MY LIFE

Each time I sit down to write about my journey from student to doc and from doc to patient, I struggle to figure out how it all fits together.  Every time I figure out how the pieces of my life come together, I realize there is more to the picture and set about rearranging them again.  So, why is writing about my journey so important? 

According to Merriam-Webster, a mentor is “a trusted counselor or guide.”  Each of us has the capability of mentoring others.  At each stage of my life, I’ve been lucky enough to find a mentor who guided me safely through that stage and passed me off to the next mentor as my journey progressed.  It’s time to pay back all the gifted people who served as my guides and support by putting our story on paper.  It is my fervent hope that this book will both encourage my readers to mentor others and to find mentors of their own.

When I look back over the years, I realize that I traversed a minefield and only survived by the grace of God.  At the age of 17, my friend and I would take his 16 foot Boston Whaler out into the Chesapeake Bay and, occasionally from there, into the Atlantic Ocean.  No one knew where we were.  Our gear consisted of 4 lifejackets and a can of gas.  We didn’t have a radio or charts; we just hugged the shoreline.  Insane? Of course, it was but those were different times.  Parents didn’t hover.  Once old enough to have a real bike, I could go everywhere; and I did.  My range was approximately 5 miles but occasionally I went further. 

When I was 16, I got my first car.  Believe it or not, my range increased to 300 miles as I spent weekends in Richmond with my best friend and dated in High Point, NC.  I had no mentor during my early years.  I had parents who were very liberal and, metaphorically, blind.  My first speeding ticket was in a stock Olds 88 in excess of 100 mph.  My father had the speedometer shop first break the speedometer, then repair it, and then certify that it was broken.  The judge stated, “Mr. Segal, even with a broken speedometer, your son should have known he was going too fast.”  He took my license for 90 days.

 My second ticket was for running a stop sign.  My dad successfully fixed that one and the next.  My dad taught me how to fix things.  Thus was born my nickname, “Milo” (the fixer in “Catch 22”).

In today’s world, my parents would have been jailed for child neglect.  They were good, hard working parents of a different era.  The lack of guidance gave me a lot of room to mess up and get hurt.  It also gave me the confidence that I would need as life became more complex.  I was lucky to survive my pre-college years. 

My first mentor showed up in college. 

Enough for today.  Here’s your joke.

A wife arrived home after a long shopping trip and was horrified to find her husband of more than 10 years in bed with a beautiful, younger woman.

She was about to storm out of the house, but her husband stopped her. He wanted to explain the circumstances that le

d to them being in bed together.

“Before you leave, I want you to hear how this all came about. Driving home, I saw this young girl, looking poor and tired, I offered her a ride.”

He explained that she was hungry, so he brought her home and fed her some of the roast in the fridge that his wife had forgotten about. He continued:

“Her shoes were worn out so I gave her a pair of your shoes you didn’t wear because they were out of style.”

The woman was freezing from being out in the chilly weather for so long, so the husband gave her the new birthday sweater his wife never wore. He said:

“Her slacks were worn out so I gave her a pair of yours that you don’t fit into anymore. Then as she was about to leave the house, she paused and asked, ‘Is there anything else that your wife doesn’t use anymore?’ “And so, here we are!”

MENTORS

Is it luck or is it God’s plan?  I believe it’s a little of both.  Much of what happens to you is determined by the paths you take; and, often, the path you take is determined by a mentor.  Mentors are like traffic control officers, stationed at key intersections and sending cars left or right depending on road conditions and other variables.

In modern terms, a mentor is akin to your car’s GPS.  The AI (artificial intelligence) has multiple routes it can use; and, on any given day, at any given time, it will serve up the quickest or safest route.  Your choice is to follow the prescribed route or go it on your own.

I’ve been lucky!  I’ve always looked for mentors and listened to their wisdom when offered.  My first mentor was a family doc in Norfolk.  I’ve written about Dr. Perlman (Jerome) in the past.  Jerome listened to me and treated me like an adult even when I was just 6 years old.  My earliest memories of Jerome were lying over his lap while he shot me in the buns with Penicillin.  You could be fairly confident that, if Jerome made a house call, you got a shot of Penicillin in the butt.  One in each bun if you were really sick. Geez, I hated that shot.

