Should I Have Been More Charitable With My Fitbit?

fitbit-question — Should my Fitbit have gone to Prostate Cancer Awareness?

I’ve been working out quite a bit lately. Lots of cardio time on the treadmill and elliptical. Been getting back to my old Saturday morning boot camp as well. My new Fitbit helps me track just how fast my heart is ticking. I enjoy having it, but every time I look at it I have a twinge of guilt. Should this Fitbit really be mine?

No, I didn’t steal it. I didn’t sneak it off of someone’s desk and register it under my name. I didn’t find it on the floor and appropriate it as my own. But I didn’t pay for it either, at least not in a conventional way.

So how did I get it? And why does it make me feel any angst? I’m not sure whether to call it a prize, or an award, or a gift. Regular readers know that I am a supporter of prostate cancer awareness, and participate every year in a 5K fundraising run promoting the cause. And I work hard to raise donations. I send out a lot of emails, I push myself to complete the race, and last year I even took a pie in the face (lemon meringue, I believe) from one of my lab associates, the winner of a fundraising raffle. I also support the causes of a lot of friends, who in turn help me out with mine–let’s face it, there is plenty of quid pro quo.

With all this activity, last year I blew past my personal goal and was the top Chicagoland fundraiser for the annual event. The Fitbit was my prize, my award, my gift. I received an email from the run coordinator asking me if I wanted to accept it. And ever eager to try new gadgets, I said “sure, send it to me.”

But every time I look at it I ask myself the question, “Shouldn’t the funds that went to purchase this been used for the cause instead?”

Even if the Fitbit was donated, couldn’t it have been auctioned or raffled off to raise more money? What was the proper etiquette? Should I have accepted the gizmo or not?

I had a similar dilemma once before. But the answer the previous time was simple. It was back in my days as a hospital pathologist at Holy Family Medical Center. Barb had the privilege of being President of the Women’s Board, responsible for planning the annual fundraising gala.

One year, I somehow found myself as MC of the event. We made a pretty spiffy couple in our evening gown (her) and tuxedo (me.) And we were even spiffier when hospital CEO Sister Patricia Ann picked a ticket with my name on it out of a big steel drum. I had just won the $5000 cash raffle!

But, being a long time practitioner of Catholic hospital politics, I realized in an instant that the cash wasn’t going to pay for a fun family vacation. No, by the end of the evening the Raff family had donated the money right back into the Hoy Family General Fund.

I suspect divine intervention was involved in my win that night, although I am not sure if it was from Sister Patricia Ann, or from a much higher being. Now I need a higher power to absolve me from my Fitbit guilt. So tell me Barb, is it ok?
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Build a Bridge; Save a Life. Let’s Prevent More Mass Killings

I was going to write about tennis. The blog was all written in my head, and I had most of it down on the page. But I kept thinking to myself, “Is this really what I want to be writing about?” While lots of good things have been happening in my family, other families are suffering the after-effects of another hideous mass killing. Once again the scene was a school, the victims mostly children.

All of us know someone in a school system somewhere. I have a daughter who teaches. I have grandchildren who are nearing primary school age. None of them can feel fully safe in their school. This is a national disgrace.

But my intention in writing this post is not to list, or even to mention, the things that I think we should we do to prevent more incidents. My intention in writing this post is not for me to scream and yell about how awful and intransigent the other side is on this issue. My intention in writing this post is not to try to out-tweet the tweeters. My intention in writing this post is to do something different altogether. My intention in writing this post is to start you building a bridge.

No matter which side of the aisle any of you are on, you probably know someone from the other side. It may be a friend, a relative, the guy on the treadmill next to you at the gym, or the new woman IT consultant in the office. Sit down with them for five minutes and see if you can come up with one suggestion that you both agree on, that could reduce or eliminate the number of mass killings in this country. The suggestion probably won’t eliminate these incidents overnight, but maybe enough good, bi-partisan, suggestions, could be a start.

