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She is probably doing it just to annoy you although I imagine it is something you have to learn. The two that drive me crazy are alot and vomitting. But, my receptionist used to write the word medication, medicaiton all the time. She knew how much it drove me crazy. I swear she did it on purpose. You would think that there would be words where they would just see them and stop and make sure they typed it correctly. I told her to just use the word, med.


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Hi Donna,

If you have to ask who would put a grub on a griddle, I suspect that you were insulated from the world of young boys camping in the great outdoors.

As for your secretary's reluctance to observe proper punctuation, it's worth pointing out again that if read aloud her efforts would sound the same-- no one listening can hear the two beautifully placed apostrophes in this sentence.

Along the same lines, Bert has mentioned his dislike of alot instead of a lot and vomitting spelled with the extra -t-. Again, no one can hear the difference when the words are read aloud.

Andrew Jackson — 'It is a damn poor mind that can think of only one way to spell a word.'

***

However, if you truly wish to for the fly-specks to be properly placed by your secretary, the Munich Taxi study comes to mind.

A Munich taxi company grew tired of its drivers damaging the fleet.

Hoping for a solution, they engaged a university to study the results of adding anti-lock brake systems.

Half the fleet was given ABS systems and stickers proudly stating so.

Unknown to the drivers, measuring devices were installed in all the cars, and their data was supplemented by university observers pretending to be ordinary fares.

The result was a classic illustration of risk homeostasis, the behavior of adjusting risks, real or perceived, to the same level that we are comfortable with.

Both instruments and observers showed that drivers seeing the ABS stickers drove faster, followed other cars more closely, braked harder, swerved more abruptly, and so on--they felt protected by their ABS and therefore increased their risks.

The same thing was shown on a much larger scale when ABS first came out and insurance companies offered reduced premiums for the wonderful new technology that improved braking in emergencies.

The insurance companies quickly stopped offering lower premiums because they found that the ABS made no difference in actual crashes, partly because many crashes happen so quickly that no one even hits the brakes, partly because the improved braking only meant that that the car hit something at 25 mph instead of 27 mph, and mostly because people increased their risky driving because they felt comfortable behind the shield of an ABS sticker.

How does the Munich taxi study apply to your secretary's reluctance to improve her punctuation?

The company gave up trying to solve the problem through technology and simply made the drivers pay for damage to the taxis, an obvious trick that led to more taxis being in service instead of in the repair shop.

You could, of course, threaten to fire your secretary over punctuation, but that seems like overkill.

If she has to put a quarter into a jar for each mistake that you catch, she might improve with surprising speed, particularly if she thinks that the proceeds go to some worthy cause instead of flowing back to her.

If she does improve, you can always give her the jar of quarters back and tell her that she's the worthy cause.

I should warn you that this approach looks good in fiction, but in real life it can be the straw that breaks the camel's back and loses you an otherwise excellent secretary.

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Hi Bert,

I should take this opportunity to confess that that I once wrote a long essay in graduate school with considerable emphasis on the theme of embarrassment in Twain--and thriftily saved wear and tear on my typewriter ribbon by using only one -r- in the word, an embarrassing mistake brought to my attention by a kindly advisor.

Chers,
smile
Carl Fogel

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Carl,

Right you are, no exposure to young boys’ camping adventures. I can’t say that I am sorry to have missed such.

Your suggested solution would surely get my secretary’s attention, and, just as surely, irritate her. I shall go on quietly correcting her messages each day….


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Pics or it didn't happen!

I copied the 128mb xray cd that they gave me, with a dicom viewer and the dicom data files to this dropbox download link:

https://www.dropbox.com/sh/aduz2svykzuxp3p/AACGSwOHkiichSa_k2J-o2Ypa?dl=0

If you download that folder, the dcstart.exe program In the sub-folder will run the dicom program and display the xrays on a windows system.

If you want only the 100mb dicom data files for an Apple dicom viewer, this is the link for just the dicom data files:

https://www.dropbox.com/sh/ehzeakorfvj0yx5/AAC7qeidt4Gvuy1nw7JIwVG7a?dl=0

Yes, the shoulder end of the collarbone was broken off a long time ago.

No, I have no idea when or how it broke.

But they said that everything looks good so far and took the cast off the right arm, which is shriveled up, won't straighten, can barely bend enough to touch my nose, and flops disconcertingly from side to side when it's out of the sling.

The skin is also peeling off the right palm and its fingerprints, while the left hand seems normal. Maybe it's just drier than anywhere I've ever been, but I can't help wondering if one of my many pills is enjoying side effects.

