Ethos and pathos

From the perch, on the rocks, high above the Aegean Sea, the sea glimmers and sparkles from the refracted sunlight reflecting off the windblown waves.  He looks, and waits, and imagines, that Zeus will demonstrate his power.   The time elapses, then wanes, and he gets up and walks towards the city, and its people, and its power.   The intense sun bleaches his dark hair and he walks in a tunic, with a cape wrapped around his body to protect against the elements. Now she is here, and she appears and stands in the sun with the light illuminating her appearance.  The stands about six feet tall, because the maker wants her strong, her hair is raven black which is common amongst the people here, but her skin is alabaster white, like fresh crème and it accentuates her long thick hair that grows down to her waist. Her eyes are dark-blue grey.   She wears Phoenician cotton, woven into a beautiful tunic of white with blue stripes, in patterns, and a belt secures the fine cotton over her body so that it accentuates her curves rather than covering them and the cloth seems to cling to her body.  Her bosom is large but not too large, and her hips full but not matronly, like Artemis, meant for running and pursuit.   All in all, she is perfect, and to good for him to have.  Her name is justice, and she lives for only one thing, ethos.   When Justice speaks, her voice is commanding and almost hypnotic so that all that behold her must obey and they obey because they want to, not because they are forced to.  This is her gift from the maker.   Her hair is dark and skin white to personify that the law has good and bad aspects, and she is female because females are merciful in a world of men.   The law has evil and godly characteristics, and mortals are reminded that the human condition is not black or white but shades of grey and she is here to interpret and command.   And everyone is forced to do what she says.   She is perfect he thinks and too good for me.    The sun still shines in the Peloponnesian place, and he moves away so not to be entranced by her beauty.   She wears a mask sometimes, because no matter what people look like, they are all the makers children and equal under the law.   She holds a scale to remind mortals, that their works and ways will eventually be evaluated and judged.  He turns away and she waves, and he doesn’t think he sees her wink at him.

They are beautiful seas, the Aegean and Ionian, dancing in blue green color, full of fish and life and home to just and virtuous people, at least for the time being.  She is Justice, and Justice is perfect for all to witness and see

It is beautiful here, and the sun shines, and the sky is blue, gulls fly, and fish jump and it should never end.

He turns upward towards the heavens and exclaims in a loud voice, “Hail Zeus, what wizardry have you besought among mortal men” I AM THESEUS.       

Lu

One day, after school, around 2:30 at Valley High, Wrak pulls the chains from a red Suzuki 250 motocross bike set up for street. He puts the chains in his back pack.  A tall person walks towards him from the Parking lot. The person has dark curly hair, sports a Hawaiian shirt, beige corduroy walking shorts and plastic flip flop zories.   The people in these parts call plastic sandals zories because Zorba wears zories and has a pair.  The person waves the classic star trek salute to Wrak and says, “Hello, my name is Lu, want to party this weekend?”   Wrak says, “Are you from around here?”  “I go to Sunni high school on the west side and am visiting a friend here in town.  I have all the stuff necessary to party and I need a shotgun. Are you in?”  “What you got?” inquires Wrak.  Lu points to a brand new Volkswagen Westphalia minivan.  “I even have curtains on all the windows,” says Lu.  “The back seat folds out into a bed big enough for four people. It gets good gas mileage and even has a water tank in case of thirst, but I try to keep the water tank full of Vodka.”  ”Are you joking,” asks Wrak?   “Can I see?”   “Sure,” says the minivan is two tones with a light blue bottom and white top.  All the windows have cute sliding curtains done in beige cotton print.  “Look inside,” says Lu.  The side door slides open with a low metallic groan.  Inside is a huge bed fitted with turquoise vinyl   foam cushions one foot thick.  A small wet bar constructed of stainless steel sits opposite the bed on the driver’s side.  Next to the door is a small closet.  Indian style curtains with beads separate the drivers compartment from the bedroom so that a person can drive and another sleep in back in total privacy. “I have the big 1800 engine.” Says Lu.  “It will do 80 miles an hour and 65 miles an hour up hill.  “How much did this cost,” asks Wrak?   “Six thousand dollars,” says Lu, “six thousand.”  The van is totally custom with an electrical outlet and running water.”  “Unbelievable,” exclaims Wrak.  “If I am in town on Friday, I will stop by and pick you up with some girls.”  “Are you in?”  Whispers Lu “I’m in” says Wrak.  Lu walks slowly to his van door, gets in, starts the engine and drives off slowly.  Wrak waves goodbye and kick starts his motorcycle to ride home.  Friday is three days away.  The sun sets early in tranquil hills because the mountains near the ocean shield the sun during its descent.  The sunsets on the beach are magnificent on a daily basis especially in the spring and summer.  The huge orange supernova orb descends minutely surrounded by   red, yellow and purple strata and Wrak never gets tired viewing them and today is a school day with homework to do, family to visit and dinner to eat before going to bed and early to rise to make a young man healthy, wealthy and wise. The little dog curls up on his cushion and lies on his side and runs and whines as he sleeps like he is chasing rabbits.  Then when you go to see, punkin has gone outside, nowhere to be seen.

