Archive for September, 2009

Imperfect Demanding Perfect

September 28th, 2009

strawbs.jpgBlemished fruits and vegetables separate humans philosophically. Much like admiring a pretty woman or handsome man, even the plainest of us demands more of the objects of our voyeurism than we provide.

 

I am in my 30th year of shopping at Boston’s Haymarket, 32nd if you count college days when I lived in Cambridge for a bit. I absolutely adore the rickety stalls on Blackstone Street. Also, much like my family members, I have a broad view and make allowances.

 

Not all are so forgiving.

 

I recall my late mother-in-law tsk-tsking over my Saturday harvests when she was on one of her protracted visits. For example, I’d bring back a full flat (12 pints overflowing of strawberries) and separate and clean them. A few pints would have a couple of moldy berries.

 

Sylvia would give a loud and long, “What a shame!” with great sincerity. While I paid 30¢ or perhaps 50¢ per pint, she thought I would have been better off paying $2 or $3 a pint in the supermarket. True enough, there were unlikely to be any moldy fruit in those. Then again, they would be half white and as tasteless as packing peanuts.

 

It would be the same with those tomato-like objects supermarkets stock and sell, the more or less permanent things, hard and vaguely pink, with no scent or flavor. Yet, they too would be without blemish.

 

I thought of her again recently as a blogger acquaintance exchanged a few emails with me on the subject. One included:

Our biggest problem with Haymarket is quality.  The prices are fantastic but often we throw out more than we eat which makes us do two things: 1) question whether the low prices are truly economical and 2) feel like we are being incredibly wasteful consumers.  I would love to try the market again but am trying to find strategies that make it truly worth it.

 

I suspect I can do what he wants, but perhaps not exactly as cleanly as he wants. Among the overlapping issues there are:

  • Some vendors specialize and there are the right places to buy fresh herbs or citrus or root veggies. I can help there.
  • Some is frequency. The vendors know me by face after so many years and quite a few will warn me off something that isn’t that good on a particular weekend.  He’d have to show up and greet them as though he were French for awhile to get that.
  • Some is watching, particularly the college students as summer help. Be sure to see that they take the product they sell in plain sight. When they bend out of sight to a hidden box, that’s often trouble. Hear how the Asian-American women yell at them if they try that.
  • Accept that the cheapest is sometimes the riskiest. Most fruits and veggies and half or a quarter of supermarket prices. That written, it makes sense to scan the Thursday grocery fliers; sometimes the supers have a great loss leader like 77¢ a pound black grapes that you may not be able to top at the Haymarket. Mostly though if the green beans are 75¢ and gorgeous, don’t hold out for the 4 pounds for a dollar; you can be pretty sure the vendor dumping goods at absurd prices has stuff bad or about to go bad. Many would rather dump that, but a few will appeal to greedy shoppers.
  • If you want to get serious about a trip, walk through the front and then the back of the market. After all, it’s one long block and two perpendicular short half-blocks. See what looks good and fix the prices for your favorites on the way. Then swing back through with the bags you remembered to bring (I use a huge messenger bad for most stuff).

Back to the philosophical part, my mother-in-law did not grow veggies and fruits for subsistence. My grandfather, William B. Michael, did and had since the Depression.  Granddad taught me many realities of vegetative matter.

 

By the bye, my mother said she, her brother and sister, and their mother really didn’t know there was a Depression. That is, they were not grossly ignorant, rather Granddad had them covered. He had a full-time job (48 years on the B&O). He sold Chevrolets on the weekend. He had a part-time dry cleaner and tailor shop next to the house. Then, there were those gigantic gardens.

 

By the time my grandmother (with neighbors, children and grandchildren) canned, the shelves lining the basement floor to ceiling has Ball jars galore and the huge freezer was full of bags of Lima beans, corn and more. Snap beans, tomatoes, pickles and…it never seemed to stop.

 

My mother also told of how embarrassed she had been to wear homemade clothes from her father. Then she went away to college and bought clothes off the rack. She be damned, they didn’t fit perfectly. She had worn tailored clothes until she was 18!

 

Many summers I worked with him from weeding through harvest on several acres. He was a great respecter of people, but also of vegetables and fruit. He taught me enjoyment of what we grew as well. If it was time for asparagus, we’d walk down one of the 100-foot rows, cutting the perfectly ripe spears. Lightly steamed minutes later, they were sublime.

 

I also learned to take beautifully ripe tomatoes, redolent with that slightly acrid sweetness, and if one of the gems had a spot of blight or mold, we’s cut that and direct it to a stew or other sauce. The taste and color were great. As with today, the “bad” tomatoes were far better used that way than any permanent supermarket food.

 

So that is another philosophic angle of food. From a man who waltzed his family through the Depression, Granddad avoided waste. He also knew sapid from insipid.  I refuse to fill my mouth with bland food as a result.

 

Many Haymarket fruits and vegetables are ripe and ready. The supermarkets don’t want that, regardless of the grand tastes and aromas. They need food that will ship around for a week and sit in the store for two more without showing blemishes or mold. That’s the sturdy, Styrofoam® stuff you find behind the salad bar sneeze guard.

 

None for me, thanks. I’ll take the lush and ready-to-eat stuff. I’ll toss the occasional really bad piece and make the most of those with minor flaws. I’m not perfect and don’t demand perfect appearance of every tomato and strawberry.

