June 30, 2014 Monday "Optamology"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 30, 2014  Monday

Chief Complaint: (written on the chart before I go in the room)

     “referred to optamology” 

Interesting Name:

    Couture

Anecdote:

       Thomas, six years old, was a gentle soul.  He had come in with a horrible sore throat, a high fever and very large, painful glands.  Despite this, he kept a sweet smile on his face and would softly stifle an almost imperceptible giggle whenever I felt his neck or checked his ears.  
     I explained to him that I would have to do a throat culture.  We practiced gently, just to get him used to the idea.  When I said I would actually do it, he interrupted me, “But Dr. Feole, what if I laugh?”
          South Carolina, 2007

Poetry:

One Woman

Oh, the old love song again and again
devotion and desire without end,
a woman half dressed somewhere and
being admired, or dressed and being admired.

These men go off alone into their rooms
and write it down: she was this and she was that.
Every man says she's the woman above all,
on a pedestal, though no one says pedestal,
that would be crazy,
and there's a thousand of these poems,
and by that I mean a million declarations
of this singular love of this one of a kind woman,
so rare, an absolute phenomenon which
many times rivals the moon or the oceans,
or the wind in the trees or night or any of the
furniture of night or day.

You see what I mean:
big unknowable things.
What are we to make of it? This:
it's true. Each man is telling the truth.
Each woman puts all the other women second.
It's the way. The strap of her gown off her shoulder,
and the paradox prevails. These poems are
all true. Each woman stands alone
in the doorway or on the pedestal
in the perfect light. 

          by Ron Carlson

Coup d'essai: …

 PART VII of XX: Migrant Health Care Journal

     I was telling the nurses that I had just seen a patient named Carlos Santana, aka the rock band.  One nurse said that she had seen Jennifer Lopez.  Another piped in that she had seen Elizabeth Taylor.

      I’ve gotten the lowdown on the eateries in Newton Grove.  Taco Rico makes the best burritos, especially "el grande".  Eddies has all fried food, is big on hot sauce and barbecue.  Also, on Sundays, if you go north on 96 (I actually know where that number is now, having traveled it in vain many times), there is a restaurant 5 miles up that has a great Sunday Country buffet, “great fat back, all Southern food.  It’s a delicious grease pit.”  

       Can’t wait.

Terry M----, the African-American behaviorist at the Salemburg clinic, is a funny guy.  He speaks and acts with the comic mannerism of Bill Cosby and does so unself-consciously.  He is a very gentle person also and works with children with ADHD, trying to avoid medication.  He takes them off medication in the summer “so that they can be kids again.”  He is tall, of a solid, athletic build, with a slightly roundish face that always has a smile, bordering on a smirk.  

     I referred a depressed Hispanic girl to him who had all the somatic signs of a major depression.  He came to see me immediately with a blank prescription.  “Let’s start her on paxil.”  He was concerned.  Back in Connecticut I wrote only one prescription for an antidepressant in a teenager.  The family was destitute and couldn’t afford to see a psychiatrist.  At the clinic here, I’m not sure if a psychiatrist is even available for these uninsured people.  So, I wrote my first antidepressant for her.

    

  

Favorite Musician/song:

  Carole King "Home Again" from Tapestry

       Atmospheric and filled with love.  A kindred spirit with James Taylor, my favorite.  

Favorite Book/author:

Istvan Banyai,  "Zoom" and "Re-Zoom"

    For my artistic patients, I often point out that, in my opinion, this is the most creative art book I have seen for children.  An inspiration and beautifully drawn, challenging, thought provoking.

Favorite Movie/DVD:

Inspector Morse, "The Remorseful Day"
 
    I love this BBC series and have watched most of the episodes dozens of times.  A cultured, sometimes abrasive, insightful, poetic British detective who does crossword puzzles.  This episode, the last of the entire series, is poignant for just that fact.  A moving tribute to Morse's relationship to Inspector Lewis, a heart wrenching ending and a stirring poetic quote in a crepuscular setting by Morse, quoting "the remorseful day."  Very moving. 

June 29, 2014 Sunday "Rainbow"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 29, 2014 Sunday

Chief Complaint: (written on the chart before I go in the room)

     “His feet begins to curl over.”

Interesting Name:

     Rainbow

Anecdote:

     Brad was five years old and was very excited to be at the doctor’s office…since it was his two year old brother’s check-up and not his.  