My thirteenth year of life was a very bad year.  I was sick, not just the sore throat kind of sick, I was major sick.  I saw a lot of Jerome that year.  I remember pulling up to and parking in front of his office at 7 a.m.  My mother would go to the front door and put our name on the list and then walk next door to the Seven Eleven for her coffee.  The office would open at 7:30; and the receptionist, Jerome’s wife, would call patients up to be seen according to the order they signed in.

Jerome would ask questions, examen me and, ultimately, send me to Johns Hopkins in Baltimore to be diagnosed as my findings were complex.  That year I peeled from head to toe (scarlet fever), turned yellow (mononucleosis/hepatitis) and slept a lot.  That was also the year I decided that I would be a doctor and work with Jerome.

I talked to Jerome throughout the years.  As it turned out, my office ran like his.  My practice paralleled his.  He treated me like family and always listened to me.  I tried to do the same for my patients.  It was a successful formula and I thanked him many times over.  He was at the right intersection at the right time and I was smart enough to follow his path.  Jerome had Parkinson’s.  That was the one path I wish I hadn’t followed.

As always, there are stories to be told.  In college, I played hard and often was not prepared for exams.  I was gifted to be able to cram a large amount of knowledge into my head at the last minute and ace the test.  One year, I was far enough behind that I needed a little medicinal help.  I called Jerome and pleaded my case.  I didn’t want to buy anything on the street and had learned my lesson.  Jerome prescribed a small amount of speed and I had my friend’s mom fill it.  (She was sweet and didn’t even charge me.)  Needless to say, I got all “As” and even had a few pills left over.

Months later, my friend asked if I had any speed as he needed to cram for an exam.  I gave him the 4 pills I had left.  He really wanted to pay me for the pills and felt forever indebted that I would not accept money.  I couldn’t tell him that his mom gave them to me.  He, too, passed with an “A.”

Neither of us ever used speed again.  Both of us continued to party but learned to set aside some time for classes and homework.  Both became doctors.

More about mentors tomorrow.

Meanwhile, here’s a joke.

Today my mentor told me if I want to achieve great things, I’d have to make sacrifices.

Anyone know where to buy live chickens for cheap?

HELP

I NEED YOUR HELP!  It’s time to start working on my book. SInce I’ve started writing about the past, some of you have been reminding me of the stories that made us laugh together, cry together and form the lifelong bonds that I hold so precious.

I need more stories.  Frankly, I’ve forgotten many of them, not because they weren’t important, but because they were spontaneous custom-made interactions.  “B,” my car man, was in for a yearly physical (now considered unnecessary).  During his rectal I often remarked, “It’s time for me to replace my car.  While I’m checking your prostate, I thought I’d negotiate a great price on a 3 series.”  “B” would laugh and relax making the exam easier and I’d get a better price on a new car.  That joke served my patients well as it’s hard to remain tense while laughing.

Over the years, I taught medical students, nurse practitioners and physician assistants.  Students are usually stressed and uptight over their workload and the stresses associated with treating patients.  My staff would pour flattened Mountain Dew into a labeled specimen cup.  I’d ask the student if he/she would retrieve the specimen and I’d offer to teach them how to process the specimen and report the results.  Once I had the specimen in my hand, I would explain that, years ago, doctors would taste the urine and if it was sweet, diagnose diabetes.  I would then open the cup, take a sip and say, “Yep, it’s sweet.  She has diabetes.  Have a taste?

As uptight as everyone is today, you’d be reported for such a stunt.  But when I did it, one of two things would happen.  The overly enthusiastic student would reach for the cup or not.  If they reached for the cup, I’d explain that their job was to learn not to please.  That if something seemed wrong, it probably was wrong and they should defer acting on it until they had time to fully assess it.  If they didn’t reach for the cup, they’d look at me like I was insane, realize what was going on and relax.  A relaxed student learns faster than an uptight student.