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Funk in Drag in Roxbury

September 28th, 2009

P-Funk Ensemble from Berklee is like and unlike the original. It’s funny both ways to think of them out there at all and specifically performing at last weekend’s Beantown Jazz Festival. There’s a lineage there direct from my high school (Plainfield, New Jersey).

The incarnation I saw on Columbus Avenue covering Parliament Funkadelic had the drag down — 1970s psychedelic jackets, dresses, hats,wigs and boas. It was incongruous to see the very young, very white (smattering of Asian and black) horde of rockers. But, hey, this was Berklee; they clearly drew on the students they have. The original band looked quite a bit rougher, tougher and darker.

Therein lies my vicarious tale and tenuous link.

While some non-rock historians say James Brown was the godfather of funk as well as soul, they are dead wrong. The funk originator and namer and pioneer was George Clinton. He was a barber in Plainfield when he assembled the original Parliaments. Through nasty business deals and expediency, they added members. When their name was sold out from under them, there were versions Funkadelic, Parliament and Parliament Funkadelic.  To his lasting credit, Clinton kept his original guys, plus, from doo wop to rock to funk.

Two of the early members were Richard and Frankie Boyce, brothers, who like all the other originals went to PHS. There were times I shared a homeroom and all was quiet. Many other times, they were on. They and sometimes other members would sing on the way to class. We had a four-story school four about 2,000. Boston Latin School is built a lot like PHS, with wide staircases. They were one-way for students. The Frankie and Richard would break into Testify or some Motown tune, harmonizing the hell out of the hallway. It was cheap thrills to have a three-minute concert several times a day. Sometimes, I’d risk being late to go with them to their floor to catch the end of a tune.

Richard is back into music. Frankie is dead from a grenade in Vietnam. Parliament Funkadelic officially folded, but the Berklee ensemble is having a good time with their style. They even had a lesson/session with Clinton.

We had several other recording individuals and groups in PHS. In a very different sound was the Critters. Classmate and friend Joel Blumert swears that Don Ciccone and Bob Podstawski, particularly the former, Critters originals are highly talented. Joel’s a professional musician and must know better. I found Younger Girl and Mr. Dieingly Sad insipid. What do I know?

My conclusion though is that we should all get to go to high school with good musicians.

Antsy Boston Poll Workers

September 23rd, 2009

Yesterday in Boston’s municipal preliminary, I was clerk at a polling location in Hyde Park. All but one of us (four inspectors, an interpreter and the warden included) had worked the past gubernatorial and presidential elections. We were disappointed.

The local rags and other media buy the line that because the 23% of registered voters appearing exceeded the city’s predictions, turnout was great (see the Herald‘s piece for one example). We in the folding chairs kept asking where the voters were.

We had a few flurries between 8 and 9 a.m. and 5:30 and 6 p.m. Only once in the 13 open hours did we have all eight of our ballot stations in two stands occupied at one time. Lackaday.

Perhaps odder to this politically minded sort, a startling number of voters commented that they knew nothing of the 15 city-council candidates. Roughly one fifth of our voters left that part of the ballot blank, voting only for mayor.

How in James Michael Curley‘s name can you have avoided:

  • Learning about the council candidates, where were ubiquitous and cacophonous?
  • Seeing and hearing the mayoral candidates debating, advertising and being covered by all media?
  • Getting excited about the sweeping changes mayoral challengers demanded?
  • Having a once-in-a-decade chance to elect multiple new councilors?

Voters managed.

Poll workers aren’t supposed to talk politics at all during the election days. That was tough. Several candidates, including Steve Murphy and Tomas Gonzalez were out front for hours. Steve said his 80-ish parents were working the polls at the precinct up the hill. Plus some of the campaign workers (including a candidate’s wife) were trash talking various contenders. It was real tempting to join in. Yet, I had my tacky marker-written ID badge with stars and stripes. I was an identifiable official with a modulated mouth.

I was a bit disappointed that Council John Connolly didn’t show, but sent a surrogate. I was not aware that his wife apparently intentionally coordinated her latest birth with an election. John and I spent 90 minutes or so talking education a week and change ago and are planning to do a podcast on it. He mentioned that she was eight and one-half months pregnant and how much he was looking forward to the new one. Conga-rats to John and Meg for Edward Ronan.

An oddment yesterday was over a dozen spoiled ballots. Those tend to be rare from my previous experience. It was young, middle-aged and elderly, men and women, and even the afternoon cop on duty at the check-out table was goofed up the ballots. A few were in attentive, like using an X instead of filling in the oval as shows repeatedly on the ballot and posted instructions. Most though were in council races, typically overvoting beyond the four maximum.

The huge list of 15 candidates seemed a bit much for many voters. Quite a few asked for clarification on how and how many to vote for or complained that it was hard to find their candidates in the pile.

In the end, we had 428 ballots in our precinct — okay, but not great.

We had none of those pesky provisional ballots that require a call to elections for a database check, filling in multiple forms, and sending off your vote with the hope that downtown will clear you and count your choices. Yet, we had a lot of people who had not returned the annual city voter census form, requiring ID checks and maybe a phone call, plus a single form.

In the many dead moments, we got to socialize among the crew. For me, an extra benefit was culinary conversation with the afternoon cop. This part of Hyde Park is rife with resident police, including both guys yesterday. The afternoon one had already tried most of the local restaurants, including the several new ones. He gave good tips and mini-reviews. Plus, he spends most of most days in a patrol car, so he thinks fat control that tilts his comments toward adult concerns.

