I’m Making Plans

        There is an old Vince Gill number from his “Here Today” bluegrass album called “I’m Making Plans.”  I remember it well, ’cause it was one of the first vocal duets I worked up with Darrell.  I remember sitting in the car at the Middle School waiting on my kids (I always picked them up on my day off- it was my only shot at it)  and he and I worked on my part singing while we listened to the cassette player in my old Scout.  (I always made good use of any down time.) 

        Right now I am making a lot of plans, and I wanted to share my direction with you.  To some degree, I’m asking for forgiveness, ’cause I know the next few months are gonna lean more towards the medical.  (Don’t worry though, the music is so intertwined in my life it won’t all be a bore.)

        I am in hard medical study right now, though, and will finish a project called Core Content Review around the first of August.  IMHO (bluegrass for in my humble opinion) this is the premier Family Doc update in the country.  It is hard to read about the differential diagnosis of fever of undetermined etiology by night and not bore you to tears with my writing by day, so if I do that, I hope you will let me know.  (If you don’t my agent will- what a tough cat he is.)

        I guess you might wonder why an old guy like me still reads so hard, and it is just pure old pride and habit.  I want to be my best till the bitter end.  Some prize fighters wait too long, and get in the ring one time too many.  So, I want to leave the fight game when the time is right, but hope everyone will say, “Tommy could have hung in there a few more rounds, I know he coulda.”  So I study on.  I guess I don’t want the young folks to get ahead of me.  Like Satchel Paige said, “Don’t look over your shoulder, someone might be gaining on you.”

        That ain’t the end of my plans, though.  After August, I’m gonna reverse field.  Oh, I’ll study every day, but I’m gonna change my mix.  It’ll be a half hour on the mandolin, one hour on the Doctor books, and three at the keyboard.  (About the opposite of my current routine.)  Come Jan. 1, 2009, I plan to have the first rough draft of my book to my agent.  He says if I am lucky, it might see the light of day eighteen months later.

        Now, I have no illusions.  I did two bluegrass CDs.  They were both an artistic success, and even sold a few thousand copies.  One of our boys was disappointed, but the lady we worked with in Nashville put it in perspective in a hurry.  She’d seen many of these self-titled released piled up for all time in a closet.  To make a profit is a small phenomenon.

        By the same token, I have similar aspirations for my books.  If they are an artistic success, ie if I get to say what I set out to say, and the first one sells well enough to interest my agent in a second project, they by definition are a success to me.  I know I ain’t the next Grisham, and I’d be lost in New York (can you imagine Tommy Bibey on Oprah?  I’ll never be on that kind of radar screen.)  So, I’ll just have to be what I am.  I do worry a bit about how well received they might not be.  But, I have no interest to modify what I want to say just to appeal to pop culture and try to sell a bunch of extra copies. 

        Still, I hold on to hope.  I want to write to let folks without a medical background in on what I believe to be the truth about modern medical practice.  And I want to let people inside the world of bluegrass music I love so. 

        I realize it will not appeal to all.  As far as the power players in the medical industry, it will even invoke some anger, and I wonder at times if they will want it banned!  On the other hand, I have found my readers to be a bright, inquisitive lot.  My agent always says to trust your readers; they are out there, so I’m gonna do just that.

        Well, now y’all know I’m making plans.  If I get published, I hope you’ll tell your friends and neighbors to buy a copy- a run of 2,000 or so will convince my agent to try again, and I have a series of three planned.  For now, though, I gotta go back to studying doctoring.  Someone might be gaining on me, and I ain’t looking back except to tell all the old war stories I’ve accumulated from a lifetime in the ring.

        Y’all wish me luck.  I’m gonna need it. 

Dr. B    

Advertisement

III Tyme Out

        Not long ago we visited Marie at Tobacco Triangle U. and heard III Tyme out was over in Raleigh, so we decided to take in the show.

        In bluegrass, you see all sorts of venues.  One week a band might play a church, then a festival and a school house, and sometimes they even can work a rock ‘n roll dive.  This was one of those kinda places- the ceilings, floors and walls were black, and there were kids hangin’ around smoking cigarettes who wore chains and spikes and baggy black jeans that were about to fall off.

        But, in the bluegrass way, it was for a good cause, a fund raiser for the local animal shelter, and it was a great band, so we were undeterred.  I’m glad we stayed, they cut the gig.