So, if you have stories that you would like to share with me, send them to ssegal@lzftc.com.  As always, I promise to guard your identity. 

Here’s your joke for the day.

A man and wife are lying in bed…

The man says, “Hey, honey, do you want to make love?”

She says “Normally I would, but I have an appointment with my gynecologist in the morning, and that seems like it would be gross.”

The man says, “I understand” and rolls over.

After a few moments, the man rolls back over and asks, “When’s your next dentist appointment?”

DEATH AND DYING

Two of the hardest things for a physician to deal with are death and dying.  Telling a patient that he/she was dying was extremely hard.  Telling a patient that their child was dying was devastating.  Over my 34 years in practice, I had lots of patients try to die.  Some were successful, others were not.  All of these patients offered up a lesson to be learned.  Every time I had to tell a patient that he/she or a family member was going to die, part of me died. 

On two occasions, the dying patient’s lessons pumped me full of life, hope, and boosted my spirits at a time when I needed a boost.  In the “House of God,” one of the resident’s decisions backfired.  The patient got worse and death was eminent.  The resident, being unable to forgive himself, committed suicide.  In retrospect, all physicians will have cases that haunt them.  Cases where, if they had turned right rather than left, their patient would have done better.  Living with those decisions weighs heavily on every physician I have ever worked with and contributes heavily to the epidemic of physician suicide that is devasting the medical community.

Now for my two teaching cases.  “X” was in his 80s.  “X” was in the ICU with chronic liver, kidney, heart and lung failure.  He was breathing 4 times a minute (not compatible with life).  His children wanted to take him home so he could die in his own bed with his family at bedside.  I told his family that he probably would die in the car but that there was no reason not to take him home.  He was discharged to home with no further medical care.  Four days later, “X” walked into his kitchen and got a cup of coffee.  “X” lived another 18 months.  He took no medication.  At my suggestion, he saw no doctors.  His chronic lung and liver failure clinically persisted.  “X” lived by the grace of God.  Every time he did see a doc, he got worse.  One of the premises of “The House of God” was that the best medical care was no medical care.  “X” was living proof of that premise.  “X” taught me that nothing is for sure.  “X’s” story gave hope to many!

My second story is right out of the pages of a Steven King novel.  However, it’s true.  It really happened.  I always hated prom night.  There was always a disaster to be dealt with on prom night.  On this particular night, an auto accident put best friends in the hospital: one in the ICU and the other on 4 West.  Both were critical; the patient on 4 West died at 3 am.  At 7 am, I made rounds in the ICU.  “R” was alert and talking.  Before I could say anything, he told me that his friend, “D,” visited him at 3 am.  “D” told him that everything was going to be ok and that he would stop by from time to time.  “R” was ecstatic that his buddy was doing so well.  I was blown away!  I dreaded telling “R” that “D” had died but “R” took it well stating that “D” reassured him that everything would be ok.

I quizzed the nurses who verified that they did not tell “R” about “D.”  “R” had no visitors.  At a time when my spiritual being was lacking, living through this was like filling my tank with jet fuel.  This story has helped many over the years. 

The hero of the book, the “Fat Man,” teaches his interns that the best medicine is no medicine.  “FM” believes that the more he does for a patient the worse the patient will be.  Crazy, right?  My first patient with cancer had an advanced rectal cancer.  My surgeon refused to operate stating that the patient had zero chance of surviving; and, even if surgery gave her a few more months, they would be lousy months.  I was young and aggressive, so I transferred her to another surgeon at another hospital for surgery.  She spent 4 months hospitalized and then died.  Her death was horrendous and has haunted me ever since.

There are many more stories. Having been there and done it all, I now agree with Fats. Doing nothing is always a viable choice; and, many times, it is the right choice.

Here’s your joke of the day.

