There was a long period where, when people would ask me the question along the lines of "What exactly do you think your problem is, anyway?", I would reply: "I listened to too many Beatles songs as a kid." This was less than half in jest. I stopped expressing this theory some years ago, not so much because it seemed less valid, but more just because no one younger than me had much idea what Beatles songs were (and, inexplicably, there seemed to be more and more of these people younger than me every year.)

By "Beatles songs" I was not referring to fine later mind-expanding compositions such as Polythene Pam, I Am The Walrus, and Fixing A Hole. I was talking more about the earlier [sappier] classics like All My Loving, If I Fell, and I Don't Want To Spoil The Party. (Seriously, this is what I was avidly listening to in my pre-teen years-- that, and REO Speedwagon, which probably didn't help.)

So I was intrigued by a theory espoused by the protagonist of High Fidelity, the latest novel loaned to me by Stay (the source of most of my reading material). On page 24, Rob expresses his impression that listening to Neil Young, The Smiths, John Prine, et. al., as he did, would inevitably leave a person "bruised somewhere". "How," he asks, "can that not turn you into the sort of person liable to break into little bits when your first love goes all wrong?"

On page 25, he expands: "People worry about kids playing with guns, and teenagers watching violent videos; we are scared that some sort of culture of violence will take them over. Nobody worries about kids listening to thousands-- literally thousands-- of songs about broken hearts and rejection and pain and misery and loss. The unhappiest people I know, romantically speaking, are the ones who like pop music the most; and I don't know whether pop music has caused this unhappiness, but I do know that they've been listening to the sad songs longer than they've been living the unhappy lives."

Interesting idea. My parents, like most good parents, were fairly protective of us kids in terms of keeping us (largely) from alcohol, cigarettes, guns, drugs, etc. But the Beatles albums (and the Peter Paul & Mary! And even the Johnny Cash, for chrissake!) were right there on the shelf in the living room, easily within reach of any seven-year-old. Should they have been locked up with the liquor?? Has the child psychiatry community ever weighed in on this?

Luckily, I don't think kids listen to this kind of stuff these days, even if they can get their hands on it (which isn't easy, since the Beatles opus is still not available on iTunes-- don't get me started on that.) They listen to much safer stuff about gangs and violence and crack and booty. Stuff that will never make them sad. For me, though-- and probably countless other children of the 1960's and 70's-- it's been a bit of a struggle back from the brink of excessive sentimentalism.

P.S. In case you're wondering, my favorite Beatles' song of all is I Will.

Green Acres - Today's Plan

Heard in team meeting today:

"I am the #3 Engineer brain in the world. First I will poison the water supply of [nearby small city]. Then I will be building a dozen shipyards. After that I will be joining together Alaska, Cuba, Israel, and North Korea, then dividing them in half, and we will bring back slavery using castrated A-rabs. I am the Absolute Master."

Where I Am

Okay, I was going to write this post, but I'm not sure I either want to or can. Maybe I will at some point. But for now, I just summarize with the words of the Canadian folk singer:

"...Though his dreams have lost some grandeur coming true / there'll be new dreams, maybe better dreams, and plenty..."

[Yes, I can get all sappy for sure, especially when the Canadian folk singers get cued up on the iPod.)

Motivational Posters Of Green Acres, Part VI

There's a new motivational poster on the ward at Green Acres since my last visit. Here it is:

The small-print caption reads: "Whatever the mind can conceive and believe, it can achieve."
Well. This may be true, or if not true then at least a useful falsehood, for the majority of the population. But I am not sure who thought it was a good idea to frame this poster and put it up on a unit that is often chock-full of very ill individuals with bizarre and grandiose delusions. I can tell you with certainty that many, many of the ideas conceived and believed here at Green Acres absolutely CANNOT be achieved, and furthermore SHOULD not be achieved even if they could be. I spend a lot of my time here trying to convince people that they really shouldn't follow through with their plans of trying to become the first King of the United States, or take over the world's oil markets, or build the first amphibious spaceship in order to impress the ex-wife and win her back. It really wouldn't help if they all start telling me that the posters are urging them to pursue their ideas, no matter what. Luckily, though, I seem to be the only person in the building who reads, or even notices, the motivational posters.

