The House Of The Rising Sun


There is a house in New Orleans
They call the Rising Sun
And it’s been the ruin of many a poor boy
And God I know I’m one

I have always loved The Animals’ House of the Rising Sun, a haunting rock ballad that was released in this country in 1964, and went to the top of the Billboard chart in the U.S., U.K., Canada, Sweden, and Finland in short order. Interestingly, this version known to most Americans today – the first British Invasion #1 not connected to the Beatles, and one currently listed amongst the 500 greatest arrangements of all time by both Rolling Stone and the Rock ‘n’ Roll Hall of Fame – was performed in one (unpracticed) take on May 18th of that year in a London studio, and was not re-recorded a single time before release.

The Animals' Album

The Animals’ Album

Having spent time in New Orleans at Charity Hospital as a resident, and being quite familiar with the seedier side of The Big Easy, I have long believed that the song lamented a young man ruined by a life spent in the song’s namesake house of ill repute. Except now, it appears that such is not the case.

The score and lyrics have also been known as the Rising Sun Blues before The Animals’ best known release. It’s had a long and storied existence on both sides of the Atlantic. The earliest known version of the song in this country was recorded by Appalachian folk artist Tom Ashley in 1934. When asked about it, Ashley merely noted that he had learned the song from his late father, and he had no idea from where his father had learned it. The tune has been covered by Georgia Turner (1937), Woody Guthrie (1941), Josh White (1947), Lead Belly (1948), Pete Seeger (1958), Frankie Laine (1959), Andy Griffith (1959), Joan Baez (1960), Mirian Makeba (1960), Bob Dylan (1961), Nina Simone (1962), the Chamber Brothers (1967), Frijid Pink (1969), Jody Miller (1973), Dolly Parton (1981), and Five Finger Death Punch (2014), to name only some; the gender of the song’s subject varies by the artist, suggesting either a ruined man or fallen woman. And there is even a Spanish language version released by Los Speakers (1965).

Paradoxically, Dylan – who arguably attained greater lasting fame – stopped playing the song in concert after The Animals’ smash hit because he was tired of being accused of plagiarism even though he did it first!

A persistent urban legend exists that both The Doors and Led Zeppelin covered the song as well, but as of this writing, no such recordings from either group are known.

Musicologists have opined that the song’s authorship is murky at best, and that it is derived from 18th century folk ballads such as The Unfortunate Rake, about a prodigal son dying of syphilis. These musical scholars suggest that the song was only adapted to a Louisiana setting after crossing the Atlantic with early immigrants.

To further muddy the (Mississippi) waters,
• Alan Price of The Animals has said in at least one interview that he was told the song was about a now-defunct Soho brothel, but he wasn’t entirely certain; he claimed that he first heard it when touring with Chuck Berry, and decided to incorporate it into their repertoire “because it was distinctive.”
• Extant records from Orleans Parish do not document any bawdy houses of the late 18th through early 20th centuries – yes, they were usually licensed and recorded back then – by the name of Rising Sun. There was, however, a small hotel thus named on Conti Street in the French Quarter that burned down in 1822 (sidebar: archaeologists have found a large number of cosmetic containers at this site). There was a coffee house with the title next to the Quarter in the 1860 census. There was a Rising Sun on Decatur Street in the late 1860s that has been variously described as a restaurant, a café, or a saloon. And there was a dance hall with the moniker in the Carrollton district of the city in the 1890s. Whether any of these businesses offered a secondary line of services upstairs is not entirely clear.
• Maybe the reference isn’t to a brothel at all, but to a proprietor of same? There was a suspected bordello at 1614 Esplanade Avenue from 1862-74 that was owned by one Madam Marianne LeSoleil Levant, her name being French for “Rising Sun.”
• And the reference to “ball and chain” in the fifth stanza suggest that the house in question may, in fact, be a jail. The front door of the old Orleans Parish Women’s Prison is said to have had a rising sun motif on the cornice. That noted, the phrase is often used as a euphemism for the bonds of holy matrimony, leading credence once again to the (frustrated husband in the) brothel angle.

Not everyone believes that there necessarily even exists a discoverable American historical antecedent to the song, especially given its apparently murky roots in Old Country folklore. Pamela Arceneaux, a librarian working at the Williams Research Center in New Orleans, has been quoted as saying, “to paraphrase Freud, sometimes lyrics are just lyrics.”

Oh mother tell your children
Not to do what I have done
Spend your lives in sin and misery
In the House of the Rising Sun

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[Copyright 2013 @ The Alienist’s Compendium]

Size Matters

There’s that old adage of Lone Star narcissism and self-indulgence that everything in Texas is bigger. In the antebellum South, the diameter of a woman’s hoop skirt usually reflected wealth and status. Sumo wrestlers are the rock stars of Japan. The number of annular rings in a cross section of a giant redwood reveals its age. European royalty and judicial luminaries of the 18th century competed to don the most luxuriant and elaborately curled perukes. And in the adult film industry, well… let’s not go there.

In short, size (or whatever parameter of magnitude you desire) does matter.

[quick sidebar: customization matters too. In the American Civil War, common military conscripts were issued frumpy outerwear called sack coats, their similarities to the canvas potato bags of the day being unavoidable. Those stylish enlistees of means and middle rank, however, paid extra for a tailored version known as the shell jacket, that which men often are seen wearing in formal portraits of the day as the antebellum females swoon]

Combining those two observations brings me to an unmistakable ‘fact’ about the doctor’s white coat.

