ÿþ<HTML> <HEAD> <title>Eric's Journal</title> </HEAD> <body> <font face="Times New Roman"> <font face="Monotype Corsiva,Bernhard Modern Roman,Unicorn,BellGothic,News Gothic MT"> <div style="float: right;"><img src="coatofarms.jpg"></div> <center> <big><big><big><big> Eric's Journal<br> </big></big></big></big> </font> <BR><BR> <I>If anyone should object to any statement I make, I am quite prepared,<BR> not only to retract it,<BR> but also to deny under oath that I ever made it.<BR></i> Tom Lehrer<BR></center> <blockquote> <a href="http://ericsjournal.livejournal.com/">LiveJournal Mirror</a><BR> <a href="disclaimer.html">Disclaimer</a><BR> <a href="randomentry.html">View a Random Entry</a><BR> <table cellpadding=0 cellspacing=0 border=0 ><tr><td>Search the Journal:&nbsp;&nbsp;</td><td> <form style="margin:0px; margin-top:4px;" action="http://search.freefind.com/find.html" method="get" accept-charset="utf-8" target="_self"> <input type="hidden" name="si" value="72284513"><input type="hidden" name="pid" value="r"><input type="hidden" name="n" value="0"> <input type="hidden" name="_charset_" value=""><input type="hidden" name="bcd" value="&#247;"><input type="text" name="query" size="15"> <input type="submit" value="search"></form></td> <td style="text-align:right; font-family: Arial, Helvetica, sans-serif; font-size: 7.5pt; padding-top:4px;">&nbsp; <a href="http://search.freefind.com/find.html?si=72284513&amp;pid=a">Advanced</a></td></tr> </table> </blockquote> <P> <blockquote> Entry 933 February 5 2012<BR> <a href="#932">Entry 932</a> February 2 2012<br> <a href="#931">Entry 931</a> January 30 2012<br> <a href="#930">Entry 930</a> January 27 2012<br> <a href="#929">Entry 929</a> January 24 2012<br> <a href="#928">Entry 928</a> January 21 2012<br> <a href="#927">Entry 927</a> January 18 2012<br> <a href="#926">Entry 926</a> January 15 2012<br> <a href="#925">Entry 925</a> January 12 2012<br> <a href="#924">Entry 924</a> January 9 2012<br> <a href="#923">Entry 923</a> January 6 2012<br> <a href="#922">Entry 922</a> January 3 2012<br> <a href="#921">Entry 921</a> December 31 2011<br> <a href="http://www.aericanempire.com/eric/901-1000/911-920.html">Entries 911-920</a><BR> <a href="archive.html">Archive</a><BR> </blockquote> <hr> <a name="932"></a> <U><B>Accentuations</b></u><p> Every Tuesday morning, the psychiatry residents at my hospital are excused from all of their clinical duties and come to the Allan Memorial Institute for teaching. We are, after all, technically and legally full-time students, in spite of the fact that we work for a living and lives hang on our merest whims on a daily basis. For three hours, we have a lecture from a senior attending physician on some topic or another. Generally, these lectures are divided up into multi-week blocks where the lectures are all somehow thematically-related, and for several months we've been studying child psychiatry -- a discipline which actually differs tremendously and importantly from adult psychiatry in a variety of ways that aren't worth getting into here. The other day, we had a particularly important lecture, which was on the topic of attention deficit hyperactivity disorder. I consider ADHD to be a vital topic because of its controversial nature; one does not have to search hard in the popular media to find people arguing over whether or not ADHD actually exists, whether it's over-diagnosed, and whether we should be "pushing drugs" on young kids. When patients ask me what I think of ADHD, I usually give the most irritating answer possible: I say I'm not sure and that both sides make some excellent points. People hate when I give them that answer; there are few things that the average person dislikes more than receiving a non-comittal answer acknowledging that two disagreeing points of view might have some truth to them. The truth is, I do believe that ADHD is probably over-diagnosed, and I do believe that this is at least in part because of the concerted -- and yes, let's call it "evil -- efforts of drug companies -- but I also believe that there is a genuine clinical syndrome in which hyperactivity and problems of attention have a meaningful negative impact on people's lives. The over-diagnosis of ADHD generally comes, not from overly inclusive diagnostic criteria, but from people applying the existing diagnostic criteria imperfectly... an understandable error for a rushing family physician or harried teacher to make. To me, the big question about ADHD is whether it justifies giving medication -- abusable medication with an established street value -- to young children whose bodies and brains are still developing.<P> The answer? I'm not sure. Both sides of the argument make some excellent points.<P> So here's something I didn't really know that, that I learned in the lecture the other day: an observed clinical response to an ADHD drug doesn't necessarily mean that the person has ADHD. In retrospect, I sort of feel that this should have been more obvious than I found it. The vast majority of drugs that we have will exert their effect whether you have an illness or not; there are a few illnesses that are diagnosed at least in part by their response to a particular medication, such as some forms of asthma or certain autoimmune conditions. On the other hand, if you give blood pressure medication to a person, their blood pressure will drop whether they have high pressure or not. An antipsychotic may not do much to someone who isn't psychotic, but a sedative will knock you out regardless of whether you have insomnia. For some reason, I had somewhere picked up the idea that someone with ADHD reacts to stimulant medications like methylphenidate (Ritalin®) differently than a "normal" person. Much as I couldn't tell you where I first learned what a haggis is, I could't tell you where I picked up this tidbit about ADHD; it's just something I "knew." It turns out that researchers -- very smart researchers without any pharmaceutical company funding -- have looked at that question, giving methylphenidate to kids with genius IQs and no ADHD symptoms either before or after a test. They showed that even when you take high-achieving, intelligent, kids with normal or above-average attention spans, their test scores improve with a bit of stimulant medication. This shouldn't come as a shock; college students drink coffee to get the same effect, and with much the same side-effects. You can give two kids Ritalin and they'll both respond, but that doesn't tell you which one of them meets strict criteria for ADHD. There are certainly some kids for whom a bit of the right medication seems to turn their whole lives around, and for these kids the benefits of medication probably outweigh the risks... but then you're stuck asking which kids *do* get the drunk to enhance their learning and which ones *don't.* If you're hearing an eerie laugh right now, that's Kurt Vonnegut Jr.<P> This leads me into one of my all-time favourite thought puzzles, actually, because honestly, I've always wanted to try methylphenidate myself. The letters tacked on to the end of my name by various institutions of higher learning came to me through great effort, great pain, and no small number of failures and humiliations. I don't study well and never have (if you're wondering, this is a criterion for ADHD, but not sufficient to make a diagnosis), and I've often wondered if taking one little pill could have made my life a lot easier. I could certainly have gotten access; I have an open-mided family doctor and my father's a pharmacist, so if I decided to take a learning drug then getting it would be the easiest part. Despite tremendous curiosity, I've never tried one... even at times when my grades suggested I could get a clear and needed benefit. With several years of hard studying and some of my life's hardest exams still ahead of me, the temptation is still there, but some part of me wants to prove that I can do this stuff without chemical aids. The fact is, I don't have ADHD, and even if a pill could make me study harder and learn better, it's misuse of medication at best and drug abuse at worst. On the other hand, if I could put on a magic headband and increase my current intelligence, I'd accept with less hesitation than I'd have if Neil Gaiman asked to put my name on the cover of his next novel. And if it was my own child, I'd want them to have every intelligence boost available, be it pharmacologic, genetic, or arcane. <P> None of which really correlates with whether I'm happy about trying to diagnose ADHD in a patient, since I'm not 100% sure it's a label I want to give people. <HR> <a name="931"></a> <U><B>403</b></u><p> It's rare that I watch a movie on the advice of a TV show, but it's hardly the most ridiculous thing I do in my life.<p> Tonight I watched a movie called <I>Forbidden Planet</i>. The movie is, by any stretch of the imagination, one of the great influential films in the history of science fiction, and although I'm not really qualified to speak authoritatively, I suspect a film expert would say it's one of the classics of Western cinema. I was a little bit surprised to realize I'd never seen it before, because I thought that I had; in retrospect, I realize I had always confused it with <I>This Island Earth</i>, another classic of science fiction released around the same time which differs mostly from Forbidden Planet in that Forbidden Planet is good. It's hard to count the number of ways which Forbidden Planet influenced geek culture; aside from introducing the iconic Robby the Robot, the film has been credited as one of the inspirations for <I>Star Trek</i> (the visual parallels were actually quite striking). I think the part that I found most shocking was that I actually enjoyed the movie. I picked it up on the assumption that, like most sci-fi of the era, it would be good in that "painfully bad" way that many 1950's movies tend to be, but the movie actually had a strong narrative, relatively few annoying characters, something approaching a plot twist, and at least a few lines of genuinely snappy dialogue. Before I watched it, I wondered whether it was something that might have been featured on Mystery Science Theater 3000; after watching it, I'm just sort of embarassed that it took me almost thirty years to get to it.