on other works. "Create your own characters!" critics will cry. "Do your own thing!"

Everything above pretty much describes what my opinion of fan fiction used to be... until I started writing it. I blame Season 5 of 24 for starting me on this hobby. Every season of 24 had loads and loads of characters and enough subplots for three other shows. Some of the subplots were more compelling than others. I got drawn into the Season 5 saga of the First Lady and her stalwart bodyguard Aaron Pierce, who were investigating the web of intrigue surrounding the President... as well as developing a relationship of their own. It may sound cliched but in the hands of two gifted actors, Jean Smart and Glenn Morshower, it worked incredibly well. Some of the online 24 commenters were also fans of these characters. We formed a discussion group and several members began contributing stories about them. I was coaxed into writing an initial story and then found that I could not stop. It was just too much fun, as well as being good writing practice. The next thing I knew I was embarked on an epic story that took me two years to write and ran to over 100,000 words.

What's good about writing fan fiction? If you want to write, it's a good place to start because it allows you to concentrate on plot, dialogue and settings. The beginning writer does not have to focus on creating characters because readers familiar with the source work know who the characters are; that work has been done for you. Original characters can be created one at a time and allowed to interact with established characters. You can also get critiques and suggestions from other writers (this is called "beta" (noun or verb). If you want your story to be beta'd before you publish it you can request input on it. Most critiques I have seen are supportive. With this kind of practice writers can become successful: "Fifty Shades of Grey" started as fan fiction of the "Twilight" series; the author changed the controlling vampire character to a controlling billionaire character. I won't claim it's great art, but the author sold tons of books and got a movie deal, so there you go.

What isn't so good about fanfic... for me this divides into two categories: stylistic errors and terrible plot ideas. The style stuff is usually pretty basic: misspellings and grammar mistakes such as changing tense from paragraph to paragraph, or even sentence to sentence. Using quotation marks erratically, a more common mistake than you'd think, drives me nuts. Sentence fragments may or may not be a problem, especially if these occur in dialogue; they can add realism and an informal tone, if that's what you are aiming for.

Terrible plot ideas: Oh, God, don't get me started.

• "What if [Character X] had a long lost sister/brother?" [Mary Sue ahoy!]
• "What if [Character X] was gender flipped?" [It's pointless! Work on your plot.]
• "What if Show X and Show Y characters met and started working together?" [A.K.A. the crossover - most of these are awful.]
• "What if [Characters X and Y, who clearly are not in love with each other in the original work] fell in love?" Especially if X and Y are the same gender... "Hey, let's make them gay, even though they weren't in the original story!" There are TONS of these stories in fanfic land. And they're total crap.
• "Take That" fics, written by someone who really hated what happened in the story or how one or more of the characters were portrayed. Often related to politics or gender issues. I call this the "Why Was Aslan So Mean to Susan" category, after the denouement of the Chronicles of Narnia series.

Let me turn the subject to my bias in favor of plot. Many of the works I read rely on romantic scenarios between characters and have little or no plot, another reason I will give a thumbs down judgement on a piece (mental judgement only; I don't post negative reviews). I love lots of plot, and subplots make me really happy.  I am heavily biased in favor of Gen (for general) fics for this reason. Usually Gen fics contain little or no romance, or at least the romance is not the focus of the piece. My 24 fic did have romance between the main characters, but this was well-established in the show and I spent a lot more time on my plot, which involved the unwinding of a major political conspiracy.

Going back to the ever popular idea of slash fiction (gay romance between characters): The authors do have a point. It's true that there are not a lot of LGBTQ heroes in pop culture, even today. My response to that is to write some original new ones. It makes a lot more sense to me to create original characters to fill a need rather than to radically change a well-established character.

Another motive for writing, if I am honest, is positive feedback. A complementary review on something I have written is an ego boost like no other. As I tend to write about works that are not so well-known, I don't get that many of these but I certainly enjoy them when I do.

Reading fanfic is like panning for gold, basically. The good stuff requires a search but it's there. If you have a favorite book, TV show or film it's worth doing a website search (see the sources above); you may be pleasantly surprised at what you find.

