There's often something else in the background. A weird platelet count, a low sodium level, a little anion gap--something that might be easier to ignore than to try to figure out how it fits into the clinical picture. I'm assuming that I'm going to at least notice these annoying details. That is, I'm already assuming that I'm vigilant.
Vigilance makes a doctor good. A good doctor will diagnose the pneumonia and treat it. Curiosity makes a good doctor better. A curious doctor will be driven to figure out why these other lab values are a little off because, it’s true that there could be all sorts of silly explanations for an out-of-range test result, yet the doctor's job is not only to figure out what's not wrong, but also--when the dust settles--what is.
Like any other job, medicine can become routine. The evidence that we have been accumulating on medical and surgical interventions has to some extent standardized our practice. Data have helped to define the 'standards of care' for investigation and management of many diseases. Some of these well-studied diseases for which there is more or less widespread agreement on management include heart attack, heart failure, diabetes, many infections, and certain kinds of trauma, to name a few. The purpose of evidence-based medicine however is not to make the job of the doctor easier nor is it to make sure everyone gets the same treatment just for equality's sake, but rather to apply particular medical decisions that have been shown, hopefully in high-quality experiments, to be effective. The medical community decides that interventions that improve outcomes should become standard because they're better.
The word that doctors use is not 'standard,' though. It's 'guideline.' This is not because doctors think that they're better than everyone else and that rules shouldn't apply to them. Rather it's to make room for judgment because it is impossible to study every intervention in every population of potential patients, and because even effective interventions are rarely effective for every eligible patient. We have therapies that may approach 100% efficacy (eg, penicillin for syphilis), but they are few and even they're not perfect. We think that preventing death in only 1 out of 42 people treated with a beta-blocker for two years after having a heart attack is pretty good. In addition, accepted algorithms for investigating disease will not include every possibility, so the doctor needs to have an index of suspicion for diagnoses that may not be on any algorithm.
So, is this science or art?
Everyone knows that doctors like to say that medicine is as much art as science. My own quibble with this has nothing to do with medicine (nor with art or science for that matter) but rather with the public's perception of these things. The word 'science' evokes--in most people I think--accurate, precise, and reproducible results. But science is nothing more than approximations and arbitrary constants, especially in the practical application of physics, chemistry, and biology. Engineers have to compromise and allow for some inaccuracy and imprecision in their end design ('tolerances') because they have to live in the real world where mathematics has to be a little looser than it is in the classroom.
At its heart, science is built on hypothesis-testing. Who comes up with hypotheses? People. Observant, curious, creative, artistic people. If hypotheses could be generated based on precise formulae then we could just build a science machine and let it figure out the secret to life, the universe, and everything for us. We know how that would turn out.
Science, like art, requires creativity (neither science nor art are sui generis things). I'm not going to pretend that I can define art, but maybe besides creativity it might include some element of perception by an observant person. At its simplest, then, art is a creative person's response to an observation synthesized into some form (canvas, performance, sculpture, music, prose, poetry, speech, hypothesis--whatever). Science is the same thing I think. Isaac Newton observes that an apple falls from a tree. It's fair to say that millions of people have seen this happen before him but he is curious--inspired--enough to design unique and creative experiments to calculate the rate at which it falls. He is finally able to synthesize his data and determine the gravitational constant (which is an estimate). Newton's laws are works of art. Da Vinci's sketches are science.
The doctor is a scientist, but the scientist is an artist and the artist is a curious human. The uncurious doctor is a mediocre one because he is just a human who is happy with what he knows and doesn’t care about what he doesn’t.
Showing posts with label rants. Show all posts
Showing posts with label rants. Show all posts
Thursday, May 28, 2009
Thursday, May 15, 2008
L'homme de 70 kg est mort !
I am the exemplar. I am the specimen in your anatomy atlas, the most deeply understood datum in your pathology textbook, the model to whom the parameters of pharmacology apply the most accurately. I am the standard-issue chassis: medically, humanly--decidedly--average. I am the 70-kg male.