<P> I'm not really sure how, exactly, it took me so long to see this movie. I can't fairly blame my lack of free time; anybody who can free up an hour and a half to watch <I>Sharktopus</i>, just to pick an example from some of my more traumatized memory synapses, can certainly have found the time to watch Forbidden Planet. I suppose I was vaguely aware of the fact that the movie was out there, but somehow the connection never really got made in my brain that this was a gap in my geek credentials. Not that my credentials are flawless; since I've been forced to reluctantly dedicate my life to pursuits other than watching movies all day, my knowledge of "classic science fiction" has more gaps than... a very gap-filled thing. This particular gap came to my attention while watching an episode of the television mystery series, <I>Castle</i> wherein the movie is mentioned repeatedly and heaped with the highest praises. I probably would have ignored it under normal circumctances, and indeed, I'm sure that I miss similar references all the time in things that I watch, read, and sometimes even write (which is easier than you might think). This time, for whatever reason, it caught my attention and got stuck in my head, until I reached that most dangerous of all mental states: curiosity. Once that seed of curiosity was planted, it didn't take me very long at all to decide to procure, and then procure, the film itself; the biggest rate-limiting step was finding a time when I could actually sit down for a full hour and a half to watch it, because that doesn't happen to me every day. I wouldn't say it totally engrossed me to the exclusion of all other thoughts -- as with almost all other movies film, I did other stuff while I was watching it -- but it kept me entertained, which I can't say about everything I watch. And it was worth the hour and a half, which I also can't say about everything I watch.<P> The only thing which I really find odd about all this, though, is a chain of coincidence which seems to have built up around the situation. Depending on what day you ask me, I'm either a big believer in coincidence -- because when whimsical gods closely observe your life, weird things tend to happen -- or else I don't really believe that there's such a thing as coicidence at all -- either because of vast conspiracies, or else because the brain's capacity to invent narratives to explain unconnected events means that true coincidence is impossible once observed. Case in point, at around the same time that I decided to watch Forbidden Planet, a series of events brought Robert A. Heinlein back into my life, and as I tend to do once every two or three years, I decided to pick up one of his novels and give it a try. Usually I deeply regret reading a Heinlein novel after I finish it, but this doesn't stop me from repeating the mistake from time to time. This time, I picked up a copy of <I>The Moon Is A Harsh Mistress</i>, which, like Forbidden Planet, is arguably one of the influential and classic works of the genre and also something I vaguely knew a certain amount about but had never actually tried to consume. I won't go into the number of connections I've been suddenly observing between the two, but suffice it to say that they involve one of my all time favourite novels, two separate conversations I've had this week with unconnected people, and some curious scrawlings I came upon today while leafing through a patient's old chart notes from the mid 90's. More important than that, it's just more proof that there's still a lot of good sci-fi out there that I've never touched and don't know when I'll ever find the time.<P> Above all else, I've learned one important thing in recent days: if I ever invent artificial intelligence and thereby bring life to an inanimate object, I absolutely have to give it a snarky sense of humour. I expect that Heinlein and th writers of Forbidden Planet all would have wanted me to pick up some other lessons from their works, but these are the ones I'm going with. <HR> <a name="930"></a> <U><B>The Thin Dopaminergic Line</b></u><p> Jung said, "show me a sane man, and I will cure him for you." <P> I'll be honest that I've never been 100% sure what Jung meant by that, exactly. I don't mean I'm entirely clueless... I have a very good idea of what I think he meant. Rather, the problem with the quote is that I can see the three or four meanings that seem, to me, to be the ones he was most likely thinking of, and I've never been absolutely sure which os those equally plausible meanings he actually intended. I often wonder if what he was really saying is that Jung was capable of working with any person, even if there was nothing "wrong" with them per se. Alternately, I wonder if Jung took a good, hard look at psychoanalysis and psychology, such as they were in his day, and observed that his skills could be used to increase, instead of decrease, a person's level of crazy. Most days, though, I think what Jung was saying is that everybody is a little bit crazy, and that a psychiatrist can diagnose pretty much anybody with something if they try hard enough. As another, rather more entertaining Doctor once phrased the same thought, "anybody remotely interesting is mad, in some way or another." The gods know that I've got my share of diagnosable symptoms, though whether I qualify as "interesting" is entirely and understandably subjective. The simple fact is that, even sticking just to the relatively confining DSM-IV, I'm quite confident that I can diagnose some form of mental disorder is the majority of people that I know. There are a small number of people I'm close to for whom I really couldn't justifiably find some stigmatizing label, but almost all of the people I'm close to, family and friends both, have pretty obvious psychological issues. That's not a complaint, mind you, but simply an observation (in fact, in my world, it might even be a compliment). I'm pondering this, though, because of a simple (by which I mean, deceptively complicated) problem which has been nagging at me: I'm not entirely sure how I, as a physician and psychiatrist, decide who does and doesn't have to stay in the hospital when "eccentricity" starts edging a bit too close to "danger to themselves and others."<P> On a related note, as I typed that last sentence, I suddenly had a Mystery Science Theater 3000 song get stuck in my head. That's probably diagnostic information right there. So anyway...<P> See, here's the big problem with a psychiatry ward. Patients come to the hospital -- often against their will -- and show up in the emergency room. They're psychotic... they're having a difficult time perceiving and responding to apparent objective reality in an appropriate manner. Maybe they've come to believe that their neighbours have built an earthquake machine and plan to destroy the world, or maybe they've come to realize that their landlord is slowly poisoning them so that he can rent out their apartment to CIA agents (seriously, those are patients I've seen in the past year... I didn't make either of those up). If the person is lucky, as sometimes happens with our manic patients, they spend a few days receiving medication and warm smiles in the emergency department, pull themselves together, and get sent home. This is often true of people who come to the hospital just a little bit on the manic side... they were well before and they'll be well after, but like anybody, they have their good days and their bad. Unfortunately, and quite commonly, we get our patients with chronic psychosis, people who don't respond well to medication or psychotherapy and who, at their best, have significantly impaired functioning. They get brought to the hospital when they're much worse than usual... they may always believe that space aliens are sending them messages via the radio, but today those messages are telling them to cut their wrists instead of, say, drink two beers with dinner like usual (again, not making this up). These patients stay in the ER for a little while and then get admitted to the hospital, where they often stay upwards of two to three months or longer. Eventually, they have to get discharged, and we can't postpone that until they're "well" because that might never happen. A man who hears voices telling him to kill himself gets sent home, not because the voices go away, but because they're no longer telling him to do dangerous things. As one of my mentors once said to me: we can't make their voices stop, we can just help make it so their voices don't bother them as much." Of course, they get discharged with very close outpatient follow-up, as opposed to just tossed out into the street or something, but discharged none-the-less.<P> The problem that I'm wrestling with, now coming to the end of my second week on an inpatient service, is that I'm having a miserable time seeing the line between "has to stay in hospital" and "safe... enough... to leave."