George Carlin never got to be as old as I am now, dying at 71 on June 22, 2007, in Santa Monica. His twisted, if amazingly logical, humor shaped much of my youthful thinking. I never expected that wisdom to be enduring, but much of what he talked about rings true today. During COVID, especially, I found comfort and guidance in “Professor Carlin’s lectures”. This in a time when anyone speaking common sense was branded a radical. I especially like his take on “germs”(1). One of my most fascinating course in grad school was “Host-parasite relationships”, taught by Rolf Freter (2). There, I began to learn the many ways microorganisms interacted with their hosts, often to the benefit of the host, all to be lost if somehow the microorganisms were eliminated. The concept arose later with recognition that our approach to hygiene may be harming our immune systems. Lacking targets to “practice” on, our immune system turns “sideways”, resulting in allergies and autoimmunity. This “Hygiene Hypothesis” (3) was largely forgotten by the framers of our COVID response. What happens when you douse your hands with alcohol at every turn, restrict with that mask entry into your lungs of most organisms (if not SARS-CoV-2), avoid human contact, and hole up in your house? That innate immune system gets no practice and thus isn’t prepared for onslaught of a real pathogen.
I first posted this lesson from Prof. Carlin over 5 years ago (1). Just today, I got an e-mail from Dr. Robert Malone (inventor of the mRNA technology which he’s railed against since the get go) with his Sunday cartoons (4). Towards the end was a black and white panel with a stark Mr. Carlin, written over it “George Carlin’s views on the Coronavirus”. Intrigued, I saw it and it is mainly a black and white video of Prof. Carlin’s “Germs” lecture. (5).
Isn’t COVID done for? Why are we still talking about this? Well, with many injured by the vaccine and/or suffering with lingering “long COVID” effects, it’s not over yet. The taste for sledgehammer measures to “protect” us has not been lost by our powers that be, looking for the next chance while failing to relinquish the few ridiculous measures still in place. The powers that be sought to increase the number in the former category (the vaxxed) by urging still more mRNA “vaccinations”. Then, seeking to ramp up anxiety and fear over all these viral infections out there to kill us, talk is of a “quad epidemic” from the combined assault from influenza, COVID, respiratory syncytial virus (RSV), and norovirus (6). How convenient that for the first three, there is an established vaccine, with work in earnest proceeding with norovirus, a single-stranded non-enveloped RNA virus that’s the main cause of gastroenteritis (nausea, vomiting, and diarrhea). It’s as if they pulled some innocent stragglers off the street and marshalled them into a quartet of menacing soldiers. Even though there’s no evidence that any of these are having a significant public health effect, it hasn’t stopped governors and other institutions in blue states from using this risk as justification for things like reinstitutions of mask mandates (7). I guess since the mosquitos are back, we need to throw up those chain-link fences.
Viruses wreak stretches of minor misery in our lives, untreatable but self-limited. Our main barrier is our innate immunity. This is not a system that can be focused with a specific vaccine but can be bolstered by exposure to microorganisms in our environment. So, if your friendly doctor offers up a boatload of vaccines to “protect” you this winter, tell him/her “thanks, but no thanks”, then go out and roll in the dirt.
Bloomfield SF, Stanwell-Smith R, Crevel RW, Pickup J. Too clean, or not too clean: the hygiene hypothesis and home hygiene. Clin Exp Allergy. 2006 Apr;36(4):402-25. doi: 10.1111/j.1365-2222.2006.02463.x. https://pmc.ncbi.nlm.nih.gov/articles/PMC1448690/
From Harbal, December 11, 2024. That’s Norwegian for “Merry Christmas”. For me and Kathy, this season stirs our (25% Norwegian) Scandinavian souls. The year past tickled all of our national origins, so here I share with you some of the highlights.
My sweetie loves Christmas. She got down to it after Thanksgiving, finding another tree farm for our 9’ concolor fir, putting it up and decorating, then put the rest of Christmas that we keep in our storage room all over the house. Outside, she liked the Star Shooter that projected all those colored lights (1) and changed the lights on Cecil – her topiary sea serpent – to red and green.
She even whipped up the season’s first batch of glühwein (2), only to have us both consume it all the same day. More is coming. She’d occasionally pause in the Holiday flurry and ask me how that Christmas letter was coming. With The Day just 2 weeks off, I figured I’d better get down to it.
