What is this change that Doc mentions?  Could he possibly be improving his attitude without sufficient notification to his readers?  No, not dramatically.  He has only tried two tanka on for size such that not every poem here is a haiku.  Pretty close, though.  The tanka expands the usual 5-7-5 form of the haiku to a 5-7-5-7-7 arrangement of syllables.  There is no reason to fear this change, gentle readers.  I have retained my expected cynical crankiness quotient.

Snowy parking lot

Unsullied by cars’ tire tracks

Beauty is fleeting

Soon to be plowed and salted

Nature an inconvenience

~

Happiest New Year

Celebrations everywhere

And a few wrecked cars

All seems better with football

New Years Day and coming down

Peace, Doc

Copyright © 2005-2008, Thomas A. Blood, Ph.D.

*

Time

Years pass more quickly

Days are so terribly slow

Waiting for answers

Alone

Feel the dying fear

Realizing how alone

And forever true

Peace, Doc

Copyright © 2005 – 2008, Thomas A. Blood, Ph.D.

*

Oh my dear, he’s used a misleading title again, hasn’t he?  We should have realized by now that he does that.  I suppose we’ll just have to deal with it, won’t we?

In the beginning, a drag race was started by a person who stood in front of, and between, the two competitors’ vehicles, ascertained that both were ready to race, and gave a signal to … umm … start.  This was a simple enough process and was relatively safe for two of the three individuals involved.  The starter, however, quite literally risked life and limb from the possibilities of fire, being struck or run over, being hit by flying parts from exploding engines, or later expressions of disagreement from the losing driver.  This was not a popular job.

Due to the danger of this unpopular but necessary function, an electrical means was developed to serve the same need.  It was primarily hand controlled by the starter, but allowed him to do his job from a somewhat safer distance.  This rather crude system of floodlights and electrical parts served the purpose.

Although it was less than perfect, it contained the same number, colors, and lighting sequence as later iterations of the device. 

The development of current models simply improved upon the original.  The top yellow lights were turned on when the racer was “pre-staged” or in position, but not yet breaking the timing beam crossing his lane at the start line with the front wheels.  The second yellow light being lit indicated that his front wheels had broken the beam and that he was ready for launch.  The next three lights were orange and initially blinked down in a “ready – set – go” manner.  The next light was green, indicated that timing had started, and suggested that one really should begin to race down the track.  The bottom light was red, and was one that no driver wanted to see, unless it was in his opponent’s lane, of course.  It signaled that the car had started too soon and was disqualified.  With all the colors and blinking going on, this starting mechanism was quickly nicknamed the “Christmas Tree.”

The tree kept this sequence of lighting for many years.  I learned, after the tire heating burnout, to back through the staging lights and inch my way forward until the very front of my front tires broke the timing beam.  Here comes one of the few useful psychophysical things I learned in undergraduate school.  Human reaction time to a visual stimulus averages roughly 0.200 second.  When this time was added to the small portion of a second that it took my car to move the first 10 inches forward, I could successfully anticipate the green light by dumping the clutch as soon as I saw the last orange light blink without red-lighting.  This advantage was referred to as getting a hole-shot on the opposing vehicle and could well make the difference between winning and losing.  The sequencing has changed twice that I am aware of since I last raced, first to showing only the lowest set of orange lights before green, and after that, showing all three sets of orange lights at once.  Both were presumably done to prevent or minimize the type of anticipatory advantage which had been learned.  Hole-shots still exist, but it is harder to achieve one without red-lighting.

Examples of more current Christmas Trees appear below. 

Peace on Earth, Doc

Copyright© 2008,  Thomas A. Blood, Ph.D.

"The cost of racing hasn't increased in 30 years. Back then, it took everything you had. And it still does." – unknown

*

The post about the Three Stooges of Unit Directorship was about Doc and Greg.  It seems only fair that I now relate a tale which includes Danny, the owner of Mudd the Jeep, who went on to become an attorney.  This episode occurred at approximately the same location in the time/space continuum as the Pearl Harbor Affair.