<P> Oh sure, a lot of the time it's easy. If the patient tells us that he doesn't believe he has this "schizophrenia" thing people keep telling him about and he wants us to let him out so that he can go drinking and kill his neighbours, our decision is fairly easy. On the other hand, there's the patient who came in a little bit manic, expressing some odd thoughts whcih scared his family; if he's been receiving medication for three weeks and he hasn't changed whatsoever, does he need to stay in hospital? On the one hand, he doesn't present "an imminent danger to himself or others." On the other hand, he might openly admit that as soon as he steps outside the hospital he's going to stop taking all these useless pills. This is the kind of case where I feel torn. In at least three case I've worked with in recent memory, the patients clearly wasn't getting helped by being with us, but couldn't be discharged simply because they didn't have homes they could go to. In effect, they were admitted to hospital because it would be unethical to discharge them to being homeless. In some respects, dealing with the violent psychopath is pleasant and straight-forward, because at least "keep or not keep" is relatively simple. Well, not really, I suppose, because you can't admit someone to a psychiatric inpatient ward for being a violent psychopath unless they're also depressed, manic, or psychotic, but you get the idea.<P> The really frustrating part of the whole question is that, of course, the patients I most want to be rid of tend to be the ones least able to leave the hospital. <HR> <a name="929"></a> <U><B>The Fear In The West</b></u><p> A week and a half into my six-month inpatient rotation, it's been interesting to discover that I experience a lot more anxiety on an inpatient service than I do on an outpatient service.<P> A therapist of my acquaintance once told me that he felt a lot of the frustrations in my life stem from a difficulty tolerating embarassment. He listened to an abreviated version of my life story and a somewhat censored list of the things I consider the biggest psychological problems in my life, and observed that the common denominator was that I have a miserable time dealing with the feeling of being embarassed. Most of my worst memories are moments of feeling embarassed, even if nobody was judging me except myself. A lot of my anger is about events where I felt embarassed. Even my gut issues have a component of fear of embarassment; I'm much less annoyed by pain than I am by the fact that my stomach produces audible, embarassing noises. My social anxiety and difficulty making new friends certainly relates to a desire not to look foolish. I would have to say that this is a bit of an oversimplification, but then again, so is much of psychotherapy, and this thought was about as parsimonious an explanation of my global behaviour as could easily be formed without somehow incorporating my religious and philosophical leanings (which don't necessarily have any place in an attempt to form a *rational* summation of who I am). A corrolary of his theory was a very accurate observation of my social style. When I'm in a social setting, it's classically been very rare for me to be the person who walks up to someone else and strikes up a conversation. For much of my life, doing this would have been almost unthinkable for me... in part because I didn't like the idea of being embarassed if the person has no desire to talk to me, for example. The obvious problem with this style of behaviour is that if you get two people who each need to wait for the other to make the first move, then no move ever gets made. I've gotten a lot better at this over the years, through very hard practice and a reluctant acceptance that we cannot make anxiety go away, we can only learn how to cope with it, but it remains a definte feature of my behaviour even now. I almost never add someone to my Facebook, for example, unless they add me first. Of course, the more outgoing I teach myself to become, the more I've found that I really *do* get snubbed, which hasn't made the learning process any easier, but I've kept at it. I have to keep at it, you see, because above all else, I'm truly driven to improve myself... and also, starting to change my ways and then stopping would just be embarassing.<P> It is my professional opinion as a psychiatrist, by the way, that in many ways, anxiety is the most horrific of all psychiatric illnesses. Depression tends to get better with time, and psychotic people are often perfectly happy being psychotic, but anxiety sufferers suffer. Not that I'm biased or anything.<P> After seven days working on the inpatient floor, I've therefore been struck by one of the ways that it really differs from the outpatient service. I enjoyed my six months of outpatient psychiatry a lot more than I thought I might, and for a number of reasons. For one, I discovered I really do have a natural aptitude for psychotherapy; I'd always supposed I would, but it's nice to have some objective proof. For another, I felt like I had the chance to really help some people. I got to follow a number of patients whose lives were truly improved simply by my being in them. It's likely that their lives would have been improved by any moderately empathic person sitting in the same chair, of course, or even a stuffed penguin which had been rigged to nod every forty two seconds and occasionally say "uh-huh" and "oh?" but the fact that they felt listened to and understood makes me feel that my unique style played at least some part. Above all, though, I found it nice because the patients were coming to me. I was seeing exclusively people who felt they had a problem and wanted to deal with it. With the exception of my one patient who had a court order for treatment whether he liked it or not, every single one of them was coming to me because they chose to. If they thought it was useless, or didn't like me as a therapist, or felt they had recovered enough not to need the help, they could just stop coming, and I would have an extra hour per week to do paperwork or something, secure in the knowledge that as a resident I get paid the same whether I see one patient or fifty. Yes, I had to make the laborious journey down three floors to the waiting room to pick up my patients when they arrived, but I never felt any anxiety over that because I knew that if they were there waiting for me, *they* had come to *me.* Not only was the power dynamic clearly in my favour, but their continued presence was constant validation that I was appreciated. That's not to say that I liked seeing all of my patients -- there was at least one that I dreaded seeing each week because I clearly *wasn't* helping and wasn't going to be able to -- but even then, it was a sense of wasting my time, and not of being anxious or embarassed.<P> The inpatient ward, in contrast, is different. Patients don't come to me. When I want to see a patient, I have to walk out of the nice comfy nursing station in the patients' area and find them. I have to ask if it's a good time to speak to them; it would be extremely unusual (and diagnostically useful) if a patient refuses, and it hasn't happened to me yet, but it could. About half of my patients are confined to the ward; they have little to no insight and often very little clue of why they're even in hospital, and quite reasonably they want to leave. Given the choice, these people would opt to never see me again. Furthermore, whereas I typically saw my outpatients once every week or two, I see the inpatients every day, whether I like it or not. I may not suffer through a long interview as they once again explain to me how they know they don't suffer from schizophrenia, but at the very least I pass them in the hall and have to deal with a few moments' awkward eye contact. Before I walk out of the nursing station to see my patients, I have a moment of anxiety when I think to myself: "I don't really have to go see them *right now.* I have other stuff I could be doing." And then, because giving in to those thoughts is the surest way to end up on the wrong side of the hospital gown, I go do my damn job and see about getting my patients well again. But I still think it.<P> A cognitive behavioural therapist would treat anxiety with "exposure," meaning putting the anxious patient into situations that provoke their anxiety until they learn how to tolerate it. The plus side of my current rotation is that every day is, effectively, exposure therapy for me. The downside is, as anyone who's gone through exposure will tell you, before you learn to tolerate you anxiety, you have to put up with a lot of it first.<P> So, inpatient psychiatry might not be the best career choice for me to make when the time comes. Good to know. <HR> <a name="928"></a> <U><B>Things I Learned From Pseudolus</b></u><p> Aristotle said, "I have gained this by philosophy: that I do without being commanded what others do only from fear of the law."<P> The other day, a friend of mine publically asked a question.<br> <blockquote>Question for all my atheist/agnostic/nonreligious friends: How much thought do you put into your moral code? How did you come to it? How well-defined is it?