When I was a student, and later intern, we were issued the medical version of the sack coat. Formless, hip-length, off the rack, of coarse scratchy fabric, and with sleeves that were always ill-fitting, these atrocities made us look like the kids’ toy Weebles (who wobble but don’t fall down). Before long, they all looked dingy despite the number of washings. The young women in my class, and those few men regarded as clothes-horses, however, bought their own jackets of higher quality and had them tailored to fit and regularly drycleaned. All, though, were hip length. And by late intern year, many hold-outs had chucked their sack coats and opted for something more fitting albeit still utilitarian and of acceptable length.

As one progressed up the food chain, the quality of the coats and length improved (and, I would posit, the cleanliness). Upper level residents wore longer coats. Junior attendings a bit longer. And eminent attendings had coats of regal length – the perception magnified if that doctor was of short stature – with stylish pleating, belts, and fabric buttons in lieu of the cheap plastic ones on the government issued varieties.

As a psychiatrist, I only wore a white coat as an intern. After that point, at least at my medical center, psychiatrists tried to eschew the fearful “I’m the doctor and you’re not” phenom on the mental health wards and opt for the warmer and fuzzier Mr Rogers approach – khakis and sweaters. I know that’s a stereotype, but it’s true. And that’s how I’ve dressed for the past quarter century. Until recently.

I took a new inpatient position at a nearby medical center, and found that the psychiatric attendings there often, albeit not universally, opted for the classic white coat.

I know that much has been written about this tradition, but given all of the above, imagine my surprise when my intern arrived on the unit the very first day of the rotation… sporting a flowing and long bright white coat (with embroidered name in script, no less!) Her coat was far nicer than mine. For a moment, I couldn’t figure out who was this person until she introduced herself. She had been a physician at that point for less than five weeks.

Double my shock when I saw other allied disciplines – nursing, social work, pharmacy, technicians – donning the same attire!

I would have been shamed out of my residency program had I tried that back in the late 1980s.

Should it matter? No. Does it matter? I suspect in some ways, yes.

And while the egalitarians applaud, I doubt that the protocol at Mass General – where I am told that attendings wear short coats to symbolize that they are students for life – will catch on elsewhere anytime soon.

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[Copyright 2013 @ The Alienist’s Compendium]

The Pink Ladies

Here’s a quiz: which of the following assertions were uttered by chronically mentally ill individuals at a state psychiatric facility, and which were headlines from a nationally distributed periodical, one that enjoyed a circulation of over 1.2M in its heyday and spawned a hit off-Broadway musical?

“There’s a giant mutant hog monster attacking Georgia!”

“Scientists have found an infant dragon preserved in formaldehyde!”

“Bat Boy to be the next Pope!”

“Elvis’ face appeared in my pancakes!”

“The Founding Fathers were all gay!”

While some/ all of this might have been said at some point by patients suffering from psychotic disorders, the above statements were actually front page ‘news’ from a widely read tabloid. The Weekly World News, bastard cousin of The National Enquirer, to be exact.

But allow me to digress for a moment before further explaining.

I was dining with family recently when my foreign-born spouse brought forth a surprise dish we’ve never before enjoyed at our house. Perhaps she thought it was an exotic food worth sharing, one that is absent from both her own memory and her culture’s traditional cuisine. She placed it on the table with a smile and asked, “does anyone know what this is?”

“Yes,” I replied. “That’s pimento cheese spread.”

She looked somewhat surprised that I recognized the edible when she has never seen me eat or talk about it in our decade together. Thus, I felt an explanation to her was in order.

At the University of Virginia, where I completed both medical school and residency, the second half of the 1980s was a period of transition. The drab old hospital, built in the years following WWII, was being replaced by a bright white edifice just across the street. That new building, with an expensive copper roof that shone like jewelry in the sunlight, had a fancy dining facility in keeping with the rest of its aesthetics. The old hospital had a run-down cafeteria in its basement – called The Skylight Inn, even though that was comical since there wasn’t a single window in the place.

And the old hospital had the Pink Ladies.

Most hospitals have a volunteer auxiliary comprised of (usually female) older retired helpers supplemented by bored high-schoolers and those looking to add a few community service brownie points to their upcoming college applications. The former were the Pink Ladies, and the latter were the Candy Stripers.

Both flavors of these volunteers had small carts that they pushed around to patients’ rooms to deliver paperback novels and chocolate bars. But they also served the medical center’s workforce. The Pink Ladies staffed a snackbar, just one flight up from the Skylight Inn in the old hospital. Although its menu was limited – a few simple sandwiches, chips, sodas, candy – it was often preferred by the doctors and nurses to the cafeteria downstairs. Why? Because the Pink Ladies made their sandwiches early each morning en masse, wrapped them in wax paper, and sold them super-cheaply. Plus, you could be in-and-out with your purchase in no time; patronizing the Skylight Inn meant lining up and waiting, and if they didn’t have what you wanted, you’d have to wait longer.

Far from gourmet, Pink Lady sandwiches consisted of nothing more than two pieces of Wonder Bread cut diagonally, usually with some sort of smear on the triangles which were then pressed/ glued together. Tuna. Ham salad. And yes, pimento cheese.

As a medical student and intern, grabbing three or four Pink Lady sandwiches, for the princely sum of approx $2.50 total and then stuffing them, taped wax paper and all, into the huge side pockets of my white coat, could keep me going for the rest of the afternoon and evening, long after the Skylight Inn had closed and the Pink Ladies had gone home to play pinochle and watch Lawrence Welk.

So that was my experience with pimento cheese. But remembering that faux-delicacy soon got me thinking about another long-forgotten aspect of the Pink Ladies, one far more nefarious.

I spent my internship in the main (old) hospital, but as a resident, I moved out to the designated psychiatric facility, Blue Ridge, a freestanding separate complex that was originally a turn-of-the-century TB sanitarium on 100 acres about five miles down Rt 20. The Pink Ladies had an outlet there as well, but it wasn’t their foodstuffs in 1989 that piqued my curiosity.