Just like in 2023, Michigan football dominated the start of our New Year. We were finally back in the Rose Bowl for the first time in 20 years. All that was missing from that otherwise perfect afternoon was the voice of Keith Jackson to tell us about it. My best friend Eric, Huck (his old dachshund) and Kathy (his new squeeze) joined us in front of our big screen. In the early going, when Alabama seemed to be on the way to domination, Eric assured us that they’d screw up soon. They did, and we beat them. Related or not, their iconic coach Saban retired after the game. The 3-touchdown win over the Washington Huskies for the championship seemed like an afterthought. Kathy and I watched that one from our living room in Madeira Beach, in a house that since then was buried by Milton. Of course, there were other distractions to be had from that front porch.
We made that trip a road trip, stopping to see friends and family in Nashville, Loudon TN, Clinton SC, Athens GA, Crawfordville FL (panhandle), and Ocala FL (horse country) (3). I think we’ve been floating on that Natty all year. M-Den had the NC gear, and even though we had to wait till the end of the month for it, it was worth it. Trust we’ve gotten a lot of wear out of each and every item.
The farthest we got out of the house in February was to Dee-troit, where on the first Sunday of the month we saw the hapless Pistons take on the Magic, with its two ex-Wolverines, the Wagner brothers, Mo and Franz. Not these guys, but two much
taller and skinnier German kids. They may have not pumped us up, but they sure did pump ‘em in, especially Franz. The Pistons never had a chance. We’d hoped for a Wolverine trio, but the Pistons had traded away Isaiah Livers after I bought the tickets. There was a 4th, with Juwan’s youngest son Jet riding the pine for the Magic. Regarding Little Caeser’s Arena and the Pistons’ basketball product, it befits an operation run by the Illitches that the best feature of the afternoon was the buffet.
Winter in Ann Arbor means Michigan basketball. Alas, not a good year for the boys. We only saw one game in person all year, a loss to Michigan State. Both of us are very fond of the coach (4), but something happened to him this year, not just a major repair of his aorta and aortic valve. We got to see him one last time at Brian Boesch’s Inside Michigan Basketball radio show at the Pretzel Bell. It was the Monday before his last home game. They’d been creamed by Ohio State at Columbus the day before and faced what might be their last week of basketball. Nevertheless, Juwan seemed happy and relaxed. But the following Sunday his team was beaten by 15 points on senior day. Two days later, they’d lose to Penn State in the first round of the Big10. So, they closed with 7 straight losses, this last one giving them some ugly records: their 28 losses were the most in the program’s 107 year history while their winning percentage (.250) was second worst. But I think Juwan got a little boost that Monday night when he and I lined up and he saw that he was again taller than me after my June ’22 car wreck crushed 2 ½ inches of vertebrae.
Warde Manual fired Juwan a couple days later. Looks like he got a winner replacement in Dusty May, but we’ll still miss Juwan. Kathy and I are both fond of Juwan – ever since the Fab Five days – and had high hopes for him as our coach (4). We’re sad it didn’t work out and wish him well with the Nets.
Early in March, I met up with Larry, my freshman roommate, for a beer. Larry had a successful career in tech, operating a consulting business in town while settling in nearby South Lyon. It would be some early steps to the big reunion we’d have in September.
Then, Kathy and I decided to go to Chicago to see just how green they actually got that river for St. Paddy’s Day. We learned they dump the dye in a full week in advance, so what we saw from lunch at Trump Tower was off peak. Home a week, we headed west for Easter in San Diego. The city sponsors a sunrise service in Balboa Park by their 1915 organ pavilion. It makes for a marvelous sight.
My own peak experience in April came well after the 1st, although it sounds like an April Fool’s joke. I’d gotten the director of the Southeast Michigan Tournament of Writers (5) to let me enter, even though the contest is supposed to be restricted to locals. Lo and behold, my entry about how in 1970 we made a movie about the moon landing was a winner! (6) Honorable mention in senior’s non-fiction division. A week later we’re off to Chicago for 3 days, always about music and meeting up with old friends.
May found us diving into the thorny issue we’d been talking about with the family for a while. My now 70-year-old brother-in-law – a freelance writer and editor for financial magazines in his prime – had entered the early stages of dementia. As he could no longer live independently; the family decided it best if he were to move back to the Midwest. He came for a medical evaluation. He wouldn’t come back to check into his new home for almost 3 months.
