Code Black: Scary look into our broken healthcare system

The always lovely Miss Wendy and I stumbled onto an interesting film recently in our little corner of the world that was entertaining in a scary and informative sort of way.

Code Black isn't a summer blockbuster, features no caped crusaders, car chases, or scantily clad vixens; and the good guys -- a hearty and wholesome band of emergency room doctors-in-training --  definitely don't always win. After all, the movie is a documentary, not a fantasy.

The film moves along at warp speed, an adrenalin rush of activity focusing on the daily grind inside the emergency room at Los Angeles County Hospital. It's a bustling and happening place, as often as not laboring under a "Code Black," the designation offered up when waiting rooms and treatment bays are spilling over with patients.

It's been said of "C Booth", the hospital's legendary trauma bay, that more people have died and been saved there than any other square footage in the country; death hangs heavily in the air. But, thankfully, so does hope.

Given all the guts and gore splashed across the screen, it would seem likely that the dramatic tension of the film would have to do with the doctoring at the heart of the action. But, no, the documentary gains traction as the filmmakers explore the impact of our anemic economy on healthcare today and the growing bureaucracy that is slowing down the works.

As the needs of the community grow exponentially, one harassed administrator is forced to shutdown a wing of the emergency room for lack of operating funds and the loss of nurses to higher paying jobs at for-profit hospitals.

Meanwhile, patients wait patiently for care while doctors are kept busy filling out paperwork -- requisition slips, medical records, privacy forms and such. It's all a little maddening. One frustrated resident, clearly upset by the misplaced priorities that rule her life, explains she often has only a few minutes to spend with patients, then must spend precious time documenting visits.

During breaks in the action, the soon-to-be physicians share their back stories, hopes and dreams, and worry about the future of medicine.

It would have been easy for the film's producers to take a political stand, weighing in on Obamacare, questioning the high-cost of care and insurance, wagging a metaphorical finger at the senseless and infuriating gridlock that's taken hold in Washington.

But to their credit, the production team steers clear of partisan politics and focuses their energy on examining the day-to-day problems that have become emblematic of a healthcare system in turmoil and the wannabe physicians struggling to hold onto their humanity and youthful idealism.

I'm thinking it's a battle worth paying attention to in a world just slightly out of whack -- and growing whackier by the day!

Life can sometimes be a pain!

I was deep into a wondrous world of light and shadows earlier this week when a nagging call came my way. It pulled me from the tranquil calm of REM sleep and demanded my attention.

The lovely Miss Wendy needed me awake. The last time I had gotten such an early wake up call was three decades earlier after Wendy had gone into labor. This time around the problem was just as urgent – at least for the moment – but involved a much different sort of pain!

Wendy, who’s up before the sun each morning, was feeling just a little faint and puzzled by a growing pain in her chest. It was the sort of feeling that moved around a bit and the sort of problem that toys with all those existential fears we push aside when night gives way to day.

And it persisted; the pain a pulsing tease, the thoughts a growing concern. Wendy talked and detailed the problem. I listened and diagnosed. We weighed our words and spent a few moments handling the issue in a high-tech sort of way, fishing about the web for answers. All we managed to do, of course, is raise additional questions and scare ourselves silly.

I’m thinking most of us of a certain age have played this little game; measuring out the problem and viewing it from all angles, then trying to figure out exactly what needs to be done. The problem is there’s nothing “exact” about the issue, unless you happen to be a physician and also keep an EKG parked in your closet!

And so it was that the lovely Miss Wendy and I found ourselves in the emergency room of one of the mega-hospitals in our little corner of the world, listening to the beeps and bings of all the gadgetry that defines modern health care today.

Five hours later, the hospitalist – that’s a term I’m thinking Marcus Welby never heard back when doctors made house calls – announced that Wendy was not only fine, but “the healthiest young lady in the entire emergency room.” Let me repeat his diagnosis: Wendy’s fine!