Labels: Pop Culture, Random Thoughts

posted by Dr. Alice at #

 
I took a sabbatical from work a while back and among other things used it to catch up on my reading. I tried the "Odd Thomas" series and rather liked it but quit after the first three books, as they all read like the same book after a while. Fellow with psychic powers communicates with the dead and saves the world, repeatedly.

I don't want to sound too snarky here, as I think Dean Koontz did a masterful job with characterization and tone in the series. Odd Thomas is likable, memorable, nice but not dull. His dry and understated reactions to the wild things that keep happening to him really make the books worth reading, and the people he meets who help him on his journey are not just afterthoughts but interesting characters in their own right. After a while though the series began to pall on me; in spite of the good writing the books were simply too much alike.

Then I took a flyer on another series, one I'd read about on the TV Tropes website. It's the Laundry Files series by Charles Stross. Home run! Man, these books are good. Stross is a British (Scottish, actually) science fiction writer who has at least two series and several standalone books to his credit. The only books of his I've read are the Laundry Files works, which I think are lighter in tone than his other work - this series is a long way from being all fun and games, however.

Unlike Odd Thomas this series has evolved over time rather than stalling out. The first book, The Atrocity Archive, was written as a standalone novelette but was eventually published in combination with a sequel story called The Concrete Jungle. Concrete Jungle won an award, publishers got interested and Stross wrote a second book, then a third. The series is now up to eight novels and several short stories. Initially each book had the same main character and narrator, Bob Howard, an IT guy who got pulled in by the Laundry when his doctoral thesis came a bit too close to summoning evil critters from other universes.

The Laundry is the nickname for a super secret organization in the British government, dedicated to saving the world from Cthulhu type monsters who get into our universe through rips in space-time. It's all about math, really. If you make the right calculations, especially using computers, you can summon all sorts of creatures you wouldn't really want to be in the same room with. The books are a combination of Lovecraftian horror, spy fiction, scifi and Dilbert workplace humor; it's a strange combination but it works better than you'd think.

When Stross began writing the books were intended to be pastiches of various writers of spy fiction (the second one, The Jennifer Morgue, borrows heavily from Ian Fleming). He's used the series to riff on other genres as well; The Apocalypse Codex has a character based on Modesty Blaise (her codename is BASHFUL INCENDIARY) and The Annihilation Score examines superhero conventions. The later books switch to other narrators and points of view. Stross has said that the series seems to be evolving into a Discworld scenario, including different genres and switching off on main characters from book to book. This really keeps the series fresh and different. Not all the books are equally successful. I personally think the two weakest are Jennifer Morgue and Annihilation Score. But they're all worth reading and I highly recommend the series.

It's the characters that make these books work. In the world of the Laundry, CASE NIGHTMARE GREEN is coming - the end of the world. Cthulhu type monsters do exist, but God does not. Stross is an atheist and he makes that very clear in several of the stories. He's also said many times that there will not be a happy ending to the series, and indeed the latest book, The Delirium Brief, is the darkest yet. But the characters' interplay, relationships and commitment to fighting evil ensure that this series is anything but unrelieved nihilism. That wouldn't be the least bit fun to read, and these books are fun. My favorite character is James Angleton, Bob's boss. He's a mysterious and scary managerial type, a master spy who's been around for decades without growing a day older...

If you want to find out if this series is something you'd want to read, some of the short stories are available for free. You can find The Concrete Jungle here and Overtime, a Christmas story, here. Enjoy.

Labels: Books, Pop Culture

posted by Dr. Alice at #

 
A Long Time Ago, In a Movie Theater About an Hour Away

When I was in eighth grade my history teacher wanted to teach us the importance of current events. One of the requirements of the class was that we would each get a subscription to Time magazine, choose a subject, and make a weekly presentation about it. The subject I chose was health and science (no surprise there). What is surprising is to look back and realize that back then news magazines were what people read once a week to keep up to date. They're on their last legs now.

