Archive for September 2009

Darin and Brooke Aldridge, Progressive Traditionalists

September 29, 2009

        IBMA showcase; Monday night.  We made our way to some empty seats up front. My advice to the kids was they were prepared and had no reason to be nervous.  In spite of that my heart pounded and my eyes were moist.  They were here.  Barring power failure or some such catastrophe, they were gonna stand and deliver.

          It was quiet for a moment.  Glasses clinked around the room as folks finished dinner.  Darin came out first.  He wore his Sunday best.  He took just a moment to check the mic.  Brooke was in a pastel evening dress.  Even an old bluegrass doc could see was she was elegant.  The boys were in dark pants and light shirts with ties.  The band carried a class professional persona before they struck the first note.

        Right out the gate it was perfection.  Brooke’s vocals filled the room, and Darin’s harmony matched her with every phrase and trill.  The instrument fills augmented the words with just the right touch.  

       They broke into their wonderful country duet, ‘The Sweetest Waste of Time.’  Someone dashed out of the room.  I later learned they had gone to alert Eddie Stubbs, the voice of WSM radio.  I have no way to know what they said, but I expect it was something like, “Eddie, you gotta hear these kids.”

         Not only did Mr. Stubbs hear them, but so did radio listeners everywhere.  Eddie Stubbs is the voice of WSM, the original country music radio brand, and I understand he put them on a live feed for the WSM listening audience.  He interviewed them after the show.

           The crowd packed in tight.  I noticed several moved up as close to the stage as possible.  My new friend from France, Henri Deschamps, tapped me on the shoulder.  “Hey Doc, they are good.”  It was a proud moment for North Carolina.  The Darin and Brooke Aldridge Quintet now belong to the world.

        The keynote speaker for the night had been Mr. Pete Fisher, the General Manger of the Grand Ole Opry.  I thought of his words as they sang.  Mr. Fisher said we need to respect tradition, and yet not have it be an anchor that weighs us down.  The man had already made good on his word when he inducted the Stanley Brothers into the Opry.  There are few groups more traditional than the Stanleys.

          At the same time Mr. Fisher is correct that to maintain and develop a commercial presence in a music world that changes faster than old Doc can type, we must push forward. We have to balance the old and the new to stay alive.

        As Darin and Brooke played, it struck me this is exactly what they do.  Darin has studied the Stanleys, and every bluegrass and country artist he can get his hands on.  He and Brooke made that heritage the foundation of their sound, and yet knew their destiny was to create their own.

        And they are unique.  From the first line the music jumps off the stage as something you’ve never heard.  Somehow though it still strikes a nostalgic chord deep inside.  You know you must have been there before, but you can’t quite recall where.  

         The closest analogy I can make it they sing in a Louvin Brothers duet style, except one voice is female and one is male.  I asked Nashville veteran Jerry Salley and he said he thought that was about right.  He went on to say in that style he felt Darin and Brooke were unrivaled in today’s country music.  Don’t take it from Doc, I’m just a music lover.  Ask Jerry; he knows the business.

        Mr. Fisher also talked about the importance of brand.  He was right again.  What brand can ever symbolize country music more than the Grand Old Opry?  When I interviewed for med school, some old Professor asked me what I knew about opra.  I pondered that a minute and said, “Sir, I don’t know too much about opra, but I can tell you all about the Grand Ole Opry.”  I got in, and I hope I’ve done okay for a country boy.  I’ve sure done my best.

        So do Darin and Brooke.  When Mr. Fisher talked about brands, I was reminded of the words of Charles Revson, the founder of Revlon.  Someone asked what he sold, and he said, “We don’t sell cosmetics, we sell hope in a bottle.”  Mr. Revson understood the importance of brand.  The rewards of brand can only come from the responsibility of quality and consistency.  As Mr. Fisher said, (paraphrased)  “You must not just meet, but exceed expectation without fail.”  

          Darin and Brooke do that.  Like Charles Revson, their brand is also hope.  They respect their elders and tradition but still push their music to new boundaries every time out.  They sell hope too.  Old guys like me who love music and rely on it to see them through the hard times know young people like Darin and Brooke are gonna keep the tradition alive.  As groups like this emerge, we can know our music will never die on the vine from failure to move forward.  At least for this music lover, that is what I look for in a brand. 

        As Mr. Fisher said, we all must strive to exceed expectations in whatever we are called to do.  Darin and Brooke do just that, and North Carolina sure is proud of them for it.

Dr. B


IBMA (International Bluegrass Music Association)

September 28, 2009

            We got into Nashville late.  It’s a pretty good drive from Harvey County, and I got a bit of car lag from the drive.  I might take a train next time.  I wonder if it stops at Union Station.

