The Walking Man on New Year’s Eve. What is Ahead?

The Walking Man was outside again this morning, his bulky winter coat casting a Michelin Man shadow on the suburban snow. Another frigid day, but he trudged down the street, a knit cap pulled tightly against his scalp. His gloves were massively thick, his matching muffler pulled tight across his face. Bulky wireless headphones arched across his head; his personal crown jewels. Sunlight, the only hint of warmth, gleamed against his thick sunglasses.

He has walked this freezing loop twice each morning of this arctic week, while others huddle inside. They walk on basement treadmills or in glitzy health clubs. Surely he has access to both; what keeps him moving on these slippery streets? Could it just be joy at being outside in the sun, using this Christmas to New Year week to escape from the four wall office and the darkness of Midwestern winter commutes?

He enjoys knowing that his are the only boot prints he sees in the snow. Maybe as the year comes to an end he is using the cold and solitude to sharpen his thoughts, to focus on the 12 months gone by. He must think about his triumphant moments and times of joy. But he is trying not to forget the incidents that turned out less well, trying to tease out what he did wrong. Is there anything he can learn, some things to carry into the New Year?

What is he listening to on those technically up-to-date, but oh, so out of style, headphones? The same songs that always play in his head, reminding him of the past? Or is Pandora streaming new sounds to him, expanding him, filling him with beats and rhythms and vocabularies that at first sound discordant, but with enough listening can become familiar and comfortable. He can learn to tolerate, just as his parents must have learned to tolerate the Beatles and the Stones.

Maybe it is not music at all that is Bluetoothing to his ears. It could be podcasts of angry Trump deniers, or even angrier Trump supporters. The vitriol and bile have been unending. Has he taken sides? Has he contributed to the tumult? Or does his head still hold the hope of people conversing with each other, not yelling at each other.

He checks his wrist frequently. Is he that concerned with the time? Or is his watch measuring something else. How many footsteps in a mile, how many miles until he reaches his goal? I like to believe there is no goal, the step count on his FitBit s a mere excuse to keep moving as the sweat soaks his tee shirt.

From time to time his humid breath, channeled upward by his muffler, forms a cataract of condensation on his sunglasses. The open spaces in front of him turn hazy and indistinct. He wonders if this blur is what old age will be like. How many New Years will he have ahead to celebrate, and where will he celebrate them?

The Walking Man will be outside again tomorrow. I know he will be. Will the New Year bring answers to his questions?

A Happy New Year to All. Join the “Getting More from Les” Facebook fanpage at https://www.facebook.com/lesraff1

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Are We Kissing Friends Now? Seven Rules for the Unsure.

A Kiss is Still a Kiss
As Time Goes Bye
Herbert Hupfeld, 1931

Would Larry David diss me as a “kisser-greeter?”

I never want to harass. I don’t want to spread germs. But I don’t want to be a cold fish either. So I never know. When do I go for the hug with a cheek-to-cheek air kiss hello and when is a handshake all it takes?

After a recent experience (see #2 below) I decided to evaluate my guidelines. Here are my 7 rules for surviving a complicated world:

MY SEVEN RULES

Coworkers and staff: Never, ever, ever hug/kiss. And in these difficult to navigate times, let me add one more NEVER!
A neighbor I am meeting for the 2nd time: Tried the hug/kiss, was chided: “So we are kissing friends now?” Best not to dive in until I know someone a little, or a lot, better.
A neighbor who hug/kisses everyone else, but who seems to duck away whenever I come to say hello: Best not to hug/kiss. And best not to feel offended. Maybe she is allergic to the cat fur clinging to me.
All the vendors and sales reps who pop into my office at the worst possible time, just so they can introduce me to the new regional manager of the Northwest District of the Midwest Zone for Product Improvement and Research: Best not to hug/kiss. A handshake and a glance at my watch is a better way to subtly let them know I really AM busy.
Vendors and sales reps who pop into my office with Garrett’s Popcorn for the whole lab and who initiate the hug: Best not to hug/kiss (see Rule #4,) but OK, I go along with it for the sake of employee morale. Especially when the popcorn is the cheese and caramel corn mix, and very fresh.
New Year’s Eve: Assuming everyone has had enough champagne, everyone I can get to between 12:00 and 12:01, (or as long as it takes to sing Auld Lang Syne on Channel 5) gets a hug and a kiss. Also anyone I have ever watched “It’s a Wonderful Life” with, after we have wiped the tears from our eyes.
Female members of the extended family: The hug/kiss seems pretty natural, all the way up to the great grandmas. For purposes of this rule, I draw the line at 3rd-cousin-twice-removed-via-marriage.

Those are my rules, subject to change. What are yours?