</blockquote> I didn't answer right away, although this is the sort of topic I enjoy bandying around, because I wasn't sure if I qualified as the sort of person he was asking. As I've observed before, I consider myself a deeply religious person... the fact that I made up one god and adopted another from a drug-inspired work of fiction doesn't enter into that. Anyway, I asked him, and he assured me that what he was really looking for was the opinions of people who had developed their own moral codes "consciously and intentionally" rather than had it handed to them by a religious source, and for that, at least I qualify. Let's be open about one thing: although I have tremendous respect for the Jewish tradition and a great love for my heritage, both cultural and genetic, as far as the Jewish religion goes, I'm a heretic at best and an apostate at worst. According to classic Jewish law, my parents would probably be obligated to treat me as if I had died, and would even be required to sit shiva and go through the ritualistic mourning process; fortunately, my family is neither that religious nor that stupid. I've broken at least seven of the ten commandments, usually with much forethought, and usually glee. Depending on one's point of view, I may have actually broken all ten (yes, including killing a human being... I am a doctor, after all, and the bare ten commandments say nothing about it being on purpose). I can't be bothered to actually go through the more complete list of 613 commandments, but a quick glance suggests I've broken a lot of those (and many of those which I haven't simply don't apply to me, such as laws regarding menstruation). That said, I consider myself to have a very strong code of behaviour -- I prefer to think of it as a code of honour rather than a moral code -- and I've held to it with something that approximates righteousness since at least 1999. More importantly, my code is something that I think about, constantly. Pondering ethics is a great joy of mine, and in fact, I spent a full month doing an elective in the medical ethics department during medical school, so that I could learn more about the more complicated and difficult issues of my profession. If the purpose of my life is to better myself, then this requires me to be a harsh critic of my own code and my own behaviour. This, at the least, makes me fit to answer my friend's question, though perhaps not helpfully.<P> How did I build my moral code? I'll give you a hint: it involves lightsabers.<P> Before getting into that, let's be good little social scientists and operationalize some potentially difficult terms, so that we can all be sure we're using the same language. All definitions come from Webster's Dictionary (online version, accessed 2012/01/20 or 2012/01/21). No changes have been made, not even to make them funnier, although I have picked and chosen parts of the definitions which best suit my rhetorical purposes.<P> 1) Heretic: a dissenter from established religious dogma; one who dissents from an accepted belief or doctrine.<BR> 2) Apostasy: renunciation of a religious faith.<BR> 3) Morality: conformity to ideals of right human conduct; of or relating to principles of right and wrong in behavior; sanctioned by or operative on one's conscience or ethical judgment.<BR> 4) Ethics: the discipline dealing with what is good and bad and with moral duty and obligation; a set of moral principles; a theory or system of moral values; a guiding philosophy.<BR> 5) Honour: good name or public esteem; a keen sense of ethical conduct; integrity.<BR> 6) Whirligig: a child's toy having a whirling motion.<P> Right off the bat, I'm going to admit that a long-held belief of mine is wrong. For years, I've thought that "moral" referred to codes which come specifically from religious sources and institutions, and that's not the case. It's very important to my sense of right and wrong that a person be open to the possibility that their beliefs are mistaken and willing to admit it when faced with strong evidence.<P> So, where does my ethical code come from? The fact is that I did have a religious up-bringing; I was in a religious school from kindergarten until my last year of high school, and I was extensively indoctrinated into what is right and wrong according to Jewish laws. It would be foolish to imagine that this had no impact on my moral development. That said, I was a precocious little bastard, and I suspect that I began questioning what I was being taught at a very young age. I recall sitting in Hebrew class in early primary school, studying the book of Genesis, and being puzzled that nobody else saw in anything at all questionable about, say, Abraham going to sacrice his own son, or people being transmogrified into common household seasonings because of a minor error. More than that, though, I was being actively taught that "rules" are flexible and that good laws serve people, not the other way around. Primary school was a tough-ish time for me because of my gut issues, and among other things I was extremely sensitive to lactose, so I couldn't easily eat dairy. Unfortunately, my school, like many Jewish schools, were strictly kosher, and kids were forbidden to bring non-dairy meals for fear that someone might damn their eternal souls by, say, eating a bite of salami and then accidentally ingesting a bit of ice cream three hours later. My parents obtained special dispensation from the school to allow me to bring meat meals to school, and I enjoyed tasty fleisch throughout those years. This was, of course, perfectly allowable under Jewish law, because it was a break in the rules in the name of preserving someone's health, but it taught me that rules aren't necessarily fixed. To a degree, I think it also taught me that rules don't necessarily apply to me personally, which admittedly may not have been the best possible lesson to teach an impressionable (and sneaky) child.<P> 7) Transmogrify: to change or alter greatly and often with grotesque or humorous effect.<BR> 8) Fleisch: Yiddish for "meat." I bet you just thought that was a typo.<P> Something important was happening to me during these same years, though. I was being raised on a steady diet of Bible and prayer in school, but at home I was receiving a very different education. At school, I was being forced to memorize passages from the stories of Isaac and Moses; at home I was being encouraged to enjoy the stories of Luke Skywalker and Kermit the Frog. I'm going to repeat that to draw attention to the important distinction: at school, I was being forced to memorize passages from the stories of Isaac and Moses, and at home I was being encouraged to enjoy the stories of Luke Skywalker and Kermit the Frog. That right there? That's a big part of how I came to drift away (if not violently cleave off from) Judaism: studying the Bible was turned into a punishment for me, and studying Prince Adam of Eternia was turned into a reward.<P> And what was I learning? Not to wash the feet of strangers and not to kill my own sons for being disobedient (although I may have picked up some lessons in the value of overkill from the story of Passover). Instead, He-Man was teaching me that a person who's ugly can still have a good heart and soul. Optimus Prime was teaching me that every sentient has the right to freedom, self-expression, and happiness. Edwin Steen was teaching me the importance of a healthy diet and Cooper MacBride was teaching me that the only way to conquer your fears is to face them. And, now that I think about it, all of them -- Biblical and animated both -- were teaching me that an ounce of trickery is worth a pound of firepower, although for some reason the Bible still insisted that lying was bad for some reason. <P> But really, as with a lot of things in life, it probably comes down to Star Wars. See, here's a major mistake that the religious authorities made: they didn't get to me early enough. I started studying the Bible in grade six; I started watching Star Wars before I could speak. How could I be expected to adopt Abraham as a moral example when his lessons clearly differed from the teachings of the much wiser Obi-Wan Kenobi? Here's what Star Wars taught me as far as "morality" goes, that the Bible didn't:<P> 1) For evil to be defeated, good people must stand against it.<BR> 2) Keep your word and honour your promises.<BR> 3) The Princess might need some help, but she isn't helplessly awaiting rescue.<BR> 4) If you aren't ready to face a challenge, you train harder.<BR> 5) One good lie can save a lot of trouble and lives.<BR> 6) Forgive someone who's truly sorry for their past sins, but don't be stupid about it.<BR> 7) Care for your body and care for your mind.<BR> 8) It's better to be just than powerful.<BR> 9) Self-sacrifice is noble and sometimes necessary, but make bloody sure you've found the right cause.<BR> 10) Wars don't make someone great. Wisdom, kindness, and mind control powers make one great.<P> Over time, of course, there was a certain degree of subtlety that got added, and then I had a bit of a paradigm shift from watching Babylon 5, but this, when you get right down to it, is where you could say my moral code comes from. That, and constantly striving to re-evaluate whether what I currently believe is really what I ought to believe.