        The Holiday Inn Express is fancy for a country boy.  Six floors up is quite a view.  The night-light twinkled and inspired my ‘Song of the Day,’ ‘Nashville Skyline Rag.’  

       We are here for the IBMA convention.  I have played all my life, but this is my first venture into organized bluegrass.  Hm.  I wonder if ‘organized bluegrass’ is anything like ‘organized medicine.’  They say organizing doctors is like herding stray cats.  I know a bunch of musicians and I am one myself.  Bluegrass musicians are even more independent than docs.  I don’t know exactly how headstrong that might make me, ’cause I am both.

        Though a neophye to the organization as a professional, (I have been a grassroots member for years)  I am sure they will welcome me in.  The only requirement is to love the music and respect it’s traditions.  We still respect our elders in bluegrass, so I have an advantage there.  Gray hair makes patients think you are wiser than what you are.  

        I’ll find my niche.  I am now a professional member in print media.  As far I know I am the world’s only physician bluegrass fiction writer.  I have been blessed with more than my share of drive and energy over the years.  Many people from all walks of life have asked where it comes from.  I tell them I give the credit to the Good Lord, my wife and family, and the bluegrass community.  They are what sustains me. 

        Then I reach in my cabinet and hand them a CD.  I try to choose one that fits their personality, and I seldom miss.  They come back later a say, “Wow, I didn’t know you folks played like that.  This is great!”

        These days I am a part-time doc, and closing in on an old man.  The music has been good to me and sustained me in hard times.  It still tears me down to lose a patient, and the music gets me through.  With ‘The Mandolin Case,’ I hope to show the outside world all about it.  So many folks have asked me about it, I felt compelled to show my story.  I hate for anyone to got through life and miss out on this wonderful music and all the fine people involved in it.

        If you don’t know of bluegrass music and our extended family come to FanFest at the Renaissance Hotel in Nashville and check it out.  It’ll change your life.

Dr. B

The Imagination Will Set You Free

September 26, 2009

        I had a patient who was confined to home her entire adult life.  Before the Internet she had a good life and many friends from all over the County, but after the Internet came in, she extended her connections around the world.  She could describe Australia better than many people who had been there.

       She was an early book editor for me and even inspired the character Mason Marley.  I would send her chapters by e-mail and she would read them and send back suggestions.  She once told me the installments reminded her of the eager anticipation of the “Saturday Evening Post’ as a child.  

         She especially loved to help embellish Mason Marley.  “Oh, have her smoke a cigar here, Bibey.” 

        “C’mon Mason, you don’t smoke.”

        “I can’t in real life ’cause of my lungs but I can in fiction.” 

        She wrote a book herself and had a lot of good advice on agents, editors, and lawyers that I follow to this day.  My only regret is the process is so long.  I would have given anything to be able to hand her a signed copy.

          I used to ask her about confidentiality.  “You know, as your doc, I’m supposed to protect your privacy.  I worry a little about this.  I’m afraid people will figure out who you are, or least who inspired the character.”

        “Oh Bibey, you are such a silly boy.  I hope you tell the whole world.”

        When I finally get around to that, I’m gonna tell you about her book too. She was one of the most special human beings I’ve ever known.  She knew the imagination had no limits to unlock a life of grace and dignity.  She showed me how every time I visited her. 

         Before she died I had not only permission but her encouragement to tell her story.  Mason understood with literature we can have a bit of immortality, and she cheered me on towards the finish line at every visit.   When I get there, much of the credit is to her.  

Dr. B

I Put You Through College and Catfish John

September 25, 2009

        Mrs. Greer was one of the first patients I saw in private practice.  She was in the ER after a sudden cardiac arrhythmia and near syncopy.  (Around here they call it a falling out spell)  Sweat popped out on her brow, and her color was dusky.  Her shortness of breath was so obvious it’d been noticed by a third year med student.  I had seen her once in the office when my dad was out ot town.  She’d seen him for years.

        I approached the bedside and looked up at the cardiac monitor.  She struggled to sit up in the bed.  “You better be nice to me.  I put you through college.”  She wagged a finger at me and sputtered out a laugh in spite of all the coughing.

       I liked this woman immediately.  How brave can you get?  Near death and made me smile.  I am proud to say we got her converted (cardiac that is; she was already saved) and she lived another seventeen years.

       I saw her daughter in the office the other day.  She has developed the exact same cardiac condition her mom had and is doing well.  I asked her how she liked the new office.  “Just fine, Dr. B.  It’s real nice.  But we don’t come to the building.  We come to you.  Wherever you go we’re gonna follow.  We ain’t gonna forget you saved mama.”