At that time, the 16th Judicial Circuit Court, which held its sessions on grounds for commitment hearings and other legal matters pertaining to hospitalized persons, was temporarily located in an older building while the one in which it usually held sessions was being remodeled.  It was quite a nice and bright room, painted in white, and had an open, airy feel.  It was, unfortunately, located in the same wing as the storage area where horse urine samples were safeguarded by the Illinois Racing Commission for eventual analysis.  What can I say?  I suppose they had to be stored somewhere and the hospital had an abundance of unused space in older buildings.  The distinctive odor wafted through the courtroom on occasion, especially on hot, sunny summer days. 

Another design deficiency for the intended purpose of the courtroom was that the majority of the bright, cheery atmosphere was provided by large glass windows, which were replaced with plastic, pane by pane, as some of those who disagreed with the court’s decisions expressed their displeasure by breaking them.  Additionally, this space was not ideal because it was located far from most of the units and required that the patient’s counselor, sometimes with the assistance of Security, ensure the client’s court appearance.  My personal and rather passionate dislike of this deficiency in the system was that it required the same counselor who was in the closest therapeutic relationship with the patient to become their “enemy” by testifying "against" them regarding their need for commitment or for continued hospitalization.

A particularly memorable example of the results of this arrangement occurred on a day when Nancy, Danny’s fiancée, was the counselor who accompanied a chronic patient to court and testified as to her need for continued hospitalization.  Other testimony was heard and the judge found that continued hospitalization was necessary.  Greg, Danny, and I were all there with other patients as Nancy began to leave the room with her charge.  The patient was not at all pleased with the court’s finding.  She grabbed Nancy’s hair, pulling some out and dragged her to the tiled floor.  The closest staff responded to the emergency to prevent as much harm as possible.  Of course, Danny, Greg, and I were all involved.  Various people held the patient’s hands so that she could not pull out any more hair, her arms, legs, head, and body so she could not hurt others or hurt herself on the floor.  Things happen quickly and one acts to pacify the situation as rapidly as possible.  Of course, Danny  was making especially certain that Nancy was not hurt, either.  When Security arrived to transport the patient back to her unit, we began to release her, a limb at a time, as Security took over.  It was only then that I could finally tell him, “Its OK Danny, you can let go of my leg now.”

Peace, Doc

Copyright © 2005-2008, Thomas A. Blood, Ph.D.

“We do not have to visit a madhouse to find disordered minds; our planet is the mental institution of the universe.” - Johann Wolfgang von Goethe

*

One of my new Spacer friends publishes information on navigating the new form of Spaces and the other services on Windows Live that the more technically challenged among us can understand.  I originally found Technogran while exploring spaces that were new to me and found an excellent tutorial about an intricacy in using Live Writer, specifically a post about how to adjust the distance that the printed word is positioned away from a photo on your blog.  I looked over several more of her posts and found a gold mine of features that I didn’t even know existed and how to use them.  I’m practicing on a closed site so when (not if) I screw up, it won’t matter to me.

In response to the recent change in Spaces that upset us so much, she is now producing more basic information.  Her most recent post, as of this writing, is titled Finding your Space on Windows Live.  I urge you to go to her site and have a look.  This comes as close as I could have wished to the instruction manual that I complained about not receiving in a previous post.  Her blog is named Living With Live, which is exactly what it teaches.  Go have a look at it.  Now.  Shoo!  It may enable you to like Windows Live again.

Peace, Doc

Copyright © 2008, Thomas A. Blood, Ph.D.

I think the Chronosynclastic Infundibulum has caught me up again.  I hop around in time with these tales in no particular order and will probably continue to do so in the future.  Just treat what I write like you would your crazy uncle Kurt and we’ll be fine.