He smiled. We smiled. Hope, yet again, rested easily on the horizon.

Dawgs, Gators and quadruple bypass surgery

My brother Larry had quadruple bypass surgery earlier this week. I’m happy to report that he’s up and about; not yet dancing but well on the road to recovery.

Doctors discovered the problem late last week. The really good news is this is the sort of health issue that, despite its seriousness, is very fixable. Once upon a time blocked coronary arteries were difficult, if impossible, for surgeons to repair. In recent years bypass surgery has become a procedure best filed away under the heading of medical miracle.

The truth is that the procedure has been perfected over the last few decades thanks to the intellect, rigorous training and passion of curious medical researchers and skilled surgeons. And let us all say Amen!

The question, of course, remains why Larry’s arteries clogged up in the first place? Some will say it’s the weekly dose of Big Macs and fries, all washed down with chocolate milkshakes. I have another theory. My brother is a loyal and true Dawg fan, who bleeds red and black and worships each fall “between the hedges.” He made the mistake of leaving the Land of Cotton several decades ago, moving south into the land of Gators. Need I say more?

Now he’s really in a pickle! I’m thinking that many of the doctors, surgeons, physician assistants and nurses who have been tinkering around with his innards this week are loyal Gators who bleed blue and orange. Those of you living outside the U.S., and have no clue about the seriousness of college football, simply need to take my word that this is not a good thing!

So I guess on some sort of cosmic playing field he’ll now have mixed loyalties. Gators or not, his physicians did make him whole again. That said, there really isn’t much of a conflict. After all, Physicians and medicine are all about science. And everyone knows that college football is a religious experience.

Here’s hoping that this little episode will be a fading memory in a month or so and that Larry will be suited up and ready to play completely in the game of life very soon. And since I’m just about out of sports clichés, I’ll simply finish with that well known Georgia prayer, “Go you hairy Dawgs!”

A-mazing: Finding friend turns into journey

I spent the early afternoon today visiting Anita, a friend and former colleague from my days at that place with the printing press. She’s a patient at Emory University Hospital, a large and sprawling medical facility here in the Land of Cotton.

The university campus was teeming with students and the hospital area was filled with doctors and nurses; patients, their families and friends. Traffic was heavy and I only had a slight idea where I was headed. I spotted a sign pointing to a parking area, made a swift left turn, then dipped into the bowels of a mega-parking deck.

I passed through a floor or two reserved for health care professionals, then ignored a sign that said there were absolutely no available parking spaces for, um, regular people. Somewhere deep below the surface, dank and dark, I circled about hundreds of cars in search of an empty spot. When I spotted it, I said a little prayer, parked and then realized I had no idea where I was or how to make my way back to the street.

Off in the distance I spotted an exit sign, then spotted yet another sign pointing in the opposite direction. Fortunately before trekking in either direction, I saw another “regular” person popping into a nearby concrete bunker that turned out to be an elevator. When I reached the lobby, I walked over to the information desk and told the clerk my friend’s room number. She smiled and handed me a printed note. I offer its contents here with no editorial comment other than, WTF!

 Press “T” on elevator
 Make 2 Lefts off the elevator
 At the end of hall, turn Right towards EUH
 Dead end at Emergency in EUH
 Receive further info from Guest Services on the L

Up to this point I hadn’t realized that I was in search of buried treasure or, perhaps, on a holy quest. I managed to find my way up a few elevators, then along the halls and corridors before, yet again, I found myself chatting with another “Guest Services” worker. She offered up another half-dozen directions and, voila, only 30 minutes after parking I walked into my friend’s room.

Anita and I go back together lots of years. She’s battling cancer; filled with courage, hope and humor. Inspiring. I was feeling a little sad as we said our goodbyes, but energized by her good cheer and willingness to continue the good fight.