Cheers,

Carl Fogel

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Unfortunately, even a layman like me will notice that the head of the left fibula is broken off and dangling well away from the rest of the fibula:

[img]https://www.dropbox.com/s/k05ehcif3uh2m39/what_is_downward_pointy_bone.JPG?dl=0[/img]

My brother-in-law the orthopedic surgeon confirmed my incredulous suspicions:

"The fibula is fractured and remains unfixed and out of place, that sharp bit is the fractured edge of the fibula head."

This undermined my confidence in the assurance after the xrays that everything is just fine.

Luckily, my brother-in-law wrote to reassure me:

"We never fix that in this context.. It is not structurally important and it should not change your activity and rehabilitation in any way."

But I still wish that someone had told me that it's normal to have a broken foot-and-a-half-long bone in my leg.

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Oh my, Carl, of course they should have told you, full explanations to patients should be expected.

I tried your Dropbox links, but got Error (404), can't find the page you're looking for, so could not access your images.

How are you feeling otherwise?


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Bah! Dropbox now refuses to share files without a struggle--wait two days is their suggestion.

Here's the whole xray folder with dicom data files and the PC viewer for them, all in a single ,zip file:

https://1drv.ms/u/s!AnkDjbadiwV71nZNwwBe-N5SuGfj

This should work, having been tested by another user who couldn't get anywhere with the dropbox links.

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Carl,

That is one heck of a set of hardware. Thank goodness you survived this horrific trauma. Keep up your wonderful sense of humor, it will go a long way toward helping you with the recovery ahead.


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Hi Donna,

My sense of humor wore thin this evening.

After waiting 71 minutes in my room to be transferred from the wheelchair to the bed, I said to hell with it and rolled out of my room to get some fresh air, a childish but satisfying act of rebellion.

As usual, I was lucky.

After cranking my wheelchair up to 3.8 mph, I noticed a fine rabbit next to the sidewalk around the building and stopped to admire it for quite a while. The rabbit eyed me suspiciously, but soon went back to browsing the grass and weeds, letting me enjoy the spectacle at a distance of about 15 feet.

When the rabbit finished gobbling the grass and slow-hopped onto the gravel, where its fur was excellent camouflage, I set off again, finished my lap around the building, rolled down the hallways to my room, and was quickly put to bed after being asked how long I'd been waiting.

All's well that ends well.

Cheers,

Carl Fogel

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Carl,

Glad to hear of your brief escape, sounds like a nice little outing!

Who knew that you were such a rebel? 😃


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Carl,
Sorry to hear of the accident. Good luck on your recovery!
...Ken


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Hi Donna,

Yesterday's acts of foolishness included snarling the power cord to the charger in the rear wheel of my wheelchair, much like tangling the rear wheel of a long-ago motorcycle n barb-wire, and sitting up on the side of the bed with my legs carefully dangling above the floor, which was great for typing, but so unpleasant for my knees that I gave up after a few minutes.

The highlight of the day came when two fellows arrived to take inventory of my bed and air mattress. I told them that someone else must have taken the tag off, a joke that they must have heard a few hundred times, and they asked me how much I weighed. I told them that I've lost ten pounds and am about 170 now, and they said that the air mattress was set for 315 pounds, so they adjusted the air mattress and hoped that it would feel better. Apparently, my predecessor was a whale.

Cheers,

Carl Fogel

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Hi Ken,

Thanks for you good wishes--I'm retired too, now.

With all my stitches and staples out and my arm cast off, there's nothing left but the catheter that I try not to think about.

After a few more weeks of guzzling chocolate Ensure, I should grow enough bone to stand up and achieve my goal of hobbling to the bathroom every morning before the rehab therapists arrive.

I hope your retirement is running more smoothly.

Cheers,

Carl Fogel

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Carl,

I have never understood why Ensure is so much in favor with medical facilities. I think it’s terrible stuff, the regular Ensure doesn’t have enough protein and has far too much sugar which is not good for wound healing. See if they can get you a high protein, low sugar supplement. You are losing so much muscle mass, higher protein intake may help you to maintain.

When my mother was in home hospice and they dropped off the hospital bed with an air mattress, the delivery man said to leave it set at maximum inflation. I tried it out, it was horrendous, like lying on a lumpy rock. We quickly deflated it. I hope you are more comfortable with the softer mattress.


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Hi Donna,

Even though I like my chocolate milk, I'll ask about higher-protein stuff that you suggest.

To be honest, I can't tell much difference in my air-mattress, but I suppose that setting down from 315 to 170 pounds must help.

