Assault Weapons Jar My Ride

“Lady Bird wanted the highways clear of billboards and junkyards, and filled with green landscaping and wildflowers.”

As I accelerate through my twice-daily commute along Interstate 294, I get a sense that Mrs. LBJ wasn’t particularly successful in her drive to beautify America. The billboards she fought against are the mile markers of my journey. Most times the giant messages pass into my subconsciousness where I keep my mental records.

I know where to expect a Blue Cross/Blue Shield “through it all.” I have counted as Brian Uhrlacher’s hair restoration billboard postings outnumber the total tackles in his Bear’s career. A big red arrow points the way to mortgage refinancing savings, while Wintrust is trying really hard to out-hometown the other guys. And the ~~strip~~ gentlemen’s clubs advertise what they have always advertised.

As a sign of the times I know who is pushing rapid COVID-19 testing, and who wants me to learn all about marijuana, both medicinal and recreational. Preferably not indulged in while zooming past construction zones and road shoulder stalls.

This month I have noticed a new billboard, a new advertisement asking for an investment of my time and thought as I thunder past. It must be about 650 sq. ft. in size, rising just to the right of the southbound lanes. And it features a silhouette image of a firearm. I am not an expert, but whizzing past, it sure looks like an assault rifle.

I assume the billboard is advertising a gun store, or a shooting range, or some other gun-related enterprise. I don’t care what it is for. It disturbs me and I despise it. I don’t get upset seeing reminders of the health plan I no longer belong to, the hair I can’t grow, or the pot and women that I don’t indulge in–but seeing weapons of mass destruction on my very favorite tollway? It brings tears to my eyes.

In the indeterminate future I will retire. I will not drive past this billboard. Better yet, I can wish the billboard, and the death it portrays, will go away. If only my wishes would come true.

Lady Bird Johnson could have told you rifles don’t beautify highways. She could also have told you how one changed her life.

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Six Vaccinations to try your Patience

I’m not an ant-vaxxer
I agree with all my might
That getting stuck, like a sitting duck,
Is the way to do things right.

But in the last six months it seems
My arms are getting sieve-y
So many holes, that bless my soul
My favorite drug’s Aleve-y.

It started with the shingles shots
A pair I’d heard were scary
It would burn your toes and crinkle your nose
And turn your tonsils hairy!

Next ‘twas time for the annual boost
Of the vax for influenza
The pharmacist jabbed, and the air I grabbed.
As I fainted ‘gainst the office credenza.

Six weeks ago it was my turn
For my left arm to surrender
I stood in line, whittled away the time
For two doses – the Moderna protector.

And when I thought that I was finally done
With Band-Aids, needles, and an alcohol wipe
At today’s physical exam, where I learned I am
Old enough for an additional type.

I’m Medicare age (a young 65)
Ripe for the shot that blocks out pneumonia
A vicious disease, brings the old to their knees
Those damn pneumococci will own ya.

But now I at last I think I’m done,
I’ve gone through all the potions
I’ll roll down my sleeve, put my doctors on leave
With my mind full of all healthful notions.

Photo courtesy Health Stock photos by Vecteezy Like what you read here? Add your name to our subscription list below. No spam, I promise! ___

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It Takes More Than My Microscope For Me To Give You A Diagnosis Of Prostate Cancer

Microscopic appearance of prostate cancer (left) with special stain (right.)

When I talk to folks, or blog to you all about making diagnosis, what I usually chat about is the time spent looking down the twin ocular barrels of my Olympus BX43 binocular microscope. After all, that is when my eyes and brain are most engaged in looking at the prostate tissue and forming a diagnostic impression. But in fact, that microscope time is probably less than half the time I spend on the hundreds of pieces of prostate tissue I see every day.

In the morning, while our crack anatomic pathology team is busy grossing, processing, embedding, cutting, staining, and cover-slipping prostate tissue to prepare beautiful slides for me, I am getting my paperwork rolling. I download a spreadsheet of all my cases for the day, using it to create individualized worksheets for each case. That lets me know the age of each patient, the name of the urologist doing the biopsy, and how many parts I can expect with each case. Basic stuff.

I then take my worksheets and progress to our online medical record (I love those online records!) Here I can get information on the patient’s past prostate history. Has he been biopsied before? What did we find? I can look at the most recent PSA blood test, and also look at a timeline of all the past PSAs to see how the values have changed over time. In addition, many patients have a “targeted biopsy,” aimed at “regions of interest” in an MRI of the prostate. I can read the radiologist’s report and learn just how suspicious those ROIs are.