A college professor reminds her class of the next day’s final exam saying, “I won’t tolerate any excuses for you not being there tomorrow. I might consider a nuclear attack or a serious personal injury or illness, or a death in your immediate family, but that’s it, no other excuses whatsoever.”

A guy sitting at the back asks, “What would you say if tomorrow I said I was suffering from complete and utter sexual exhaustion?”

The teacher smiles sympathetically at the student, and says, “Well, I guess you’d have to write the exam with your other hand.”

Here’s a second joke.

There was an American wrestler from Texas named John, who throughout his high school career had never lost a match. As he went on into college, he continued undefeated. He became a national icon and symbol of American strength.

News began to circulate of a Russian wrestler who was fierce and unstoppable. As each wrestlers’s legends grew, a match was set up between the two, America versus Russia. The match would be held in Texas.

John began training immediately. Every day his coach would tell him, “This Russian has a move called the Mongolian Death Grip. No one has ever escaped the Mongolian Death Grip. DO NOT let him get you in the Mongolian Death Grip.”

The day of the match finally came. Just before each wrestler stepped onto the mat in front of the capacity crowd, the coach once again said, “Whatever you do, do not let him get you in the Mongolian death grip. No one has ever escaped the Mongolian death grip”.

Four seconds into the match, the Russian had the American in the Mongolian death grip. The coach buried his face into his hands and cursed John for not listening to his advice. All of the sudden he heard the crowd erupt in a chant of USA, USA, USA. He looked up and saw the Russian pinned by John. The coach ran out to meet John and embarrassingly told him, “I didn’t see… Once he had you in the Mongolian Death Grip I looked away. How in the world did you get out of the Mongolian death grip?”

With heavy breath, John told him, “Well, coach, that Russian grabbed me and twisted my body in ways I never imagined possible. I was wincing in pain when I open my eyes and right in front of me were two testicles. So I bit them.”

“What???” said the coach… “John I don’t think that is legal. You could be disqualified.”

“I don’t know about that, coach. But I can tell you one thing. You ain’t got no idea how strong you are until you bite your own balls.”

HOG PART 3

“The House of God” is one of the best books I’ve read. As mentioned previously, I’m actually reading it for the second time.  I think you should read it.  Of course, I’m biased.   It was published in 1978, the year I did my Fifth Pathway/Internship.  The story takes place at a Jewish-owned hospital/medical school established to educate young Jewish doctors as many teaching hospitals had Jewish quotas limiting acceptance to medical school.  Congressman Whitehurst, my district’s representative, informed my parents that the reason I did not get into The Medical College of Virginia was because their Jewish quota had filled.

Are you starting to get the picture?  Yep, I strongly relate to this book.  I lived most of it and recognize many of the doctors, nurses and patients depicted by the author. Fortunately, or unfortunately depending on your point of view, I cannot relate to the portrayal of the interns, residents, doctors, and nurses (that staffed the House of God Hospital) fucking like bunnies. (Since my readership goes up if I mention sex, I thought I would use “fuck” and see how many readers I can bring onboard.)

The stresses of medical training are tremendous.  On June 30, 1978, I was a student.  The next day, July 1, 1978, I was a doctor seeing hospitalized patients, working 36 hour shifts, living in the hospital when on call and, occasionally, torturing patients.  You do not want to be admitted to any hospital on July 1!

I guess I should explain what “torturing patients” means.  The only written complaint I ever got was from a middle-aged female admitted with pneumonia.  She was built like me (fat) and had horrible veins.  I missed on three attempts to start an IV, succeeding on the fourth.  The director of my program took great pleasure reading me the following: “I have nightmares in which Dr Segal is chasing me down the hall with an IV needle.”

My director and I did not see eye to eye on most things.  He had ‘book sense” but lacked clinical knowledge and people skills.  While I honed my diagnostic skills and learned how to relate and care for people, my director went to meetings and honed his political skills.  From the age of 13, I was convinced I would be a family physician.  Under Dr “S’s” tutelage, I grew to hate family practice.