The summer was otherwise pretty darned quiet. Come July, we got Chicago for 3 days, one of them Kathy’s birthday. We celebrated looking out over Millennium Park from Cindy’s (7), in the Chicago Athletic Club, where we also stayed. Cool place, where used to hang out the likes of Johnny Weissmuller (Tarzan), Ernie Banks, Muhammed Ali, plus Sport Donnelly and Pudge Heffelfinger (first players to be paid to play football). And many more. The club formed in 1890, building up in ’93. William K Wrigley – not yet owner of the Cubs – was one of the founders (the other 3 were Marshall Field, Cyrus McCormick, and A. G. Spalding), . He helped design the club logo, which bears a striking resemblance to what the Cubbies wear on their caps these days.
Cindy’s is a later addition (7), named after Cindy Pritzker, wife of Jay, one of the high rollers who rescued the CAA in the 70s, son of the man whose name graces my medical school. An Andy Warhol portrait of her hangs over the fireplace in the dining room. Nice lookin’ babe.
The next week we were off to lower brow activities, taking in “Beer n’ Brats” in Vicksburg. Always fun, but not the same as when my old physics teacher was the guy pouring my beer.
We were homebodies in August, save for some in-state trips. September saw a couple more quick local hops. We went to Lake Orion to see Robbie Fulks (8) and then to Grand Rapids to see Tucker Carlson and Kid Rock. The football season was proceeding if not inspiring. After 2023, we were surely spoiled. With Michigan’s last 3 national championships won ’47, ’97, and ’23, I guess we should set our clocks for around 2050. The ReliaQuest bowl in Tampa in New Year’s Eve (to which we have tickets) will have to do. At least we get a crack at Alabama again.
But the big event in September, while football based, was so much more than that. Early in the year, I got to talking to Mark, championship QB from little Mendon (12 miles south of Vicksburg), who lived on my dorm floor. 4th floor of Chicago House West Quad to be exact. Then, it was an “honors house”, for students in the L.S.&A. Honors College. Lotta smart dudes (yes, it was all male at the time). Indeed, at the reunion one of the guys asked me if I was one of the rumored several who had perfect SAT scores. Not me. Mark reminded me that this year was the 50th anniversary of our graduations. I found an outfit that does tailgates (9), hired ‘em, invited all I could find, and by the Minnesota game we had ourselves a party. Of course, we hired a limo to traverse the difficult 3 miles from my house to the stadium. Below see the gang. I know I said Chicago House was all male, but Brigid was our mascot. She ended up marrying my sophomore year roommate (it didn’t last). Next to our group pic, see a smaller pic shot indoors. On the way home, I suggested we stop off at ol’ Chicago House and check things out. Our driver was willing. After hanging out at the very securely locked back door long enough to get some innocent student to let us in, we explored the place. Those stairs to the 4th floor, where we’d all lived, were still there, but steeper than I remember. It was on those stairs a young security guard caught up with us, asking after our business there, He didn’t turn us in, but stayed with us as we climbed those stairs, probably to make sure none of us keeled over. We wandered the halls and happened upon an open door with a couple coeds inside. They were happy to invite us in and explore their room. None had ever heard of “Chicago House”, although one was from Chicago. Project for us to figure out what happened. Home it was snacks and talk till the middle of the nght. A good time was had by all.
We left Washtenaw County 3 times in October. First Saturday was a quick jaunt to Vicksburg to take in a historical tour. Since the ‘burg has been a thing since 1837, there’s a lot of that about. Next was Music City, where we took in the “You Got Gold” concert at historic Ryman Auditorium, original home for the Grand Ole Opry. These have been put on yearly by the Prine family since John died in 2020. Nashville artists lovingly perform some of John’s songs. We didn’t recognize all of them, but Shawn Colvin, Bela Fleck, Todd Snider, RoseAnn Cash, and Jackson Browne were familiar. Trips in that direction always include a stop in Cincinnatti, where we visit with Kathy’s 88 year-old Uncle Chuck.
Our last trip was decidedly non-musical, as we went to hear politico Larry O’Connor speak at Hillsdale College. Since I foreswore writing about politics when I started this blog, there’s a lot about November I won’t write here. Suffice it to say, we’re pretty happy around Harbal these days. Our only outing that month was back to the ‘burg to attend the memorial service of 88-year-old Eddie Knapp. He was my 8th grade basketball coach on a team with 6 strings! He made his name as a baseball coach and is in the Michigan Hall of Fame. His packed service included others, including wrestlers he’d coached and those students who had him for driver’s ed.