     My every move was accompanied by Brad's dramatic explanation in a shouting voice as he would explain to his wide eyed brother what I was about to do to him…and every word was greeted by more frenzied crying by his brother.  Brad was happy and excited, caught up in the drama of this moment.
     Finally, after the shots were given and the volume of his brother's wailing temporarily overtook Brad’s frenzied explanations, the door slowly cracked open.  Brad’s head poked out and he had a remorseful worried expression on his face.   
     He quietly informed me, 
     “Tommy needs a sticker and some chocolate.”

               April, 2007, South Carolina

Poetry:

                         

Coup d'essai:

PART VI of XX: Migrant Health Care Journal

     To get to this satellite clinic, I have to drive through Spivey’s Corner.  That is where they have the annual “hollerin” contest, and the top three children go on David Letterman’s each year.  It now makes sense to me.  I’ve actually started hollerin at the cows for directions.  I might try out for the contest next year.

8/28/02: 

     A nurse at the satellite clinic said she was going to bring in some ‘whomp’ biscuits for everyone tomorow.  I looked puzzled so she explained what a whomp biscuit is: you take the cylindrical canister filled with uncooked biscuits from the refrigerator and you WHOMP the lid on the counter to open it.  

     We had just shared some delicious soup that one of the staff brought it.  It had everything in it that you could think of…except one.  One nurse said in horror, “I hope you didn’t put boiled ochra in here again.  I only like friend ochra, not boiled.”  A new cooking concept for me to digest.

     Connie, in helping me pick areas to consider living in, got a wistful look in her eye and said, “Benson.  Ah, you should consider Benson.  That’s the best little town to live in around here.”  I asked her what went on in Benson and it was like a dream that my Irish Leprechaun Father-in-law would have loved.  She explained, “Once a year, they have Mule Pull Day.  You know, they see how far some mules can pull a large weight."  I looked down at my stomach.  

     "Everyone gets dressed up in cowboy hats, boots, and over-all jeans.  Well, my son wears that any way.  I just put a straw cowboy had on him.  They have a rodeo and parades all day.  People come from all over the country.  They have blue grass music and dances at night.  I used to do those dances when I was younger but those days are gone.  And then they vote for Miss Mule Pull.”  An image  was pulled through my mind.  

Favorite Musician/song:

Cat Stevens, "Moonshadow"

    Like Paul McCartney's bass playing, exquisite in it's simplicity and beauty.  1970, Freshman year, surrounded by friends, with all the bright future to come.  Love and peace (aka "The Peace Train").  That's what his songs mean to me.  That alchemist's chemistry when everything comes together and transforms...everything: the voice, the touching lyrics, the melody, rhythms, guitar, bass and drums.  

Favorite Book/author:

The New Yorker  

    I have had 100's stacked up in my closet at different points in my life.  Files filled with my favorite cartoons and articles.  Incredible fiction, dry cartoons, amazing non-fiction that would take me on a journey of discovery and self-forgetting.  I could devour unknown pages and explore the hidden crevices that I had missed at random future times and never be disappointed.  I would always be rewarded with great delight: even the descriptions of new restaurants, the events around town, art exhibits, movies, music…all done with the highest intellectual and aesthetic tone.
    Here is a quote I just found from one of John Updike's collection of essays called Picked-up Pieces He was asked about how he felt being associated with the magazine (he was a Talk of the Town writer  for two years after graduating from Harvard): "…their acceptance of a poem and a story by me in June of 1954 remains the ecstatic breakthrough of my literary life.  Their editorial care, and their gratitude for a piece of work they like, are incomparable.  And I love the format - the signature at the end, everybody the same size, and the battered title type…"

Favorite Movie/DVD:

The Doctor, with William Hurt

     As a physician, I wish every medical student could watch this DVD.  Maybe it is Dr. Schweitzer's idea of the "mark of the wounded" that transforms a doctor into a more caring, compassionate person.  It is a gradual, subtle, sometimes painful transformation.  First the struggle to become knowledgeable with the vast amount of data to learn, and eventually to see beyond that and actually see the patient as a fellow suffering human being.  

June 28, 2014 Saturday "Everything"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 28, 2014 Saturday

Chief Complaint: (written on the chart before I go in the room)

     “everything”

Interesting Name:

     Excess Rice

Anecdote:

     Since I encourage Mothers to get rid of the pacifier at age six months, or by one year at the latest, it goes without saying that I would see some of my patients somewhere outside the office door, just before they came in, sneaking a last long suck on their beloved pacifier like a furtive last forbidden cigarette.  I remember seeing a three year old sucking contentedly on a pacifier, savoring every precious moment, as if it were a deluxe Macanado cigar.  