Near the end of that school year (it was May 1977) I picked up my latest issue and looked at the cover. There was a small banner across the upper right corner of the magazine that said "The Year's Best Movie." Curious, I turned to the article.

It was a science fiction movie, which interested me not at all, but I kept reading anyway. I had never heard of the director, although he had directed a movie I had heard of - American Graffiti. The article talked about filming in Tunisia, as the movie was set on a desert planet called Tattooine. One of the actors had been in American Graffiti.

I showed the article to one of my friends.

"Have you ever heard of this movie?"

She looked at the article and shrugged. "Nope."

Yes. We're talking about Star Wars. That was 38 years ago. It seems impossible to believe now, but the film which left a massive impression on popular culture and led to (now) six sequels was completely under the radar until it hit the theaters. I don't recall any advance word of mouth regarding this movie at all.

I don't think I saw Star Wars until July. By that time it was well established as a blockbuster; it stayed in theaters for six months at least. I still recall that day, sitting in the darkened theater, wondering what to expect. Then electric blue letters appeared on the screen.

Labels: Pop Culture

posted by Dr. Alice at #

 
So Bad It's... Bad. 

Ladies and gentlemen, I am proud to announce the return of Workout Movie Theater. In this ongoing series I review fragments of film I have caught on the elliptical or treadmill while at the gym. (Yes, I belong to one of those chichi gyms that have television screens attached to the workout equipment.)

Today's film is Con Air, an action-adventure film from 1997. I like to think of the nineties as the golden era of crap action movies, possibly because that was the last decade when I actually had time to go to the movies. This film is outstandingly, memorably bad, not least because the cast is really very good. If only Arnold Schwarzenegger had been in it it would have been perfect. It's based on an actual federal air transport system used to move convicts and illegal aliens across the country. You don't have to be psychic to predict the plot: the criminals take over the plane and wreak havoc. Needless to say we've got a good guy on board who tries to take down the criminals.

So far so good. Things start to unravel when you realize that the hero is played by Nicholas Cage, who has clad himself in a wifebeater T-shirt and Southern accent for this film. He's supposed to be a former Army Ranger from Alabama who went to jail for manslaughter committed when he was trying to protect his pregnant wife from assault. He's been in jail for seven years and has never seen his kid. Why he wound up on a plane with a bunch of mad serial killers I have no idea (I missed the start of the movie). The cast includes John Malkovich (chewing the scenery as the head bad guy), Steve Buscemi as a serial killer who really doesn't seem so bad compared to Malkovich's character, Colm Meaney (aka "the Irish guy from Star Trek") as a DEA agent, and John Cusack, who looks about twelve, as a U.S. Marshal. (I understand Cusack hates this film so much that he refuses to talk about it in interviews. I can't say I blame him.)

So. With a cast like this, why is it so bad? Let's list the reasons.

• Language. Not only do we have F-bonbs galore, we have more gratuitous racist insults than you would believe. In the setting of a plane full of convicts, half black and half white, I would have expected to hear some of this stuff, but it was almost nonstop. This film is 18 years old and in this respect, it shows. I don't believe any movie, R rating or no, would get away with this today.
• Predictable plot twists. The climax of the film involves the plane landing in Las Vegas. They've cleared the runways for the plane to land at the airport, but of course it's out of fuel. The pilot then announces that he's going to land on - wait for it - the Las Vegas Strip. Cue the crashing neon, screaming crowds, flying propellers... on what seems like an endless loop for at least three minutes. 
• An unbelievably corny script. Nicholas Cage's cellmate was apparently also assigned to this flight. When Malkovich announces that there's a traitor on the plane and threatens to kill one of the guards, the cellmate does an "I am Spartacus," takes the blame before Cage can confess and gets shot for his trouble. The cellmate, lying on the floor of the plane and looking like he's about to check out, announces that he doesn't believe in God, whereupon Cage responds "I'm going to show you that there IS a God!" as he jumps up and heads forward to take over the plane. (Did I mention that he has shoulder-length Jesus hair?)
• The ending. Ugh. Our hero has been toting a stuffed bunny rabbit as a gift for his daughter throughout the movie. The blasted thing somehow survives the crash, landing in the gutter in a puddle of mud. Cage picks it up and presents it to his daughter, who promptly hides behind her mother. (I think this is supposed to play on the audience's heartstrings; I admired the daughter's good taste.) Prompted by her mother, who is dressed in a two-piece sweater set and has her hair in a headband and generally looks like she stepped out of Good Housekeeping magazine circa 1962, she takes the rabbit and hugs her daddy. The only thing that cuts the glucose here is the final scene in which we see good old serial killer Steve Buscemi, who survived the crash, shooting craps in a casino and announcing that he feels "lucky."