Unfortunately, I worked one precinct away from my voting location up the hill. They needed a clerk down the hill. So, I didn’t get to meet any close neighbors. In my previous work in a JP location, I knew and chatted with a lot of folk on my block and nearby. Likewise, the cop on duty worked the whole day, lived on my street and generally could check out the voters on the way to the machine by sight. It was a jolly room.

We’re likely to have the same crew come November 3rd. We can build on some of our personal tale. Then again, we may be too busy. We’re hoping for twice, but not three times, the number of voters for the general. There’s a pride of participation on our side of the check-in table too.

Cross-Post Note: This appears at Marry in Massachusetts.

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Permission to Die by Car

September 18th, 2009

waving handWhat are the seemingly accommodating drivers thinking? Waving a cyclist or driver into onrushing traffic is the oddest generosity of all — kindness that can kill.

For example, I have experienced this once or twice a week as I bike from the West Roxbury Y to the new alpine digs in Hyde Park.

Turning left from Quinn Way at the stop sign depends on timing for safety. When cars are racing or just rolling north and south simultaneously on Centre Street (see inset from Google Maps), I wait for an obvious clear shot.

Quinn Way map

Sometimes I get the oblivious wave that seems at once thoughtful and thoughtless. A driver stops in the nearest lane and dismissively waves me to cross three lanes to head south. I’d like to roll up to the driver’s window and ask what the hell the thought process is.

Invariably, the waver does not seem to notice cars and trucks to the left which would be visible in the driver’s side mirror, as well as more motor vehicles barreling down the hill for anyone looking ahead. Those other drivers would not be able to see me on a bike suddenly claiming a lane in front of them. Smash-o, crunch-o, ouch-o.

The body language of the waver suggests arrogance and noblesse oblige. My interpretation is, “I’m feeling generous and in control of the space around me. I shall deign to let you advance, non-driving peasant.”

That may be putting too find a point on it. Instead and in the least, that driver needs more RAM. Processing the visuals would make it clear that safety and generosity require passing so that the cyclist and on-coming traffic in both directions can see each other. Minimal intelligence would conclude that waving a bicycle into three lanes of moving traffic is, shall we say, unwise.

When I’m safe and in a chair, I have mused on what such drivers are thinking and feeling. I suspect at heart it related to another of my raps, how very few of us are capable of multitasking, yet nearly all of us are sure we are. (See one example of my take here.) If you don’t realize you are not gathering enough information to make a good decision, any check and balance has to come from others.

Too many drivers look only right in front of their cars’ hoods. Simultaneously scanning visual cues in plain sight is the rarity. That way can lead to death or maiming for the pedestrian or cyclist waved into traffic.

Yet almost invariably when I smile but drop my cleated shoe to the pavement instead of following the flicking fingers’ direction, the driver is obviously irritated. I rejected the controlling generosity.

I’ll take the scowl rather than the ambulance ride.

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NYCycling

September 16th, 2009

New Yorkers constantly build on their base. I saw lots of evidence of that with cycling over this past weekend.

Manhattan bike lane map piece

First, in Manhattan, bikes were ubiquitous. The felt sense was much more than Cambridge, more like Cambridge, England.

Big, cross-town bus stops had commuter bike racks under the roof. The city has huge biking maps there as well.

More impressive were the relatively new and still irritating to some separated bike lanes. The map piece here shows those in green, as on 8th Avenue (going uptown) and 9th (downtown).

Pix click trick: Click on a thumbnail for a larger view. If this opens in the same window, use your browser’s back function to return.

These illustrate several differences between NYC and Boston, including:

  • New York boroughs tend to have spacious avenues, which offer the option of simply stealing a full travel lane. A few U.S. cities, like Washington, D.C. and Columbia S.C., were planned like that and do as well, but we aren’t here.
  • Once the city had its hearings and planning, it went ahead. Like many big European cities, it simply moved or took parking and travel, devoting it to pedestrian and cycling. We don’t yet have the will and courage for that.

Note the separation in the pic below. You can see the concepts and diagrams in the design doc here. It gives a 10-foot lane for bikes (actually a 5-foot travel lane with a buffer road space on each side. There is a median or other physical barrier between motor vehicular traffic and another for pedestrians. Everyone is safe. Everyone has his own lane. Numerous NYC blogs whine (here for one example) about not having enough such lanes yet. They have that NY urgency.

There’s also lots of info about biking in the city, including these lane here.

9th Ave bike lane

Of course, not everyone is pleased, even where there is lots of physical space on a broad avenue to do this.

At the top of pissed pyramid would be merchants on 8th Avenue. Near that are the delivery truck guys, who either have to circle the block to find parking spaces (which do exist on the avenues), risk a $115 ticket for driving in and blocking the bike lane, or push their loads across the street.

For the truckies, this was similar to the crackdown about 30 years ago. When the police responded to thousands of complaints of blocked cross streets by giving tickets for double and triple parking, it was to be the end of the world. They adjusted and traffic has flowed since.

Similarly, a wonderful piece in Chelsea Now, a local weekly, shows the level of complaint here. Some merchants are just sure they are losing business or that their costs have to have gone up. It’s all apocryphal. There are no numbers to back that up, even though they would be very easy to gather.

I can see them not wanting change, but they’re going to have to do better than it’s-only-common-sense. That’s what people say when they can’t prove their contention.