     As a solo pediatrician, I rarely had even a weekend off.  If I could arrange for coverage for a few days, I would take my family and we would dart off to Boston, treating our four young children to a beautiful hotel for two nights.  It was Heaven.  Once, while we were there for a weekend, we picked a luxurious restaurant at random on up-scale Boyleston Street and walked in for lunch.  

The walls were a deeply polished oak, the whole atmosphere was dark and soothing.  The heavy rounded handrails were of a lustrous brass.  This was not the place for a young family with children to frequent.  As we noisily clammered up the rich velvet carpet to the upper floor, I saw a very attractive blond Mother sedately sitting in the corner of the enormous book-lined room with a cup of coffee in front of her.  We looked at each other and I noticed a small blond head sitting next to her.  After that split second of recognition, she looked down and yelled.  "Tommy, give me that pacifier!  It's Dr. Feole!"  

     It was a year later that Will, now two years old, accompanied his older brother who was sick to the office.  After I examined his brother, I turned to give Will a stamp on his hand (I used these instead of stickers…natural, made of wood, vegetable dye, no paper pollution and nice, artistic stamps…I am a product of the 60's...) and, voila, there it was: THE PACIFIER.  

     His Mother jumped to her feet in mock horror and said, "Oh my gosh!  Will!  Quick.  Get rid of that pacifier.  We're in Dr. Feole's office, remember?"

          Westport, Connecticut, 1987-1998

Poetry:

Windchime

She goes out to hang the windchime
in her nightie and her work boots.
It's six-thirty in the morning
and she's standing on the plastic ice chest
tiptoe to reach the crossbeam of the porch,

windchime in her left hand,
hammer in her right, the nail
gripped tight between her teeth
but nothing happens next because
she's trying to figure out
how to switch #1 with #3.

She must have been standing in the kitchen,
coffee in her hand, asleep,
when she heard it—the wind blowing
through the sound the windchime
wasn't making
because it wasn't there.

No one, including me, especially anymore believes
till death do us part,
but I can see what I would miss in leaving—
the way her ankles go into the work boots
as she stands on the ice chest;
the problem scrunched into her forehead;
the little kissable mouth
with the nail in it. 

        by Tony Hoagland

Coup d'essai:

PART V of XX: Migrant Health Clinic Journal

  My first patient was an eight year old Mexican girl namd Amada Jeda, who spoke no English.  She complained of a stomach ache and some vomiting.  After some careful bilingual detective work, it turned out to be a subtle case of strep throat.  Just testing the new gringo doctor, I guess.  She and her mother were actually very kind.  I gave her a script for penicillin, “tres veces al dies”  (three times a day). (Note my poor Spanish grammar and spelling…I didn't speak much Spanish when I started but learned by listening to my patients and my nurses.)

I went out to the desk later and heard the nurse telling her friend that a “white floor shows every spank of dirt.”

  

The clinic building is only a year old and out the back you can see corn trying to grow in this drought.  The field extends for thousands of feet into the distance.  Everything here extends for thousands of feet into the distance.  Columbus would have had a very hard time proving his theory here.  When I went out to lunch, the very kindly psychologist, an African-American in his late fifties, told me which barbecue pits to avoid and which to go to.  A good one was Joyce’s Corner Store, which was at the corner.  They have seafood on Wednesdays and the whole clinic goes there then.

  

The lab technician is named Mini.  She is Hispanic and very nice.  She just moved here from the Bronx.  Yes, the Bronx.  She keeps asking me if I like it here.  When I say yes, she seems confused and just stares at me.  I finally say, “Don’t you?”  She lets out a sigh and says, “It’s just so hicky.”  I ask her, “Salemburg?”  She says, “No.  All of North Carolina.”  She goes back to her lab.

Favorite Musician/song:

Brian Eno, Music for Airports

     I may have mentioned this, but for a long time I lived without a TV (I still don't have one and my children were raised mostly without one either) or a computer.  I would put on music and then draw, write poetry or compose and record music.  A beautiful life.  One of the songs that I knew would always lead me into a gentle, contemplative and creative state was this CV by Brian Eno.  It stirs the imagination for me and something creative would always happen.

Favorite Book/author:

Catherynne Valente, The Girl Who Circumnavigated Fairyland in a Ship of her Own Making

Superb, playful, a work of such creativity and joyful innocence.  Her word play alone makes me drool - images, names, thoughts that are as delicious as chocolate.  Phenomenal reviews.  A great pleasure.  
“One of the most extraordinary works of fantasy, for adults or children, published so far this century.”—Time magazine.