It’s widely accepted that, when managing patients with disorders of perception and cognition, maintaining predictable routines in structured surroundings with known staff helps reinforce reality-testing. That’s why ward schedules are often the same every day, familiar faces are encouraged to visit, and rooms usually have large windows, bold calendars, seasonal décor, and clocks that are easy to read – it helps those with a tenuous grasp of this dimension keep from further slipping.

Those patients with off-unit privileges were allowed to leave the ward and walk outside to smoke, or else stroll down the hall to the Pink Ladies’ venue for a treat.



Imagine my amazement when, the first time I visited the Pink Ladies’ satellite at Blue Ridge, my eyes were greeted by issues of the Weekly World News trumpeting the exploits of P’lod (an extraterrestrial famed for his affair with the First Lady), Tonya (the world’s fattest cat at 80lbs) and old fallbacks such as Bigfoot and Nessie. All things supernatural and paranormal do not make the psychiatrist’s job any easier, trust me. Patients would see this drivel, and even if they didn’t purchase the rag, they would come back to afternoon group espousing further paranoid delusions and conspiratorial theories despite the epic amounts of Haldol that I dutifully dispensed.

Was this someone’s idea of a joke? Perhaps the lighthearted satire of WWN was amusing for medical-surgical patients at the main hospital, but at Blue Ridge?!?! It only rendered the task of preserving reality all the more difficult, Rx or no Rx.

I finished residency in 1992. Blue Ridge closed its doors in 1996. The Weekly World News folded in 2007 after a 28 year print-run (it now lives online). And if the Pink Ladies’ shop still exists in the main UVa hospital, I suspect that those sandwiches are much more expensive, and the only periodicals on the rack are Time and Newsweek.

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[Copyright 2013 @ The Alienist’s Compendium]

The Rolling Stones!

Age is a cruel taskmaster indeed.

I attended the College of William and Mary for my undergraduate education. Back then, as a Phi Beta Kappa history major with a biology minor, I studied a lot. There were no girls’ schools nearby. I didn’t do drugs or drink to excess. It was difficult to get into too much trouble in that small picturesque tourist-laden town. So opportunities to road-trip and have some ‘real fun’ were not only few and far between, but much desired.

It was December of 1981, my second year in college half-over. Grades were on-track. It was starting to feel more relaxed. I breathed a sigh of relief. Perhaps it was not too late to start having some real fun.

Then the news hit. The Rolling Stones were playing the Hampton Coliseum on the final stop of their ‘Tattoo You’ tour on the 18th and 19th of that month, just after exams were finished. Unfortunately, to get to Hampton required a car… something that I didn’t have in college. One of the fellows across the hall in my dormitory did have a car, though, and the next thing I knew, he had landed six tickets to see the Stones, and I was offered one of them.

I was excited! The Rolling Stones, always the bad boys to the (initially clean cut) Beatles and Elvis, had by then outlasted the Fab Four and the late-King on the live concert circuit by twelve and four years respectively. The Stones were the premier act of the British Invasion still going strong. This was an opportunity not to be missed!

But fate had other ideas. Most college students wind up getting the sniffles around exam period, the effects of long hours, poor diet, and intermittent sleep. Some get it worse than others. I came down with a bad upper respiratory infection in the days prior to the concert. I even had to go to student health, something we all tried to avoid because of the long wait times. Needless to say, I felt awful when the day of the concert rolled around, and with great regret had to let someone else take my coveted place.

Med school and residency. Marriage. Children. Dogs, Relocations. Re-marriages. Jobs. Jobs. Jobs. They all intervened. That missed gig in Tidewater was the only opportunity for me to see the Stones conveniently from that time… until this month.

I was at work three months ago when a fellow psychiatrist texted me that she had gotten tickets to see the Stones at Carter-Finley (the 58,000-seat NCSU football stadium here in Raleigh) in early July, and did I want a pair of the tickets that she had snagged? I had a flashback to 1981, and told my thoughtful friend that my wife and I would be thrilled to go with her and her group!

There was an inauspicious start to this plan, though. I excitedly texted the missus and told her I had tickets to see the Rolling Stones! She texted back that she was happy… and would have to Google ‘Rolling Stones’ to see if she knew any of their music.

Google the Stones?!?!

[sidebar: in her defense, she only emigrated to this country in 1994, but still, the Stones are known the world over. The Iron Curtain wasn’t THAT impermeable, was it?!?]

I planned on taking the day off work so that I wouldn’t have to worry about missing the concert in the early evening commute/ traffic jam. I read all that I could about parking and routes by which to approach the stadium. I had planned on scanning eBay for some Stones’ paraphernalia to wear on the big day. I showed the missus a t-shirt I wanted to buy, one with the large red ‘lips and tongue’ logo that the Stones have been using since at least the mid-1960s. She asked me why I wanted to buy a KISS t-shirt?

[sidebar: this wasn’t looking too good; even my ‘golden oldies’-knowledgeable teenage stepdaughter rolled her eyes when her mother made such comments, and she wasn’t even BORN when I missed the Stones in Tidewater!]

Last night was the event. We left on time, got to the stadium parking without difficulty, and found a decent spot (though it was far from the exit, which, I knew, would make egress a nightmare when the concert was over). Everyone was tailgating. Grills. Cooking meats. Ice chests with libations. Though the youngsters were there in force, there was an equally large contingent of folks who, like myself, sported more than a few grey hair. I kept thinking of that line from Don Henley’s ‘Boys Of Summer’ about having seen a Dead Head sticker on a Cadillac.

I found my friend’s car. She and several others were standing around drinking and eating snacks at the rear hatchback. Talk turned to work. And kids. And our various physical ailments. Really, you had surgery? How much did you lose on that diet? So-and-so retired/ died? I don’t remember you wearing those glasses? Then it was time to head to the stadium entrance.