<p> When you get right down to it, it probably also helps that I was raised by good-hearted, intelligent, intellectual, question-asking parents. And then studied the great philosophers, particularly Socrates, throughout CEGEP and university. These, too, may have made some small impact on my moral development. <HR> <a name="927"></a> <U><B>Mature Defenses</b></u><p> The other day, I got ahold of -- and fairly shortly afterwards finished -- a relatively new videogame called "Orcs Must Die!" Usually, the few videogames that I play are games rich in story and content, with an extensive plotline and a compelling narrative. This wasn't. Orcs Must Die is a completely straight-forward tower defense game, wherein the player must prevent a predetermined number of enemies from crossing a battlefield and achieving some sort of objective, primarily by setting up various enemy-killing traps all over the battlefield. I'd like to say that there are various innovative aspects to this game which made it stand out from other similar games that I've played, but the only reason that I'd like to say so is because I enjoy lying. It was a fun game, but neither brilliant nor inspiring. On the plus side, I wasn't disapointed; I got hold of a copy because I was looking for something brainless, overflowing with cartoon violence, to distract myself from various real-world responsibilities, and it di that job nicely. The game promises the player an opportunity to viciously slaughter numberless orcs, and that's exactly what it delivers, with just enough snappy dialogue and clever jokes to keep the player from falling asleep. I respect anyone who's good at their job, whether they're a rocket scientist or a garbage collector, and I respect any game which sets out to deliver something and then delivers precisely that.<P> Needless to say, I cheated the whole way through. For once, I can't justify that by my usual stand-by of "I want to follow the story" so instead I'll just say "it was more fun that way." I wasn't looking for a mental and physical challenge; I was looking to callously slaughter thousands of orcs.<P> Curiously, I've always had a soft spot for these tower defense games. I say "curiously" because I've always maintained that what I look for in a game, more than anything else, is a good story, and as a general rule these games are almost completely devoid of story. The tower defense genre falls under the heading of "strategic" videogames, which usually means that the games are targeted to people who are looking to solve riddles more than they are to read novels. As a general rule, I'll only play a game which promises a well-crafted story, and I'm willing to overlook almost any flaw in a game -- bad controls, lousy graphics, stupid concepts -- as long as it delivers a powerful and well-written narrative. There have been some notable exceptions to this, mostly games such as Minesweeper which I can use to keep my hand and brain occupied while I watch television, but by and large what I want out of a videogame is the same thing I want out of D&D: plot. This is why my fascination with tower defense games has always puzzled me; it's possible that I've played one that had something resembling a story, but if so, I can't recall it off the top of my head. I've played dozens if not hundreds of tower defense games over the years with very variable amounts of pleasure obtained from doing so, and every so often I go through periods where I just really want to play one. My iToy has been a great boon in this respect, because there's a seemingly endless supply of free tower defense games available in the Apple store. I can feed my addiction in the comfort of my own home or in the discomfort of the hospital when I'm not busy with work, and the nice thing about an iPad is that I have the ability to turn it on and off in seconds, so I really can play thirty seconds of a videogame here and there throughout my day. Of course, when I bought the iToy, I promised myself I wouldn't use it *primarily* as a videogame-playing device, and I've been true to that promise... but that's certainly turned out to be its secondary purpose. <P> As for why I enjoy these games so much, I've never been able to figure that out. I think that on some level, they appeal to my sense of laziness; in most tower defense games, the player takes a very passive approach, building static defenses and letting the enemy charge into them and die. I like to think that they also appeal to my intellect, since most of these games require (or at least reward) some amount of planning and strategic thinking. I like them because they tend to encourage a bit of creative thinking and problem-solving, which many story-driven games don't necessarily do. Above all else, I think in some respects the games just play to my ego; I'm amused by the idea of numberless hordes crashing uselessly against unbreakable defenses as I point and laugh. Actually, this is probably what I enjoy about most videogames, and quite possibly many non-video games that I play.<P> Slightly ironically, I haven't actually got a single tower defense game on my iToy right at this moment, but that's only because I've gotten bored of and deleted quite a number of them over the last six months. Plus, finishing Orcs Must Die! will probably tide me over for a couple of weeks at least. Since my workload is likely to be much higher in my current rotation than my last one, and since I no longer have a private office in which to go and hide, I'll need to cut back a bit in any case. <HR> <a name="926"></a> <U><B>Vincible</b></u><p> Yesterday, I picked up a new Epipen. I was without one for rather a long time, first because I was too lazy to really go about replacing it for quite some time, and then because it took me a few weeks to figure out where I'd put my drug insurance card after I got my new job a year and a half ago. I started the process of getting a new one towards the end of 2010, and only then because that's when I replaced my backpack and had to empty out all the pockets of my old one anyway. In my old backpack, I found my long-forgotten Epipen... which had, apparently, expired some time in the summer of 2009, which gives you some idea of how often I have to inject myself as well as how closely I pay attention to potentially life-saving equipment I'm supposed to have with me at all times. It may seem odd that I -- a creature with a moderate degree of paranoia at the best of times and who would, were it possible, never leave home in anything short of a suit of powered armour -- would be so blase about medication which could save my life one day, but in some respects I suppose that I've never really taken my Epipen seriously. On an intellectual level, I'm well aware of the fact that I'm allergic to... well, to save time, let's just say almost everything in nature... but currently none of these allergies are life-threatening to me, at least in theory. Of course, the funny thing about allergies is that they tend to get worse over time; whereas people can become immune to poisons over time (a process called "tachyphylaxis") and resistant to drugs, every time you expose a peanut-allergic child to a peanut, their reaction will get more severe, so in theory I could one day receive the very last surprise of my life. The funny thing is, I'd never let myself run out of tylenol at home, and I keep my medicine cupboard well-stocked with all the other little over-the-counter remedies that I use as rarely as possible but from time to time, but somehow there was a mental-block-ish thing that kept me from getting overly excited about an actual important medicine. Despite the fact that I walk around every day with an actual potentially deadly medical problem, some part of my brain seems reluctant to let me identify myself as having an illness.<P> Well, that isn't really fair. Anybody who knows me knows that I don't consider myself a healthy person, but when I think of myself as "having an illness" it's always in terms of my gut issues, which are really an irritation more than anything else. It's probably perfectly reasonable to make a bigger deal out of a problem you deal with every day, as opposed to my food allergies which have been a problem precisely once in my life, but it'd also be reasonable to get much more excited about the problem which could be dangerous. My gut, inconvenient as it may be, will never kill me. Well, not directly, anyway...<P> See, here's something I've had to spend some time thinking about in the past year or so, and the last six months especially. People -- most people, anyway, certainly not all -- don't really want to think of themselves as sick. Your average person will, quite reasonably, put up a lot of resistance to being told they have an illness. This was something I had to deal with daily when I was working in family medicine -- some of the most frustrating conversations in my life have been in the course of explaining to previously healthy, fifty year-old men that they have diabetes and need to watch their blood sugar from now on. In some ways, it's something that's even harder to deal with in psychiatry, because if it's hard to convince a healthy middle-aged male that he's got a problem, just imagine how hard it is to explain to an athletic twenty year-old with a culturally-appropriate belief in his own invicibility that he's got bipolar disorder... especially if he's a bit on the manic side and has never felt so good in his life. Very few people want to be told that they have an illness, especially a chronic and lifelong one, and when someone *does* want to be told that, we've got psychiatric diagnoses for that. Even someone like me -- whose self-image already includes "yes, but he's not at all well" and who can't really image how it feels to be 100% healthy and problem-free -- can put up a tremendous psychological resistance to having another illness added. <P> The result being, it takes me upwards of two to three years to renew an Epipen. If that's any indication, I can probably expect to have a miserable time controlling my diabetes when I develop it in another fifteen years. <HR> <a name="925"></a> <U><B>It's All About the Solaris</b></u><p> And so, a little over two years after they first went on sale, I today sold off the very last of the Aerican Empire 2009 coins. I can now officially say that I lost money on the venture, but quite a bit less than might have been expected. It's my opinion that while it would have been nice if I'd made money on this, or at least broken even, there's no harm in paying money to do something fun, let alone amazing, and as long as one takes pains to ensure one doesn't lose more money than necessary, there's no harm in occasionally going to a casino, or seeing a movie in IMAX, or minting up a hundred coins and selling them to collectors. These are things that make life more interesting.