Such ped/bike/motor separation is not an NYC invention. It worked well and first elsewhere. There, they had the space and the will. I have no doubt that even as early as mid-term, all modes of transportation will be fine, just fine with it. Even the store owners will realize they are not harmed.

As for Boston, we don’t have a lot of places to do this. We could on Tremont where it changes from Cambridge and goes past the Common, but in most places, we’d first have to lay down another lane for the ped/bike/motor separation.

On the good side, we are inching that way. Even the three guys contending to unseat Mayor Tom Menino share the big man’s affection for more bikes and fewer cars.

I think of the new, narrow bike lanes painted for a short distance on Columbus Avenue here. Eleven days ago, I took it both ways. In that short distance, I counted 22 motor vehicles blocking the lane, 9 one way and 13 back. Of course, there was no enforcement. Bikes had to take the single lane in either direction from cars and trucks to move instead.

The equivalent to 8th/9th Avenue would be to create that separation in one direction. Then another street, like Tremont in the South End and Roxbury would go in the other direction. Set up the physical barriers and voila, safe separation.

What did Bob the Builder ask — can be build it? Sure we can.

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Broken Health: Part 3

September 8th, 2009

Of course men and women are sensitive and even paranoid about problems with their primary and secondary sex characteristics. For example, cancers of the breast, prostate, ovary or testicle have strong emotional and identity components.

Text Notice: This post is not sexual but does contain mentions of nether region body parts.

Series Links: Part 1 on hip replacement is here and Part 2 on shoulder surgery is here. Also, this is cross-posted at Marry in Massachusetts.

Thus, you can likely imagine my distress at severe pain in my right testicle during my first year of marriage. The agony was frequent and daily. It often immobilized me and doubled me over as well. I imported my new wife to my tiny bachelor apartment and moved to a larger one also in the West Village. This was not a good omen for our new lives.

In my 20s, I knew I was at prime age for testicular cancer. That has a much higher morality rate than breast cancer and most others. Such a diagnosis would have been particularly grim three decades ago.

Yet, being a typical  member of my family, I did not hide, but staggered to the doctor to face the diagnosis of whatever it was. Instead of physical and emotional relief, I experienced months of continuing pain and uncertainty. Also, the process further diminished my dwindling respect for doctors in general.

I went from what we used to call a GP to an internist to a urologist to a proctologist. There were numerous x-rays, scans and other diagnostic tools, hard and soft-tissue. In particular, I remember two sessions of tears-to-the-eyes prostate milking for testable fluids.

The weeks passed in slow and too vivid spasms, literally and figuratively. Multiple doctors had no cures and no causes. My wife and I remained nervous. Plus the time and money costs mounted.

This ended up not being one of the chronicles of dogged diagnosis the Sunday New York Times Magazine or the TV series House feature though.  In contrast, there was a specific problem and remedy, one that illustrates another reason to be skeptical about medical treatment.

Coincidental to the agony of the right testicle was a follow-up on my shoulder dislocations that had been under control since the introduction of the chest expander. The neurologist who was checking for internal damage up top found the problem below.

pudendal nerve diagram

My tests for him were fine and he was a trifle bored after the quick session. Then he asked whether there was anything thing else.  Suspecting he could do nothing the gang of other generalists and specialists had failed at, I said something about my painful right nut.

He seemed to light up and asked for some of the information the other doctors had gotten. He was particularly interested to hear that we had recently moved. He asked if I carried heavy furniture and I noted that there was a huge oak and Masonite desktop that I protected my much smaller wife from handling because of its weight. I had discussed the marriage and move with the other docs, who dismissed such personal detail as meaningless.

He then asked me to turn around and lower my trousers. My testicle was in moderate to high pain at that moment, but he changed that. He placed his thumb firmly on a spot in the lower back and gave me instant relief.

He had properly and precisely figured that I had severely strained major nerves from the spine leading directly into the scrotum. What would now be called acupressure proved his hypothesis.

Moreover, he pulled down a chart and out an anatomy book. Those nerves run like two huge hands with very long fingers from sacral vertebrae 2, 3 and 4 directly into the external genitalia. The major pudendal nerve structure was the cause of the pain.

My immediate question to him was why didn’t the large set of other doctors think of that. He allowed as that was a very good question, as the nerve plexus and geography are very basic anatomy they all had taken.

My solution was treating the damaged nerves with rest, massage, heat and cold. All the years later, I can still cause a flareup with macho behavior, but I know what to do for relief.

This instance at least did not lead to recommendations for unnecessary surgery and I did get relief. However, the months of fretting and pain were avoidable through what seems to be reasonable competence by the previous medical guys.

I am not a litigious sort and have never sued a doctor. However, given my experiences with bumbling diagnoses, I am not too sympathetic with plaints of the medical types over what they say are unfair suits and resulting high malpractice premiums.

No doubt, some people try to make big bucks off others for the smallest reason, or no reason. On the other hand, shunting patients into unneeded surgeries and other treatments because of incompetent or lazy diagnoses may be all too common.

Medical doctors in the main enjoy, expect and demand high status and income in this society. As G Love has sung, “You got to earn it to own it.”

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New Favorite Bike Shop

September 7th, 2009

http://harrumpher.com/wordpress/wp-content/uploads/2009/06/thinwheel.jpgSing, Goddess. Sing the skill and glories of Quad Bikes.