The hill was long. I was sweating by the time I reached the gate. I was starting to feel sore. I asked my friend about the quality of the seats. She looked sheepish, and said that, though she had been made a special offer through her credit card company to buy these tickets in advance, one of our party had decided to come at the last minute, had bought his ticket only that afternoon, and had apparently scored a much better seat than did the rest of us (he bid us farewell as he veered off for the seats nearer the stage, while we hiked up into the section requiring supplemental oxygen).

The logo, through zoom lens

The logo, through zoom lens

Far removed from the days when big-name acts played small club venues, the organizers of today’s mega-concerts have developed a trick to fool those in the nosebleed seats. By putting up giant Jumbotron video screens around a site, one gets a clear picture of who is on stage, even though this is essentially like watching TV at home, only minus the comfort and nearby refrigerator. That was the case last night. I could clearly see the faces of the ants on the stage. But that was really the least of my concerns. The stadium bleachers were the most infernally uncomfortable seats I have ever experienced. Plus, much like flying coach on domestic airlines, the people were crammed in so tightly that it was a challenge to keep my knees out of the backs of those in front of me, or even stand to stretch (since it would be difficult to wedge myself back in the seat afterward).

It was hot and sticky. The crowd was loud. The wannabe warm up band blared in the background. My butt hurt. The concessions were highway robbery, and the band’s merchandise was outrageously expensive too. My cellphone had no reception. The restroom lines were unspeakable. But hey, I was going to see the Rolling Stones, right?

At 9:30 p.m., the lights dimmed, and then in a technicolor explosion, the Jumbotrons flashed the red ‘lips and tongue’ logo, and onto the stage strolled Ronnie Wood, Charlie Watts, Keith Richards, and Mick Jagger. Or at least that’s who the TV showed me was on the stage.

They launched into their first number. Someone had turned the volume WAY up since the warm-up act. The seats reverberated. My pacemaker vibrated. I strained to figure out the song. Was it ‘Tumbling Dice’? Or perhaps ‘Brown Sugar’? Maybe ‘Midnight Rambler’? After close to a minute, I figured out that it was ‘Jumpin’ Jack Flash,’ but only because I recognized features of the beat, not because I could actually understand any of the lyrics.

By 11:00 p.m., the band was still going strong, but I was not. I couldn’t possibly be heard over the din to explain to my group that we were leaving, assuming that I could have even stretched over to yell in their ears. I told my wife we were going to do ‘the English departure’ (a former Soviet term for slipping out without saying goodbye to the hosts). I ‘went to the restroom,’ and she followed five minutes later. We made our way to the car. At least, I thought, we’ll avoid the total jam that will occur when all 58,000 fans head for the parking lot when the concert is finished.

Not exactly. Stiff and palsied, it still took us a while to exit – a lot of those formerly-referenced grey haired fans were making for the doors as well. And sadly, the sound quality was far superior in the parking lot, probably more than half a mile away from the stage. We should have saved the ticket price, paid for parking, and listened to the concert from outside!

Home by midnight, I fell fast asleep like the dead. I have no idea what time the concert ended, or what time those hold-out stalwarts actually made it home. But as I drifted off, I could not have cared less how many encores were played.

Thirty four years after Tidewater, Mick Jagger is right. You can’t always get what you want.

[Have an idea for a post topic? Want to be considered for a guest-author slot? Or better, perhaps you’d like to become a day-sponsor of this blog, and reach thousands of subscribers and Facebook fans? If so, please contact the Alienist at]

[Copyright 2013 @ The Alienist’s Compendium]

For The Superstitious

Humans are a superstitious lot. It’s not uncommon for even the most rational of us to engage in some magical thinking now and then. Consider the whole schtick surrounding black cats. Or walking under ladders. Or that silliness involving the number ’13.’ Or the breaking of mirrors.

Luckily for the credulous, there are talismans and rituals on the good side too. If one is spiritual, holy medals provide supernatural protections and strengths. For those of us pagan, consider horseshoes, lucky pennies, rabbits’ feet, knockings on wood, and four-leaf clovers. In the Far East of antiquity, one might carry a netsuke. And a sprig of garlic around the neck was certainly held to be an auspicious possession if the medieval wearer succeeded in avoiding vampires!

Some others have taken this in a slightly different direction. Wade Boggs, the third-base Hall of Famer, would only eat fried chicken immediately before a big game. Basketball player Lamar Odom, late of both the New York Knicks and the Kardashians, chows down on handfuls of candy. Both believe that these particular pre-game consumptions bolster the likelihood of winning.

[sidebar: speaking of eating, most cannibal tribes hold that consuming one’s enemy not only yields the strength of that vanquished person, but renders the consumer invincible to later attacks from the same source, which would prove lucky indeed… if only accurate]

There are athletes who avoid sex for days before a competition – a number of Olympians have subscribed to the belief that abstinence channels energy that is otherwise lost to flagrante delicto, and thereby guarantees victory.

One B-26 Martin Marauder in my father’s USAAF squadron had a good luck message inscribed on the inside of the nose, left there by an anonymous worker who had helped construct the bomber before it headed for the European Theatre. That plane, the Coughin’ Coffin, returned from 50 missions over Nazi Germany having never lost a crew member.

In school, I had friends who would only take tests using their ‘special’ pencils, the ones that somehow produced a ‘B+’ on the quizzes that they should, by all logic, have failed. Such a pencil was believed to counter the fact that the bearer didn’t study as much as recommended. Sometimes it ‘worked,’ other times not, but it was always held to be ‘special.’

In all of the above, while the action or possession, from a rational perspective, might not have exerted any measurable impact, if the person in question enjoyed greater confidence because of it, then perhaps there was a benefit regarding the eventual outcome?