Luckily, the director of the ER rescued me.  Dr. “A” was dying (literally).  On occasion, he taught with chemo running into a vein in his arm.  On graduating, I went to work in the ER at a local hospital.  ER medicine was exciting, even fun.  It also could be incredibly stressful.  One night, I was running the major illness, trauma side.  The paramedics dropped a 24-year- old female in our ER (in 1978, paramedics basically were a taxi service).  She was trying to die from a knife wound that penetrated her heart.  The cardiovascular surgeon was 30-45 minutes away, so my partner and I opened her chest and plugged the hole.  She lived!  Can you imagine how freaked out I was? Can you imagine how depressed I would have been if she had succeeded in dying?

According to “The House of God’s” author, I should have decompressed/celebrated by banging the “head” nurse.  Of course, I would never contemplate such a thing (Renee proofs this) as I was married.  But remember, “It is impossible to be depressed with an erection” (HOG)?  So, maybe the answer to the sharp rise in doctor suicide is hospital-based orgies. 

If your doctor appears stressed and overwhelmed, then, at the very least, you could ………  If you’re reading this, I got it past my editor!

Here’s a joke for today:

It ain’t always easy having erectile dysfunction

but it sure as hell ain’t hard

APPRECIATION

The sun is out, the sky is a beautiful blue and it’s supposed to be in the 60s today.  Mackenzie is upstairs playing with Renee and I can hear them laughing.  Unfortunately, I can’t join them as I can’t walk up the stairs this morning.  We’ve been here since May and I’ve only ventured upstairs a dozen times.  I’m glad the girls have a little alone time.  It’s good for them!

I’m working on my Blessings List and realize that there are many things that are not on the list that should be.  The missing items are things I’ve always taken for granted; and, now that they are gone, I feel their absence.  Today is one of the bad days.  Bad days are when having a Blessings List to fall back on is really important.

My morning dose of medicine has failed me. I’m having problems walking.  My feet shuffle when I walk and I’m having frequent periods when I literally freeze in place (can’t move).  Yesterday, I struggled to walk a block, froze so frequently I almost called Renee to come and get me, and eventually made it home.  One of the reasons I avoid steps is my tendency to “freeze.”  Being able to walk was never on my Blessings List.  It should have been!

Being able to wash myself, dress myself and clean up after myself should have been on my Blessings List!  When I was well, I never would have thought about it.  When I was well, taking a walk on a sunny day was a given.  As these skills leave me, I can’t stop thinking about them. My losses are accelerating despite my medications and my newfound attitude.

Parkinson’s may diminish me and may ultimately kill me; but, as long as I can breathe and be with family and friends, I will fight it.  I’m currently being assessed for DBS (deep brain stimulation).  In layman’s terms, a surgeon is going to drill into my skull and place electrodes in my brain.  In theory, by stimulating the parts of my brain that aren’t working, I’ll get better.  Over the next few months, I’ll be going through a battery of pre-op testing to optimize me for surgery.

In the meantime, I’ll concentrate on expanding my Blessings List, exercising when I can and enjoying my family and friends.  You should do the same.  What’s on your Blessings List? 

Here’s your joke for the day.

The doctor says, “Larry, everything looks great. How are you doing mentally and emotionally? Are you at peace with God?”

Larry replies, “God and I are tight. He knows I have poor eyesight, so He’s fixed it so when I get up in the middle of the night to go to the bathroom, poof! The light goes on. When I’m done, poof! The light goes off.”

“Wow, that’s incredible,” the doctor says.

A little later in the day, the doctor calls Larry’s wife.

“Bonnie,” he says, “Larry is doing fine! But I had to call you because I’m in awe of his relationship with God. Is it true that he gets up during the night, and poof, the light goes on in the bathroom, and when he’s done, poof, the light goes off?”

“Oh, no,” exclaims Bonnie. “He’s peeing in the refrigerator again!”

SEX PART 3

I shouldn’t be surprised but I am.  I know that, on days when I mention sex, my readership increases.  Yet, when it does, it still amazes me.  We are bombarded with sexual topics every time we turn on the TV, computer or go to the mall.  Victoria Secrets posters are every bit as good if not better than the Penthouse that I hid under my bed when I was young.