Favorite Movie/DVD:

Wrestling with Ernest Hemingway

    Robert Duvall, Richard Harris, Shirley MacClaine…nothing more needs to be said.   

June 27, 2014 Friday "Ovid"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 27, 2014 Friday

Chief Complaint: (written on the chart before I go in the room)

     “child is pre-contemplative”  (from a consult report on one of my patients who had a sleep study)

from "Impressions of the Met"

Interesting Name:

     Ovid

Anecdote:

     Christopher was very interested in medicine despite his young age.  He was always very inquisitive and peppered me with questions throughout his exam.  

        Once, as he came out of the bathroom, having left a urine specimen, he asked me, "Dr. Feole, did you shipdick my urine yet?" 

                Westport, Connecticut, 1980's-1998

Poetry:

Going to Bed

I check the locks on the front door
and the side door,
make sure the windows are closed
and the heat dialed down.
I switch off the computer,
turn off the living room lights.

I let in the cats.

Reverently, I unplug the Christmas tree,
leaving Christ and the little animals
in the dark.

The last thing I do
is step out to the back yard
for a quick look at the Milky Way.

The stars are halogen-blue.
The constellations, whose names
I have long since forgotten,
look down anonymously,
and the whole galaxy
is cartwheeling in silence through the night.

Everything seems to be ok. 

      by George Bilgere

Coup d'essai:

"There is some of the same fitness in a man's building his own house that there is in a bird's building his own nest," Thoreau, Walden.

     This makes me think with admiration and sadness about Pete Seeger with his gentle songs of peace ("Where have all the flowers gone") who, with his wife, bought some property in New York State and build a cabin with his own hands, chopping wood for the fireplace.  With all his fame and wealth and notoriety, he did this and lived out his life there with his wife.  Some one was quoted in his obituary that "he was the most accessible famous person I have ever known."

PART IV of XX: Journal from Migrant Health Clinic

       During one of my lost journeys across the barren countryside, I came across this large, plain store with huge red letters painted on the white building, proclaiming, “Wilson’s Store.”  Simple.  As I pulled in, my gas tank below zero, I saw Mr. Wilson walk out.  (He was one of the board members that approved my position at the Migrant Health Clinic, as mentioned yesterday).  He was…well...dusty. He had the same jeans on, with an all-business look, probably about some cow issue.  

       The gas pump was from the 1950’s.  It didn’t take long for me to stop searching for the slot to put my credit card in.  The gauges that showed the amount of gas pumped were on rusty metal wheels and seemed to wheeze as they slowly, reluctantly moved.  No electrons dancing on an easily read LED here.  Everything was coated in dust.  The rust was coated with dust.  I was standing in dust.  The car was coated in dust.  

       I decided to saunter into the store.  It was a huge dimly lit barn-like metal structure with a sloping concrete floor that stretched out to cover this single room.  There seemed to be a couple of large barn door entrances connected to it in the distance, perhaps for tractor repair.  (A sign outside mentioned tractor repair.)  Apparently, you could come here and get gas, buy your chewing tobacco and a loaf of bread, while waiting for them to rotate the tires on your combine.  

      The only lighting was what reluctantly drifted in from the dusty windows.  The same dust motif was in here.  I could see the profile of an elderly gentleman who was in a wheelchair.  He faced his friend, who was the cashier behind a long counter that seemed to be about five feet tall, and dusty.   They both were in their seventies.  He was motionless.  The old farmer behind the register greeted me very kindly with a smile and a thick Southern accent.  I handed him my credit card and he laughed.  “We don’t take those things around here.”  I looked puzzled.  He then said, “We’re just a bunch of farmers around here.  We keep it simple.”  Some time went buy as I let this sink in, my hand still outstretched.  “The owner doesn’t like them.  They complicate things.”  That made sense.  Amen.

Favorite Musician/song:

     Bob Dylan, especially his first two albums.
     Favorite song, "Girl from the North Country"

     What can I say?  I broke my teeth on his early songs.  St. Louis, Missouri, 1964, seventh grade.
Girl from the North Country is painfully beautiful…looking back on a first love, long gone…hauntingly evocative harmonica and vocals… the intricate rhythm of the finger picking…the suggestive 9th cord.  It brings back memories of "the sixties": the sincerity, the questioning of hypocrisy, striving for peace, social commentary of his songs, non-materialism.  His songs touched me and motivated me to make music and philosophical striving a central part of my life.  And this song: I have been playing it for over 50 years and it's magic has not ceased.   