Kathy and I have both taken up writing in our retirements. I had a head start, but she has gone whole hog with her children’s books about the solar system. If you care to scrutinize our output, you can check out our Amazon author’s page (10,11). She belongs to a writers’ support group, and they’ve been encouraging her to get out and push her product. In November she started to do this in earnest, with an event at the “Best Life Holiday Arts Sale” at Saline United Methodist Church especially productive. I’ve been sitting in the background but was ecstatic when I learned that the book I’d been working on since 2021 was accepted by a “real” publisher. My latest Amazon book of bundled blogs will be out as soon as it is finished getting formatted. Only the latter will be out anytime soon.
One thing Kathy’s learned from her writer’s group is that promotion is key to sales. So she jumps at any invitation. See her here at Gilbert & Ivy Bookstore in Vicksburg holding the little kids spellbound. The Navy gave her that flight suit when she was a guest on the carrier George Washington and flew an F-18 (from the back seat) on and off the carrier 6 times.
This last month is just started, but all I see ahead are some basketball games and Christmas concerts. We’re off to Tampa on the 29th, but that’s basically next year.
But we mind none the least spending time right here on Harbal, comfy and cozy in our Ekornes Max’s while Regis Pruis’ wood burns, helped along in this 3/22 pic by some masks, but that’s another story (12) Whatever the fuel, we got ourselves a lot of hygge (13).
With the tree up and decorated, thanks to sweetie, there’s that obligatory photo of us in front of it. If we had Christmas cards to address, we’d be up plenty fine to do it after those drinks we’re holding. Not that we needed the energy, but here we go wishing you and yours Merry Christmas and a Happy New Year! (and God Jul!).
Those are espresso martinis (14). We’re staying up for a while! Like ol’ Ben said “There’ll be sleeping enough in the grave”.
Among the many things COVID has taught us is that we should be wary of those insisting we be jabbed with something foreign to protect us and others. Turns out the vaxx didn’t protect against infection or slow its spread, and oh those side effects! Peter McCullough, one of the heroes in bringing reason to our fight against COVID, continues to fight the good fight and keeps his followers posted with his “Courageous Discourse” site.
This morning (1), he brought to our attention a study published in 2012 (2) that the seasonal flu shot increased the frequency of common colds. In a prospective, randomized study kids 6-15 were given either the 2008-9 seasonal flu vaccine or placebo and followed for 14 weeks. Vaccinated kids got way more colds. Like the flu shot was distracting their immune systems from what they’re supposed to be doing. Like Dr. McCullough, I had to take the flu shot as condition of my continued employment for 40 years. One of the many small joys of retirement is that I don’t have to do that anymore. The vaccine doesn’t work very well anyway (3). The virus mutates all the time and scientists just guess to see what structures the vaccine should mimic; furthermore, it seems that each vaccination reduces the efficacy of each subsequent vaccination (4).
Dr. McCullough abstracted the study’s findings as follows:
“In 2012, Cowling et al performed a prospective, double-blind randomized placebo controlled trial in children ages 6-15 years to who received either the 2008–2009 seasonal trivalent influenza inactivated vaccine (TIV; 0.5 mL Vaxigrip; Sanofi Pasteur) or placebo. The results were stunning. While summer and winter colds were not statistically different, proven viral infections within two weeks of the shot confirmed by PCR testing were 4.4-fold greater in those who took the flu shot.
The shortcoming of the study was the narrow 14-day window. With summer infection trends among the vaccinated up 30 to 49%, it is possible that if all infections were captured and tested that the immune dysregulation effect could have lasted far longer than 14 days. Since the chances of any healthy child or adult getting hospitalized with influenza is <1% in any given year, many will choose to remain healthier and have a greater freedom from getting sick by skipping the flu shot. Because influenza vaccination has modest to no efficacy against flu each year and tends to strike the vulnerable, the burden of illness remains substantial. Early treatment with antiviral and antibiotics is the mainstay for preventing hospitalization or death.”
Of course, the flu isn’t fun, whether you’re just achy and feverish for a few days or hospitalized in respiratory distress (influenza primarily attacks the lungs), so who wouldn’t want to do something to avoid it? Turns out, the shot doesn’t really do that. Perhaps the infirm, immunosuppressed and elderly should be protected, however meagerly. But us normal folks? Nah. There are safe antivirals out there that will reduce the duration of flu, especially if taken soon after onset of symptoms. Tamiflu (oseltamivir) gets all the press. A pill, it can cause some stomach distress. I have personal experience with the less commonly used Relenza (zamivir), an inhaled powder that competes with the virus as it tries to attach to lung cells. About 10-15 years ago, I went into my office one morning feeling fine and by noon was a basket case: cough, fever, achy, extreme fatigue. I diagnosed myself with the flu and got a colleague to prescribe me Relenza. I puffed on that puppy as directed and by the next day was all better. A miracle. I still have a couple unused devices in my medicine cabinet. So, my free medical advice to you – always worth every penny – is to refuse the flu shot but ask your doc to prescribe Relenza (not Tamiflu) if the flu hits you.