Often, I wonder why anybody would get paid to make a commercial that sucks, as, in my opinion, most do.  Occasionally, I’ll see one I really like.  The majority of the ones I like are sexual.  After all, I’m like you and find that the mere mention of sex increases my interest.  To illustrate my point, I’ve linked the word sex to one of my favorite commercials.  Click on sex and watch the commercial.  Did you like it?

So, if sexual inuendo and outright soft porn is everywhere, how is it that the mention of sex in an article will still boost my readership?  In my opinion, no matter what your age or particular tilt, you can never get enough sex.  Even after menopause (male menopause included), interest remains.

Have you noticed that, when it comes to sex, the majority of couples seem to be mismatched?  If the husband has a high libido, the wife’s is low (and vice versa).  There appears to be a universal law governing couples’ sexual appetite.  It makes sense.

Survival of the fittest would have necessitated such a law.  If Renee’s libido matched mine, I’d be thin and broke.  We’d never leave the house!  In the book I’m reading, “The House of God,” the resident’s mind (and eyes) are fixed on the nurses breast rather than on the patient they were coding.  Get my point?  Without the mismatch in libido, those with low libido would fail to propagate while those with high libido would propagate like rabbits and starve to death and the patient who was coding would be pronounced.  (Cause of death; Doctor pumped the wrong chest.)

So, my friends, don’t complain if your significant other’s sex drive is different from yours.  Accept the fact that mother nature knows best and that you need to get out of the house on occasions to work, shop and visit your favorite sex shop to purchase toys.

One of the most frequent marital problems I treated stemmed directly from the mismatch in sexual drive I’ve written about above.  One of the best kept secrets in the medical field is that sexual therapist /counselors do exist and if your mismatch is causing real problems, you should discuss your situation with your physician or move to California where surrogate programs are legal and, in some instances, covered by insurance.

Here’s your joke of the day.  It’s one of my favorites!

It’s a beautiful day, and love is in the air. Marie leans over to Pierre and says: “Pierre, kiss me!”

Our hero grabs a bottle of Merlot wine and splashes it on Marie’s lips. “What are you doing, Pierre?”, says the startled Marie.

“I am Pierre, the fighter pilot! When I have red meat, I have red wine!” She smiles and they start kissing. When things began to heat up a little, Marie says, “Pierre, kiss me lower.”

Our hero tears her blouse open, grabs a bottle of Chardonnay and starts pouring it all over her breasts. “Pierre! What are you doing?”, asks the bewildered Marie.

“I am Pierre, the fighter pilot! When I have white meat, I have white wine!”

They resume their passionate interlude and things really steam up. Marie leans close to his ear and whispers, Pierre, kiss me lower!”

Our hero rips off her underwear, grabs a bottle of Cognac and pours it in her lap. He then strikes a match and lights it on fire. Marie shrieks and dives into the river. Standing waist deep in the water, Marie throws her arms upwards and screams furiously, “PIERRE, WHAT IN THE HELL DO YOU THINK YOU’RE DOING?

Our hero stands up defiantly and says,

“I am Pierre, the fighter pilot! If I go down, I go down in flames!”

SEX

In the tour through my life, I’ve decided to re-read “The House of God (HOG).” It was published the year I started my internship in the south Bronx, N.Y.  It’s a great read.  It opens with the following statement, “Life is like a penis.  When it’s soft you can’t beat it.  When it’s hard you get screwed.”  I’ll let you think about that for a while.

I interviewed and accepted a family practice residency at Lutheran General Hospital in Park Ridge.  The director of the program was impressive.  He promised great things.  Boy, was I sold a bill of goods!  My program sucked.  Perhaps they all suck as suggested by the author of “The House of God.”  Staying sane for the three years I was at LGH was not easy.  Renee was my anchor and kept me afloat during my internment in LGH. When I first read this book, I took to heart the statement, “It is impossible to be depressed with an erection” (HOG).  Never a truer statement has been said and Renee successfully treated my depression during my stay at LGH and subsequently.  Who needs a SSRI when you can have can have erections.

