Recommended doc for autistic family and friends: "Dad's in Heaven with Nixon"

The title's as odd and perplexing as the complex family portrait that plays out from simple summers in South Hampton to the eventual diagnosis of autism in one of its youngest.

When I recorded the documentary (airing on Showtime) it was described as "A woman ensures that her autistic young son will become an independent adult."  Well, only someone with a particular interest in the subject is likely to respond to this.  Let's just say I do a lot of reading on the subject because of some of my own relationships.

But the fact is, and I don't mean this as an insult, the film's main subject (Christopher Murray) is the closest thing to Forrest Gump as I've ever seen; hell, the entire film is a love letter from his brother Tom. 

Sure there's early misunderstanding of Chris' condition --- autism is relatively new to the medical vernacular, after all --- but his seeming limitations end up translating the world into an artful, beautiful place of blue skies, puffy clouds and sturdy buildings.

And some freakin' impressive celebrity fans!

Seriously, you can't believe who pops up in there. There's a better description of the documentary written by a random IMDB contributor. It still doesn't quite capture all that happens in the brief hour and twenty-five minutes, but it ain't bad.

Read IMDB's more robust plot summary.

There's also a fan page on Facebook if you want to "like" the movie. While the caliber of the actual film may not be on par with a true Hanks/Zemeckis team-up, it'll definitely lift your spirits and remind you to appreciate the simplicity of life and family.

And to be frank, it almost makes you wish you could borrow that autistic lens to look at the world every now and then.

Kay Redfield Jamison risked everything to talk about her mental illness

I discovered Kay Redfield Jamison during a voracious consumption of memoirs in 2009.  I undertook most of the memoir readings as both examples and support once I made the decision to write my own medical narrative.

Although I myself do not suffer from any discrete mental illness, due to circumstance I've always taken a strong interest in issues of the mind.

And so, the title of her first memoir grabbed me and I plunked down my credit card eagerly, only to return a week later and purchase her follow-up that chronicles the grief of losing a spouse.  It's certainly on par with Joan Didion's "The Year of Magical Thinking," with an acknowledged dash of crazy mixed in.

As it turns out, "An Unquiet Mind" was Kay's own poetic speak for bi-polar disorder. But the soul-baring confessions of her manic depression nearly overshadowed the most shocking part --- her professional credentials:

Kay Redfield Jamison
Professor of Psychiatry
Co-Director Mood Disorders Center
The Johns Hopkins Hospital
John Hopkins School of Medicine

There are some truly awe-inspiring interviews with Dr. Jamison available throughout the online universe (video and audio). I would like to recommend this one as an introduction because I think it covers some pretty major territories in 25 minutes or less.
Listen for free.

I'd also like to take a moment to commend her for her courage in speaking so frankly about her extremely private life as a way of helping other people. Personally, I plan to focus many of my own confessions on medicine's other dirty little secret --- pain. 

But believe me, there are infractions aplenty on my own medical rap sheet (thereby germinating a book).  And it's thanks to people like Montel, Michael J. and Kay that it's a lot less scary to tell it.

I don't like babies, but I love "Babies"

The newly released documentary chronicles a year in the lives of four babies (from birth canal to first steps). It's a wonderful observation on the universality of human development and behavior, posed poignantly against the diversity in our cultures. 

Read the "Entertainment Weekly" summary and review for more.

Basically, it amounts to 87 minutes of no narration, little dialogue and very occasional musical editorialization. I could hear impatient conversation from the audience at times, sandwiched between the many ooh's and aww's. Although everyone thoroughly enjoyed it, I'm not sure American audiences really know what to do with that much reality.

The first part of the movie, you know when the baby arrives, was slightly off-putting. And I probably would have been more comfortable in "A Nightmare on Elm Street" than with the breastfeeding scenes. Having said that, I think the effort involved in birth and rearing might be exactly what inspires those who procreate to have such an entitled attitude. At least in my neck o' the woods.

Not that I'm against parenthood as a choice, but keep in mind that it is your choice, so keep that snot away from me!