Leave your suggestions as Comments here on the ChicagoNow site, or as Comments on Facebook. Alternatively, you can send the idea that you and your new partner agree on to me at les.raff@post.com. I will do my best to collate the list. I’ll pass it on to my Senators and to my Congressman. I’ll publish the list so readers in other locales can do the same. And please feel free to share this post. The more ideas, the better.

Maybe after that, I can get back to writing about tennis.

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From the Autopsy Files – The Triangle of Death

young-pathologist — The author as a young pathologist reviews autopsy slides.

A recent article in the New York Times had me thinking about surprise diagnoses I had made in my career. Most were made via an unexpected finding on a biopsy examination, but the first was undoubtedly during my Pathology residency, spending manyy hours in the morgue on the hospital autopsy rotation.

Mr. Jones was an older gentleman, in his 80’s but still spry! Why, according to my review of his hospital chart (paper, not electronic back in in 1979), he had been active enough to be running for a bus a month or two earlier. He had taken a tumble and missed the bus, but he was certainly an active fellow.

Further reading of the chart revealed that about a month before his death he began experiencing bleeding from his mouth. Various studies were done, and it was determined that the bleeding was arising in his esophagus. X-ray studies showed a mass about midway between his mouth and his stomach, and a tentative diagnosis of esophageal cancer was made. A specialist performed an esophagoscopy, passing a viewing tube into Mr. Jones’s esophagus, and performed a biopsy of the growth he saw.

The biopsy result from that procedure was inconclusive. Degenerating cells were seen, but no clearly malignant cells were identified. The pros and cons of performing extensive surgery on a man of Mr. Jones’s age, especially without a definite diagnosis, were discussed by his medical team. Unfortunately, Mr. Jones’s condition was not waiting around for a decision. He experienced severe chest pain, began bleeding heavily from his mouth, and was transferred to our hospital, where he succumbed that evening. The family, at the behest of the Doctor Will, who had been the last doc to see him before he died, consented to an autopsy.

Mr. Jones was my first autopsy of the morning, during a three month period in which I performed about 100 post-mortem exams. There are two philosophies about the best way to go about doing an autopsy. Some pathologists will read the chart, decide where the main findings will be, and make that the first thing they examine. Others take a more methodical approach, following the same dissection order with every case. I have always followed the latter, going organ system to organ system in a prescribed plan. The gastrointestinal tract, the probable site of Mr. Jones’s pathology, had to wait until I was done with cardiovascular, renal, and respiratory systems. I could feel Doctor Will’s impatient foot taps as he waited for me to “show him the money.”

Finally, I grabbed a pair of scissors and openned the esophagus and stomach. Surprise number one, although the esophagus revealed three long gashes through its internal lining, there was no tumor! Surprise number two was a triangular piece of firm pink plastic laying within the stomach. The points of the triangle precisely matched the esophageal damage. We speculated that the triangle had lain in the esophagus for weeks, causing bleeding and appearing to be a mass on the x-ray studies. On his final day, the plastic had moved from the esophagus to the stomach, causing pain and the massive, fatal, bleeding. Doctor Will was satisfied, we had our cause of death.

But what was that piece of plastic? Remember that run for the bus a few months back? It turns out Mr. Jones had done a bit of a face plant while falling and broken his upper dentures. He had grabbed the fragments, but no one had ever tried to reconstruct the dental plate. If only they had!

We recovered the fragments from his family, and sure enough, the deadly triangle had once been part of that upper plate. We published our findings in the Southern Medical Journal. Perhaps the first recorded case of death by denture.

I don’t do autopsies anymore. In fact not that many are done, in part because of the belief that with all of our advanced technology, not much can be learned from them. But you never know when there is going to be a surprise!

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On a separate medical note, my acquaintance Howard Wolinsky writes for the online journal MedWebPage Today. Here’s a link to his article about our discussion about the pathologists role in prostate cancer. Give it a read!

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My Evolution: Three Dogs at Night

milo-2 — Milo and I have evolved together.

Evolution. Darwin promoted it, science supports it, and even some politicians believe in it. And as the world around has evolved, so has my relationship to the height of evolution, the canine. Slowly, over time, I have learned to…accept.