<p> If there's one thing that can be said about my life, it's that it's interesting. <P> The 2009 coins were quite an experience to produce. I'd wanted to try minting money for the longest time, but for obvious reasons, I held off. It looked like it would be expensive, after all, and who would imagine that there would be people who'd actually buy an Aerican Empire coin? 2009 was a good year for the Empire, though, and a fair year for me financially, so against most reason and logic, I decided it would be the time to make it happen. It didn't hurt that this was the year that some of my citizens got together and came up with a good coin design. I'd designed a number of coins in years past but I'd always thought they weren't very good, and there was something reassuring for me in knowing that someone other than me had made the coin. Getting them made was surprisingly easy and painless; it turns out there are all sorts of companies out there who'll stamp a picture into a circle of metal for you if you pay them for it, and they'll bend over backwards to facilitate the process for you. I can still remember the feeling I had when I opened the big box and held one of the coins in my hand for the first time; it wasn't *quite* as amazing as holding my first published story, but it was up there. It was a tangible representation of something I had created. At that moment, I knew I was going to lose money on the coins, and I didn't care. I decided to set myself a goal; I sat down and calculated how much my colleagues were spending on coffee each month, and decided that as long as I lost only that much -- and didn't buy any coffee or such myself -- it'd be a win. Based on interviewing some of my colleagues, at a conservative estimate, the average medical student in my year in 2009 spent between 56 and 85 dollars on coffee and related costs per month. Altogether, getting the coins made and sent out ran me about $550.00, including the cost to make them, some surprise customs and duty fees I hadn't budgeted for, and the cost of shipping all the coins back out to people all over. Despite poor record keeping, I make back about $470.00, meaning I lost about $80.00 dollars on the deal. I recognize that this is a phenomenal amount of money for many people, and it makes me feel very fortunate that I live a life where I can afford to lose eighty dollars minting and selling novelty coins.<P> It must also be said that this takes into account the extra customs fees, which as an inexperienced importer and exporter, I could not have anticipated. I also undercharged people for shipping, because I was trying to be nice, and gave away a few coins for free. Had I been a more ruthless businesscalidan, I could have actually turned a profit. Sadly, I'm a better psychotherapist than I am a businesscalidan... and due to much the same personality traits.<P> All of this has some pretty obvious for the <a href="http://www.aericanempire.com/econ.html" target="_blank">coins I'm selling right now</a>. I'm still making every effort to keep the prices as low as possible (my first priority, after all, is to distribute as many as possible worldwide, not to make money doing so), but this time I was able to better plan for a few issues. I knew to inflate the price of the coins by the extra import fees I'd be charged, and I knew to inflate all the shipping charges a bit more (still charge something fair, but enough to cover my costs better). With all the data available to me, and a better idea of how things would go, I was able to actually create a formula which calculated how many coins I'd need to sell to break even... which came out to be close to 200 of the 300 coins I had made, a number which suggested I was still going to lose money on the 2012 coins since it took me two years to sell off all 100 of the first minting. At the time of this writing, I've sold off about seventy of the new coins, with another 20 or so claimed but not yet paid for. It's extremely likely that I'm going to lose even more money on the new coins than I did on the old ones. Like I said, I had these coins made on the assumption that I would lose money; the way I see it, I'm not selling merchandise for a profit, I'm paying for the pleasure of distributing my artwork to homes all over the world. People pay a lot more money than these coins are costing me for pleasures which are a lot more selfish and a lot more transient.<P> On the other hand, I'm perfectly happy to let it take another two years to make more of my money back, since these days, two years is a pretty short timeline for a lot of my schemes. I can wait. As a certain character of mine used to say, given a enough time to plan, I can find a way to profit from this. <HR> <a name="924"></a> <U><B>Coming Up Empty</b></u><p> This week marks my final week working in the outpatient psychiatry department of my local hospital. It's hard to believe that the rotation is almost over; it feels like I just started, when in fact I've actually been working on the same service for 28 weeks... half a year, or long enough to name a really lousy zombie film. Seven months may not seem like a very long time to hold down a job, but as a medical student and then resident, my life for the last six years has been split up into four to eight week increments, and working at the same position for more than two months is almost inconceivable to me. The thought that I've worked on the same service for more than half a year -- let alone that this time is coming to an end and it's time to get thrown boldly into Something Completely Different -- is jarring. Among other culture shocks, I've had the same office assigned to me since July 1st, and as I change services, the biggest change will be losing my office and having to settle into a new one.<P> Speaking of really bad zombie films, I've finally thought of a concept I like better than <I>George Romero's Weekend at Bernie's</i>: <I>Home Alone: Lost in the Apocalypse</i>. Film makers, I hope you're writing these down for future reference.<P> So anyway...<P> When I first moved into my current office, it was a nice change. Medical students, and most residents, don't tend to have a private workspace to themselves. The best that most residents can hope for is a private examining room, and even there it's rarely the same exam room from day to day. Psychiatry is a little bit different, particularly on the outpatient service; because we do psychotherapy, we need a private, consistent and comfortable place where we can bring our patients. The residents working on the outpatient service therefore have their own private offices. They aren't very nice offices -- my paint was peeling, my desk was about forty years old, and my heater didn't have an "off" setting -- but it was my little space to call my own. I got to put my name up on the door. I could bring my choice of books in to fill up the bookcase. I could decorate, a little bit. I had my own private computer, so that ethically I could keep patient files on it... or spend a few hours checking my email or browsing eBay if I had nothing else to do. By the standards of a resident, I actually had one of the better offices, because I had a window that opened and a fan to make the room liveable during the summer. My office didn't have any paintings when I moved in, unlike some offices, but that just meant I could stick up something of my own onto the wall (the astute reader may remember me talking about the Oath of Maimonides some months back). I got very comfortable in that office over the course of six months and it really started to feel like my personal space, and now, come this Friday, I have to vacate it and hand in my key, so that somebody else can move in. <P> The worst part isn't that I'm losing my private office, but that I'm not really getting a new one. I'm now moving into a six-month block working on an inpatient ward, which means I primarily see my patients on the floor, and not in my own office. As such, due to space constraints, while I do have an office, there are two residents assigned to it, and it's entirely possible that another two residents will come to work on the floor with me come February or March, in which case it may suddenly get very, very crowded.<P> As my last week moves forward, I find myself in a new position of having to empty my office, and deciding how to do that is in some ways as much of a challenge as deciding how to decorate it.