While we're on the subject, you may notice how the overbearing spoilage manifests in developing little personalities. I found myself most attracted to the Mongolian approach to raising a baby. Just tie him up close by and he'll be all right. Let the cows walk on him and big brother beat him up a little; gets him ready for the real world.

American audiences are sure to be shocked at times, but take one step outside the red-white-and-blue box and remember that not everyone on the planet lives the way we do. Some don't even have movie theaters!

Regardless, babies have been surviving just fine for millenia. And yes, there are plenty of bodily fluids, germs and genitalia for your dollar. But the most entertaining --- and cringeworthy --- moments involve siblings and animals. And babies.

If you're into that sort of thing.

Let Bret Michaels be your guide --- even the most modern medicine can be clueless

It's times like these that everyone should take a moment to consider exactly how little we know. 

Since 1996 a very close friend of mine has often confided her intense fear of a brain aneurysm. Still in my mid-20s, I couldn't understand how she could have cultivated such a medically random fear.

But 15 years later I'm shocked at how often I've learned of people with unexpected death or disability due to brain bleed. Sometimes explicable, most times not.

The sheer amount of speculation in Bret's case is key. Surprisingly, the words "Aqua Net" have yet to come up. However, I've read multiple stories questioning whether that curtain falling on his face last year caused his brain hemorrhage. That's not where I'd put my dollar, but at this point even his treating physicians would have a hard time placing any bets.

Read a neurology article intended for general public.

In Ron McLarty's novel "The Memory of Running," the narrating character has an exchange with a physician in intensive care after his father's car accident has caused a head trauma. The father, who was in excellent shape, was severly compromised and quickly succumbed due to the leakage of this life-sustaining substance into his head.

"Blood is one of the most toxic entities known. When it gets out of the old veins, well ..."

"I didn't realize that," responds Smithson Ide.

Did you?

Are physical therapists the hot new characters?

More than one film of the blockbuster summer season are centered a around a physical therapist (PT).  "Mother and Child"  --- set to release May 7 --- features one played by Annette Benning, and packs a powerful cast with a lotta backstory, But the title holds the bigger clue as to what the film is really about.

A week later though, in "Just Wright", Queen Latifah plays a physical therapist who falls for an injured NBA player she's helping rehabilitate. Her story is billed as a "PG-rated romantic sports comedy." In other words, does the vulnerable but swagger-rich basketball star fall for the vapid groupie or the confident caregiver? 

Although PTs are located quite a few pay grades below sports medicine docs and surgeons, they're usually the ones who spend the most time with the patient. And relatively intimate time when you think about it. 

There's lots of talking and touching; it certainly takes a special type of person to encourage someone back from an injury, stroke or accident. Someone who's both physically and emotionally strong but with an extensive knowledge of the human body and all its tiny components.

Guess there's a reason why "therapist" is still part of their job title.

Pathology of 80s headbanging; Slayer frontman Tom Araya gets neck fused, warns fans

After a back surgery forced him to cancel tour dates in 2009, but didn't put an end to his pain, Tom Araya decided to go back under the knife and have a fusion in his cervical (neck) region in 2010.  

Listen to his first post-operative interview.

The interviewers ask silly questions about drugs, metal plates and airport screeners. Too bad they didn't bother to learn about the cadaver bone that's usually part of this excruciatingly painful solution.

But Tom keeps the interview focused as he makes clear that both he and Mike Muir (from the band Suicidal Tendendies) avoid painkillers in order to sidestep the addiction trap --- and also to have clarity regarding their symptoms; hard to know when to slow your roll when you don't feel the reality of your own body.

His understanding of pain is pretty enlightened for a guy in an industry famous for its excesses. As it should be, there have been times when he's utilized medications for pain and muscle spasms for short periods of time. 

Tom shares personal medical details about compressed nerves and other specifics that may surprise the average radio listener, but will likely thrill a dark, gothy one. Many of Tom's fans --- and heavy metal colleagues --- have been around long enough to experience some instance of back injury or pain themselves.