I was raised in a dogless apartment; Mousy, a first generation house cat, was the ruler of the roost. My encounters with pups were limited and not always pleasant, with a nippy German Shepard living next door. No dogs for me, and I was content.

Of course, I met Barb, a dog lady through and through. Her family pet, a toy schnauzer named Nappy, hated me. The feelings were mutual. He was near the end of life when I met him, and through sheer willpower I outlasted him.

Barb and I spent about the first 10 years of our marriage without a dog. We had cats, we had kids. Once more I was content. But I evolved to the point where I could live with a dog. We adopted Murphy, a medium sized mixed breed, named after the popular TV character Murphy Bown (I know, she’s back!)

We did it right. As 10 pm approached, we would tell her “Bedtime, Murphy” and she would trot off to her bed in the first-floor office. An electric fence kept her downstairs while we slept upstairs. Yes, I was content.

Murphy was eventually followed by Max, the big, loveable Irish Wolfhound impersonator. No electric fence was going to stop the big fella, and when we said “time to go up, Max” he bounded up the stairs with us. I gave him a scratch under the chin, the cat took a swipe at his ears, he gave a mighty groan and settled down on his doggie bed. I had reached evolution point two.

Now there is Milo, the latest bundle of energy. For the first few months, we crated him in the kitchen at night. In the beginning, it appeared to be acceptable to him. After all, anything was better than living in a shelter. But lately, he became edgy at “lights out.” He would whine, he would whimper. Classical music calmed him down for awhile, but that didn’t last. Soon his crate migrated to our bedroom. Days later, the crate disappeared and Milo settled in on his bed on our bedroom floor.

Finally last night, the moment I had sworn to myself would never occur, occurred. Milo planted himself on the bed by Barb’s side and he was not going to budge. He was our bed partner. I waved the white flag and went to sleep. And when I woke up this morning, I was content. My evolution is complete.
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The Walking Man Is Back, But He Is No Longer Alone

I saw him again this morning. It was the early gloamin’ hours, maybe 5:30 a.m. Sunrise was not yet near, but the streets were sufficiently illuminated by the three-quarter moon, glimmering weakly behind stars, a sorry remnant of the dominating “Super Blue Blood Moon” of days before. Every third or fourth porch light was on, waiting for the coming dawn when their electronic timing systems would shut them down. No cars were about, no commuters getting an early start on this first day of the weekend.

I assume he had chosen this early time because a winter storm alert was posted for the mid-morning hours. The air was brisk, but not the soul-shaking cold I had seen him walk through on previous encounters. He had retained his ski cap pulled tightly over his ears, but he no longer needed a thick woolen scarf over his nose and mouth. He must have shed one of his layers of jackets as well, his Michelin body slimmed as if a tire or two had been deflated. And surprisingly, for there was still chill in the air, his hands neither wore gloves nor were they jammed into the pockets of his down jacket.

I looked down and noted the canvas slip-on shoes on his feet. Inappropriate for the frozen asphalt I thought, perhaps they were a reminder of warmer days traveling in a more temperate climate. Maybe the walk was spur of the moment on an early morning awakening, and these were the closest shoes at hand. No matter the reason, they lent a jauntiness to him as he strode through the suburban neighborhood.

Most unlike his previous, solitary, excursions, today the Walking Man was not alone. In his bare hands was clutched a thin leather leash, and trotting at his feet was a terrier of sorts, a humdinger of a dog, curly tail held high. The pup pranced like a Clydesdale Draught Horse, each paw raised high with every step, proud and happy to be out on such a singular morning with his master at his side. If the cold was an assault on his small body, he didn’t show it, his sleek dappled fur all the protection he needed as the temperature hovered around the freezing mark. They matched each others stride and pace, tennis partners anticipating each other’s every move.