A few moments later, headed back to my car, I realized yet again I had no idea at all where I was. It would take another half hour, roaming around endless halls and corridors, then strolling about the campus before I managed to spot the mega-parking complex where my journey had begun. Exit signs were still pointing in two directions and I had to backtrack more than once after driving into an area that came to an abrupt dead end.

As I finally made it to the main thoroughfare on the campus, I couldn’t help but wonder if Rube Goldberg had worked as an architectural consultant when Emory planned out its hospital complex. The place is filled with more twists and turns then a Daniel Silva novel.

When next I visit, I’ll make sure to drop bread crumbs along the path. My only fear is that other visitors, lost for days in the dark and dank parking area for “regular” folks, will gobble up my trail markers.

Gonna need an ocean of calamine lotion

I’ve been itching to stop itching. The scratching began with a little reddish patch that worked its way over one shin, jumped across my crotch and took over a thigh, then rapidly took hold of small bits of turf around my belly, arms and neck.

Can you say uncomfortable? The problem, as usual, can be traced back to that moment after I left the place with the printing press two years ago and decided I would conquer my lawn. As I’ve reported here ad nauseum, the war with my yard has taken a toll – bumps, scrapes, cuts and falls; mosquito and tick bites; sunburn, battle fatigue and, now, poison ivy.

Ignoring all those three-leafed weeds as I go about pulling them from my lawn doesn’t mean they will ignore me. In fact, I’ve scratched my way across my yard for two years, breaking out now and again with small signs of the toxic stuff. I won those battles, suffering only a little discomfort. Not this time.

After nights of little sleep, bathing in calamine lotion and becoming addicted to Benadryl, I finally waved the white flag and called for medical assistance. My doctor sent in the big guns – Prednisone, served up in massive dosage. After just a day, I could sense the tide of battle was turning and victory seemed possible.

Now, a week later, the battle of Ivy fields is a fading memory and mankind, yet again, has prevailed over the expansionist hopes of plant life – at least its impact. Unfortunately, the war rages on; my yard calling out to me for help. It remains a gruesome mess of damaged turf, weeds and debris.

My days of rest are coming to an end and I will soon be grabbing my weed wacker and heading back into battle. I know that glory hides in the dawn, tucked behind a fallen pine cone, buried underneath a blooming dandelion. I can hear the mowers starting up now, my neighbors puttering about in support. Damn, how I love the smell of exhaust in the morning!

Capped, crowned and smiling once again

The lovely Miss Wendy has her lovely smile back. It only took two dental appointments and a few hours with our favorite neighborhood dentist, Dr. S.

That’s what happens when you crunch on a crouton that’s crisp and tasty – and, unfortunately, hard as a rock. For a variety of reasons, Wendy asked that I go with her for all the drilling and heavy lifting on Monday. It was an eye-opening experience. Well, actually, Wendy’s eyes were closed for most of the appointment.

But with the blessing of Dr. S and his irreplaceable and charming assistant, I had an up close and very personal demonstration on how to fix a cracked tooth and replace it with a dental crown. Standing above it all, the experience is all together different than when you’re sitting in the big chair! I don’t know about Wendy, but I had a grand time.

Did you know that all the initial drilling is simply to whack away the enamel surrounding the tooth’s dentin and core? It’s not unlike sanding away a peeling layer of paint on a wall – if the wall happens to be tiny, filled with nerve endings and has a huge tongue that keeps getting in the way!

What you’re left with after the dust clears is a smallish post that serves as an anchor for the crown. The majority of the work – the aforementioned demolition; sanding, blasting and creating molds – has much more to do with artistry than science. It’s the sort of work I think a carpenter would be better at than, say, a theoretical physicist.

Of course dental work takes a good deal of focus. Dr. S certainly seemed to be paying attention to Wendy as he worked and we discussed what’s new and happening at the local cinema; his plans to take his entire office to Vegas in the fall; the ups and downs of the Braves, Falcons and the U.S. economy; and the incredibly fishy smell of a piece of salmon his wife recently bought at that oh-so popular specialty market that is bulling its way into our little corner of the world.