        “Maybe I better take you to visit Corporate.  I’m getting kinda gray you know.”

        “Don’t matter to us.”

        “I gotta take good care of you guys.  Your mama put me through college.”

         She smiled at the memory.  “Y’all need to have an open house.  We could do a covered dish supper.”

        “Sounds good to me.”

        “You’ll bring your mandolin won’t you?”

        “I’ve played for my supper before.”

        “Hey Doc, you remember when Sis……”

        It was like that all day.  The only patient I had seen less than twenty years was the fifteen year old with strep throat.  Every time the whistle blew I did think about what it might be like to hop a freight train, but I knew I’d make it a round trip.  I thought how lucky I have been.  I’ve been seeing the same folks for all these years.  I’ve had the same doctor myself.  My barber cut my hair as a kid.  My mechanic and I went to high school together.  My uncle was my dentist until he retired and now I go to my cousin.  I’ve played music with the same cats and golf with the same choose-up boys at the muni.  One way or another, they all of take care of me as much as I take care of them, and all I have to do is read books and write prescriptions.  Mrs. Greer even put me through college.  I didn’t make a big pile of money, but I don’t see how any human could have been more blessed. 

        All I gotta say is what the heck kinda million dollar insurance executive in Raleigh really believes he’s gonna know my patient better than me?  He can photo-copy records all he likes, but he won’t be Doc for my people any more than I’m gonna jump on a stage and turn into Mike Marshall on the mandolin.  Like Mike I gave it my life.  It’s hard to whup a guy like that.

        Don’t tell this, ’cause it might get me in trouble, but when a patient of mine like Catfish John gets a letter from the government or insurance company that recommends a change in their medicine he just laughs at them.  “Don’t them SOBs know I tried that in 1993?”

        “I know that guy, John.  He used to get picked last in softball.”

        “I ain’t surprised.”

        I went back to my desk and picked a few bars of ‘Catfish John.’  If that fellow was to come to town he wouldn’t have any idea where to look for a guy like John.  If he did luck up and find him, he’d be best off to take me on his first few visits.  John doesn’t take to strangers until he’s had a decade to size ’em up and he’s got no more use for a man in a suit and tie who shows up in Harvey County out of the blue and gonna ‘help’ him than I do.

Dr. B

The New Modern Multi-Specialty Complex (Home is Where the Heart is)

September 23, 2009

        The new office is a modern, efficient, multi-specialty clinic.  It offers all the newest services.  There is no question it is better for patients.  When I am worried someone has a clot in their leg I’ll be able to send them downstairs for an ultrasound, get an answer from a Board Certified radiologist in real time, and have it all done on a co-pay rather than have to farm them out all over town.  This is a good thing.  

        Perhaps the best benefit of the impact on the competition.  They used to grumble at times about being ‘inconvenienced.’ Now they fall all over themselves to help my patient when we call to arrange some of the tests we don’t do in house.  I don’t understand how people can forget it, but the patient rules.  Without them we have no reason to be.  I am glad the competiton is there to spur us on, too.  Whatever health care system emerges, the patients should be empowered by choice and freedom.  If a doc or an institution gets lazy and does not live to serve they need to get canned as a reminder of why we are there.  It ain’t so we can belong to the Country Club.

        Even though the office is new, I guess there is room for one gray haired old-fashioned doc.  I hope so.  I set up my personal study to be an exact replica of my old one.  I have the same desk and bookshelves.  I do have a new desk chair per request of the boss, but I kept the blue ‘C.F. Martin & Co. est. 1833’ director’s chair that came from Johnny’s Jewelry and Pawn.  

        My door looks more like the entrance to a bluegrass night club than a doc’s study.  Someone already grumbled it looked unprofessional.  I like that.  So do 98.93 % of my patients.  Many of them are bluegrass.  Bill Monroe still stands guard at the door.  Memorabilia from years of Neuse River shows covers the door alongside Bill’s larger than life picture.  My family still watches over me right by my desk.  The same signed photos of artists of everyone from Scruggs to Hartford to the obscure are scattered around.  There is a poster of a young Darin Aldridge, and one of Butch Baldassari from one of his Nashville mandolin seminars.  My office ‘Little Martin’ guitar sit behind my desk in case the power goes off and I need to gather the flock.  My Kentucky mandolin is out on loan, but it’ll be back next month.  I have all my old books, though much of the text has been rendered obsolete by on-line data bases.