I look forward to seeing them in the spring when the temperature begins to creep above 6oº. The pup looks like he is geared to run, perhaps the Walking Man, unburdened by coat and hat, will join him. It’s not too far away, I hope.
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Photo Credit: https://creativecommons.org/licenses/by/2.5/

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President Donald Trump Salutes Super Blog CC

To recognize this blog’s 200th edition, I have asked President Trump to comment. Below is an unedited transcript of a voicemail I received this morning.

“Ok, this is President Trump. I love CiCi’s Pizza. Love their pizza buffet. It’s huuuuge. And the pepperoni slices are big enough to cover up a porn star’s…oh wait, Sarah is telling me this call isn’t about pizza. I am supposed to talk about your blog’s 200th edition. She says CC means two hundred in Roman. They didn’t teach me those foreign languages at my boarding school. Didn’t know we would wind up with a country full of Romans and Mexicans and Hondurians.

“Anyway, Sarah made me read some of your blogs. Well, she didn’t really make me read them, she just told me about them. I can relate to all your stories about building your house. You just screwed it up one way. If you had declared bankruptcy you could have avoided paying ANY of the contractors and saved beaucoup bucks. Call me we can talk about this, believe me I know.

“Sarah showed me the thing you wrote last year when you wanted to be my science advisor. You seem really smart and know some science. But I like my appointees to have some skin in the game, like the CDC Director buying stock in tobacco and big pharma. I knew she wouldn’t go after any of my big donor friends. But then she kept recusing herself, just like that ass Sessions. I need loyalty damn it!

” I liked what you wrote about Crooked Hillary. The only thing keeping her out of jail is the Justice Department. In my next term, that whole department is going to go. Or I am going to appoint Diana Ross as head of the Supreme Court. I can’t remember what I said in my last tweet about that.

“You just came back from Vietnam. I did too. They love me there. They told me they love me as much as any American President since Richard Nixon. I’m thinking of turning the Hanoi Hilton into a Trump Tower, but there is no room for a golf course. Maybe I’ll put it where that Ho Memorial is. I don’t need a memorial to remember my ho’s.

“Did you ever get onto Family Feud? We were going to do it too. Me and Melania and Donald Jr. and Ivanka and Jared. But Steve Harvey wouldn’t give us the questions in advance. Said it would be an unfair advantage. I asked Vladimir P if he could get them for me and he said I would have to wait because all his hackers were busy working on the 2018 Congressional Elections. I said V you gotta do me a solid here but he told me to wait until next year. So it will be a while before we get onto the Feud. But the ratings when we do will be great, really great.

“So congrats on your blog. Come down to Mar-a-Lago and we will play a round of golf. But I gotta warn you, I am good, really, really good.”

I can’t wait to see what the President says on my 300th!!

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Uncle Les’s Travel Diary: Good Morning Vietnam, Good Afternoon Cambodia, Good Night Thailand.

We did it! We took our 15 hour flights, our good walking shoes and a crate of Pepto-Bismol as we explored a part of the world we had never seen before.

Read on for a brief summary of our travels.

Day 1: Arrive in Hanoi, Vietnam. Hot. Meet 30 American tour companions. All agree it is hot, and share pictures of dogs and grandchildren. Meet Tour Director Mr. Larry, Oklahoma ex-pat now living in Bangkok. Is herding tourists easier than herding cattle? To be determined.

Day 2: Explore Hanoi. Hot. May be more stars in skys than motorbikes in Hanoi, but I doubt it. Interstellar travel is safer than trying to cross street. Visit Ho Chi Minh’s tomb and get three hour lecture on Uncle Ho, the Abraham Lincoln of Vietnam. Or maybe it was Thomas Jefferson.

Day 3: Hot. Tour of Hanoi Hilton, infamous prison. We learn the French tortured heroic Vietnamese patriots in the compound for 100 years. We learn Vietnamese treated American POW’s to volleyball, shuffleboard and afternoon tea. History is written by the winners.

Days 4-6: Hue and Danang. Hot. Lots of shrines and lots of buffets. One very cool temple is inside a cave in a mountain, but the buffets are all in hotels. We wave to China Beach.