Yet an exhausting week weaving up and down midtown Manhattan clearly leaves me thinking that the 70-kg male is dead--at least economically--in the estimation of clothiers and cobblers. Especially this 70-kg male, searching for a simple white shirt with a french cuff that does not make me look like I'm wearing my daddy's nightshirt for walkies. Or for a light jacket, or a pair of trousers, or even a pair of shoes that actually measure what they portend to measure.
As usual, several things are bothering me at the moment and if you know me, then you know that I wouldn't have it any other way.
The fattest common denominator.
It seems that clothing manufacturers and their retail henchmen are complicit in this plot to systematically disrobe those no longer falling within the nation's ballooning average. Put another way, they are seeking to surreptitiously recreate 'average' in their own bloated overgrown image.
This runs deep. Oh I'll feed you, children. Gargle this mindful of truth-flavored listerine:
The people eat. The people get fat. The people try to buy clothes but oh! now they've moved up a couple of sizes and they feel bad, guilt-stricken by their doctors and ridiculed by bufoons in fat suits. Meanwhile, they are herded into Big & Tall and have to start dressing like Cedric the Entertainer. No, you're not going to like the way you look, I guarantee it.
Oh but here's the hat-trick.
The clothing giants, hand-in-dirty-hand with the food conglomerates, agree to slowly increase the real sizes of their clothes while maintaining their labeled sizes. In essence a medium is now the size of what was previously large and a small is now what used to be medium. And the little guy gets shut out. We, the old mediums, are now sifting through piles of small and extra-small and shopping at Petite Sophisticate which is very gay because the stretch-pants-and-skirt look is not unisex.
Système International d'Unités? Bah and harumph.
It doesn't stop there. Not content with the outerwear and the casual vestments of the commonfolk (sized as they are in an appropriately common and course scale: s, m, l, xl, xxl, xxxl, 4xl, 5xl, and two-seat-minimum), the sartorial serpents are infusing their venom into our all-important standard units.
How else could it be that, despite being a very clear 9.5 on the Brannock device (pictured here), I must purchase Johnston and Murphy's in a size 8.5? Or Kenneth Cole's and Aston Grey's in a size 8? So what if I wasn't going to buy them anyway? I should be able to try on a pair of $350 shoes at the store with confidence as I gather the necessary capital over the next few years.
Why is there so much variability in 30x30 trousers? Some fit perfectly, yet many hang from my frame like wet underpants.
Why is it that the neck of this 70-kg male--an exquisitely empiric 14.5 inches--happens to be the smallest size in production anywhere? Still, there is not a 14.5 shirt that will fit me adequately enough to look presentable. When I am told by the helpful salesman at Thomas Pink that I'd be hard pressed to find 'a man's shirt' in my size without having it tailored, and that--if pressed for time--I should shop in the boys' department, I feel so very small. And little boys don't wear shirts with French cuffs, sir. Cufflinks are a choking hazard.
From the ashes, a gaunt phoenix arises!
I know that I am not the smallest man on Fifth Avenue. I know there are people in the Village who share my travails, who've felt the diminution of standing next to the mother of a prepubescent scamp trying not to cringe at the horrible things t-shirts have stamped on them these days. I've seen these men: skinny, lanky men, wispy even. It is as though our money is stained yet we have no voice.
Brothers!
We must speak as one. Join me now to fight the tyrany of these coddlers of the corpulent, these pamperers of the portly, these indulgers of the inhumanly big! They subserviently change their tallies for the tall and the tubby, and yet they spurn the business of the slim and the slight! We say they can't have it both ways! We say we can no longer be the average when it suits science, while being the extra-small when it suits suits. We can no longer abide the slights of this...this obesity-industrial complex! React! Rebel! Revolt!
Or we could just go for coffee. Either way we can meet for sandwiches at Ben's Deli on 38th and 7th but I can't be out too late (my wife, she worries). Or bring a sack lunch why don't you, we might eat outside if it's nice. And a beverage maybe? Whatever.