In fact, Tom was surprised to learn just how many of his contemporaries had struggled or undergone some type of procedure to relieve chronic pain. They all came out of the medical closet to show him support.

I will say that much of what Tom decribes from a treatment perspective was fairly "old school" in my own non-professional opinion. I know first-hand exactly what he's talking about (even our cervical numbers match up). The fact is, this brutal fusion process he describes is performed frequently in a number of different medical specialties. Although I cannot boast being the frontman for a heavy metal band all these years, I would place a small wager on the type of doc who performed his based simply on how it was handled.

The pop culture impact of the Slayer frontman's return to (modified) live performance has been widespread. Even "Entertainment Weekly" put it on this week's Hit List. I was, however, pleased to hear one of heavy metal's toughest guys announce that he's now an advocate of moderate headbanging.

As one of the radio interviewers blithely comments: We woke up in a different world today.

Two faces to love on "Sober House with Dr. Drew"

These fine fellas didn't even make the cast bios on "Sober House with Dr. Drew," but be assured that the celebrity shit would really hit the fan without 'em.

Give it up for Bob Forrest (shown top left) and Will Smith.

Bob is a recovering addict who never cracks under pressure, although the deeply ingrained lines in his face belie his long history with heroin. As for Will, he's the muscle. Also in recovery, this gentle giant is often the first one called if there's any hint a detoxing patient may perchance get physical. Or if if anyone has to be forcibly removed from any premises, anywhere.

I hold them up for consideration because I think they represent the unsung heroes who staff rehab centers around the globe. Often hired as non-professionals, these folks work side-by-side with specialists in addiction medicine, clinical psychology and nursing for a fraction of the pay. Those who stay sober are often revered as leaders in their 12-step meetings and they ultimately advance professionally with time. 

In addiction medicine, experience can be one of your greatest resume builders.

Bob started out as a musician and today he holds the position of dependency program director, working closely with Dr. Drew.  You can read more about Bob here.  As for Will, the giant remains a mystery. But I know if I ever hear a deep, sensitive voice asking if anybody wants a peanut, I'll expect it to be coming from a guy like Will.

"Sober House With Dr. Drew," which chronicles the sober living process, began airing on VH1 in January 2009. Watch episodes online here.

Nurse Jackie asks, "Have you tried smoking pot?"

This week, a patient checks into Jackie's emergency department severely malnourished and dehydrated. Given the fictional hospital's Big Apple setting, could it be due to homelessness? Mental illness? Washington Square Park martyrdom?

Nope. Turns out he's an all-American stage three lymphoma patient and he's just completed his third chemotherapy treatment. For lymphoma, that's probably not even the halfway mark.

In other words, his cure is killing him.  Imminently.

While young Dr. Cooper runs through a litany of possible anti-nausea meds, the patient responds in kind with the side-effects that have already rendered each one intolerable to him. Finally, Nurse Jackie Peyton (played to perfection by Edie Falco) asks directly, "Have you tried smoking pot?"

The desperate --- and willing --- patient explains that due to his straight-laced lifestyle he would have no idea where to obtain such a solution.

Of course, the writers couldn't miss the chance to point out that in a different state this guy could get a prescription for the stuff quicker than Dr. Cooper could say "Pass the dutchie." And so, always walking the line between lawless rebellion and exceptional patient care, Jackie takes the apple into her own hands and helps a brotha out. Cue hinty episode title here:  "Apple Bong" Season Two, Ep 4

In other "Nurse Jackie" news, if you want to show your support for the show and spread the notion that "Doctors diagnose, nurses heal," you're welcome to do so with your morning coffee mug (Vicodin optional).  However, this mug comes with a disclaimer you probably didn't see coming (included below).

Huh.  Wonder what Nurse Jackie would say?  

 

                           ***

Available in the Showtime store: "Nurse Jackie is known for her sometimes unusual bedside manner. She may be tough, but her concern for her patients is always genuine. 

