Category: reflections

Blast from the Past Blog

I thought I’d re-post something from my previous blog, The Practical Psychosomaticist, which I cancelled several years ago. The title is “Face Time versus Facebook.” I sound really old in it although it appeared in 2011.

I’m a little more comfortable with the concept of social media nowadays and, despite how ignorant I was back then, I later got accounts in Facebook, Twitter, and LinkedIn. I got rid of them several years later, mainly because all I did was copy my blog posts on them.

The Academy of Psychosomatic Medicine (APM) to which there is a link in the old post below, later changed its name to the Academy of Consultation-Liaison Psychiatry (ACLP), which made good sense. I still have the email message exchange in 2016 with Don R. Lipsitt, who wrote the book “Foundations of Consultation-Liaison Psychiatry: The Bumpy Road to Specialization.” It’s an excellent historical account of the process.

Don liked a post I wrote, entitled “The Time Has Come for ‘Ergasiology’ to Replace ‘Psychosomatic Medicine?” It was a humorous piece which mentioned how many different names had been considered in the past for alternative names for Psychosomatic Medicine. I was actually plugging his book. I don’t think ergasiology was ever considered; I made that part up. But it’s a thing. It was Adolph Meyer’s idea to invent the term from a combination of Greek words for “working” and “doing,” in order to illustrate psychobiology. Don thought “…the Board made a big mistake…” naming our organization Psychosomatic Medicine. He much preferred the term “consultation-liaison psychiatry.” We didn’t use emoticons in our messages.

The Don R. Lipsitt Award for Achievement in Integrated and Collaborative Care was created in 2014 to recognize individuals who demonstrate “excellence and innovation in the integration of mental health with other medical care…”

I don’t think the ACLP uses Facebook anymore, but they do have a Twitter account.

I also included in the old post a link to the Neuroleptic Malignant Information Service (NMSIS). I used to call the NMSIS service early in my career as a consultation-liaison psychiatrist. I often was able to get sound advice from Dr. Stanley Caroff.

Blog:  Face Time versus Facebook

You know, I’m astounded by the electronic compensations we’ve made over the years for our increasingly busy schedules which often make it impossible to meet face to face.  Frankly, I’ve not kept up. I still think of twittering as something birds do. If you don’t get that little joke, you’re probably not getting mail from the AARP.

The requests for psychiatric consultations are mediated over the electronic medical record and text paging. Technically the medical team that has primary responsibility for a patient’s medical care contacts me with a question about the psychiatric management issues. But it’s not unusual for consultation requests to be mediated by another consultant’s remarks in their note. The primary team simply passes the consultant’s opinion along in a request. They may not even be interested in my opinion.

I sometimes get emails from people who are right across the hall from me. I find it difficult to share the humor in a text message emoticon. And I get more out of face-to-face encounters with real people in the room when a difficult case comes my way and I need to tap into group wisdom to help a patient. These often involve cases of delirium, an acute confusional episode brought on by medical problems that often goes unrecognized or is misidentified as one of the many primary psychiatric issues it typically mimics.

The modern practice of medicine challenges practitioners and patients alike to integrate electronic communication methods into our care systems. And these methods can facilitate education in both directions.  When professionals are separated geographically, whether by distances that span a single hospital complex or across continents, electronic communication can connect them.

But I can’t help thinking there are some messages we simply can’t convey with emoticons. By nature, humans communicate largely by nonverbal cues, especially in emotionally charged situations. And I can tell you, emotions get involved when physicians and nurses cue me that someone who has delirium is just another “psych patient” who needs to be transferred to a locked psychiatric unit (although such transfers are sometimes necessary for the patient’s safety).

So, when do we choose between Face Time and Facebook? Do we have to make that choice? Can we do both? When we as medical professionals are trying to resolve amongst ourselves what the next step should be in the assessment and treatment of a delirious patient who could die from an occult medical emergency, how should we communicate about that?

As a purely hypothetical example (though these types of cases do occur), say we suspect a patient has delirium which we think could be part of a rare and dangerous medical condition known as neuroleptic malignant syndrome (NMS). NMS is a complex neuropsychiatric disorder which can be marked by delirium, high fever, and severe muscular rigidity among other symptoms and signs. It can be caused very rarely by exposure to antipsychotic drugs such as Haloperidol or the newer atypical antipsychotics. The delirium can present with another uncommon psychiatric disorder called catatonia, and many experts consider NMS to be a drug-induced form of catatonia. Patients suffering from catatonia can display a variety of behaviors and physiologic abnormalities though they are often mute, immobile, and may display bizarre behaviors such as parroting what other people say to them, assuming very uncomfortable postures for extended periods of time (called waxy flexibility), and very rapid heart rate, sweating, and fever. The treatment of choice is electroconvulsive therapy (ECT) which can be life-saving.