If you missed it: 7 Words Pathologist Won’t Use

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Seven Words Pathologists Shouldn’t Use Any More. Number 6 Says It All.

George Carlin set the standard. His “Seven Words You Can’t Say on TV” has lasted for more than four decades as both a comedy classic and as a listing of what American eardrums are too sensitive to hear being broadcast. Yes, there have been some breaks in the wall, and cable subscribers have moved well beyond his words both aurally and visually.

And now we have the seven words/phrases the CDC can’t use. Things like “science-based,” “fetus,” and that truly shocking word, “transgender.” I am sure some Trump bureaucrat wanted to add the word “truth” to the banned list, but that would have meant delisting an important word such as “entitlement.”

Not knowing what is coming next, in a pre-emptive move, I have decided to delete the following 7 words and phrases from my future pathology reports. With luck, this can become a nation-wide trend and we can all live happier, healthier, lives:

Breast: I don’t want any impressionable schoolboys tittering over my reports. “Mammary Gland” is an acceptable alternative, but cutting funding for mammography screening should help us eliminate breast biopsies, and we can forget about them entirely.
HIV: White, heterosexual Christian males don’t have to worry about this. On future reports, I will replace the acronym HIV with “The Gay Virus from God.”
Emphesyma: I will call those giant air spaces I see in miner damaged lungs “Parenchymal Pillows.” No way to link that to the rebirth of American coal mining industry.
Ovarian: Men don’t have ovaries. Therefore why report on them? No substitute word needed.
Malignant: People who know they have cancer want therapy. Freeloaders, such as Medicare recipients, expect the government to pay for the treatment. That just increases the national debt and forestalls more tax cuts for big donors. My future pathology reports will refer to cancer cells as “not-quite-normal cells.”
Diagnosis: Too much certainty. I will only use this word when accompanied by a totally loony “alternative diagnosis” agreed to by Sarah Huckabee Sanders.
Nuclear: To me, it means the center of the cell, but to others, it’s the sound of bombs away. “Round thing in the middle” will have to do for now.

Or maybe I should just retire now.

The opinions above are the opinions of the author and not of UroPartners LLC.
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It Is The Chocoholiday Season. Do You Love Chocolate Too?

I know this is the time of year to party. And that means eat and drink. Diets, be they caveman or Weight Watchers, go out the window. Champagne gets popped, in a morning Mimosa or a midnight toast. Rising hemoglobin A1C courses through bodies, riding on a chariot of elevated blood glucose. A time for moderation this is not.

It may be like this every year, but I can’t remember a past December month of merriment filled with so much chocolate. It is everywhere; it is everything. Nobody doesn’t like chocolate (ok, I once did meet someone who was not a chocoholic, but I purged that person from my memory banks.) Where is it popping up this year?

The first sign of the holiday binge was a consulting firm’s annual gift of a box of Frango Mints. This is a mixed blessing. Since Barb worked in the candy department of Marshall Field’s as a teenager and developed Frangophobia, these are forever banned from our home. Good thing they get delivered to the lab. 5 points to anyone who knows the original name of these chocolate mint delights.
This was followed by a giant milk chocolate bar from one of our clinical offices. As special decoration, the corporate logo was etched into the chocolate. This is a variation from years ago when the group etched profiles of their own faces onto the bars. I must say there was some satisfaction in the old days crunching on those heads.
Earlier this week, I received a text from the lovely people who bought our old home. A FedEx package for us had been delivered to them. Could I come by and pick it up? The delivery consisted of a nice note from a vendor and a box of, what else, chocolate. This time it was molded around caramel and nuts in luscious turtles. More treats for the lab.
Another vendor provided us with the largest box of Russell Stover Chocolates I have ever seen. Roughly the size of a carry-on suitcase and accompanied by a 12-page instruction manual, it was filled with enough chocolates to pave a new runway at O’Hare. Somehow all those candies were gone in 2 days.
Our toxic liquid waste hauler (yes OSHA Inspectors, we follow all the rules!) chipped in with several boxes of chocolate. I’ll let you come up with your own comments about the cream fillings.
Instead of an elf on a shelf, I had the pleasure of a choc on a chair. Somehow, with all that chocolate goodness floating around, a piece found its way to my desk chair from where it was ground it to the seat of my slacks and the driver seat of my car. There I found Barb trying to dislodge it with her nails. Manicure for her, carwash for me.

There is lots of holiday time ahead. By year’s end, I anticipate chocolate gelt for Hannukah, and Barb and I have decided a Portillo’s Chocolate Cake is in our future as well. I’ll pack on the pounds, but it will always be with a smile. How about you? Are you ready for some CHOCOLATE!
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Six Real Life Slides. Which Ones Show Prostate Cancer? Can YOU Make the Diagnosis?