        Russell Moore set the tone just a squallin’ the first number, “The White House Blues.”  The tune combines a history lesson and hot picking, and recounts the assassination of President McKinley.  Be not fooled by the banter, these boys are good students.  The banjo player, Steve Dilling, is a product of North Carolina Public School system, though his former Principal denies it.

        Mandolinist Wayne Benson got to rocking, and one poor woman in the front row had a falling out spell.  She had no focal neurological deficits, so we walked her out to the night air to cool down.

        She was quite upset.  “I wish that young man on the mandolin wouldn’t move so much- it was about too much for me- it was almost like rock and roll.”  I handed her a wet paper towel and she sat on the bench and mopped her brow.  The excitement had been too much for her.

        “Well ma’am, you gotta understand.  That man and the mandolin are one in the same.  Mr. Benson wrings every ounce of emotion out of that mandolin- he is one of my favorites.  He can’t help it that he’s the Mick Jagger of the mandolin.”

           She was a bit incoherent, and babbled on about “that ain’t bluegrass,” so I sent her to the hospital to get checked out.  I did advise her to consider a pre-show beta blocker next time, and to think twice about going to see Sam Bush.  We went back in to take in the rest of the set.

        I wish the lady had been up to going back to hear more, ’cause we got back and Wayne was just a nailing Monroe’s “Bluegrass Special,” and Dilling done his banjer break just like Earl.  I’ve been around the music all my life, and if it wasn’t bluegrass I wasn’t sure what it was.           

        These might be country boys, but they are sophisticated musicians beyond what folks know.  Any band that can pull off a black spiritual acapella number, “Feed me Jesus” and follow it with a perfect rendition of the Platter’s hit “Only You” (the bus driver sings the bass part) in a rock ‘n roll bar fund raiser for homeless animals has the respect of this musician doctor any old time. 

        Russell sang the timeless lament of a lonely road musician “Erase the Miles.”  They have done the song for years, but it still sounds new.  If you want to understand the emotions of a life on the road, this is one to hear out.  Russell is an effortless and powerful singer who somehow gets better with every season. 

        Then Wayne did his Celtic composition “Tillary Cove.” (he jokes it is as Celtic as you can get when you grew up two blocks from Burger King)  The tune was a magical transport to some Irish Pub.  (Maybe we were in one- it was awful dark in there, I couldn’t say for sure.)

        After the show, the boys headed out to the Waffle House.  I expect they’ll hit Pollard’s Grill in the morning since they are in the Raleigh area.  One of these times I need to take them over to Soul Shack Mamas in Tobacco Triangle.  I think the banjo man would dig the catfish and eggs.

        Fabulous musicians, great folks.  Check out III Tyme Out.  They are worth a stop on your tour.

Dr. B

Office Brain Biopsy

        O.K. the title was just to get your attention.  We don’t have a code for office brain biopsies.  That is good ’cause I have no intention of ever doing one.

        Years ago, though, I coined the term to make a point.  I was cleaning out someone’s  ears and the young lady assistant stood on the other side of the patient.  For reasons I don’t understand, she decided the patients needed to have their head repositioned, and gave it a push in my direction.

        When you have a metal object down in someone’s ear canal it is not a good time to make such a maneuver.  I saw it coming, though, and took the cerumen spoon out pronto.  No harm was done.

        I was not happy.  More impulsive in my youth, I blurted out, “Young lady, this almost wasn’t an ear cleaning, but a brain biopsy!!”

        Of course she broke into tears, and quit in a few weeks.  Since those days, I’ve learned no one wants a smart @^^ for a boss or a doctor, and I’ve mended my ways.

        Nowadays, I would never correct an employee in front of a patient, (I don’t expect them to do that with me) but I still would find a way to tell them not to do that.

        These days, I’d probably pull them off to the side and say, “Look kid.  You gotta realize these old Docs might not be quick enough to anticipate everything you’re gonna do.  If you need to reposition the patient’s head, let the Doc know.  Some of ’em can be kinda dumb.  I don’t want to be doing no brain biopsies.”

          It’d go over better and the employee would still get the point, I just wouldn’t embarrass them.