Since NMS is rare, many consulting psychiatrists are often not confident about their ability to diagnose the condition. There may not be any colleagues in their hospital to turn to for advice. One option is to check the internet for a website devoted to educating clinicians about NMS, the Neuroleptic Malignant Syndrome Information Service at www.nmsis.org.  The site is run by dedicated physicians who are ready to help clinicians diagnose and treat NMS. Physicians can reach them by telephone or email and there are educational materials on the website as well. I’ve used this service a couple of times and found it helpful. The next two electronic methods I have no experience with at all, but I find them intriguing.

One might be a social network like Facebook. In fact, the Academy of Psychosomatic Medicine (APM) has a Facebook link on their website, www.apm.org. Psychosomaticists can communicate with each other about issues broached at our annual conferences, but probably not discuss cases. Truth to tell, the Facebook site doesn’t look like it’s had many visitors. There are 3 posts which look like they’ve been there for a few months:

Message 1: We have been thinking about using Facebook as a way to continue discussions at the APM conference beyond the lectures themselves. Would anyone be interested in having discussions with the presenters from the APM conference in a forum such as this?

Message 2: This sounds great!

Message 3: I think it’s a very good idea

 It’s not exactly scintillating.

Another service could be something called LinkedIn, which I gather is a social network designed for work-at-home professionals to stay connected with colleagues in the outside world. Maybe they should just get out more?

Email is probably the main way many professionals stay connected with each other across the country and around the world. The trouble is you have to wait for your colleague to check email. And there’s text messaging. I just have a little trouble purposely misspelling words to get enough of my message in the tiny text box. And I suppose one could tweet, whatever that is. You should probably just make sure your tweet is not the mating call for an ostrich. Those birds are heavy and can kick you into the middle of next week.

But there’s something about face time that demands the interpersonal communication skills, courtesy, and cooperation needed to solve problems that can’t be reduced to an emoticon.

Amaryllis Blooming

The Amaryllis today is blooming like crazy. A new bloom opened today right next to the one that opened yesterday. Now there are two buds in the shade of the two open flowers. Will that stunt the growth of the buds?

Should I worry about what’s in the shadows or be glad for what’s out in the light?

What About Social Media?

I read this article about social media last night, written by Rachel Young, PhD, Associate Professor, Undergraduate Studies.

It made me think about my WordPress blog and my YouTube accounts. I ask myself what I’m doing with them.

I like to think I’m doing the right things with them. I use a sense of humor and try to use common sense. I never drone on about politics because I feel bad about what’s happening with it most of the time. I don’t want to spread that around.

I stopped accepting comments on YouTube years ago because all I seemed to get were spammers. Frankly, I get a lot of that on my blog as well. But I also have commenters whose opinions I respect.

I used to have accounts with Twitter, Facebook (I guess that’s called something else now?), and LinkedIn. I dropped all of them a few years ago, mainly because all I did mostly was copy my blog posts to them. I found a web article, the title of which indicated there are more than 133 social media platforms.

Why?

Blogging is a part of social media. I don’t get much traffic. I don’t mind that so much when I realize how much of the traffic is negative and empty.

I blog because I really like to write; I always have. I kept one blog going for about 7 years and dropped it because I was unhappy with how personal information was being collected and what it might be used for.

I also didn’t think the General Data Protection Regulation (GDPR) didn’t treat hobby bloggers (like me) fairly. That was the main reason I dropped my first blog. I don’t collect anyone’s personal data. Hey, let’s be clear. Social media does that. I’m not trying to sell anything here. I’m just trying to have fun and share that with anyone who’s interested.

I wasn’t going to write this much about social media. I guess that means I’m ambivalent about it. I think that’s normal.

What do you think?

University of Iowa Psychiatry Residents Get Shout Outs

Recently, University of Iowa psychiatry residents worked hard enough to get shout outs. One of them was exemplary performance on the consultation and emergency room service. The service was following over two dozen inpatients and received 15 consultation requests in a day. This is a staggering number and the resident on the service did the job without complaints. In addition, the resident was the only trainee on the service at the time. Other residents were working very hard as well.

