Category Archives: Social issues ( be civil ! )

You can’t con an honest man, but you can con yourself

How could Kavanaugh and Ford tell two diametrically opposed stories, which both sincerely believed to be true? Here are 3 examples of exactly how it could happen, the first from clinical neurologic practice, the other two from the New York Times and the Journal of the American Medical Association.

As a neurologist I was asked to do an Independent Medical Evaluation (IME) on an unfortunate man who was electrocuted at work (he worked on high voltage transmission lines). He went into cardiac arrest and sustained severe brain damage. The issue was not fault, which the power company readily admitted, but whether in what appeared to be a vegetative state, with no visible response to verbal commands, he was in fact conscious but unable to respond. In the latter case the reward to the family would have been substantially larger (for pain and suffering in addition to loss of consortium, etc. etc.). It was claimed that facilitated communication showed that he was able to write the answer to simple calculations given verbally, not visually.

Reviewing the chart before seeing the man, showed that he and his wife were truly admirable people, adopting children that no one else wanted and raising them despite limited income. He was seen at the rehab facility, with attorneys for the insurer for the power company and his family present. It was apparent that the people caring for him were quite devoted, both to him and his wife and were very sincere, especially one of his young therapists.

The neurologic exam showed that although he did react to deep pain (sternal compression), he did not follow simple commands (e.g. blink). He appeared to be in a coma. Following the neurologic examination the young therapist then demonstrated how when he held the man’s hand to which a pencil was attached, the man could actually perform calculations — add 2 and 2 produce a 4, etc. etc. Several such calculations were produced all with correct answer.

What do you think I did next?

No peeking. Think about it.

 

 

 

 

 

I took the first sheet of paper away, placed a clean sheet under the man’s hand and asked for a repeat (this time with the therapist’s eyes closed).

This produced a bunch of random lines, nothing more.  When the therapist opened his eyes and saw the results, he was visibly shaken and close to tears.

Was therapist faking the whole time? At any time? I seriously doubt it. A fraudster could easily have produced a reasonable number with his eyes shut. Try it yourself. He didn’t.

“You can’t con an honest man” — http://www.amazon.com/The-Sting-Man-Inside-Abscam/dp/0143125273

True, but you certainly can con yourself.

The second example is of a highly educated woman (a tenured professor of ethics at Rutgers Newark) using ‘facilitated communication’ who convinced herself that a severely retarded individual could communicate, and was in fact in love with her.  The jury convicted her of sexual assault and sent her to prison.

The article appeared in 25 October 2015 New York Times Magazine — here is a link

https://www.nytimes.com/2015/10/25/magazine/the-strange-case-of-anna-stubblefield.html.

The third example is the product of the youngest author ever to appear in the Journal of the American Medical Association (Emily Rosa age 11). She put a definitive end to “Therapeutic Touch”— http://jama.jamanetwork.com/article.aspx?articleid=187390

The point of all this is that highly intelligent people can con themselves.  I take no position on whether Ford or Kavanaugh (or both) conned themselves.  Syracuse, when I was practicing in the area in the 90s, was a hotbed of facilitated memory recollection, usually resulting in claims of sexual abuse, and I saw several parents whose life had been destroyed by it.  It would be of great interest to find out if Dr. Ford’s therapist used the technique.  We’ll likely never know and the Ford Kavanaugh affair will be the Patty Hearst affair of the decade.
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Who doesn’t want to be smarter?

I’ve never met anyone (even future Nobel laureates) who didn’t wish they were smarter.  So cognitive training should do the trick.  Right?  Not so fast.  In a very well written (and even funny in parts) article in PNAS vol 115 pp. 9897 – 9904 ’18 titled “How to play 20 questions with nature and lose: Reflections on 100 years of brain training research” all the pitfalls of setting up a study to prove or disprove the benefits of cognitive training are laid out.  The paper is worth reading for anyone considered any sort of manipulation to change human behavior it (including medication which is why drug chemists should be interested in it).  You can read it for free at

http://www.pnas.org/content/early/2018/09/26/161702114.full

This didn’t work for someone —

Try this one — http://www.pnas.org/content/115/40/9897

An enormous number of pitfalls of the work already done on the efficacy of cognitive training are laid out, far too numerous to summarize here.