With these observations in mind, I offer you my experience with the bar exam.

I took the bar exam in 2008, not in North Carolina, but rather in New Mexico. It was in February of that year, and despite the image that many East Coast people hold of New Mexico being hot and arid (that’s the southern part of the state), the further north one travels in the Land of Enchantment, the more mountainous and Colorado-ish becomes the terrain. Even Albuquerque, decidedly mid-state, has a huge mountain, Sandia, just to the northeast of downtown, and in the winter, it is usually snow-capped.

I decided to fly to ABQ several days prior to the exam. I wanted to be alone with my prep books. I planned on checking into a nearby hotel, studying without interruption, and then walking to the convention center to take the test on the appointed day. Arriving at my hotel, I could see snow-capped Sandia in the distance. The weather was chilly – night-time lows dip below freezing not uncommonly, and day-time highs are usually in the low 50s at that time of year – and the wind was blowing more than I had remembered from previous visits.

The hotel was comfortably furnished, but I began to have trouble with the thermostat. The room was just a couple of degrees warmer than ideal for me. I tried to adjust the temperature, to no avail. The front desk was of no assistance. I then experimented with various combinations of shirts, pants, and shorts to find my comfort-zone, all to no avail.

I’m not much of a Starbucks caffeine addict. And if you mix slight warmth with the study of (not always exciting) contracts, evidence, and civil procedure, plus a few inevitable study-snacks, well, you can easily start to nod off. Which is exactly what was happening to me before long. And the test was only 72 hours away!

After several hours of alternating between futile poking of the thermostat, standing up every five minutes to avoid sleep, pinching myself, and swearing, I decided I had to do something drastic. I had to make myself just a bit uncomfortable. Not so uncomfortable as to produce actual pain or be a distraction, but uncomfortable enough that I wouldn’t be zombified reading about property owners’ riparian rights in Guadalupe County.

There was only one option. I had to get naked.

Yes, you read correctly. Naked. Being in the buff, I thought, would render me just a tad chilly, since being dressed rendered me just a tad warm. Frequent stretches and reading while walking back and forth in the room weren’t working (plus I was bumping into things). There was no time to waste.

Off came the clothes. I mean, I was alone, so it’s not as if it were a prurient act, but rather merely one of desperation in the final countdown to the big test.

It worked like a charm. I wasn’t drifting off in my birthday suit, even while reviewing commercial paper for the umpteenth time. Over the course of three full days, I dressed only to go downstairs to eat one meal a day. I became a hermit-in-the-raw, and this unorthodox ‘technique’ kept me alert and focused.

The day of the test came. I passed with flying colors.

But now, do I want to spoil a good thing? I am batting 1.000 – granted, that average is based on a single event – and with my psychiatry board recertification and the patent bar both looming, must I head to yet another hotel for tried-and-true lucky prep time?

[Have an idea for a post topic? Want to be considered for a guest-author slot? Or better, perhaps you’d like to become a day-sponsor of this blog, and reach thousands of subscribers and Facebook fans? If so, please contact the Alienist at]

[Copyright 2013 @ The Alienist’s Compendium]

Customer Service

[today’s post is sponsored by my friend, neighbor, and loyal reader Alessia Petrucci; at a recent dinner gathering, she good-naturedly chided me for being “slack” in my recent postings. Embarrassed, I wrote this on an early Sunday morning. Enjoy, Alessia!]



I’ve traveled widely in the Far East, eastern Europe, and the former Soviet Union. As some of these countries have made the transition to a less centralized economy, one thing with which they’ve struggled is the basic idea of customer service. Employees often give the impression of doing you a favor even by looking half-interested in whatever question or problem you pose.

If you are dealing with government bureaucrats, however, you can multiply that effect by a factor of 2 or more.

Before we in the US of A get too smug, however, let’s not forget our own domestic experiences with any state’s DMV, cable TV conglomerates, the IRS, and cell phone companies. It seems that a lot of those who are supposed to be serving the public aren’t coming even close.

And that’s why an experience I had recently with a bureaucrat – albeit not one in the United States – was so unusual and noteworthy.

I hold dual US-Canadian citizenship, and when I’m traveling to offbeat and not-infrequently adversarial places around the globe – think mainland China or Russia – I often ‘go Canadian.’

[sidebar: sometime soon, I need to blog about my train trip several years ago from Riga to Moscow, a journey not for the faint at heart thanks to surly border guards]

Thus, I keep my northern passport up to date, and as instructed by the government in Ottawa, I register with the passport office when I am overseas.

[sidebar: Ottawa considers me overseas living here in the U.S., so I am current registered in case any civil unrest occurs in, say, my local Walmart and I might need to be evacuated along with other stranded Canucks]

A quick digression: I’ve had an AOL email account since the mid-1990s. It seemed relatively simple and utilitarian, until one day my daughter told me that, amongst her know-it-all teen generation, it was thought of as ‘,’ something only for old farts and nursing home residents. I pondered this for a while, and decided to shut down this stodgy reminder of the dial-up internet days and move to something more hip/ professional and 21st century. I selected Microsoft’s Outlook.

I knew I would need a mechanism by which to have non-spam forwarded to the Outlook account should something important arrive in the AOL dead letter box after I had stopped checking the latter. Then I learned that my undergraduate alma mater, William & Mary, offers free alumni email. So I created an AOL auto-reply that lists an otherwise unused ‘’ address as the one to which a sender should write in the future. Those auto-replies would be ignored by spam-computers, but would otherwise allow me to personally filter emails sent to me by actual humans before replying.

So I opened the WM account. I created the AOL auto-reply. And then I promptly forgot about them.