Favorite Book/author:

    Jhumpa Lahiri
         Short stories: "Unaccustomed Earth"  "The Third and Final Continent"

    I have fallen in love with her fiction.  Gentle, perceptive insights of such compassion into the human condition of love.  Uncovering our common fears and doubts, but always with the touch of compassion and redemption.  I reread these stories every few months.  

Favorite Movie/DVD:

     Alamar

     A movie about a boy's return to nature, leaving his Mother in Italy, meeting his Father, a fisherman, in Central America, getting off the plane as his Father gradually peels off most of his son's clothes until he walks around bare chested, in bare feet, living simply and fishing all summer.  A elegiac, lyrical tale of nature and the Father-son bond… with very few words.  An all-time favorite.

June 26, 2014 Thursday "speach therapy"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 26, 2014

Chief Complaint: (written on the chart before I go in the room)

       “Refer to speach therapy.”

Interesting Name:

       Honest U 

Anecdote:

       A typical Christmas story for some of the less fortunate children in Greenwood.  A five year old little girl was here alone, accompanied by a gentle and compassionate woman who works for the local Catholic Charity called Healthy Learners for families in need.  The little girl was dirty, had cavities, was wearing frayed and soiled pajamas and was extremely underweight…all skin and bones.  Her parents’ electricity had just been turned off and she was living with a cousin.  The parents weren’t available.  

      I was told that the kindergarden teacher was worried about ADHD because she was irritable and not paying attention.  We both agreed that it would have been a miracle if she were attentive and had wonderful behavior under these circumstances.  

       She didn’t get any ADHD medicine from me.  Instead, I  ran down the hallway and rummaged in my back office and found a pretty summer dress for her (gifts from family and friends to give out), gave her a large, stuffed Neymo fish (she didn’t know who he was) and an apple.  I started her on some pediasure knowing that Catholic Charities would help with that.  

        It was a good Christmas.  

                December, 2013, South Carolina

Poetry:

Holy Thursday

'Twas on a holy Thursday, their innocent faces clean,

The children walking two and two in red and blue and green:
Grey-headed beadles walked before, with wands as white as snow,
Till into the high dome of Paul's they like Thames waters flow.

O what a multitude they seemed, these flowers of London town!
Seated in companies they sit, with radiance all their own.
The hum of multitudes was there, but multitudes of lambs,
Thousands of little boys and girls raising their innocent hands.

Now like a mighty wind they raise to heaven the voice of song,
Or like harmonious thunderings the seats of heaven among:
Beneath them sit the aged men, wise guardians of the poor.
Then cherish pity, lest you drive an angel from your door.

          William Blake

Coup d'essai:

PART III of XX from Migrant Health Care Journal

I have seen my share of hog farms already in the limited time I’ve been here.  Also, there are all sorts of ‘feed’ farms, from Purina Chow to dog chow to, who knows, hog chow.

During my lunch hour, I attempted to drive back to the main office.  Yes, eighteen miles away.  I admit it was a courageous act on my part.  The roads in this rural part of North Carolina are largely just numbers, and for the third time since my orientation last week, I managed to take an unmarked road and travel for fifteen minutes through unfamiliar winding roads.  All the dilapidated farms and tractors start to look the same to me, as I wrack my brain for any signs of déjà vu.  Was that particular rusted tractor near the uprooted tree trunk by the grazing cows familiar?  One hog farm starts to look like all the others.  A hog farm is a hog farm is a hog farm.  A hog farm by any other name would smell as sweet.  In any case, I finally give up my lost journey, and I have to retrace my steps …which takes another twenty minutes down the same vaguely familiar roads.  

      There is something Dantesque or Quixotic about my repeated lonely quests through the farmlands, searching for my way back home.  Two weeks later, I’ve come to realize my mistake.  After turning from 242 to 421, it’s easy to miss the  right turn.  All you have to do is look for Barefoot’s Florist, then pass the small six by six foot “car demolition” office on the left, then pass Cecil’s foodstore on the right and as soon as you see a small family cemetery on the corner of the next right, TAKE IT.  It is not numbered, and may even say “Easy Street.”  I don’t know, and I don’t want to know.      