Obviously, I’ve strayed from my original intent in writing this article; but since I’ve gone in this direction, I might as well continue.  When you look at the number of people either reading or sharing a particular article, a pattern forms.  My readership goes up when I mention sex.  In other words, mentioning sex gets a rise out of my readers. 

One of the most difficult problems to discuss with a patient was always anything sexual.  Patients were often very hesitant to bring up the subject and, when they did, often held back key information.  Further complicating the issue was that most of the time, significant others were involved in the conversation, knowingly or unknowingly.  Then there is the problem of what is “normal” and what is “abnormal.”  For simplicity’s sake, the answer to that question is: anything you want to do is normal and anything you don’t want to do is abnormal.  At the onset of therapy, the problem is that, in the eyes of the patient, it’s always the partner’s fault; and often your partner refuses to engage in counseling as he/she/it know what’s coming.  When you take blame out of the equation and insert understanding, things improve.

The important point to make is that, if you are having a problem, discuss it with your significant other and your physician.  If they are uncomfortable, ask for a referral to a therapist trained in sexual disorders.  While often your significant other will refuse to join you in therapy, over the 34 years I practiced medicine, I found that, in time, your partner’s curiosity as to what is being said in your sessions will eventually bring her/him/they (or whatever pronoun fits) into the office and counseling.

Most of my readers are in their 60s and 70s.  Some will take offense to this article as anything sexual in nature was considered taboo when we were growing up.  Unfortunately, that attitude is the cause of much of what I treated.  Some will see this article as sexist.  “It is impossible to be depressed with an erection” (HOG) may sound sexist at first but let me remind you that erections are not uniquely male as the clitoris becomes erect when stimulated.

Over the years, the majority of the patients I saw were females.  Because I spent a great deal of my time discussing man’s shortcomings with my female patient, at times, I find myself thinking like a female. (Men tend to be great at taking care of the cars and poor at taking care of themselves.) 

Yes, as we age, hormonal changes complicate things for both sexes, making a trip to the doc even more important. 

Now, your joke of the day.

Ethel checked into a Motel on her 65th Birthday.  She was lonely, a little depressed at her advancing age so decided to risk an adventure. She thought, “I’ll call one of those men you see advertised in phone books for escorts and sensual massages. She looked through the phone book, found a full-page ad for a guy calling himself Tender Tony, a very handsome man with assorted physical skills flexing in the photo. He had all the right muscles in all the right places, thick wavy hair, long powerful legs, dazzling smile, six-pack abs and she felt quite certain she could bounce a dime off his well-oiled buns.

She figured, what the heck, nobody will ever know. I’ll give him a call. “Good evening, ma’am, how may I help you?”

Oh my, he sounded sooo sexy! Afraid she would lose her nerve if she hesitated, so she rushed right in, “I hear you give a great massage. I’d like you to come to my motel room and give me one. No, wait, I should be straight with you. I’m in town all alone and what I really want is sex. I want it hot, and I want it now. Bring implements, toys, everything you’ve got in your bag of tricks.  We’ll go at it all night … tie me up, cover me in chocolate syrup and whipped cream, anything and everything, I’m ready! Now how does that sound?”

He said, “That sounds absolutely fantastic, but you need to press 9 for an outside line.”

FULL CIRCLE

I’ve come full circle back to one of my original premises: diets are bad for you!  Over the 34 years I was in practice, the average patient would go on a diet and lose 20 pounds only to gain back 30.  You may be asking yourself, “If diets are harmful, how am I going to lose weight?”  I’ll give you an answer shortly; but first, let me do a quick recap.

When I had to retire due to ill health, I lost my identity.  Dr. Segal disappeared.  Gone was his off-color sense of humor.  Gone was his medical knowledge.  Gone was his zest for life.  What was left was an old decaying body, waiting for Parkinson’s to do its worst.