I’ve written about one such pitfall (expectancy effects) earlier — here it is

Science proves cognitive training will raise your IQ 5 – 10 points

Who among you doesn’t want to be smarter? A placebo controlled study with 25 people in each group showed that cognitive training raised IQ 5 – 10 points [ Proc. Natl. Acad. Sci. vol. 113 pp. 7470 – 7474 ’16 ].

You know that there has to be a catch and there is. The catch points to a problem with every placebo controlled trial ever done, particularly those with drugs, so drug chemists pay attention.

What was the placebo? It was the way subjects are recruited for these studies. Of 19 previous studies in the literature, 17 recruited patients using terms like ‘cognition’ or ‘brain training’, so the authors put out two ads for subjects.

Here are the two ads they used

Ad #1

Brain Training and Cognitive Enhancement
Numerous studies of ahown that working memory training can increase fluid intelligences (several references cited)
Participate in a study today !
EMail for more information GMUBrainTraining@Gmail.com

Ad #2

EMail Today and Participate in a study
Need SONA credits? (I have no idea what they are)
Sign up for a study today and earn up to 5 credits
Participate in a study today !
cforough@masonlive.gmu.edu

I might mention that the two ads were identical in total size, font sizes, coloration used etc. etc.

” Two individual difference metrics regarding beliefs about cognition and intelligence were also collected as potential moderators. The researchers who interacted with participants were blind to the goal of the experiment and to the experimental condition”  Not bad. Not bad at all.

The results: those recruited with ad #1 showed the increase in IQ, those recruited with ad #2 showed no improvement.

It was an expectancy effect. Those who thought intelligence could be raised by training, showed the greatest IQ improvement.   Every sick patient wants to get better, and any drug trial simply must mention what it is for, the risks and rewards, so this effect is impossible to avoid. It probably explains the high placebo response rate for migraine and depression (over 30% usually).

What is really impressive (to me at least) is that the improvement was not in a subjective rating scale (such as is used for depression), but in something as objective as it gets. IQ questions have a right and wrong answers. You can argue about whether they ‘really’ measure intelligence, but they measure what they measure and fluid intelligence is one of them.

Medicine is full of fads and fashions, sugar is poison, fat is bad (no it’s good) etc. etc. and this is true in spades for treatments, particularly those touted in the press. Next time you’re in a supermarket, look at the various nostrums mentioned in the magazines at the checkout stand.

When I first started out in practice, one particular headache remedy was getting great results. The rationale behind it seemed bizarre, so I asked a very smart  old GP about it — his advice — “use it while it works”. Rest in peace, Herb

How art and science differ

The difference between art and science was really brought home to me on a visit to a museum on our recent trip to Venice.  I’d never heard about the Memphis Group of artists before — https://en.wikipedia.org/wiki/Memphis_Group.  They mostly made wacky looking furniture, as a revolt against the austere Bauhaus style –https://en.wikipedia.org/wiki/Bauhaus.   Back in the day, people living in the Harvard Law dorms Gropius (one of the Bauhaus founders) designed hated them as unlivable.  Similarly one can regard Pop art as a revolt against abstract expressionism, impressionism as a revolt against classicism, etc. etc.   The very notion of progress and building on the past is antithetical.

Science also produces a succession of theories, but they build on previously successful theories extending and incorporating them.  Special and general relativity subsume Newtonian mechanics, Maxwell’s laws merge electricity and magnetism.  Current molecular biology extends the classic dogma of the 60s and 70s — DNA makes RNA makes protein.  None of the older theories are rejected just improved.

So progress is inherent to the scientific enterprise, and is unheard of in the arts.  In one sense the arts are closer to the creative destruction of capitalism than its practitioners would like to admit.

I’ll be back to writing more scientific posts shortly, but here’s a question to be answered in a later post.

What extremely famous artist, spent more of his life as a mechanical and military engineer than as an artist?

 

Back from band camp for grownups

While at band camp, we heard a fabulously intense performance of a piece which must be witnessed rather than listened to on the radio or on a CD while you’re doing something else.  It was Messiaen’s Quartet for the End of Time. You couldn’t ask for a better audience — 150+ raptly attentive amateur musicians with all cell phones off and no program notes.  The piece takes an hour to play and is full of long silences.  In some parts just one instrument plays while the other players sit stock still staring ahead, so the piece really is part theater.

You can always tell when a string player or a pianist starts to play as something moves and your mind expects a sound.  No so with the many long silences of the clarinet solo.  Parts begin so softly that you can’t even be sure the clarinet is playing, as there is no motion to clue you in.  Then, suddenly you realize you’ve been hearing a sound for a while.   The piece ends with a violinist ascending slowly into the tonal stratosphere while producing a prolonged decrescendo.  She was in tears at the end.