***

I now have an artist's reconstruction of the moment before my accident:

https://drive.google.com/file/d/1kWZXtQ6S-a7Bjs8Wr4ixk1UpbSe8U6gK/view?usp=sharing

Cheers,

Carl Fogel

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Carl, I'm impressed that you can maintain a sense of humor about so serious a misfortune!
A couple of years ago, a 300+ lb. buck ran in front of my 2017 Subaru Forester and totaled it. It was only sheer luck I wasn't totaled myself; the towing company said it was the worst deer collision they'd ever seen. When I looked into replacing the Subaru, the dealership wanted me to purchase a 2019 model, which had been newly redesigned. I said I would rather stick with the 2018, which was no different than the 2017, and had obviously saved my life!

I hope you are able to make continued progress in your recovery.
Best wishes, Kurt

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Hi Kurt,

A long time ago, a friend taught out in western Colorado and often drove back through the mountains to Pueblo on deer-infested roads.

On one trip, he slammed on the brakes and managed to stop a foot or so short of a dim-witted deer, which leapt up into the air in terror, landed on the sturdy hood of his car, and did a tap dance before leaping off and escaping.

His story was easy to credit because there were lots of dents in the hood of his car.

Thanks for your good wishes.

Cheers,

Carl Fogel

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"dim-witted deer"
I wasn't aware that there was any other kind!
:-)

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Originally Posted by carlfogel
I now have an artist's reconstruction of the moment before my accident:

https://drive.google.com/file/d/1kWZXtQ6S-a7Bjs8Wr4ixk1UpbSe8U6gK/view?usp=sharing

Cheers,

Carl Fogel


Carl, we have never met face-to-face. In the picture, are you on the right or on the left?


Jon
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Originally Posted by Jon
Carl, we have never met face-to-face. In the picture, are you on the right or on the left?

LOL


Bert
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Hilarious, Carl and Jon!


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Hi Bert,

I'm on the right, depicted nude but modest in the classic Grecian style.

On the left is the somewhat confused artist's notion of a charging minotaur..

***

Here's the action spread out in four panels by a well-known artist:

https://miro.medium.com/max/2400/1*Pi2q2R-mFJVVes7jQnuH4w.jpeg

Cheers,

Carl Fogel

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Doesn't look like the board is slow anymore, lol. wink


Bert
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DocGene Offline OP
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Originally Posted by Bert
Doesn't look like the board is slow anymore, lol. wink

All it takes is a picture of a rhinoceros and a naked guy.......


Gene Nallin MD solo family practice with one PA Cumberland, Md

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But wouldn't a girl make the board move faster? Or grind it to a halt?


Bert
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Yeah, Bert, pretend you didn't notice the hippo was a girl.


Jon
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Originally Posted by DocGene
Originally Posted by Bert
Doesn't look like the board is slow anymore, lol. wink

All it takes is a picture of a rhinoceros and a naked guy.......

Originally Posted by JBS
Yeah, Bert, pretend you didn't notice the hippo was a girl.

Alright, now I am really confused. Is it a girl hippo or a boy rhino?

Carl?

Last edited by Bert; 05/10/2021 8:16 PM.

Bert
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Please, be reasonable and read more carefully.

Despite the feral hippos breeding in Colombia*, there are no rhinos or hippos of either sex outside of zoos in Colorado.

I clearly stated that it is a charging minotaur.

* https://www.livescience.com/cocaine-hippos-boost-colombian-ecosystem.html

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Well, I learn something here every day, I had no idea that there were hippos in Colombia.

But Carl, I am sure that I do need new glasses, but I don’t see any horns on that supposed “minotaur”.
I am sorry that it took your terrible accident to liven up the board, I hope this correspondence is a good distraction for you.


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Hi Donna,

The Wart thought it was time to ask a tactful question, so
he made a polite cough and said: "Please, who is Morgan the
Fay?"

Robin, Maid Marian and Little John all answered at once.

"She'm a bad 'un," said Little John.

"She's a fairy," said Robin.

"No, she isn't," said Marian. "She's an enchantress."

"The fact of the matter is," said Robin, "that nobody knows
exactly what she is. It's only my personal opinion she's a fairy."

"And to that opinion," added the chief of the outlaws,
staring at his wife, "I adhere."

--T.H. White, "The Sword in the Stone"

It's only my personal opinion that it's a minotaur.

But who ever heard of a hippo rampaging around Colorado?

Cheers,

Carl Fogel

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I believe the point of the story is that Carl would henceforth prefer to be referred to as Theseus.