I laughed my way through this thing and managed 40 minutes on the elliptical while watching it, so I suppose it did its job. But afterwards I realized something that depressed me for the rest of the day: since 1997, movies have gotten even worse. At least Con Air had an original script. It was not a remake, had nothing to do with Marvel Comics or transformer robots, and had very little CGI. It had a cast of experienced professional actors who did the best they could with the material they had. There were no fart jokes, at least not in the part of the film I saw.

These thoughts left me asking myself "Whither Hollywood?" I could only answer with a shrug and "Nowhither, I guess."

Labels: Critiques, Pop Culture

posted by Dr. Alice at #

 
A View to a Crash

Driving home from work tonight I turned on the radio and found myself in the middle of a freeway car chase. If you aren't from Los Angeles, you may not realize how frequent a happening this is: L.A. has 527 miles of freeway and a whole lot of cars, not to mention any number of lawbreakers whose first instinct, when the police turn on their flashing lights, is to put the pedal to the metal. The first really heavily televised car chase was back in 1994 and I blame O.J. Simpson and his white Bronco for this whole phenomenon. Tonight's chase was out in the Lancaster-Palmdale area north of the city and was eagerly being narrated by the clowns John and Ken on KFI, a talk radio station with a conservative bent.

"They say he's going a hundred and twenty miles an hour!"
"He's slowing down. Why is he hitting the brakes?"
"He just went into a GATED COMMUNITY!" (The driver apparently rammed the gate, drove in, a passenger [who has since been arrested] jumped out of the car, and then the driver headed back out and onto another freeway. As one of the radio hosts pointed out, this has never happened before in the televised history of Los Angeles car chases.)

One well-meaning network journalist on television recommended that people in the area keep their children indoors. John and Ken greeted this rather obvious piece of advice with glee and every five minutes would again remind their listeners to lock their doors and stay inside. As I listened I heard that the chase had started in Northridge, in the San Fernando Valley - a good 40 miles back - and that the driver had hit a pedestrian there. No word on how the pedestrian was doing. Who cares? There's a car chase to narrate!

 Eventually the chase petered out, as these things do. The fox - I mean, driver - was run to earth on a dirt road out in Palmdale. Driver then proceeded to sit in his car for about fifteen minutes, before eventually being persuaded to come out of the car, where he was promptly cuffed and will no doubt face any number of charges. I just hope manslaughter isn't one of them.

Labels: Los Angeles, Pop Culture

posted by Dr. Alice at #

 
Perfecto!


I say, Your Majesty, you know how to handle a weapon. Rumor has it Jack Bauer took lessons from you.

Labels: Politics, Pop Culture

posted by Dr. Alice at #

 
"As God Is My Witness, I'll Never Go Hungry Again!" Said the Dieter

So I'm counseling a patient on weight loss. She mentioned that she goes to a fair number of social functions and has to eat what she's served there; which is often a problem.

"You could always do a Scarlett O'Hara and eat before you go," I suggested.

She looked blank. "Huh?"

"Surely you know your Gone With the Wind?" She didn't.

"Well, early in the book Scarlett O'Hara is getting ready to go to a barbecue at a plantation nearby. Apparently in those days ladies weren't supposed to have an appetite, or to eat much in public. So she eats a whole meal before she goes to the barbecue. Then she gets there, and the host is serving wonderful food that nobody's eating, and it's just like Beverly Hills!"