About ten years into my career at Elgin State Hospital, we had recruited a few licensed physicians and we all definitely liked Dr. M. who worked on my unit.  He was overtly strange, at times, but one expects some eccentricities in mental health staff.  One day he came to me and told me that he was being moved and would not be on our unit anymore.  “Why? I asked. How soon?”  “Well, now.  You’re getting a new psychiatrist.”  As was my usual response to the bureaucracy at this point, I set out upon a mission to discover what the hell was going on, why had I not been told anything about this in advance, and why had I not been allowed any input into the decision.  I was stonewalled.  “We decided it was better and you are getting Dr. A. today.”  Hmmm.  To say the least, I was angry, the unit was a beehive of upset staff, and the patients did not like the change, primarily in response to staff grumbling.  The new Dr. A. entered into this very uncomfortable situation. 

Dr. A. was treated with respect, but was covertly viewed with suspicion and a bit of resentment, simply because she had taken the place of a doctor we loved.  Additionally, she was a real, live board certified psychiatrist.  That bothered some of the clinical staff more than the rest.  Psychologists were afraid of being displaced as the psychological authorities, social workers didn’t know who they “really” reported to, nurses just plain missed Dr. M., and the mental health specialists and technicians generally didn’t like it but weren’t quite sure why.  This unspoken standoff lasted for about two weeks until a discharge staffing occurred to determine if all criteria had been met prior to a patient’s release to outpatient services. 

Our previous Standard Operating Procedure had the psychologists and social workers “overseeing” the doctors’ decisions to make sure that they had not missed anything.  That procedure stemmed from the days when most of the units had no full-time physician, were lucky if they did, and were extremely lucky if the physician was licensed.  Ooh.  Dr. A. was both a stimulus overload and such a novel element introduced into the system that we were falling over ourselves trying to adapt to the changes.  During the discharge meeting, each specialty had recommendations to be included in the discharge plan.  We were so used to the old order that we still questioned the physician’s readiness assessment.  If a problem was listed on the treatment plan, it was supposed to be resolved prior to discharge.  A single exchange between a psychologist (not me, for once) and Dr. A. set the tone for all future interactions with her.  The listed problem?  Hemorrhoids.  The treatment issue?  The psychologist protested that we could not discharge the patient until the medical problem on the treatment plan had been resolved.  Dr. A’s perfect response?  “I’ll let you know if they’re life threatening.”  We instantly decided she was “a keeper” and loved her until she retired.

Peace, Doc

Copyright © 2005-2008, Thomas A. Blood, Ph.D.

“The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.” – M. Scott Peck

*

This tale explains what I expected my staff to call me at work, and its consequences.  I quite simply preferred “Tom.”  I only used “Dr. Blood” when I was answering an outside call, and then only to lend an air of credibility and authority when I did not know who might be calling.  It was much easier to become more familiar by saying, “just call me Tom” than answering as Tom and then requesting the caller to call me Dr. Blood.  So it came to be that I was generally called Tom unless a staff member was angry with me or we had relatives or outsiders present at a meeting or on the unit.  Life was good.

Then a unit was closed on the hospital campus and the staff were assigned to various other units as need dictated.  Although I had known K........ slightly before she came to ATC-1, I really did not know much more about her than being able to connect a face to her name.  She was displeased at being moved to our unit from a unit where she knew everyone and had worked for many years.  Therefore, the first few weeks were somewhat strained, with K........ maintaining a mildly angry, “stay away from me” attitude.

The defining moment came one day when I walked into the nursing station to find a chart.  K........ was sitting at the work counter, making a chart entry, as were others doing their respective work.  I guess I took a bit too long, standing behind her, searching for a chart that was gone but had not been signed out.  I even looked at the ID box in the lower right corner of every page in a chart to see if that might be the one I was looking for.  Hers was not the chart but I apparently stood there long enough to upset her.  K........ rather loudly asked, ”Well, what do you want di*kh*ad?”  Stunned silence in the small room.  I am rather proud to say that this may have been the finest of possibly four occasions in my career that I thought fast enough to make the correct response quickly enough for it to be effective.  “K........, that would be either Tom or Doctor Di*kh*ad.  You choose.”  Staff were deathly silent until K........ emitted a snort and we both started laughing.  Then the tension was broken and everyone felt free enough to laugh along with us.  It was apparently the appropriate response for K........ to accept, because from that moment on it was clear, both to us and to the rest of the staff, that we were friends.  It seemed that I had passed her test and that I was OK with her, a most singular honor.  It also set the stage for her being welcomed onto the unit and becoming a very productive member of the group.