But I, ah, digress. Everyone was smiling once again – especially the lovely Miss Wendy – when Dr. S finished up his work. In fact, the only person frowning at the end of the day was the guy holding the bill. Oh, right, that would be me! But, hey, a million dollar smile and a healthy set of pearly whites are worth a few bucks, right?

I'll take the wrinkled machine with a heart

I walked into my doctor’s office and went to the desk to sign in. But the sign-in sheet wasn’t there. It’s always been there before, but now it wasn’t. I glanced at the receptionist and she pointed to a high-tech gizmo that I had walked by on my way to her desk.

No sign-in sheet, no pen – just a sparkling new computer console. In fact, there were two gizmos, cheek by high-tech jowl, just across from the reception area. So I followed the receptionist’s outstretched hand to this new thingy in my life and tapped its screen.

It blinked and I realized, again, life was changing and it was time to learn one more computer program to make someone’s life simpler. And it appeared, at least in the short term, that someone would not be me.

With each touch of the screen I was prompted to take some sort of action – place my driver’s license on the conveniently located scanner pad; turn my driver’s license over and scan the other side; scan in my insurance card; turn my insurance card over and scan the other side; check my name, address, contact numbers to make sure they were my name, address, etc.

Despite my phobia with all things digital, I quickly managed to work my way through the process, tapping my way through the list of doctors, appointment time, reason for my visit, then quietly acquiescing to the machine’s demand that I go find myself a seat in the waiting room.

If I had known about the new gizmo when I walked into the office, I would have managed the entire check-in process without actually having any contact at all with another living person. And, well, I guess that’s the idea.

At least that’s the story my doctor is telling. I walked into his exam room at exactly the appointed time and mentioned to him how it seemed his office was really jumping into the 21st Century.

He grimaced. Dr. S just celebrated his 70th birthday and is having a bit of a problem embracing all the new changes that his profession is adopting. Don’t get me wrong; he’s been my doctor for over two decades and knows me, well, inside and out!

But not that long ago he was part of a two-man practice that shuffled along when warp speed wasn’t yet de rigueur. All that changed when his little pond and little office was bought out by one of those mega-practices that always seem to have “medical group, LLC” at the end of its name.

Just a year or so later and the little office was dumped, replaced with lovely new digs that feature designer furniture, track lighting, color-coordinated everything – carpeting, tiles, uniforms for the nurses and techs – and at least a half-dozen additional physicians.

I guess there’s nothing wrong with all of that – really, nothing at all; I mean, ahh, really. Oh, right, there is this one thing. While all the stuff has been updated, the attitude of the staff seems to be heading in the other direction.

Dr. S said if he was still the boss – he’s just an employee now – that he’d immediately fire a half-dozen or so folks, the ones he labeled rude, lazy and, ahh, fat! His words. He also said that everything has become so impersonal. Well, duh!

There’s no question that the digital age is going to create scientific breakthroughs – miracles, plain and simple – that will dramatically improve the quality of life for all of us, wiping out all sorts of aches, pains and diseases that today are thought to be incurable.

But hopefully our physicians and all those who are part of the “healing arts” won’t lose their humanity working alongside the cool efficiency of digital thingies. A machine might compute its way through a crisis, but it’s the care and compassion, kindness and empathy of the machine with a heart that will provide real healing.

There’s a name for those machines. Humans!

A long and lonely road filled with sunshine

It was a long and grueling weekend – for my mom and family. I could write pages, detailing the health issues that had us spending days in an area emergency room and hospital, but it all can be summed up in two words – blood clot.

My Mom, gamely plugging away on that long and winding road we label dementia, was not feeling well toward the end of last week. Aides checked her out at the assisted living facility she now calls home and decided to call in the medics.

Her vital signs were good but she continued to complain about some vague discomfort – pain in her legs, a sense of unease and a small problem with breathing. At some point she used the words chest and pain in the same sentence. Bingo! That’s the magic phrase that will win you a trip to the local emergency room every time it’s uttered.