I just told you a true story about a patient who was dying from the ill-founded belief that he was going to die. Much like that patient, I had given in to a scared, depressed mind.  On my journey, I started relieving parts of my past.  Using Google Earth, I started visiting places I had lived over the years and searched for the happy memories each place had.

It was on a Google Earth visit to my old office that I found my sense of humor.  Yes, I had lost my sense of humor along with everything else.  I remembered a time when the tension of a patient having a heart attack in the office was balanced by the use of a fart machine that was strategically hidden under a chair at check-out. 

Yes, while not very professional, laughter is good medicine and nothing is more universal than the humor associated with farts.  There were patients who needed the healing power of laughter and I had found a way to give them a good dose prior to leaving the office.  There were also people who needed a little kick in their butts.  One such person was a pharma sales manager who consistently berated his employees in front of me.

My staff made sure to sit him in our special chair and to sit his underling next to him.   When I finished seeing “P,” an elderly patient with a great sense of humor, I walked her to the front.  As she was talking to Dawn about a bill, I pushed the remote button in my pocket and lit the sales manager up with a low, long fart.  The reaction was immediate. “P” turned to the manger with a scald on her face.  The rep turned turned away from his manager, suppressing a laugh.  I attacked letting loose another loud fart.  At that point, “P” blurted out, “That’s disgusting!” The rep burst out laughing, got up and left.  My staff suppressed their laughter long enough to let the manager leave.

I called “P” and let her in on the prank.  She thought it was “funny as all hell.”  When the manager asked me why I would do such a thing, my response was, “Now you know how belittling your staff in front of others feels.”  While he never came back, my reps informed me that his management style had changed.  He no longer berated his staff.

Once I found my sense of humor, I realized that attitude is everything and the first thing I needed to do was adjust my attitude.  I’m not my father. He lost his sense of humor.  He was the eternal optimist until he got Parkinson’s, then he became the worst of all pessimists.  I realized I was programmed to follow in my father’s footsteps (I look like him).  I needed an attitude adjustment.

Diets belong to some one else.  No matter which one you choose, they were written to fit someone else’s lifestyle.  In my book, I suggested that, in order to lose weight once and for all, you need to slowly correct your own diet.  I’m working hard, tweaking my diet daily.   My book recognizes the value of exercise and making small deposits in your physical account over a long period of time.  I’m back to walking short distances frequently and increasing distance and speed as my body will permit.

My emotional count has been devastated by Parkinson’s and Covid.  I am taking a regular dose of humor daily.  At the end, when asked how his day was, my father-in-law would say,” I’m alive, aren’t I.  It’s a good day!”  Well, I’m alive and kicking!

So, I’ve come full circle, back to the creation of the wellthy life.  How’s your attitude?  Maybe you need a fart machine!

Here are your jokes for the day.

Farts are like children.  I’m proud of mine but disgusted by yours.

An old woman decides to get a physical after a number of years.

While the doctor is examining her, she mentions that over the years she has learned to fart silently and they never smell anymore. The doctor said “Ok, that’s great”, finishes up the exam, gives her a prescription and tells her to come back in a couple of weeks.

When she returns, she complains that her farts now smell awful.

“Good” he said. “Now that we’ve cleared out your sinuses, let’s work on your hearing.

A young punk gets on the cross-town bus.

He’s got spiked, multi-colored hair that’s green, purple, and orange.

His clothes are a tattered mix of leather rags.

His legs are bare and he’s wearing worn-out shoes.

His entire face and body are riddled with pierced jewelry and his earrings are big, bright feathers.

He sits down in the only vacant seat that’s directly across from an old man who glares at him for the next ten miles.

Finally, the punk gets self-conscious and barks at the old man, “What are you looking at, you old fart… didn’t you ever do anything wild when you were young?”

Without missing a beat, the old man replies, “Yeah, back when I was young and in the Navy, I got really drunk one night in Singapore and screwed a parrot….

I thought maybe you were my son.”