The players (correctly) decided on no descriptive program notes (which were read aloud at the beginning) as they didn’t want to break up the intensity with rustling paper (or the spoken word).  Probably it’s better to hear the piece not knowing the background, but there’s a Wiki page for it which is pretty good if you already know its provenance.

Pianists don’t have to count.  When we get stuck we just stop and then start over.  Even with chamber music we have the score so we always know what the other players should be doing, so we can pretty much fake what we can’t play and keep things going.  Our only problems are the incessant page turns, sometimes with all the other instruments cutting out leaving us alone playing with both hands, turning the page and trying not to miss a beat.  All this was true until I got to play a piece with bassoon, clarinet, oboe, violin and cello by Martinu — https://en.wikipedia.org/wiki/La_revue_de_cuisine, which had only the piano part, and long 9 and 10 measure rests which I was supposed to count.  I thought it would be a total disaster, but the coach conducted it, and shouted out numbers when I was supposed to play. I bought him a beer later that week.  An interesting piece with a tango, and a Charleston in it.

Participants at the camp decided that there would be no talk of politics, just music, and the world did manage to spin on its axis for a week without our help.

I spent 300 miles or so of the 1,100 mile drive back on backroads through the verdant midwest countryside.  I made it a point to pace off a mile or so every now and then in a particularly beautiful stretch of country and then get out and walk it.  Typical of the midwest, each time I did, someone would stop and ask if I needed help.

The many miles of the country I went through on the way back look very good.  The stores and  restaurants and malls were full, the campgrounds crowded, and help wanted signs were everywhere. Much better than the previous trips of the past 5 years.

So then I get back to Massachusetts and the alternate universe of the New York Times.  When the Times talks about the longest bull market in history, they note in the same breath that it is only for rich people, ignoring the fact that all pension plans, IRAs and 401k’s have been beneficiaries.  Also on the front page was a story about a payoff to a porn star, something of minimal consequence to the daily lives of those outside the bubble.

Paul Krugman, Nobel Laureate in economics, appears on the opinion page, despite having declared election night the stock market would never recover, and a few years ago informing us that we were at peak oil production.  At least no articles by Larry Summers (smartest guy in the room and former president of Harvard) about secular stagnation and the impossibility of 3% economic growth.

Linus Pauling was one of the great chemists of the 20th Century — electronegativity, the nature of the chemical bond, the alpha helix etc. etc.  Yet when he said vitamin C could cure colds and cancer, he was proved wrong and his pronouncements on the subject roundly ignored.  No so with political and economic pundits.

The disconnect between the bicoastal mainstream media and the center of the country is profound.  The November elections should be fascinating.  Help stamp our minority employment — vote Democratic.

Off to band camp for adults 2018

No posts for a while, as I’ll be at a chamber music camp for adult amateurs (or what a friend’s granddaughter calls — band camp for adults).  In a week or two if you see a beat up old Honda Pilot heading west on the north shore of Lake Superior, honk and wave.

I expect the usual denizens to be there — mathematicians, physicists, computer programmers, MDs, touchy-feely types who are afraid of chemicals etc. etc. We all get along but occasionally the two cultures do clash, and a polymer chemist friend is driven to distraction by a gentle soul who is quite certain that “chemicals” are a very bad thing. For the most part, everyone gets along. Despite the very different mindsets, all of us became very interested in music early on, long before any academic or life choices were made.

So, are the analytic types soulless automatons producing mechanically perfect music which is emotionally dead? Are the touchy-feely types sloppy technically and histrionic musically? A double-blind study would be possible, but I think both groups play pretty much the same (less well than we’d all like, but with the same spirit and love of music).

A few years ago I had the pleasure of playing Beethoven with Heisenberg —   along with an excellent violinist I’ve played with for years, the three of us read Beethoven’s second piano trio (Opus 1, #2) with Heisenberg’s son Jochem (who, interestingly enough, is a retired physics professor).  He is an excellent cellist who knows the literature cold.  The violinist and I later agreed that we have rarely played worse.  Oh well. Heisenberg, of course, was a gentleman throughout.