She laughed with delighted recognition. That she got. And if I'm lucky, I may have even inspired her to read Gone With the Wind. (If you haven't, do give it a try; it combines the best qualities of the soap opera and the historical novel.)

Labels: Pop Culture, Weight Loss

posted by Dr. Alice at #

 
Mediball


My flight home from Australia included Moneyball as one of the featured movies. In this film Brad Pitt plays Billy Beane, the general manager of the Oakland A's baseball team. He is faced with the challenge of putting together a winning team on a very tight budget. Fortunately he meets Jonah Hill's character Pete, an Econ nerd recently graduated from Yale, who believes he can find undervalued baseball players by analyzing their stats. For example, if a player does not have a great batting average but often gets on base via walks, that player is more likely to score (although his low batting average causes him to be undervalued). Billy hires Pete to help him find these undervalued players. Although they meet a lot of resistance at first, Pete's theory proves to be correct.

In the course of the film we learn via flashbacks that Beane was drafted out of high school as a promising baseball player. He never lived up to his early promise and eventually quit the sport to become first a baseball scout and then general manager. His experiences give him a very clear-eyed view of professional sports. He does not find baseball romantic; in fact, immediately after the climax of the film in which the A's set a new League record, we see Billy Beane explaining to Pete that he isn't interested in setting records or winning World Series rings. What he wants is to change the game. Left unanswered is the question, is he changing it for the better?

Today at work I sat through a very dispiriting meeting and was irresistibly reminded of Moneyball. The issue is that The Firm has to reduce the cost of patient care. We are at risk of losing several insurance contracts, as we're being told that we as a group are simply too expensive. We, the primary care doctors, have been divided into "pods" and told that we will be meeting monthly to analyze our practice habits; the meeting today was for the pod leaders. (I'd make a "Pod People" joke here, but it is simply too close to the truth to be funny.)

We were handed sheets of paper listing the number of studies and lab tests each of us had ordered in the past year. This included EKG's, echocardiograms, radiologic studies, neurologic studies and so forth. Our "efficiency score" was also included. We were told that the doctors in general are undercoding patient diagnoses. The higher you code, the sicker the patient and the better your efficiency score is (but if you overcode, woe betide you! You will be cast into the seventh circle of Hell - meaning the Feds will sue your sorry ass off.)

Nothing on these sheets of paper said anything about patient satisfaction... or doctor satisfaction, for that matter. Nothing about the pleasure we take in treating three generations of one family, or congratulating a patient on their retirement or a grandchild's marriage, or in saving somebody's life. Nothing, in other words, about the romance of medicine. Our performance was boiled down to a handful of statistics presented to us by a clear-eyed, hardbitten MD in charge of numbers. Now to be fair I know this guy to be a great doctor, one of the Founding Members, who really knows what he's doing. And I also know that he's right and we have to be more efficient in what we do. But today was a new emotional low for me.

I come from a medical family and I often think back to the stories my mother has told me. Her father and his brother ("Uncle Doc") were a dentist and a doctor respectively. They lived in the same small Southern town and shared office space. In that time and place tobacco was the main cash crop. The farmers were flush with cash once a year, after the tobacco auctions, and that was when they paid off their accounts. My mother remembers them coming in: "They'd say 'How much do I owe ya, Doc?' and they'd pull a wad of bills out of their overalls that could choke a horse." My grandfather carried them on account the rest of the year, knowing they were good for it.

Obviously this billing method has its weak points. But as I sit through these meetings belabored with statistics and ICD-10 coding, I often find myself visualizing that 1940's office and wishing I worked there instead of here. At least no one there was reduced to a statistic.

Labels: Medicine, Pop Culture, Random Thoughts

posted by Dr. Alice at #

 
Chupacabra vs. the Alien


In the past few months I have acquired a Secret Shame so delightful I feel compelled to share. The Shame in question goes by the name of Sci Fi Original Movies. If you ever wondered what happened to made-for-television films (remember the "Movies of the Week" from years ago on major networks?) they are alive and thriving on cable. The Lifetime channel is the proud progenitor of its own set of shameful films, but given the choice between women's exploitation and cheesy science fiction I'll take the movie with the alien in it every time.