I also stopped at Wilson’s Store for some gas.  Some background information: I had sat across from Mr. Wilson at the Board meeting last Thursday where I was introduced and my employment with the clinic confirmed.  He is one of the well-off farmers in the area I was told.  You wouldn’t know it from looking at him.  His face and neck were burnt a deep brown and deeply furrowed from the years he had spent in the sun.  His fingers were thick and gnarled from his life of labor, just as my Italian grandfather’s were.  The nail on his index finger was slightly bent and deformed from some long forgotten farm accident.  It was so incongruous watching him pick up the delicately buttered bread rolls and put them in his mouth with those unwieldy claws.  The rolls looked like little virginal objects next to his dark hands.  He had on the requisite suspenders, made of thin leather strands woven together, and well worn jeans.  This was our board meeting.  He was a man of few words as he occasionally injected a short pithy statement that was full of common sense.  He always hit the nail on the head and this resulted in laughter from the board members.  

Favorite Musician/song:

Bruce Hornesby, all, "Mandolin Rain"

    A favorite of my family as well, with such beauty and nostalgia…I have memories of our young family growing up in Connecticut always surrounded and embraced by such sweet music.   In a recent concert in Richmond his incredible talent and big heart shown through.  

Favorite Book/author:

Updike, John, some of his poetry

    I just haven't read many of his novels although his prose is elegant and his writing perceptive.  I will include a couple of my favorite poems of his soon.

Favorite Movie/DVD:

Air Guitar Nation

    Some comic relief - just the thought makes me laugh.  The main character is so likeable - an Asian American with very soft spoken parents who are in the medical field, with aspirations for him to become a doctor.  He just couldn't help it though with his effervescent personality…he tried but he just had to become a comedian and entertainer.  Awesome air guitar playing as you follow his journey to the world championships.

June 25, 2014 Wednesday "Summer"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 25, 2014 Wednesday

Chief Complaint: (written on the chart before I go in the room)

     “Sore throat and spitting.”

Interesting Name:

     Summer

Anecdote:

     It was a big day for Joey, age three.  He had brought in his "binkies" (pacifiers) to give to me in one fell swoop since it was his third birthday.  He was very attached to these, to say the least.  His Mother pulled out a huge bag filled with his pacifiers and I was beginning to have my doubts about his intentions as I watched him.  
     He looked inside and screamed with delight as he joyfully rummaged through the bag.  He pulled two out and gazed lovingly at them.  One was multicolored and shiny and he greeted it like a long-lost friend.  As he gazed at it, he exclaimed under his breath, "Ahhhh!  Ooooooh!"  He turned it over in his hand a few times and then, like a wine connoisseur, quickly popped it in his mouth and gave it two or three expert sucks, I guess to check the bouquet.
      He then immediately turned his attention to the second pacifier.  He suddenly became subdued as he entered a trancelike state, staring stone faced at the glistening pacifier.  Soft murmuring sounds came from his lips, "Ummmmmm...aaahhhhh."  

Suddenly, he was shocked from his deep reverie as his Mother said, "Now Joey.  You remember how we talked about your binkies.  You're three years old now and you said you would give them away after your birthday.  Say goodbye now."  
     He looked down at the binky and then looked up at me, raised his hand and said, "Goodbye, Dr. Feole."
               Westport, Connecticut, 1990's

Poetry:

The New Song

For some time I thought there was time

and that there would always be time

for what I had a mind to do

and what I could imagine 

going back to and finding it

as I had found it the first time

but by this time I do not know

what I thought when I thought back then

There is no time yet it grows less

there is the sound of rain at night

arriving unknown in the leaves

once without before or after

then I hear the thrush waking

at daybreak singing the new song

                           -W. S. Merwin

                            from The New Yorker, 12/12/2011

Coup d'essai:

"There are only two families in the world: the Haves and the Have-nots," Don Quixote, by Cervantes, Chapter 19.

PART II of XX: from my Migrant Health Clinic Journal

Dr. Prasad, the Indian Medical Director, then elaborated on this unusual, to me, state of affairs (a pig had stepped on the patient's foot). “This happens pretty frequently.  But what happens more frequently is that the workers, in trying to tackle the hog and give it an injection, often miss and stab themselves in the thigh or arm.  They ignore that too and show up here a week or two later with an infection.”  

     He was speaking very nonchalantly, giving me scientific data in his precise Indian accent.  He rolled his eyes slowly to the ceiling as he told me this aspect of routine medical care in the country.  

     After a pause, his eyes lit up and he started talking about his new found love again: golf.  He again looked up at the ceiling, this time wistfully, and said, “Golf.  I wish I could play that game every day."  He had actually bought some clubs for his wife and daughter, but they were resisting mightily.  