Yet an exhausting week weaving up and down midtown Manhattan clearly leaves me thinking that the 70-kg male is dead--at least economically--in the estimation of clothiers and cobblers. Especially this 70-kg male, searching for a simple white shirt with a french cuff that does not make me look like I'm wearing my daddy's nightshirt for walkies. Or for a light jacket, or a pair of trousers, or even a pair of shoes that actually measure what they portend to measure.
As usual, several things are bothering me at the moment and if you know me, then you know that I wouldn't have it any other way.
The fattest common denominator.
It seems that clothing manufacturers and their retail henchmen are complicit in this plot to systematically disrobe those no longer falling within the nation's ballooning average. Put another way, they are seeking to surreptitiously recreate 'average' in their own bloated overgrown image.
This runs deep. Oh I'll feed you, children. Gargle this mindful of truth-flavored listerine:
The people eat. The people get fat. The people try to buy clothes but oh! now they've moved up a couple of sizes and they feel bad, guilt-stricken by their doctors and ridiculed by bufoons in fat suits. Meanwhile, they are herded into Big & Tall and have to start dressing like Cedric the Entertainer. No, you're not going to like the way you look, I guarantee it.
Oh but here's the hat-trick.
The clothing giants, hand-in-dirty-hand with the food conglomerates, agree to slowly increase the real sizes of their clothes while maintaining their labeled sizes. In essence a medium is now the size of what was previously large and a small is now what used to be medium. And the little guy gets shut out. We, the old mediums, are now sifting through piles of small and extra-small and shopping at Petite Sophisticate which is very gay because the stretch-pants-and-skirt look is not unisex.
Système International d'Unités? Bah and harumph.
It doesn't stop there. Not content with the outerwear and the casual vestments of the commonfolk (sized as they are in an appropriately common and course scale: s, m, l, xl, xxl, xxxl, 4xl, 5xl, and two-seat-minimum), the sartorial serpents are infusing their venom into our all-important standard units.
How else could it be that, despite being a very clear 9.5 on the Brannock device (pictured here), I must purchase Johnston and Murphy's in a size 8.5? Or Kenneth Cole's and Aston Grey's in a size 8? So what if I wasn't going to buy them anyway? I should be able to try on a pair of $350 shoes at the store with confidence as I gather the necessary capital over the next few years.
Why is there so much variability in 30x30 trousers? Some fit perfectly, yet many hang from my frame like wet underpants.
Why is it that the neck of this 70-kg male--an exquisitely empiric 14.5 inches--happens to be the smallest size in production anywhere? Still, there is not a 14.5 shirt that will fit me adequately enough to look presentable. When I am told by the helpful salesman at Thomas Pink that I'd be hard pressed to find 'a man's shirt' in my size without having it tailored, and that--if pressed for time--I should shop in the boys' department, I feel so very small. And little boys don't wear shirts with French cuffs, sir. Cufflinks are a choking hazard.
From the ashes, a gaunt phoenix arises!
I know that I am not the smallest man on Fifth Avenue. I know there are people in the Village who share my travails, who've felt the diminution of standing next to the mother of a prepubescent scamp trying not to cringe at the horrible things t-shirts have stamped on them these days. I've seen these men: skinny, lanky men, wispy even. It is as though our money is stained yet we have no voice.
Brothers!
We must speak as one. Join me now to fight the tyrany of these coddlers of the corpulent, these pamperers of the portly, these indulgers of the inhumanly big! They subserviently change their tallies for the tall and the tubby, and yet they spurn the business of the slim and the slight! We say they can't have it both ways! We say we can no longer be the average when it suits science, while being the extra-small when it suits suits. We can no longer abide the slights of this...this obesity-industrial complex! React! Rebel! Revolt!
Or we could just go for coffee. Either way we can meet for sandwiches at Ben's Deli on 38th and 7th but I can't be out too late (my wife, she worries). Or bring a sack lunch why don't you, we might eat outside if it's nice. And a beverage maybe? Whatever.
Sunday, November 11, 2007
Viva la Revolución Antiséptica!
I've written at length, though never coherently,* about the mockery we make of curbing the spread of nosocomial infections by insisting on wearing ties. Fie upon the tie et cetera.