CA Proposition 65-California residents please be advised, as per the Prop. 65 Warning: The colored artwork or designs used on this product contains lead and/or cadmium, a chemical known to the State of California to cause birth defects and other reproductive harm."

Julia Sweeney talks cancer, and god

Can you think of two more personal issues to share with the public? Long thought of as a fantastic improv actor and comedian, Julia Sweeney's persona took a quixotic turn when early in 1995 she was diagnosed with cervical cancer. 

"It was a fine cancer experience, as cancer experiences go," said Sweeney to USA Today in 2002. When she received the results as part of the annual set of gynecological tests women get, she was already acting as caretaker and witness to her brother's own extreme suffering, a battle that led to his succumbing to a long-undiagnosed, non-Hodgkin's lymphoma.

Raised a devout Catholic, Julia's "Letting Go of God" monologue  lasts more than two hours and chronicles her journey from deep belief to skepticism.  It's more a spritual and intellectual memoir than a medical narrative.  But clearly her medical experiences as caretaker and patient had great influence. And yet hers is such a different response than most patients with a life-threatening illness.

"I was starting to get nervous about my relationship with god," confesses Sweeney during her one-woman-show-turned-movie in 2008. "I felt like we were this married couple in trouble just trying to find some common ground." 

As always, my purpose in this blog is not to judge; it's simply to muse. Julia has since turned her attention toward educating women about cervical cancer, and adopting a child. She also still acts, speaks and even blogs. While her persona today evokes a person far removed from her crazy Saturday Night Live characters, the important thing is, she lives. And she's still funny as all get-out.

On March 9, 2010 Julia blogged that she planned to "hang up her mouth." I expect it's both brave and exhausting to share this much of your mind and body with so many people, and for so long. Personally, I admire her courage to make her internal life known for the benefit of others (whether for purposes of education or laughter). And I also respect her choice to reinstate her personal privacy. Read her post.

"The Pacific" peeks into wartime mental wards

Private Leckie is a reliable U.S. soldier (and man) who finds himself in a shittstorm of bullets, rain and deadly critters on the opposite side of the globe during World War II.  In Part Four of HBO's series "The Pacific," Leckie (played by James Badge Dale) has a slight pee-pee problem that first renders him incontinent, then lands him comfortably (?) in the psych ward.

"Main ward is full, they put overflow with me," says the good doctor in charge (pun probably not intended) played by Matt Craven. And so Leckie is sentenced to heal among his fellow soldiers who aren't even allowed to wear shoelaces.

Amongst the incoherent, Leckie finds a caged former comrade named Gibson, whom he stumbled upon in the act of strangling a Japanese soldier. By most forensic accounts, that's the most personal type of murder there is, and it's exceedingly indicative of pathology.  But that's not what got Gibson committed to the ward. About Part Four of "The Pacific."

The medical opinion offered by Dr. Grant is that most of the men who arrived at the ward legimitately, are there due to exhaustion. I'm sure you've heard the term "battle fatigue." And the only goal of this mental health facility erected from tents and temporary buildings is simply this: to determine who can return to his unit, and who can't.

So how does this makeshift battlefield facility compare with our modern mental health system?  Put simply, it's probably not all that different. You merely have to replace the word "unit" with "life." 

Certainly today's docs try to channel more of their energies toward treatment, and sincere effort is put into resolving core issues by delving into a patient's life experience. I would wager this gives them a better shot than Dr. Grant, who doesn't dare explore the actions of men like Leckie and Gibson; actions that have led them in human shambles directly to his doorstep. But the decision to release a human back into their environment still remains. Leckie made it easy on Grant, he checked himself out and headed back to battle.

That's what they used to call gumption. The doctor shows slight concern for Leckie's decision --- it calls to mind a few Alan Arkin scenes from "Catch 22" --- but he accomodates the soldier's request. After all, he's required to let the man out while he's still a danger to others, right?

During their final exchange, Dr. Grant equivocates about his relatively ignorant vantage point by admitting, "I don't know what the war is like."