A friend and I were reminiscing the other night about our high school biology class at Sullivan High with Mr. Dubin. That course was the first time I ever used a microscope. Believe me, I had no idea that staring at magnified pieces of tissue would be the basis of my future career.

What crosses my desk, or more literally my microscope stage, on a daily basis? Looking at five or eight or twelve sets of prostate biopsies, with multiple parts to each set, I may be examining over 200 slides in a day. There is plenty to see. But since the goal of 99.9% of prostate biopsies is to try to either confirm or rule out the presence of cancer, most of what is on the slide is background music, or sometimes just noise. Just as you tune out much of what you hear every day, I have to tune out the other “stuff.” It is on the slide, but like an Evelyn Wood trained speed reader, I try to hone in on the important and try to ignore the rest.

Remember that study a few years ago claiming pigeons could identify cancer on a slide? That was a lot of pigeon poop. But how about you? Could you think back to your own high school biology class and separate the benign from the malignant? Give it a try. Take a look at pictures A through F at the beginning of the post, make a diagnosis, and see how accurate you are. You can click on the picture to get an enlargement. Leave your number correct in the Comment field on the blog site or on Facebook. All the pictures are from cases I saw in the last day. A shout out to the great Anatomic Pathology Team at UroPartners Lab that keeps the slides coming.

Answers are below.

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A) You might have thought this picture looked very busy. Lots of cells here, but most of them are inflammatory cells. This patient probably has prostatitis, an inflammation of the gland. No fun to have, but not cancer. I am sure the patient was relieved to get his benign diagnosis.

B) Did you recognize this as normal prostate? Benign, with nothing to indicate the glands are at any risk to become cancerous. That’s all we identify in about half of our patients. It’s good to see.

C) Yes, those are cancerous glands. This is what we would consider a low grade (less aggressive) prostate cancer. Some men with this type of lesion may not need any treatment, just careful follow-up and a good relationship with their urologist.

D) No, these glands are in the biopsy, but not part of the prostate. They are colon glands. How did they get into the sample? To take the biopsy, the urologist passes the needle through the patient’s rectum, the end part of the colon. Little fragments of colon tissue frequently become incorporated into the biopsy. Nothing to worry about for the patient, and usually pretty easy to recognize on the slide.

E) See all those small dark cells? This is an aggressive prostate cancer. Tumors like this have a propensity to spread, so most men with a tumor formed by cells like this will get some form of therapy. Fortunately, there are some great new treatments, some even involving the bodies own immune system to fight the cancer.

F) This can be a tricky one. The cell nuclei look dark and irregular, often a hallmark of cancer. But see all that golden brown pigment? That’s called lipofuscin, and that easily identifies the glands as being part of the seminal vesicles, benign structures that sit on top of the prostate. I have often felt there must be some higher being that put that lipofuscin there to save me from making a bad diagnostic mistake.

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So how did you do? Could you separate the good from the bad? I’ll bet you could do better than a pigeon, but maybe not better than me!

Don’t forget to give your score in the Comment field of either the blog page or Facebook.

The opinions expressed above are the opinions of the authors, not UroPartners LLC.

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Our Biggest Fan Is Moving On, But Because Of Him We Will All Keep Blogging

The ChicagoNow Blogger Community has a little monthly ritual. On the last Wednesday of the month, Jimmy Greenfield, the Community Manager — the guy who keeps ChicagoNow clicking — announces a topic and gives all the participants one hour to write and publish a blog. He calls it Blogapalooza, because nothing is really big unless it is a palooza; I guess it could have been called Blognado, but maybe that name was already taken.

Many of the ChicagoNow bloggers palooz on the given topic. I have never been one of them. When it comes to what I choose to write, I am a bit persnickety. I wait for a great topic, or a nifty headline, or an ear-catching phrase to enter my right cerebral cortex. The idea either ferments nicely and I sit and write, or it turns to vinegar and winds up in our toxic waste barrel here in the lab for appropriate disposal. It was the same in the years I gave the annual Board of Education High School Commencement Address. I would be stymied for days or weeks until the right inspiration hit the right synapses. So even though I always get the Blogapalooza announcements, I have never participated. It just isn’t my bag.

Nonetheless, I was aware the topic for last weeks ‘Palooza was (spoiler alert) “write about goodbyes.” A topic you can sink your keyboard into in many ways. I have penned a few goodbye blogs myself–to a missed mentor, to a marvelous mutt, to Thursday Tennis. But I now suspect Jimmy had a deeper motivation when he chose this topic.