These days make me wonder if those crazy Firesign Theater guys back in college had it right all along.
You can hear the whole side here (5). To recreate that atmosphere in my West Quad dorm room where I first heard it in 1970, you’ll need some help from your local dispensary.
“Weird Al” has a more tuneful take on the same concept (6).
Be well. Stay as far away from doctors as possible, seekers.
A dear friend and double classmate of mine (VHS, UofM), Darai, got to asking me about my medical career. We were discussing our dear old teacher and coach who had just turned 90. I had helped orchestrate a campaign to get him cards and letters for his birthday. I mentioned that for a teacher, hearing from old students is precious. It certainly was for Mr. Horn. But it got Darai asking about my teaching experience, and she was confused about just what duties I had at UofM. So, I let her know, as follows:
Here’s your academic medicine primer: at U of M in 1984, there were two tracks: “physician-scientist” and “clinical scholar”. The former were the lab hotshots. They were expected to spend most of their time in their lab, get grants, then see patients maybe one-half day a week in clinic and on the wards for a month. I was in the latter track. We were to spend most of our time with patients, but research with them was encouraged (which I did, getting grants and publishing papers along the way). I had 3-5 half-days in clinic/week (more as I got older) and attended on the wards roughly 3 months out of the year (when I still did everything else). Attending on the wards meant either looking after a service of rheumatology patients (which went away in the 90s) to advising on hospitalized patients who might have a rheumatic condition. Any teaching was the side-by-side apprentice style. I didn’t do any classroom teaching (which I hated) after my first few years. Both tracks are eligible for tenure (can’t fire me!), which you get by establishing a reputation and publishing papers. I got mine after 8 years, the max allowed before they ask you to go elsewhere. In the 90s, they brought along the “straight clinical” track to accommodate all the docs they hired just to see patients. No other expectations, although you get a little credit for publishing, and you serve from year to year. Most big academic medical centers follow a similar system. If you want to get a better idea of what my career comprised, you can check out my CV, which I keep on my blog (1). I still treasure my CV and keep adding to it. I just got a paper accepted about “physician burnout”, in which I take a position contrary to the mainstream POV (2). Most of my post-retirement papers (I’ve published more in retirement that I had in the 19 years before that) is about some of the semi-unique things I did for which I want people not to forget. I still have several projects on my to-do list, so I expect the entries to accumulate. Sometimes I see it as settling scores. A lot of people didn’t care for what I was trying to do, so f*ck them. Medicine is very screwed up these days and I’m glad I’m out of it. No sign yet that they’re calling back the greybeards to fix things, but I stand at the ready.
Last week, a certain Orange Man sat down with former comedian Joe Rogan for 3 hours of calm discussion of many subjects. Among things the guest mentioned were the skyrocketing numbers of whale deaths along the East Coast, which is dirty with those modern 3-blade windmills, with plans for many more. As Orange Man put it, the windmills are driving the whales crazy. Each windmill makes loud low-frequency repetitive vibrations. And how do whales communicate? Through low frequency sound. The creatures are so musical they have many records, including some big hits, with the 1970 album “Songs of the Humpback Whale” credited with spurring the “save the whales”movement (1). And scientists have only recently figured out how they sing (2). So the poor cetaceans are being shouted at continually by the damned windmills!. Worse than hip-hop blaring from the big scoreboard in the Big House before a game (3). And you thought they were just chopping up birds! Estimates are that each windmill kills 4-18 birds a year, with a rough annual total of about 5 million bird deaths per year worldwide (4). And the majestic birds – eagles, raptors, cranes – constitute a large portion of the victims.
One of the most effective tools used by the environmental movement has been identifying an endangered species adversely affected by whatever project they’re trying to stop. Before Global Warming captured all the attention, was there a more compelling environmental slogan than “Save the whales”? Seeing these two benighted causes at cross purposes, ya gotta wonder how bloody the conflict will get. Downright poetic. Pass the popcorn.