A couple of years ago the Sci Fi channel changed its name to the horrendous SyFy but the production company, still known as Sci Fi Pictures, continues to be the savior of underemployed members of the entertainment industry everywhere. These films usually contain one or two reasonably good, recognizable actors to anchor the thing as well as terrible CGI effects and/or guys in monster suits. They are generally filmed in out-of-the-way parts of the world on the cheap; I award bonus points if they are filmed in Bulgaria.

What are the movies about? You can get a pretty good idea by casting your eye down the list of titles linked above. Aliens are quite popular - five movies on the list have the word "alien" in the title; natural disasters such as volcanoes, tornadoes and massive storms; horror flicks featuring monsters or the supernatural. Someone at Sci Fi Pictures really has a knack for coming up with titles: How can you read the words "Reign of the Gargoyles" or "Android Apocalypse" and not be tempted to watch? (Full disclosure: the scriptwriter for "Frankenfish" is a friend of mine. Do him a favor and rent it even if you don't watch it.)

You'd probably appreciate these films more if you're a fan of Mystery Science Theater 3000 and are comfortable with the idea of screaming abuse at your television. Most recently I found myself yelling "That doesn't make any sense!" at poor Xander Berkeley, playing a vulcanologist out to save the world in Magma: Volcanic Disaster. He was expounding his character's theories about what would cause all the volcanoes in the world to erupt at the same time, and none of it was the least bit logical or realistic. Still it was great fun to watch, especially if you are a fan of Mr. Berkeley as I am.

And this is the real reason why I watch these movies. My hobby is crushing on character actors. The chance to see Xander Berkeley in a starring role, playing a good guy for a change? Awesome. I'd watch the guy read the phone book. Want to see Bruce Campbell playing an "astronaut and osteopath" in Alien Apocalypse? Sure you do. John Rhys-Davies as a ship's captain in Chupacabra: Dark Seas, Ron Perlman as an evil corporate head in Absolon - there are many more. It's a delight to watch these actors do their thing, manfully keeping straight faces in the midst of monster makeup and really bad acting from their compatriots.

I wouldn't recommend these films over, say, Citizen Kane but if you're looking for a pleasant way to waste time and laugh your head off I can't think of too many better ways than watching these movies. You can find the SyFy channel's schedule here. Click and soon you too can be watching Bruce Campbell and Stacy Keach in Man with the Screaming Brain.

Which was filmed in Bulgaria. Ten points!

Labels: Pop Culture, Science?

posted by Dr. Alice at #

 
Consider the Following.

Setting up the shot took nearly an entire workday - before they were even ready to begin filming.

Culver City was operating under a water shortage.

He wasn't feeling well, in fact was running a temp of 101° F. The director told him to go home, but he refused and wanted to try one take.

They hadn't choreographed the dance except for the "start" and "end" marks, essentially, he IMPROVISED THE WHOLE THING.

That first take was the take they used for the film.

So now, ladies and gentlemen, I present to you: Singin' In the Rain.

http://www.youtube.com/watch?v=p7QL46cK7B8&feature=related

Labels: Pop Culture

posted by Dr. Alice at #

 
Medical Twittergate


Those of you who don't inhabit the medical Twitterverse may be surprised to know that quite the storm broke loose in that sheltered cove these past two days. An anesthesiologist who tweets under a pseudonym posted a few comments about a case she was called in on (it involved priapism, to be specific) and a self-anointed social media medical cop named Dr. Bryan Vartabedian called her out on it. I should emphasize here that there was absolutely no way to identify the patient Doctor #1 referenced and the patient's privacy was not violated. If you want to see the tweets in question, they are linked at the end of his article. I am revealing the name of Dr Vartabedian specifically because he used Doctor #1's tweets and identity without disguising them, despite wondering aloud whether the patient's privacy had been violated (again, in my opinion, it was not). The word "unprofessional" was tossed around - very carelessly, I should add.