        All my old staff is there.  Lynn and Myrd are closing in on a quarter century.  We merged with another fine group of fine folks.  They seem great, but just in case I built in the same old safe-guards I had before.  If anyone on the office staff is ever rude to my people, there is a secret code word that’ll straighten it out, and my folks know how to find me.  

        It will be rare this will be needed though.  For some reason no one ever seems inclined to make my people mad.  Along the way we had a few who did, but they don’t work there anymore.  My people are all I got and I intend on sticking by them to the end.

        I’m gonna stick by my office people too.  One time a patient took to cussing one of them.  I told him these ladies work harder for him than I do.  If he was gonna cuss someone he’d either have to chew on me or go somewhere else to the doctor.  He apologized.  I still see him. 

        I know people aren’t at their best when they are sick and I try to make allowance for that.  But I am getting older.  I used to allow three cussings per patient before I’d get too bothered by it, but I put the word out I am too old for all that now.  With the new place I cut my limit to one.  So far, everyone seems to go along. 

        We are near the tracks.  When the train comes through it isn’t loud enough to disrupt patient care, but when the whistle blows it does remind me all of life is not sickness and other adventures await.  Maybe Corporate shouldn’t have chosen that location, because that lonesome pull of the train whistle reinforces my independent streak every time she passes through.  Bluegrass folks love trains.

        Bill Monroe is on my door for a reason.  When you come into my office, you have to go right by him.  Monroe was a proud man, and stubborn to a fault.  I keep him there to remind me I need to work on flaw in myself.  At the same time Monroe was devoted to excellence, and took no grief from anyone less committed to their craft.  I like that part of Monroe.  

        Even though we are new and modern I don’t want anyone to forget I am doc, not a businessman.  I figure every modern multi-specialty complex needs an old curmudgeon and I am ours.  Someone has to remind us where we came from and not to get above our raising.  It has to be me.  I am the only one who is old and gray enough to get away with it.

       So far the new office is a good gig.  As Grisman says, home is where the heart is.  As long as I have a stethoscope and a few folks to try to help out, I’m okay.

Dr. B

The OSHA Inspection

September 20, 2009

        I promised I’d never tell this story until we vacated the old office.  We have so here goes. 

        Back in the old days when they enacted OSHA we all grumbled.  I did too, but I knew we’d have to cope with it.  

        Soon a new industry sprung up of folks who you hired to prepare you for OSHA.  It wasn’t hard to see what this meant.  Most of them were former OSHA inspectors who gave it up to go into the more lucrative consultant business.  For a fee they could ‘OSHA’ proof you.  We knew if we had them come through, we’d survive OSHA.  In a way it was like protection money. 

          Of course, very little of this had a thing to do with patient care.  For my European friends who are perplexed by American ways, it is sad but simple.  The whole thing was about money.

        One year OSHA came to town.  They showed up over at the urology office.  A nurse pal of Myrd’s called to give us a head’s up.  The urology office passed, but did get one ding for an open SunDrop Cola.  I guess that makes sense.  After all, it is one of those yellow drinks.  Besides, those urology docs don’t care for soft drinks anyway.  They took me off of ’em after my last kidney stone. 

        I always thought it would be poetic justice for one of those little regulator fellows to come down with a stone while at the urology office.  Can’t you just see Dr. Johnson standing over him?  “Have we passed inspection yet?  We can’t treat you until we are OSHA approved.”

         Myrd came to warn me OSHA was in town.  “You better go get your lab coat,’ she said.

         “Where did I leave it?”

          “It’s in the blue room.  Lynn put it there after OSHA KLEAR (O.K.) was here last year.”

        “Oh, okay.”

        “Did you fix the directions on the map?”

        “Naw.  OSHA KLEAR didn’t notice.  OSHA won’t either.”  So far, no one had noticed except me, Myrd, and Lynn, and none of us had any trouble figuring how to get out of the office anyway.  

       She shook her head.  When OSHA first cranked up all these high powered consultants offered to draw up some kind of fancy maps with directions on how to find the exits.  We elected to do it our own way.  The fee was exorbitant, and I knew patients would never look at it anyway. 

        Besides, our emergency plan worked fine.  If the power went out I’d get my office Martin guitar and lead all the patients to the middle hall.  I had a friend who was an engineer and he said it was the safest area for everyone in the event of a tornado.   “Just follow the music, guys,” I’d tell the patients.  I was like some kinda hillbilly doctor pied piper, but it worked.  You gotta be what you are.  