Day 7: Cu Chi. Hot. Experience history of Vietnam War and explore Viet Cong tunnels. Barb is champion tunnel rat and leads the way, even dodging pesky bat. I see a new hobby in her future.

Day 8: Saigon, aka Ho Chi Minh City. Hot. Shopping for gifts to bring back home. SPOILER ALERT: You get a scarf, and you get a scarf and you get a scarf!

Day 9: Saigon: Hot. Visit Vietnam War Museum — most moving part of entire trip. Take night-time Vespa motorbike ride through the city, taking life into our own hands.

Day 10: Cambodia. Very Hot. Three ancient temples including Angkor Wat. Very cool, but hard to keep the Hindu-Buddhist-Blend Transitions straight. Fitbit registers new record for steps in one day, not including steps at breakfast buffet.

Days 11-14: Luxury resort in Northern Thailand. Hot. Go on mixed zipline/Ninja Warrior adventure taking life into own hands. Go on elephant trek, taking life into own hands once again (but very slowly.) Buffet triples in size, as does my waist line.

Days 15: Bangkok. Very hot with added humidity. See more shrines and temples and discover that the Peoples Republic of China eases population crunch back home by sending 1 million visitors to Bangkok daily to visit each shrine and temple. Hear story of “King and I” from three different local guides. I assume the Chinese tourists are not told this story.

Days 16: Bangkok. Visit Jim Thompson’s House. Surprised to learn Big Jim lived in Thailand, until realize this Jim Thompson was the founder of a silk empire, and not the former Governor of Illinois. And unlike most Governors of Illinois, the Bangkok JT didn’t end his life in jail, he just mysteriously disappeared one day and was never seen from again. Shoe boxes full of cash were not said to be discovered in his closet. Evening brings a choice of Kick Boxing or a Cross Dressing show, because what trip to Bangkok is complete without one of those?

Day 17: Goodbye to all our new friends and warm thanks to Mr. Larry who succeeded in his mission. No tourists lost, no temples vandalized, no buffets left uneaten. We couldn’t have done it without you!

Note in closing: Written in early hours after 37 hour travel day and one hour sleep in my own bed. All omissions are mine. And oh yeah, we had a great time!
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Presidential Thoughts on War-President Trump Buttons Up Number Seven

Some Presidential Thoughts on War.

George Washington: “While we are contending for our own liberty, we should be very cautious not to violate the rights of conscience in others, ever considering that God alone is the judge of the hearts of men, and to him only in this case they are answerable.”

Thomas Jefferson: “We took the liberty to make some enquiries concerning the ground of their pretensions to make war upon nations who had done them no injury, and observed that we considered all mankind as our friends who had done us no wrong, nor had given us any provocation.”

Abraham Lincoln: “There’s no honorable way to kill, no gentle way to destroy. There is nothing good in war. Except its ending.”

Woodrow Wilson: “Our object now, as then, is to vindicate the principles of peace and justice in the life of the world as against selfish and autocratic power.”

Franklin D. Roosevelt: “More than an end to war, we want an end to the beginnings of all wars.”

Barack Obama: “So, yes, the instruments of war do have a role to play in preserving the peace. And yet, this truth must coexist with another: that no matter how justified, war promises human tragedy. ”

Donald Trump: “My button is bigger than your button.”

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The Walking Man on New Year’s Eve. What is Ahead?

The Walking Man was outside again this morning, his bulky winter coat casting a Michelin Man shadow on the suburban snow. Another frigid day, but he trudged down the street, a knit cap pulled tightly against his scalp. His gloves were massively thick, his matching muffler pulled tight across his face. Bulky wireless headphones arched across his head; his personal crown jewels. Sunlight, the only hint of warmth, gleamed against his thick sunglasses.

He has walked this freezing loop twice each morning of this arctic week, while others huddle inside. They walk on basement treadmills or in glitzy health clubs. Surely he has access to both; what keeps him moving on these slippery streets? Could it just be joy at being outside in the sun, using this Christmas to New Year week to escape from the four wall office and the darkness of Midwestern winter commutes?