This high level of performance is outstanding and raises questions about health care system level approaches to supporting it.

I read the abstract of a recently published study about Mindfulness Based Stress Reduction (MBSR) compared to medication in treating anxiety in adults (Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. Published online November 09, 2022. doi:10.1001/jamapsychiatry.2022.3679).

On the day I read the abstract, I saw comments which were cringeworthy. The commenter is an outpatient psychiatrist in private practice who had some criticisms of the study. He thought the report of results at 8 weeks was inadequate because symptoms can recur soon after resolution.

Another problem he mentioned is worth quoting, “A course of treatment that requires as much time as the MBSR course described in the study would be out of the question for most of my patients, most of whom are overworked health care professionals who don’t have enough time to eat or sleep. Telling people who are that overworked they should spend 45 minutes a day meditating is the “Let them eat cake” of psychotherapy.”

That reminded me of a quote:

“You should sit in meditation for twenty minutes every day—unless you’re too busy; then you should sit for an hour.”

Zen Proverb

I know, I know; I should talk—I’m retired. Actually, I took part in an MBSR course about 8 years ago when I noticed that burnout was probably influencing my job performance on the psychiatry consultation service. I thought it was helpful and I still practice it. I was lucky enough to participate in the course after work hours. The hospital supported the course.

The residents who are being recognized for their hard work on extremely busy clinical services may or may not be at high risk for burnout. They are no doubt extra resilient and dedicated.

And the University of Iowa health care system may also be offering a high level of system support for them. I don’t see that University of Iowa Health Care is on the list of the American Medical Association (AMA) Joy in MedicineTM Health System Recognition System, but that doesn’t mean they aren’t doing the kinds of things which would merit formal recognition.

Anyway, they all get my shout out.

A Day Without Glitches in the Matrix

Yesterday was the one of those days where everything seemed to happen for a reason. If we had arrived at Terry Trueblood Recreation Area a few minutes too early or too late, we would not have seen the mesmerizing rise and fall of the shore birds on Sand Lake.

I thought of the word “murmuration,” which refers to starlings flying in tight, swirling patterns. I checked the dictionary and discovered that the word “murmuration” refers to the murmuring sound similar to low-pitched noises starlings make as they fly in flocks, swirling this way and that, presumably to avoid predatory birds.

This led to my wondering if starlings were the only birds that form a murmuration.

I wonder of shore birds also do it because we saw them flying in a sort of swirling pattern when there were no visible predators.

We might have missed the light shining just right on a majestic American Sycamore in all its glory, festooned like a Christmas tree with its seed balls hanging from almost every limb. In fact, some people do make Christmas tree ornaments out of them.

We might also have missed the squirrel munching on his lunch in a tree. It was not eating American Sycamore seed balls, probably only because it was not sitting in an American Sycamore tree.

We have walked the Terry Trueblood trail often, in every season, including autumn. We’ve never seen the seed balls before.

And we might have also missed the Subaru Outback with Wisconsin license plates in the parking lot. It was covered with decals. And later I discovered that the word “decal” is short for “decalcomania,” which is exactly how I would describe how the car came to be so heavily decorated—from an episode of decal-co-mania.

A lot happened yesterday which seemed somehow just right. Some people see so-called “glitches in the matrix,” which are events that seem out of place and ill-timed, leading to the idea we’re living in a poorly run computer simulation.

What about the times we see and feel everything occurring so smoothly that we’re surprised by the flow? Maybe we don’t call attention to it so as to avoid interrupting the miracle.

Taming the Juggling Balls

As of November 7, 2022 it has been 22 days since I purchased the Learn to Juggle kit from Barnes and Noble. So far, my learning experience reminds me of a story by Mark Twain, “Taming the Bicycle,” which was published posthumously—obviously after he succumbed from his injuries in the attempt to ride the high-wheeled bicycle in the early 1880s.

Just kidding of course, about his death from the bicycle riding adventure. He did mention using about a barrel of something called Pond’s Extract, which was a liniment for scrapes and other wounds.

Twain was writing about learning something new—a thing all of us are called on to do many times in our lives. He didn’t try to learn to ride the bicycle until he was over 50 years old.

I didn’t try to learn how to juggle until was well past my mid-sixties. How do you account for decisions to embark on new hobbies, adventures, and other nonsense at an age when most people would be content vegetating on the porch or in front of the TV?

I just answered the question, in case you didn’t notice.