All this information is running through my head when I look at the slides. Although it is a pathology maxim that “the truth is in the glass” the other data can guide me as I am making decisions on what I see. Oh, and while I am looking at that glass I am recording my findings on my worksheet, leafing through textbooks or websites for help on difficult cases, ordering the special stains I need, and filling out billing sheets. Sometimes it feels like my head is bouncing back and forth like a ping-pong ball, with a glance through the ‘scope as I am turning left and right.

Once I have handled the last slide of the afternoon I drop the worksheets with our administrative team. It is their job to transfer all my codes into our Lab Information System to create a nicely formatted report.

Next morning, I review the reports and add any information I have garnered from the special stains I ordered the day before. It is almost time to electronically sign the reports, and whisk them via the magic of interfaces to the performing urologist. But before that can happen, especially in malignant cases, there is one essential review step.

Nobody wants to call a benign biopsy malignant. So before a cancer case is signed out, we have it reviewed by at least one additional member of our pathology staff. In the oldest days that would be done at a multi-headed microscope. In the more recent old days (i.e. pre-Covid) we would review cases on a video screen in my office. Since the pandemic, we have avoided congregating and now place our slides on a tray and pass them to another pathologist for review in their own offices. A log sheet ensures all cases are seen and diagnoses are concurred with. Only then are the cases signed and distributed.

Am I done at that point? Almost! Since UroPartners has a very vibrant Cancer Registry, my final step is to mark the parameters of each cancer (grade, number of positive cores, length of involvement, other findings) on a sheet for our Tumor Registrar. This data allows our group to have an ongoing understanding of the patients that pass through our doors and to follow large cohorts of patient data. This has fueled numerous scientific papers and advancements in prostate cancer treatment.

My microscope may be my best friend, but it has lots of help in making sure our patients have the correct diagnosis in a timely manner. And that is always my goal.

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The above is the opinion of the author and does not necessarily reflect the opinion of UroPartners LLC.

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Searching and Dreaming for Mini-Snickers Ice Cream Bars

Are Snickers Mini-Ice Cream Bars Gone For Good?

Don Quixote with an impossible quest. Ponce De Leon exploring for the Fountain of Youth. Humphrey Bogart seeking gold in the Sierra Madre. Great searches all, but none can compare to my hunt for the Mini-Snickers Ice Cream Bar.

As a candy craving youth, I was never a tremendous fan of the Snickers Bar. While I did prefer Snickers to its stablemate, the overly-fluffy 3 Musketeers Bar, Snicks just didn’t compare well to the smooth and sweet Milky Way Bar. The peanuts in the Snickers Bar just felt wrong.

It was between 7th and 8th grade, while a camper at a Rogers Park summer day camp, that I discovered frozen Snickers Bars at the concession stand. I found that the crunch of the peanuts merged perfectly with the icy-chilled nougat, chocolate, and caramel. I enjoyed those frozen bars at break time all summer long, and then forgot all about them when the school year rolled around and camp came to an end.

It was years — more like decades–later that I came across Snickers Ice Cream Bars at the local grocery. Snickery flavored ice cream, chocolate coating, one or two peanuts. I bought a box and fell in love.

But there was a problem. Six to a box, they were large and loaded with calories. A blood glucose nightmare. Fortunately, on my next weekend shopping trip, I found Mini-Snickers Ice Cream Bars, a box of 12 with just 90 calories each. Surely my nutritionist couldn’t object to that.

So each evening, after finishing dinner and before clearing the plates off the table, I would pet the dog and walk to the fridge, open the freezer door (frequently forgetting to close it after) and treat myself to my 90 calorie bar of heaven.

Until the pandemic. While you were noticing the toilet paper disappearing from the supermarket shelves, I noticed that there were no Snickers Ice Cream Bars of any size to be found. My depression was palpable.

I replaced the Snickers with Mini-Ice Cream Sandwiches, squishy concoctions of phony ice cream between two faux-chocolate wafers. Dreadful. And I waited. After a few months, the full-size Snickers Ice Cream Bars reappeared. But where were the Minis? Nowhere, man.

And still, a year into Corona, I search. At every grocery store we go to (Sunset, Woodman’s, Mariano’s, even Whole Foods,) I prowl the freezer cases hunting for the elusive 90 calories. Barb knows we can’t leave the store until I have investigated. And I find nothing, nada, zilch.

What about online shopping sites? I enter Snickers Mini Ice Cream Bars into search bars and the sites just say Not Available in this Zip Code, Not Available In this City, Not Available All!

But one day they will be back. I just know it. Until then, I will join Don Quixote and dream the impossible dream.