         Either way, though, I’m against office brain biopsies.  One rule I have is if I ain’t done it by now I’m not gonna start at this age.  I’ll leave that to the young smart @^^es.  (as opposed to the old ones.)

Dr. B

The Lazy Musician

        Contrary to what many folks think, the musicians I know are far from lazy.  Most spent  hours every day in a endless quest for mastery of their art.  (Hence a saying we have: “Study your instrument.”)  So, you might be surprised to find that Ben, one of my mandolin gurus, wants me to be a bit more lazy.  

         Huh?  Don’t see how I could be.  After all, I only put in fifteen minutes to a half hour of practice a day.  How could I get any more lazy than that?

        Of course, that is not what he meant.  He wants me to to explore the fingerboard and become more economical with my left hand movements.  The exercise he has me doing is to work on the high octave of Manzanita (a tough Tony Rice number) and do it with three different fingerings.  It makes the point. As you get up to speed, method number three begins to emerge as superior.

        All this reminds me of a saying I heard from a jazz pianist.  “The amateur practices a piece until he/she can play it right.  The professional practices the piece until they can’t do it wrong.”  I tell you folks, Ben, like my buddy Darrell, can’t do it wrong.  They are pros.

        I am an amateur, but who knows?  At least if ain’t worried too bad over my patients this month, I might surprise Professor Ben, and get Manzanita down where I can’t do it wrong.  And right at the moment, I have all my folks tucked in good and figured out to suit me, so maybe I can study my instrument even a full hour a day.  But, if the sick ones take a turn for the worse and I lose my mandolin focus, I’ve always got next month.  At the level I play, there is always room to improve, and it gives me something to look forward to.  Hey, if I don’t get the tune down cold, I’ll just tell Ben I got a bit too lazy, and he’ll forgive me. 

        I guess it is like being a Doc.  If you only took care of folks who were perfect, there wouldn’t be anybody to help.  (And Doc would also have to go home with his own case of perfection deficiency.)  And if Ben and Darrell only had students as good as them they wouldn’t have anyone to teach, ‘cept they might be able to help each other, I guess. 

        My computer is on the blink, and going on the shop for a day or two.  (Even my boy couldn’t fix it, a sure sign of the need for a specialist.)  If I’m a bit late to answer your comments, forgive me.  I’ll either catch ’em on someone’s computer, or in a day or two on mine.

        Will be back soon.

Dr. B

A Wonderful Life

        I don’t know about y’all but I’m a sap for old Jimmy Stewart movies, especially ‘A Wonderful Life.’  As you get on towards the last leg of your journey on earth, there are times when you wonder how much difference you made.  For me, I wasn’t smart enought to figure out a cure for cancer, and I sure didn’t get rich or famous.  I pulled a few out of the fire along the way, and had a heck of a lot of fun with my music, but there are thousands of others who have toiled away at their daily routine, and many got a whole less credit than I did for it.

        Last night was one of those moments where things make sense, though.  We played music at one of the rest homes, and an aide stopped to speak to me.  She said she enjoyed the music, and I thanked her. 

         She went on to tell me I inspired her to study to get her degree and she became a nurse’s aide because of me.  It turned out I took care of her mother, who had a stroke years ago, and much difficulty swallowing afterwards.  As often is the case, the daughter was the only one who could get her to eat, and she fed her every day.  In the end, the patient aspirated one day, and died soon after from aspiration pneumonia.  One of the Docs (I remember the guy, he was a harsh rascal) came along and made the young woman feel guilty.

        I didn’t recall the precise moment, but she said I came by right after that, found her in tears, and heard out the story.  She said I patted her on the shoulder and told her mama would have never made it as long as she did if not for her feeding her every day.  (Which I am sure was true.)

        This was not a highly educated woman, or even one who was extremely bright, but she said it inspired her to go on.  Apparently she wanted to be a nurse’s aide and felt like she had a knack for it, but the first Doc made her feel like she wasn’t worthy.  I changed her mind.  That simple act, long forgotten by me, made her think again.

        She went on to proudly tell me she was the best one at the rest home, and when no one else could get a patient to eat, she was the one they called on.

        I patted her on the shoulder.  “I tell you what kid, I’m getting toward old.  I hope when I get here, you’ll be the one to take care of me.”

        “I will, Dr. Bibey.  You can count on it.”