I read the posts and was not convinced that Doctor #1 had done anything unprofessional or inappropriate. If you read the comments at the end of Dr. V's post (there were over 130) you will see that there was a vast divide between the "appropriate" and "inappropriate" sides of the debate. Doctors, nurses, pharmacists and even patients felt that the idea of making even mildly joking anonymous comments about patients and work frustrations was either human and understandable or appalling and horribly unprofessional, depending on what camp you fall into. My comment was the last of the bunch (I guess Dr. V. got his nuts kicked in and decided to close the comments. How... unprofessional!) and I supported Doctor #1.


The best way to explain my take on all this is, I think, to reference the movie and TV show M*A*S*H. Healthcare professionals are under fire on a daily basis (metaphorically speaking). The show is a perfect reference for what we go through all the time. Black humor is our only defense. Doctors, nurses and everyone else in healthcare have been making sick jokes and complaining about patients since the dawn of time. That doesn't mean we aren't dedicated to what we do. I love my interactions with patients and I love primary care, but if you cut off my ability to crack wise, I'd quit tomorrow. It's a stressful profession and we see terrible things. That's just all there is to it.


Medical "social media," and how I hate that term, is an updated version of the doctors' lounge. However, Dr. V is correct in that now anyone can peer in to see what we're saying and we do need to watch ourselves. I limit my posts about specific cases for this very reason. When I do post I change ages, genders and other minor details. The underlying issues, though, are the same and will remain the same no matter how many changes I make. It's a relief to air my frustrations and a relief to see that other healthcare professionals face the same problems I do. Were Dr. V to make the rules, I daresay none of us would be allowed to post. The hell with that. I need my vent just as much as my fellow posters do. Instead of complaining, Dr. V should observe more... he might learn something.

Labels: Medicine, Pop Culture, Random Thoughts

posted by Dr. Alice at #

 
Weekend Off


This past weekend was my first weekend off in, I calculated, five weeks. Factor in the ACP meeting in San Diego, two weekends in Guatemala and a weekend on call and you will understand why I did a faceplant into my bed Friday night and spent the weekend doing as little as possible. It felt goooood. I did a little cleaning, a little writing (a very little), some office scutwork and began to rewatch Season Five of 24. Man, what a great season that was. Jam packed with great character actors and a star who was generous enough to step back and give Gregory Itzin and Jean Smart breathing room to do what they do best. They stole the show out from under him (and I mean that in the very best way). Part of the problem with the three seasons that followed is that the writers fell back on the Jack Bauer character to do most of the heavy lifting, instead of trusting the other characters and storylines more. Seasons Six, Seven and Eight were not nearly as good. I guess lightning only strikes once.

This week I'm covering for the medical director and I really don't think I want to do this again. In the past it's been a formality with not much for me to do, but this time the administrative second-in-command has also been out and I am getting snowed with vacation requests and patient complaints to review. Unlike the guys who usually do this job, I don't have any administrative time built into my schedule to handle this stuff. At least it's only for a week.

Office drama: the Old Doc who moved into my office two years ago had a blowup with his secretary last week and she has cleared out. This means he's now on his third secretary. (The other two were extremely competent, IMHO; he's just an exasperating micromanager.) Number Three is a nice young woman who's worked here for a while, but I honestly don't know how long she's going to last. I wish to high heaven that Dr. Oldguy would retire and leave us all alone. However, I don't see that happening any time soon.

And lastly, a co-worker has been going through some very difficult changes in her personal life (I won't say more except that I feel for her, and it isn't something that's her fault). She has been needing to take some time off to deal with these issues, and that means I've been trying to cover for her as well. So, it's been busy. We'll see how this week goes.

Labels: Pop Culture, The Doctor's Life

posted by Dr. Alice at #

 
Somewhere Ayn Rand Is Cackling With Glee


The film version of Atlas Shrugged is being released this week on April 15. For those of you not in the US, that's Income Tax Day. How absolutely appropriate.