        Still, we knew we had to have some sort of maps posted to comply with OSHA regulations, so we had the kids draw them up, put them in some frames from the Dollar Store, and then placed them around the office.  Most of them were quite good, but as predicted no one ever paid the maps any attention.  One day I realized if you followed the directions on one of the maps it would lead you into a closet with no exit.  I envisioned the marching band in ‘Animal House’ when they made a wrong turn in the parade and all the trombone players smashed their slides into the wall at the end of the alley.  The image of everyone in the office being dumb enough to pile up in there was too much for me.  I never took it down.

        “You’re gonna get a fine one of these days,” Myrd warned.

        “Betcha twenty bucks they don’t notice.”

        After OSHA checked the urology office, they came to our place. 

        The fellow was a little guy who looked like a bank examiner and had about that much humor too.  He was bald on top, but had grown some hair on the sides real long and pasted it over the top of his head.  He peered over his glasses.  “Are you are Dr. Bibey?”

       “Yes, sir.”

        “And what have you done to prepare?”

        “We have OSHA KLEAR come in every year.  Passed at 98%.    ‘OSHA KLEAR every year.’  Great slogan huh?”

        He didn’t laugh.  “Were there any deficiences?”

        “Uh, well, yeah there was one.  We left out some perfume.”

         “Perfume?”  He made a note.

        “Oh, not me.  One of the ladies up front.   She was reprimanded, though.  We’re cool now.”

        “I see.”

        “Can I show you around?” I asked.

         “No thanks.  I will inspect on my own.”  He hung around about a half hour, then found me.  “All looks to be in order.  However, please, no crackers at the nursing station.”  He tore off a sheet of paper with his findings.  “Please keep this for your records.”

       “Yes, sir.  I’m sorry.  The crackers were half my fault.”


        “Yes, sir.  I assume they were Nip Chee.  Me and Lynn O’Carroll split a pack and a Co-Cola every day at three. ‘Schools out,’ you know.  You ought to try some.  Those Lance crackers are the best even after they took the lard out of ’em.”

        He made another note.

        “Anything else?” I asked.

       “No, you passed.  96%.”

       “No crackers?”

        “Please.”  He wrinkled his brow, squinted, and took another look at me.  “You look familiar.  Don’t I know you?”

       “Tommy Bibey.  I play mandolin with Neuse River.  Bluegrass.”

       “Bluegrass ?

        “Yes sir.”  I walked over to the cabinet and found him a CD.  “Here, take one with you.”

       “I’m sorry.  We can not accept gifts.”

       “Hell, it ain’t a bribe, man.  You already said we passed.”

        He almost smiled.  “Okay.”  He turned to leave.

        “Oh one more thing,” I said.


        “Be careful.  On your last turn go left instead of right.  Last year a patient wound up in the closet ’cause they didn’t read the signs.”

         “Thank you.”

        I thought Lynn and Myrd were both gonna kill me.  I put my white coat back in the blue room to await next year’s OSHA KLEAR visit.  Indie always did say I was a good Boy Scout.  You know; ‘Be Prepared.’

        I sure am glad the government comes around every so often to help me.  I don’t know what I’d do without ’em. 

        I won’t tell you the regulator’s name, but later he became a bluegrass fan.  I promised him I wouldn’t give him up.  The government has our SSNs so they would know whether or not we are HIPAA compliant and respect privacy.  I was hip to HIPAA before HIPAA was cool.  The man can’t afford to be caught hanging out with me.  He needs his job, and I don’t want to get him in trouble with his boss, so we stay under the privacy radar.

        But the government needs to be warned.  He is now one of us.

Dr. B

The Old Office

September 18, 2009

        The old office was like a favorite uncle.  Just ’cause you knew his time had come and gone didn’t make you love him any less.  It’d seen thousands of sick folks, but it took time out to hear some mandolin music and fishing stories.  Everyone had a cake on their birthday back when I was the ‘boss’ if we really had one.  If the office had been a person it’d be about like Indie;  full of character and not one bit ashamed of being human.

          It had its flaws.  It was drafty and cold in the winter and every summer it got so hot in room six you couldn’t use it most afternoons.  Corporate let me keep my desk even though it had nicks and gouges and a few missing drawer handles where kids had tugged on them over the years.  The chairs in my study were condemned, though.  The stuffing showed through and they were deemed unfit for a brand new modern medical multispecialty complex.  (I don’t think we are supposed to call it an office)

        We only worked ’till lunch the last day then it was a mad dash to move and crank up for the new crib.  I’d already put away my favorite photos of my family.  The one of my wife was the picture they put in the Harvey Herald for our engagement.  My children were frozen in time as toddlers.  I promised to add a few recent ones after the kids protested they were too far out of date even for old Dad. 