This morning Jimmy notified the ChicagoNow blogger community that he was leaving his position and the blog site he had midwifed and nurtured to life. He is not leaving the Tribune, but moving over to the digital sports page. He is choosing a moment where Chicago sports is at a low point, so I know he isn’t doing it for fame and glory, but perhaps he is seeking a local journalism area that needs his expert touch.

Jimmy, thanks for the insight and guidance. Thanks for the technical know-how you shared. Thanks for being the champion for all of us, with our varied backgrounds, our different careers, and so many novel reasons for writing. Go do your digital sports thing. I know your love is for the Cubs, but don’t forget we are a two baseball team town.

So grab a cold one and remember, this blog’s for you!

———-

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“The Marvelous Mrs. Maisel”–“Mad Men” For Jews, and for Gentiles Too.

After reading some great reviews and hearing Laury tell us how wonderful it was, Barb and I sat down last night and watched the first two episodes of Amazon Prime’s new streaming series The Marvelous Mrs. Maisel.

Oy vey, did it feel good.

Mad Men set the bar for recreating the mood and atmosphere of the early ’60s. With Mrs. Maisel, we are back in 1960* New York City, but this time the setting ranges from the doorman managed co-ops on the Upper West Side to the shmatte factories and clubs of Lower Manhattan, all with a decidedly Jewish spin. Don Draper may have had a Jewish mistress in Mad Men, but with Mrs. Maisel, we take center stage, literally.

In the first two episodes, we see young marrieds Miriam and Joel Maisel each try their luck as stand up comedians. One of them steals material from Bob Newhart, the other finds humor in the catastrophes of everyday life, forges a relationship with Lenny Bruce, and learns to get a receipt for bail money. Want to guess which is which?

We care about the characters and their faltering (think not-too-bright secretary) relationship, but it is the atmospherics and little details that steal the show: Snaring the Rabbi for the Yom Kippur Break the Fast meal. Making up your face and getting the curlers out of your hair before your husband can see you in the morning. Bribing the club manager with a brisket and latkes. Meddling mother and father-in-laws. And the panic when someone dares to admit out loud there is shrimp in the eggrolls (something we all must surely know.) Universal touches for Jewish America early in the Age of Camelot.

With This is Us on December hiatus, Barb and I should have plenty of time to savor the remaining episodes of Season 1 of Mrs. Maisel. And word is that a second season has already been approved for production. So we will have the fun of seeing whether Miriam can make it on comedy club circuit and whether Joel gets over his secretary. And with every episode we can ask the primordial question, “but is it good for the Jews?”

*I know, some reviews say 1958. But the Bob Newhart never appeared on the Ed Sullivan Show before 1960. That is also when “The Button-Down Mind of Bob Newhart” album was released. So it is 1960 for me!

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Volvo Pledges No Fatalities. Ten Other Pledges for 2020 I Would Like to See.

Recently Volvo, the safety-first Swedish car manufacturer, has been advertising its safety pledge; by 2020, no one will die in a new Volvo automobile. Quite a bold promise to make! I applaud the manufacturer’s gumption, but question the likelihood of success. Especially since I despised the one Volvo I owned — one electrical failure after another. Let’s hope the company has made tremendous strides in quality control!

I don’t know if Volvo can pull it off, but I do know that there are lots of other promises, pledges, and guarantees I would like to see by 2020. Who is bold enough to make these commitments?

PLEDGES I WANT FOR 2020: NON-TRUMP DIVISION

The airline industry will promise to utilize artificial intelligence to devise a system in which no passenger traveling from Chicago, Illinois to Fairbanks, Alaska gets routed through Miami, Florida.
The recording industry will pledge that I recognize at least one song nominated for the Record of the Year Grammy.
The Sox, Cubs, Bears, Bulls, and Blackhawks will each pledge not to be in Year 1 of a 5 Year rebuilding plan.
While the airlines are making pledges, how about a guarantee that there are no bumped passengers hauled off a plane by air marshalls, or better yet, no bumped passengers at all?
The Democratic Party will pledge to have a viable Presidential Candidate. (I know this one is a b-i-g stretch!)
Progressive Insurance and Toyota will pledge to swap Flo and Jan for a month. Just because it would be fun.
Brian Urlacher will promise to readopt the shaved head look so we can get rid off all the awful hair growth billboards along I-294.
NBC will pledge that “Chicago Streets and Sanitation” will be the last show in it’s “Chicago” pantheon, and will return the streets of Chicago to the residents of Chicago.
Wisconsin will pledge no new shootings by 8-year-olds legally licensed to carry a weapon.
Chip and Joanna, Jonathan and Drew, and all those House Hunters will promise to take a year-long sabbatical so my TV sets can take an HGTV sabbatical too!

What pledge would you like for 2020? Leave your comment on Facebook, or email me at les.raff@post.com. And check out our new Facebook FanPage!

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