<P> See, I can't just empty out my office all at once. I walk home each day; it's downhill all the way, but I still don't want to be carrying fifty pounds of crap with me. I also can't necessarily bring some things home too early in the week; if I bring home my DSM-IV on Monday and then realize that I need it to write a report on Thursday, I have a problem. I keep a gift that one of my patients gave me on an upper shelf of my bookcase, so that she'll see it when she walks in; I can't bring that home before her last appointment because she might notice it missing. It's all terribly strategic, as you see, and involves complex plans. I started the process last Friday by bringing home some of my non-essential textbooks (the ones I'd brought into the office solely to make it look more doctor-y and never actually cracked open). Today I brought home some essential papers and some course packs that I've accumulated and don't want to just throw out, as well as one of my boxes of Kleenex (I keep one opened and two unopened boxes on-hand for crying patients (and allergic residents), but I *probably* won't go through an entire full box between now and Friday). I'll probably bring home the one or two toy-ish things tommorow, and bring home the gift from my patient on Thursday. I would have liked to leave my framed Oath of Maimonidies until Thursday, but that probably won't be feasible, so I'll likely bring that home tommorow. The real pain is going to be bringing home my printer (I bought and brought my own printer into my office because I just hate hand-writing my notes that much) since it's a big and bulky twenty pounds; I'll have to bring that home on Thursday and hope that we don't have freezing rain that night (the weather report says we'll have uncomplicated snow... see, strategy strategy and planning!). I don't want to have anything big or heavy left to bring home on Friday for a number of reasons.<P> And then, come Monday, I'll be in a new office (more likely, an old and decrepit office) shared with another doctor (pleasant company, but not as pleasant as having a a personal hidey-hole). I'll have to bring even more toys into this one to make it clear whose room it really is. <HR> <a name="923"></a> <U><B>The Wisdom Of Italian Martians</b></u><p> Some days, I feel like I have a lot in common with Jerry Doyle. Including his luck, but not, fortunately, his hair or his wardrobe.<P> In the television show <I>Babylon 5</i>, which I generally say is the finest series to have ever aired on television despite the fact that it's a close run against <I>Boston Legal</i>, security chief Michael Garibaldi gets one of my favourite lines from the entire show (this is actually saying something, since I loved the show's dialogue sufficiently to make an entire 70-minute CD consisting of nothing but sound files from it). The line is: "tea just happens to be my third favorite thing in the Universe." It's a simple line, but it's done with such perfect delivery that I love the sound of it. The line is delivered with a sublime mixture of earnest seriousness and tongue-in-cheeck humour, and there's this very brief pause right after the word "tea" which I find very powerful rhetorically. For the curious, <a href="http://b5.cs.uwyo.edu/bab5/b5-t.html">this</a> is link to the audio clip in question, so you can see what I mean. Part of the humour comes from the fact that elsewhere in the series, we learn Mister Garibaldi's second favourite thing in the universe is Daffy Duck, and/or the whole Looney Tunes universe. Much of the series centers around Garibaldi being a good but inherently flawed man, and this little vignette into who he is as a person and all he really wants out of life really changes the way the character can be seen. We never learn what Garibaldi's favourite thing in the universe is, which is a bit of a shame; it'd be a bit of a letdown no matter what it was, but I'm really curious anyway. I suspect it was bagna càuda.<P> The reason that this is at the forefront of my consciousness at this moment is that yesterday, I was talking to a couple of my co-workers about how everyone spent their New Year's Eve, and I described mine: I had a number of my closest friends over for tea, movies, and boardgames. I happened to mention in passing that no alcohol was involved, at least on my part. A couple of people seemed kind of skeptical that this sort of thing could constitute an appropriate celebration of the new year, and one person specifically derided my tea. Without missing a beat, I rejoinded that, "hey, tea just happens to be my third favourite thing in the universe," and I received the very reasonable response of a blank stare. <P> I wisely refrained from adding that I had indulged in my second favourite thing in the universe that night, too: muppets. I suspect they may not have taken this as the proof of my superior wisdom which it obviously is.<P> And this, you see, is at least in part why I consider myself to be such a blessed person. For all the ridiculous plots I have in motion at any time, no matter how many stories I write or Aerican Empire coins I sell (fifty two so far, for what it's worth), a big part of me wants nothing more than to have the freedom to indulge in my second and third favourite things in the universe: silly movies and tea. To a degree, every other success and failure in my wholly ridiculous life -- at least during my incarnations as Eric 4 and 5 -- has been in the pursuit of those two things. And why not? Out of all the many pleasures in life, it's hard to find two others which are as reliably pleasurable, physicially and spiritually harmless, easily obtainable, and re-experienceable (I'm fairly certain that last one isn't a real word, but it gets the point across). <P> And I'd probably be a pretty big fan of bagna càuda too, if I was courageous enough to try eating it.<P> We never do find out what Garibaldi's favourite thing in the whole entire universe is, but at least I get to know what mine is. What really helps make events like New Year's Ever special for me, and a bit part of why movies and tea are my second and third favourite things, is that I get to share with people. My favourite thing in the universe is to have entertaining people around me sharing the other pleasures on my list. There may not be a *lot* of people I know who qualify as sufficiently pleasant to be my favourite thing in the universe, but they exist, and I can tolerate a lot of the other stuff life throws my way as long as I get to watch The Muppet Movie with them some of the time. <P> As it happens, my sixteenth favourite thing in the universe is the words "sort of the Egyptian god of frustration." But that's not precisely relevant to any other thoughts I'm having tonight. <HR> <a name="922"></a> <U><B>The Curse of the Ghostbusters</b></u><p> A little know fact about me is that I believe in curses.<P> Back in 2004, I tried to celebrate Games Day, the 29th of December, by running a Ghostbusters one-shot game. The game was entitled "Franchise to the Rescue" and it followed a group of parapsychologists and adventurers who've just bought the rights to a new Ghostbusting start-up, only to find that their first case rapidly spins out of their control. I wasn't going to be a wholly epic game, but I put a bit of work into it and I was moderately excited about it. Just before the game took place, one of my grandparents inconveniently died, which necessitated some last-minute changes to my schedule and, among other things, the cancellation of that game. This marked the start of a somewhat inconvenient period of my life; for the next several years, almost every time I tried to run a game, something went horribly wrong and plans fell through. The Ghostbusters game was followed by several attempts to get players together for "World of Darkness: Hostile Alien Life Form," followed by a rather catastrophic first attempt at running a superhero game which eventually got played as "Where Walks the Shadowripper" on December 29th 2005. Attempts to run a D&D game for some CEGEP people failed throughout 2005, as did a pirate-themed game called "Doubloons and Flagons in May 2006. I ran a brief 3-session D&D campaign for a group of newbie players in the summer of 2006 and a cartoon game on December 29th 2006, and then met a half-dozen failures at trying to ressurect WoD: HALF. During these years, a number of other, less exciting game ideas fell through. Now, one could certainly point to a number of confounding factors which interfered in my gaming throughout that period of my life, such as the fact that I was going through my rather difficult first years of medical school and was seeing a lot of changes in my circles of friends, but when you get right down to it, the bottom line is that I tried to run a lot of games, and the majority failed... often due to events outside of my control, and often quite spectacularly. <P> This past December 29th, I tried to run the rewritten and much-improved "Ghostbusters: Franchise to the Rescue," now making use of the Aerican Empire Gaming Interest Society's ultra-modern multimedia-enabled gaming center, but as half the players had to cancel at the last moment or else were suffering physical ailments rendering them unable to play, the game didn't happen. Not to say we had a bad Games Day; a very good group of people joined me at the AEGIS club where, amongst other things, we played a brilliant and riveting game of GMT's <i>Dominant Species</i> and a fantastic time was had by all. Regrettably, this fantastic time didn't involve any roleplaying, dice, or portable unlicensed nuclear accelerators, which had been the original idea.<P> So, over the years, I've come to believe that certain games are cursed, and that whenever I try to run them the Universe steps in and smacks down the people around me until there aren't enough of them left for the game to be playable. If this is so, then it would actually be unethical for me to try to one such a game again, knowing as I do that anyone who agrees to play has about a 50% chance of something going wrong in their lives. Also, I'm running low on grandparents.