Apparently the book has been filmed in three parts; this is Part I. I never have read it, but I have read The Fountainhead, which she also wrote, and found it pretty interesting. I'm probably going to go see AS, unless it gets terrible reviews.

The book has a long history in Hollywood. People have been trying to film it for decades. According to IMdB, there was talk in the 1970's about turning it into a TV miniseries - and Rand wanted Farrah Fawcett to play Dagny Taggart! Who knows, perhaps Fawcett could have pulled it off. I do think Clint Eastwood would have made a great John Galt.

Labels: Pop Culture

posted by Dr. Alice at #

 
"Lydia, oh Lydia, that Encyclopiddea..."

Lately I've been unable to get this song out of my head:



Check out Groucho's "gesture" at 1:04 (apparently one of his trademarks). Why Mr. Marx!

Labels: Pop Culture

posted by Dr. Alice at #

 
Conformity Trumps Iconoclasty


So last night at The Golden Globes Glee picked up several awards. I know several people who love this show; I am not one of them. It's like The West Wing set to music, combining arch, rapid-fire dialogue with an overwhelming sense of political correctness. Multiethnic cast? Check. Kid in wheelchair? Check. Gay character who's "proud of being different?" Check. Character who dresses Goth and is persecuted by those in authority? Check.

These days the gestalt presented by the Glee characters is neither groundbreaking nor courageous. It's all over the airwaves. It's par for the course. You know what would have made the show brave and original? Casting a bunch of untalented Caucasians who can't dance. I'm serious: A show that reenacted the whole Lawrence Welk/ "Up with People" nightmare that was the Seventies (and, incidentally, is still true of Glee clubs all over the country today) would be as watchable as a slow-motion car crash and ten times more fun than the hectoring, nanny-minded show we're stuck with.

The real problem with Glee, in my opinion, is that it propagates the dirty lie that Being Yourself is all you need to do. Why work an after-school job to save up for college when you can dress up like Lady Gaga and prance around instead? Guess what, kids. Those thuggish football players mocking your artistic statements? They're the ones going to college -- on scholarships. You are not. Studying and sports practice may be a drag, but they're investments in your future which will pay off much, much more than waving your freak flag high will ever do.

But Alice, we're talking about a one-hour diversion once a week. Aren't you reading too much into a harmless TV show? I don't think so and I'll tell you why. I know people who center their lives around Glee and other TV shows. Instead of getting out into the world and being themselves, they're watching shows that tell them to celebrate The Wonder That Is You. Their personal lives have narrowed to an incredibly small circle of similar thinkers, both in real life and online. Instead of (dare I say it?) working for a living, they live in semipoverty and spend huge chunks of time on work no one in their senses would ever reimburse them for - like fan websites and fanfiction. Don't get me wrong, these things are fine for a hobby. But at some point, you have to turn the modem off and go make a living. Join the real world!

Oh, and when their parents try to intervene? My family doesn't understand me! Only (sob) you guys do! Yeah, right, only your fellow navel-gazers really "get" the real you. Now let's get back to that Battlestar Galactica fanfic and forget about your mean family, who want you to get a job. News flash: being understood is not as important as you think it is. Too often, in my experience, this phrase translates to "If you don't appreciate me exactly as I am, there must be something wrong with you."

Full disclosure here: I write fan fiction myself. And I know, either in person or online, plenty of people with iconoclastic interests - one of whom is a Star Wars fan who leads a squadron of Imperial Stormtroopers. (Yes, they have all the armor and look completely authentic.) The difference? We do this stuff in our spare time. It adds fun to our lives; it has not become the center of our lives. The Stormtroopers, for instance, show up at the kids' section of the library every once in a while to entertain them. They volunteer their time to help the wider community.

Who sounds more attractive to you: the buttoned-up banker with the stormtrooper soul or the guy who lives in his parents' basement, collecting action figurines and defending the "vision" of George Lucas against all who dare to question it? I know which one I'd choose.

Oh, and to the characters of Glee, I close with the immortal words of William Shatner: GET A LIFE!

Labels: If I Ran the Universe, Pop Culture

posted by Dr. Alice at #