"Sure you do," assures Leckie, "you see it in every guy who comes through here."

Dr. Oz says don't use toilet paper

It turned out to be the most unfortunate audience question ever on "Dr. Oz Show" Episode 198, which aired in my market today.  A seemingly thoughtful wife got up and asked a question about hemhorrhoids on behalf of her husband who was in absentia. 

Next thing you know, Dr. Oz has her pursing and puckering her lips in order to demonstrate exactly what an anus looks like.  If her husband is anything like mine, the ass-face jokes shall go on in perpetuity. 

But an important point was made without a whole lot of specifics being offered. After having the woman go to all the trouble of pulling her lower lip down to show the tiny veins inside her mouth that apparently mimic that other sensitive opening, all he said was to keep water and fiber in the diet, and you shouldn't use toilet paper.  Specifically he said, "you should wash your bottom."

What he didn't say was that it's a long-standing custom in so many countries --- outside of the United States --- to use a bidet.  That's the little faucet-type of potty accompanist that does just that; it washes your bottom. 

And if you follow through with Dr. Oz's example, you could also use it to brush your teeth. 

Perhaps since I'm female I was a little more open to trying out these contraptions during my trips abroad.  I've found them extremely pragmatic and effective. In fact, when my husband and I bought our new home, we put in a Bidanit.  This is an adapter that can be installed on any regular toilet. This particular model only cost $29.99 and shipped free from Amazon.

Although I'm not saddled with this man's particular affliction, there's something to be said for the conservation of paper products along with the comfort and cleanliness of plain old-fashioned water.  I'm stunned when I see Americans who move overseas act absolutely offended that there's a bidet in their bathroom.  More often than not, they cover them up. Sometimes they take them out!

I say no matter your gender or country of origin, there's a reason bidets have been a staple appliance in nearly every region of the planet. So let's take this opportunity to listen to Dr. Oz, put our best ass-faces forward and end our abrasive American ways. 

Medical Mondays make for diagnoses with "Angels on Call"

We have entered the next generation of psychic medicine, a practice of reaching into the great beyond in order to make medical determinations --- via radio call-in show. Tale as old as time, right? But the crazy part isn't in the practice itself, it's the fact that very often this tea-leaves approach takes a much more cautious and conservative tack for its so-called patients than the medical community does.

Mary Occhino has a daily satellite radio program that broadcasts to a large audience on the SIRIUS XM Stars channel.  She's also a psychic-medium / intuitive explorer of consciousness (description according to her own Celestial Whispers site). Whatever you may think about her work, talent, spirituality, ability, soul, shenanigans, etc., the fact is I've often heard people call up in a state of utter confusion after garnering multiple medical opinions about a condition.

Mary is quick and frequent in pointing out that her qualifications are not as a physician, but as a medical intuitive. Sounds nice, doesn't it? 

And minimally invasive ... I think. 

Either way, from a patient perspective I have heard her give wonderful advice and urge callers to question surgical necessity on an applaudingly consistent basis. 

My purpose here is to muse, after all, and I offer you Mary's show purely as information. There are those in my social circle who would argue vehemently on both sides of the question of validity, and I think most of their points would be salient. On the flip side, there's as much hokum in today's modern health care system as you'll find in any jar of medicinal leeches, and I'll bet a pint there's a crew o' them critters at a health center near you. Nothing wrong with going back to what works.

Personally, it may not be my favorite radio show on the planet, but it sure gives me something to think about first thing on Medical Mondays. 

Here's a link to Mary's Web site and blog.  Her radio show "Angels on Call" offers these daily themed programs along with a toll-free number to call with questions.  

• Medical Mondays: The intuitive approach to listeners’ current and future health  
• Tumultuous Tuesdays: Get a grip on personal crises  
• Wondrous Wednesdays: A celebration of miracles  
• Beyond Thursdays: Connect with relatives and friends from the “beyond”  
• Forever Fridays: Life and all eternity  

Mtv's "True Life" implicity asks: Would you give your kidney to an ingrate?