Anyway, ties are only the beginning of my usually pointless griping. The original idea for my anti-sartorial campaign came in the cliched form of a dream. Actually, it was a nightmare, but it wasn't as scary as it was boring and horribly written and shot. The director was probably asleep during filming. Suffice it to say that the talentless protagonist (through whose eyes this farce was depicted) was being interviewed at a prestigious teaching hospital for a residency position and was not clothed in the complete and traditional interview getup.
Namely, he was missing a tie. But also a jacket, a shirt, and pants. And he was unshaven and crusty-eyed. I mean, he had all of these things with him but he was holding them in his hands as if to say, 'I have no use for these! Ask me your questions, sir, and do not mind the hole in my boxers, for I am confident that you will find me to be nothing less than professional.'
Interpret this however you want, but I take it to mean that something must be done about clothing. Obviously, given the popularity of sculpture, nude photography, and sex and pornography, I am right. Don't argue with me, for I can weave a straightjacket of syllogisms around you faster than you can say 'that doesn't make any sense, you idiot.' And it's true, I am an idiot, I should know.
The point is that in addition to banning the necktie in the hospital we must also ban sleeves, white coats, and pants. Every time a tie, shirtsleeve, or pant leg brushes over some germy metropolis on one person's backside, it takes some of those citizens on a ride to the next person's face and, of course, the physician's lunch and no amount of hand sanitizer or handwashing will address the domino effect of cross-contamination. What we need is leadership on this issue. What we need is a Truman Doctrine--a Marshall Plan if you will--for the containment of microbial evil. While I'm no leader, I will gladly take up my position as behind-the-scenes pragmatist and insidious instigator of antimicrobial attrition and realpolitik. A neurotic germophobic George Kennan if you will (and if you won't).
We must therefore institute funding for an armory consisting of the weapons necessary for this war--for make no mistake, that is what this is comrades and we must not shirk our responsibilities! What this plan amounts to is the distribution of scissors to a contingent of able-fingered guerilla housestaff who will use them to carry out lightning raids, cutting dangling bits of clothing not closely adherent to the bodies of caregivers in the hospital. These soldiers of sanitation will fly by nursing stations snipping off germ-dinghies and bacteria-boats as they swarm, bringing back the sleeveless look from the outskirts of fashion onto the catwalk of the clinically responsible.
We must then fortify our offensive with daring propaganda. This is no time for bashfulness comrades, for the revolution cannot wait. Our message must be clear and strong:
* On a parenthetical lever, I don't want to give you the wrong impression. This post will certainly not be coherent either. Homie don't 'play that' and he's n't about t' start today. D' n't question m' use of the apostrophe. It's ours to dispense with as we each please. I don't come to your house and tell you not to end sentences with a preposition.
Anyway, ties are only the beginning of my usually pointless griping. The original idea for my anti-sartorial campaign came in the cliched form of a dream. Actually, it was a nightmare, but it wasn't as scary as it was boring and horribly written and shot. The director was probably asleep during filming. Suffice it to say that the talentless protagonist (through whose eyes this farce was depicted) was being interviewed at a prestigious teaching hospital for a residency position and was not clothed in the complete and traditional interview getup.
Namely, he was missing a tie. But also a jacket, a shirt, and pants. And he was unshaven and crusty-eyed. I mean, he had all of these things with him but he was holding them in his hands as if to say, 'I have no use for these! Ask me your questions, sir, and do not mind the hole in my boxers, for I am confident that you will find me to be nothing less than professional.'
Interpret this however you want, but I take it to mean that something must be done about clothing. Obviously, given the popularity of sculpture, nude photography, and sex and pornography, I am right. Don't argue with me, for I can weave a straightjacket of syllogisms around you faster than you can say 'that doesn't make any sense, you idiot.' And it's true, I am an idiot, I should know.