Later that evening, several of us had the pleasure of discussing quantum mechanics with him. He didn’t disagree with my idea that the node in the 2S orbital (where no electron is ever found) despite finding the electron on either side of the node, forces us to give up the idea of electron trajectory (aromatic ring currents be damned).   He pretty much seemed to agree with the Copenhagen interpretation — macroscopic concepts just don’t apply to the quantum world, and language trips us up.

One rather dark point about the Heisenberg came up in an excellent book about the various interpretations of what Quantum Mechanics actually means: “What Is Real?” by Adam Becker.  I have no idea if the following summary is actually true, but here it is.   Heisenberg was head of the German nuclear program to develop an atomic bomb.  Nuclear fission was well known in Germany, having been discovered there.  An old girl friend wrote a book about Lise Meitner, one of the discoverers and how she didn’t get the credit she was due.

At the end of the war there was an entire operation to capture German physicists who had worked on nuclear development (operation Alsos).  Those captured (Heisenberg, Hahn, von Laue and others) were taken to Farm Hall, an English manor house which had been converted into a military intelligence center.  It was supplied with chalkboards, sporting equipment, a radio, good food and secretly bugged to high heaven.  The physicists were told that they were being held “at His Majesty’s pleasure.”.  Later they told the American’s had dropped the atomic bomb.  They didn’t believe it as their own work during the war led them to think it was impossible.

All their discussions were recorded, unknown to Heisenberg.  It was clear that the Germans had no idea how to build a bomb even though they tried.  However  Heisenberg  and von Weizsacker constructed a totally false narrative, that they had never tried to build a bomb, but rather a nuclear reactor.  According to Becker, Heisenberg was never caught out on this because the Farm Hall transcripts were classified.  It isn’t clear to me from reading Becker’s book, when they were UNclassified, but apparently Heisenberg got away with it until his death in 1978.

Amazing stuff if true

 

A modest proposal (with apologies to Jonathan Swift)

Sunday’s New York Times magazine was entirely devoted to global warming and our lack of response to it.  Doubtless it was read with great approval by the denizens of the upper East and West Sides as they sat in their million dollar apartments, vowing to fight until the last coal miner and oil field roughneck was out of work.  This will cost them nothing.

Virtue signaling notwithstanding, it’s time they had some skin of their own in the game. Having practiced medicine in the People’s Republic of New York, I know the love of New York state government for regulations and mandates, and the approval with which they have been met by the above denizens.

So here is a modest proposal for fighting global warming.  Mandate that governors be placed on air conditioners so that room temperatures can be no lower than 80 in the summer.  Similar governors should  be placed on heating, allowing room temperatures no warmer than 60 in the winter.  Start in the upper East and West sides of Manhattan, and if met with general approval extend it further.

I think it will be accepted as well they accepted the wind farms proposed off Martha’s Vineyard and Nantucket near their summer homes.

Quotas by any other name

I received the following from Drew Faust, president of Harvard University, 2 days ago.  My comments are at the end.  I’d be interested in what readers think about the issue. Click “Post a Comment” at the end to do so.

Harvard University - Office of the President

Dear Alumni and Friends,

In the weeks and months ahead, a lawsuit aimed to compromise Harvard’s ability to compose a diverse student body will move forward in the courts and in the media. As the case proceeds, an organization called Students for Fair Admissions—formed in part to oppose Harvard’s commitment to diversity—will seek to paint an unfamiliar and inaccurate image of our community and our admissions processes, including by raising allegations of discrimination against Asian-American applicants to Harvard College. These claims will rely on misleading, selectively presented data taken out of context. Their intent is to question the integrity of the undergraduate admissions process and to advance a divisive agenda. Please see here for more information about the case.

Year after year, Harvard brings together a community that is the most varied and diverse that any of us is likely ever to encounter. Harvard students benefit from working and living alongside people of different backgrounds, experiences, and perspectives as they prepare for the complex world that awaits them and their considerable talents.

I have affirmed in the past, and do so again today, that Harvard will vigorously defend its longstanding values and the processes by which it seeks to create a diverse educational community. We will stand behind an approach that has been held up as legal and fair by the Supreme Court, one that relies on broad and extensive outreach to exceptional students in order to attract excellence from all backgrounds.

As this case generates widespread attention and comment, Harvard will react swiftly and thoughtfully to defend diversity as the source of our strength and our excellence—and to affirm the integrity of our admissions process. A diverse student body enables us to enrich, to educate, and to challenge one another. As a university community, we are bound across differences by a shared commitment to learning, to pursuing truth, and to embracing the rigor and respect of argument and evidence. We never give up on the promise of a world made better by an assumption revisited, an understanding expanded, or a truth questioned—again and again and again.