Jon
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Maybe this is the scene of the crime:

Hippo Bike Trail


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Hi Donna,

What a nice site! I'll grant you your hippo!

Elsewhere it shows where I've been going since '72 on trials machines, but it doesn't look as if I'll make it this year:

https://www.mtbproject.com/trail/7038401/saint-charles-1326

Like most of the trails in the Wet Mountains west of Pueblo, the St. Charles trail was built in the '30's by the out-of-work fellows who joined the Civilian Conservation Corps. You can still see places where they hand-drilled the rock to blast inconvenient obstacles.

I knew some amazing fellows who actually rode pre-war Harleys and Indians up that trail.

It was much easier back then before ninety years of erosion exposing rocks, fallen timber forcing difficult detours, and smooth hairpins turning into nightmares.

But those fellows were stil amazing,horsing huge, heavy, clumsy machines up the mountain.

Cheers,

Carl Fogel

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Hippo hippo hooray!

Carl, that looks like some hard core biking on your trail. Being in good shape prior to your accident should help with your recovery. Very interesting history of your trail.

Personally, I prefer a short peddle around the flat roads at the beach. I am afraid that I have become quite lazy.

How is your arm coming along, are you doing PT?


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Hi Donna,

I would never try to pedal up the St. Charles-Cisneros-Snowslide trails.

In the last few years, I've seen a few hardy bicyclists on those trails.

But there are lots of places where a bicycle just won't go--they get off, hoist the bikes on their shoulders, and struggle up on foot.

In contrast, I rely on the engine of a trials motorcycle.

I am--well, was a road bicyclist, not a mountain biker.

***

Yesterday was devoted to helping a long-time client with hardware problems and then fighting my puzzling new iphone, which has quite a few quirks for a novice--it took a while to make it take my Vivaldi ringtones. Wrestling with computer problems felt good, even though I was cursing Apple and their insistence on ringtones from itunes.

***

I'm waiting for Matt the Physical Therapist to arrive. He runs me through lots of leg-waving exercises to keep or increase my range of motion, but no weight for a few more weeks. He measures the angle and says that my knees are bending more and more, up from 85 degrees a few weeks ago to about 120 degrees now.

Later--I blush to write this--will be my third date with Maddie the Occupational Therapist, very gently twists my arm this way and that while telling me to relax as she very gently pokes at tendon--I think of it as holding hands with her. She measures how far my right arm will bend or straighten (not very far) and says encouraging things.

But she does all the work while telling me to relax. ISo far, i's more like having a gorgeous masseuse than occupational therapy.

In other medical news, Karen, today's nurse, gave me a whole new catheter and said that no, the question of when it will be taken out after training my sphincters did not come up at the Wednesday meeting yesterday, even though I'd been told that it was on the agenda, so maybe next week they'll discuss when I can try to pee on my own.

Meanwhile, the insurance company has blindly tried to toss me out again, despite having its nose bloodied the last time. They argue that I should be at home, but then we appeal their discharge attempt and the doctor who reviews my case takes about five minutes to squash the idea, since I'm still four limbs non-weight bearing and about as helpless as a turtle on its back, assuming that a turtle could type stuff like this.

When I say "we appeal," I actually mean that my sister does all the paperwork and phone calls--I'm very lucky to have so many friends and relatives taking care of everything from my taxes to the legal aftermath of the accident to my basset hounds, plus all sorts of medical matters that would be beyond me

Cheers,

Carl Fogel.

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Carl,

I see, so you were in good shape from your road biking, but not quite the Superman of the trails.

I am glad you got to work on some IT issues, I am sure that felt great to have some sense of normalcy and productivity.

It sounds like you are getting good treatment from your team, and wonderful that you have such good support.

The insurance companies are the bane of our existence.

Keep up the progress!

PS I have now learned what trials machines are, again, I learn something new!


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Hi Donna,

New to observed trials machines?

Here's an old Scott trial film from 1938:



Here's what it looked like in my era, not that I could have ridden in the Scottish Six Day Trial:



And here's an allegedly modern pair of riders:



I firmly believe that this is CGI, not real, but there's a lot of it on YouTube.

Indignantly,

Carl Fogel

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Carl,

Yes, had never heard of observed trials. I lead a sheltered life. Around here, people ride “dirt bikes” on trails. Interesting competitions for young men with lots of testosterone!


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Originally Posted by DCubed
young men with lots of testosterone!

What could possibly go wrong with that combination? Especially when it is followed by "Hold my beer"??????


Gene Nallin MD solo family practice with one PA Cumberland, Md

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