     It was funny to observe.  It’s was a reverse theme of the  wonderful movie, East is East, where the Pakistani father, who owns a fish and chip shop in London with his English wife, struggles in vain to get his children to maintain their Pakistani ties.  This in the face of rock music, dating, television, drugs, and sexuality everywhere.  Dr. Prasad, or “Prasad” as his wife calls him (which seemed to indicate a comedic, playful understanding of her Quixotic husband) seemed determined to acclimate his family to an American lifestyle...but his ten year old daughter was already a little too acclimatized: she didn’t want to get off the couch.  Or stop watching TV or playing computer games.  His gift of golf clubs was a personal affront to her.  She will get off the couch, though, to shop at the Raleigh mall.  She’s also expert at shopping through the catalogues and on-line he told me.  

     When they returned to Indian last month, she met her cousins there for the first time.  They were amazed at the amount of American money she carried around.  She further amazed them by buying a large bejeweled Indian jewelry box and subsequently filling it to the brim with her favorite bangles, earrings, and necklaces.  I’m sure they got an eyeful of their rich American cousin.  

     I was about to blurt out, “Do you really want to join the ranks of the mindless T.V. programmed American consumer?” But as I thought this, I happened to glance out the office window to see his brand new, gleaming SUV (or was that his wife’s new SUV?) just staring at me, daring me to say something.  Or daring me not to lust after something similar.  The irony struck me: the wealth this man, himself an immigrant from India, was accumulating with this brand new car, sitting in a dusty, dirty parking lot of a clinic teaming with poor immigrant Latino workers.  I had a lot to learn, and a lot to experience; there would be no easy answers here.

Favorite Musician/song:

     Fleet Foxes, all, especially the CD Sun Giant
     Song: Blue Ridge Mountains

    Delicate rhythms and soft, haunting guitars, his voice the most important and transporting instrument in the band, the intricate harmonies and lyrical songs...pure poetry.
    Among my favorite groups.

Favorite Book/author:

     Don Dellilo, White Noise and End Zone

     Intelligent, perceptive, ironic, humorous, deep.  Incredible books.

Favorite Movie/DVD:

     Whale Rider
 
     I love movies with rural, small town settings, in this case a Maori village in New Zealand.  Add to this the Grandfather/granddaughter relationship and love; and a coming of age, empowering story of this young girl.  I agree with the reviews: "timeless…astonishing…enchanting"

June 24, 2014 Monday "Shabazz"

First Words

      …thoughts of an anachronistic, solo pediatrician

                            by Glenn Feole, M.D.

"Be careful too that the reading of your story makes the melancholy 

        laugh and the merry laugh louder," Cervantes, Prologue to Don Quixote

Contact: ishmaelish36@gmail.com

Blog site: ishmaelish36.blogspot.com

June 24, 2014  Monday

Chief Complaint: (written on the chart before I go in the room)

“Child has the normal daycare cooties.” (ENT consultation)

Interesting Name:

Shabazz

Anecdote:

     Today I am going to start an Twenty Part Series of journal entries from the time I started working at a Migrant Health Clinic in North Carolina in 2002.

PART I: Migrant Health Center Journal

     I worked at Tri County Community Health Center (a Migrant Health Clinic) in the metropolis of Newton Grove, North Carolina from August to December, 2002.   It was my first medical job since sadly leaving my solo practice of eleven years in Westport, Connecticut in 1998.  

     I searched for underserved clinics on the Public Health Service web site and found this one - a Latino migrant clinic in Newton Grove, North Carolina.  I was only there for five months, having left when the director decided to expand the clinic to include private practices in the area.

     After leaving Connecticut, in need of respite, I took some time off and…read.    From Don Quixote to Jane Eyre, Harold Bloom, reams of poetry, hundreds of mysteries and Edgar Award winners, which led me to all 56 works of Lawrence Block, all of Robert Parker and Michael Connelly (my favorite), and then Patricia Cornwell due to my work as a Medical Examiner.  I wrote perhaps five books and worked as a Medical Examiner (I wanted to stimulate my intellect by listening to those most intelligent of doctors, the pathologists) for the warm, fiery and Sherlockian Dr. Fierro in Richmond for one year, writing the Lawrence Block book during that time and working with the free clinic in downtown Richmond sporadically.  At long last, I applied to work at Tri County in 2002.  

      (I lost most of my notes from my time at Tri County except for the first month, and have separate journals from my time in Columbia and then in Greenwood.)