I met my daughter Lauren at the ER and the good news is Mom seemed to be more alert than I had seen her in weeks. She was kvetching, but alert. Her nurse pretty quickly had Mom tethered to an assortment of monitors and within the first hour or so had managed to draw enough blood to feed a family of vampires and keep a battery of techs busy for the evening.

The ER doctor – a friendly enough sort of guy with a shock of white hair, the body and facial features of Woody Allen – checked Mom out, examined her leg – which, btw, was swollen – and ordered up another series of more sophisticated and invasive tests.

The good news, I guess, is that within the next hour we learned that Mom had a blood clot dangling about in her left leg, that she was to be put on blood thinners immediately and would be admitted to the hospital for observation to figure out the next step in her treatment.

That next treatment ended up being one of those little medical miracles that are now available – a tiny filter implanted in her vena cava. It’s a simple device, “a tiny catcher in the vein,” that should snag any bits of a clot before any real damage happens in her heart or lungs.

This news was offered up early Friday and by that afternoon the filter was in place and Mom was back in her room recuperating. The family – sons, daughters-in-law, grandchildren and others hovered about while Mom pretty much slept. My brother Larry, sisters-in law Amy and Betty Ann and niece Allison dropped by the following day to pay a short visit and learned that Mom was to be discharged.

I’ve been around hospitals now for a couple of years, taking Mom for various visits and exams; simple procedures and hurried emergency room visits. One of the happiest words you can hear in these places is “discharge.” It generally means that all is well and the ordeal is about to end.

Sadly, is also means that you’re nicely buried in the bureaucracy and there’s a good chance you’re going to be beaten to a pulp before you make your way out the door.

About eight hours after being told Mom would be released, my brother, sisters-in-law and niece managed to make it to the parking lot with Mom. The last two hours or so were spent waiting for a wheelchair to be delivered.

The family stayed busy chatting with Mom, telling her stories and teaching her songs, feeding her lunch and offering her snacks and water. I kept track with them throughout the day, planning to meet Mom and the others back at her assisted living facility.

We all finally managed to get together in the early evening. Mom looked haggard, but in reasonably good spirits. We got her settled and arranged for one of the aides to get her dinner. Betty Ann, one of the angels of the day, fed Mom bits of Salisbury steak and mashed potatoes, while the rest of us stood around and made small talk.

The facility, about as good as these places get, is still pretty much buried down in the proverbial rabbit hole, dazed and befuddled residents wandering about, looking for relatives and friends, watching TV or staring off into space. Yes, a few of them are drooling.

For whatever reason, one of the other angels of the day, my sister-in-law Amy, began singing one of the songs they had taught Mom earlier that afternoon – “You Are My Sunshine”. Most everyone picked up the tune, a tiny chorus celebrating family and love.

Mom continued eating, hearing how she makes us happy when clouds are gray. For a moment I thought we might be disturbing a few of the other residents, but after only an instant I realized there was little chance of that happening. If anything, several of those nearby seemed pleased by the break in routine.

A few minutes more spent singing and chatting, then we said our goodbyes. As we were all headed out to dinner, Mom was being wheeled to her room. I overheard one of the aides ask her if she was happy to be home and Mom quietly whispered, “Oh, yes”!

Well, perhaps. I like to think in some fashion Mom was happy and in some fashion knew that she was connected to all those folks coming in and out of her life over the weekend.

Monday afternoon I was back visiting and checking on some pressing health care issues. Mom was in bed, pillows strategically placed about to keep her resting on her side. I mentioned the weekend, the hospital and minor problems with her leg. She nodded and smiled occasionally, but mostly drifted slowly away, her eyelids heavy with sleep.

I sat back, glancing out the window just feet from her bed and watched a few clouds roll by and a bit of sun streak across the lawn and into her room. It was about then that I heard a tiny sound and looked around at Mom.