Anyway, I am making some progress as juggling, although it’s uneven. It’s hard to believe, but sometimes I think I juggle better as I wander around. I think it might be because there is a natural tendency to throw the balls away from you. That way, I look more adept simply because I’m making a frequently observed beginner’s mistake. But I seem to be steadier even when I walk backward a few paces.

 When I stand firmly in one place and attempt to juggle, I can often barely make it past half a dozen throws. Wandering a little, I have made thirty throws.

But then, randomly, the opposite occurs and the theory fails.

Counting the number of each throw seems to help—occasionally. I also notice that unscheduled, short practice episodes for 10 minutes or less work better than struggling along for a half hour or so at set times.

I don’t dread the practice sessions; in fact, I have a sort of itch to juggle at various times during the day. Sometimes I believe I do it to help me collect my thoughts, to keep my hands occupied, or just to pass the time.

I remember learning to ride the bicycle for the first time when I was a kid. I fell down a lot, just like Twain did—until I got the hang of it. Maybe juggling will turn out to be the same.

But I won’t need Pond’s Extract for juggling mistakes—as long as I don’t try juggling while climbing or descending stairs.

Evolutionary Thoughts

By now, you’ve probably read the digital news article describing how we’re all going to evolve into beings who resemble extraterrestrials (ETs) because of our preoccupation with digital technology.

The authors describe us as eventually developing another eyelid that’ll protect us from the blue light emanating from our gadgets. Our hands will become claw-like and permanently flexed because of the way we’re always gripping our smartphones.

You’ll also develop a third hand that protrudes from your butt so you can catch your cell phone as it slips out of the back pocket of your skinny jeans. Come to think of it, that’ll also give rise to a weird new meaning for the term “butt dialing.”

Of course, the article is a criticism of our preoccupation with our gadgets, but it’s still fascinating as speculation about how creatures, including humans, evolve in response to the pressures in our environment.

This kind of thing makes me wonder whatever happened to Neanderthal. The males were huge, especially their arms, which came from frequent arm wrestling with Sasquatch for the last shred of beef jerky. Neanderthal had a very prominent brow which developed to keep snow and pterodactyl droppings out of his eyes.

And this reminds me of the discovery of the fossil of a giant creature on the Greek island of Crete in 2003 (I think). The skull had a huge nasal opening in the center of the skull. That was probably for a trunk, as in elephant trunk. But paleontologists thought it might have been the explanation for why ancient Greeks came up with stories about the terrifying one-eyed cyclops.

And what about that carp with a human-like face on the top of its head? I saw that one a week ago on the show The Proof is Out There. I thought sure Michael Primeau, the forensic video analyst on the show, would dryly dismiss it (“This video is clearly faked.”). Instead, the other experts thought it was natural. Tony summarized it as an example of the “plastic” evolution, by which I think he meant phenotypic or evolutionary plasticity. These are changes in a creature’s appearance, morphology, or physiology in response to changes in its environment. Regarding the carp, one expert opined that the face would confuse its main predator, the eel, by confusing it.

I still don’t get that one. How would the carp species even begin the evolutionary process? Does the carp just think, “Huh, I think that eel might get confused if I had a face like a human”? I get it that the changes occur at the genetic level, but how exactly does it get started?

Could you google the answer? I couldn’t find anything specific, like x plus y equals human-like face on a fish that many humans would not care to eat.

And how about writing? I wrote this blog post longhand using pen and paper, something I gave up doing years ago but which I am sort of rediscovering gradually. I had an old typewriter for a while, which gave way to something called a word processor, which was a stand-alone device made writing and editing text, and eventually I got a computer—which really messed things up.

The thing is, I can remember getting something called writer’s cramp. If you remember that, then you probably recall how painful it was. Back then, did anyone ever wonder whether that would lead to the evolution of a claw like hand?

Could evolution have consequences pertinent to people who are always looking up at the sky looking for UFOs? Some of them, for some unexplained reason, never seem to have a smartphone with them. Anyway, could their eyes migrate, carp-like, to the top of their foreheads to counter neck strain? And could this lead to the evolution of a third eye in the center of the forehead? It would prevent falling into manholes. There are other consequences from evolving into a cyclops.

We would be adept at forging thunderbolts. We would be very talented at cultivating vineyards and herding sheep and goats. But our tempers would still be pretty bad, even worse. We would abandon courts of law and ignore justice. We would be violent giants, feasting on the flesh of ordinary humans. All this because we kept searching the sky, hoping to see UFOs and see ETs, which we would eventually resemble anyway because of our preoccupation with our devices.