When taking quick breaks during the work day over the past several weeks, I’ve been registering my new Outlook email with a variety of websites and organizations that I have joined over the years. And one such recent update was at the website of the Canadian passport office.

Within ten minutes of submitting my contact information to Canada and having turned back to my desk, my cellphone showed an incoming call from area code (343). I didn’t recognize that area code, but I knew it wasn’t local, so I ignored it, assuming it was a mid-day telemarketer.

Five minutes later, the number called back. I answered. A heavily accented voice asked for me. I tried to reply, but the connection wasn’t good, and the caller had trouble hearing me. Now I was convinced of telemarketing, so I hung up.

Five minutes later, the number called back. I was getting a bit annoyed. I answered again. The connection was clear.

“Hello,” said the heavily accented voice. “I’m looking for John Carbone.”

I replied in the affirmative. My finger rested on the ‘end’ button for use as soon as the expected rote sales pitch began.

“This is the passport office.”


[sidebar: (343) is Ottawa’s area code]

“I just noticed the contact information change on your passport file,” the voice continued. “But when I sent a message to your old AOL account acknowledging the change, I rec’d an email back saying that the new address was actually and not Outlook. That didn’t match the information you had submitted, so I am calling to make sure that you are okay.”

You mean a bureaucrat was sitting at his desk 850 miles away monitoring my account’s information change from less than 15 minutes earlier, sent an email of acknowledgment, and then called to check on me given an apparent discrepancy?!?

I was able to prove my identity with some add’n questions, and I assured him that the Outlook address is correct, and that is only a forwarding address. Satisfied, he wished me a nice trip ‘overseas.’

God Bless the Canadians. And try THAT with any agency of the U.S. government!

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[Copyright 2013 @ The Alienist’s Compendium]

Der Zauberlehrling, or The Sorcerer’s Apprentice

It is common practice for magazine publishers to send complimentary issues to doctors’ offices, where it is presumed the periodicals are kept in waiting rooms for patients to read until the practitioners are ready to see them. Free magazines for the office, entertainment for bored patients, and exposure for the publishers and advertisers. Everyone wins.

My father graduated medical school in 1936, practiced as a generalist until WWII, and then served as a flight surgeon with the 34th Bomb Squadron in the North African and the Mediterranean theatres. After discharge from the USAAF, he went back to residency and completed his training as an OB-GYN. He was in private practice from the late 1950s until 1965, at which time he went to work for the federal government as a medical disability reviewer, pouring through charts and other data, but with no hands-on duties. He maintained that professional role until he retired in 1996 (at the age of 85).

My point? The last time that dad had an office with a waiting room was in the mid-1960s, when I was a toddler. Though he worked for years after that, he didn’t see any patients.

All through my teens – starting more than a decade after dad had maintained his private practice – I recall women’s magazines arriving regularly in the mail at home. Vogue. Cosmo. Glamour. Ladies’ Home Journal. Whatever else was popular at the time. I knew that my mother, who was always sensible with a dollar, wasn’t subscribing. That’s when I found out about the complimentary subscriptions. Somehow the publishers still thought that dad was seeing patients, and that our home address was, in fact, his practice’s office address (even though, by then, we were living in a different state). I doubt dad had notified them of any address changes – he frankly couldn’t have cared less. I suspect it was just the publishers’ assumption, and we were too busy with our lives to worry about these unrequited deliveries.

Dad passed away in 2002, more than 35 years after his last office practice. Over that span, I can’t even imagine how many magazines had come to us. We’d recycle them. We’d give them away. We’d leave them in waiting rooms in which we ourselves were forced to wait. At last, I thought, the magazines will now come to an end. I don’t recall whether I phoned or wrote, but as his executor of his estate, I notified the publishers and distributors that my father was deceased, and there was no further need to send magazines.

Alas, this act merely sent them further into distribution agita.

More magazines started to come, but now to my address. Women I dated over the years found this amusing (and to their benefit… no need to buy their own subscriptions). I called them ‘Magazines from the Great Beyond.’ We laughed.

But the titles expanded. While once strictly magazines aimed at reproductive-aged females, I started to get Newsweek, Time, and the occasional National Geographic. Good Housekeeping and TV Guide were represented, as were Ebony and Jet. There were a few Spanish-language mailings. And Opera News. Cheerleading periodicals showed up. Once there was a fishing magazine, and some other unusual titles, such as Cigar & Spirits, Cigar Aficionado, Food & Wine, and Wine Enthusiast (I do not smoke, and my taste in wine is usually not very exotic).

I moved out of state. The magazines followed.

I moved again. They kept coming, and there were more of them.

I’ve moved three times since dad passed. They have always followed, and I’ve never once submitted a ‘change of address’ notification. They follow, and they’re not merely being forwarded by the post office, since they arrive at my door with the correct address on the label from Day #1.

The strangest part? They are still addressed to my dad (we do not share the same given name).

I feel sometimes like the modern Sorcerer’s Apprentice, the computer-generated mailing labels that stalk me being the 21st century equivalent of Goethe’s powerful spirits inadvertently unleashed.

This is proof positive that once a computer has you targeted, you can never really escape.

I am curious if, with my passing, my son will be similarly cursed?

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[Copyright 2013 @ The Alienist’s Compendium]


I have written previously about the placebo effect, especially as it pertains to psychotropics in general, and soporifics (sleeping pills) in particular.

It’s well known that if a patient believes a drug will work, it is far more likely to produce subjective relief of symptoms. This is even more noticeable if a patient believes a drug will work AND is expensive (i.e., studies have shown that telling a patient that a medication/ placebo is generic, as opposed to the “costly name brand,” cuts down on placebo-efficacy).

Placebos are a testament to the power of the human brain to overcome some medical issues. There is, however, a downside. If we can convince ourselves that a non-treatment is making us better, can we also similarly convince ourselves that a non-malady is making us sick?