Last month, I presided over our Commencement Exercises for a final time and reveled in the accomplishments of our graduates and alumni, and in the joy and pride of the faculty who educated them, the staff who enabled their manifold successes, and the family members who helped nurture them and their aspirations. Tercentenary Theatre was filled with individuals from the widest range of backgrounds and life experiences. It was a powerful reminder that the heart of this extraordinary institution is its people.

Now, we have an opportunity to stand together and to defend the ideals and the people that make our community so extraordinary. I am committed to ensuring that veritaswill prevail.

Sincerely,
Drew Faust 

© 2018 The President and Fellows of Harvard College | Harvard.edu

Harvard University | Massachusetts Hall | Cambridge, MA 02138

Dr Faust:

You are not defending diversity — you are defending quotas against Asians as Harvard did against Jews years ago — and I’m not Asian

 M. S.  Chemistry 1962

Tom Wolfe R. I. P

Tom Wolfe has passed on.  It’s worth republishing an appreciation of him and how he changed writing in America. It contains links to a 3 part review of what was probably his last book “The Kingdom of Speech”

Tom Wolfe — an appreciation

Tom Wolfe’s writing style and the genre he created have been part of the intellectual wallpaper for so long, that it’s easy to forget how badly he was needed. The following is quite autobiographical, but it does put his emergence in context.

Intellectually isolated adolescents in the early 50s read books, lots of them (minimal TV of any intellectual content, no internet etc. etc.) I had plenty of time in high school, with two 16 mile rides on the school bus each day. So I managed to read a book a day my senior year in high school. I particularly loved Balzac and Dickens for the way they wrote about all levels of society.

So although I was fairly well read on entry into Princeton in the fall of 1956, I was a geographic naif, never really having travelled west of Philly. I was a social naif as well, with only 6/24 boys in my high school class going on to collage. The ones that didn’t went into the military, law enforcement or the trades. None of the 24 girls got further education, initially at least. This was not a high or wealthy social background. I was the first member of my family not to go to Rutgers (the state school of New Jersey).

The Princeton Triangle Club put on a rather sophomoric show each year which toured the east coast and midwest on Christmas break. Earlier famous members included Jimmy Stewart and Josh Logan. Later, after women were admitted, Brooke Shields. I was good enough to make pianist in the pit band for the show and did this for two years.  The incredibly creative guy writing the shows was Clark Gesner, who soon after wrote “You’re a Good Man Charlie Brown” and essentially retired in his late 20s.

The class of 1959 was the first at Princeton to have more High School graduates than preppies. To the alums that put us up in their homes after the show, it was assumed that we were to the manor born (as many of them were).

Seeing upper class society was quite an education. After each show the performers (and band) were invited to debutante parties. I’d never seen anything like it, and none of the American novels I’d read dealt with it. The musicians in the band would listen to the society orchestras playing (Lester Lanin, Peter Duchin, Meyer Davis) and dance with the debs. In Chicago, I even was the male presenting one debutante, rather than a local — probably because she was Jewish and none of the locals would do it. In Grosse Point Michigan the following exchange occurred with a deb who seemed intelligent. Where do you go to school? Oh someplace back East. How do you like the party? Enough for me to decide not to attempt to become part of that world (not that it was ever possible).

Then in grad school at Harvard, I met extremely intelligent guys from the West Coast (Caltech, Berkeley, Brigham Young) who were reading “Road and Track” in all seriousness (camp hadn’t been invented yet). Road and track was for the guys back home who went to work in garages, and dragraced with each other.

No one in the 50s and early 60s was writing about this stuff — here’s a link to the best-sellers of the 50s — https://en.wikipedia.org/wiki/Publishers_Weekly_list_of_bestselling_novels_in_the_United_States_in_the_1950s
if you don’t believe me. Some were good (To Kill a Mockingbird). A lot were by foreigners (Dr. Zhivago, Francois Sagan, Simone de Beauvoir).

We had this fascinating diverse society, and our literature wasn’t dealing with it — that is until Tom Wolfe came along. He wrote about car customizers, astronauts, high society, low society, enjoying it all. These weren’t thought to be the stuff of serious literature until then. Some of the best sellers back then bore the same relationship to reality (Marjorie Morningstar, Not as a Stranger) as the Doris Day Rock Hudson movies of the time bore to the sexual interactions of male and female.