Where I Thought I'd Be

17 years ago, when I started medical school, I had a vision of how things were going to be 17 years later. I was going to become a family doc and have a practice somewhere rural, probably northern New England, but maybe out west. I would see people for their boils and diabetes and broken bones, and they would pay me with wadded-up twenties or rhubarb or car repairs. I would be married to a brilliant, attractive woman—probably also a city transplant— and we would have a couple of kids.

We would live in a fabulous old farmhouse on about 50 acres. Almost certainly the house would be Greek revival style, with ancient wooden columns out front. The columns and trim would be white, the paint would be ever-so-slightly peeling. The rest of the house might be yellow. There would be meadows, a swimming pond, perennial gardens, apple trees, and an old elm with a tire swing. In the summer there would be bottomless lemonade, and we could watch the fireflies for hours on end after sunset. There would often be the smell of newly-mown grass, mixed just slightly with a whiff of lawnmower gas. I’m not sure who I envisioned would do all the mowing—certainly it wasn’t me, or my beautiful wife. Maybe there was a young handy-man type guy who lived above the barn in exchange for doing fix-it jobs. Did I mention the barn? There’s a barn, too.

In spite of being a small-town doc, I would at some point have continued to pursue my interests in anthropology and international health, through which I would have made many fascinating friends in foreign countries. With these friends we would keep up a lively correspondence, somewhat by email but largely by actual written letters sent on those gossamer light-blue fold-on-themselves airmail papers. These international friends would not be ultra-famous (no Nobel laureates, for example, at least at first) but they would be prominent in their fields—assistant directors of healthcare NGO’s, that sort of thing—and so they would often travel to the States for conferences etc. When they were in Major Metropolitan Area delivering a speech at Harvard, they would invariably tack on a couple days to their trip and detour up to relax at our place in the country. They would bring us news of developments in Africa and Asia, and we would feed them organic mustard greens and watch them doze away their stresses on the pond raft in the sun. At night we would drink a lot of wine and debate things and reminisce about how we all met years ago in that café in Tanzania or Florence. They would leave refreshed and reinvigorated for their important work; they would send thank-you notes from Bhutan.

The kids would be happy and they would play in the pond catching frogs, or building igloos, depending on the season. We would rarely have to drive them twenty miles to soccer practice or ballet or any such thing, because they’d rather build tree-forts or study butterflies. Then, in the summer, we’d take in a kid from the Fresh Air Fund, and they would become life-long friends with our kids.

We would watch the seasons change, and now and then take on a new project, but somehow we would escape the temptation to become preoccupied with fixing things or remodeling things. I would go to work but never get exhausted. I’d have medical students who would come for summers and they would think I was the best doctor they’d ever met. After a few years of observations I would build some cairns across the meadow to indicate where the sun would set at the solstices and equinox. Eventually I would write a book about it all.

That’s what I had in mind. Next post (maybe): Where I actually am.

Percentages

At Green Acres this week, and next, pinch-hitting. It makes me a little grouchy. I gave a little thought to the various contributing factors, and have tried to assign relative percentages:

The 118 mile round-trip commute: 9%
The 5:20am alarm clock: 12%
Using a Windows machine all day: 21%
Problems that have no solution, yet continue to consume many people-hours of discussion, even after seven years: 18%
The lack of a place for staff to buy some lunch: 11%
The "prison-style" toilets and sinks, even in the staff bathrooms: 5%
False fire alarms: 6%
The one or two patients, at any given time, who have the potential to loosen my teeth or break my neck: 17%
All the rest of the patients: 3%

Hmm. Does that add up to more than 100%? Well, that's how the math works at Green Acres.

CSSLSIMH

Canadian singer-songwriter lyrics stuck in my head, this week:

"It was then that I knew that I knew that I'd had enough
Burned my credit card for fuel
Headed out to where the pavement turns to sand
With a one-way ticket to the land of truth
And my suitcase in my hand
How I lost my friends I still don't understand."