<P> I see curses in other instances, too, and not merely in games. For example, my relationship with one of my oldest friends is clearly cursed; for over ten years, whenever I make plans to see her, something happens to her a day or so before that makes it impossible. It isn't me personally, either; if she plans to come to a party that I'll be at, her front door will break or a pet will get deathly ill or she'll get called into work at the last moment for an emergency. It's gotten so that I pretty much stopped arranging to see her, because I worry that if I initiate plans, it'll be my fault when, say, a stray meteor crashes into her apartment. Another of my friends has a particularly nasty curse on him: his dice almost always roll poorly. You'd imagine that dice ought to be reasonably random, but some people that I've met tend to roll absurdly well, and others roll absurdly poorly, and I've known at least three people in my life, this friend among them, where you can actually graph their typical dice rolling after a game and see a stastically significant difference between their rolls and someone else's. His curse holds true even if he takes someone else's dice that were previously rolling well, and when someone else rolls their own dice for him at a critical moment. In that sort of circumstance, it's kind of hard not to believe that curses are real.<P> See, here's the thing about curses: I believe in them as a form of narrative structure. As I've observed before, I believe in luck, and I believe that some people seem to be improbably lucky or improbably unlucky compared to other people. This sort of thing can be a lifetime pattern -- the so-called "lucky bastard" effect -- or might last for a shorter period. I've met people who seem to have predictable patterns of alternating good luck and bad luck, which I call "bipolar fortunative disorder." The trick is, either because of the miracle of human perception or, depending on one's philosophical bent, an actual effect of cognition on the universe, in my experience, reality is shaped by the narrative that people build up around everyday events (or, to turn that the other way, whoever controls the narrative shapes reality). For years, I've believed myself to be an improbably lucky person because I chose to see good luck in the things that went on around me, selectively attributing positive outcomes to being lucky and disregarding negative outcomes from that narrative. Curses are the opposite effect: a person or thing is cursed when the events that surround it form a coherent narative of consistently bad outcomes. Oftentimes, when you manage to really look closely, the only way that such a narrative is able to stand up to scrutiny is when scrutiny selectively ignores data that doesn't fit with the narrative. Ergo, I believe in curses... in part because I choose to believe in curses and because my very unique brain is optimized to create that story from the events around me.<P> All of which is to say, I'll feel safe trying to run my Ghostbusters game again later this year, because it's doubtful that I'd have the same series of unfortunate events, but you couldn't pay me to make another attempt at WoD: HALF, because that game's cursed and my last remaining grandfather would probably die three days before we played. That's just the way the story goes. <HR> <a name="921"></a> <U><B>Unresolved</b></u><p> Around this time last year, I sat down to write some New Years resolutions for myself. I did so, more than for any other reason, because it was easy fodder for a thousand-word post, but also for the far less important reason that I believe in self-improvement and stuff. Last year, I came up with four resolutions, or as I like to think of it, three resolutions and a sardonic cop-out. They were:<P> <B>1) I will read at least twenty-six books, and at least five of them will be by authors I've never tried before.</b> Done and done, and no more need be said about it than that.<P> <B>2) I will get back to exercising, and will do at least one half hour of cardiovascular exercise, specifically for the sake of getting exercise, every two weeks.</b> As with so many things in life, whether or not I accomplished this really comes down to one's point of view. I didn't end up regularly scheduling specific half-hour blocks for cardiovascular exercise, which is what I'd intended this to mean. I did increase my general exercise level, though, and occasionally deliberately took a longer route walking home from work. I also got back into weapons training this year, which I'd almost completely stopped in past years; it was both disapointing and amusing to see just how much skill I'd lost. This also made me realize that it's been a very, very long time since I re-wrapped the handle of my sword, which is something I really ought to do one of these days if I'm going to get back into using it regularly. <P> <B>3) I will run at least one game.</b> In 2010, I woke up one day and realized that I hadn't run a single game of any sort since 2006, not counting one failed attempt to run something in 2007. In 2011, I promised myself that I would storytell at least one game, and ended up hosting three: the <i>Hotel Atsah</i> and <i>Dungeons & Psychiatrists</i> one-shots, plus the first session of my Nevestulka game (arguably, since the Nevestulka game failed to play a second session, this actually constitutes a failed campaign, but at least it was a successful one-shot). If we choose to ignore the failure to follow-through with Nevestulka, each of those games was a tremendous success which left the players asking for more. <P> <B>4) I will continue to do all the other things I resolved last year.</b> This one was really just a recommitment to keep doing stuff I'd previously decided was worth doing, namely submit a story for publication (done, and sold), edit and correct errors in old entires in my Journal (done), socialize with my colleagues (a tremendous success), and host at least one pillow-fort night (which was one of the best days I had in 2011). <P> Did I accomplish all of my resolutions to 100% success? Well, no, but I'm not going to be hard on myself for getting a merely "almost perfect" score. Now, as the final hours of 2011 count down, the question becomes, what shall I resolve for 2012? <P> The answer: nothing.<P> See, I had a very small epiphany the other day -- probably not as small as a picopiphany, but perhaps a bit less than a nanopiphany -- when I started thinking about what resolutions I wanted to abide by in the next year. When I really thought about it -- by which I mean, when I devoted almost one full second of undistracted thought, which is more dedicated processing time than I ever give to most ideas -- I realized that making resolutions had stopped being funny. I originally started making New Years resolutions more out of irony than anything else; it amused me to think of the millions of people who religiously make resolutions and then fail to abide by them, and I liked the idea of therefore having gag resolutions which, though ridiculous, I could actually work towards and achieve and thereby possibly make myself both a better and more snarky person. Over the few years I was doing it, it quickly became apparent that I was basically resolving the same stuff every year with fairly mild variations. There's nothing wrong with that, since the stuff I was resolving is all ongoing stuff that's well worth continuing. Then, the other day, as I was thinking about making some resolutions, just for a second, I actually cared a little bit that I hadn't exercised quite as much as I said I might. That tiny little pang of guilt passed in less time than it took to label the emotion, because, after all, I'm in excellent shape, walk daily, eat carefully, and take fairly good care of my health. It struck me, though, that some small part of me had actually taken that resolution a little bit seriously, which isn't like me at all. The instant that a New Years resolution stopped being a throwaway gag for me and started being another burden in my life was the moment when the resolution stopped being worth the glucose it takes to conceive of it. I already dedicate my life to self-improvement, expanding my mind, keeping myself fit, and improving the lives of those around me; if resolutions are going to make those goals more annoying instead of less, then I've got neither interest nor need to make any.<P> Thus, I enter 2012 entirely free of any resolutions for myself. That doesn't mean I'm going to slack off on any of the important things in my life. I'm going to keep reading and writing, keep running games, and keep opening my home for pillow fort nights, but I'm going to do it because it's what I want to do and what will continue to reshape me into the person I want to be. I'll probably even keep exercising, because I want to stay in shape and because it feels good to exercise now and again. <P> After all... the purpose of a New Years resolution is to force you to improve yourself. I'm already pretty darn fantastic and only becoming more so. There's plenty of room for improvement, but all the stuff I intend to work on this year is stuff that I wouldn't make resolutions about anyway. <P> Penguin, on the other hand, resolves to eat more fish. 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