I have a pretty good supply of pens and paper.

Thoughts on Birds Banging into Windows

The other day we heard this big bang against one of our windows. We both guessed what it was—another bird collision. A couple of years ago, one crashed into a window, got knocked out, lay on its side, and puffed really hard for a half hour or so.

Then it flew away.

This bird was not so lucky. It was hard to identify until we looked at the large flock of similar looking birds in the backyard trees. It was one of a large gathering of juvenile Cedar Waxwings. They didn’t have the red wingtips but they had sporty yellow tail feather tips and they had typical masks around their eyes.

Sometimes birds attack their reflections in windows. Several species do that but this one was not on the list. We think it was just an accident.

They were probably after the winterberry shrubs. There are a lot of articles on the web about birds getting drunk from eating fermented berries. I’m not sure how anyone knows, but some writers say it can cause birds to crash into windows. Have the birds undergone some kind of field sobriety test (“Okay buster, stand on one leg, and touch your beak with your wings.”)?

Cedar Waxwings are very gregarious, raucous, and rowdy birds who eat berries with gusto. The adults look a little like clownish (and maybe drunken) bandits.

We planted an Amaryllis in a pot to celebrate the bird’s life. I guess Amaryllis bulbs can sprout new blooms for several years, almost like being reborn many times.

A little story from Greek mythology says that a maiden named Amaryllis had a monster crush on a shepherd named Alteo, a first-class heel who ignored her but loved flowers. She tried stabbing herself in the heart every day with a golden arrow for thirty days but at first that only led to a lot of trips to the local emergency room. But on the thirtieth day, a gorgeous flower grew from her blood. That’s the only thing that got Alteo’s attention; can you believe that jerk? They got married and honey-mooned at Niagara where they both got smashed on fermented winterberries, jumped out of the Maid of the Mist boat, crashed into a rainbow which turned out to be a wormhole portal to another galaxy where they finally sobered up by eating beef jerky from Sasquatch, who is an interdimensional creature as everyone knows.

The moral of the story is you should close your window shades more often, which might deter some birds from crashing into your windows—unless they’re really drunk.

Sometimes Names are Hard

I was listening to John Heim aka Big Mo on the Big Mo Blues Show (radio KCCK 88.3) last night and he was talking about this time of year, calling it “Indian summer.” He second-guessed himself about calling it that and even wondered aloud whether it might be “politically incorrect.” Sometimes names are hard.

All of my life I’ve know that this time of year, which can be pretty warm and dry for autumn, has been called Indian summer.

Honestly, I have never given any thought to the term “Indian summer.” I looked into it and it turns out that the term can be offensive to Native Americans (indigenous peoples). One article pointed out that the American Meteorological Society removed the phrase from its official glossary in October 2020.

That was an eye opener for me. It also jogged my memory. I remember hearing about the name for the opposite time of year in North America when I was working as a land surveyor’s assistant and drafter for consulting engineers when I was a young man. It’s called Blackberry winter. According to the Farmer’s Almanac, it’s the time of year when there is a brief period of cold weather in the late spring about the time blackberries are in bloom.

It turns out there are a few other names for the season in which certain flowers bloom during the cold snap, like Locust winter and Dogwood winter.

Alternative names for Indian summer have been proposed; one of them is simply late summer or “Second summer.”

I guess Second summer is okay, although I wonder if we could come up with something snazzier and analogous to Blackberry winter. There are some flowers that bloom during that time of year. How about?

Marigold summer

Zinnia summer

Sunflower summer

I got these ideas from a web article entitled “Indian Summer Flowers; Summer Season Flowers in India.” I realize the meaning of the word “Indian” in this article refers to the country of India, which highlights another complexity of names. On the other hand, marigolds are the flowers a lot of people plant in their gardens in North America.

I also found a web site which calls the Black-Eyed Susan, “Indian Summer Black Eyed Susan.” This one didn’t connect the flower to India. I guess you couldn’t apply the same rule above to rename it to something like Marigold Summer Black-Eyed Susan—too confusing.

So, just call it a Black-Eyed Susan and leave it at that. Sometimes names are hard—which makes us think a little harder about the names we choose.

The Secret of Patience

The secret of patience is to do something else in the meantime.