He enjoys knowing that his are the only boot prints he sees in the snow. Maybe as the year comes to an end he is using the cold and solitude to sharpen his thoughts, to focus on the 12 months gone by. He must think about his triumphant moments and times of joy. But he is trying not to forget the incidents that turned out less well, trying to tease out what he did wrong. Is there anything he can learn, some things to carry into the New Year?

What is he listening to on those technically up-to-date, but oh, so out of style, headphones? The same songs that always play in his head, reminding him of the past? Or is Pandora streaming new sounds to him, expanding him, filling him with beats and rhythms and vocabularies that at first sound discordant, but with enough listening can become familiar and comfortable. He can learn to tolerate, just as his parents must have learned to tolerate the Beatles and the Stones.

Maybe it is not music at all that is Bluetoothing to his ears. It could be podcasts of angry Trump deniers, or even angrier Trump supporters. The vitriol and bile have been unending. Has he taken sides? Has he contributed to the tumult? Or does his head still hold the hope of people conversing with each other, not yelling at each other.

He checks his wrist frequently. Is he that concerned with the time? Or is his watch measuring something else. How many footsteps in a mile, how many miles until he reaches his goal? I like to believe there is no goal, the step count on his FitBit s a mere excuse to keep moving as the sweat soaks his tee shirt.

From time to time his humid breath, channeled upward by his muffler, forms a cataract of condensation on his sunglasses. The open spaces in front of him turn hazy and indistinct. He wonders if this blur is what old age will be like. How many New Years will he have ahead to celebrate, and where will he celebrate them?

The Walking Man will be outside again tomorrow. I know he will be. Will the New Year bring answers to his questions?

A Happy New Year to All. Join the “Getting More from Les” Facebook fanpage at https://www.facebook.com/lesraff1

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Are We Kissing Friends Now? Seven Rules for the Unsure.

A Kiss is Still a Kiss
As Time Goes Bye
Herbert Hupfeld, 1931

Would Larry David diss me as a “kisser-greeter?”

I never want to harass. I don’t want to spread germs. But I don’t want to be a cold fish either. So I never know. When do I go for the hug with a cheek-to-cheek air kiss hello and when is a handshake all it takes?

After a recent experience (see #2 below) I decided to evaluate my guidelines. Here are my 7 rules for surviving a complicated world:

MY SEVEN RULES

Coworkers and staff: Never, ever, ever hug/kiss. And in these difficult to navigate times, let me add one more NEVER!
A neighbor I am meeting for the 2nd time: Tried the hug/kiss, was chided: “So we are kissing friends now?” Best not to dive in until I know someone a little, or a lot, better.
A neighbor who hug/kisses everyone else, but who seems to duck away whenever I come to say hello: Best not to hug/kiss. And best not to feel offended. Maybe she is allergic to the cat fur clinging to me.
All the vendors and sales reps who pop into my office at the worst possible time, just so they can introduce me to the new regional manager of the Northwest District of the Midwest Zone for Product Improvement and Research: Best not to hug/kiss. A handshake and a glance at my watch is a better way to subtly let them know I really AM busy.
Vendors and sales reps who pop into my office with Garrett’s Popcorn for the whole lab and who initiate the hug: Best not to hug/kiss (see Rule #4,) but OK, I go along with it for the sake of employee morale. Especially when the popcorn is the cheese and caramel corn mix, and very fresh.
New Year’s Eve: Assuming everyone has had enough champagne, everyone I can get to between 12:00 and 12:01, (or as long as it takes to sing Auld Lang Syne on Channel 5) gets a hug and a kiss. Also anyone I have ever watched “It’s a Wonderful Life” with, after we have wiped the tears from our eyes.
Female members of the extended family: The hug/kiss seems pretty natural, all the way up to the great grandmas. For purposes of this rule, I draw the line at 3rd-cousin-twice-removed-via-marriage.

Those are my rules, subject to change. What are yours?

If you missed it: 7 Words Pathologist Won’t Use

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photo credit: Thomas Hawk Lip Service via photopin (license)