The point is that in addition to banning the necktie in the hospital we must also ban sleeves, white coats, and pants. Every time a tie, shirtsleeve, or pant leg brushes over some germy metropolis on one person's backside, it takes some of those citizens on a ride to the next person's face and, of course, the physician's lunch and no amount of hand sanitizer or handwashing will address the domino effect of cross-contamination. What we need is leadership on this issue. What we need is a Truman Doctrine--a Marshall Plan if you will--for the containment of microbial evil. While I'm no leader, I will gladly take up my position as behind-the-scenes pragmatist and insidious instigator of antimicrobial attrition and realpolitik. A neurotic germophobic George Kennan if you will (and if you won't).
We must therefore institute funding for an armory consisting of the weapons necessary for this war--for make no mistake, that is what this is comrades and we must not shirk our responsibilities! What this plan amounts to is the distribution of scissors to a contingent of able-fingered guerilla housestaff who will use them to carry out lightning raids, cutting dangling bits of clothing not closely adherent to the bodies of caregivers in the hospital. These soldiers of sanitation will fly by nursing stations snipping off germ-dinghies and bacteria-boats as they swarm, bringing back the sleeveless look from the outskirts of fashion onto the catwalk of the clinically responsible.
We must then fortify our offensive with daring propaganda. This is no time for bashfulness comrades, for the revolution cannot wait. Our message must be clear and strong:
The noose of the enemy chokes you! Off with your tie!
Cut off support to the enemy of the people! Cut off your sleeves!
Pants are the haven of the antisocialite germ! Remove them from our midst!
May the sounds of steel kisses and flying fabric resonate in the halls of healing! Viva la Revolución Antiséptica!
* On a parenthetical lever, I don't want to give you the wrong impression. This post will certainly not be coherent either. Homie don't 'play that' and he's n't about t' start today. D' n't question m' use of the apostrophe. It's ours to dispense with as we each please. I don't come to your house and tell you not to end sentences with a preposition.
Saturday, September 29, 2007
Goethe and the proverbial substance
In its finality, the cul-de-sac of knowledge impresses those who've been disappointed by education as the mode and mark of social evolution. It is where, in order to learn more (that is, to drive through the proverbial living room of the proverbial house at the end of the cul-de-sac and out into the backyard and through the proverbial fence and into the darkness beyond, perhaps into a ditch or ravine of some sort where we might meet an early but satisfying proverbial death), we must peer over our shoulders at what we learned before we turned into the cul-de-sac o'proverbs after we bought 'cigarettes' at the proverbial corner store when the (proverbial) man said something kind of profound but not so much really because he was selling cigarettes at a corner store and of course every once in a while he'll say something that's not completely bereft of substance as he exhales. That sort of thing makes me feel warm inside.
That reminds me of the time when Goethe and I were camping in a totally appropriate male-bonding sort of way, making 'smores and conversation and dispensing wisdom and recyclables (and recyclable wisdom) across arcades of sparks and embers. He was sugar-high and said something like--and I am translating his medieval German--'Yo Cauliflower, monkey library Simon as scallops handbanana cheek absolute yellowcake* sportyshine leaf-faucet National Public Radio fork.' I'm paraphrasing; my medieval German isn't as superbly excellent as my English.
My memory does fail me at times, but this time I am fairly certain that what G-Tonez was trying to tell me was that we must reflect upon our past if we are to avoid living hand to mouth. To me this just sounds like an elitist assault on the decent hard-working hunter-gatherers in society, especially the ones who have amnesia. But even though he probably meant collective and mostly scientific memory--the (proverbial) shoulders upon which we stand before we can advance as a species--social memory is no exception, I think.
The problem is that memory does fail, and social memory is no exception. One might say that, because of the sheer noise involved in the laying down of memories on a social scale, it is impossible to nuance them with those subtle (and essential) features that temper the imagination and tame the reflexes. Indeed some social memories occupy such an inflamed corner in our collective mind that even accessing those memories tends to lead to wildly impulsive, base, even animal responses. Case in point: September 11, 2001. Despite it not being the first nor the worst event of its kind, our self-proclaimed keepers of the social memory (journalists, politicians) have wrapped us so tightly and rigidly in the inflamed axons of its memory that to move one way or another, to reach into our pockets for nuance, becomes impossible at least as part of the mainstream discourse.