Saturday, I had a second wonderful experience with them, or specifically with David. I fully expect a third of three next week.

Anyone who knows me understands how I love biking and how I can harrumph about typical bike-shop dealings. The people at Quad (on the Radcliffe quadrangle) have disarmed me. I have told drinking buddies and now expand my own song of praise.

A tip of the toupee has to go to the Weekly Dig, which published one of their typical quarter-assed guides in May. This was the briefest of sketches for a wee selection of area bike shops, comparing tune-up prices.  Quad stood out there with kind of a warning that went off for me — did their much cheaper price mean much lower quality?

I had reason to find out a couple of months later. Regular readers know I have been recovering from serious leg surgery. I’m slower than before I got an ankle-to-knee titanium tibia nail, but I kept hoping some of my diminished speed was the condition of my road bike.  So, I decided it was time to tune up the equipment as well as me and figured at $36, I wasn’t risking much. That’s about a third of what Wheelworks charges.

So, the answer to the warning is no, siree. Quad is as good, much faster and really understanding of customer relations.

 

Service or Serve Us

 

To my normal repair-shop rants, they are notorious for not meeting their promised dates, making mistakes, delivering less than you pay for, charging a lot, and far too often being arrogant or sullen or both.

In contrast, the non-profit gentlemen (no distaff staff in sight) are pleasant, even jolly, as well as highly competent. Perhaps being only in their 20s has so far inoculated them from the grumpiness of stereotypical bike-shop guys.

I could go on about the tune-up I got for my road bike. Suffice it to say it was excellent work at the best price I have seen in the past 20 years. Moreover, it was one-day service and they accurately said when it would be done.

Consider though my panic  last week. Since my operation, almost daily biking has been essential, physically and emotionally, to my leg rehabilitation as well as fitness and weight control. When my chain snapped Wednesday as I headed up the 12- to 15-degree grade hill heading home, I was a bit concerned. Then when I replaced the chain with its many thousands of miles, I was very concerned as the new one seemed fine…all except for serious skipping and slipping under load up hills. There are many hills to and from the Y, in addition to the killer alp I face whenever I want to get to my new home.

I had already arranged to bring by my over 20-year-old Schwinn Sierra (that brand’s original mountain bike, heavy and hard tail) for evaluation. So, I called to see whether they’d squeeze in a repair of my road bike as well, to find if I had goofed up the chain installation or the bike had worn components that limited me to flat land.

This was a Saturday and a typical bike shop might have said, “Sure. Get in line. We’ll give you a mechanic’s time after Labor Day.” Quad said to bring it over. Holiday weekend or not, they kept to the 1 to 6:30 hours.

I got two joys from them:

  1. They diagnosed and fixed my road bike within the hour of my arrival.
  2. They said my old, beaten-up mountain bike could be fixed enough to make it a useful commuter.

In honesty, my baleful countenance may have aided in the road-bike repair. David’s a great enough guy and at least as enthusiastic as I about cycling. He responded when I moaned. Rather than simply feel gratitude that they’d fix it before the end of the day,  I found that he offered to do the job immediately.

His diagnosis, which he showed me proof for, was that my old chain had married to the rear cassette cogs as it stretched and they wore down. The new chain, which I had apparently put on well and the proper length was too healthy and accurate. It slid right off the worn cogs.

 

Out of Service, Alas

 

That required a new cassette in the rear wheel. Not only did they have a compatible one in the store room, but he would do the job that day.

I asked if I should disappear for a few hours (thinking that Cambridge Common, a bar with a great selection of taps and low prices was two blocks away). David looked at me and either to keep me sober or more likely to keep my cycling vital said he’d do it within 15 minutes or so. I can’t imagine that service and responsiveness from Belmont Wheelworks or Ferris Wheels or other bike shops I’ve used.

Realistically, inserting that repair in the queue made a negligible difference to other customers but huge one to me. It counters what I had to do in one of my college jobs in a German deli. The owner there insisted in absolute FIFO service. Even if I had to wait for part of one customer’s order to grill, I wasn’t to switch to a single item for another. First come and all that…

At Quad, David did what he said. The bill was low — $40 and change for part and labor. I was road ready as well as placated.

For the Schwinn, it was my first mountain bike. It had been down a lot of hills, back when I used the downhill beast to go up hills, over boulders and down the other side. I am emotionally attached. I have given other cycles to Bikes Not Bombs and put my Girvin with the frame crack in the trash.  I’ve lugged this beaten-up buddy around. Its gears need serious adjustment and likely new cables for them and the brakes. The headset is a bit wobbly too.

David said he can get it into shape for my fall and winter riding, conditions too perilous for a road bike with 23 or 25mm tires. In the snow, that would be like walking in socks on a huge porcelain plate.

Quad, by the bye, has the rights to the many abandoned bikes on the Harvard and Cliffy campuses. Students and others lock and leave their losers rather than bother paying for help or fixing them. Quad takes those declared vagrant by the Harvard cops and repairs and sells, or if necessary, junks them. Their mechanics have lots of experience making the inert roll again. It seems my Schwinn is not as abused and neglected as many of those.

If you need a second or an inexpensive mountain or road bike, Quad is likely to have several choices. Particularly in the late fall or winter and spring, they reclaim quite a few and tend to sell them in the $100 to $250 range after rehabilitation. That’s a bargain as well as environmentally sound.