The ep was titled "I Need a Transplant." Sounds tragic enough, two young twentysomethings are each fighting life-or-death battles during which a family member swoops in to save the day by offering up a body part.

The wrinkle lies in the fact that Morgan, a lovely young girl of 22, has already gotten one kidney ... from her father.

However, in trying to live the normal life of a college kid, she leaves home only to end up neglecting her daily medication regimen (about 20 pills per day) while partaking in the sort of kidney-stressing recreational substances and dietary habits that college kids often do. The required routine care was a burden on her personal and social life, explains Morgan. But what's the alternative?

She had to return home not only contrite, but sick enough to have to ask her mom for a kidney. After eight and a half years her first kidney transplant is now failing in the doctor's opinion because of a "lack of good adherence to taking your medications."

"I think this time I actually have, like, my priorities straight," says Morgan. But after a lifetime of illness and a short respite of pretending to be normal, she's faced with some pretty high stakes.

Diagnosed with chronic kidney disease at four years old, Morgan endured long nights of dialysis until the time she was 13 when it stopped working and she accepted the kidney donation from her dad. Of course he was more than happy to do it.

But what about now? What about mom? Not only is this a huge physical sacrifice (and ongoing health risk), it's also mom's first surgery. And it's a major one. Thankfully, all went relatively smoothly and both mother and daughter emerged as well as could be expected. But if Iwere in that mother's shoes, in the deepest and darkest corners of my soul, I would have to question the validity of my decision; that's because I judge people on actions, not words. And past actions spoke far louder and clearer than I would like.

Of course, maturity plays a role in this, and I don't think any of Morgan's neglect was done with malice. Still, if anyone, this child should understand the risks and general malaise that comes with surgery and serious illness.

Morgan does take on some personal accountability regarding the future by telling her sister --- who's actually her best donor match --- that no matter what happens, she won't ever accept a kidney from her.

Whether playing to the cameras or planning for reality, at least it's a step in the right direction.

Check out the episode online.

Gladiator to fight The Big C; "Spartacus: Blood and Sand" delayed

I freqently joke that the salad I had for dinner will probably give me lymphoma. That's because it's a side effect of nearly every medication, fertilizer, virus, toilet seat contact, pencils, shark eyes, rubber tires turned inside out ... Well, you get the drift.

On the TV show "House" the two most frequent diagnoses you're likely to hear are lupus and lymphoma. Even the writers joke about this, but facts are facts: seems almost everything can lead to lymphoma. And almost everything can behave like lymphoma.

When I first had to describe this condition, my exact words were "leukemia's kinder cousin." It's a type of blood cancer so it's systemic, therefore its treatments are harsh. But these days they're mightily effective.

Get some legitimate information here.

This oft-occurring cancer seems to be making special rounds in real-life pop culture recently (not just the usual scads of movies and books). First, production on our favorite serial killer "Dexter" was suspended while Michael C. Hall underwent treatments for Hodgkin's Lymphoma. This week, it was announced that Andy Whitfield from "Spartacus: Blood and Sand" is being treated for non-Hodgkin's Lymphoma.

I'd like to take a moment and pay homage to Larry David who really brought the fun in on cancer commentary during "Curb Your Enthusiasm." He kept saying his friend's dad --- diagnosed with non-Hodgkin's --- was lucky because he got "the good kind."

Clearly, no cancer should be characterized as "good," and Larry's friends were appalled as usual. But for the rest of us, it's best if we keep the record straight. Although seemingly non-intuitive, it is non-Hodgkin's that's the tougher of the two. (Note mnemonic device included there free of charge.)

And while there's absolutely no way to avoid all things probably lymphoma inducing, it should be an easy proposition to at least avoid eating the rubber tires.

Bob Flanagan should be dead

If you've never heard of him, Bob Flanagan is a performance artist, writer and self-proclaimed supermasochist. Well, he was. He was also one of the longest lived cystic fibrosis patients on record in his time, living well into his forties with a disease that had historically taken the lives of nearly all sufferers as children.