Here is a documentary from X with all the facts. Serious people know this is a bad thing (5).
Fiona Rowe, via e-mail from Cambridge UK, informed me this morning that her company – Pegasus Publishers – wants to publish my book Lost in the Ozone …Again! The Commander, his Boys, and Me. 50 years and Counting. This very personal memoir traces this iconic band and its members from their beginnings in UofM 60s frat houses to their Berkeley brush with greatness, and all that’s happened since,
Some work needs to be done till we see physical books. You can imagine how I felt when I read that e-mail. Too Much Fun! (1).
A week ago marked 5 years since George W. Frayne IV (a.k.a. Commander Cody) ascended to the outer Ozone. He was 77. He’d been unable to tour for over 2 years, his last gig at Chan’s in Woonsocket Rhode Island. I meant for this post to go out that same day, but my screen crashed and I only got my laptop back yesterday. The NY Times had a nice obit the week he passed (1). He’s still remembered, as in this July piece from NPR (2).
Mr. Frayne, son of two artists, entered UofM Art school in ’62 (on full scholarship!). 9 weeks of boogie-woogie piano lessons at his Long Island high school gave him enough chops to hang with several frat bands, and in the kitchen of Phi Psy, washing dishes, he met John Tichy, who taught him the wonders of old country. CC & the Lost Planet Airmen wouldn’t get going for a few years, a momentous afternoon in the Jones Beach lifeguards’ bar including some TV watching of a Sci Fi series from the 50s featuring Commando Cody (3).
I’ll not get much into the history of that great band. Their mix of old country, boogie-woogie, and old-time rock and roll was unlike anything going down then, when the scene featured hard rock and blues. They call that mix “Americana” these days, and practitioners are legion. Tho’ big in their hometown, they found their fortune in Berkeley, cranking out 5 albums and for a while considered the hottest live act in the land. Warner Brothers used their crowd noise on other albums. Having attended many of those concerts, I can tell you that reputation was well deserved. They broke up in ’76, but all band members kept at it. The living members of the band still tour as the Lost Planet Airmen and even put out a CD last year (4).
I first saw the band at Hill Auditorium on 4/17/71, last day of my freshman year classes celebrated by a campus-wide blow out. I broke into the side door and was rapidly smitten by those 8 hippies wailing away. I celebrate the anniversary of that momentous encounter every year (5)
Let’s take a look at the ol’ Commander over the years.
Obviously, I can dole out only so much Commander Cody, here. This little sampler should be a good start.
“Hot Rod Lincoln”. A remake of a 1955 record the band probably found in some used record bin. They gave Commander talking songs, and this was one of them. Their only “hit”, which rose to #9 on the Billboard charts and ended the year ranked #69. Here see the Commander and the boys doing it before 17,000 at Crisler Arena in the rally for John Sinclair (6). They stole the show from a bill that include Bob Seger, Stevie Wonder, and John Lennon (yes, the Beatle).
“Beat me Daddy, 8 to the bar.” Is, IMHO, the best boogie-woogie number. This clip has the additona lfeature of George’s videography. He put clips from Hollywood movies over a number of CC&hLPA songs (7)
“We used to ride”. A good “looking back at our wild times” song. George cut this 10 years after the breakup. I’m not sure if he did the videography as he usually worked in black and white (8).
“Two triple cheese”. By this time, the only LPA around was Bill Kirchen, who helped out bigly here, get down on those French fries! The video won an Emmy and is in the permanent collection of the Museum of Modern Art in NYC (9).
Thanks for reading. Realize, there’s no status that can’t be elevated by listening to the Commander. So, please join Mr. Ozone and me in inviting you to listen away! Maybe you’ll have too much fun!(10). George, we boogie on in your memory.
(Addendum: Mr. Ozone is the work of Chris Frayne, George’s brother and another very talented artist. When he died in ’91 of multiple sclerosis, George took over the illustrating and you’d have trouble telling the difference)
6. Commander Cody and His Lost Planet Airmen. Hot Rod Lincoln. (from Ten for Two, premiered 4/1/72. Produced by John Lennon and Yoko Ono). Posted to YouTube by RW Ike 3/19/21. Available at https://www.youtube.com/watch?v=c8TeHA4UL_8
Sorry, but this is a boring bit of using WordPress as a file systems. I like to have a copy of my CV attached to a URL for the times I wish to share it. Here’s the September 2024 version:
Ann Arbor is a different place on game day. The 110,000-faithful headed to the Big House take up a lot of space, from bars and restaurants and parking spots to simple space on streets leading to the game. It wasn’t much of a surprise when Kathy and I were making wedding arrangements in 1986 – we wanted a fall wedding – that the first question from every establishment we consulted was “is that a game day?”. Fortunately, 10/4/86 was at Wisconsin, a game Kathy watched downstairs while still in her wedding dress.