It appeared she was sleeping peacefully, but she seemed to be softly humming. I leaned over but couldn’t make out any words. Then I recognized the tune, “You Are My Sunshine,” and didn’t know whether to laugh or cry.

It would seem that at least on this day, somewhere on that road she’s traveling, Mom no longer has to worry about skies turning gray. I like to think, if nothing else, she still remembers how much we love her and we'll make sure that her sunshine never goes away.

Now I've got a good reason to be ticked off!

The lovely Miss Wendy and I just returned from an emergency visit to the local fire station. I needed a little attention from one of the medics.

The episode began simply enough with my wife noticing a little blemish on the back of my neck. I’ve been spending way too much time outdoors in recent weeks, doing yard work and exercising, and Miss Wendy thought perhaps I might want to make an appointment with a dermatologist.

Then she noticed that the blemish had, ugh, legs and our little problem took on a bit of added urgency. She made an effort to remove the thingy that was clinging to my neck, just below the hairline – okay, there’s not much hair atop my head – but the critter wasn’t budging.

Just a day earlier, both of us had read an article in the local newspaper detailing the growing problem of ticks in the Land of Cotton. The little buggers have been multiplying like, well, ticks. Apparently the female of the species, in the last days of her life, can lay up to 3,000 eggs. And it seems my yard has become tick central this summer.

I can’t say that I recall actually ever seeing a tick before. But in the last week I spotted one climbing up my leg, another attached to my arm and now this most recent episode. Since the newspaper story made it very clear that removing a tick is a delicate procedure, we decided to seek professional help.

Five minutes later a medic was checking out my neck and figuring out the best way to remove the pest. If you yank at a tick, there’s a good chance its head, oh gross, will remain attached to your skin. Worse, if you pinch it too hard, there’s a very real possibility the ugly critter will regurgitate all manner of bacteria into your bloodstream.

In fact, it’s believed such puking is how people contract Lyme disease, a particularly nasty malady characterized by arthritic and neurological problems. All this was buzzing through my noggin – plus images of Sigourney Weaver battling that foul-smelling, disgusting Alien creature that came busting through the guts of its victims – as the medic slowly doused the tick with alcohol then gingerly pried it away from my skin.

Just to be safe, we now have the tick buried in two zip lock bags and stored in our freezer. Hey, that’s what the newspaper article suggested you do if bitten. Then, if you do become sick, the culprit can be examined and might help in a final diagnosis.

I’m hoping a month from now we can toss the tick, along with any residual worries. But to be on the safe side, I just had Miss Wendy strip search me. Okay, I know that’s an image you probably could have managed to live without. Too late now. Sorry.

OH, GROSS: Wet weather in the Land of Cotton this spring and early summer has provided perfect conditions for ticks (photo above) to produce and prosper in lawns, shrubbery and trees.

Reason for hope on a dark and lonely road

My mother, as I've detailed here before, is trudging down the long road of dementia. It's an ordeal that many have faced, a problem for both those afflicted and their families dealing with the myriad of problems that are part of this disease.

One of the greatest hurdles, ironically, comes from the bizarre system of medical care that's been created in this country. It's a system that provides remarkable aid for all sorts of mundane and catastrophic situations -- broken limbs and sore throats, heart disease and cancer. But the healthcare community seems to still be stumbling around in the dark ages when it comes to treating any form of dementia.

The problem, and I'm speaking now from experience, is that when patients grow old and lose the ability to pay close attention to their care, they and their caregivers fall into a bottomless pit, filled with an assortment of doctors -- primary care physicians, neurologists and psychiatrists -- physician assistants and physical therapists, all making suggestions and all passing the buck.

My guess is that people and caregivers dealing with any sort of chronic ailment probably face the same issues. The problem isn't the disease, but the number of healthcare workers involved in treating ongoing ailments and the archaic system of communication that remains at the heart of our medical community.