Croft M. Pentz

A few days ago, Sena noticed a noise in one of the sunroom window shade wand controls. She can hear noises I can’t hear, which is a good thing. She wondered if the wand battery needed recharging. We have 3 window shades like this and they came with a recharger that works the same way a cell phone recharger does. You plug the small end into the back of the wand which has control buttons for raising and lowering the shade. You plug the two-prong end into a regular electrical outlet.

We had never recharged them. The instructions said that when plugged into the charger the wand indicator light would shine red. When fully recharged, the light should turn green.

I waited one hour, then two hours. I checked the red light every few minutes or so. Finally, I quit looking and did other things. I replaced the refrigerator water filter. I purged the system. I emptied the ice bucket. I did a load of laundry. I vacuumed the carpet in the house. I exercised. I sat in mindfulness meditation. The light was still red. I checked it after 5 hours—still red. I finally just forgot about it.

About 6 hours later, I passed by the sunroom, glanced at the window and didn’t see the red light. I looked at the wand and couldn’t see the indicator light very well. I got the magnifying glass out and caught the light just right. It was green! Sena said the noise was gone.

I plugged in another window shade wand. The red light didn’t turn green until 8 hours later. I checked it several times. There was nothing to do but be patient.

I finally just did something else. I checked my blog site and was amazed to find a comment from a colleague, Dr. Ronald W. Pies, MD. He is according to a brief bio: professor emeritus of psychiatry and a lecturer on bioethics and humanities at SUNY Upstate Medical University in Syracuse, New York; a clinical professor of psychiatry at Tufts University School of Medicine in Boston, Massachusetts; and editor in chief emeritus of Psychiatric Times™ (2007-2010). He is the author of several books. A collection of his works can be found on Amazon.

I had written a short shout-out blog post about the article he and Dr. George Dawson, MD had written and published on September 26, 2022 in Psychiatric Times, “Antidepressants Do Not Work by Numbing Emotions.”

What was unusual about Dr. Pies’ comment was that it actually turned up in my spam box! If I had not patiently waited a second to read it carefully, I would have automatically trashed it. That was close.

And I would have missed the golden opportunity to tell him that I consider both him and George my friends.

About a half hour before the wand control light turned the green, our cable TV and internet went out. Wow. I had been watching a TV show rerun, probably for the 100th time, so it was no great loss. There was the usual message you get when the service is out: Please wait while this channel is being restored kind of thing. You can’t do anything but just be patient. It was getting late in the evening and I usually don’t do much on the computer then.

A little later, after Sena had gone to bed, I thought of writing this post. I didn’t want to clack on the keyboard and wake her up, so I did something I haven’t done in years. I got pen and paper out and did some long-hand writing. I had skimmed some articles on the internet before it crashed about how reading and writing on paper were better for your brain than doing those on a computer.

It felt good to write. As I did in the distant past, I scribbled in the margins, drew arrows above lines and carets to corrections and notes. It was a mess—a partly satisfying mess.

I say “partly” because it was also not quite right. I didn’t try to type it that night or even the next day. In fact, I couldn’t post anything the following morning to my blog because the internet was still out. The cable TV came back sometime during the night. Obviously, there had been a service outage.

But because the internet was still out, I called the cable company. This was another exercise in patience. I don’t know if every other cable company puts those automated telephone recordings in front of you before you can reach an actual person. They are nuts.

Cable Company Voice (CCV): Hello, please hold on while I check your account. OK, there, I found it. Am I speaking with the owner of the account or Bozo the Clown?

Me: Nobody here but us bozos.

CCV: Great, how can I help you, Bozo?

Me: Was there a power outage in my area?

CCV: OK, I see you’re having a problem with your internet connection. I can help you with that. Are you in front of your computer now or on the roof of your house dancing the merengue?

Me: In front of my computer.

CCV: Great! Please unplug your modem and wait 3 millenia; then plug it into your toaster. This will reset the incoming signal. When you have completed this step, say “Continue.”

Me: Continue.

CCV: That was a rather quick 3 millenia. Which would you prefer: Going through another dozen more trouble-shooting steps with me or speak to an agent?

Me: Speak to an agent.

I finally got to an agent whose mere presence on the line seemed to lead to an immediate, magical restoration of our internet connection. When I specifically asked her if there had been a service outage, she said that, indeed, an outage in our area had occurred. She then arranged for an account credit to ensure we would not be charged for service during the time of the outage. Patience.

This post does not look much like the hand-written one. But waiting a while to let the thing simmer probably didn’t hurt.