Many years have passed since. The season tickets we use to access the game were first acquired by Kathy’s dad – an Ohio orthopedic surgeon who nudged athletes to Ann Arbor – were first acquired in ’61. Every year at homecoming, they ask season ticket holders to remain standing according to the status of their holdings. Kathy is usually “the last man standing”. So, football Saturday has always been a big deal for us. And we thoroughly enjoy it, sitting amongst 110,000 of our best friends, enjoying the band, and – at least for the past year – enjoying excellent football.
But something seemed to happen this year. The drive into the B-school parking lot less from the stadium encountered construction at many stops along the way. The 1.3 mile walk from there to the stadium was o.k., although the “music” blaring from the frat houses along the way was an annoying feature that would only be amplified by the big scoreboards at the stadium. We enjoy negotiating the crowds to a tailgate dedicated to “Hero of the Game”, run by a friend of ours. The band always stops by, and the director – John Pasquale – gives his friend Kathy a hug. Carl Grapentine – Michigan’s golden throat announcer – gives notice as to how long it is to kickoff. We in the crowd respond, seeking the big steps into gate 1. Last week, some sort of security issue slowed the ascent of those steps to a crawl. By the time we got in, “band take the field” had long passed. We were in soon enough to hear more hip-hop from the big scoreboard. As the game proceeded, our sensibilities felt things like the 3-minute time outs (so many), the cheesy diversions during time outs, ostensibly to keep us entertained (kicking contests by students, etc), and the total absence of any music from the band in the quiet pauses, favoring instead all the raucous stuff from the scoreboard.
I actually bought a pair of noise cancelling headphones for the game. Our seats are kitty corner from the student section, but that big scoreboard blares everywhere. I do thank them for introducing me to “Mr. Brightside” (1). Our seats are in the same section I scrambled with my buddies to attain as we were trying to make the most of our senior class seniority in ’73. We still had to watch Bo’s boring teams, but we were in the stadium!
As youngsters, we wouldn’t have cared for obstacles for the game. After all, we each had our own bottle of Boone’s Farm. But as oldsters, all this crap makes sitting home by the TV all that more attractive. We did that today, sitting with my brother-in-law in his assisted living facility watching the game on their big screen. Kathy dampened some of my output. Yelling “Orji, Orji, Orji” might not be appropriate in a facility of older persons. But what we learned is that love of Michigan football never dies. Go Blue!!
Come next month, I’ll have not seen a patient for 5 years. But those questions coming in from friends and relatives can still jog this old medical brain. A couple weeks back, Ron, who’s a distant cousin, good friend, and husband of much missed Barb (1), a nurse who used to field most of his medical queries, sent me his latest. Writing for his brother, still having quite a bit of trouble after a stroke, came a link to a recent paper addressing the use of etanercept (Enbrel) in post-stroke pain (2). While very familiar with Enbrel, I was not aware of this application. To quote the South Park kids, “I learned something today” (3) and want to pass it on.