In the last year or so, my Mom has gone from living in her own condo, taking half a dozen different medications, following the advice and instruction of one doctor -- her primary care physician -- to now living in the "Memory Care" ward of an assisted living facility. Today she takes 14 different pills -- meds for blood pressure and cholesterol, depression and insomnia; pills to boost her appetite and quiet tremors and hallucinations. There's another half-dozen pills prescribed for use as needed for aches and pains, stomach upset and anxiety. She has a neurologist, two psychiatrists, physician assistants and physical therapists. I've lost count of the number of nurses and aides responsible for her care.

At first blush all this attention might seem to be a good thing, something to celebrate and not condemn. There's only one problem -- these people don't talk with one another and there is no central database where information is stored and updated. It's up to me, my brothers and other caregivers to make sure instructions are passed along correctly, that aides charged with handling meds are doing so correctly, that the orders of one physician countermanding the orders and prescriptions of another are correct and carried out. This is absolute madness.

But there is a bit of good news. Today started out badly, very badly. It ended on an optimistic note.

My brother and I met at Mom's assisted living facility to pick her up for another appointment, this one with yet another physician assistant at the geriatric hospital where she has been treated several times. In the last few weeks, Mom's condition has worsened significantly -- she's no longer able to walk, to feed herself or take care of any of her personal needs. She's lethargic, speaks only if prodded and is now showing signs of Parkinson's, one of the nasty little side effects of the form of dementia (it's called Lewy Body) that she's battling.

So what's the good news? The physician assistant seemed to be more shocked by Mom's condition than either my brother or me and set about finding out what the hell has been going on with her care. She pretty quickly announced that it was clear Mom was over medicated and dehydrated. She studied the med info they have on file at the hospital and checked out the folder I brought along that details recent visits and med changes. She then repeated the line I've heard so often from physicians and other healthcare workers in recent months, "this is what we're going to do now."

But unlike her colleagues, after making several changes and suggestions, this physician assistant detailed a plan of action -- new meds, plans to contact the med nurse at Mom's assisted living facility, notes to care workers about the importance of hydration and the need to monitor Mom as old meds are stopped and new ones are started.

Most startling and refreshing is I just got off the phone with the physician assistant -- she called me! The details aren't really important, it's the fact that she took the time to touch base with me about a topic she thought important regarding Mom's care. She then added that if Mom doesn't perk up in the next couple of days that I should give her a call and there are some additional tests that she'd like to order.

It was about then that I recall something she had said in a sort of absent-minded way while looking over my mother's chart earlier in the day. "If this was my Mom, I'd certainly be concerned about her care." It was just a little break in the professional facade, a bit of empathy that hopefully means we might have stumbled onto someone special.

To be sure there will be additional challenges in the coming weeks and months. But I'll grab hold of help and hope anywhere I can find it. And on this day it seems we were handed a small gift that just might lighten the dark road my Mom is navigating.

Dead sea a lively way to spend a day in Israel

BIZARRE AND BEAUTIFUL: The Dead Sea is framed by a mixture of minerals, all that remain when the water along the shore quickly evaporates from the intense heat in this region of the Middle East.

It's Friday, time yet again for another "Interesting Jewish Stories & Facts" (IJS&F) posting. Today we visit Israel and dip our tootsies into the brackish waters of a fascinating and picturesque tourist attraction.

The Dead Sea is salty and muddy and, well, absolutely dead.

It's also one of Israel's most interesting attractions. Most first-time tourists include a trip to this remote region of the country to see Masada -- the ancient fortress about 90 minutes by bus from Jerusalem -- and find the nearby Dead Sea, despite its name, the perfect place to relax and get cool.

That's what I and a group of companions from Atlanta did on a visit sponsored by the Jewish Federation of Greater Atlanta. After a couple of hours of exploring the ruins of Masada, most of us were ready to experience the unique -- some might say bizarre -- offerings of this gigantic inland lake.