It just goes to show that once in a great while pulling rank can be useful.

Peace, Doc

Copyright © 2005-2008, Thomas A. Blood, Ph.D.

“There's no sense being exact about something if you don't even know what you're talking about.” – John von Neumann

*

The psychiatric hospital at which I worked was very sensitive to the issue of fire, as well it should have been.  Any facility that is responsible for the lives of everyone in its buildings must be.  That is the reasonable part of this story.  It is quite possibly the last reasonable part.  I personally got into trouble for extinguishing fires on my unit on three occasions.  I had a peculiar ability to break rules while doing the right thing.  I also possessed an equal but opposite ability to accomplish positive and common sense outcomes without being caught doing so by upper level management.

The first occasion of fire containment occurred when I was a new employee and really didn’t know any better.  I was located on an all male unit and the game room was a primary patient gathering spot.  It had a pool table, a TV set, and other entertainment like books, games and other things that the patients ignored.  I was standing outside the door to the game room talking with a patient when I heard the sound of an imploding TV cathode ray tube.  When I rushed in, the situation was as I had expected.  Someone had thrown a billiard ball through the TV screen.  Inside the TV, the high voltage transformer was crackling, arcing, sputtering, billowing smoke, shooting fiery sparks into the room and generally looking dangerous.  The patients were of no help as they were arguing loudly about who threw the pool ball and who would have won the game had it not been thrown.  During this excitement, staff had called Security and the Fire Department.  Being new to to State work, I didn't know that I was not to do the logical thing, so when I walked across the room and pulled the TV power plug from the wall socket I was unaware that I was doing anything wrong.  I was mistaken.  I had somehow denied the Fire Department and Security the glory of saving the unit.  I guess.

The second time I put out a fire was several years later and even sillier.  I saw smoke coming from under the door of the janitor's closet.  This was at a time when people could smoke freely in any part of the building except in the dorm rooms at night.  Again I thought I should do something about it so I did, even though I had been given several years to learn the rules.  I opened the door, found a dry mop smoldering from a cigarette that had been kicked under the door.  I poured my coffee on it.  Of course the Fire Department and Security had been called, ran onto the unit and started chewing me out again.  By that time I had reached a position of enough authority that I simply said, "The mop was on fire so I put it out.  You may clean up if you wish," and walked away.

The third fire was much more serious and everyone on the unit worked together perfectly to get all the patients outdoors, make sure all were accounted for, and be certain that the clinical records were taken care of.  A psychiatrist and I went into action because a bedroom was clearly on fire.  He felt for heat at various levels of the door before opening it while I got a fire extinguisher.  We saw it was a mattress on fire, the kind of foam that produces very toxic fumes.  Suddenly I remembered all the training I had dozed through, hyperventilated myself and ran low into the room to spray the mattress with fire suppressant.  At the time, the room was so completely full of smoke that one couldn't see more than two to three feet.  I had to repeat the performance of hyperventilate in the hallway, spray the mattress and check for patients on or under each bed four times.  No one hurt.  Fire out.  Lots of smoke on the unit.  Two doors open to clear the fumes.  Dr. R. and I were about to give each other the shrink equivalent of a high five when my boss, the program director, walked onto the unit and just looked around without saying anything to us.  He went to talk to the other staff who were watching the patients in the courtyard.  Of course Security came then and set up a fan to clear smoke out of the hallway.  Then the Elgin fire Department, which the hospital retained at a charge of $700 per response, arrived lights flashing and siren screaming. 