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COVID-19. A year in the life.

One year. One long, never-ending, never-repeatable year.

One year ago I told the story of our shopping trip to Woodman’s, as a maskless, non-socially-distanced, throng filled the aisles and their shopping carts with paper towels and toilet paper and anything else they thought would help them in a long siege. Our year of Covid-19 had begun.

I sit here now, as one of the fully-vaccinated, physically undamaged, lucky survivors. No one close to me lost their lives, indeed, I have to think hard to come up with anyone in my circle who even tested positive.

We never closed the lab, though we limited our on-site staffing in the early days. We never stopped seeing our children and grandchildren, with drive-bys graduating to driveway and back yard visits, then in-garage celebrations, and eventually, small gatherings in the kitchen.

We voted (by mail.) We mastered many difficult jigsaw puzzles (and gave up on some impossible ones.) We wrote haiku and parody songs and scripted our favorite TV shows. And we binge-watched. Oh, how we binge-watched. Who knew there were so many dramedies coming out of Australia! We cooked.

We avoided one pet while gaining another, the dog who has grown and grown both in his own body and in our hearts. We have joined Boards, volunteered, and served on committees, now knowing enough to mute our microphones on interminable Zoom calls.

And what have we learned? The pleasure of welcoming our friends and neighbors to our socially distanced back yard, instead of trying to converse in a noisy restaurant. That many movies are just as good at home as at a multi-plex. That books can still take us away from our everyday life. That science will win out–but not always right away.

My thoughts go out to all of you who have suffered much much more. The fact that we have turned a corner may be no solace to those of you who have lost a mother or father, lost a job, lost financial security. Still, I pray we are all on our way to a better place and time.

Seinfeld: The Vaccine

Setting: Jerry’s Apartment
Jerry: Did you get it?
George: I got it.
Jerry: Where did you get it?
George: I got it in my arm, where do you think I got it!
Jerry: No–I mean where did you go to get it?
George: I went to the Clinic.
Jerry: Oh, the Clinic.
George: What’s wrong with going to the Clinic.
Jerry: Oh nothing, you know it’s just…
George: Just what?
Jerry: They treat things there.
George: I didn’t go to get TREATED. I went for the vaccine!
Jerry: Who gave you the shot? A nurse?
George: I don’t know, she was wearing a white coat. I think she was a nurse. I don’t know. I didn’t ask. You know how I feel about authority figures. Especially in white coats.
Jerry: Yeah, you melt and you fantasize.
George: No fantasies! No fantasies! I was thinking about my health.
Jerry: So did she give you the “pinch?”
George: The “pinch?”
Jerry: Yeah. They lift up the skin on your arm jab the needle in there.
George: Now that you mention it, yes I got the “pinch.”
Jerry: Hmmm
George: What’s hmmm?
Jerry: I read that the “pinch” makes it less effective.
George: Oh great, so I went to the Clinic, waited two hours, and now I’m still gonna get the virus? You kill me Jerry, you just kill me.
Jerry: It won’t be me, George.
Buzzer rings
Elaine’s voice comes over the intercom: Let me up, Jerry.
Jerry pushes the door buzzer button and Elaine bursts into the room and does a happy dance.
Jerry: Look at that, I think she’s infected.
Elaine: I got it, I got it.
George: Did they give you the “pinch?”
Elaine: Hell no–they give you that you die anyway.
George sinks his head into his hands, mumbles.
Elaine: They gave it to me in my car, and then I had to sit in my car for another 30 minutes to show I wouldn’t pass out.
Jerry: Wasted time?
Elaine: No–the tech who gave me the shot was sort of sexy so I…
Jerry: Oh you…
Elaine: It was a good half-hour.
Knock on the door.
Newman’s voice from outside the door: Hello, Jerry.
Jerry swings the door open: Hello, Newman.
Newman to Elaine: I saw you there. And I saw that smile on your face. I know what you were doing.
Elaine: And what else did you see.
Newman: Nothing.
Elaine: And that’s all you are going to see…ever.
Kramer explodes into the room, carrying a metallic contraption.
Kramer: Have you seen the lines? It’s taking them waaay too long. But I’m going to do something about it.
Jerry: And what is that, dare I ask?
Kramer: I made this auto-shooter. It takes my shooter half the time that it takes a nurse to give the vaccine.
George: Is it battery operated?
Kramer: No, you have to plug it in. Let me show you.
Kramer pulls out a power cord, plugs into a wall outlet, sparks crackle, and the room goes dark.
Camera pans out to the whole building, and then the whole city, all going dark.
George: Why did she have to give me the “pinch?”

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