     “Be sure you brush your teeth,” says Lu.  Girls do not like grungy teeth.  He is in the classic Hawaiian surfer wardrobe as usual.  My father looks at Lu, Lu looks at my father, and my father looks back at Lu.  My grandmother peeks out from the behind the hall door with one eye and then she is gone. “Let’s go partying,” yells Wrak. “Yes.”  “Party we shall.”  Shotgun in the Van with seatbelts and down Bacon Way past Mellowman’s’s Lane to Market Street and then on Moonrise Blvd. the van hums with tuned exhaust headers and a glass pack muffler.  Lu pulls a gas mask from underneath his seat.  “What is that?” asks Wrak. This is an oxygen mask from a B-17 with a meerschaum pipe secured to its end.  “What do you smoke in it?” asks Wrak.  “Weed,” says Lu, “and Lots of it.” From behind the seat, Lu pulls a 30 gallon black trash bag into the drivers compartment.  The bag is full of something.  The something is Mexican commercial green marijuana, about, two pounds worth.  Lu stuffs some Mexican grass into the meerschaum pipe, secures the gas mask to his head and hands Wrak a Bick Lighter.  “Light me up,” says Lu.  “The police cannot see me smoke anything while I drive,” says Lu.  “I can smoke pot on the freeway.”  Wrak takes the Bick lighter and flames the pipe bowl.  Lu puffs hard inside the mask and smoke jettisons out the side ports like a fire breathing dragon.  The whole cockpit fills with smoke.  “I will smoke a cigarette,” says Wrak.  Lu pulls down his mask and says, “Rag weed.”  I don’t smoke rag weed, only the best.” “The police cannot believe I smoke weed through a B-17 oxygen mask.  They never pull me over.”  He pulls over to a street off the Sunset Boulevard in tranquil hills and stops in front of a residential address.  He honks twice.  Two girls run out from the front door of a house set in lush bushes.  They have light brown hair rendered blond by the sun or peroxide.  Lu says, “This is Joanie and Jennie.  Jennie says she wants to meet you because she likes your surfing. 

       Both girls have hot pants on without nylon stockings, and halter tops set off by tan bikini lines.  They have purses with chain straps.  “Don’t you feel cold,” says Wrak.  “Not at all,” says Jennie, “Not at all.”  “Wrak, get out of shotgun and go sit in back with Jennie.”  “Joanie wants to sit with me.”  Wrak opens the side door, gets out and then unlocks the side door and lets Jennie in.  Wrak and Jennie sit together.  She feels very warm to the touch.  “Would you like a drink,” says Jennie.  “Sure,” says Wrak.  Underneath the wet bar is a refrigerator, Lu says, “Jennie, there is a quart of beefeater gin underneath the sink, break it out, we are partying.”   Jennie obtains a plastic glass from the refrigerator and pours some beer into the glass and hands the cup to Wrak. “Drink all of it,” she says.  “Sure,” says Wrak,” ” I love Coors beer.”  Wrak drinks the cup down in one gulp and burps. “Pardon me,” says Wrak.  “That was really good.” “Here,” says Jennie. “Drink another.”  “I love beer.” Says Wrak.  Night moves in to tranquil hills and Death wood and happy hills.  Wrak never could remember where the party was that night, only that it was fun.  The party location exists somewhere in between the lines.