Some names of the Latino patients I had at the clinic:

Jennifer Lopez

Carlos Santana

Nimcy

Innocente

My nurses: Angel and Angela

Azucena

8/26/02:  

     My first day on the job at Tri County Community Health Center in Newton Grove, North Carolina. I’m actually in a satellite office on Mondays and Fridays in Salemburg, called Carolina Pines Community Health Center.  It’s eighteen miles and only four turns from Tri County, and two thousand light years from Westport, Connecticut.  Although its only four turns away from the Mothership, the trick is to find those turns among the unlabeled winding roads.  When I do get lost, there are plenty of opportunities to ask directions.  From cows and horses.  The cars that zip past me at seventy miles an hour don’t seem interested.

     I actually spent last Tuesday at an interview at the North Carolina medical board, and talked with a very warm, sensitive retired woman dermatologist.  We had a wonderful talk and she gave me a temporary license on the spot.  I stayed over night in a run down hotel and started my orientation on Wednesday and Thursday.  I was given a list with about forty names on it and encouraged to go around and meet these people.  They would each give me their take on the situation and protocols, etc.  More on that later.

      Dr. P---, of Indian descent, the medical director, and I were talking near the end of the day when the nurse came in and grimaced. “Mr. Jones is in room two and his toe looks awful.  A pig stepped on it.”

Poetry:

I Swim

late at night

alone 

my guitar rests on the chair

by the pool

thirty years of scratches

         like wrinkles

on my Grandfather’s face

my guitar watches

listens silently and waits

for me

under the dark covering sky

the air warm as a lover’s breath

the moon glows above

a soothing nightlight

in my children’s bedroom 

so long ago

the water a rhythmic caress

the underwater lights as yellow

as the floating moon above

the pool gently sways 

a fluorescent green

that suffuses my soul

        Glenn Feole, 2010

Coup d'essai:   On Writing

"Moreover, I, on my side, require of every writer, first or last, a simple account of his own life, and not merely what he has heard of other men's lives; some such account as he would send to his kindred from a distant land; for if he has lived sincerely, it must have been in a distant land to me," Thoreau, Walden.

Introducing "George Joiner," an artist; a character from a book
I wrote and illustrated. 

    Why do I write?  I feel like Oliver Sacks in many ways - my experiences seem to be deeper and more profound with pen in hand.  I don't go many places without a pencil and an empty journal clutched by my side in anticipation, as my family and friends know so well.  My thoughts and feelings need the sense of the approaching night, craving the passage of time to mellow and age.  Only then the deeper thoughts and feelings, almost imperceptibly, distill to the surface. 

Favorite Musician/song:

The Allman Brothers, "In Memory of Elizabeth Reed"

    The band I was in while I lived in New Jersey in the 1970's was called "Synergy." We played this song and it was one of my favorites.  It would transport me during its long duration, changes and improvisations.  A creative journey for all of us that transported me.  I remember certain fans talking with me about the song; they were like myself - grateful, and silently mesmerized by the lyrical improvisations of the other musicians at this beautiful journey that changed night after night.
    Some background: the keyboardist, Dave, was  pursuing a Masters in classical music at Princeton and could play (and write) anything…from Bach, Mozart to jazz, rock.  A true creative genius and he had the look too - long straggly hair, narrow face, prominent nose, huge teeth clamped on a cigar smack dab in the middle  of his mouth, always crunched down with his constant, incredible smile and sense of humor.  A happy person with his musical passion; a compassionate soul.  To top it off, he had an ancient Rhodes keyboard with it's magical tone that I love.
     The guitarist, Greg, was a gentle, laconic soul, an undergraduate at Princeton who was extremely intelligent.  He was a look-alike for Spock on Star Trek, thin as a rail and unrattle-able at some of the more dicey dives we played at first.  He would practice mixolidian scales for hours every day and had an insatiable interest in music theory.  I awaited his solos with great anticipation, never knowing what eclectic element he would throw in with his great technical skill.  We all got along like brothers as we piled into an old VW van going to gigs around NJ.
     The drummer, Sandy, was an editor at the Princeton University Press and had studied philosophy a few years ahead of me at Princeton.  He once dressed in a large American Flag cape and uniform for an outdoor concert we played…also imperturbable, with a Bob Newhart demeanor.  He was key to the group because…he owned the van.  

Favorite Book/author:

Billy Collins, poet.  All of is books.  I will include some of these poems later.

Favorite Movie/DVD:

The Day of the Jackal, the original

     This was the 1973 version in black and white, starring Edward Fox as the suave, handsome, in control would-be assassin of Charles de Gaulle (the prequel to our current Matt Damon and prior Clint Eastwood).  Suspenseful and beautiful in the simplicity of 1973 film making.