         I got out my mandolin and tried “When You’re Smiling.”  A picture of Bill Monroe hung on my door by a single tack.  I put it aside along with a faded one of Earl Scruggs as a kid.  I’d put them up in the new office even if corporate objected.  Some things never change.

         By noon-thirty the movers had taken most of the furniture.  I dictated my last chart and downloaded to the computer, then they whisked it away.  Soon we were down to cell phones.

        I picked a few bars of  ‘Blues Stay Away From Me.”  Someone brought a pizza.  We ate and then most everybody left.  Then it was the ‘East Tennessee Blues’ in honor of Knoxville where I trained years ago.  The notes bounced around the empty building.  It was down to me, Lynn O’Carroll, and Myrd, the original three musketeers who started the practice on a shoe string.  At times we barely kept it all tied together.

       Lynn carted out a few more boxes.  “Me and Myrd are going on.  You coming, Doc?”

        “Yeah, I’ll be over in a minute.  I’ve got time to get a haircut but I’ll be on over.”

        “You okay?”


         Their foot steps echoed down the hall.

         A dust bunny rolled by.  I smiled and took a stab at ‘Tumbling Tumbleweeds’ but didn’t know the whole tune.  I put my mandolin in the case and carried it to the back door. 

        I closed the door, turned the key in the lock, and didn’t look back.  We had done our best.

Dr. B

Healthcare and Populist Backlash

September 16, 2009

        I’ll get back to our left brain/right brain discussion in my next post.  For now though I wanted to digress. 

        Take heart, there are small signs some power might get back to the little guy.  All we gotta do is revolt.

       If you think about it, big ain’t working in modern society.  What went wrong in Health Care is it got too big.  When an Insurance company CEO makes 64 million bucks a year they need to be busted.  

        It happened in sports.  Too many guys who don’t have the skill or passion to learn to shoot, throw, dribble, or hit made a business out of a game.  I’d rather play golf at the local muni on a pretty day than watch the ‘sports’ business.

        The same is true for country music.  Business people who can’t pick ‘The Wildwood Flower’ on the guitar controlled the flow of the money and the art suffered.  It is one reason I love bluegrass music so much.  We don’t care if you are rich or poor.  Anyone can join in.  The only requirement for recognition is dedication, practice and time.  You can not create a market image and package a  picker.  The music is too hard to learn to play and can not be faked.    

         In medicine you can make far more money by denying care than providing it, at least at the primary care level.  Greedy people who report to stockholders rather than patients brought the system to its knees.  I don’t want the Government plan to get too big either, but I would like to see it position the other players where they have no choice but to do right.  (Against their will for some of them, by the way.) 

        A model which creates true competition would help.  Every day when I go to work I need to understand someone younger, smarter, and better looking than me (ie a heck of lot of people) would like to have my job.  I do my best for my people ’cause that’s the way my mama taught me.  (in the South you never go against mama)  For the ones who aren’t natured or trained that way, I’ve found they can learn fast if they are forced to.  It should stay that way too.  (In reality no one wants my job right now.  Primary care is now a hopeless quagmire.  Big insurance makes it as difficult to help people as possible, at least as far as daily grunt work.)

        No doctor needs to survive because of political favor.  I know some who do.  They couldn’t pass Boards on a day of divine inspiration, but are protected because of their alliances.  Trust me, you don’t want them as your doc.  I’ll take one like legendary Dr. Jess every time.  He’s a surgeon at a major medical center, plays the fiddle and wears string ties.  He has no use for administrative fools.  They’d get shed of him, but the guy is too dang smart and good to patients for the political types to take him on.  They are at least bright enough to understand there’d be a populist backlash.  It amuses me to know how they lay awake at night and worry about maverick docs like Dr. Jess.  Indie was that way, as you will see in ‘The Mandolin Case.’  (Still slated for a 2010 release).     

         Here in Harvey County, true competition salvaged some hope for our little medical landscape.  (I plan to show you how in a second novel.)  It’s like George Bailey said in ‘A Wonderful Life.’  “This town needs the measly Building and Loan, Potter; if for no other reason so everyone doesn’t have to crawl to you.”  (paraphrased)  Monopolies, be they business or government always get bloated.  I never dealt with a bureaucrat with a heart.

         According to Newsweek, “the Founder’s vision was a republic of self reliant farmers and small town tradesmen.”  The article referred to banking, but the same principle applies to medicine.  It was better off in the hands of patients and providers.  Now it is controlled by very large institutions whose ‘important’ people often can’t distinguish gas from a heart attack, nor do they care or realize why this might be an important skill.  As one industry insider wag told me, “When I got into health care I thought we’d be talking about germs.  All we talk about is money.”  