The answer is ‘yes,’ and it’s called the nocebo effect.

The New York Times wrote in August 2012 of a patient in an antidepressant drug trial who was, unbeknownst to her, in the placebo arm of the study. She overdosed on almost fifty of the sugar pills in a suicide attempt. Even though the tablets were chemically harmless, the participant’s blood pressure is said to have dropped precipitously following her ingestion (she lived).

It would seem that the nocebo effect is real and, potentially, problematic. To make matters worse, nocebos – even though they are solely comprised of thoughts resident in our own minds – can be contagious.

An example of a contagious nocebo can be found with ‘wind turbine syndrome.’ That’s not actually a medically-recognized condition. Many in the public, however, believe that the large electricity-producing windmills emit a barely audible buzzing noise, one which can result in nausea, dizziness, fatigue, tinnitus (ringing in the ears), and headaches.

Scientists have postulated, however, that when multiple individuals near wind turbines complain of these symptoms, it’s a result of a ‘communicated condition,’ one that, like a mass hysteria, spreads from mind to mind. People can literally worry themselves sick.

Simon Chapman, PhD, a professor of public health in Australia, is quoted in The Guardian as stating, “if wind farms were intrinsically unhealthy or dangerous in some way, we would expect to see complaints applying to all of them, but in fact there is a large number where there have been no complaints at all.”

Chapman cited a study out of New Zealand that exposed 60 healthy volunteers to both real and fake low-frequency noises, the former similar to what is produced by wind turbines and is sometimes known as infrasound. Half of the volunteers were shown television documentaries about the purported health problems associated with wind turbines, while the other half were not. Then both groups were played random noises: some infrasound, some not, and some a mixture. And those who had seen the videos about the allegedly adverse effects reported higher levels of subjective symptoms regardless of the type of noise to which they were exposed.

The wind turbines may be harmless, but breathless media coverage of them isn’t. In the words of one perplexed scientist, news stories about wind turbine syndrome aren’t reporting on the disease… they’re actually creating and spreading it!

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[Copyright 2013 @ The Alienist’s Compendium]

Hamilton Beach meets Adam and Eve

Are you female?

Are you having trouble sleeping?

Are you experiencing fluid retention?

Are you irritable?

Do you have a tendency to “cause trouble”?

If so, based on medical texts from the late 19thc, you are obviously a hysteric. As many as 75% of middle class women in America were then thought to suffer this ailment. And at the time, the standard of care – for those women who couldn’t afford to travel to Europe and lie on Freud’s couch – was a “pelvic massage” resulting in therapeutic “hysterical paroxysms.”

In other words, the patient needed a medical sex surrogate to bring her to climax (weekly was the suggested frequency) and all would be restored to normalcy.

Today, this strangely sexless office sex would almost certainly result in a lawsuit and loss of licensure. Not so in 1900.

Apparently most doctors at the time found the manipulation to be tedious, as literature of the day reported with seeming straight face that it often took hours to accomplish. The good doctor needed something to assist.

Enter the vibrator.

The first vibrator, called a “massage and vibratory apparatus,” was invented and patented in the U.S. by George Taylor MD in 1869. It was steam powered, large, heavy, and sold only to physicians and spas. It was hardly discreet.

One must wonder: did females see the clinician unwrapping said apparatus and feel even fleeting anticipation, or just the kind of dull disinterest one would experience while watching a mechanic change the car’s oil?

The first (smaller) battery powered unit followed from the fertile mind of British physician Joseph Granville a mere eleven years later. Manufactured by the Weiss Company, it was lighter, easier to move, and less expensive than the Taylor machines.

Then homes started to be wired for electricity. By 1900, there were more than a dozen companies in the U.S. and U.K. that were churning out mothers’ little (plug-in) helpers. The Age of Electricity saw the advent of the electric sewing machine, the electric fan, the electric tea kettle, the electric toaster… and these contraptions (which, I might add, predate the electric vacuum cleaner). To our modern eyes, such devices hardly seem alluring. The giant noisy motors. The thick cloth that covered the cords to prevent sparks from flying. The need to add oil occasionally – that last feature yielding the ambience of a bedroom chainsaw.

Marketing was then expanded beyond medical journals. Ads began to appear in Modern Woman and Woman’s Home Companion. These ads remain legendary, promoting such claims as “relieves all suffering,” “wonderfully refreshing,” and “curative of many diseases.” Gushed one, “it can be used by yourself in the privacy of dressing room or boudoir, and will furnish every woman with the essence of perpetual youth!”

And they were economical too. With doctors charging $2 per, er, treatment at the turn of the century, the $5.95 cost of hand-held plug-ins meant that a machine paid for itself after a mere three self-help sessions.

Throughout the 1910s and ’20s, print ads flourished, providing hysterics around the country with relief, courtesy of USPS mail order. Hamilton Beach made such equipment. So did Sears Roebuck, their 1918 catalog vaguely mentioning that the devices were “very useful and satisfactory for home service,” hoping you got the idea and no further explanation was necessary.

Vibro-Life, Eureka Vibrator Co, 1908

Vibro-Life, Eureka Vibrator Co, 1908

There also existed, briefly, pneumatic and hand-cranked models, Macaura’s Pulsocon from the 1890s and the Vibro-Life from 1908 being examples of the latter. Given the relatively recent cultural vogue of total depilation, one cannot help but ponder the cringe-worthy outcomes of applying to one’s self, pre-Brazilian waxes, a metal instrument that twisted not unlike a baker’s mixer.

Even though it was a poorly kept secret – wink wink – once vibrators began to appear in naughty pictures, they were driven almost instantly from the pages of ‘respectable’ publications. They reappeared only during the Sexual Revolution of the ‘60s, and then purely and unabashedly as erotica, where they have remained to this day, their stiff-collared Victorian roots notwithstanding.