         The best parties have a live band and a keg of free bear, or three kegs of free beer, or four kegs of free beer and a smoking room.  This party has it all.  Wrak feels high and Jennie asks him to dance.  Wrak starts doing the twist like Chubby checkers and then the swim like Goldie Hahn.   Somehow a strange force throws him on the ground and he becomes the first break dancer in southern California, spinning and sliding on his back.  Jennie squeals with delight.  The night has just begun and the band plays “Gimme shelter,” and “Brown sugar”   and more.  A ton of pretty girls in scanty clothes appeared and now everyone is dancing.  The girls dance. The guys dance.  Kool is here. HP is here with the Doctor’s daughter and night moves into night.  “Let’s sit awhile,” says Wrak.  “Let’s go back to Lu’s Van and listen to the radio,” says Jennie “I left the door open.”  “All right,” says Wrak, “Let’s go.”

“It is more comfortable back here,” says Jennie.  “Why are you closing the curtains,” inquires Wrak.  “So we can have some privacy,” says Jennie.  “Want some more beer,”  “Sure, “says Wrak.  Wrak drinks beer. Wrak drinks beer because the world is incredibly high and colors and textures vivid and exciting. Wrak hopes the beer will cut the buzz that somehow permeates his being.  “I turned on the radio,” says Jennie. “You have a radical bottom turn.”  “What shall we talk about?”

   The door pulls open with ferocity and Lu pulls Wrak off Jennie.  “Get off her you idiot.”  “I was wondering where you two were.”  “I have to get the girls back home by 11:30!  “I don’t know what came over me.” Says Wrak.  Jennie closes the door and composes herself. Lu and Joanie get in the front and start the car.  Wrak and Jennie lean on each other.  Wrak is back on earth and the van hum’s down the highway from Happy Hills to Tranquil Hills to the beginning of rationality and reality.  “See you later girls,” says Lu.  “Bye Wrakie, let’s go party again,” says Jennie.  Wrak waves good bye.  Jennie turns around, puckers her lips and gives the air a slow long kiss, and then they are gone.  “Use the one day delay,” says Lu, “The one day delay.”  “What is the one day delay.” Says Wrak.  “Date them once and do not touch them, the next date they are all over you.”  “I understand,” says Wrak. 

The custom Westphalia sputters off into the night.  Lu has to visit a friend at Saint Elsewhere.  The night is dark and long and quiet and the porch lights on bacon way glimmer sadly and emphatically.  The quiet permeates the seaside atmosphere, and in the quiet broods something unearthly living on the house on the corner.  Wrak opens the front door with his Schlage key.  Grandma stands at the door with punkin sitting next to her standing there.  “You are home,” she says, “thank God.”  Punkin wags his tail and yips with a high note.  “It is fun dancing grandma,” says Wrak.  “It is late, go to bed,” she says. The door is locked and the house of Wrak closes up for the night, tonight and all are home and accounted for and Saturday is today when the sun comes up, Almost like slaughterhouse five.  

My CCU

Well says Q, the head of the ICU is back from sabbatical, you are free to rotate.   Surgery wants your back, they say you have good hands.   Surgery residency is six days a week with every three days on call, why can’t I work in the outpatient clinic and hand out ampicillin like everyone else says Dr. Wracks.  You passed the boards didn’t you says Q, now you have to work.  I have an alternative autistic choice paradigm says Q, how would you like to spend a couple weeks in the CCU, it is on the same floor, just doors down from the ICU.  It is the same thing, just a Shepard looking over the flocks says Q seriously.   OK says Dr. Wracks, I thought passing the boards would get me my shingle, and it doesn’t.  When do I start.  Right now, says Q, this is my realm and they are already waiting for you.  Tally ho.   