         Niall Ferguson wrote in Newweek that the Founding Fathers had a significant mistrust of big.  There isn’t much new.  Maybe history will just recyle.   He recalled there has been more than one backlash against big in the past.  President Andrew Jackson used to say about the central second Bank of the United States, ‘The Bank is trying to kill me, but I will kill it.”

          Large institutions, be they banks, sports, country music, newspapers, publishing houses, government, political groups, or health care conglomerates need to heed history.  The privileged few depend on the daily toil and drudgery of ordinary folks to sustain their good fortune.  When they forget where they came from and get above their raising, a populist backlash awaits.

        Oh, by the way, you might note there is no longer a second Bank of the United States.  It went out in 1832. Old Hickory was  a stubborn man, and he prevailed.

Dr. B

‘My Stroke of Insight’ Dr. Jill Bolte Taylor

September 13, 2009

        I have not read this one yet, but it is on my ‘must’ list.  Dr. Jill Bolte Taylor is a neuroscientist by profession who shares her insight into the illness of stroke.  Her book is titled ‘My Stroke of Insight.’

        She knows, and both from a right brain and left brain perspective, because she suffered a stroke herself a few years back.  Like many of us as medical professionals, prior to her stroke she was a left brain human.  Logical, organized, driven, time pressured etc.  I am not judging.  Lord knows I have plenty of ‘Type A’ to go around.

        When she had her stroke she knew it was in the left side of the brain, because she began to lose the use of her right hand, and her speech began to get garbled.  As it progressed, an odd thing happened.  Her right brain took over, and she began to experience an unexplained tranquility.  It was like she was able to step outside herself and look at the situation with near bemusement.  She began to think, “Well, isn’t this interesting?  My, my.  It sure is peaceful over here.”  (Paraphrased)

        The left side fought back.  “What are doing?  You are a scientist.  This is a stroke.  Call 911!”

       She never forgot the feeling, though.  Her full recovery took years, but as her left brain came back to normal, she was still able to tap into the right side and access all those warm fuzzies.  Even after the resolution of her stroke she did not lose that ability.  I think her book is very important.  If we read it with passion we might learn more about how to access both sides of our brain with equal ease.

        I am reminded of the early days when I began to write my book.  Some days I’d come in from work and start to type.  I was still in left brain mode.  I’d send it to my agent and he’d say, “You wrote this like a doctor.  It’s terrible.  Do it over.” 

        He thought about how to break this pony for a while. One day he called.  “I don’t want you to ever write a word until you have strung your mandolin around your neck and played until you have logged into your right brain.”

        It worked.  In fact, what few times I tried to get speed up the process and get it by him he’d notice right away.  “Tear it up.  Go get out your mandolin.”

        The last time I saw Wayne and Kristin Scott Benson we got into a discussion about Ms. Taylor’s book. I told Kristin that I looked forward to the read, but at the same time I had a notion I understood what the doctor was trying to say. 

        Kristin looked at the mandolin case at my feet and smiled.  “That’s how you get there, Doc.”

        How come woman are so intuitive?  She 100% got it.  The mandolin and writing has always taken me over to the tranquil side.  I just didn’t have to suffer a stroke to get there.  I bet there is a lot to learn from Dr. Taylor as to how to access it with more efficiency.  Or maybe I am just too danged left brain-ed analytical about it all, who knows?

      In my next post I plan to share some about the Wayne Benson left-brain right brain balanced mandolin method.  One time I told Kristin it seemed to me Wayne understood the why of how he played better than any great player I’d ever worked  with.

       She just smiled and nodded.  I’m sure she must have wondered how old Doc could be so slow to understand.  To her, as a woman, an artist, and as Wayne’s wife, that understanding was second nature.  It takes a community to make a right brain artist out of a left brain doc, but with the help of ‘The Mandolin Case,’ I’m getting there.

Dr. Taylor’s web site is:

Dr. B

Army Golf

September 11, 2009

        First off, let me update you on Australia Sam. They had to put his surgery off till Monday.  I think it was due to exhausted surgeon syndrome.  As much as I know they hate to wait, I’m glad the surgeon was up front.  If he’d been up all night, it’s best to rest and then go again Monday AM.  Y’all keep up the prayers and I will update you then.


        There’s an old joke in golf.  When a man has a bad day and can’t keep the ball in play, we often call it ‘Army golf.’  (You know; “left, right, left right.”)  With that concept in mind I want to open discussions about the human brain.  What makes us work off the left vs. the right side?  More important, how can we learn to tap into both?