         I figure that woman has had a wonderful life.  When you get down to the science of it, she has saved more lives than I have, and no one will ever hear of her, except on this little blog.

        Like I say, I’m an old sap, but I still think Jimmy Stewart had a few things to say we don’t need to forget.

Dr. B

       

 

Hoop Jumping 101

        Last week I got my C.C.C.S.R. (Corporate Chart Compliance Score Report) and passed with flying colors.  I thought y’all might enjoy the background on this aspect of medical practice.

        If you want to be a modern Doc, you’ve gotta get real good at hoop jumping.  I can’t speak to the realities of other professions with authority, but my guess is the same is true for other lines of work such as a teacher or minister.  I have a saying I came up with.  “If you want to do some good in the world, be prepared for a hard time and hurdles to jump to make it happen.  If you want to do bad, you can count on adequate  latitude and tolerance, and significant empathy.”  So be it for hoop jumping 101.

        Like all modern health care delivery systems, we have Corporate Compliance Officers.  For all my teasing, they do a great job.  They don’t know anything about being a Doc, but they are master chart coders, and can tell you within a .01% tolerance range whether or not your charts would hold up to the scrutiny of the meanest of the mean government inspectors.  Mine always pass, in fact I usually grade out at 100%.  Here’s how.

        First of all, I’ll tell you as far as a bubble test, (standardized computer scored test- another story there) I was always an ace.  Maybe not as good as old Brilliancy, but good.  And I could spot urosepsis at fifty paces with uncanny accuracy.  As far as caring, I did.  I went to bed many a night worried over someone’s microcytic indicies on their blood count, and how I might convince them a colonsoscopy was in their best interest. 

        Also, I knew my patients well.  Whenever we had a young nurse fill in, the old hands would tell her to ask me about a patient, and not let me have the benefit of a chart to refer to.  I would start out,  “Oh yeah, well, ten years ago, back in the old ER….”  They soon learned not to ask unless they really wanted to know.

        None of this personal data base is of any concern to the government or insurance chart jockeys, though.  They want to know what is on the piece of paper, and nothing else matters.  (By contrast, I want to know the patient and nothing else matters.) 

        Whenever we went through corporate acquisition, I knew formal Corporate Compliance would be part of the package, and believe it or not this old bluegrass boy welcomed the help.  Taking good care of my people in no way qualifies to navigate the mysteries of the burecratic maze that must be unraveled to satisfy all the regulations, so I welcomed our new C.C. Officer with open arms.  She was surprised, to say the least.  Here is how it went.

        The first day I laid eyes on the woman, I had my doubts.  I figured she was a regular General Patton.  I wasn’t gonna be surprised if she was packing pearl handled pistols.  However, it was my best interest to put aside any preconceived notions.  Even if this turned out to be the enemy, it would be an enemy I needed to hold close.  “Hey, I’m Dr. Bibey.  Nice to meet ya.”  I stuck out my hand to shake and howdy.

          She placed a briefcase and a thick sheaf of papers on the table, and shook my hand.

        “Ma’am, before you start I want to tell you my philosophy and how you can help me.”

        “Certainly, Dr. Bibey.”  She seemed wary.  Generally speaking, Docs hate supervision or anyone telling them what to do, and many view the C.C. officer as just a shade above a Gestapo.  (Organizing Docs is like herding stray cats.)  We sat down at the table. 

        “Ma’am, I’ve kept up with medicine to the best of my ability, and I do good by my patients.  However, I’ve been through three dictation formats, and none of them satisfy both my desire to communicate with other professionals about my patients and meet Government guidelines.  I can keep up with the patients easy enough, but the format I use that meets Government criteria is so unwieldy no one can sort through it and make any sense about what was going on with my patients.  You gotta help me find some middle ground that will satisfy both needs.  I am beyond frustrated with it.”

        “Dr. Bibey, I am confident we can do that.”

        “Well good.  What I want you do is beat me like the worst yard dog you ever thought of.  I want to to get out a rubber hose and just whale away till I can’t take no more punishment.  I want you to plum torture me.”

        “You do?”  I don’t think she’ d had this request before.