But his was an unpleasant life, to say the least.

I first heard of Bob Flanagan back in the mid-1990s, a period I now think of as "before" in my own patient brain. I watched the documentary titled "Sick" with shock and awe (warning: this film is unsuitable for most humans). I won't go into detail here except to say that my interest then was more from a filmmaking perspective.

Today, having recently passed the 10-year mark of my own medical odyssey, I watched it again. Admittedly, I blew through a few of the most graphic images, but my mindset was much more philosophical.

In essence, Flanagan's goal was to battle the pain of his illness by becoming a supermasochist. His reason for inflicting unspeakable pain upon himself was simple: He wanted to be able to control his body for a change.

As a prognosis he was promised an early death. He lived with that knowledge for decades. And during that time he committed such acts of violence against himself --- although it was surely comparable to anything the doctors did --- that he has become a quiet legend, especially among cystic fibrosis patients.

One 17-year-old girl featured in the filmed documentary met Mr. Flanagan as part of the Make a Wish Foundation's activities. Accompanied by her mother, she confessed to him that his book was her bible. Trust me, it resembles the actual Bible in no way shape or form. She thanked him for laying himself so bare for those who come behind him. Mom was clearly out of her element here given the living environment Flanagan and his partner, and dominatrix, had created for themselves. But parents with dying children tend to fall more on the liberal side when it comes to doling out rules.

But it made me ask myself: are we stronger as patients if we bond together? Or are we better off to go about our lives trying not think about it? I know the latter isn't totally realistic, especially with illnesses of such a chronic and deadly nature.

I have a close friend, we'll call him "BTK," who explained to me that he'd become a practiced needle, scalpel and rigger-type dungeon dweller (literally) who focused much of his time "playing with" a young woman with multiple sclerosis. He worked to help ease her pain by inflicting it upon her with disciplined application and sterilization.

As I tried to wrap my head around this concept, it occurred to me over and over while I revisited the documentary. I understand the desperation and the desire to control your body, rather than having it control you. And although this isn't the type of therapeutic regimen I myself would want to pursue, I think to some degree I comprehend it in a way that's slightly terrifying.

I should also note that, blissfully, Bob Flanagan is dead.

Read his obit in the NY Times.

Just because they say jump ...

I want to start off by saying that I truly value the role of medicine in society. I'd like to proactively deflect any perception of malice toward doctors by adding that one of my best friends is a hospital-based physician who's been in practice for many years.

But also please note the word "practice" in the previous paragraph, and as you move forward in your life, begin to note just how often you see or hear this term when reading about medical matters.

When I began writing a medical narrative in the summer of 2008, my doctor friend and I began to engage in even livelier intellectual discussions about the "practice of medicine" and the reasons why it's so ubiquitously referred to as the "art of medicine." Sure, there's plenty of science to it; no question about that. But so many things are not exact and our knowledge base increases exponentially on a daily basis thanks to medical research and, frankly, mistakes.

There are so many variables that go into formulating an opinion or diagnosis about a patient that the opportunities for error are truly endless. Consider these obvious few:

• Patient omission of facts or history
• Lack of patient knowledge about facts or history
• Mistakes in the lab
• Lack of or unusual variation of symptoms
• Incompetent doctoring

And those are the easy ones. A factor most patients never consider are what type of doctor they're seeing. For instance, if you're seeing a surgeon, chances are they're gonna want to cut. If you're seeing an allergist, everything is allergies. I speak from experience on both counts.

There's nothing wrong with seeing the board certified men and women who have achieved specialist status. They're a necessary part of the machine that struggles to keep all our manifold parts in working order. Just keep in mind that if you're a hammer, all the world looks like a nail.

Which brings me back round to the subject, which is simply this: Before you agree to any procedure or treatment that will forever alter your body and/or any of its unique chemistries, do your research. Get a second opinion. Ask questions and question everything. Check credentials. Check risks. Check the bleeping success rate!

Just because one doctor says jump, doesn't mean we must immediately dive headlong into the infinity pool of contingencies.