Having written for the management and business press for years before turning to tech writing, I see Quad as a big step above average customer service. Far too many companies, even little ones, seem to think customers are there for profit and convenience, not to serve and satisfy. In contrast, Quad staff grok customers’ needs. I have already told numerous people about the glories of these guys and shall continue to do so.

Not only does Quad keep me on the road, its staff give a damn about doing so.

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Broken Health: Part 2

September 3rd, 2009

shoulder x-rayAspects of our daily American lives call out for trust. We need to believe that our food is safe for one. Likewise, we long for the days when we just knew for sure that doctors could fix what ailed us.

With this nation now consumed with thoughts of health care, it is not always best to divorce the subject from the personal. This is the second of a multipart post relating my wee private experiences in the wonderful world of medicine, a field too often conflated with medical science. Part 1 on not having hip-replacement surgery is here. Part 3 on non-diagnosis of a more sensitive body part is here. I’ll cross-post this at Marry in Masachusetts.

Now, let’s consider my shoulder operation.

In my early 20s, I was used to full shoulder dislocations. While there is a cliché that swimming is an injury-free sport, ask a swimmer. I had been a breaststroker, which tends to bring with it damaged knees and shoulders, including dislocations. Both of us on the high school team ended up with full dislocations in which the shoulder would pop out of joint. Joel’s went up by his ear and mine down by my rib cage.

With the nerve, ligament, tendon and muscle damage, the pain of each dislocation is, how shall we put it, exquisite.

Moreover, I had very stupidly body surfed at the tail-end of a hurricane out in the Hamptons on Long Island. Catching a great wave, I jetted well over dry sand, only to find my fingers embedded like a spearhead while my body continued. That wrenched the shoulder into its components.

The catalyst for getting the dreadful modified Putti Platt procedure came less than two years later. I was helping a girlfriend move apartments. As it happened she was a Ph.D. in medicine and the woman with us was an M.D. They both saw me turn white from the pain as my shoulder popped down below the joint. I was wearing a tee shirt and they being medical sorts knew exactly what was up (or down).

The pain was blindingly intense. All I could think of was lessening the tearing of the body parts by getting the ball back in the socket. I grabbed my misplaced right upper arm with my left hand and pushed it away from my ribs. Sure enough, this caused the ball to be sucked back into the socket or rather yielded to the straining muscles to relocate it. In that moment, I went from agony to bearable severe pain.

 

Time for the big fix

 

My companion said it was time, past time, to stop avoiding the surgery just because I had never had any operations. Moreover, she did her research at NYU Medical and knew the best orthopedic people or professors who knew them. I had an inside track to the best evaluation and cutting.

She wangled an appointment with a famous joint surgeon for the evaluation. He literally wrote the books.

That didn’t start well. The man was a serious artiste. He heard my tale and quickly and very firmly informed me that I was totally wrong, that I could never have relocated the shoulder solo. In fact, he pulled out a text on orthopedics what proved that in writing. I would have had to have gone to a hospital, had weights applied to the limb and let the doctors guide the joint into alignment.

I looked at the front of the book to discover that he was the author, the expert. Yes, indeed, his circular citation was to convince me that my experience had no validity. My laughing surprised him but did nothing to change his mind. However, when he learned that the two witnesses had an M.D. and Ph.D. in medicine between them, he allowed as how this might be the first such case he had ever heard of for self-relocation.

Regardless, he did agree that the big cut and shortening of muscles and tendons was the only way to go. However, he limited his surgeries to wrists and hands, so he wasn’t the guy.

My girlfriend though personally knew the head of ortho at NYU Medical. He agreed to supervise the operation, unofficially doing it though the residents nominally performed these.

I was resigned, sort of. I was quite the drama queen about this, even having to travel to St. Vincent’s emergency room nearly my West Village apartment with the shakes a couple of nights before entering the hospital. Another girlfriend was there and went with me, only to hear that it was sheer nerves.

There was the tableau like a Viking funeral in the small hospital ward. I thought little of it because I was being so self-centered, but in retrospect it was absurd and theatrical for a small parade of current and former girlfriends visiting before the surgery to wish me well and bring me treats. Several of the men in the other beds later commented on how nobody was visiting them and I had enough attention for everyone.

The night before the operation, a nurse shaved my chest and arm. Then in the morning, they painted me with iodine solution and drugged me (demerol maybe?). The drug was powerful and I recall being paralyzed as they wheeled me to the operating room. The ceiling needed scraping and painting all the way down the long corridors.

Then in my diminished capacity I had the realization that my surgeon, the head of the department, should have been in scrubs, but I saw him walking toward me in street clothes. Wearing his wonderful, full smile too, he slapped me on my good shoulder before talking. He said they had discovered an infection two beds down and could not risk opening up my pecs and shoulder. He was sending me home.

My medical girlfriend was at her apartment a few blocks south. When I could dress and walk, I went to tell her. It was a tiny Rashomon moment. I ranted at high volume and speed, displaying my anger at being finally emotionally and intellectually ready for the scalpel, only to be cast out. She recalls as clearly that because of my heavy sedative and painkiller, I spoke and moved in extreme slow motion. It was all she could do to keep from laughing at me.

One would suppose given the seriousness and randomness of the dislocations, I would head in as soon as I could. However, a wreck intervened. While visiting a high-school chum in New Jersey, I was a passenger in his car when a drunk hit us as we parked. My friend got a broken hip but I just had another dislocation.