       “Yes Ma’am.  Let me tell you a story.”  (I tend  to talk in parables.)  “My best mando buddy is a guy named Darrell.  When I first met him, I realized he was a very gifted musician- way beyond this old boy.”  I know she wondered what this had to do with medical charts.  “I told him I wanted him to be honest with me.  Any time he saw something in my playing, or singing, that needed some work I wanted him to point it out.  I made it clear he could not hurt my feelings or ego.  I knew he could help me from the get-go, and I hoped I could help him in some way, too.  I figure it’s the same way in this deal.  You know all about the regulations, and I am lost in ’em.   I’ll promise you the same thing I promised Darrell- you can’t hurt my feelings.”

        “Dr. Bibey this is most unusual.  Usually the Docs hate me.”

         “Kid, they don’t hate you.  They hate the process.  It’s just displaced anger.  I don’t see any point in shooting the messenger.”

        She laughed.  “O.K. Dr. Bibey.  But it might be harder than learning how to sing.”

        “You don’t know how bad a singer I was when Darrell got a hold of me.” 

        Well for the next months this woman came in and turned every chart of mine inside out.  She came up with every possible suggestion to drag me kicking and screaming into the modern world of bureaucracy. 

        As you might guess, I emerged on the other side better off for the process.  I never miss on a chart review.  Like a man with an ethical and smart tax adviser, I have no fear of the I.R.S., and I don’t run scared of an unknown bureaucrat either.   

        And as it turned out ole Patton wasn’t a pistol packing mama anyway, and became a bluegrass fan who comes to my shows.  I’m sure she believes Darrell should have been a bit harder on me about my singing, but she forgives me.  If I was a better singer someone might ask me to hit the road, and I’m the only Doc she’s ever had who demanded she kick his @^^.  I’m one less thing to worry about for her, and she has plenty.     

        If I weren’t happily married, and if it weren’t against Corporate Harassment policy, I’d hug the kid’s neck.  She’s a good’un.   On my last review I made 90.  I missed one ’cause I recorded the fact I got the wax out of a patients ear but didn’t say how I did it, or dictate what instrument I used.  Given I always use my favorite old cerumen spoon with the bend in it, it wasn’t hard for to tack on an addendum (and date for the day of the addition.)  Why in the world anyone in Washington would care is beyond me, but whatever.  I’ve learned what I have to do to satisfy all the regulators and keep practicing medicine.   Just to be clear though, none of it has a thing to do with taking care of patients.  It is something we get out of the way so we can continue doing what we love.  The two are unrelated.

        But, I have always been a good student.  Under the tutelage of the master coder this bureaucratically disinterested bluegrass boy can ace Hoop Jumping 101 on a regular basis. 

        This ear wax gig is a non-problem.  From here on out, without fail, I’m gonna dictate I used my O.G.A.C.C.C.S. (official government approved corporate compliant cerumen spoon- my favorite one with the bend on the end) to dig out ear wax.  And this will go on till the G.O.E.M.A. (Government Office for the Eradication of Medical Abbreviations) catches up with me.  Then I’ll just have to dream up some other creative way to worry them.

        So, Ms. Patton, this post is in honor of you.  Go kick some b#^^ and next time you eat lunch with one of them regulator folks, tell ’em to come out and hear some good music.  They need a hobby!

Dr. B  

       

Arm Chair Music Critics

        One time Chet Atkins decided to sit on a park bench and play the guitar for a while.  A fellow walked by and sat down to listen.  What luck.  Can you imagine that?  A personal concert from an all time legendary artist.

       After a few tunes, the man got up to leave.  “You’re good,”  he said.  “You ain’t as good as Chet Atkins, but you’re good.”  Now there’s an expert, huh?

       An old farmer was in the office last week and had seen me play on T.V.  “Hey, Doc.  I seen you on T.V.  You done real good on that mandolin.”

        “Thank you sir, I appreciate that.”  I was flattered.  He must have noticed some of those new licks Darrell and Ben had shown me.

        “You ain’t so good on the guitar, though.”  (I did a couple rock ‘n roll songs on electric Tele, and I’d be the first to admit I am not an expert on the instrument.)

        So much for my reputation as a multi-instrumentalist.  I took it for what is was and had a good laugh for the day.  I did take heart, though.  Children and old folks tend to be very honest.  He was right- I ain’t much of a guitar man, but then on the other hand, he spoke highly of my mandolin work.  I must be coming along.  The way I figure it, those salt of the earth people don’t know know how to lie, so it must be true.