A stroke is a horrible thing. Stroke is the fifth leading cause of death in the United States and a leading cause of long-term disability. The annual incidence of stroke in the U.S. is about 795,000 (4). Whether embolic, thrombotic, or hemorrhagic (I’ll explain), that segment of brain suddenly deprived of blood flow stops sending signals to the portion of the body it controls, and there goes function. That sudden loss was so striking to the ancients who observed it, they considered it a strike from the hand of God, possibly a punishment. Several Brazilian neurologists published their contention that a clear description of stroke symptoms appears in the Old Testament, Psalm 137:5,6 (5). David writes (RSV)” 5 – If I forget you, O Jerusalem, let my right-hand wither! 6 – Let my tongue cleave to the roof of my mouth, if I do not remember you, if I do not set Jerusalem above my highest joy!”. The authors provide their neurologic version “If I forget you, oh Jerusalem, I will suffer a stroke of the left middle cerebral artery, causing motor aphasia and right hemiplegia, if I do not remember you, if I do not keep Jerusalem as my greatest joy.” They comment “Psalm 137 is a relevant contribution from Hebrew culture to the history of neurology.” Is this description of a punishment corresponding to the symptoms found in cerebrovascular stroke of the middle cerebral artery a coincidence? Or did the Hebrews know at that time that left hemiplegia may occur without aphasia, did they know of cerebral dominance about 600 years before Christ?” Interesting, to be sure, but maybe a bit too much inside baseball for what I want to communicate here. But just a few more basics. The sudden cessation of blood flow to a portion of the brain can come about from a plugging material arriving from another part of the body, like the heart in atrial fibrillation (embolic), from a clot forming in a feeding blood vessel (thrombotic), or from bleeding into the brain (hemorrhagic). “Clot-busting” interventions are fraught with hazard as they do nothing to those thrown plugs and can worsen the bleeding of a hemorrhagic. Some recovery is usually possible due to the brain’s incredible plasticity (ability to take in one part over functions handled by another). But post-stroke care still consists mainly of physical therapy. Recently, it has been understood that a stroke was followed by a fairly intense inflammatory response in the brain. Not a surprise, as our bodies respond to damage and death anywhere with inflammation to clean up the mess and start to effect repair. The brain response included high doses of tumor necrosis factor (TNF), a prime inflammatory mediator. Similar high levels of TNF in inflamed joints led to development of an agent to block its attachment to cells: etanercept, a compound that transformed my rheumatology practice (6). Getting this agent into the brain and seeing if it made a difference in poststroke patients was the focus of the paper Ron sent me. I’m glad I finally read it. Here’s my reply to Ron.
Well, Ron, getting stuck in the back of the plane for the ATL-DTW last leg of our Mexico trip last night finally gave me a chance to look this over. Had it been a manuscript sent to me for review, I would have scrawled red ink all over it and sent it back to the editor to have the authors make some major revision, but they got it into Cereus, which is not a bad journal. What they describe are the effects of injecting Enbrel (etanercept) deep enough into spine to get it into blood vessels that run right up to the brain. The justification for this is the fact that strokes bring out an inflammatory process, and tumor necrosis factor (TNF) is a major mediator in this process. Enbrel blocks the attachment of TNF to cells, and is something I used since 1998, when it first became available. It was the first “biologic” (an agent grown in living tissue rather than made in a test tube) and is remarkably effective in rheumatoid arthritis. It really transformed my practice, as patients came back happy instead of just enduring their burden ever so slightly modified by my ministrations. Many other biologics followed, all very expensive ($1000/mo and up) with a few peculiar side effects and conferring an enhanced susceptibility to infections. RA patients just inject themselves in the leg once a week. That wouldn’t work for post stroke inflammation, as TNF is too big to leave the central nervous system and Enbrel won’t cross that barrier. Hence the perispinal injection (7). That must be delivered by a doc, and I’m guessing this is a thing now. When I Googled to find difference between perispinal and intrathecal injections (intrathecal injections are a spinal tap where the drug is delivered right into the cerebrospinal fluid – some chemotherapies go this way), up popped a choice “perispinal etanercept near me”. The author’s very sloppy table did describe 4 studies where this treatment seemed to have an effect.
I even found a YouTube describing the whole process (8).
Thanks for making me dive into something I really knew very little about. Hope this helps.
Bob
My bottom line, stroke patients having troubles with pain or slow return of function should consider this therapy.
2. Joseph AM, Karas M, Jara Silva CE, Leyva M, Salam A, Sinha M, Asfaw YA, Fonseca A, Cordova S, Reyes M, Quinonez J, Ruxmohan S. The Potential Role of Etanercept in the Management of Post-stroke Pain: A Literature Review. Cureus. 2023 Mar 1515(3):e36185. doi: 10.7759/cureus.36185.
5. Resende LA, Weber SA, Bertotti MF, Agapejev S. Stroke in ancient times: a reinterpretation of Psalms 137:5,6. Arq Neuropsiquiatr. 2008 Sep;66(3A):581-3. doi: 10.1590/s0004-282×2008000400033.
6. Burness CB, Duggan ST. Etanercept (SB4): A Review in Autoimmune Inflammatory Diseases. BioDrugs. 2016 Aug;30(4):371-8. doi: 10.1007/s40259-016-0188-z. Erratum in: BioDrugs. 2016 Oct;30(5):481.
7. Tobinick EL. Perispinal Delivery of CNS Drugs. CNS Drugs. 2016 Jun;30(6):469-80. doi: 10.1007/s40263-016-0339-2.
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