One of the nurses asked if I was alright and my response was "Sure. Why?"  "You're all white."  "Huh?  Oh.  Yeah.  That's the powder from the fire extinguisher."  The Fire Department pulled the mattress out into the side yard and poked at it until they got it to smoke a little and then put it out again.  My boss never said anything to me or to Dr. R. about the incident at the time.  He waited until the next general medical/managerial staff meeting, attended by about 40 or so psychiatrists, physicians, nursing administrator, supervising nurses, and unit directors to say anything.  What he said absolutely stunned me.  "As you know, there was a fire on ATC-1 last week.  Not everyone evacuated the unit."  Before I stopped my mouth, I glanced at Dr. R. and said, "No.  Some of us were putting out the f**king fire!"   I suppose I could have phrased it a bit more elegantly, but the arrogant SOB got exactly what he deserved.  Every single person in the room burst into laughter at him, humiliating him badly.

Oh, yes.  I paid for it later in various ways, but I would never take it back in a million years.

Peace, Doc

Originally published as Fires! on 7/23/2005

Copyright © 2005-2008, Thomas A. Blood, Ph.D.

“It is the answers, not the questions, that are embarrassing.” - Helen Suzman

This is becoming an almost traditional recycling of a post I wrote three years ago.  It takes me back to a much happier time in my memories to retell it.  It truly was a much simpler world then.  Certainly there were troubles.  When have there not been? 

“December 7^th brings with it strong memories that are only incidentally connected to the bombing of Pearl Harbor. When I began work at Elgin State Hospital in 1974, it was a much different place than it is today. In some ways, it was still in the dark ages of mental health but in others, the staff was a point of light in that darkness.

Two of the people I consider best friends, though I have not seen them in many years, were part of that time. You know one, Danny, from an earlier post. He was the owner of Mudd, the Jeep, which we used to explore abandoned areas of the hospital’s old farm colony. I still think we should have been warned that it had also been a gravel pit that was overgrown, but we lived through the experience, so I suppose that doesn’t really matter.

Greg was the other friend in this trio. He was the unit director on the ward on which I worked at a time when unit directors were managerial leaders while psychologists or social workers were clinical leaders. Danny had been a unit director and moved into a counseling position so that he could finish law school. Greg was the unit director and moved to another agency after a few years to get the time to earn his doctorate and become a practicing psychologist on the west coast. I was the psychologist who would become the unit director but did not know it at the time. This slightly more intelligent version of the Three Stooges could be incredibly kind and funny with the patients while maintaining a safe environment on the admitting unit for acutely disturbed male patients. We could also torment each other mercilessly. I don’t remember ever having an argument with either Greg or Danny; disagreements, yes, but among three late-twenty-something men, “no arguments” was miraculous.

Greg was a third generation Japanese American who, when once asked where he was from in Japan, responded, “The South Side.” Actually, he was referring to the South Side of Chicago. You may have begun to suspect that there is a connection between Greg and Pearl Harbor Day. We were all Baby Boomers and had no personal memories of WWII and therefore, no prejudices stemming from it. Our senses of humor also matched well. December 7^th therefore became a sort of informal holiday for us. It became “Get Greg Day.” He always knew it was coming but anticipated it with both smiles and mild trepidation. He was never certain whether it would be a tiny, subtle gotcha or a whole day’s worth of continuing pranks. The indignities perpetrated on him ranged from the old paper clip and rubber band “buzz bomb” wound tightly and included in an interoffice envelope (from someone else, of course, like a hospital administrator, with an unused envelope and typed address label,) to the all out disasters created by placing every moveable object in an office on top of one’s desk.

The most memorable “celebration,” at least to me because I did it, was The Year of the Poppers. Poppers are the tiny fireworks that produce a small explosion when thrown on the ground or against a wall. They used to be tiny gold colored, BB sized devices that worked much better than today’s paper wrapped, gravel and powder imitations. They could be placed almost anywhere and if pressure was applied – Bang! They could be used somewhat obviously by simply placing them on the floor to be stepped on, under a welcome mat or, for a delayed effect, under stack of papers, under a toilet seat in the men’s room, or virtually anything else that would put pressure on them.

