Monthly Archives: December 2012

Dec 31 2012
1 Comment
climbing

Oh Suzanna

Elusive ice in Ten Sleep

Elusive ice in Ten Sleep

The pick made a distinctive ‘plink’ as it bounced off the rock. The sound always sends a shock down my spine, but I can’t tell if it’s the nature of the noise itself or purely the implications. I tapped a little higher and the tool set with a hollow sound no less disappointing than the ‘plink’. The resonance came from a layer of air separating the ice from the cliff face. I spared a glance down.

By the road in the shadow of the canyon floor, I could just make out a tiny brown stain by the car where the dregs of my coffee had flash-frozen when I poured them out an hour ago. The shadow ended in a sharp line half-way up the steep drainage and the upper portion took full morning sun.  Twenty feet below me, my last ice screw basked in the direct radiation. I drove another short screw into the ice. It gnawed through with dismissive ease.

The ice may have been just four to six inches thick, but it was not vertical and was well supported by a thicker lip of ice at the bottom. So, even though it was not continuously attached to the rock, it wasn’t likely to break off in a sheet unless I got very clumsy. The consistency was perfect, too. Though too soft to hold an ice screw well, it allowed the points of the tools and crampons to bite and set. ‘Hero ice’ was the name for it. The whole trip had been black and white like that.

CIMG3941

Every time we drive through Ten Sleep Canyon we look up into the second drainage East of the fish hatchery, hoping to see ice. Usually, we only see a water streak. Sometimes we see a thin smear. Very rarely, we see a fully formed climb. When the ice is formed, we vow to climb it on the way back through, but it always disappears before we return. Nevertheless, when we saw substantial ice in the drainage on our way out this time, we took it as a good omen.

High on Boulder and Moonrise from the river

High on Boulder and Moonrise from the trail.

The sense of good fortune evaporated as we traveled from Cody to the Southfork the following morning. Just as we reached the gravel road, something went wrong in my stomach, and the organ decided to right things by turning itself inside out. We were reduced to a driving tour of the valley between puke stops. The conditions looked dry. Moratorium was thin. Mean Green had a translucent 4th pitch. Ovisight lacked a first pitch. Broken Hearts looked pretty good, though.

High on Boulder and Moonrise (right-hand climb)

High on Boulder and Moonrise (right-hand climb)

Rich had to make a day of downtown Cody once we got back, but my problems subsided over that time and once again we felt fortunate. By the following morning, I was ready to try again. We headed for the lower pitches of High on Boulder, plus Moonrise.

CIMG3929

I hate Moonrise. Rich says I have a psychological problem with the climb. I may, but it often forms up with a series of short roofs, and as everyone knows, roofs are for short people – short roofs the more so.

Another view of Moonrise

Another view of Moonrise

I climbed poorly on Moonrise. After such a depressing reversal, I was sure that the column in Ten Sleep had fallen. Yet as we passed the fish hatchery, there it was intact. We pulled a quick, dangerous U-turn on the shoulderless highway and parked in the last pull-out. The approach was longer and steeper than expected. The climb looked less steep than expected, maybe a WI 4(-) but with the thin ice, imaginary protection and bent pick, it remained interesting. As we rappelled from a bundle of icicles at the top, an old song kept running through my head, “…sun’s so hot I froze to death, oh don’t you cry for me… ‘least I don’t live in Alabama, so don’t you cry for me…” Or something like that.

Tagged , , , ,
Dec 24 2012
3 Comments
medical ethics, medicine, philosophy

There’s a Pill for That

While waiting for labs with me in the ER yesterday, a younger colleague made an offhand comment about quitting medicine. She felt frustrated because, instead of helping people get over their health problems and get on with their business, she spent her time treating public health problems in the clinic and emergency room. Even worse, she had begun to feel complicit in the distortion. I didn’t know whether to offer congratulations, condolences, or both. Most medical professionals never get that far. They continue to feel good about encouraging dialysis for blind, depressed diabetics with one remaining limb and prescribing cholesterol-lowering medication to nonagenarians. Thereby, only the superficial dissatisfactions of their jobs remain.

I don’t think that doctors should feel guilty about the public health problems confronting them in clinics. Nobody planned for our society to fail us. We spent so much of our history working so hard to make life easier and more certain that we just didn’t notice when we started working harder and harder to make life easier than we needed. The illusion of increasing certainty helped us zoom past the point of diminishing returns. Once enough surplus accumulated to ensure against starvation, twice the surplus seemed to offer twice the insurance against shortage, but the excess would only mold and spoil the lot. Our surplus is spoiling in us now, clogging our blood vessels and glycosylating our nerve fibers.

A solution to the problem lies beyond the scope of clinical medicine. The only solution may be time and economic dissolution. The furor over limiting soft-drink sizes in New York City does not bode well for self-conscious alternatives. But medical professionals can feel bad about their complicity in the whole scheme, because our business is to tell people that there’s a pill for all that.

We tell the public that we can “treat” and “manage” diabetes, coronary artery disease and heart failure. The proper terms would be “attenuate” and “temporize”. The proper terms would imply a lack of control however, and a sense of control is what we’re selling as much as medication or surgery. We keep the illusion of control on offer in the name of comfort. We want our patients to feel free from anxiety about their health. They should feel empowered, and they do, which is good since they will still be physically ill under treatment, just a bit less so than when they consulted us.

I guess there really is a pill for surplus-mold, at least on a psychological level, but it will cost those who take it a lot of money, and the motive to seek out the roots of their ailment. Besides, it will keep the doctors feeling good about something they shouldn’t be doing. It may appear to buy some time, but it won’t cure anything.

Dec 06 2012
2 Comments
evolution, medicine

You Eyeballin’ Me?

ATTENTION

ATTENTION

An older gentleman lay on the gurney. His son had brought him in from the ranch suffering from abdominal pain. I pushed on his liver.

“Does that hurt?”, I asked.

“Well,” he replied after a moment’s reflection, “it ain’t sore, but it is a little tender.”

Attention

Attention

Tender, not sore. Twelve years and I still don’t know what the hell that means. A former colleague grew up in Wyoming, and since she habitually spoke more than three words in a day (not including ‘Yep’ and Nope’) I asked her a couple of times to explain it to me. She just looked annoyed and said it didn’t matter. I finally understood that she was right. The difference between sore and tender is clinically irrelevant.

attention

attention

‘Tender’ does not have any distinct denotative value, only a connotative one. It still bothers me not to understand its meaning. I’d like to think language can give me a working knowledge of other people’s thoughts and feelings. My expectation of understanding is not realistic. Symbols and their associated concepts just approximate the sets of unique experiences that constitute our shared mental universe. It’s all a big analogy of me to you, words or no. While imprecise, the analogy has one great advantage: it is durable. I may not be able to compare my experience of tenderness to the rancher’s to any good effect, but I can achieve a dialog with the dogs.

Attn.

Attn.

I can even predict the salamander’s response to me looking at it and it can anticipate my response to it clawing at the glass. All of us know our perceptions of each other are about something, which allows us to form these relationships, however vague and riddled with projection they may be (though the salamander does not beg food from people who are not looking at it or objects moving outside the glass, it does respond to the cat staring at it and she is surely looking in with a different intent than it understands).

Attention

Attention

I’m pretty sure I share an extensive mutual understanding with the mammals in the house, even the ones with ear-buds. I’m less confident about what passes between myself and the slimy monsters in the terrarium, but after a day of contemplating human tenderness with all its consequences and deficiencies, an amphibian’s intentional stare is the most reassuring.

Tagged ,