        Better either practice my guitar or put the thing up and not play it in public, I guess.  The mandolin I can handle, at least for an amateur.  I don’t need to give up my day job for it either, though.

Dr. B 

A Heart Attack in the Mail Slot

        This post today goes out to Ms. Pande and Mr. Demonic, wherever my globe trotting pals might be at the moment.  Pande said she didn’t want me to forget to do some doctor posts, so I’ll dedicate this one to her and her hubby, Mr. Demonic, and their young’uns, the California girl and Pande’s violin.

        I saw a patient recently with a silent M.I.  (Heart attack without symptoms she didn’t know she’d had.)  Here’s how I found it.

       One day some blood work came across my desk. It was from another doc who was seeing one of my patients as a consultant.  It was a patient I had not seen in some time.  I noticed an abnormal test, a high CPK.  This could be a lot of things, but heart attack is on the list. 

        My nurse that day was Lynn O’Carroll, and I had her track down the patient.  Lynn was unable to convince her, and got me to come to the phone.  Given the patient had no symptoms, she was incredulous.

        “Whatda ya mean?  I ain’t had no heart attack.  I’m fine.”

        It took some kinda persuasion, but she did come in.  Her E.K.G. was abnormal, but the findings were subtle; only a few flipped T waves in the lateral leads.   She didn’t want to accept the possible diagnosis.  

        I began to get frustrated.  I mean, this was the same lady who read on the Internet a few years back about someone who developed a cough from an ACE inhibitor and called to yell at me for my choice of the medicine such as that.  (It was a side effect I was well aware of but one she did not tell me had developed in her case.)

        I almost pulled out the office policy manual- you know the rule I have quoted before- “sudden death is against office policy,” but I was able to convince her to see the cardiologist without all that drama.  Sure enough, she had a recent lateral M.I. and some intervention was indicated.  She’ll probably be fine.

        I’m glad my mama had me take that speed reading course, and thankful I read my mail, though I admit some of it is in a hurry.  I wish the patient had been more appreciative, but like my wife says, with some folks if you want gratitude you’d better look it up in the dictionary.

        Hey, don’t feel sorry for me though.  I love this job, and I’ve tried to my best on every encounter without fail.  For the most part I’ve been successful, and very lucky.  I have no regrets, even on the days when there is some verbal abuse.  I figure it comes with the territory.  I’m just glad the lady is O.K. 

        I suppose there is one lesson in this I do want patients to get.  Be sure all your blood work and tests are tracked down before you close the book on it.  Sometimes things can get lost or filed away without the Doc seeing the report.  (That is also against office policy, but I have seen it happen.)  Never assume no news is good news- it might be no news.

        Some of my folks want a copy, and that is O.K. with me as long as they promise to follow another office rule- “Don’t worry till Dr. Bibey says worry.”  (A variation of NTW.)

        If someone has some minor abnormalities, but they are O.K. in the context of the big picture, I don’t worry and try to reassure.

        However, if the abnormality seems minor but Dr. B says worry, I’d commence to doing just that till the thing is resolved.  The trick is learn to worry about the right things.  This patient got confused for a moment, but it worked out.  The Good Lord and mama’s speed reading course were looking out for her.  (Dr. B just happened to be there- it was pre-programmed.)

        Another rule I have is to always worry about the things that could do my patient in before I get another shot at it, so the stakes can be rather high.  (This is why I am not serious about golf, or even music, as much as I love it.)   

        So, if your Doc calls and says they’ve looked at your blood work and they are afraid you’ve had a heart attack, better take ’em seriously until you can prove them wrong.

        Even an old country Doc had better pay attention.  (As you get older, it is even more true, I’m not as quick as those young-uns.)  We don’t make the dignosis this way very often, but it is best to stay alert.  It ain’t every day a heart attack shows up in the mail slot.

Dr. B        

Docs and Athletes

        Docs play golf on Wednesdays, right?  For me these days, I do.  I am the senior guy in the group, and don’t ask for any favors ’cause of it, but the younger ones let me play on Wednesday.  I realize it has no redeeming value, but I go anyway.