The situation of the ICU is nearly the same as the CCU except the heart monitors are bigger and all the patients are hooked up with electrodes like a Frankenstein movie.   The nurses sit in a nest behind closed doors until they are needed, and the light is fluorescent, buzzing and bright and all the patients are sedated almost to a coma. Physicians like prescribing benzodiazepines.   It is part of the heart thing I guess, says Dr. Wracks.   A cardiologist sits at the bedside of a patient and watches the heart monitor for fifteen minutes at a time.  The sine wave gives the status of the heart patient almost to a T.   If the patients have color, they are surviving, if they don’t a physician must intently evaluate the monitor.  The most important aspect of the EKG is the p wave and time till the QRS or heart contraction.   If the p wave disappears occasionally, the heart doesn’t beat and there exists Mobitz type one phenomena.  If this occurs a problem exists because the sinoatrial node pacemaker is not functioning correctly, and an infarct may exist or there is an electrolyte imbalance.  An adrenergic agent like epinephrine or methamphetamine may correct the anomaly, and if not, cardioversion might be necessary.  Fortunately, this condition does not occur frequently and is most often caused by an overdosage of beta blockers.   This is the main reason why beta blockers should not be used.  If the sinoatrial node depolarizes but the latency time before QRS contraction increases slowly over time a Mobitz type two phenomena exists and this occurs most commonly with an overdosage of Ouabain or other cardiac glycosides.  Cardiac glycosides like Lanoxin while increasing the force of contraction, (inotropism) and rate of contraction (chronotropism), are extremely toxic so their use is indicated for the dying patients of congestive failure so they can get their estate together (6 months).   QRS phenomena usually indicate massive infarct and the prognosis is unfavorable, See the work of Sokolov for details.

For the most of the patients that survive the infarct which for them evidences with T wave inversion, disappearance, or S-T wave anomalies.  It is a good idea to check the monitor a couple of times every shift because a S-T wave depression signifies a developing subendocardial infarct and immediate necessary intervention.

The main drugs of the heart patient are beta blockers, adrenergic agents, cardiac glycosides and ganglionic blockers, all of which are toxic and must be titrated accordingly by body weight.  Beta blockers and procainamide induce cancer, particularly cancer of the pancreas and should not be used.  Morphine is the drug of the dying and the ancient told Dr. Wracks, “it is the angel of the elderly”.  Morphine should be used in excess but the prescription hand delivered by the pharmacist, and signed for,  must be injected by the attending, usually 10mg subcutaneously, because if left to the nursing staff, they will mainline half of it before injecting the patient.  This must be kept in mind.  Bretylium used to be used as a ganglionic blocker for Purkinje system anomalies but are now treated with calcium channel blockers like verapamil, but the slow onset of action and inhibition of the slow C channel is often non-efficacious.  Nicotine, now anathema has an immediate onset of action, short duration of action (two hours) and immediate elimination by the kidneys.  Other drugs exist but it has been fifty years and in the Wracks estimation, all heart patients should be maintained on morphine and nicotine, with injections of Benzedrine if necessary.    It seems overly simplistic and supercilious, but heart patients should be morphine addicts and vape nicotine to survive and shoot Benzedrine if their autonomic pacemaker fails.  Morphine is the angel and it decreases preload to the heart, is histaminic to increase vasodilation, and is negative bathmytropic to eliminate ventricular tachycardia. 

Dr. Wracks sits in front of the monitors and makes notes on the patient chart. The older doctor in a walker comes into the unit and speaks with the nurses. He is making sure the staff does not kill Dr. Wracks.   Dr. Wracks waves hi.,    Thanks to the immediate intervention in triage by the emergency room staff, the CCU is not an exciting place to work and the cardiologists are extremely meticulous and demand compliance because failure of one iota results in death and a malpractice suit.  The next assignment for Dr. Wracks is in pediatrics, screaming kids, vaccinations and liquid ampicillin bottles, but as a bonus Dr. Wracks is placed in Pediatric Oncology and surgical ophthalmic trauma.  

On a south swell the waves move into the point and give a long ride.  The girls are in the briefest bikinis, designed by a talk show host, and the wind at two pm calms down and the waves increase with the upcoming tide.  A beautiful place and a beautiful time in a peaceful era that the Wracks will never know.  Now we have YouTube and the information superhighway and memories can be stored on a flash drive. Memories that will not occur, and the world turns and time goes on.  And so, it goes.