The Dead Sea is fed mainly from the north by the Jordan River. But the fresh water evaporates quickly because of the hot desert climate. What remains is a mineral-rich pond -- it's 10 times saltier than the Mediterranean -- that is incapable of supporting life.

But it will support bathers -- literally.

Because of the density of solids in the water, when you jump into the Dead Sea, you bob to the surface like you're made of cork and float -- effortlessly. You don't have to arch your back. You don't have to paddle your hands and kick your legs. In fact, you don't have to do anything but enjoy the experience.

You can also enjoy the sun -- there's an average of 330 full days of sunshine in the region each year.

And because the Dead Sea is 1,320 feet below sea level, the lowest point on Earth, harmful ultraviolet rays are filtered through an extra atmospheric layer -- an evaporation layer that exists above the Dead Sea and a rather thick ozone layer. So sun lovers can bake for hours with little risk of burning.

That's not to suggest there aren't problems. If you have a cut, even a tiny scratch or small rash, the sting of the mineral-rich water will probably drive you out of the area with a grimace on your face and a crusty glaze of salt all over your body.

At least that was my experience. I lasted only five minutes or so before bolting for one of the fresh-water showers that dot the nearby beach.

Others in the group had no such problems. I spotted them as I washed away the brackish water -- a flotilla of pink-skinned tourists bobbing leisurely and comfortably atop the calm waters of the lake.

And then there's the mud. It covers the banks and sea floor, squishing coolly around your feet and ankles, and feels like a gooey mess of Jell-O. It's also thought to be good for you.

People take the stuff and smear it all over their bodies, a practice that stretches back thousands of years -- supposedly Solomon, Cleopatra and Herod the Great all enjoyed playing in the mud.

The gelatinous gunk, a brew of minerals including magnesium, calcium, bromine and potassium, offers relief for people suffering from psoriasis and other skin disorders and is used as a beauty aid. It's marketed under the brand name of Ahava and can be purchased online or at most department stores, spas and many beauty salons.

The entire area is remarkable, one of the treasures of Israel and just one of the reasons you might want to visit the Jewish homeland.

Lovely -- and full of crap!

Here's a "crappy" fact I find a bit alarming. One Canadian Goose defecates 28 times a day!

And if you do the math -- and apparently there are people that have -- that groaning effort produces up to two pounds of, ahhhh, feces per goose, per day.

Down here in the "Land of Cotton", it would seem that that's a nugget of info that's interesting but of little concern. Au contrair, mom ami!

Let me explain. There's a lovely walking path in my neighborhood, parallel and only a few yards from several parks, natural green space and the Chattahoochee River.

I spend a good bit of time there, exercising and thinking, watching people and being watched in return.

Walk far enough -- the trail meanders about for nearly six miles -- on a gorgeous day when the Georgia sky is a deep blue and the temperature has yet to break a sweat and there's a good chance you'll share the space with joggers and bikers, kids on skateboards and teens on rollerblades.

There are often couples cuddling on blankets and families having picnics; fishermen on the banks and boaters in the water; dogs and cats, squirrels, chipmunks and an assortment of other critters too shy to show themselves.

And there are Canadian geese -- gaggles and gaggles of geese -- waddling about, drawn by the river and the inviting marshlands nearby. They spend their days doing what geese do -- sleeping and swimming, eating and pooping.

Did I mention they crap up to 28 times a day?

So, other than aesthetic considerations, why should this concern me -- and you, if you happen to live in an area that these flying rats call home?

It turns out goose turds are loaded with all sorts of bad stuff. Recent research at the Centers for Disease Control in Atlanta confirms that Canada goose excrement is laden with potentially dangerous bacteria, including E. coli and salmonella microbes.

So, the CDC suggests, be careful where you walk, where you eat, where you play when visiting the Chattahoochee. Because it turns out my lovely walking path -- and other similar areas across the U.S. and Canada -- is nothing but a pretty toilet for our feathered friends.