        This will take more than one post, but I’m gonna start with golf.

        Once I had a patient who was a brilliant man. He was a true rocket scientist.  I had all respect for him, but he was a hemi-hypertrophied left brain man if there ever was one.

        He’s forever bring me complicated mathematical formulas he’d derived to adjust his Coumadin dose.  The only problem was they didn’t work.  Coumadin adjustment has always been more art than science, a fact that distressed the man to no end.

        When you’d talk to him about blood clots you couldn’t say, “Well brother, think of it like the difference in a river and a mill pond.  All that junk won’t grow on a rapid river but the water on the pond just sits there, and vegetation can fluorish.  Your circulation is slower now, and when that blood pools up it makes for a good place for blood to clot.”

        He’d look at me funny every time.  It was an indication he didn’t know whether to trust a man of science who talk such as that, so I’d proceed to go on and on about the latest theories on endothelial cell dysfunction and platelet aggregation.  Then he was satisfied.  As for me, I liked the mill pond analogy better, but the other was the latest hip thing he might have read in ‘Scientfic American’ and it suited his style better.  It is always best to know your audience, and play their tune.    The only practical value for me was it helped me fill in more correct bubbles on my Boards.

        Anyway, my rocket scientist patient decided he was gonna take up golf.  I advise most folks past fifty who are as left brain-ed as this man to take two weeks off then quit, but he was insistent.  He wanted to come out and watch me hit some balls one day, so I gave in.

        I recalled a surgeon friend who took a stab at the game in middle age.  He was very left brain dominant, and also a man I respected highly; one I would let operate on me or my family in a minute.  After a few tortuous years, one day he threw his clubs down and said, “I’m just too d@#^ smart to play this game.”  The man was right.  He just couldn’t let his right brain take over even for a day.

         My rocket scientist pal joined me on the range one Wednesday.  I was a beautiful sunny Carolina spring day.  A few clouds drifted overhead, and a pilot buzzed around in a Piper Cub.  Some birds rode the wind.

        “Let me warm up,” I said.  I tossed a bit of grass in the air, and made a very rough calculation of the wind, more out of habit than necessity.  I closed my eyes for a minute and tried to recall the old days with Snookers in  high school when we had not a concern in the world.  I began to hit  some wedge shots.

        After my back was limber, I moved on to a driver.  Trust me, I am no great golfer, but as a 7 handicap I can play enough to fool the uninitiated.  I hit a few draws.

       He watched intently for a while, then spoke.  “I notice as you project the ball it tends to ascend and then just before the the apogee it curves from the three o’clock positon back to the mid-line.”

       “Yes sir.  They call is a draw.  When Billy Casper hit the tour his shot was a big draw; more like a hook.  Sam Snead watched him and said,”I know a man can hit a ball like that, but I don’t know why he’d want to.”

       My patient didn’t even hint at a smile and remained in deep concentration.  “I notice the ball has a number of circumferential small indentations.” 

       “Yes sir, they are called dimples.”

       “My interpretation is to achieve the desired trajectory, and for it to be repetitive, one must impart the correct amount of spin by delivering the strike to the ball in a consistent fashion.”

        “Yes sir, something like that.”

        “Hm.  I notice your left thumb is slightly right of a vertical position, approximately three millimeters of deviation from midline.  I assume this results in a slight closure of the striking surface as it contacts the ball.  Is that how you generate the required torque to accomplish this repetitive flight pattern?”

       “Hm. Well not exactly.  I ain’t no great golfer, but I just try to set up a bit closed and think draw.  Sometimes the image of tossing a bucket of water over my left shoulder helps.”

        “Beg your pardon?” 

        Oh yeah, I thought.  I forget he wasn’t that big on a water analogies.  He came out of the space program.

        He stuck with it about two weeks.  The man was retired and had plenty of time on his hands.  I’d go by on my way to work and there’d he be studying that grip and doing his best to calculate a formula that might conquer an impossible game.

        I saw him a month later.  “How’s the golf going?” I asked.

       “I gave it up.  It is not a reasonable game for a man of science.”

        “I agree, John.  I think you’re too d#^%^d smart play that game.”

        He smiled.  We had connected.  He was my patient all the way until he moved to Florida, and brought me scientific articles to read just as regular as some folks bring tomatoes.  They were quite good, and my left brain and his got along fine.  I’m glad he didn’t take up the mandolin though.  Somehow I don’t think it’d a worked out.

Dr. B

Note:  I finished this post before I realized what day it was.  God bless all the victims of 9/11.  -Dr. B