Another high-school acquaintance was a lawyer who advised us, telling me to get my shoulder looked at. I didn’t think that was necessary, but he convinced me. He sent me to an unusual orthopedic surgeon, one who specialized in children and one who didn’t like to cut unless necessary.

Until those visits, I had heard only the three different operations to prevent recurrent shoulder dislocations. The wrinkles were things like whether they also put in effect a hook and eye in the ball and socket to keep them mechanically fixed. No doctor had said there was any non-surgical alternative.

 

The cheap solution

 

This doctor, however, fixed me with a $25 chest expander — four large springs on two handle grips — like they advertised in the the back of comic books. Using it for long periods daily in effect did what Putti Platt’s operation went for. Tightening the pecs and tendons made it much, much less likely that the ball would disengage from the socket. I also learned to ease off if anything felt loose, as in opening my arms to spread a bedsheet or doing some acrobatic moves under those sheets. Stay still, tighten up and keep bones where they belong.

So, I have friends, mostly swimmers and including teammate Joel, who have had one or two of those operations. A lot of pain, permanently limited lateral motion and a long recovery (and some ugly scars) are included. The chest expander and hundreds of hours, maybe thousands of them, of exercise were a better deal.

So in this time of passionate concern of health care, are there any lessons from such anecdotes? I would think they might include:

  • It can be well worth standing up for yourself with any arrogant doctors, as the surgeon who evaluated me. He could well have badgered me into stifling my certainty and not getting apt treatment.
  • Pressing for viable alternatives may be as important as the proverbial second opinion. Everyone involved just knew that drastic reconstructive surgery was the only solution. Yet that turned out to be very wrong in this case.

There was a time when I trusted doctors implicitly. Of course that was the same period when I truly bought into the magic of transubstantiation. I was a kid.

As an adult moving to different cities and seeking physicians for preventative and curative reasons, I learned differently. I have also learned a hard lesson for a fairly introverted person. It’s tough, but you have to be your own advocate if you expect reasonable medical care.

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Broken Health: Part 1

September 2nd, 2009


With our governor just subject to scalpel (and drill and hammer), I shall personalize the health care topic a bit here, with cross-posting at Marry in Massachusetts

We could note in passing that this is not a very scientific presentation, much open to the criticism of bloggers as opiners without checkable facts. Yet, blending facts with illustrations from experience is pretty much what you get from a visit to your typical primary-care physician or even specialist. More on that later and here.

Let’s consider a few aspects of Gov. Deval Patrick’s hip replacement. First and most obviously, he’s covered. He has the excellent insurance from the state and he and wife Diane are quite wealthy on their own. They don’t have concerns of getting the best care, paying for it or losing his job while he recovers.

Second, he has the great advantage of getting a mechanical repair. Like work from skilled cabinet makers or auto mechanics, a hip replacement is an eye-guided, hands-on job. Surgeons do a lot of these and the vendors have fine-tuned the gouge-out and pound-in joints for decades. They can see what they’re doing and be sure all is well before sending him back to bed.

Contrast that with the far less precise visit to your family physician. Whether you come in for a checkup or with a particular complaint, you rely on the doc’s art and even mood. There’s a lot less medical science in an office visit than we think and hope.

Sure FPs (what we used to call GPs) read medical journals and attend training to keep up on studies and developments. Unfortunately, the findings often contradict previous and current studies. That understandably leads to doctors’ faddishness, of waving a single study as now-we-know proof of how to proceed. Far too often as well, studies funded directly or indirectly by drug companies prove, kind of, that doctors should treat this or that symptom with drugs.

Only a few of us are demented in ways that we enjoy pain or seek being incapacitated. When docs say they’ll alleviate our symptoms, it sounds sweet and, well, necessary.

On the other hand, I have a base contention that this illustrates a fundamental failing of U.S. health care. If rather than treating symptoms with drugs our docs analyzed, diagnosed and cured underlying causes of patients’ problems, we would be much healthier, I hold.

Many doctors and surely all pharmaceutical giants would quickly and loudly squeal that there is no scientific evidence of a causal relationship between treating symptoms with drugs first or exclusively and our pathetic national longevity. (We’re like 17th on the list of long-living nations.) Pardon my snickers as I note that drug-company funded research does not study outcomes associated with drug-for-symptoms v. underlying-cause treatments. The best outcome for patient has not been on the table.

Every medical college and research university should have such a study in the works. This goes to the core of our national health as well as our medical practice and procedure. More on this in future posts.

Today, I’ll tell you about my hip operation. There are stories about my shoulder repair, testicular agony and leg surgery pending. Each contains lessons of health care.

Over at Left Ahead!, we’ve been asking for our promised podcast with Gov. Patrick. Former chief of staff Doug Rubin was setting this up before he went to the re-elect campaign. Three different staffers since say it’s in the works. However, the subtext included a personal health question — is he a big consumer of diet sodas?

Thus, you can open the lid to the box of my own hip-surgery tale. Rather, peek at how and why I ended up not getting both hips replaced a decade ago.

Our governor had long-term hip pain. His doctors attributed that to a combination of an auto accident and arthritis, reasonable factors that may well account for his troubles.

In my case, various FPs and orthopedic surgeons likewise had good explanations of why I was crippled. They also projected numerous x-ray and CAT views before me that showed plain striations on my hip-socket balls. They had me heading for a double hip replacement.