So hats off to Tom Wolfe. He’s still writing — I recommend his latest – “The Kingdom of Speech” about which I wrote 3 posts. Although the book starts in Victorian England, it winds up in the USA with Chomsky and company and the social high jinks of the left, which Wolfe has been skewering for decades. Here’s a link to one of the posts — https://luysii.wordpress.com/2016/10/16/book-review-the-kingdom-of-speech-part-iii/

Cultural appropriation, neuroscience division

If Deng Xiaoping can have Socialism with Chinese Characteristics, I can have a Chinese saying with neuroscientific characteristics — “The axon and the dendrite are long and the nucleus is far away” mimicking “The mountains are high and the Emperor is far away”. The professionally offended will react to the latest offense du jour — cultural appropriation  — of course.  But I’m entitled and I spoke to my Chinese daughter in law, and people over there found it flattering and admiring of Chinese culture that the girl in Utah wore a Chinese cheongsam dress to her prom.

Back to the quote.  “The axon and the dendrite are long and the nucleus is far away”.  Well, neuronal ends are far away from the cell body — the best example are axons from the sacral spinal cord which in an NBA player can be a yard long.  But forget that, lets talk about the ends of dendrites which are much closer to the cell body than that.

Presumably neurons have different types of dendrites so they can respond to different types of inputs. Why should dendrites respond identically if their inputs are different? They don’t.    A dendrite responding to acetyl choline will express neurotransmitter receptors distinct from another dendrite on the same neuron distinct from a dendrite responding to dopamine.  The protein cohorts of axons and dendrites are different.  How does this come about?  Because the untranslated part of mRNA on the 3′ end (3’UTR) contains a sequence called a zipcode which binds to specific proteins which then move the mRNA to a specific location in the neuron (axon or dendrite).  Presumably all dendrites initially had the same complement of mRNA.

So depending on what’s happening at a particular dendrite on a neuron, more or less of a given protein is made.   This is way too abstract.  Suppose you want to strengthen a synapse.  You’d make more of a neurotransmitter receptor or an ion channel for whatever transmitter that dendrite is getting.

It is well established that axons and dendrites store mRNAs and make proteins from them far from the nucleus (aka the emperor).  If you think about it, just how a receptor for dopamine gets to a dendrite receiving dopamine and not to a dendrite (on the same neuron) getting glutamic acid as a transmitter, is far from clear.  There are zipcodes distinguishing axons from dendrites, but I’m unaware that there are zipcodes for dopamine dendrites distinct from other types of dendrites.

If that weren’t enough consider [ Neuron vol. 98 pp. 495 – 511 ’18 ].  Even for an mRNA coding for the same protein (presumably transcribed from just one gene), there can be more than one type of 3’UTR (and this in the same cell).  Note also that 3’UTRs are longer in neurons than in other tissues.

So the authors looked at the mRNAs in dendrites — they did this by choosing a tissue (the hippocampus) where rows of cell bodies are well separated from their dendrites.  They found that for a given dendritic mRNA there was more than one 3’UTR, and that the mRNAs with longer 3’UTRs had longer halflives.  Even more exquisitly neuronal activity altered the proportion of the different 3’UTR isoforms. The phenomenon is quite general — over 50% of all genes and over 70% of genes enriched in neurons showed multiple 3′ UTRs.

So there is a whole control system built into the dendritic system, and it varies with what is happening locally.

The emperor emits directives (mRNAs) but what happens locally is anyone’s guess

A Touching Mother’s Day Story

Yes, a touching mother’s day story for you all. It was 51 years ago (yes over half a century ago ! ! ), and I was an intern at a big city hospital on rotation in their emergency room in a rough neighborhood. The ER entrance was half a block from an intersection with a bar on each corner. On a Saturday night, we knew better than to try to get some sleep before 2AM or until we’d put in 2 chest tubes (to drain blood from the lungs, which had been shot or stabbed). The bartenders were an intelligent lot — they had to be quick thinking to defuse situations, and we came to know them by name. So it was 3AM 51 years ago and Tyrone was trudging past on his way home, and I was just outside the ER getting some cool night air, things having quieted down.

“Happy Mother’s day, Tyrone” sayeth I

“Thanks Doc, but every day is Mother’s day with me”

“Why, Tyrone?”

“Because every day I get called a mother— “