Whenever I use words such as 'mainstream' and 'discourse' I know that I've gone too far and need to shut up.
* I would like to stay off the no-fly list, please, because I have places to go from time to time.
That reminds me of the time when Goethe and I were camping in a totally appropriate male-bonding sort of way, making 'smores and conversation and dispensing wisdom and recyclables (and recyclable wisdom) across arcades of sparks and embers. He was sugar-high and said something like--and I am translating his medieval German--'Yo Cauliflower, monkey library Simon as scallops handbanana cheek absolute yellowcake* sportyshine leaf-faucet National Public Radio fork.' I'm paraphrasing; my medieval German isn't as superbly excellent as my English.
My memory does fail me at times, but this time I am fairly certain that what G-Tonez was trying to tell me was that we must reflect upon our past if we are to avoid living hand to mouth. To me this just sounds like an elitist assault on the decent hard-working hunter-gatherers in society, especially the ones who have amnesia. But even though he probably meant collective and mostly scientific memory--the (proverbial) shoulders upon which we stand before we can advance as a species--social memory is no exception, I think.
The problem is that memory does fail, and social memory is no exception. One might say that, because of the sheer noise involved in the laying down of memories on a social scale, it is impossible to nuance them with those subtle (and essential) features that temper the imagination and tame the reflexes. Indeed some social memories occupy such an inflamed corner in our collective mind that even accessing those memories tends to lead to wildly impulsive, base, even animal responses. Case in point: September 11, 2001. Despite it not being the first nor the worst event of its kind, our self-proclaimed keepers of the social memory (journalists, politicians) have wrapped us so tightly and rigidly in the inflamed axons of its memory that to move one way or another, to reach into our pockets for nuance, becomes impossible at least as part of the mainstream discourse.
Whenever I use words such as 'mainstream' and 'discourse' I know that I've gone too far and need to shut up.
* I would like to stay off the no-fly list, please, because I have places to go from time to time.
Tuesday, August 7, 2007
Emotional meteorology
Warning: This post contains brain violence and emotional nudity. Also, it is ridiculous.
Last night, I was taking a mercury bath and had a thought, maybe. I don't remember. But I guess what I'm trying to say is that I wish I knew how to talk good about my feelings. Like, I want to be able to go from feeling a feeling, to noticing that I am feeling it, to figuring out what feeling it is, to deciding whether or not I like feeling the feeling, to being able to make the words with my brain that would stick to the feeling and make it so that when someone asks me what I'm feeling I can say something that makes sense like, 'hungry' or, 'my heart hurts because I missed the Golden Girls on the TV box.'
That was a bad example. I should come up with a point before bringing forth the examples.
See, I wish I knew how to make points. They told me in school that it was like whittling an arrowhead from a piece of obsidian. Not a big clumpy piece like one you would find buried in a river bed but the nice flat smooth pieces you find in cowboy skeletons that were once part of the circle of life on ocean floors 50 hundred million years ago.* Case in point: I was having a conversation on (in?) the subway and a dude came up to me and told me to get to the point. It was none of his business, so I was like, 'why don't you get to the point?' Really. I wasn't talking to him or to anyone in that car so it was none of any of their businesses. I was having a great conversation nevertheless. Mobile phones don't work in (on?) the subway.
So I gave him the old Garrison Keillor, 'No, no, it's a different story, about a pontoon boat.' And then my studio audience laughed. With me, not at me. 'Ha ha' and not 'hee hee,' as it were.
So to get back to what I was talking about before: some people have what those same people like to call 'emotional intelligence.' As far as I can tell, it's like the force, except it is missing some forcey things the most lamentable of which are levitation and deadly (but peace-loving) skill with a hybrid light saber.
Sometimes I wish I were able to identify the things that I know I must be feeling and to describe them in the same way that I can describe other things that I like such as juice. (Oh my gosh have you had it? It's delicious.) People who have this emotional intelligence feature are ever-aware of their own emotional climate--and they can sense the emotional meteorology of others.