I don’t get emotionally invested in pain. I am well aware of it and dislike it, but I can go about my business without whining and without drugs. I headed for the doctors and endured the tests because I couldn’t walk. My hips hurt to the point that I needed a walking staff to make it the 20 feet from bed to toilet.

Noting my personal history, the various doctors had a pretty good idea that it was arthritis. I was about the age Patrick is now, early 50s. That’s typical for the onset of symptoms. More to the point, I had been an athlete. As a team swimmer, I figure I had done well over a million whip kicks in practice and competition. Plus, I was a regular cyclist as an adult. My hips had taken their share of abuse.

Sure enough, the internal images showed what the surgeons predicted. Their solution was new hip joints. Ta da.

At a very different corporal locale, I had very different symptoms. For example, when I’d shower and close my eyes, I saw an intense light show. That concerned me more. I had had a gruesome injury at 19 when I was hit as a pedestrian and thrown head-first through a windshield. Then recently, I got a strong concussion when an inattentive driver broadsided me on my cycle as she turned and floored her car without looking.

So, I was a mess top and bottom. My brain might be imploding and I couldn’t walk right or without agony.
Complicating this was that I still had my tonsils, or put another way, I had never had surgery of any type and didn’t want any.

Yet, I had physical, visual, quasi-scientific proof that arthritis crippled me. The fix was plain and inevitable and the surgeons were positive of cause and cure.

Well, I never had the replacement surgery. I was cured without cutting. It was not through prayers to a saint or other such miracle.

Instead a friend pointed me to what sounded like a serious crackpot, one with the unlikely name of Betty Martini. Someone with my last name of Ball, surely the most risible in the language, should never goof on another’s name, but really, Betty Martini?

She is a relentless foe of aspartame, a.k.a. by brand name NutraSweet®. Our FDA approves the sweetener and the company carrying the name cites many studies alleging its safety. However, at her Mission Possible group, Martini piles on studies, news and personal reports that say otherwise. She led me to try my own personal (universe of one) quasi-scientific study.

Relevant details in my instance included:

  • History of head injuries.
  • Two key symptoms, according to Martini’s work, of aspartame reactions —hip pain and brain electrical anomalies.
  • Heavy use of aspartame (one to two two-liter bottles a day, in lieu of water or juice).

The short of it is that after years of increasing hip pain, I was free of even discomfort within three weeks of stopping the Diet Pepsi. Likewise, the light shows totally disappeared after more than a year of daily occurrence.

Being hardheaded, masochistic or scientific, depending on how you look at it, I had to know. I reintroduced aspartame by my liquid of choice three times. I had the same effects each time. Within two days, the hip pain and flashes returned and then went away a few days after stopping. That’s not pure science, but I remain convinced.

 

A mess top and bottom

I confess now as then, I was highly skeptical of Martini’s assertions. Not only did she seem New Age and even crackpot, but real surgeons had waved x-rays and aired solid reasoning at me. I had to prove or disprove this in my own little and very personal experiments.

I won’t debate the NutraSweet folk or any aspartame vendor. That’s Martini’s business. It’s quite likely that sensitivity to the substance varies considerably and just as likely from my perspective that many have symptoms they attribute to other causes. I certainly understand why the vendors pretend their chemical limo is very safe to ride every day everywhere.

For my part, I do tell people my story. Non-surgical, non-drug solutions to chronic pain and other symptoms seem to intrigue us all.

Moreover, I have no way of knowing whether Gov. Patrick fit my mold at all in this. He and I both had doctors positive that our hip pain required metal replacing bone. Mine were wrong, but his may well have been right.

In my deepest heart, I would like to return to my childhood belief that doctors truly know causes and cures. Alas, I have had too many experiences contradicting that. I’ll share a few more in future parts and link to them here as they post.

Part 2 of this series is here and part 3 is here.

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Cos Play at the Y

September 1st, 2009

“Where’s your cape?,” demanded the four-year-old lad. Realizing that I had been sucked into a cos-play vortex with her kids, the mom was very quick to do almost all the lying for me. flying superhero

I had no idea my long-sleeved Superman shirt — blue with the big old S logo on my big old chest — would be so worthy of comment at the West Roxbury Y. Already two different 30-ish women in two sections had called out, “Great shirt!” and winked.

After my workout, as I sat in the entry room changing into bike shoes, the boy and his slightly older sister had to visit. It wasn’t exactly Santa, but I was their target courtesy of mom. As I passed the clot of families at the pool area, she called to them, “Look. Look. There’s a superhero.”

My youngest is just 16. My days of being even a plain hero to him are behind and maybe ahead of him. Suddenly I had the respect and rapt attention of the kindergarten crew.

They wanted to know just the basic superhero facts. Was I flying home? I said I was taking my bike. Mom added both that superheroes don’t always fly and that I was putting on my special bicycle shoes and my helmet. She was shameless in both making stuff up and entertaining her charges.

I didn’t feel the deceit was too deep or harmful. The son particularly was clearly going to continue to ask the why and how questions today and until he was satisfied, perhaps at age 35. Truth would out.

Well, I do have the big shoulders and obvious muscles. However, instead of the field of jet black hair, I wear some blond cotton candy over my shiny scalp. Had I been five or four, I think I would have wanted to know what had happened to Superman’s hair.

Nevertheless, mom made the mundane magic. Her kids had a seven-minute interlude with Superman right at the Y.

Now I think I feel the need to go fight some crime.

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