The best Get Greg Day was preceded by careful thought and preparation. Poppers were placed in multiple locations in his office. The obvious places were included as a partial ruse to lead him to believe that the festivities were over quickly. Many other less obvious places were also booby-trapped. Doors had poppers taped to the jambs so they exploded when they were closed, light furniture had them taped to the legs as did a lamp to its base. They were placed under every leg of every chair in the room, in the window closures, under the “In-Out” box, and finally, attached with black electrician’s tape to be nearly invisible, to the rollers on his desk chair, about 15 or so per roller.

I arrived for work early that day, an unusual thing for me, to await Greg’s arrival. It was worth the effort. The tiny explosions began when he stepped on the mat in front of his office door, continued when he closed his door, when he stepped on a few under a throw rug, and again when he set his briefcase on the papers on his desk. Each of these pops resulted in a sound or expletive from Greg. When he finally had his coat off and sat down, a miniature version of “Shock and Awe” occurred which resulted in a string of expletives, beginning with “Holy f***ing s**t!” and ending with something like “I’ll get you for this, Tom!” Not only was this the desired response, but it turned out to be a gift that kept on giving for the next several days as people sat on side chairs, stepped on other parts of the rug, closed doors harder, closed windows, and moved other objects.

Wherever you are, Greg, Happy Pearl Harbor Day.”

Peace, Doc

Copyright © T. A. Blood, Ph.D. 2005 – 2008

“The smart enemy attacks you exactly where you think you are safe.” -  Admiral Kimmel

I believe I have found a solution to the “irritation” of having one’s whole history of comments on other Spacer’s pages shown as the prelude to being actually able to view or comment upon their space.

I have been so angry with this problem that I started working on undoing as much of the damage to my space as possible as soon as possible.  At this point I believe we will still have to get through the gauntlet of the “landing page” before being allowed onto the site we were trying to get to, but we will not be forced to have as much private (Hah!) information about us revealed.  I would list a live URL, but if I use the one I have, it is specific to my site. 

As you land on your own landing page, a blue circular “thing” appears just to the right of the time of your comment or post when you mouse over it.  Otherwise it is invisible.  Click on the “thing.”  A dropdown box with the options of “Remove this update” and “More options” will appear.  Click “More options.”  This action will take you to a page named “Manage what’s new with you.”  It will look like this:

From this, screen, you may uncheck any information that you do not wish to “share” on your landing page.

This design appears to be typical of Spaces Live defaults in general (friend requests that are set to accept, landing pages which reveal all your information, etc.)  It further appears to me that they are trying to emulate Facebook or Twitter.

Microsoft is one of a very few contenders to house a national Protected Health Information (PHI) database for the Electronic Health Record (EHR) system which is being forced on healthcare providers by higher powers (No, not God.)  Do you think we should trust them for that job?

Peace, Doc

Copyright © 2008, Thomas A. Blood, Ph.D.

“The people I distrust most are those who want to improve our lives but have only one course of action.” - Frank Herbert

WTF!?  Somebody stole my space and replaced it with this … bad impersonation!  I do not approve.  I shall do something!  Perhaps I will take a nap.  Perhaps I will watch The Manchurian Candidate.  Take heed, however.  I am armed!

@ Spaces Live Team:  I am twice your age, possibly more.  Old people do not like change, especially when it comes abruptly and without warning or instructions.  In addition, you moved the cheese on Tuesday, rather than implementing these aberrations on a Friday when you leave work for the weekend as you usually do.

Peace, Doc

Copyright © 2008, Thomas A. Blood, Ph.D.

“… And she said we are all just prisoners here, of our own device.  And in the masters chambers, they gathered for the feast.  They stab it with their steely knives, But they just cant kill the beast.” – Eagles, Hotel California

*