Even though it sounds like a load of goat cud, I wanted to raise my 'emotional IQ,' as it were. One of my good friends claims that he is one of these feeling Jedis. Let's call him 'Linda.' I thought that, since I've been calling him by a girl's name, this might have something to do with why he's so good at keeping in touch with himself. (Don't even.)
So for two weeks, he called me 'Janet' at my request. We would go out for sushi, and I'd say, 'Hey Linda, pass the wasabi.' Then he'd say, 'Janet, I think you're being passive aggressive.'
'Can you shut up and grab me that white tuna** from the conveyor belt? You always get the good seat you bastard, where you get to see what's coming upstream while I have to keep asking you to feed me like a fessacchione. Ooh, wait, is that a $4.00 plate? Forget it. By the way, that's active aggression, right? How'm I doing? Good?'
I guess what I'm trying to say is that I wish I had wider shoulders so that I could wear a double-breasted pea coat without people thinking that Manute Bol had an albino midget son with a homeostasis problem.
* Note: this is not true at all.
** My second favorite variety of sushi in the world, after eel kabayaki nigiri.
Last night, I was taking a mercury bath and had a thought, maybe. I don't remember. But I guess what I'm trying to say is that I wish I knew how to talk good about my feelings. Like, I want to be able to go from feeling a feeling, to noticing that I am feeling it, to figuring out what feeling it is, to deciding whether or not I like feeling the feeling, to being able to make the words with my brain that would stick to the feeling and make it so that when someone asks me what I'm feeling I can say something that makes sense like, 'hungry' or, 'my heart hurts because I missed the Golden Girls on the TV box.'
That was a bad example. I should come up with a point before bringing forth the examples.
See, I wish I knew how to make points. They told me in school that it was like whittling an arrowhead from a piece of obsidian. Not a big clumpy piece like one you would find buried in a river bed but the nice flat smooth pieces you find in cowboy skeletons that were once part of the circle of life on ocean floors 50 hundred million years ago.* Case in point: I was having a conversation on (in?) the subway and a dude came up to me and told me to get to the point. It was none of his business, so I was like, 'why don't you get to the point?' Really. I wasn't talking to him or to anyone in that car so it was none of any of their businesses. I was having a great conversation nevertheless. Mobile phones don't work in (on?) the subway.
So I gave him the old Garrison Keillor, 'No, no, it's a different story, about a pontoon boat.' And then my studio audience laughed. With me, not at me. 'Ha ha' and not 'hee hee,' as it were.
So to get back to what I was talking about before: some people have what those same people like to call 'emotional intelligence.' As far as I can tell, it's like the force, except it is missing some forcey things the most lamentable of which are levitation and deadly (but peace-loving) skill with a hybrid light saber.
Sometimes I wish I were able to identify the things that I know I must be feeling and to describe them in the same way that I can describe other things that I like such as juice. (Oh my gosh have you had it? It's delicious.) People who have this emotional intelligence feature are ever-aware of their own emotional climate--and they can sense the emotional meteorology of others.
Even though it sounds like a load of goat cud, I wanted to raise my 'emotional IQ,' as it were. One of my good friends claims that he is one of these feeling Jedis. Let's call him 'Linda.' I thought that, since I've been calling him by a girl's name, this might have something to do with why he's so good at keeping in touch with himself. (Don't even.)
So for two weeks, he called me 'Janet' at my request. We would go out for sushi, and I'd say, 'Hey Linda, pass the wasabi.' Then he'd say, 'Janet, I think you're being passive aggressive.'
'Can you shut up and grab me that white tuna** from the conveyor belt? You always get the good seat you bastard, where you get to see what's coming upstream while I have to keep asking you to feed me like a fessacchione. Ooh, wait, is that a $4.00 plate? Forget it. By the way, that's active aggression, right? How'm I doing? Good?'
I guess what I'm trying to say is that I wish I had wider shoulders so that I could wear a double-breasted pea coat without people thinking that Manute Bol had an albino midget son with a homeostasis problem.
* Note: this is not true at all.
** My second favorite variety of sushi in the world, after eel kabayaki nigiri.
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