Interested in further reading? Google ‘antique vibrator museum’ and be amazed by the collection on display in San Francisco. Better, plan a visit there the next time you’re in town

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[Copyright 2013 @ The Alienist’s Compendium]

Death Takes A Holiday (XVI)

to wit, a middle-aged peripatetic shrink undertakes the Great American Cross-Country Road Trip with help from little leaguers, German bikers, the King of Rock ‘n Roll, porn stars and an abandoned brothel, a flock of domesticated ducks, the Department of Homeland Security and the West Memphis police, a decommissioned atomic warhead, some dodgy motels… and a strange rider in the back of a 2013 Ford Fusion.

The Grim Reaper and I headed for Interstate 40 to make the dash east. It had been a long exhausting trip, but we were on the final stretch at last. Though Raleigh was now directly in front of us across the breadth of both Tennessee and North Carolina, I once lived in in the Volunteer State, so Nashville, Knoxville, Asheville, Winston-Salem, and Greensboro are all very familiar to me. Cruise control set on 70mph, now it was just an 11 hour straight shot to home.

The Explorers’ Adventure and our travelogue had come to a close.

No, wait. There is one part still that I have left out.

On 26 January 2014, in my first installment, I mentioned being stopped by the Border Patrol. For those of you who don’t remember 13 months back, here is what I wrote:

“The day was clear and sunny as it began its fade into impending twilight. I was driving along a secondary road in the far southwestern corner of Arizona, less than a dozen miles north of the Mexican border. There was little traffic, just clear sailing, no obstacles, and a tank of gas as the sun started to dip behind the nearby hills. In short, a perfect and relaxing early evening for a drive. That is, until I saw it up ahead – ‘it’ being a U.S Border Patrol check-point. A sign by the side of the road commanded those traveling north to stop ahead to submit to inspection, and I could see that the armed federal agents had a dog which was sniffing each and every vehicle.

Normally, this wouldn’t present a problem. I wasn’t in a hurry to reach my next destination, the car wasn’t stolen, I don’t do drugs, I wasn’t intoxicated, and I’m a natural-born U.S. citizen.

I did, however, wonder if the revolver sitting on the passenger seat next to me might present a problem. That… and the human remains boxed up in my back seat.”

You know already about the human remains if you’ve been reading this series. As for the gun… I had purchased several months prior a M1851 Colt Navy, and as it happened, the dealer was going to be in Las Vegas for the big antique militaria show that occurs every January. I told him I’d pick it up in person rather than chance entrusting it to the USPS.

So it was a 150 year old black powder firearm. And I have a license. But it was a gun nevertheless, and I had a dead guy in the car with me.

But what happened next was really amazing.

I put the revolver in the armrest. Glancing back, I could see that my calcified friend was boxed up with his lid closed, and thus entirely hidden. What could go wrong?

The officer approached my window and asked for my drivers license, while the Belgian Malinois and its handler inspected the car from the rear, out of my vision. The officer kept glancing back at the dog handler. After exchanging a few words, he said to me, “our dog has alerted on this vehicle, and I’ll need for you to pull over to the side so that we can examine your car more thoroughly.”

Alerted?! On what?! And through a closed car door?!

I pulled over and the officer asked me to step out of the car. He was very professional, but never smiled and was all-business.

“Our dogs are trained to alert to drugs and also to humans who are inside the vehicle but not visible. Do you have either in your car?”

I explained that there were no drugs in the car. I then paused. Adding, “but I have a corpse in the back seat” somehow didn’t seem the correct thing to say to an armed federal agent.

I told him about the dried bones and that I am a physician.

He still wasn’t smiling.

“Sir, I’m going to have the dog come over here to further investigate. Please remain outside the vehicle.”

Over came the dog and handler. The handler and the officer conferred. The handler, who seemed more chatty, then approached me.

He told me that the dogs – even the veteran canines – are routinely put through exercises where they encounter unusual items or situations to see how they react. The handler was very interested in the story of the ancient relic and wanted to see how his dog would behave up close.

You see, research into the chemical odors released by decomposition has provided scientists with a powerful tool to detect a body and then determine how long that person has been dead, a term known as post-mortem interval (PMI). Using mass spectrometry, scientists have been able to characterize the volatile organic compounds (VOCs) associated with cadavers, including carboxylic acids, aromatics, sulfurs, alcohols, nitro compounds, as well as aldehydes and ketones. The combination and quantities of these VOCs change as a function of time as a cadaver goes through decomposition. And while detecting various combinations of VOCs don’t provide a foolproof way of locating bodies or estimating PMIs, the process can help search-and-rescue and law enforcement enormously.

But mine were dried bones, totally denuded of tissue and with a century’s worth of handling having rubbed them clean!

I had been eating a sandwich when stopped, and I had wrapped it back in its paper and put it on the dashboard when exiting my car, leaving the drivers door open. The dog was brought over to the car and allowed to walk once around it. Then he was taken off the leash, at which time he leapt into the drivers seat, not 18 inches from that delicious ham and cheese which he ignored. Instead, he made a beeline for the back seat. He then proceeded to whine and paw at the box.

I was truly amazed. An antique desiccated cadaver had emitted enough odor for a dog to initially sense it THROUGH a closed car door!

More feds had walked over. They all peered inside the box. They thanked me for the training opportunity and bid me farewell.

And they never asked about the gun.

[Have an idea for a post topic? Want to be considered for a guest-author slot? Or better, perhaps you’d like to become a day-sponsor of this blog, and reach thousands of subscribers and Facebook fans? If so, please contact the Alienist at]

[Copyright 2013 @ The Alienist’s Compendium]