        Today was a good match.  I knew we had a chance on the first tee ’cause I drew Joey, a former Hooter’s tour player who got his amateur status back, as the “A” man.  I was the “B” player and Coach was our third man.  (He only fell to the slot ’cause of a wrecked ACL- Coach can still play.)

        Crash rounded out the foursome.  We don’t let him drive.  To paraphrase Burt Reynolds, never get in a footrace with a guy named Flash, never bring a girl named Bubbles home to meet your mama, and to add Dr. B’s two cents worth, never let a guy named Crash who likes to drink beer drive your golf cart. 

        Anyway, I had a good front side and birdied nine to turn at 38.  I felt ten years younger and five pounds lighter.  Coming home I got to leaking oil, but hung in for a round of 78, not too bad for an old guy.  Joey was a bit off his feed at 73.  Coach threw in two birdies and a crucial par, and Crash parred 18 so we let him drive to the parking lot.

         I was already counting Marfar’s mad money (I always give her my golf winnings) but but my old buddy Snookers blistered it for a 68 and took home everything.

        Oh well, an athlete, even one three sheets in the wind, will whup a doctor most every time.  Better keep my day job. 

        Enough foolishness.  Ms. Pande requested a medical post and when my readers speak I listen.  We had an interesting case at the office last week, and I’m gonna write it up for you guys.

        For now, though, Marfar calls.  I might not have won her any money today, but I have promised her a big night on the town at the local BBQ joint, and then we’ve got some friends coming over to play music.  Talk to ya in a day or two.

Dr. B

April 1, 2008

        It is a fine day.

        I woke up this morning and checked out my Beatle mop-top in the mirror.  There’s nary a gray hair in my head.  Ms. Marfar’s dark eyes dance.  I know everyone says we ain’t old enough to be married, and I have to admit she is just a young’un.  We’ll show ’em- the two of us can conquer the world. 

        My Miss Marie toddles at my side, and I am still the man in her life for years to come.  Tommy Jr. is just a kid, but can bust a golf ball 275 yards.  The Golf Channel is new, and we watch over supper and try to pick out the future stars.  (Golf is still the elusive game not conquered but this kid named Tiger shows a lot of promise.)  Tommy watches a Nike tour boy rope hook his drive into the hazard.  “Shoot Dad, you can take him.  I’ve never seen you hit one like that.”  His youthful confidence is unwarranted, but appreciated. 

        I pick up my mandolin and rip through some difficult tunes without effort.  I sound somewhere in between Darrell and Ben, my mando gurus.   Perfect tone and timing, and all the exactly correct embellishments.  Man, what a player.

         The Moose says we have big gig this weekend.  Someone was gonna have one of those BBQ, hay bale, and checkered table cloth parties, and they thought of that crazy doctor who plays the ukulele.  They are gonna pay us a grand to play, and with gas at 85 cents a gallon, that is a heck of a lot of money.

        Alison called today, and wondered if I could hit the road with Union Station.  She wanted a mando player/doc/road nanny combo for her young’un, and being the big kid I am she thought I was the perfect match.  As it turns out, there is a new vaccine that is gonna end all childhood illness, so I don’t think she’ll need me.  I recommended a young man named Dan Tyminski.  I can’t bring myself to say I can sing as good as him.  This might be a fiction forum, but outright bold faced ones aren’t allowed, even on April 1.

        My Board scores came in the mail today.  Instead of reading my ^** off to make the 94th percentile, it was an effortless 99th like my old friend, Tom “Brilliancy” Bailey back in med school.

        I’ll sleep well tonight, but April 2nd I will awake for a moment at 12:01.  Not only is childhood disease going to be a thing of the past, but the Good Lord says in Heaven there will be no illness of any kind, and I can retire to play mandolin in Heaven’s bluegrass band for all eternity.  I wasn’t perfect, but I was the best I could be, and sorry for any mistakes or misjudgments I have made.  Being human is good enough for the Good Lord.  I am forgiven for the errors I have made; He knows I didn’t make ’em on purpose.  

        He promises Ms. Marfar and those kids will reside there with me in a perpetual youthful state.  Once home, there will be no sickness or suffering, and I can finally lay down my stethoscope once and for all.  And that folks, ain’t no April Fools, but the real thing.

        I’ll drift back to peaceful sleep.  Come morning, I’ll have the strength to carry on, and to be a Doc for another day. 

Dr. B